Loading...
HomeMy WebLinkAboutTUXEDNI PARK BLK 1 LT 8Tuxedni Park lock I Lot 8 041-022 -10 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: OSP101156 PID Number: 041-022-10 Name: Merit Homes, Inc. Wastewater System: [] New [] Upgrade Address: P.O. Box 111982 Anchorage, AK 99511 ABSORPTION FIELD Phone: Number of Bedrooms: 334-9233 3 [~ Deep Trench [] Shallow Trench [] Bed [] Mound [] Other: LEGAL DESCRIPTION Soil Rating: Total Depth from odginal grade: 1.2 GPD/Ft2 8-8.5 Ft. Block: 1 Lot: 8 Subdivision: Depth to pipe bottom from odginal grade: Gravel depth beneath pipe: Tuxedni Park 4-4.5 Ft. 4 Ft, Township: Range: Section: Fill added above original grade: Gravel Length: 0-1 Ft. 40 Ft. Well: [] New [] Upgrade Gravelwidth: 5 Ft. iumberoflines:l Distance betweenlines:Ft. Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material: Private 61 Ft. 61 Ft, 400 Ft2 ASTM D3034 PVC Ddller: Date Drilled: Static Water Level: Installer: Date Installed: Alpine Drilling 10/4/10 48 Ft. Red Dog Excavating 10/12-13/2010 Yield: GPM PumpSetat: Ft. CasingHeightAboveGreund: 15 62 >2 Ft. TANK SEPARATION DISTANCES [] Septic [] Holding [] S.T.E.P. [] Other: T~To Septic Absorption Lift Holding ~ublic/Private Manufacturer: Capacity: Tank Field Station Tank Sewer Line Anchorage Tank 1,000 Gal. Material: Number of Compartments: wen >100' >100' N/A N/A >25' Steel Two (2) Surtacewater >100' >100' N/A N/A ~ / LIFT STATION I Size: Manufacturer: Lot Line >5' > 1 O' N/A N/A Gal. "Pump on" level at: "Pump off" level at: in. High water alarm at: Foundation >5' > 10' N/A N/A in, in, Curtain Drain None Noted Pump Make & Model Electrical Inspections performed by: Remarks: BENCH MARK Location and Description: Lower Level Floor Slab. Assumed Elevation: 100.0 Ft. Inspections performed by: A. Harala Dates: 1st 10/12/2010 __.~,~4,~,.~, o .... .f~,.t'o Development Services Department Approval,,.~~""~': 49 T_..H ,~ Conditional Approval Date: , '. MICHAEL E. ANDF~SON Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 Permit Number: OSP101158 Page 2 of 3 PID No. 041-022-10 PLAT NO. 67-103 TUXEDNI PARK SUBDIVISION LOT 8, BLOCK 1 60,121 S.F. S2 21.3' 32.1' C5 55.4' 74.1' M1 33.7' 41.3' TH1 / / C5 TH4 TH3 Three Bedroom Home Well '¢3.18' ~' PLAN AS-BUILT SCALE 1" = 50' \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 345-7904 On-Site Wastewater Disposal System or Well Inspection Report Permit Number: OSP101158 Page 3 of 3 PID No. 041-022-10 93.8 89.8 Finished Grade 98.3 97.2 Geotextile Fabdc Drainfleld Rock 40' (Trench Length) 81.2 / No Groundwater 98.3 93.8 PROFILE AS-BUILT No Scale Royal Interiors 9073349773 Alpine Drilling & Enterprises Well Log Permit Number: #S~NOSP701158 Date of Issue: 8-18-10 Parcel Identification Number: 041022~0000 Date Started: 'I0-4-~0 Date Completed: 10-4-~0 Is well located at approved permit location? x Yes [-~ No Legal Description: TuxedinJ Park BIR 1 Lt 8 G:2042 Property Owner Name & Address: Merit Homes LLC PO Box 1 '11982 Anchorage, Alaska 99671 Borehole Data: Depth (ft) Soil Type, Thickness & Water Strata From To Stick-up 0 2 Organics & silt 2 3 Gravelly sill 3 5 cobbly gravel 5 J2 silt ]2 14 grm, elly silt 14 57 water sand & gravel 57 61 Method of Drilling x air rotary [] cable tool Casing type: steel Wall Thickness: .250 inches Diameter: _6 incF, e~ Depth: 6_L~' feet Liner Type: Diameter: ~ inches Depth: ~ feet Casing stickup above ground: 2 feet Static water level (from ground level): 48 feet Pumping level:. 60 feet after 2_ hours pumping 1._~5 gpm Recovery Rate: 1._~5 gpm Method of Testing: air lift. Well Intake Opening Type: X Open End [] Open Hole [] Screened Start__ feet Stopped ~ [] Perforations Start ____ feet Stopped__ feet feet Grout Type: bentonite granules Depth: Start 0 feet Pump: Intake Depth _. feet Pump size __ hp Brand Name Volume: 1 bg Stoppezt ? feet Well Disinfected Upon Completion? x Yes [] No Comment~: Well Driller: 211pine Drilling & Enterprises PO Box 110496 Anchorage AK 9951 ! Mark Begich Mayor Development Services Deportment Building Safety Division On-Site Water & Wastewater Program 4700 Elmore 5tract P.O. Box 196650 Anchorage, AK 99519-6650 www.rnuni.orq/onsite (907) 343-7904 Pump Installation Log Well Drilling Permit Number: SW101158 Date of Issue: 11/15/10 Parcel Identification Number: 041-022-10 Replacement Only: YES NO Legal Description Lot &Block 1, Tuxedini Park IIProperty Owner Name & Address: IMerit Homes Pump Installation Date: 11/18/2010 Pump Intake Depth Below Top of Well Casing: 62' feet Pump Manufacturer's Name: Grundfos Pump Model: 15SQE07-150 Pump Size 3/4 hp Pitless Adapter Burial Depth: 13 feet Pitless Adapter Manufacturer's Name: Campbel Pitless Adapter Installer: Red Dog Well Disinfected Upon Completion? [] Yes [] No Method of Disinfection: Recirc Comments: Pump Installer Name: Aarow Puml~ & Well Service LLC PO Box I I0496,Anchorage, AK. 99511 (907) 346- 9355 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. On-Site Water & Wastewater System MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 OSP101158 O41O2210OO0 WellSeptic Permit Number: Tax Code Number: Work Type: Initial Permit Effective Dates: August 18, 2010 to Design Engineer: ANDERSON ENGINEERING Subdivision: TUXEDNI PARK August18,2011 Permit Site Legal Address: TUXEDNI PARK BLK 1 LT 8 G:2042 Owner/Address: MERIT HOMES LLC PO BOX 111982 ANCHORAGE AK 995111982 Site Mailing Address: 9555 Copper DR, Anchorage Lot Size in Sq Ft: 60121 Total Bedrooms: 3 This permit is for the construction of: Y Disposal Field Y SepticTank 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. Received By: ' ~' ~"~-' ~'~*'--'~'~'~'-~' Date: (~"~/~/-~"/¢ ~?. ./' /' ~.-' /,,,,. .., Issued By: ..... , Date: , ...... / ,,, ~ Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street Anchorage, Alaska 99519-6650 www. muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 041-022-.,,46"/~L~ Property owner(s) Merit Homes, Inc. Mailing address P.O. Box 111982 Anchorage, AK Site address Chenega Drive Anchorage, AK Day phone Zip Code 99511 Zip Code 99507 Legal description (Sub'd., Block & Lot) Lot 8, Block 1, Tuxedni Park Subdivision Legal description (Township, Range & Section) Lot Size 301,742 Sq. Ft. Number of Bedrooms Three (3) THIS APPLICATION IS FOR ([~ all that apply): Absorption Field [] Septic Tank [] Holding Tank [] Privy [] 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 13, 2010 Municipality of Anchorage Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 8, Block 1, Tuxedni Park Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 8, Block 1, Tuxedni Park Subdivision intends to construct a new three- bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new well and septic system to accommodate the home. The attached Site Plan and backup documentation identify the location and configuration of the proposed well and septic system along with the alternate site. Also identified on the plans are the existing wells and septic systems on surrounding lots. No conflicts exist between the proposed well and septic system and wells or septic systems on adjacent lots. 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 indicate clean poorly graded sand with some silt and gravel (SM/SP/GP). The percolation rate of the soil was determined to be 4.3 minutes per inch. No groundwater was found during the placement of the test holes and none was noted during the monitoring period. An application rate of 1.2 gallons per day per square foot was used in the design of the absorption system. We are proposing to place a new 1,000-gallon septic tank and a 40' long by 5' wide by 4' effective depth absorption trench to treat and dispose of the effluent generated in the house. The elevation of the distribution line in the absorption trench will be 4' below the surface and the total depth will be 8'. 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 septic system slopes to the northwest. The new trench will be constructed parallel with the contours of the slope as much as possible in conformance with Municipal requirements. The new septic system will be Lot 8, Block 1, Tuxedni Park Subdivision August 13, 2010 Page Two constructed a minimum of 100' from all wells and any surface water and 10' 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 2 WelFe \ 8 %%. '%% ? / ? / / / ExiB~Tn(:l Well'e \ \ \ ./ ./ ~elF~ / / / / / / / / / 3 2 AREA MAP ~CALE 1' = 100' PLAT NO. 67-105 TUXEDNI PARK SUBDIVISION LOT 8, BLOCK 1 60,121 S.F. TH2 ~ TH1 40' Long x 5' Wide x 4' Effective Absorption Trench \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \' \ Alternate Site '%/j 1,250 gallon /Tan k Zoz.,t Septic T~H5 Three Bedroom Home N_.k~,/ 0 T T ~ ~ I A k J ~ N~CHAEL E, ANgERSaN LOT 8, BLOCK 1, TUXEDNI PARK SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Three Bedroom Home 5' Wide Trench System Perc. Rate: 1-5 Min./Inch 1,000 Gallon Septic Tank Application Rate: 1.2 GPD/SF 4' Drainfield Rock 3 Bedrooms X 150 GPD/1.2 GPD/SF (Application Rate) = 375 SF Absorption Area 375 SF/5 SF/LF*.5 (Red. Factor) -- 37.5 LF Trench Length THEREFORE: Construct a 40' Long x 5' Wide x 4' Effective Depth Absorption Trench at the Location Shown. Flow Line Elevation in Trench to be 4' Below Original Ground Surface. Total Depth to be 8' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption Trench. Maintain 100' Separation from Wells in the Area. '6" 11 Natural Backfill Geotextile Fabric 4" Perforated PVC (Holes Down) Drainfield Rock TYPICAL 5' WIDE TRENCH SECTION (NO SCALE) -*?~b~'''~'' ......... NOTE: Grade Area Over Trench to Drain Away. ~ Minimum 6' Separation From Bedrock. ~ .......................... A,,,,,~ Minimum 4' Separation From Groundwater. ,~,~t~ MICHAEL E'ANDERS~:~I Minimum 100' Separation From Wells in the Area. ~ ........ ~'~~ Minimum 1 00' Separation From Su¢ace Water or Streams. - ~/~ NO. CE4381 MUnicipality of Anchorage ~ Development Services Department /7/~%~,~, Building Safety Division /,/ 41~[~ ~"~"~ '~.~ On-Site Water and Wast~a~ Prmram [.{~~ ~J~ ~700 Etm~e Road %~~ ~.¢~ncb~Re.ak,us ~ (907) Soils Log- PemoiMion T~t Pe~o~ F~ Merit Homes Date Re e~l ~s~iption: Tuxedni Park Lt 8, B 1 Township, Range, S~tion: 4- 5- 6- 7- 9- 10- 11- 12- 13- 14- 15- 17- 18- 19- 20- TH 3 · Slope '~te Plan / WAS GROUND WATER ~.1 ENCOUNTERED? S L IFYES, ATWHATDEPTH? X , O Depth to. Water After _~ _ p Monituring?, ~1~ E Reading Date Gross Time. Net Time Depth to Water Net Drop " " .E.COL^~ON ~TE ~5 TEST RUN BETWEEN COMMENTS The percolation cavit3t was presoaked on (minutes/inch) PERC HOLE DIAMETER PERFORMED BY: C_~RD~,NCE/~/~ ~"~ WI [ CERTIFY THAT THIS TEST WAS PERFORMED IN AC TH ALL STATE AND MUNICIPAL GUIBELINES IN EFFECT ON THIS DATE. DATE: Legal Descriptic~n: TH 4 MUnicipality, of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Bax 196650 Anchorage, AK 99507 ' ~.ci.anchora.qe.ak.u s (9O7) 343-79O4 Soils Log - Percolation Test Performed For:it Homes ' Date Parf~rmed:~]l~ Tuxedni Park Lt 8, B I TOWnship, Range, Section: 5- 6- 7- 17- 18- 19- 20- ..~ape WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Monitoring?, PERCOLATION RATE .~, ~'~ (minutes/inch) PERC HOLE DIAMETER COMMENTS The percolation cavitywas presoak"&'~-o~ ,.,! It/!'-;~- ,~:, Reading Date Gross Time, Net Time Depth to Water Net Drop .t PERFORMED BY: ~'¢ I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 8, BLOCK 1, TUXEDNI PARK SUBDIVISION GENERAL: The scope of this project includes the procurement and placement of a new 1,000-gallon septic tank at the location shown on the Site Plan. Work also includes the construction of a new 40' long X 5' wide X 4' effective depth absorption trench at the location also shown on the Site Plan. The distribution line in the trench will be placed at 4' below the existing ground surface. Total depth of the trench will be 8' below the existing ground surface.. The new absorption trench and septic tank must be placed a minimum of 100' from all private wells and any surface water in the area and 10' from the water service line proposed for 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 verify 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 Development Services Department Building Safety Division 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 1,000-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, Block 1, Tuxedni Park August 13, 2010 Page 2 of 3 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All 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 installed 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. The 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. 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 a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. Lot 8, Block 1, Tuxedni Park August 13, 2010 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, Fernco, 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 backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill 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. u56 7 8 9 10 • 1i • -" Municipality of Anchorage z o t _ On-Site Water and Wastewater Program a JUi . f SAF► • .. (907) 343-7904 Q �� SAFETY E T Y Certificate of On-Site Systems Approval 0/ 6 8 / 9 5 Parcel I.DL 1-022-10 Expiration Date: ©cci oer 9, a 01i 1. GENERAL INFORMATION Complete legal description Tuxedni Park, Block 1 , Lot 8 Location (site address) 9520 Chenega Drive Anchorage, AK Current Property owner(s) Steven Hunt & Deborah Gideon Day phone Mailing address P.O. Box 242503, Anchorage, AK 99524 Real Estate Agent Jaime Harvey Day phone 907-227-1059 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Q Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: L/ 1( j-1WA MAL( Date: l l COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ SZ( DO Waiver Fee $ Date of Payment 1131w & Date of Payment Receipt Number d Li 7q7/^ Receipt Number COSA# ©SCI 813)3 Waiver# 5. STATEM,E.NT 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 Forge Engineering Phone (907) 522-7773 Address PO Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 6/02/18 OFA��S11 /*'Agy49 TH /\ •.*t1/ 6. DSD SIGNATUREA,.4 L `^ J System#1 Approved for 3 bedrooms / '. Michael E.Anderson . ri Eps% 7 4381-E tE .'4' System #2 Approved for bedrooms Iie.•••, •` 'r Disapproved ili \������' Conditional approval for bedrooms, with the following stipulations: �. pE Mit;/-/0 Q_ - G<c` ONS\ Pro moo. `NPOGRki\ By: !�i�J�,(', C0iocJJ?. i fkkun el Original Certificate Date: J T The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet j .: c If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: Tuxedni Park, Block 1 , Lot 8 Parcel ID: 041-022-10 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 10/4/10 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 61 ft. Cased to 61 ft. Casing height (above ground) 24 in. FROM WELL LOG AT INSPECTION Date of test 10/4/10 6/23/18 Static water level 48 ft. 43 ft. Well production 15 gpm 5.4 g p m WATER SAMPLE RESULTS: ;Ir.' Coliform MO colonies/100 mL Nitrate /. c�� mg/L Arsenic ND ug/L Date of sample: 6/30/18 Collected by: Forge Engineering B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 10/12/10 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 5/14/18 Pumper A+ Home Services C. ABSORPTION FIELD DATA Date installed 10/13/10 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.2 GPD/SF System type Wide Trench Length 40 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth 8.5 ft. Eff. absorption area 400 ft2 Monitoring tube Y Depression over field N Date of adequacy test 6/23/18 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 8 in. Water added 610 gal. New depth 10 in. Elapsed Time: 1440 min. Final fluid depth 8 in. Absorption rate >= 450 g p d None Any rejuvenation treatment(past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on' level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot >100' On adjacent lots >100' Absorption field on lot >100' On adjacent lots >100' Public sewer main '75' Public sewer manhole/cleanout >100' Sewer/septic service line >25' Holding tank X75' Animal containment areas >50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: >5' Building foundation Property line >5 Absorption field 5 >10' >10' >100' Water main Water service line Surface water Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: >10' ' Property line Building foundation X10 Water main Water Service line 1�� Surface water 1��� Driveway, parking/vehicle storage 10' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and ..��F Ax‘v review of Municipal records that the above systems are in .'9s 1, conformance with MOA COSA guidelines in effect on this date. jCo.. �i• •.i$0 Michael E. Anderson, P.E. j*: 49 TH /\ 1ykr Engineer's Printed Name /-4;:t -4'•••,1.;_i,.ea.: Date 7/02/18 �� Michael E.Anderson r01'?`.. 4381-E ••`�% Rk F.PROFESSI0�A,+ COSA brown sheet 10-10-12.doc 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 Parcel I.D. 041-022-10 Expiration Date: GENERAL INFORMATION Complete legal description Lot 8, Block 1, Tuxedni Park Subdivision Location (site address) 9555 Copper;Drive Anchorag~e;:.;A'K:~:~ Current Property owner(s) Merit Hor~es, [.LC Mailing address P.O. Box 111982 Anchorage, AK 99511 Day phone 334-9233 Lending agency 'Day.phone Mailing address Real ES;tate Agent ',:, Mailing Address Unless othem,ise requ~s~d, COSA will be held by DS~)~'fo.r pickup. NUMBER OF BEDROOMS: Three (3)'~?:~¢~ . ' Day phone 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. 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. DSD SIGNATURE '~'"/' Approved for -~ bedrooms. Disapproved. Conditional approval for Phone 522-7773 Date 12/20/2010 ~[.' ~ '-.o~., 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 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot 8, Block 1, Tuxedni Park Subdivision A. WELL DATA Parcel ID: 041-022-10 Well type Pr~ate Date completed 10/4110 Total depth 61 ft. Date of test Static Water level Well production 15 WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL IfA, B, or C provide PWSID tt Sanitary seal (Y/N) Y Cased to 61 ft. FROM VVELL LOG 10/4/10 48 g.p.m. Nitrate 1.82 mg/L Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION Y Y >18 g.p.m. A. Harala' Collected by:. Arsenic: N/D ug/L date of sample: 12/8/10 B: SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1,0oo gal. Foundation cleanout (Y/N) Y Date of pumping 'New Const. C. ABSORPTION FIELD DATA Date installed 10/13/2010 Length 40 ft. Number of Compartments Two Depression over tank (Y/N) Pumper N/A Date installed 10/12/2010 Cleanouts (Y/N) Y N High water alarm (Y/N) N Soil rating (g.p.d./~ or ~/bdrm) l~ GPD/SF Width 5 ft. System type Shallow Trench Gravel below pipe. 4 ft. Total depth 8.5 ft. Eft. absorption area 400 ftz Monitoring tube Y Date of adequacy test New Const. Results (Pass/Fail) ~ Fluid depth,in absorption field before test in. Water added gal. Elapsed Time: min. Final fluid depth Any rejuvenation treatment (past 12 mo.) (Y/N & type) Depression over field N For bedrooms New depth in. in. Absorption rate >= g.p.d. If yes, give date. in. D, LIFT STATION Date installed Size in gallons "Pump on-" level at in. "Pump off" level at Datum Cycles tested SEPARATION DISTANCES 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 >100 Absorption field On lot > 100 Public sewer main N/A Sewer/septic service line >25' Animal containment areas >50' >100 On adjacent lots On adjacent I°ts > 100 Public sewer manh(~le/cleanout Holding tank N/A Manure/animal excrete storage areas N/A >100' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Absorption field Water main N/A Water service line >10' Surface water Wells on adjacent lots >100' >5' >100' G= SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line. >10' Building foundation > 10' Water Service line >10' Surface water >100' Curtain drain None Noted Wells on adjacent lots >100' COMMENTS 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 Pdnted Name 'Michael E. Anderson, P.E. Date 12/20/2010 COSA Fee $ Date of Payment Receipt Number (Rev. 4/10) Waiver Fee $ Date of Payment Receipt Number Water main N/A Driveway, parking/vehicle storage. >25' PLAT NO. 67-103 TUXI-:DNI PARK SUBDIVISION LOT 8, BLOCK 1 60,121 S.F. SEPTIC SYSTEM 1 "=40' BUILDING DETAIL SCALE: 1 "--20' AS- U I L T , HEREBY CERTIFY THAT I HAVE SURVEYED THE ......... PROPERTY DEPICTED ABOVE AND THAT NO GASTALDI LAND ENCROACHMENTS EXIST EXCEPT AS INDICATED. SURVEY I NG, LLC IT IS THE RESPONSIBILITY OF THE OWNER TO JEFF A. (~ASTALDI, R,L.S. DETERMINE THE EXISTENCE OF ANY EASEMENTS, 2000 E, DOWLING RD., SUITE 8 COVENANTS OR RESTRICTIONS WHICH DO NOT ANCHORAGE, ALASKA 99507 APPEAR ON THE RECORDED SUBDIVISION PLAT. PHONE 24~-545~ UNDER NO CIRCUMSTANCES SHOULD ANY DATA GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR 2042 12/16/2010 ESTABUSHING BOUNDARY OR FENCE UNES, .... ANCHORAGE RECORDIN(~ DISTRICT, ALASKA F.B, JOB NO. NOTE: NO CORNERS SET THIS DATE. 10-09 TPS81