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HomeMy WebLinkAboutT15N R1W SEC 8 LT 202T15N RIW Sec 8 Lot 202 #051-153-40 Municipality of Anchorage �F Development Services Department Building Safety Division OnSlte Water and Wastewater Program, 4700 Elmore Road 1 r of P.O. Box 196650 Anchorage, AK 99507 Page wwwci.anchorage.ok.us (907)343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM ANDIOR WELL INSPECTION REPORT Permit Number: SWO70257 PID Number: 051.15340 R•'"• Elaina Shawback Wastewater System: 21 New E]Upgrade Ae m P.O. Box 670810 Chugiak,AK 99567 ABSORPTION FIELD Prions N~ a B• 11 4 B D,Trsltat 13 Slulw. Trench D Bea O Mara O Onw, 230.3447 Sd Raxq Tda Depn horn nr,prol V•as LEGAL DESCRIPTION 0.6 GPM' 9 Ft. SaMmsun Dealt m Pp lxxlan ttax aq+ 9'" Gwrw"11 wren pas Buri LN 202 2 Ft. 7 FI S•apl f+i •aria soo.• aq+w vae crMl L•r10n1 TO iAQ 15N RB1Q° 1W 8 1.3-1.5 Ft. 76 Ft. � ,•,an N,mw to Yre Dmwue Eettvert Yre Well: 0 New ❑ Upgrade 3 Ft. 1 Fl cwm*14Ft. Cassa to Taa eD.aqun was Pp mwI Private nm (Prmd. A e. CI 1064 Fe ASTM D30341F810 Private R. 158 Fl $rw. Ww•r L•'A1 RIRYnOr Do. srtalra SulkTweed Excavating 9/212007 Sullivan Water Wells 101 Ft y„u Pu v SM Mco•a rrax now. DraxrTANK 4 DPM 2 Fl SEPARATION DISTANCES 0 Septic O Holding ❑ S.T.E.P. 0Other. Mdmal.clow •P.uIY Mptic Absorption Lift Holding ubllUFnvate Premier Plastics 1300 ow ank Field Station Tank Sewer Llne Nuaw CO canes -tMls M.Iwrl ' 13T 25'+ HDPE 2 •+ 100'+EE LIFT STATION 46' GY 31'PuneMMe6 EMcvuM N.pKI,msPerrrr^nWWNone Known BENCH MARK loulun sra pssdpm Top of foundation near poinl'A• rvalun tt 100' Fl .I' _ •:-1 .Iti,��� lfl^• '', i:. t. 'tel i.l S&S Engineering '=.A :.Engin amp amp Inspections performed by: 16961 S Birchwood LD Rd Dates: 1" 921/2007 �.+ Chugiok, Alaska 99567 2nd 9212007 ; • Lfi1- ^ •••""' " b� Development Services Department Approval a f �T; a ? �' Date: !r i.. ..... ,t... Conditional Approval .. .......,M»! ,. .�.,.»..,•�..., �� A1C Reviewed and approved by 1 � Date: .�.t,..l+ (R.. Hans) /� 0 PERMIT NO. SW070257 PAGE 2 OF 4 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 • Telephone (907) 343-7904 • www.ci.anchorage.ak,us ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 202, SECTION 8, T15N, R1W, S.M. P.I.D. No, 051-153-40 I I I I I I I I I I TRENCH M C01 ATH DBL1 & DBL2 1300 GALLON E SEPTIC TANK ..-- 33' SECTION LINE EASEMENT UNDEVELOPED Z 1" - 49' A. zlll €dw 143"7-'n F PERMIT No. SWO70257 PAGE 3 OP 4 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 Telephones; (907) 343-7904 • wwwci.onchorage.ak.us ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 202, SECTION 8, T15N, R1W, S.M. P.I.D. NO. 051-153— LOT 199 LOT 200 LOT A I I I I I I I I I I I I I I H w I W CO2 i2 T-#2 ...,,.1 E- NEW TRENCH `- TMTST LOT B ST1 . M COt STH 5 O pP BM DBLt k DBL2 N NEW 1GALLON W SEPTIC AREA y SEP ECO HOPE SEPTIC TANK y �o NEW A HOUSE g 1° q 60' — — — — — — — — — — — — — — — — — — — . /� °°••••a eeyyA •1 _ — — _ — — — — _ • i��y���N �. % DOTTIES° r! T :.•i••T•P 33' SECTION L DRIVE ... ....°.�.' tob A. Shaft o. 1457-E va y.• do �NOEVELOPED� `' S A °°°cw° M••a••t` Aw Ap �@ `� OFESS 6'N PERMIT No. SW070257 PACE 4 of 4 DEVELOPMENT SERV CESCDEPARTMENT - BUILDING SAFETY DIVISION ON-SITE WATER AND WASTEWATER PROGRAM, 4700 BRAGAW STREET P0. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone (907) 343-7904 • www ci.anchorage.ok.us ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 202 SECTION 8 T15N R1W S.M. P.I.D. No. 051-153-40 TOP OF TANK = 94.4' ST1 ST2 96,9' ORIGINAL & FINAL GRADE 2" INSULATION NEW 93.3' 1300 GALLON POLYETHYLENE 93.0' SEPTIC TANK FINAL GRADE ORIGINAL GRADE=94.6' D1T1=85.6' NIT2=85.5' 'HOUSE OFFSET (USES POINT A) C01= 95.8' CO2=96.0' 2" INSULATION C01=92.6' CO2=92.6' NO WATER FOUND 78.5' B.O.H. P. A. Vxe get Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw, SL P.O. Box 196650 Anchorage, AK 99519-6650 www d anchorage a_k tis (907) 343.7904 Fla $011'5 Lo Performed For: a I n a Legal Description: 4-7 _ eGz� �Pth (Feet) Al L/p /� 1 8-a/� 9. 10- fr 11- e 12- - 1Y 13-1.1 14 ', 15- Ir . e 17- 19- tsp law SILzt j t h WAS GROUNDWATER -.� ENCOUNTERED? s IF YES, AT WHAT DEPTH! L Depth to Water After U Monitoring? P E Dote: Reading aI Date 6.0.14 COMMENTS __FH –}/e �ationnTest 2aC_ (_ Date Perfo� �L Township, Range, Section: PERCOLATION RATE TEST RUN BETWEEN Gross Time 3(D O 6V 0 Net Time I Depth to Water t—meahgh) PERC HOLE DIAMETER Fr AND —,JL FT Net Drop v PERFORMED BY:CERTIFY ) PERFORMED IN ACCORDANCE WITH ALL STATE AND 6fUNICIPAL GUIDELINES IN EFFECT ON THIS DATE.? DATE:IS TEST WAS Sullivan 19076882259 p.? �C�rtiiieD� 4Dritting Rog by DOC o^. daa SULLIVAN WATER WELLS P.O. BOX 070272, CHUGIAK, ALASKA 99567 TELEPHONE 658.2759 OWNER OF LAND:t-}�/�%_�_Ac dSORE HOLE DATA ADDRESS: c^DEPTH LEGAL DESCRIPTION:.�"l�i� PILL) S�4_L Ff DATE: ----- PERMIT NUMBER: Q t7 +_rt'ate 04Issue Cr -f�o- TAX IDENTIFICATION NUMBERQS/ -- /f3__�O_ Is well located at approved permit focatan? <d'P6s ::No Melhod of Drilling: (af ctary :I cable tool Depth of %e!f: _ 15-e w _� Casing Type rJ9LWab-rhi^kness, + _inches Diameter -_.-_b inches, depth � feet Liner Type:. Casing Stickup Above Ground: --feet Static Water Level: --LQ f feet Recover Rate: — -gpm Method of Testing: �f VVetl Intake Opening Type: Sf-1pen end * open hole * Screened; Start ___--feet Stopped feet O Perforations Start `— feet gapped Leet Grout Type ...sT�.� — Depth: from _ feet, to O --_feet WiRll Disinfected Upon Completion? 'j� o No Method of Disinfection: Ga_.�ao,�, _ _S"wy" Comments: c5+/L F t -�J �.•%t9 c_.,/��(a /C rilt�r?C L34tJ C cel J, 644J44. k/ 71 Driller's Name -.-�eJ cJ-Ij ATTENT,DN: It is the rssponsibilty of the property ovrner to submit a Copy of the well Iog to the proper authority, Municipality of Anchorage: Department at Health & Human Services aiwor Department of Ew;ronnnenat Conservation, Matsu Borough: Department of Environmental Conservation. 11/20/2008 10:16 FAS 907 Jag 7997 0\ SITE ARCTIC PUMP & WELL INC. Jim Sullivan, CPI PO Box 770197 rieia Eagle River. AK 99577 (907) 688.2510 (907)258.2510 (907)745-2510 pnt^n-eaI nn Pump Installation Log Well Drilling Permit Number: S W070257 Parcel Identification Number: 051-15340 MEH Date of Issue: 9-20-08 PrOPerty Owner Name & Address: Elaina Shawback PO BX670810 rh..n;.4 A1C oaG77 Pump Installation Date: 8-14-08 Rump Intake Depth Below Top of well Casing: 146 Feet Pump Manufacturer's Name: Dempster Pump MOdel:MBF3-75-S2 Pump Size:3/4 hp Pitless Adapter Burial Depth:10 feet Pitless Adapter Manufacturer's Tame:Martinson Pitless Adapter Installer. Tweed. Well Disinfected Upon Completion? Yes Method of Disinfection: Chlorine Comments: Pump Installer Name: Arctic Pump & Well, Inc. Arufc Pump & Well, !mc Page / of I SCS Ra La 1086697001 Client Name S & S Engineering Project Name/a Lot 202 Sec 8 TI 5N R I W Client Sample ID Lot 202 Sec 8 T15N R I W Matrix Drinking Water P1i:SID 0 Sample Remarks: Printed Date/rime 01/052009 23 Collected Date/time 12/162008 10025 :25 Received Daterrime 12/16/2008 14:40 Technical Director Stephen C. Fade Pamm`t`r ResultsAllowable IYJL Units hletMal Pre Analysis Container ID Limits Date 6mc Init Metals_ by I Arsenic ND 5.00 ug/L EP200.8 C (<to) 12/18/08 1224/08 NRB Waters Department Total Nivatc/Nitritc-N ND 0.100 mg/L SM204500NO3-F B (<I0) 1229/08 JD7. Microbiology Laboratory Colony Count 0 Total Coliform 0 col/100mL SN120922211 A (<200) 12/16/08 Fecal Coliform col/100mL SM209222B A (<I) DLC 0 col/100ml. SM209222B A 12/16/08 DLC (<I) 12/16/08 DLC .v�9'Y9'w Jz9.J I N : trPr� I�� •f �"i..ri r I�• � AMi A z�• ti y:•,.s¢' /ice 9 �c • G ' / TT � Js�• L/�'E �riw, I Hs�'yB � fr9.7 I S 4SBUILT SEWARD h ASSOCIATES LAND SURVEYING 694-08 I H=P.EBY CERTIFY THAT I HAVE SURVEYED THE SCALE,!yv FOLLOWING DESCRIBED PROPERTY: _ Z OF Al LoT Zb2 ftl, DATE. r Q ' • • • •. S,�,_b� AND THATrNO FNC 64CHMENSS EXIST EXCEPT AS INDICATED. IT IS THE RESPONS131LITY OF THE i + OWNER TO DETERMINE TH'•. EXISTENCE OF ANY GRID •"•" 6 EASEMENTS, COVENANTS, OR RESTRICTIONS wwizs6 j ... WHICH DO NOT APPEAR ON THE RECORDED SUBDI- 4 ", . M..: s..•e : �S • VISION PLAT. UNDER NO CIRCUMSTANCES SHOUD FB`sy �j �' , L5'� 3 < <s'i ANY DATA HEREON BE USED FOR CONUrRUCTION L? OF FENCE LINES, OR FOR ESTABLISHING BDUND- DRAWN ARY LINES. MUNICIPALITY OFANCHORAGE II0't u Development Services Department On -Site Water 8 Wastewater Program p 4700 South Bragaw Street r1 P.O. Box 196650, Anchorage, AK 99519.6650 �� 0 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM /WATER SUPPLY PERMIT Initial Permit Number: SW070257 Legal Description: T1 5N R1 W SEC 8 LOT 202 Date Issued: Sep 20, 2007 Expiration Date: Sep 19, 2008 Parcel ID: 051-153-40 Design Engineer: 0003 S & S ENGINEERING Site Address: 19605 S. BIRCHWOOD LOOP ROAD Owner Name: ELAINA SHAWBACK Lot Size: 108900 SQ. FT. Owner Address: PO BOX 670810 Total Bedrooms: 4 Permit Bedrooms: 4 CHUGIAK , AK 99567 - This permit is for the construction of. Q 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 closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. Engineer needs to do an additional percolation test during construction of septic field. A new soil log needs to be submitted with the Inspection report. If the results require a design change, construction of the system will stop pending On -Site review and approval. Received By: Date: Issued By: I I A Date: ?o Municipality of Anchorage .� Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsile (907)343-7904 ON-SITE SEPTICMELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. o 5 i — (e-)-3 - y0 Property owner(s) G I(?, I ri G( -/i Mailing address Po QO X 67075 Site address lgLcOJ, 'S 1 Legal description (Sub'd, Block & Lot) Legal description (Township, Section & Range) Lot Size It)?- QbD Sq. Ft. THIS APPLICATION IS FOR (®all that apply): Absorption Field V Septic Tank ❑ Holding Tank ❑ Privy 11 Private Well Water Storage ❑ IV ZD phone 230-387 Code of S- Se�f��� 2T15PJ P I W Number of Bedrooms Ll THIS APPLICATION IS AN: Initial V Upgrade ❑ Renewal ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwellincg andi"cc rid `ce-with-applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/RushFees: 1160^ 17S" Date of Payment: hi/013 Receipt Number: (Rev. 1 V05) Vdaia-r Fees: 11457 Date of Payment: gi-7-d07 Receipt Number: OV5,004 September 19, 2007 ROBERT C. COWAN PE CML ENGINEERS (907)694-2979 FAX (907) 694-1211 IEALTNAIJTNGRTV MUNICIPALITY OF ANCHORAGE AP°RMALS . Development Services Department P.O. Box 196650 Anchorage, AK 99519 SEWER 6 WATER "NEXTENSIONS REFERENCE: Lot 202; Section 8; T15N; RI W; S.M. SEWER&WATER It Is requested that you issue a permit to install a new well and septic system to serve 'SPECTION the proposed four bedroom dwelling on the referenced property. An additional test hole and percolation test will be performed during excavation to confirm soil consistency. EMiNEERINGSTUDIES ""°REPORTS We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent wELL*rPECnoN properties. &FLOWTEST If you require additional information, please contact us. SITE BANS Since y, PAW DESIGN ;t?obe hafer, P.E. SOCTEST Psc=nON TEST STRUCTURAL& MECHANICAL PSPEcnaNS ONSITE WASTEWATER CMPOSALS'STEM DESIGN Z ;;O ON M O*v �0 In ON O� m ON �F �z DESIGN r 0 O ,v} I I A.o I OMO O�^ I NAN O — co oN� I r^o� m I ;v I I I N 1 Il o 11 z C L A 1 p in cy) z I oaf r op I �o S oc)o 0 ooc) z 1 --LD r^ yo .4 C I [' O z ~ I Ao C I F I i I 1 1 E------------- pip SITE -PLAN V NV(D N O O O p + m o ^Z .gym V / O rrl -0 V-. OOA f O — co oN� m r Il o 11 z C L in cy) n O oc)o 0 ooc) N 0 ,0 Vi 1 tCI..�.y aA M O t.r " z � 1 /� Op W �^O i^o t6X P'. M o =0 �O (Q • y oft I a. A OG I�y OM /" Z "meq= 0Lu 0 rid~ /i^Iy (7N Alt - (AO A Z p V I H(AO y y O ocn � 71 c _ 6,v mo C z r -•I O _--------------------------------0'9 CYRUS STREET t � O t O 0VIEN, ti O c! A Performed rot: �oq �•s Legal Desalplion: LG�G Municipalily of Anchorage Development Services beparimeni Building Safety Division On-Slle Water and Wastewater Program 41DO South eragaw SI. P.O. Box 196650 Anchorage, AK 99519"6650 Y,ww,cL4nfhoml-A&I (907) 043.7904 Solis g - Percolation Test ��in R �j g// w Bac bate Tovms 1 P. Flange. Section: S oe 14• ` F 15 8-0. H alte 18- 17- iB-1 COMMENTS l4trUmn Reading Depth Gross TMne Net Tone (reel) `Lt L — — — -- z- e.• - �yP��, 4; j• S/9 n7D bO 3Y�"_� ±40 D 60 Z,, WAS GROUND WATEn ENCOUNTERED? 10-L (. IF YES. AT WIIAT OEPIII7 11• y bsprhlo Wa(sr Allsr b Mon110r11,97 p A le �� 12- �t O 1J- 14• ` F 15 8-0. H alte 18- 17- iB-1 COMMENTS l4trUmn Reading bale Gross TMne Net Tone Deplh to Water Nel Drop '� bO 3Y�"_� ±40 D 60 Z,, 30 ' 70 3Y" /'Jg" 170 :z it O ruwvanrr.n rwt 7V (.d w.eindl TEST RUII BETWEEN 5 rT AND PERC IIOLE DIAMEJER b •. rT PERrORMED DY: Ss �' ��' I \1-1.1 CERTIFY i11Ar 1ESi WAS PERFORMGU IN ACCORDANCE Willi ALL ATE —AND MUNICIP UIDE l E fECT ON 11IIS UAIE. VAIE: E: ROBERT C. COWAN, P.E. CMLENOINEERS (907) 6942979 FAX(907)694-1211 ON-SITE WASTEWATER DISPOSAL SYSTEM 'F'1TMN11ON V APPRDJAu CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS SEWER& WATER MAIN E MNSIOfS REFERENCE: Lot 202; Section 8; T15N; RIW; S.M. September 19, 2007 SEWER&WATER NSPECTION GENERAL: 1. The scope of this project includes the installation of a new 1300 gallon HDPE septic tank and a septic trench to serve the proposed four bedroom residence AE oWPORTS aEs located on the referenced property. 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all ;TTINSPECTION applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. SITEPIANS 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. &DAO DESIGN 5. Contractors installing wastewater disposal systems must be certified by the Municipal Development Services Department or ADEC if required, for system installations. Owners installing their own systems must also receive �L'aT prior approval from the respective agency. PERCOLATION SEPTIC TANK INSTALLATION: TEST 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. All HDPE &TRLCTURAL& septic tanks are required to have a 4" monitoring pipe installed next to the INSPECTIONS tank extending to the bottom of the tank. ONSITE WASTEWATER DISPOSALSKTEM DESIGN Page 2 Lot 202; Section E; T1 SN; R1 W; E.M. September 19, 2007 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. All HDPE septic tanks are required to be covered with a minimum of 2" direct burial insulation, and a maximum of 4 feet of cover. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCII/DR.AINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page 3 Lot 202; aaction S; T1 SN; R1 W; a.M. September 19, 2007 MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Tyne of Pine Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever requirement applies. Page 4 Lot 202; Section S; T1 SN; Rt W; E.M. September 19,200T INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre - construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR / INSTALLER • Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval I Parcel I.D. 051-153-40 Expiration Date: 1. GENERAL INFORMATION Complete legal description TI 5N R1 W SEC 8 LOT 202 Location (site address) 19605 SOUTH BIRCHWOOD LOOP RD., CHUGIAK, AK 99567 Current Property owner(s) LOIS SHAWBACK Day phone 230-3446 Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: 0 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 Fx� Individual E Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: NONE Distance: --- Received by: Date: S I 11S11,3 COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $�0 l Waiver Fee $ Date of Payment gB�ad�3 (+� Date of Payment Receipt Number Oqq q aQ Receipt Number COSA # 01�c Q ?) i1R 1 A Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below. I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm SPURKLAND ENGINEERING Address 203 W. 25TH AVE.,STE.202A, ANCHORAGE, AK 99501 Engineer's Printed Name LARS SPURKLAND 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Phone 279-3916 Date 8/9/13 i..:.. .T". .. .. ........... LA, E. SPUR'KLAND; J` % Popo Conditional approval for bedrooms, with the following By: 11 p Original Certificate Date: 7) J!7 1 Th ume'ipali 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 COSAblveeheet v . c If more than 7 septic system is on the lot: COSA Checklist # 1 of 1 Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: T1 5N R1 W SEC 8 LOT 202 A. WELL DATA Well type PRI If A, B, or C provide PWSID # Date completed 9/25/2007 Sanitary seal (YIN) Y Total depth 158 ft. Cased to 158 ft. Date of test Static water level Well production FROM WELL LOG 9/25/2007 101 4 WATER SAMPLE RESULTS ft. Coliform NEG colonies/100 mL Nitrate ND mg/L Arsenic ND ug/L Date of sample: ANSON 7Ja'I t3 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/HDPE Tank size 1300 gal. Number of Compartments Foundation cleanout (YIN) Y Date of pumping 7/30/2013 C. ABSORPTION FIELD DATA Depression over tank (YIN) N Pumper Sanitary Pumpers Parcel ID: 051-153-40 Well Log (YIN) Y Wires properly protected (YIN) Y Casing height (above ground) 2 in. AT INSPECTION 8/8/13 M ft. t!1!ud An5oA Collected by: MOXNESS Date installed 9/21/2007 Cleanouts (YIN) Y High water alarm (YIN) N Date installed 9/21/2007 Soil rating (g.p.d.e or ftz/bdrm) 0.6 System type TRENCH Length 76 ft. Width 3 ft. Gravel below pipe 7 ft. Total depth 12.3 ft. Eff. absorption area 1064 ft2 Monitoring tube Y Depression over field N Date of adequacy test 8/9/13 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 36/31 in. Water added 1000 gal. New depth 52/49 in. Elapsed Time: 1440 min. Final fluid depth 42/39 in. Absorption rate >= 600 9 p d Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum M Size in gallons _ in. "Pump off" level at - E. E. SEPARATION DISTANCES WELL ON LOT TO: Cycles tested -- Septic tank/lift station on lot '100' Absorption field on lot '100' Public sewer main NA Sewer /septic service line 25 Animal containment areas '50' Manhole/Access (YIN) - in. High water alarm level at in. Meets alarm & circuit requirements? On adjacent lots '100' On adjacent lots '100' Public sewer manhole/cleanout NA Holding tank NA Manure/animal excrete storage areas '100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5 Property line >5 Water main NA Water service line '10' Wells on adjacent lots '100 ABSORPTION FIELD ON LOT TO: Property line '10 Building foundation >10, Water Service line '10' Curtain drain '50' (N.O.) F. COMMENTS G. ENGINEER'S CERTIFICATION Surface water '100' Wells on adjacent lots '100' 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 LARS SPURKLAND Date 8/9/13 COSA brown sheet 10-10-12.doc Absorption field >5 Surface water >100'(N.O.) Water main NA Driveway, parkingtvehicle storage 10 .Z71 o. F. A (,,q 1k1I A,. `'' g T 00 s. na puRKLAND (I�F�PR FE S\OhP�_