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Home My WebLink AboutT12N R2W SEC 30 E2NE4NE4NE4SE4TI 2N R2W Sec . 30 E2 NE4 NE4 NE4 SE4 #021-022-08 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 Page of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: OSP101206 PID Number: 021-022-08 Name: Marjorie P. Polley Wastewater System: ❑✓ New Ll Upgrade Address: 2453 Captain Cook Drive Anchorage, AK 99503 ABSORPTION FIELD Phone: Number of Barrooms: 2 ❑ peep Trench ❑ Shallow Trench ❑ Bed 0 Mound ❑ Other LEGAL DESCRIPTION Sail Rating: Total Depth fmm original grade: .7 GPD/Ft' +4.6-6.3 Ft. Block: Lot Subdivision: Depth to pipe bottom from original grand: Gravel depth beneath pipe 2.3-4.0 Ft. .5 Ft. Township: 12N Range: 2W Section: 30 E2NE4NE4NE45E4 Fill added above original grade. Gravel Length: 4.6-6.3 Ft. 30 Ft. Well: ✓❑ New ❑ Upgrade P9 Gravel witldc Number of lines: Distance between lines: 15 Ft. 0 5 Ft. Classification (Private, A, B, C): Total Depth Cased to: Total absorption area: Pipe Material: Private 167 FL 48.5 Ft 450 Ff ASTM D3034 PVC Driller Data Dolled Starve Water Level: Installer Date Installed Alpine Drilling 9126110 11 Ft Owner Installation 10!20-11110/2011 Yield Pump Set at I Casing Haight Above Ground TANK 3 GPM 144 Ft. 2 Ft SEPARATION DISTANCES ❑ Septic ❑ Holding m S.T.E.P. ❑ Other: To Septic Absorption Lift Holding ubliHPrivate Manufacturer Capacity: From Tank Field Station Tank Sewer Line Anchorage Tank 1,250 Gal, Material Numbef of Compartments war >100' >100' >100' N/A >25' Steel Three (3) Surface water >100' >100, >100' NIA LIFT STATION Size: Manufacturer Lot tine >5' >10' >5' N/A 250 Gal. Anchorage Tank/Orenco "Pump on" level at: "Pump off" level at: High water alarm at: Foundation >5' >10' >5' NIA 42 in. 42 in. 44 in. Curtain Drain None Noted Pump make &moral OSI P2005-11 Electrical Inspections performed by: Electric and More Remarks: 20 j BENCH MARK Landscaping of Mound to be Completedy by 7/1r29 Location and Descriplon: Garage Slab. Assumed Elevation: Ft Inspections performed by: A. Harala Dates: 18' 10/20/2011 p e'�VQ@fie€��OF A 14t 2nd 11/10/2011 4 =;�•'•. •. •..� •;QSPi' Developme4Services De_partmentApproval Conditional Approval Date: Li '/ -PJ"r , AUCNAEL E ANDERSON ce 4381 �ate:l'�'IJ-J D Revdiewedandapprovedby: �iO�AB*p^5��:'i CHUGACH STATE PARK Permit Number: OSP101206 N 89'49'35"W �\ 164.05' r r � r /r foo /,r ooa r/rr c r r r r 0 1 o r r i� T1 2N R2W N Section 30 W2 ro NE4 NE4 SE4 .......................,..................... MICHAEL E. ANDERSON j No. CE -4381 �_�% : ♦♦♦�� pROFESSI4NPi••• �� r e ,r ae r r r aA r r ' r ' ' , r r , r r , r r , r r r ' , r r , r r , r r , r r , r r TI 2N R2W Z Section 30 E2 O NE4 NE4 SE4 r . o r r � r 4•' Insu Line Ur MH S1 M --M2 , L--------- 1� Alt. Site Existing Well A B S1 61.5 —85-54– S2 65.7 90.3 MH 68.0 92.5 M1 04. 91.8 M2 91.8 72.5 J'so coo`" Bea .",e GO( ALTERNATE SITE Cotegory III Septic System with 5' Wide x 20 Long Absorption Trench N 89'44'33"W 164.19' PLAN AS BUILT SCALE 1" = 40' c E a) U) 0 w a) c J c 0 v 0 N Page 2 of 3 PID No. 021-022-08 VACANT of N M r. LEGEND S1 – Septic Tank Vent CO – Cleanout M1 – Monitor Tube TH – Test Hole FCO – Foundation Cleonout MH – Monhole Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: OSP101206 89.2 co 75; 2" INSULATION 1 .26, PVC 1,250 Gallon STEP Tank Page 3 of 3 PID No. 021-022-08 104.5 r1, BR0 LE AB BU LT Scale: 1" = 10' >und �•�� •• • r 49th `; 1 0.....:. ..... �. yr........ 0�7pk- MICHAEL E. ANDERSON ♦♦ �'. No. CE -4381 `=i ♦♦•••4114 pROFESSI�N��••• Alpine Drilling & Enterprises Well Log Permit Number: #SWOSP101206 Date of Issue: 9-23-10 Parcel Identification Number: 02102208000 Date Started: 9-26-10 Date Completed: 9-28-10A/Cy�Is well located at approved permit location? x Yes F-1, No Legal Description: T12N R2W Sec 30 E2Ne4NE4S4 G:2943 Property Owner Name & Address: Bob & Marjorie Polley 2453 Captain Cook Dr Anchorage. Alaska 99503 Borehole Data: Depth (ft) Soil Type, Thickness & Water Strata From To Method of Drilling x air rotary ❑ cable tool Casing type: steel Stick-up 0 2 Wall Thickness:.250 inches Bedrock 2 167 Diameter: 6 inches Depth: 48.5 feet Liner Type: Diameter: inches Depth: feet Casing stickup above ground: 2 feet Static water level (from ground level): 11 feet Pumping level: 167 feet after 4 hours pumping 3 gpm Recovery Rate: 3 gpm Method of Testing: air li Well Intake Opening Type: ❑ Open End x Open Hole ❑ Screened Start feet Stopped feet ❑ Perforations Start feet Stopped feet Grout Type: bentonite Volume: 4 bgs De the Start 0 feet Sto ed 46.5 feet Pump: Intake Depth feet Pump size hp Brand Name Well Disinfected Upon Completion? x Yes ❑ No Method of Disinfection: chlorine tablets Comments: Well Driller: Alpine Drilling & Enterprises PO Box 110496 Anchorage AK 99511 Oct -24-2011 12:20 PM Alaska Court System 907-264-8291 Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Mark9eglch Anchorage, AK 99507 Mayor WW W Myni.oro/oneita (907) 948-7904 Pump Installation Log �p Well Drilling Permit Number: SW 0f 1 1a I zo�p Date of Issue• �° `QC) Parcel Identification Number- fi 490$1)00 Legal Dee riptiou �'� �D t i� �dJS Pump Installation Date: _%F?556 Pump Intake Depth Below Top of Well Casing: 144 feet Pump Manufacturer's Name: Mler:5 Pump Model: q 01 P 4 Pump Size �q_hp Pitless Adapter Burial Depth: N feet Pitless Adapter Manufacturer's Name: � f A Pitless Adapter Installer: ij [A 6 Well Disinfected Upon Completion?ices F-1No Method of Disinfection: / , Comments: 1/1 ¢ qr Tne & Address:9vt cook r0Aej H 995D3 Pump Installer Name: o YO LJ ��I YYl•tr✓ rvic& , LSC Attention: The pump Installer shall provide a pump installation log to the DSD within 30 days of pump installation. Nov 03 11 10:08a Cecilia Hidalgo (907)522-9186 p.2 ..+. vv yes. a vv .`ry n�ti sv /r lc it V DUJI-U ^7b f 04ZD KmJL Y. 171 ELXCTMC AND MOn P.O. BOX 111794 ANMORACZ, AX 99511-2794 907a4S 530 03 NOVEMBER 2011 MR. DOB POLLY 13155 GLEN ALPS ROAD ANCHORAGE, AK 99516 MR; POLLY: I HAVE COMPLETED WIRING YOUR SEPTIC SYSTEM LIFT STATION AND ALARM. ALL WORK THAT I HAVE DONE HAS FOLLOWED THE REQUIREMENTS OF THE NATIONAL ELECTRICAL CODE (2008). WIRING FROM THE BOILER ROOM TO THE SEPTIC TANK JUNCTION BOX IS IN PVC CONDUIT (INSTALLED BY THE GENERAL CONTRACTOR). THE PUMP, FLOAT SWITCHES AND ALARM HAVE BEEN TESTED AND WERE TOTALLY OPERATIONAL WHEN TESTED ON 27 OCTOBER 2011. ?'m"+,04 EDWARD C, j ■ On -Site Water & Wastewater System Permit Permit Number: OSP101206 Tax Code Number: 02102208000 Work Type: WellSeptic Initial Permit Effective Dates: September 23, 2010 to September 23, 2011 Design Engineer: ANDERSON ENGINEERING Subdivision: T12N R2W SEC 30 Site Legal Address: T12N R2W SEC 30 E2NE4NE4NE4SE4 G:2943 Owner/Address: POLLEY MARJORIE P 2453 CAPT COOK DR ANCHORAGE AK 995030000 Site Mailing Address: Lot Size in Sq Ft: 54450 Total Bedrooms: 2 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy Y Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. bed due .1-0 ,5�ajldwsi bed rock C r - ) Gh�nY �° 9 �7vun d Received By: -.: .dam �. - Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 s Fax (907) 343-7997 hftp://www.muni.orci/Onsite Development Services Department On -Site Water and Wastewater Program sent , G T v Department **** VARIANCE/WAIVER REVIEW **** Waiver#: OSP101257 COSAM Permit#:OSP101206 PID#: 021-022-08 Legal Description: T12N RM Section 30 E2 NE4 NE4 NE4 SE4 Engineer: Anderson Engineering Applicant: Marjorie Polley Your request for a waiver of the required 3:1 slope on part of the mound has been approved to 2:1. See engineers design for special construction methods. Also, the bed is approved to be slightly not parallel to the contours. See the site plan for approved orientation. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ............................................................................... Waiver is Granted: X Waiver is not Granted: Date: Approved by: Name of Revi er Rec#: 052840 Amount: $200 Date Paid: 10/27/10 **** VARIAN C E/WAIVER REVIEW **** So SV4.I / USP IU i25�1 �l �LrikHC� pyPIDa04 Parcel I.D. 021-022-08 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/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Property owner(s) Marjorie Polley phone Mailing address 2453 Captain Cook Drive Anchorage, AK Zip Code 99503 Site address Glen Alps Road Anchorage, AK Code 99516 Legal description (Sub'd., Block & Lot) T12N, RM, Section 30, E2, NE4, NE4, NE4, SE4 Legal description (Township, Range & Section) Lot Size 54,450 Sq. Ft THIS APPLICATION IS FOR (® all that apply): Absorption Field [-Wi Septic Tank F1 Holding Tank ❑ Privy ❑ Private Well F-1 Water Storage ❑ Number of Bedrooms Two (2) THIS APPLICATION IS AN: Initial 0 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. fttltl-� ELAI-� (Signature of property owner or authorized agent) Permit/Rush Fees: % ,� 4— q 3Z Waiver Fees: 2.0 Date of Payment: Date of Payment: Receipt Number: Receipt Number: 0=�q' Ll 0 (Rev. 11/05) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 FAX September 22, 2010 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: T12N, R3W, Section 30, E2, NE4, NE4, SE4 Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of the subject lot intends to construct a new two-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 septic system along with the alternate site. No existing wells or septic systems are closer than 100' from the proposed well or septic system. 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 with sand and silt (GM). The percolation rate of the soil was determined to be between 12 minutes per inch. No groundwater was found during the placement of the test holes and none was noted during the monitoring period. Bedrock was found in the test hole at 6.2' below the surface. An application rate of .8 gallons per day per square foot was used in the design of the absorption system. We are proposing to place a new 1,250 -gallon STEP tank and 2 — 38' long segments by 5' wide by .5' effective depth absorption trenches to treat and dispose of the effluent generated in the house. The elevation of the distribution line in the absorption trench will be .5' above the surface and the total depth will be 2.5'. Organic material will be removed to 2.5' below the surface and coarse sand utilized to replace it. A minimum of 3' of fill or 2" of insulation and 2' of fill will be placed over the absorption trenches and 4' over the STEP tank. The ground surface on the lot in the area of the absorption trenches slopes to the northwest at a grade approximating 14%. The new trenches will be constructed parallel T12N, R3W, Section 30, E2, NE4, NE4, SE4 September 22, 2010 Page Two 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 proposed and existing water services in the area. The house and STEP tank will be lower than the absorption trenches with the septic effluent pumped to the absorption area through a 1.25" PVC line. If the system is constructed in accordance with our design the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments .`�P. "�F...... JW 49th••. ..' % ..a. .... .yCl.a... % 0 ........ .................................. % MICHAEL E. ANDERSON : ,j �� •. ILIO. CE -4381 I'D AW .= �_� i ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 FAX October 19, 2010 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: T12N R2W Section 30 E2 NE4 NE4 NE4 SE4 Backslope Waiver Dear Onsite Services Engineer: Very little area is available on the subject lot for placement of a septic system. The area identified at the west side of the property is the only location found during a recent field investigation. The backslope of the bed to the east and west must be 2:1 to prevent the toe of slope from encroaching on the adjacent property or the driveway. The slopes to the north and south will remain 3:1. A polyethylene or HDPE liner will be placed along the edge of the east and west sides of the bed to prevent effluent from migrating in these directions. In addition, jute mesh will be placed on the slopes to stabilize the slopes and prevent erosion. We hereby request a waiver allowing the backslopes at the east and west ends to be 2:1 rather than the required 3:1. Sincerely, Michael E. Anderson, P.E. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 FAX October 19, 2006 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: T12N R2W Section 30 E2 NE4 NE4 NE4 SE4 Absorption Bed to Slope Waiver Dear Onsite Services Engineer: The subject lot has limited area for construction of a septic system due to the presence of bedrock. We have located an area with acceptable soils, but it is situated slightly askew from the ground slope on the property. We are therefore applying for a waiver allowing placement of the absorption bed at this location. The bed is aligned from east to west and at 12' from the west property line. The area of placement has a 7% slope. The placement of the bed slightly askew to this slope will allow the entire bed to remain in the percolation zone and have no impact on the effectiveness of the absorption bed. Sincerely, Michael E. Anderson, P.E. OF 0• 49th MICHAEL E. ANDERSON j � •• NO. CE -4381 AV 1 �F •../d ,lc•i �� ••.... �.. . p �P� �,��iaESS�� CHUGACH STATE PARK �o N 89'49'35"W 164.05' ---,- i G , vc � °& i' o 0� , I T1 2N R2W i Section 30 E2 i +• NE4 NE4 SE4 I > m I xis Ing I W N We I: VACANT I I J N I I I C p M T12N R2W o)` Section 30 W2 M I °' w NE4 NE4 SE4 I ,Mrd o I I O O n N \ I �\\ I z O \ O 5.5' Max. fill Over \ I Septic Tank.\\ 4" insulation Over Two \ Cn \\ Un Under Drivewa Bedro m o• H e I \\ Septic si j System I \ • i \ 15.5'——L---�� Raise Dn o Gafage-- — \ 2.1 .------------ Cover Back op I _MT_ ?' I -------- tirr. I ------------ H2 I I ' TH1 b= I iu Alt. Site �Qg: alit 4 Contour Interval i LEGEND F I SV — Septic Tank Vent I CO — Cleanout MT — Monitor Tube TH — Test Hole SYSTEM REQUIREMENTS I FCO — Foundation Cleanout 1. 1,250 Gallon STEP Tank. MH Manhole' 2. 15' Wide x 30' Long Absorption Bed. ' I / �V&"1MV1%�� / �� F ♦1♦ ��P�,.. ALTERNATE SITE Category III Septic System with 5' Wide I 1♦ 41C.) �1 x 20 Long Absorption Trench I i � ,. 49th •j ........ .. • N 89'44'33W 164.19' �............................. NOTE: .......... ......� 0 � =, MICHAEL E, ANDERSON• SITE PLAN NO COnfIICtS With Existing Wells Or Septic Systems in the Area. ♦1♦�� :. No. CE -4381 ; �ti ♦j♦�•�C �i /FP�� AV SCALE 1' = 40' ♦�, ;: ES;;�� T12N, R2W, Section 30, NE4, NE4, NE4, SE4 DESIGN FACTORS: SYSTEM REQUIREMENTS: Two Bedroom Home Raised Bed System Perc. Rate: 4 Min./Inch 1,250 Gallon STEP Tank Application Rate: .7 GPD/SF Pressure Distribution System 3.0' (Min.) Coarse Sand 2 Bedrooms X 150 GPD/.7 GPD/SFAp lication Rate) = 428.5 SF Absorption Area 428.5 SF/15 LF (Width) = 28.57 LF �edpLength THEREFORE: Construct a 30' Long x 15' Wide Raised Absorption Bed as Shown Below. Remove Existing Organic Material and Replace with Coarse Sand. Level Bed Area with Coarse Sand. Place Distribution Piping at 3.5' to 4.5' Above Original Ground Surface. Provide 2" of Insualtion and 2' of Cover Over Bed or 3' of Cover. Place Topsoil and Seed on Outer 6" of Mound. 3:1 Back Slopes on Longitudinal Sides. 2:1 Back Slopes on Horizontal Back Slopes. 3 1[ 3 Topsoil and Seed 1 Outer 6" of Mound 2" Insulation & 2' Cover (Min.) to Prevent Erosion 5 O O O 1" PVC 5' Drainfield Rock 3/16" Holes 10/Lateral 4.0' 3.0' 7% S Remove Exsting Organic Material final a an ee Specification) Orig' 7% Sloe Level Bed as Necessary With Clean Sand 1.0'-2.4' Original Ground 1.0'-2.4' 2.5' 5.0' 5.0' 2.5' i i i NOTE: Organic Depth Varies from V to 2.4'. Remove all Organics. See Specifications for Clean Coarse Sand. TYPICAL RAISED BED SECTION (NO SCALE) NOTE: Grade Area Surrounding Bed 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 Surface Water or Streams. Minimum 10' Separation From Water Service Line. L N CD 0 O ••• P��i•�� o2S � c •(� •c• J� a) 0 _ .oCD ; wco 4.:�� NC N F Q W N cn / . cn aO ; ;�: U 4 LL _ w0 O 1? H o a Z Q i U Q AV N �.}. a c V Z > O -� W w 3 a(OU) CL �/� t _ Y U) E m3ai m LLl i m 0 O m �+ _ >, c N W mac Q 0<roc 0 Z � �W 70 O Cnm CN N d Ti—�E2 a m 0�= - W �} CC fn : 00 O -0 > O m m V G 000 mJUm0 rF LJJ Q m = (n c W H m c W co -0c 0f W CL co U }mo�� LO am'=o° �a,r m� -cn0f-fn m 2m' r a m co vii a) > 0 -14 p2 O <M CD m O -C 7 W Q 0-0—m c co N Z _ 0� > y o = w °'Z @ U O o 0 0 �U-00 U c c "0 0LO O 9 'O m W M m a m o �n C cn J_ cmccm aa) o m Cl)LL -}--+ LL W c m •L3'm c c U U CL c _ c f\n J p p N m /1/ W ,. ` J c m J a) LL -j W aU.)o°:°pc U �U CCD/1 U- (D co r) m j` O � fn ly m 2 Q N O in CL c•`�U 0 O O L) a ` m❑ 45 U W �. O C (7;_0 c 2) Cl) O _Ile (0 N ~ E O?j O O N CL U- Ev m XJ w 0'p m� m J (n cl Z 0 .. a7 LO Q' •X c c Cl) 1 1 1 Z `O� C E� OW m.0 > a a) LL1I (� a"D O LL W (D U) O � V J N m�� "DLO W 0E2n0 = Li LU o 'Q mc6 w E m =g Q Q Hd Q N� t— W' U 0 0 Z -LO i0 O O L � r N O O r C O O w O OO O N� L6 fn Cp r r W O aU o I d Property Line I MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 DEPTH (feet) 1- 2- 3- 4- 5- 6- 7- 8- 9 10 11 12 13 14 15 16 17 18 19 20 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: T12N, R2W, SECTION 30 PERFORMED FOR: BOB POLLEY DATE: 9/19/10 PROJECT No.: PARCEL ID#: TECHNICIAN: TEST HOLE 1 OG/OL GM a I I II BEDROCK A. HARALA SLOPE 7% SITE PLAN SEE SITE PLAN i WAS GROUND WATER ENCOUNTERED? NO IF YES @ WHAT DEPTH? S DEPTH OF WATER AFTER MONITORING: NONE 2% DATE OF MONITORING: 10/18/10 DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH To WATER (INCHES) NET DROP (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 10/9 1 12:30/12:40 10 3.25/5.75 2.501' 2 12:41/12:51 10 3.38/5.88 2.50" 3 12:52/1:02 10 3.13/5.50 2.37" 4 1:03/1:13 10 3.25/5.75 2.5011 5 1:14/1:24 10 3.06/5.69 2.63" 6 1:25/1:35 10 3.13/5.75 2.63" PERCOLATION RATE: 3.8 (MIN/INCH) PERC. HOLE DIA. ! (INCHES) TEST RUN BETWEEN: 3.0 FT. and 3.5 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. ORIGINAL PERC. TEST COMPLETED AT BEDROCK LEVEL CAUSING SLOWER PERCOLATION RATE. TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 10/19/2010 Municipality of Anchorage Development Services Department Building Safety Division r On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.ci.anchora_ae, ak.us (907) 343-7904 Soils Log - Percolation Test Performed For. •--------- .� _ .'tit •MKHAM 13 ANDMSM i •CE -4381 00 ,�41; pROffS51QM� ��►�• Date Performed: October 7, 2010 Legal Description: Township, Range, Section: (Feet) I- 2- 3- 4- 5- 6- 7- 8- 9- 10- - 2 -3- 4 -5 -6- 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20-1 11- 12- 13- 14- 15- 16- 17- 18- 19- 20 - WAS WAS GROUND WATER A ENCOUNTERED? S IF YES, AT WHAT DEPTH? 0 Depth to Water AfterI P Monitoring? !4 Date: I a g7 f n TEST RUN BETWEEN LFT ANDFT COMMENTS Perc cavity was presoaked - PERFORMED BY: A. Harala L I `/C� THAT THIS TEST WAS/ PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: September 22, 2010 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program Re: Request for Owner/Builder to Excavate for On -Site Wastewater Disposal System To Whom It May Concern: As an Owner/Builder, I am requesting authorization to perform my own excavation for a planned septic system on a lot in Glen Alps. The lot parcel ID is: 02102208-000. I have retained the services of Anderson Engineering to design the septic system and obtain an on-site sewer/well permit. I have comprehensive experience in construction, including volunteer construction work with Habitat for Humanity in Seattle and, more recently, being an Owner/Builder for a remote cabin in the Lake Louise area. For any assistance needed during excavation, I will be working with contractor Carl Luchsinger, who has vast knowledge and experience in excavation projects. In addition, the excavation and installation of the proposed septic system will be closely supervised by staff from Anderson Engineering. As an Owner/Builder, I would appreciate having the ability to conduct the excavation for proposed septic system and ask that you approve this request. Please do not hesitate to call me if you need any additional information. Thank you for your assistance. Robert Polley 907-942-7931 September 23, 2010 Municipality of -'Anchorage Development Services Department Building Safety Services Division On -Site Water. and Wastewat.ea•.Pro ite: Addendum to 9/22/10 Letter To Whom Tl May Concern This is to provide additional clariTicatic n regarding my request For authorisation to perform my own excavation, as an Ow er/Btiilder, Fo.r it planned septic system on a. lot in Glen Alps. T will be actively involved in all tispect: of construction on the lot, including the excavation/insufflation for the proposed septic system. While Carl Luchsinger, a contractor residing nearby, may provide advise and guidance regarding excavation, 1. am nO�t retaining Mr_ Luchsin.ger to intitall the proposed septic system. As mentioned, Anderson Engineering v providing oversight and inspection for all phaties of the septic installation process.: Thank you again for your assistance in hitt --natter. Sincerely, Robert Pollcv ! I ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) MEMORANDUM DATE: October 11. 2012 TO: Jeff Poet FROM: Mike Anderson, P. E. SUBJECT: T12N, R2W, Section 30, E2, NE4, NE4, NE4, SE4 Septic System Revegetation The revegetation of the mound over the new absorption bed on the subject lot has been ongoing for nearly a year. The grass has taken hold and no erosions is evident on any of the slopes. We hereby request the conditional status the COSA be removed and an unconditional COSA be issued. Parcel I. D. 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/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING 021-022-08 1. GENERAL INFORMATION COSA # 0 -4L lit 433 Expiration Date: / ®— 3j—J2_ Complete )—J2- Complete legal description T12N, R2W, S30, E2, NE4, NE4, NE4, SE4 Location (site address) 13155 Glen Alps Road Anchorage, AK 99516 Current Property owner(s) Robert R. Polley Mailing address Lending agency Mailing address Real Estate Agent Mailing Address P.O. Box 8793 Kodiak, AK 99615 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Three (3) Day phone 942-7931 Day phone Day phone 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ✓❑ Individual On-site ❑✓ Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 5. DSD SIGNATURE 1/ ? Approved for Disapproved. 3 bedrooms. Phone 522-7773 Date VZ43arAy L_ A�P�F, ,� 497ii *pd I VJCHAa E AHDW- ON.'Z ,; , 6E •4381 4 i 9 e Conditional approval for bedrooms, with the following stipulations: Attachments COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By. Original Certificate Date: IR.v itrod -2- Municipality of Anchorage ro* Development Services Department�� G Building Safety Division q G On -Site Water and Wastewater Program 4700 Bragaw Street , P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite • 1 (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 021-022-08 1. GENERAL INFORMATION COSA # C_ `\ V A :b�5 Expiration Date: a "" Gy /2_ Complete legal description T12N, R2W, S30, E2, NE4, NE4, NE4, SE4 Location (site address) 13155 Glen Alps Road Anchorage, AK 99516 Current Property owner(s) Robert R. Polley Day phone 942-7931 Mailing address P.O. Box 8793 Kodiak, AK 99615 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup 2. NUMBER OF BEDROOMS: Three (3) 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well✓❑ Individual On-site 0 Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained frpmthp Municipality of Anchorage files and from my investigation and inspectio , the on-site water supply,arKVor wastewater disposal system is(are) in compliance with all applicable Munici apd State codes, ordindes `and regulations in effect at the time of installation. # Name of Firm Anderson Engineering Phone 522-7773 A' Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 5. DSD SIGNATURE Approved for bedrooms. Disapproved.. Conditional approval for bedrooms, with the following stipulations: m U S Attachments: COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineers Report Nitrate Advisory Other By: Original Certificate Date: 12-1-11 (Rev 11/05) Municipality of Anchorage • '� Development Services Department s� V Building Safety Division ` On -Site Water & Wastewater Program S A `' Y 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: T12N, R2W, S30, E2, NE4, NE4, NE4, SE4 Parcel ID: 021-022-08 A. WELL DATA Well type Private Date completed 9/26/10 Total depth 167 ft. Date of test Static water level If A, B, or C provide PWSID # Sanitary seal (Y/N) Y Cased to 48.5 ft. FROM WELL LOG 9/26/10 11 ft. Well production 3 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate N/D mg/L Arsenic: N/D mg/I Date of sample: 10/19/11 B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEP/Steel Tank size 1,250 gal. Number of Compartments Three Foundation cleanout (Y/N) Y Depression over tank (Y/N) N Date of pumping New Construction Pumper C. ABSORPTION FIELD DATA Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) >24 in. AT INSPECTION ft. 9 - p.m -Collected by: MEA Date installed 10/20/2011 Cleanouts(Y/N) Y High water alarm (Y/N) Y Date installed 11/1-10/11 Soil rating (g.p.d./ft2 or ft2/bdrm) I GPD/SF System type Raised Bed Length 30 ft. Width 15 ft. Gravel below pipe .5 ft. Total depth +4.6-6.3 ft. Eff. absorption area 450 ft2 Monitoring tube Y Depression over field N Date of adequacy test New const. Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed 10/20/11 Size in gallons 250 "Pump on" level at 42 in. "Pump off" level at 42 in. Datum Bottom of Tank Cycles tested New const. E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot _ Public sewer main Sewer /septic service line >100' >100' N/A >25' Animal containment areas >50' Manhole/Access (Y/N) Y High water alarm level at 44 Meets alarm &circuit requirements? On adjacent lots >100' On adjacent lots >100' Public sewer manhole/cleanout N/A Holding tank N/A Manure/animal excrete storage areas >100' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation �5' Property line >5' Absorption field >5' Water main N/A Water service line >10' Surface water >100' 94 Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water main >10' Water Service line >10' Surface water >100' Driveway, parking/vehicle storage >25' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS: COSA Fee $ _ _Co5 ((,sV) Date of Payment Receipt Number 09. �) 4 b (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number e G. ENGINEER'S CERTIFICATION Ar�;••*• ••��® '• 49n I certify that 1 have determined through field inspections and 00•••• a. ••• "se .....:.... jo review of Municipal records that the above systems are in p..........�.•�•�•••,,,,,.,,•,•„ conformance with MOA COSA guidelines in effect on this date. �� q •: , Engineer's Printed Name Michael E. Anderson, P.E. ♦ �� :; .;tom z 4381 : �`` w I�'j,;•. u_s^N �.• ik�vie AV Date 11/3/2011 COSA Fee $ _ _Co5 ((,sV) Date of Payment Receipt Number 09. �) 4 b (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number Oct -10-411 0856 AM Alaska Court System 907_264-8291 5 r / / /,cV , Cc x,-,% ¢r I hereby cgrilly1hat q suryey of --- --- --- 113 �9 35 x:05 o► "` ov 7-14 v r1ZQ.Lt`7 C?•• Shea was made on and that the improvements situated thereon are within the property Ines and do not overlap or encroach on the property lying adjacent thereto , that no Improvements on property lying adjacent thereto encroach on the 3remises In question and that there are no roadways, transmission lines or other visible easements on said property except as Indicated hereon. It Is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. Under no circumstances should any data hereon be used for construction or for establishing boundary or fence [Ines. Dated at Anchorage, Alaska, this.L��.� day of tipLa/! CONSTRUCTING ENGINEERSAON. 9601 Buddy Warner Dr. Anchorage, Alaska 346.2000 tt&91i8 4 5- z U I IR t . sd'Alav, IL; L- A -t- 4 ,z—fr 4, i I M r+ � r•,~. �