HomeMy WebLinkAboutHYLEN CREST #3 BLK 4 LT 5Hyl n Crest
#3
B 1ock 4
Lot 5
#050- 474- 19
Inspection Report_1-1-12:doc//
Municipality of Anchorage
Community Development Department Page 1 of 3
On -Site Water and Wastewater Program
4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904
ONSITE WASTEWATER INSPECTION REPORT
Permit Number: OSP111129
PID Number: 050-474-19 ❑✓ New ❑ Upgrade
Name:
Spinell Homes, Inc.
ABSORPTION FIELD
21Deep Trench ❑Shallow Trench El Bed El Mound
Address
1900 W. Northern Lights Blvd. Anch., AK 99517
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
344-5678
5
8 GPD/SF
12 0 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
4.0 Ft.
Gravel depth beneath pipe
8-OFt.
Subdivision
- Block Lot
Hylen Crest No. 3
4 5
Fill added above original grade
1.5-2 Ft.
Gravel length
77.0 Ft.
Township Range Section
Gravel width
3.138.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Lift Station
Tank
Line
1,232 Ft2
1
Ft.
Well
N/A
N/A
N/A
N/A
N/A
TANK O Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Anchorage Tank
Capacity
I 1,500cal.
Surface water
>100'
>100'
N/A
N/A
Material
Number of compartments
Lot Line
>5'
>10'
N/A
N/A
Steel
Two (2)
NA
Foundation
>5'
>10'
N/A
N/A
LIFT STATION
Manufacturer
Capacity
Curtain Drain
None
Noted
Gal.
Remarks
Pump on level at
in.
Pump off level at
in.
High water alarm at
in.
Pump make and model
Electrical Inspections performed by
Installer
PIPE MATERIAL HousetotankD3031 Tank to D3031
drainfield
Pomraning Excavation
Drainfield F810 CO/MT D3031
Inspector A. Harala
BENCH MARK (Assumed elevation) 100.0n
InspectionLocation
1 8/9/11
8/10/11
and description
dates:
2'°
Garage Slab
3°'
4,h
COMMUNITY DEVELOPMENT DEPARTMEN TAPPROVAL
®.:FAST
C
Conditional Approval:
Date
®69.-
"# : 4Soo91li *��
.. . .. ..... .,
uMK....bM.NN .............�
a B ANDERSON
ICE t4381
Approved
Date -3
,�/F® PRaFFS5ltf�p� ms's
Inspection Report_1-1-12:doc//
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904
Permit Number: OSP111129
PLAT NO. 83-114
HYLEN CREST SUBD., UNIT NO. 3
LOT 5, BLOCK 4
20,024 S.F.
------------
STEWART DRIVE
0
n
15'T.&E. ESW. 10
o �
A.C. DRIVE
Five Bedroom Home
N
z
FCO
Cs _ THA s7
® s2
TH
LEGEND:
FCO - Foundation Clean Out
C3 - Clean Out
M1 - Monitor Tube
TH - Test Hole
�S't'
PLAN AS BUILT
SCALE 1' = 30'
:3
Page 2 of 3 I
PID NO.: 050-474-19
- MUTUAL RECIPROCAL
EASEMENT
(8K. 02657, PC. 355)
x MNW ML
B
.2'
1.5'.2'2.7'7.9'3.8'
*86'
STEWART DRIVE
0
n
15'T.&E. ESW. 10
o �
A.C. DRIVE
Five Bedroom Home
N
z
FCO
Cs _ THA s7
® s2
TH
LEGEND:
FCO - Foundation Clean Out
C3 - Clean Out
M1 - Monitor Tube
TH - Test Hole
�S't'
PLAN AS BUILT
SCALE 1' = 30'
:3
Page 2 of 3 I
PID NO.: 050-474-19
- MUTUAL RECIPROCAL
EASEMENT
(8K. 02657, PC. 355)
x MNW ML
Municipality of Anchorage Page 3 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
Permit Number: OSP111129
U) �93.7
y UU
1,500 Gallon
Septic Tank
PID No. 050-474-19
PROFILE AS -BUILT -
No Scale
DEPTH
(feet)
1-
2 -
3 -
4-
5 -
6 -
7 -
8 —
9 —
11
1
17
18
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: LOT 5, BLOCK 4, HYLEN CREST No. 3
PERFORMED FOR: SPiNELL HOMES. INC.
DATE: 8/8/11 PROJECT No.:
PARCEL ID*: TECHNICIAN: A. HARALA
TEST HOLE A
OB/OG
d
d"
SILTY SAND
WITH GRAVEL
d SM/SW
d
c
d
a -
d
a
d
a
a BOH @ 18.5'
SLOPE
N
0
WAS GROUND WATER ENCOUNTERED?
No
IF YES ®WHAT DEPTHS
�READINGJGROSS
S
DEPTH OF WATER AFTER MO
o
NET DROP
TEST HOLE PRESOAKED STING:
4/5
DATE OF M
9:14
4
MICHAEL E. ANDERSON
SITE PLAN
SEE SITE PLAN
ffi
x
i
NITORING: NONE O
ONITORING: P
E
I 2%
DATE
�READINGJGROSS
TIME
(MINUTES)
(MINUT(INCHES)
NET TT1.38
o
NET DROP
TEST HOLE PRESOAKED STING:
4/5
1
9:14
"
2
9:44
30"
2.50"
3
9:45
"
4
10:15
30
2.25"
5
10:16
6
10:46
30
3.63"
2.25"
PERCOLATION RATE: 13.3 (MIN/INCH) PERC. HOLE DIA.-6L(INCHES)
TEST RUN BETWEEN: 4.5 FT. and 5.5 FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. SOILS VERIFICATION SAME AS EAGLE RIVER ENGINEERING TEST HOLE.
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: 3/29/2012
On -Site Wastewater Disposal System Permit
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
Permit Number: OSP111129
Tax Code Number: 05047419000
Work Type: Septic Initial
Permit Effective Dates: July 08, 2011 to July 07, 2012
Design Engineer: ANDERSON ENGINEERING
Subdivision: HYLEN CREST #3
Site Legal Address: HYLEN CREST #3 BLK 4 LT 5 G:0057
Owner/Address: SPINELL HOMES INC
1900 W NORTHERN LTS BLVD #200 ANCHORAGE AK 995173342
Site Mailing Address: 10231 STEWART DR, Eagle River Lot Size in Sq Ft:
Total Bedrooms:
This permit is for the construction of:
20024
5
Y Disposal Field Y Septic Tank N Holding Tank N Privy N 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.
Special Provisions:
The Engineer needs to do an additional test hole prior to the construction of the septic field.
Construction may proceed at your own risk before the 7 day water monitoring is complete. Please
submit stamped and signed results with the As -built Inspection Report. If the results require a
design change, construction of the system will stop pending On -Site review and approval.
Received B_N„ i-M,1A(,1 �1 , . Date:
Issued By: I42ZDate: /
MUNICIPALITY OF ANCHORAGE
Community Development -p. ` • '1 •.
Development Services Division Fax: 907-343-7997
On -Site Water & Wastewater Program
Mayor Dan Sullivan
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I. D. 05) - `4 P4 -i
Property owner(s)6P r r C -'(,^L., 0-,o M C- ZG5 � . Day phone -Vy
Mailing address 11760 (,-'j . !��i'�.zi '2��
��t.
'Z..�G�
cA4
Site address 3 I 5`t`tr�.sALLa-
i2 ivr'.4(,i=
C57L
Legal description (Sub'd., Block & Lot) �4 "y L�-�1
r
l y2,:- ; _
Legal description (Township, Range & Section)
Lot Size C' i, 4 Sq. Ft. Number of Bedrooms F,
THIS APPLICATION IS FOR:
(® all that apply)
Absorption Field
Septic Tank
Holding Tank ❑
Privy ❑
Private Well ❑
Water Storage ❑
THIS APPLICATION IS AN:
Initial °i
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.
(Signature of property owner or authorized agent)
Permit/Rush Fees: 536
Date of Payment: 401 l
Receipt Number: ri ?j $& I
Permit No. d5 f 1 � 11 a 01
Waiver 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 25, 2011
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 5, Block 4, Hylen Crest Subdivision No. 3
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 5, Block 4, Hylen Crest Subdivision No. 3 intends to construct a new
five -bedroom home on the lot. We are therefore requesting a permit be issued for the
construction of a new septic system to accommodate the home. The lot and
surrounding subdivision is currently served by a public water system and no wells are
within 200' of the subject lot. The attached Site Plan and backup documentation identify
the location and configuration of the proposed septic system along with the alternate
site. Also identified on the plans are the existing septic systems on surrounding lots. No
conflicts exist between the proposed 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 hole placed on the lot in 2007 in the area of the absorption trench and
alternate site indicate well graded sand (SW) with some gravel. The percolation rate of
the soil was determined to be 12 minutes per inch. No groundwater was found during
the placement of the test hole 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 1,500 -gallon septic tank and a
new 60' long by 3' wide by 8' 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 12'. 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 south at
grades of 20% to 25%. The new trench will be constructed parallel with the contours of
the slope as much as possible in conformance with Municipal requirements. The new
Lot 5, Block 4, Hylen Crest Subdivision No. 3
June 25, 2011
Page Two
septic system will be constructed a minimum of 200' from all wells and 100' from any
surface water and 10' from the proposed and existing water services in the area.
If the system is constructed in accordance with our design the following statements
apply:
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
OF 44
! 49th.
A,. MICHAEL E. ANDERSON
��••.� NO. CE -4381
LOT 4
Public Water
b
Z
50'
LOT 15
Public Water
LEGEND:
FCO — Foundation Clean Out
CO — Clean OUt
MT — Monitor Tube
TH — Test Hole
NOTE:
No Slopes >25% Within 50' of
the Septic System. Ground
Surface Slopes to the
Southwest in the Area of the
Absorption Trenches. No
Surface Water Within 100' of
Septic System.
PLAT N0. 83-114
HYLEN CREST SUBD., UNIT NO. 3
LOT 5, BLOCK 4
20,024 S.F.
STEWART DRIVE
0
M
N 89'45'00"E 138.50'
15' T. & E. ESMT.
------------ ----- --- ----'
A,C, DRIVE
x
� 1
1 1
— 1 l
mcwt L J G.5�1, r
r— EL = 1
r
I
I
1 1- J
Hive Bedroom Home1
M
I
I
co
1
,vin
N
40
1,500 Gallon
z
Septic Tank
MUTUAL RECIPROCAL
EASEMENT
(BK. 02457, PG. 355)
LOT 6
R1 Public Water
60' Long x 3' Wide N/
x 8' Effective Depth 11
Absorption Trench +e
S
N�®TH
k
N�
Septic Area
Alternate Site
- X29.89• 1
LOT 16/
Public Water j �� �� OF �4
SITE PLAN
SCALE 1' = 30'
LOT 5, BLOCK 4, HYLEN CREST SUBDIVISION NO. 3
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Five Bedroom Home
Perc. Rate: 12 Min./Inch
Application Rate: .8 GPD/SF
Deep Trench System
1,500 Gallon Septic Tank
8' Drainfield Rock
5 Bedrooms X 150 GPD/.8 GPD/SF (Application Rate) = 937.5 SF Absorption Area
937.5 SF/16 SF/LF = 58.6 LF Trench Length
THEREFORE: Construct a 60' Long x 3' Wide x 8' Effective Depth Absorption Trench at the Location
Shown. Flow Line Elevation in Trench to be 4' Below Original Ground Surface. Total Depth to be
12' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption
Trench. Maintain 10' Separation from Water Services in the Area.
Natural
Backfill
3'6"
Geotextile
Fabric
6 + �U Perforated
PVC (Holes Down)
Drainfield Rock
3'
TYPICAL DEEP TRENCH SECTI% fj
NOTE
(NO SCALE)
Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock.
Minimum 4' Separation From Groundwater.
Minimum 10' Separation From Water Services in the Area.
Minimum 100' Separation From Surface Water or Streams.
EAGLE RIVER ENGINEERING,. P�� OF
10421 VFW RD, SUITE 201 y ��
EAGLE RIVER,99577
(907) 694-51955 FAX: (907) 694-3297
SOILS LOG - PERCOLATION TEST �'i .CHRISC0PH0387WOQD. I
PERFORMED FOR: CHRIS KASPER _ DATE PERFORMED 5f17 2007 #`i�Krr�r�����'+
LEGAL DESCRIPTION:_ HYLEN CREST#3 BLOCK4 LOT5 TOWNSHIP RANGE SECTION_ T14N, R1W SEC.8
TEST HOLE f/ 1 11- }
— In
(FEET)
COMMENTS:
WAS GROUND WATER
ENCOUNTERED? NO
SITE PLAN(NOT TO SCALE
STEWART DRIVE f
Jo' 3w
WATER TABLE DATA
TIME NET TIME DEPTH TO WATER1 4:37 0:00 5' 5 7/8
0
2-
=DATEGROSSSS
5:07
3—
3
°
�o
05/18/2007 NONE
3/8
05/24/2007 NONE
PERC TEST RESULTS
4-
5:08
0:00
5, 5
`. .
7/8
0
4
BROWN SW
g
010
SAND WITH GRAVEL
8
3185
SLIGHTLY SILTY
7
5:39
8
o .
o. . o'
5
y
9-
6
05/18/2007
0
0:10
5'
o ,
5116
10
10
°
12
d.._.
13-9
14
°
15
�. `...o
16
17
18
19
20-
021-"-
21---
22
22
COMMENTS:
WAS GROUND WATER
ENCOUNTERED? NO
SITE PLAN(NOT TO SCALE
STEWART DRIVE f
Jo' 3w
WATER TABLE DATA
TIME NET TIME DEPTH TO WATER1 4:37 0:00 5' 5 7/8
0
DATE WATER LEVEL
=DATEGROSSSS
5:07
05/17/2007 NONE
5'
05/18/2007 NONE
3/8
05/24/2007 NONE
PERC TEST RESULTS
READING
TIME NET TIME DEPTH TO WATER1 4:37 0:00 5' 5 7/8
0
2
=DATEGROSSSS
5:07
0:10
5'
8
3/8
2 1/2
3
5:08
0:00
5'
5
7/8
0
4
:3$
010
5'
8
3185
5:39
000
5'
5
7/8
0
6
05/18/2007
6:09
0:10
5'
8
5116
2 7/16
F'tKGOLA TION RATE= 12 (MINIINCH) PERC HOLE DW METER=6"
TEST RUN BETWEEN._5_Ej_AND-..._"6 FT
SOIL LO ED RIS ' PHER WOOD PERCOLATION TEST BY: CHARLES BALZARINI
I / CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE
AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: -5"2_ SZ`
Municipality of Anchorage
On -Site Water & Wastewater Program
(907) 343-7904
APR 7 1014
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I. D_ 050-474-19 Expiration Date: 3
r
1. GENERAL INFORMATION i RUSH!'l
t
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Real Estate Agent
HYLEN CREST #3; BLOCK 4, LOT 5
10231 STEWART DRIVE *EAGLE RIVER AK 99577
MIKE & SUSAN GIEDT Day phone
10231 STEWART DRIVE *EAGLE RIVER, AK 99577
2. TYPE OF DWELLING:
E Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 5
4, TYPE OF WATER SUPPLY:
Day phone
703-795-1138
TYPE OF WASTEWATER DISPOSAL:
Individual Well
❑
Individual Or -site
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
Public Sewer
❑
WaiverNariance request for:
Received by: y Ff Date:
COSA to be released to the engineer, unless onewise requested by the engineer
COSA Fee $ 52-rc, . o 10_U )
Date of Payment `1 �C tl 7
Receipt Number or?--
COSA #
ZCOSA# o5 C IZ4 1llr�-
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
Distance: —
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the
information obtained from the Municipality of Anchorage files and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E
Engineer's Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
6. DSD SIGNATURE
System #1 Approved for bedrooms.
System #2 Approved for bedrooms.
Disapproved.
Date
o
Conditional approval for bedrooms, with the following stipulations:
337—f61j79
oo60�p
i11
,
?rc f e s sio�_a
Original Certificate Date: 7- 8 —
The MudfepaliffIc4/Anrtfiyrage Develop,emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the represenatations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska.
The Municipality ofAnchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTCHMENTS:
COSA Checklist Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
,Rev isms
j
ON SITE
=�
WATER AND
�o
WIASTEWATER
Original Certificate Date: 7- 8 —
The MudfepaliffIc4/Anrtfiyrage Develop,emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the represenatations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska.
The Municipality ofAnchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTCHMENTS:
COSA Checklist Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
,Rev isms
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: HYLEN CREST #3• BLOCK 4 LOT 5 Parcel ID: 050-474-19
A. WELL DATA
Well type
Date completed
Total depth ft.
Date of test
Static water level
Well production
WATER SAMPLE
Coliform
PUBLIC WATER
If A, B, or C provide PWSID#
Sanitary seal (YIN)_
Cased to ft.
FROM WELL LOG
colonies/100 ml.
ug./L.
B. SEPTIC/HOLDING TANK DATA
Nitrate mg./L.
Date of sample:
Well Log (Y/N)
Wires properly protected (Y/N)
Casing height (abo round) in.
AT IN CTION
ft.
g.p.m.
Collected by:
Tank Type/Material
SEPTIC/STEEL
Date installed
8/9-10/11
Tank size 1500 gal.
Number of Compartments E
Cleanouts (Y/N)
YES
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (YIN) N/A
Date of pumping / Pumper
5
C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE
Date installed 8/9-10/11 Soil rating (g.p.d./ft2or � 0.8 System type TRENCH
Length 77 ft. Width 3 ft. Gravel below pipe 8 ft.
Total depth *1 0+ ft. Eff. absorption area 1232 112 Monitoring tube **YES Depression over field NO
Date of adequacy test 3/26/14 Results (Pass/Fail) PASS For 5 bedrooms
Fluid depth in absorption field before test 19 in. Water added9�6 gal. New depth 31 in.
i9•zs
Elapsed Time: 950 min. Final fluid depthlTin. Absorption rate >= 750+ g.p,d,
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date —
**MT'S DO NOT EXTEND TO BOTTOM OF TRENCH. ROUGHLY 18-24 INCHES TOO SHALLOW.
D. LIFT STATION
Date installed Size in gallons Manhole/Access
"Pump on" level at in. "Pump off" level at in. r a arm level at in.
tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot On adjacent
Absorption field on lot On adjacent lots
Public sewer main
Sewer /septic service line
areas
manhole/cleanout
Holding tank
Manurelanimal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 200'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water
10'+
Water service line 10'+ Surface water 100'+ Driveway, parking/vehide storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 200'+
F. COMMENTS
G. ENGINEER'S
I certify that 1 have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSH guidelines in effect on this
date.
Engineer's Printed Name JEFFREY A. GARNESS
Date
(Rev. 11/0.5)
IJSH! i
Parcel l.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
050-474-19
1. GENERAL INFORMATION
COSA # 050— Q t OR L3
Expiration Date: 3 — .3 0 _ / 3
Complete legal description Hylen Crest Subdivision No. 3, Block 4, Lot 5
Location (site address)
10231 Stewart Drive Eagle River, AK 99577
Current Property owner(s) Spinel] Homes, Inc.
Mailing address
Lending agency
Mailing address
Day phone 344-5678
1900 W. Northern Lights Blvd., Suite 200 Anchorage, AK 99517
Day phone
Real Estate Agent Day phone
Mailing Address
'k
Unless othenvise,requested, COSA will be held by DSD
for pickup.
2. NUMBER OF BEDROOMS:
Five (s)
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.
J
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 then er of bedrooms and type of structure indicated herein. I further verify that based on the information
nobtaihye f1 the Municipality of Anchorage files and from my investigation and inspection, the n -site water
sup pl'' or wastewater disposal system is(are) in compliance with all applicable Municipal and 'State codes,
4 ordinances, and regulations in effect at the time of installation.,.
Name of Firm Anderson Engineering Phone 522-7773
Address P.O. Box 240773 Anchorage, AK 99524 -
Engineer's Printed Name Michael E. Anderson, P.E.
5. DSD SIGNATURE
Approved for
Disapproved.
bedrooms.
Date 3/29/2012
AH. a MmacsoN ; ,�
CE!4381
J� ZR
.------
Conditional approval for bedrooms, with the following stipulations:
Attachments
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
By: Z ��
(Rev.1 W5)
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date: 3— 3 Q —12—
Municipality of Anchorage
•� Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99507
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: Lot 5, Block 4, Hylen Crest Subdivision, Addition No. 3 Parcel ID: 050-474-19
A. WELL DATA
Well type Public
Date completed
Total depth ft.
Date of test
If A, B, or C provide PWSID # 213289
Sanitary seal (Y/N)
Cased to ft.
FROM WELL LOG
Well Log (Y/N)
Wires properly protected (Y/N)
Casing height (above ground) in.
AT INSPECTION
Static water level ft. ft.
Well production g.p.m. g.p.m.
WATER SAMPLE RESULTS:
Coliform colonies/100 mL Nitrate mg/L Other bacteria colonies/100 mL
Arsenic: _ ug/I Date of sample: Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel Date installed 8/9111
Tank size 1,500 gal. Number of Compartments Two Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YIN) N
Date of pumping New construction Pumper
C. ABSORPTION FIELD DATA
Date installed 7/9-10/2012 Soil rating (g.p.d./ft2 or ft2/bdrm) .8 GPD/SF System type Deep Trench
Length 77 ft. Width 3 ft. Gravel below pipe 8 ft.
Total depth 13-14 ft. Eff. absorption area 1,232 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) N If yes, give date
D. LIFT STATION
Date installed
"Pump on" level at _ in.
Size in gallons
"Pump off' level at _ in.
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOTTO:
Manhole/Access (Y/N)
High water alarm level at in.
Meets alarm & circuit requirements?
Septic tank/lift station on lot N/A
On adjacent lots N/A
Absorption Feld on lot N/A
On adjacent lots NIA
Public sewer main N/A
Public sewer manhole/cleanout N/A
Sewer /septic service line NIA
Holding tank N/A
Animal containment areas None
Manure/animal excrete storage areas None
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >5' Property line >5'
Absorption field >5'
Water main >10' Water service line
>10' Surface water >100'
Wells on adjacent lots >200'
Engineer's Printed Name Michael E. Anderson, P.E.
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line >10' Building foundation
>10' Water main >19
Water Service line >10' Surface water >100' Driveway, parking/vehicle storage >25'
Curtain drain None Noted Wells on adjacent lots
>200'
F. COMMENTS: Property is Served by AW WU Water System.
COSA Fee $ (n �j—_ jjA We.).�ns�'a�K. 4 J" l Waiver Fee $ _
Date of Payment Jj,JO� 1, ( Date of Payment
Receipt Number 000 l u Receipt Number,
(Rev. 11/05)
J�Q>•. S
G. ENGINEER'S CERTIFICATION
,or(,� • y
Aw
�_49MI
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.
$'�• 0
Engineer's Printed Name Michael E. Anderson, P.E.
"' C8e4381 •S�
��♦�JS'�.�`
Date 3/29/2012
+' ���'�
!.NffSirs ito
COSA Fee $ (n �j—_ jjA We.).�ns�'a�K. 4 J" l Waiver Fee $ _
Date of Payment Jj,JO� 1, ( Date of Payment
Receipt Number 000 l u Receipt Number,
(Rev. 11/05)
PLAT NO. 83-114
HYLEN CREST SUBD.,
LOT 5, BLOCK
20,024 S.F.
STEWART DRIVE
0
N R9'45'nn" F 17;R Sn'
UNIT NO. 3
4
AS -BUILT
GASTALDI LAND
SURVEYING, LLC
JEFF A. GASTALDI, R.L.S.
2000 E. DOWLING RD., SUITE 8
ANCHORAGE, ALASKA 9950
PHONE 248-5454
GRID I DATE
NW0057 10/27/2011
JOB NO.
HC5354
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
PROPERTY DEPICTED ABOVE AND THAT NO
ENCROACHMENTS EXIST EXCEPT AS INDICATED.
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 LINES.
ANCHORAGE RECORDING DISTRICT. ALASKA
NOTE: NO CORNERS SET THIS DATE.
MUTUAL RECIPROCAL
EASEMENT
BK. 02457, PG. 355)
RETAINING WALL
1 "=20'