HomeMy WebLinkAboutNORTH SLOPE BLK 4 LT 11ANor'th
lop
lock 4
Lo1' 1 lA
050- 581
-23
Municipality of Anchorage
Development Services Department ~i'~ ~'
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: OSPl11078 PID Number: 050-581-23
Name:
Troy Davis Homes, Inc. Wastewater System: [] New [] Upgrade
Address:
165 E. Parks Highway Wasilla, AK 99654 ABSORPTION FIELD
Phone: Number of Bedrooms:
357-9394 4 [] Deep Trench I)I Shallow Trench [] Bed [] Mound [] Other:
Soil Rating: Total Depth from original grade:
LEGAL DESCRIPTION .6 GPD/Ft2 4.7-5.5 Ft.
Block: 4 Lot: 1 lA Subdivision: Depth to pipe bottom from odginal grade: Gravel depth beneath pipe:
North Slope 2.6-3.5 Ft. 2 Ft
Township: Range: Section: Fill added above odginal grade: Gravel Length:
.5-2 Ft. 106 Ft.
Well: [] New [] Upgrade Gr~ve~ width: Number of lines: I Distance between Ii ....
5-8 Ft. 2 >10 Ft
Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material:
Private 191 Ft. 190 Ft, 757 Ft2 ASTM D3034 PVC
Driller: Date Ddlled: StaticWater Level: Installer: Date Installed:
Sullivan Water Wells 6/13/2011 60 Ft, Pomraning Excavation 6/23-24/2011
Yield: GPM Pump Set at: Ft. Casing Height Above Ground:
20 2 Ft. TANK
SEPARATION DISTANCES [] Septic [] Holding [] S.T.E.P. [] Other:
T~ To Septic Absorption Lift Holding ~ublic/Private Manufacturer: Capacity:
~rom~
Tank Field Station Tank Sewer Line Anchorage Tank 1,250 Gal.
Material: Number of Compartments:
Well >100' >100' N/A N/A >25' Steel Two (2)
surface water >100' >100' N/A N/A % / LIFT STATION
Size: Manufacturer:
Lot Line >5' >10' 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,
Pump Make & Model Electrical Inspections performed by:
Cur[ain Drain None Noted
R .... ks: BENCH MARK
Location and Description:
Concrete Slab Lower Level.
Assumed Elevation:
100.0 Ft.
Inspections performed by: A. Harala Dates: 1st 6/23/2011
2nd 6/24/2011
~;~'..'
Development Services Department Approval
Conditional Approval Date:
Reviewed and approved by: /'.~ .... / ,)/:'~ /Z'/~
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904
On-Site Wastewater Disposal System or Well Inspection Report
Permit Number: OSP111078
F
/--108.2
=~1,250 Gallon
~J I SepticTank
5--' I ' 103.35
Page 3 of 3
PID No. 050-581-23
102.0
101.2
107.5
105.5
Finished Grade / /
Existing Grade --
Geotextile Fabric
Drainfield Rock
100.0--/
92.8 53' (Trench Length) I
Groundwater @ 93.5' "~
6/10/11
NORTH TRENCH
102.0
104.6
103.8
Finished Grade / /
Existing Grade
Geotextile Fabric
Drainfield Rock
99.1
92.8 53' (Trench Length)
Groundwater @ 93.5'
6/10/11
SOUTH TRENCH
PROFILE AS-BUILT
No Scale
101.2
Permit Number: 0SPl11078
~TH1
NORTH SLOPE
'~ LOT 1 la,
SUBDIVISION
BLOCK 4
50,851 S.F.
s4
Four Bedroom
Home
Sl 1~.6' B
34.1'
S2 I 20.2' 39.6'
FSV 39.2' 58.5'
C4 I 32.6' 48.1'
M1 I 78.8' 95.8'
M2 74.5' 100.1'
C5 79.1' 98.0'
C6 25.5' 55.8'
FCO
(~) THA
2-45' Long x 5' Wide
x 1' Effective Depth
Absorption Trenches
Existing
Well
Page 2 of 3
PID No. 050-581-2,'
NO CONFLICTS
THIS LOT
PLAN AS-BUILT
SCALE 1' = 40'
LEGEND
C5 - Cleon Out
M1 - Monitor Tube
FSV - Flow Splitter Volve
TH - Test Hole
FCO - Founcotion Cleon Out
Well Log
Permit Number: OSP 111078 Date of Issue S/2512011
Date Started: 611312011 Date Completed: 611312011
Property Description NORTH SLOPE Lot llA Block 4
Property Owner Name & Address:
Parcel Identification Number: 05058123000
Is well located at approved permit location?
Section: Town:
TROY DAVIS HOMES
165 E. PARKS HWY. #204B WASILLA, AK 99654
Borel~ole Data: Depth
Soil Type, Thickness & Water Strata From To
Casing Sfickup 0 2
Fill 2 4
Overburden 4 6
Silt Sand Gravel W/Cobbles 6 22
Hardpan WlBouldem 22 89
Silt Sand Gravel W/Clay 89 109
Hardpan W/Cobbles 109 186
Sand & Gravel 485 191
X~Yes
Range:
[~No
Method of Drilling ~] air rotary ~] cable tool
Casing type:
Wall thickness 0.es inches
Diameter 6 inches Total: 190 feet
Liner type:
Diameter inches Depth: feet
Casing stick-up above ground: 2 feet
Static Water Level(firom top of casing)
Pumping Level: feet after
1 hours pumping gpm
Recovery Rate 20 gpm
M~h0d of Testing: Air
6o feet
Well Intake Opening Type
Screened Start feet Stopped feet
Perforations Start feet Stopped
Grout Type: Be~ntonite dry granular Volume: 100 Pounds
Depth ~ Start o feet Stopped 44 feet
Pump Intake Depth: i~ct
Pump size: HP brand name
Well disinfected upon Completion? iX! ~-~ No
Method ofdisinfection CHLORINE 50 PPM
Comments:
172
Water Sample Results:
Amenic: ....... ug/l Well Driller:
Cole Sullivan
Nitrates , mg/I Sullivan Water Wells
Total C01ifiarm Bacteria co[onies/100mL P.O. Box 670272
............... Chugiak, AK 99567
Other bacteria: col/[ OOmL (907) 688-2759
Attention: The property owner shall provide this log to DSD (onsite) and DNR within 30 days of completion.
12/85/2811
23:34
9872438742
Pump lnstl
~p ML~ / hp
INC.
PAGE
82/82
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
MEMORANDUM
DATE:
December 19, 2011
TO: Jeff Poet
FROM:
Mike Anderson, P.E.
SUBJECT:
Lot 11A, Block 4, North Slope Subdivision
Septic System As Built/COSA
No bedrock was found at or near Lot 11A, Block 4, North Slope Subdivision. The well
log for this lot and the adjacent Lot 12 indicate the absence of bedrock to nearly 200'.
We are confident no bedrock or impermeable soil lenses are found within 6' of the
bottom of the absorption trenches.
Permit Number:
Tax Code Number:
Work Type:
On-Site Water & Wastewater System
OSPl11078
05058123000
WellSeptic
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
Initial
Permit Effective Dates: May 25, 2011 to May 24, 2012
Design Engineer: ANDERSON ENGINEERING
Subdivision: NORTH SLOPE
Site Legal Address: NORTH SLOPE BLK 4 LT 11A G:0703
Owner/Address: COX MARVIN DEAN
PO BOX 771287 EAGLE RIVER AK 995770000
Permit
Site Mailing Address: 30740 SAGWON AVE, Eagle River
Lot Size in Sq Ft: 50851
Total Bedrooms: 4
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.
MUNICIPALITY
Community Development Department
Development Services Division
On-Site Water & Wastewater Program
Mayor Dan Sullivan
OF ANCHORAGE
~ Phone: 907-343-7904
Fax: 907-343-7997
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. (~'-O- ~"'~l-
Property owner(s)/4./)~hlu~ ~T,~..,(_./' (.~ Day phone
Mailing address ,DO. ~o,< 7717--$7 ~ ~q'-_.,~-z.~_- ~_,'z-r2, ¢¢14'
Site address ~,¢.d-co.d
Legal description (Sub'd., Block 8, Lot) ./1)o.¢,-r~/ 5~r'~- S,,'~, ~b;c~:
Legal description (Township, Range & Section)
Lot Size ~O~ ~S'~ Sq. Ft. Number of Bedrooms
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 []
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
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.
(Sig~-~tu~e of proper~y owner or authorized agent)
Perrr~t/Rush Fees:
"D'~e of Payment:
Receipt Number:
Permit No. ~'~
V~ti~ar-Fees:
Date of Payment:
Receipt Number:
Waiver No.
G:\Building\On Site\Forms\Client Forms\Permit App_010411 .doc (Rev. 1/11 )
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677..7766 (FAX)
June 10,2011
Municipality of Anchorage
Development Services Department
On-Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject:
Lot 1 lA, Block 4, North Slope Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 11A, Block 4, North Slope Subdivision intends to construct a new
four-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 silty gravel with sand (GM). The percolation rate of the soil was determined to
be between 6 and 15 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 .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 septic tank and 2 -
53' long by 5' wide by 2' 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 3' below the surface and the total depth will be 5'. A minimum of 3' of fill
or 2" of insulation and 2' of fill will be placed over the absorption trench and 4' over the
septic tank.
The ground surface on the lot in the area of the absorption trench slopes to the
southwest at a grade approximating 10%. The new trench will be constructed parallel
with the slope as much as possible in conformance with Municipal requirements. The
new septic system will be constructed a minimum of 100' from all wells and any surface
Lot 11A, Block 4, North Slope Subdivision
June 10, 2011
Page Two
water and 10' from the proposed and existing water services in the area.
If the system is constructed in accordance with our design the following statements
apply:
]. The system, if constructed as designed, will have no adverse impact on the wells
in the area or those to be constructed in the future.
2. The system, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
3. The system, if constructed as designed, will have no adverse impact on reserve
space, either surface or subsurface, on any lots located in the area.
4. The system, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
Sincerely,
Michael E. Anderson, P.E.
Attachments
Z
o
ALTERNATE SITE
2-45' Long x 5' Wide
x 1' Effective Depth
~Absorption Trenches
®TH1
Existing
Well
NORTH SLOPE SUBDIVISION
~.. LOT 11A, BLOCK 4-
50,851 S.F.
s4e o v
~6 ~' ~
Proposed
® Well
Four Bedroom
Home
/
/
Gallon
)tic Tank
TH2
CO
2-55' Long x 5' Wide
x 2' Effective Depth
Absorption Trenches
NO CONFLICTS
THIS LOT
SITE
PLAN
SCALE 1' = 40'
LEGEND
CO - Clean Out
MT - Monitor Tube
FSV - Flow Splitter Valve
TH - Test Hole
LOT
11A,
E.~) cci
BLOCK 4, NORTH SLOPE SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Four Bedroom House 5' Wide Trench System
Perc. Rate: 6 to 15 Min./Inch 1,000 Gallon Septic Tank
Application Rate: .8 GPD/SF 2' Drainfield Rock
4 Bedrooms X 150 GPD/.8GPD/SF (Application Rate) = 750 SF Absorption Area
750SF/5 SF/LF*.7 (Red. Factor) = 105 LF Trench Length
THEREFORE: Construct 2 Absorption Trenches Each 53' Long x 5' Wide x 2' Effective Depth.
Flow Line Elevation in Trench to be 3' Below Original Ground Surface. Total Depth to be
5' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption Trench.
Provide Flow Splitter Valve to Assure Even Flow to Each Trench.
'6"
11
1011
Natural
Backfill
Geotextile
Fabric
4I' Perforated
PVC (Holes Down)
-- Drainfield Rock
TYPICAL 5' WIDE TRENCH SECTION
-- -- ~(~--~c~ .... ~;;,~%..o..~...~,~;,
NOTE: Grade Area Over Trench to Drain Away. ,".~ ."' ~,~'~.
M n m m ' ' - .-' 49th ~-~
u 6 Separabon From Bedrock. _-.....~ ............ .~ ............. ,~ ..... .~.,....~
Minimum 4' Separation From Groundwater. ~.~__ ~,.~,~./.
Minimum 200' Separation From Wells in the Area.
Minimum 100' Separation From Surface Water or Streams. . ~6~,/~-... No.
Minimum 10' Separation From Water Services in the Area ~'~'."-.~--"~_~,~
Minimum 10' Separation From Trench Sidewall to Trench ~idewall.'ee~,~l~'i~'(~'~_~.~
Performed For:
Legal Description:
COMMENTS
Municipality of Anchorage
Development'Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Road
P.O. Box 196650 Anchorage, AK 99507
www.~i,anch~raqe.ak.u$
, (907) 343-7904.
Soils Log -'Percolation Test
2011
Pomraning Excavation, LLC DatePerformed: 6 / 2 /
North Slope Sub&, L 1 lA, B 4
Slope
WAS GROUND WATER
ENCOUNTERED? No
IF YEs, AT WHAT DEPTH?
o
Depth to Water After ~. p.
MOnitoring? /('[ ~ E
Township, Range, Section:
,/
Reading Date · Gross Time Net Time Depth to Water Net Drop
6/6/2011 I~': ~f,~ ~' ~,~ ''~ /
/~:~1 / ~,~"
PERCOLATION RATE 12 (minutes/inch)
TEST RUN BETWEEN - 4.0 FT AND
the test cavity was presoaked pdor to testing-
PERC HOLE DIAMETER 7"
--4.5' FT
PERFORMED BY: A. Harala I CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
SOILS LOG - PERCOLATION TEST
TEST HOLE 1
OR ORGANICS
2--
3--
SILTY SAND/
4 -- SP/GP GRAVEL ~ W~ ~
W/ROCKS
7 BOH X
8-- TH
.1o -- TH-1 TH-2
WAS GROUND WATER SLOPE
14 -- ENCOUNTERED? Y
.15 -- iF YES, AT WHAT ;
~ TH
16 -- DEPTH? -6-' X
'17 -- DEPTH TO WATER AFTER
MONITORING? -5'-
18 DATE: 5/23/11
DATE PERFORMED: 05/06/11 READING DATE CLOCK WATER
TIME NET TIME LEVEL NET DROP
READING
I 5/6/11 9:48 5.85
I
2 9:58 10 MIN 10.36 4.51 I
3 9:58 5.85
4 10:08 10 MIN 10.30 4.45
5 10:08 I 5.85
6 10:18 I 10MIN
10.28
4.43
PEROLATION RATE 2.3 (rain/inch) PERC HOLE DIAMETER 6 inches
TEST RUN BETWEEN 2 FT AND 3 FT
COMMENTS: Test hole excavated by FLINTSTONE ENTERPRISES. Test hole was pre-soaked before perc test.
Test run for one hour. Last three readings shown.
PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST.
NOTES: PANNONE ENG SVC, LLC '"
FOR CONSTRUCTION P.0. B0X 102954 ANCHORAGE, AK 99.510
PHONE (907) 272-8218 FAX (907) 272-8211 Scale
NORTH SLOPE S/D, BLOCK 4, LOT 11A '~'~'~"$'t~:'P~Fn'¢~&'~ o5o-581-2~
MARVIN DEAN COX
SOILS LOG EAGLE RIVER, AK 99577 ~c'Yc')I~P/~0FESS~0~'ki~.~."¢""'~ Sheet
READING DATE CLOCK WATER
TIME NET TIME LEVEL NET DROP
READING
I 5/6/11 9:48 5.85
2 9:58 10 MIN 10.36 4.51
3 9:58 5.85
4 10:08 10 MIN 10.30 4.45
5 10:08 5.85
6 10:18 10 MIN 10.28 4.43
SOILS LOG - PERCOLATION TEST
TEST HOLE 2
SILTY SAND/
4 -- SP/GP GRAVEL
W/ROCKS
5~
:
~ 5/20/201
7--
X
8 TH
BOH
9~
10 --
11 --
~5 ~ IF YES, AT WHAT TH
16 ~ DEPTH? ---' X
17 ~ DEPTH TO WATER AFTER
MONITQRING? -6.5'-
~ 8 DATE: 5/20/11
CLOCK WATER
DATE PERFORMED: 05/06/11 R~DING DATE TIME NET TIME LEVEL NET DROP
READING
~ ~ 5/6/11 10:32 5.40
2 10:42 I 10 MIN 8.69 3.29
3 10:42 - 5.40
4 10:52 10 MIN 8.59 3.19
5 10:52 - 5.40
e 11:02 10 MIN 8.54 3.14
PERO~TION ~TE 3.2 (min/inch) PERC HOLE DIAMETER 6 inches
TEST RUN BE~EEN 2 FT AND 3 FT
COMMENTS: Test hole excavated by FLINTSTONE ENTERPRISES. Test hole was pre-soaked before perc test.
Test run for one hour. Last three readings sho~.
PERFORMED BY: Steven R. P~none, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST~
NOTES:9g.~}~[, D~te
FOR CONSTRUCTION P.0. BOX 102954 ANCHORAGE, AK 99510 ~&~l"' ~:~?~a 5/25/11
PH0iE (907) 272-8218 r~X (907) 272-8211 ~... ~..~ ~a sco~e
MARVIN DEAN COX ¢J~~E~ 8~9 ,:/~;~ PERMIT NO.
P.O. BOX 771287 ,~.. ..~ 0SP1~1078
-~--__~~ 4 OF 4
CLOCK WATER
READING DATE TIME NET TIME LEVEL NET DROP
READING
1 5/6/11 10:32 5.40
2 10:42 10 MIN 8.69 3.29
3 10:42 - 5.40
4 10:52 10 MIN 8.59 3.19
5 10:52 - 5.40
e 11:02 10 MIN 8.54 3.14
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.
1.
050-58~-23
COSA# C)-~P,~
Expiration 'Date:
GENERAL INFORMATION
Complete legal description Lot 11A, Block 4, North Slope Subdivision
Location (site address) 30740 Sagwon Avenue Eagle River, AK 99577
Current Property owner(s) Troy Davis Homes, Inc.
Mailing addreSs 165 E. Parks Highway Wasilla, AK 99654
Day phone 357-9394
Lending agency
Day phone
Mailing address
2.'.NUMBER,OF B~:DROOMS:
- 3. ,T~YPE OF'WA~TER SUPPLY:
Individual W~II
Individual Water Storage
comrnunity Class __ Well
Public Water System
Real Estate Agent
· ~;. ,~,il~rf~,,.Address
Unless othefwise~requested, COSA will be held by DSD for pickup.
"'~:i;
Four (4)
Day phone
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.
Disapproved.
Conditional approval for
bedrooms.
Phone 522-7773
bedrooms, with the following stipulations:
By:
Attachments:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
(Rev 11/05)
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
~'~¢T4-~Origina' certificate Date: /2-
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & 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 CHECKLIST
Lot 1 lA, Block 4, North Slope Subdivision
Legal Description:
A. WELL.DATA
Well type Private
Date completed 6/13/201
Total depth 191 ft.
If A, B, or C provide PWSID # ~
Sanitary sea! (Y/N) Y
Cased to 190 ff.
FROM WELL LOG
6/13/2011
60 ff.
20 g.p.m.
Parcel ID: 050-581-23
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mL
Arsenic: N/D mg/I
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel
Tank size 1,250 gal.
Foundation cleanout (Y/N) .Y .
Date of pumping New Construction
C. ABSORPTION FIELD DATA
Date installed 6123.24/11
Length 106 ft.
Total depth 5.7-7.5 ft.
Well Log (Y/N) Y
Wires properly protected (Y/N) ......
Casing height (above ground) >24.
AT INSPECTION
Nitrate .434 mg/L
Date of sample: 11/16/11
Collected by:
g.p.m.
A. Harala
Number of Compartments Two
Depression over tank (Y/N) __
Pumper
Date installed 6/23/2011
Cleanouts (Y/N) Y
High water alarm (Y/N)
Soil rating (g.p.d./ft2 or ft2/bdrm) .8 GPD/SF
Width 5-8 ft.
Eft. absorption area 757 ft2 Monitoring tube
System type 5' Wide Trench
Gravel below pipe 2
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
Elapsed Time: ~ min. Final fluid depth in. Absorption rate >=
Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date
in.
in,
g.p.d.
LIFT STATION
Date installed
"Pump on" level at
Datum
in.
E. SEPARATION DISTANCES
Size in gallons
"Pump off" level at
Cycles tested
in.
Manhole/Access (Y/N)
High water alarm level at
Meets alarm & circuit requirements?
in.
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot >100'
Absorption field on lot >100'
Public sewer main N/A
Sewer/septic service line >25'
Animal containment areas >50'
On adjacent lots >1oo'
On adjacent lots >1oo'
Public sewer manhole/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'
Water main N/A Water service line >10'
Wells on adjacent lots >lOC'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Absorption field . >5'
Surface water >100'
Property line >10' Building foundation >10'
Water Service line >10' Surface water >lOC'
Curtain drain None Noted Wells on adjacent lots >lOC'
COMMENTS:
Water main >10'
Driveway, parking/vehicle storage >25'
·
certify that I have determined through field inspections and ~ ~ . -e~ ~. ~ . ~ ~
rev,aw of Mun/c,pal mcords that the above systems are ,n ~ ~~~
~eeee ~e~e.~
confo~an~ with MOA COSA guidelines in effect on this date. ~ '~~
Engineer's Printed Name Michael E. Andemon. P.E. ~a~% ":' ~:~81 ..~
COSAFee $ (~
Receipt Number
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
SGS ReL# 1115631001
Client Name Anderson Engineering Printed Date/Time 11/23/2011 16:39
Project Name/# North SlopeS/D, Add#2, LI l, B4 Collected Date/Time 11/16/2011 13:45
Client Sample ID Private Well Water Laundry S Received Date/Time 11/16/2011 15:50
Matrix Drinking Water Technical Director Stephen C. Erie
Sample Remarks:
Allowable Prep Analysis
Parameter Results LOQ Units Method Container ID Limits Date Date Init
Metals by ICP/MS
Arsenic ND 5.00 ug/L EP200.8 C (<10) 11/16/11 11/23/11 NRB
Waters Department
Total Nitrate/Nitrite-N 0.434 0.100 mg/L SM20 4500NO3-F B (<10) 11/22/11 AYC
Microbiology Laboratory
Colony Count 0 col/100mL SM20 9222B A (<200) 11/16/11 DLC
Fecal Coliform 0 col/100mL SM20 9222B A (<1) 11/16/11 DLC
Total Coliform 0 col/100mL SM20 9222B A (<1) 11/16/11 DLC
10
~E~LL
o ORAiN
LOT I1A BLOCK 4 HAS
50,851 SQ.FT. OF AREA
-77.
EXISTING HOUSE
RETAINING W~
'CL£4NouT
-1.$' CANT
RETAINING WALL ~S~PziC~
~5 0 ~5 30 60 / ~
/
FOR:
TROY DAVIS HOMES
LanMark
Surveying, Inc.
9330 Vanguard Drive, Suite 131
Anchorage, Alaska 99507
(907) 562-6050
Date
10-11--11
Scale
1" = 30'
Grid As-Built
603 &703 2110170
Drawn by
CEF
Field Book
238
I hereby cerLify that the property described hereon has been surveyed
by me, or at my direction, and that the improvements situated thereon
are within the property lines and do not overlap or encroach on the
property lying adjacent thereto unless otherwise shown. That no
improvements on the property lying adjacent thereto encroach on the
premises in question and that there are no roadways, transmission
lines or other easements on said property except as shown.
It is the responsibility of the owner or builder, prior to construction,
to verify proposed building grade relative to finish grade and utility
connections and to determine the existence of any easements, covenants,
or restrictions which do not appear on the recorded subdivision plat.
Listed distances prevail over scaling.
Reproduction may cause distortion.
Legal Description
Lot 1 lA Block 4
NORTH SLOPE
SUBDIVISION
ADDITION NO. 2
CHARLES E~ FORBES : ~ ~
~'~',. 10-13-11 ,' 3 ~
