Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutWARD LT 2Ward
Lot 2
#011-122-81
Inspection Report_t-1-12.dbc /
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
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP121020
PID Number: 011-122-81 0 New ❑ Upgrade
Name:
Dittrich Company LLC
ABSORPTION FIELD
❑ Deep Trench []Shallow Trench ❑Bed E] Mound
Address
2449 Brooke Drive Anchorage, AK 99517
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
632-8790
4
8 GPD/SF
12 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
4 Ft.
Gravel depth beneath pipe
8 0Ft.
Subdivision
Block Lot
Ward
2
Fill added above original grade
4-5 Ft,
Gravel length
50 Ft.
Township Range Section
Gravel width
3Ft.
Beds: Number of Lines
Distance between lines
I Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Lift Station
Tank
Line
800 Ftp
One
Ft.
Well
N/A
NIA
NIA
N/A
N/A
TANK El Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Anchorage Tank
Capacity
I 1,250G,I.
Surface Water
>100'
>100'
N/A
N/A
Material
Number of compartments
Lot Line
>5'
>10'
N/A
N/A
Steel
Two
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 House to tank D3034 Tankto D3034
drainfieltl
Glacier Masonry
Drainfield HDPE COJMr D3034
Inspector MEA
BENCH MARK (Assumed elevation) 100.0ft
Inspection 1" 5/6/12 ,� 5/7/12
Location and description
dates:
3" 5/9/12
2
a
Back Deck Northwest Corner.
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
111r%%tgp
11;10
ArSA— &.A4 9o�!
Conditional Approval:
Date
or oo,. r. ' ••'••�S'.�5�
49
•too
oil
-N,•----- - �.
• • ..1\.������
Al 4 • Q '
•MOMp
CE,43e1 U.2§.:
f 1 ft I
oo
1PF®��•::::i#`•�`'w
�1
Approved
/rC� Date `'�_?'L
'ROFESS1t1�A���
__�
Inspection Report_t-1-12.dbc /
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
Permit Number: OSP121020 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904
LEGEND
S1 —
Septic Vent
M1 —
Monitor .Tube
C5 —
Clean Out
TH —
Test Hole
FCO
— Foundation Clean
WARD SUBDIVISII
LOT 2
40,262 S.F. FENCE
' 49th
FEL E. ANDERSON
No. CE -4381
N 89'51'06"E 134.00'
0
M
PENNY ROSE CIRCLE
PLAN AS -BUILT
SCALE 1' = 40'
Page 2 of 3
PID No. 011-122-81
A I B
51 17.4' 45.7'
S2 23.3' 48.3'
C5 78.1' 70.8'
C6 752 98.4'
M1 1 74.2'1 72.7
Municipality of Anchorage
Page 3 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904
On-Site Wastewater Disposal System or Well Inspection Report
Permit Number: OSP121020
PID No. 011-122-81
97.4
U (n fn UU
Exislin Finished
Grountl Grountl
1,250 Gallon
Septic Tank
90.85 90.7
97.1
93.1
Fidms dGma
Original Gratle
Geotextile Fabric
89.2 Drainfeld Rock7771--
89.2
81.2
75.1
No Groundwater
2/28/05
50' (Trench Length)
:'.
.......49th. ......
PROFILE AS-BUILT
.� MICHAEL RSON; ~=
. , NO. CEA-4381
��
No Scale
"�... !,`,. `• •�
On -Site Wastewater Disposal System Permit
Permit Number: OSP121020
Tax Code Number: 01112281000
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
Work Type: Septic Initial
Permit Effective Dates: April 23, 2012 to April 23, 2013
Design Engineer: ANDERSON ENGINEERING
Subdivision: WARD
Site Legal Address: WARD LT 2 G:2222
Owner/Address: DITTRICH COMPANY LLC
2449 BROOKE DRIVE ANCHORAGE AK 995171252
Site Mailing Address: 7035 PENNY ROSE CIR, Anchorage Lot Size in Sq Ft: 40262
Total Bedrooms: 4
This permit is for the construction of:
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.
Receivf
Issued
MUNICIPALITY F ANCHORAGE
Community Development Department , Phone: 907-343-7904
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. 011-122-81
Property owner(s): The Dittrich Company Day phone: 632-8790
Mailing address: P.O. Box 90411 Anchorage, AK 99509
Site address: Penny Rose Circle Anchorage, AK
Legal description (Sub'd., Block & Lot): Ward Subdivision, Lot 2
Legal description (Township, Range & Section)
Lot Size: 40,262 Sq. Ft. Number of Bedrooms: Four (4)
THIS APPLICATION IS FOR:
THIS APPLICATION IS AN:
(® all that apply)
Absorption Field
X
Initial X
Septic Tank
X
Upgrade ❑
Holding Tank
❑
Renewal ❑
Privy
❑
Private Well
❑
Water Storage
❑
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.
or authorized agent)
Permit/Rush Fees: Jr - (0
Date of Payment:
Receipt Number: a lloa_
Permit No.
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
C:\Users\BenSAppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\DF3WQFBP\Permit Application Lot
2.docC:\Users\Ben\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\DF3WQFBP\Permit Application Lot
2.doc
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766(FAX)
February 20, 2012
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 2, Ward Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer
The owner of Lot 2, Ward 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
septic system to accommodate the home. The subdivision is served by the AWWU
water system. 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 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 tract in the area of the absorption trench and alternate site
indicated clean sand (SM/SP/SW) material with some silt. The percolation rate of the
soil was determined to be from 6 to 15 minute 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 a 47' 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 3.5' below the surface and the total depth will be 11.5'. 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 is nearly flat with a
slight bias to the north at a grade of 5%. 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 1 00'from all wells and any surface
Lot 2, Ward Subdivision
February 20, 2012
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:
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,
njami� . Schiller, P.E.
Attachments
we��---•alb
�
•�F OF A( st
P,.• 4 .4
; • 4 9 H -H
0
...........e
9� ,Benjin 1 Schiller;
1&% CE -12592 C
I
-----------cn
I
I
1
I
I
a
1
I
I
�
I
I
I
I
u.M Wei
2c-1
I
I
YI
N
IDl .E 4n1
I
I
I
I
m
I
o
Lot 9
o
c.
I
I
I
L
t.
10' Utility Esmt
—
I
-
T-
O
U)
T
I
=�
1
`I
1
IO
I
L
I
Mw
r�
y
10
cn Q/
IC
1
1Z7
I
I
I
1
I�
I
�I
YI
Hanks Subdivision
.a J
i
VACANT
o
IPENNY
- — - - - — ROSE
S89'51'10"W 329.76' o CIRCLE
10 249.69' "
1*
--------------- -
k
I• I �15' Gas Esmt
I
I i �
I
I
-----------cn
I
I
1
I
vi
e
a
o
I
_0
W WO
O
rn �,
C
N
IDl .E 4n1
I
I
I
Do
m
I
o
Lot 9
o
I
I
I
Lot 4
10' Utility Esmt
—
L------133.99'----
T-
O
---- - Drainage s\ \
e Esmt \ \-
o O Lot 7 \\
o w 42,134 \
W
� N sq.ft. `;\\
+ m VACANT sem\\\
10' T&E Esmt
--134.00'---- ------- 223.06 ------
Ratcliffie Subdivision
1 3
2
AREA PLAN
SCALE 1° = 100'
I I I
S0' 1 1
1 VACANT 1 1
U)
-----------cn
I
a
I
2c-:
I U
E Q
_ H83'S1'C6'E 118.x'
IDl .E 4n1
I
I
I
I
I
I Ise
I_
e.
Lot 4
�4Wi N.I. 1
I
I
O
U)
T
V)
I
-O
Vn
IO
VACANT
1., s
r�
y
cn Q/
Lot 6, I\
45,681 0,
sq.ft. b I�
N 1N
Ip
Izt
.` 49th /�V•
E. ANDERSON
F241' 244'
N 89'51'06"E 134.00'
10' Utility Easement
---------------------
�J
7
kf TH4
�o(
e S(e
47' long x 3' Dept
ec
de
x Efftive Depth TH3
Absorption Trench
c0
MT k
kj CO
cc
2i
v
C
C
r
i
i246.5 -
z
.n
mi in
avi
rv
x
x
Home
SLAB
5'
/ Jx
N
/ x O
V
N �
(/ N
I H A.C. DRIVE
N RQ'S1'1n"F 1za n'
249.4' o - -
17
PENNY ROSE CIRCLE
SITE PLAN
SCALE 1" = 40'
WARD SUBDIVISION
LOT 2
40,262 S.F.
LEGEND
SV —
Septic Vent
MT —
Monitor Tube
CO —
Clean Out
TH —
Test Hole
FCO
— Foundation Clean Out
z4z.3 �0. ....�....gGq!��i
a GJp'` Q
49th �...} �
1 -9 -'.MICHAEL E. ANDERSON i
•1 : No. CE -4367 I Al
LOT 2, WARD SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Four Bedroom Home Deep Trench System
Perc. Rate: 6-15 Min./Inch 1,250 Gallon Septic Tank
Application Rate: .8 GPD/SF B' Drainfield Rock
4 Bedrooms X 150 GPD/.8 GPD/SF (Application Rate) = 750 SF Absorption Area
750 SF/16 SF/LF = 46.88 LF Trench Length
THEREFORE: Construct a 47' Long x 3' Wide x 8' Effective Depth Aborption Trench at the
Location Shown. Flow Line Elevation in Trench to be 3.5' Below Original Ground Surface. Total Depth
to be 11.5' Below Existing Ground. Provide 3' of Cover Over Trench and 4' Over Tank or Provide
2" of Insulation and 2' of Cover. Maintain 10' Separation From Water Services in the Area.
Natural
Backfill
3'0"
Geotextile
Fabric
6'. 4" Perforated
PVC (Holes Down)
1.3104
3'
Drainfield Rock
TYPICAL DEEP TRENCH SECTION
(NO SCALE)
NOTE: Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock.
Minimum 4' Separation From Groundwater.
Minimum 100' Separation From Private Wells in the Area.
Minimum 100' Separation From Surface Water or Streams.
Minimum 10' Separation From Water Service Line.
MUNICIPALITY OF ANCHORAGE
mLOpt9ENT SERVICES DEPARTME$7MUIL9ING SAFETY DmSjON
-SITE WATER "ANN WASTEWATER PROGRAM
4740 SAVJTH $RAGAYB APaCHoRAGE, AK 99519
PROJECT #:
SOILS LOG -PERCOLATION TEST
PERFORMED FOR,
DATE PERFORMED, �Clb/45
LEGAL DESCiiipTIOIV: teF 2 Jot t+sPers Sobdlroi�ian
TEST HOLE # 3 SLOPS SITE PLAN
t�
1
A
3z 6
i
Qs
'
See Site Plan
LAI
y
J
9"�tl Sm
n,
Olive
r yv Sand with Sit
WAS GH ATcR
Y
ENCOUNTERED? &16
O
IF YES, WHAT DEM?
Sea Site Plan
DEPTH DF'WATER p
a ;
.:AFTER MONITORING: E
DATE: 2/28/2405
.5 .
e44
It READING DATE G NET DEPTH To NET
L
TIME :TIME WATER ORz7F
Start
` 2/18 1424 6.51
apsrls
L 1 14:5& 3D 9.32'
35
Rem rge 105:226{ 6t9.p32'
5i56 10
'~ R •0 I�llfa Stv
FERC RATE: , M#N./INCr PERC. HOLE DIAMETER.—.—
TEST RLW SETWEEN 4 -fl FT.S..— FT,
CDmt: n
Test Nate pre Soaked Prior to Percolai
''REST PERF IEA By,,
1, � -AND CERTIFY THAT Tms TEST WAS PES D lu ALiSA%CE
..&PITH ALL. STATE AND i LWICIPAL GUIDELINES. ON.Tms LATE: 2/28/2005.
MMICIPALITY OF ANC GE
DEVELOPMENT SERVICES DEFARTMFNT%BUlLDIrjG SAFETY DIVISION
ON-SITE MATER Atop WASTEWATER PRCGRA.M
4704 SOUT; BRAGAW ANCHORAGE'99519
PROJaC
SOILS LOG - PERCOLATION TEST
PE1C7RMED FOR,
DATE PEEP ED. _ 2Ff6P�5
LEGAL DESCRIPTIOM
1prt nns o s 5 IVI Ion
TESTHVp Sf
Lr � SLOPE IT PLAN
F1
C
ee
S See Site Ran
r r.
- Sand with Silt
ntl�; ,,
{ ..
WAS GROUNDWATER
�
'�
KCtSUMfERs�. - NO S
IF YM WHAT DEPT*d?
Sea Si7a Pints
E:
i1EPYtf €F WATER
I I
••
.�
Nene
AFTER YSo[+ItT{}idlR%;: E
`
DAM MV2885"
OF �mnRErilllN6 [SOT[ i CRUS$ AiEY i?EEPIH To
NIIL
, i TIME - TIME WATERTF¢R.....
Il
"�' "�.a ��
�`'4 �� Start 2t7? i &3:78 5.38'.
°.
ti4th r 7 73<2Q 10 7.87`
Rechnr
r a 73;23 5.38"
7�:��
� J}�
3 y��+`��
f1,47 •
sol$ 76
FERC RATE: MIrr.PleaCw PERC. HOLE DIAMETESt
'TEST RIX4 SETW!!FN A& R'!-. ANU S -G T,
UU� 22
L�+rM ��t�ws
t �d� ��I� T�� �v'��I,f�.� li{iiI•. �'� £��I,i���l€i�:.i�iJ. -.
TEST PERP -. Dr.
M 3, bnM&!.A_MMKM CERTIFY THAT TiffS TEST WAS FEWOFNED I'N AOWMANCE
tWIT4 ALL STATE AND FSUNICIPA(. GUIDELINES gra TIAs DATE:. 2/28/2005
pe pv:-)
„, ;e.
®;`f ' Municipality of Anchorage
On-Site Water and Wastewater Program R
(907)343-7904 5 A 1 t't'r
Certificate of On-Site Systems Approval
Parcel I.D. 011-122-81 Expiration Date: 10/24//
1. GENERAL INFORMATION
Complete legal description Ward L2
Location (site address) 7035 Penny Rose Circle
Current Property owner(s) Danielle Ryman Day phone
Mailing address 7035 Penny Rose Circle , Anchorage, AK 99502
Real Estate Agent Day phone
2. TYPE OF DWELLING:
Q Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ❑ Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community El
Public Water System Public Sewer ❑
WaiverNariance request for: Distance:
r � -
Received by: Date:
8/7//e
COSA to be released to the er,unless otherwise requested by the engineer.
COSA Fee $ 52 Waiver Fee $
Date of Payment t( 15i!A Date of Payment
Receipt Number (5 -11AC'') Receipt Number
COSA# AC IA 19 Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,based on procedures outlined
in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater
disposal system is(are)safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that
based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection,the on-site water supply
and/or wastewater disposal system Is(are)in compliance with all applicable Municipal and State codes,ordinances,and regulations in effect at
the time of installation.
In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA
guidelines and regulations.The reported results describe 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 soil
condition,ground water 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 this system. All systems eventually fail and satisfactory test results do not guarantee future
performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty
for future performance, nor can we estimate remaining life of the system.The content of this report is for the sole benefit of the owner listed
above.
Name of Firm Pannone Engineering Services LLC Phone (907) 745-8200
Address P.O. Box 1807 Palmer, AK 99645
Engineer's Printed Name Steven R Pannone Date /f &_
ilk
6. DSD SIGNATURE �#10'
•
X System #1 Approved for Lt bedrooms i'••Steven• •. annone• )09
CE-8149
System #2 Approved for bedrooms
Disapproved l\ PR4FESS1ctkl'\'+
Conditional approval for bedrooms, with the following stipulations:
ON-SITE
e"
WATERAND
WASTEWATER o
PROGRAM
c
4,, r4•
By: ija)v-7,1:71-z—z,„_-- Original Certificate Date: fl/7�S
The Municipality of AnchDevelopment 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` -
If more than 1 septic system is on the lot:
COSA Checklist# 1 of 1
Structure served by this system 1
Certificate of On-Site Systems Approval Checklist
Legal Description: Ward L2 Parcel ID:011-122-81
A. WELL DATA
Well type n/a If A, B, or C provide PWSID# Well Log(YIN)
Date completed Sanitary seal (Y/N) Wires properly protected (Y/N)
Total depth ft. Cased to ft. Casing height(above ground) in.
FROM WELL LOG AT INSPECTION
Date of test N/A N/A
Static water level ft. ft.
Well production g.p.m. g.p.m.
WATER SAMPLE RESULTS:
Coliform N/A colonies/100 mL Nitrate mg/L
Arsenic ug/L Date of sample: Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic / Steel Date installed 5/6/12
Tank size 1250 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/A
Date of pumping 10/29/18 Pumper A+ Home Services
C. ABSORPTION FIELD DATA
Date installed 5/6/12 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.8 System type Deep
Length 50 ft. Width 3 ft. Gravel below pipe 8 ft.
t6.2 'per P6 800 Y N
Total depthS. ft. Eff. absorption area ft2 Monitoring tube Depression over field
Date of adequacy test 10/26/18 Results(Pass/Fail) Pass For 4 bedrooms
Fluid depth in absorption field before test 79* in. Water added 600 gal. New depth 86 in.
Elapsed Time: 1440 min. Final fluid depth 79 in. Absorption rate >= 600 g p d
Anyrejuvenation treatment None Known
(past 12 mo.)(Y/N &type) If yes, give date
D. LIFT STATION
Date installed N/A Size in gallons Manhole/Access(YIN)
"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 N/A On adjacent lots
Absorption field on lot On adjacent lots
Public sewer main Public sewer manhole/cleanout
Sewer/septic service line Holding tank
Animal containment areas Manure/animal excrete storage areas
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation + Property line 10 + Absorption field 101+
Water main 25'+ Water service line 25'+ Surface water 100'+
Wells on adjacent lots 100 +
ABSORPTION FIELD ON LOT TO:
Property line + Building foundation 10+ Water main 10 +
Water Service line 25'+ Surface water 1 00�+ Driveway, parking/vehicle storage 101+
Curtain drain 50'+ Wells on adjacent lots 100 +
F. COMMENTS
As-Built on file
*System 83% used
G. ENGINEER'S CERTIFICATION 4•.�`0F. ��t'
I certify that I have determined through field inspections and ''�p'�P' �4, •.
� .7
review of Municipal records that the above systems are in ;• • i /r •• tf�
;lir:
conformance with MOA COSA guidelines in effect on this date. 47 .1.140W
Engineers Printed Name Steven Pannone
9� ��`0119,-..
•••Seven •..Pannone.
11/2/18 0 CE-8149
Date vii49 • ,te r
t, `\\t—�"'
COSA canary sheet_2-6-15.doc
Parcel I.D. 011-122-81
1. GENERAL INFORMATION
Complete legal description Lot 2, Ward Subdivision
Location (site address)
COSA # 6SC Q I'A Xo
Expiration Date: 5-- Cts - Z 1
7035 Penny Rose Circle Anchorage, AK 99502
Current Property owner(s) The Dittrich company
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
P.O. Box 90411 Anchorage, AK 99509
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: Four (4)
3. TYPE OF WATER SUPPLY:
Individual Well
Municipality of Anchorage
Individual Water Storage
Development Services Department
Community Class Well
Building Safety Division
Public Water System
On -Site Water and Wastewater Program
1
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99507
^
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 011-122-81
1. GENERAL INFORMATION
Complete legal description Lot 2, Ward Subdivision
Location (site address)
COSA # 6SC Q I'A Xo
Expiration Date: 5-- Cts - Z 1
7035 Penny Rose Circle Anchorage, AK 99502
Current Property owner(s) The Dittrich company
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
P.O. Box 90411 Anchorage, AK 99509
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: Four (4)
3. TYPE OF WATER SUPPLY:
Individual Well
❑
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑✓
Day phone 632-8732
Day phone
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-sife 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
_Approved for bedrooms.
Disapproved.
Phone 522-7773
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: oC ,e_ f Original Certificate Date: L -
(Rev. 11M)
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 2, ward subdivision Parcel ID: 011-122-81
A. WELL DATA
Well type Awwu If A, B, or C provide PWSID # _ Well Log (YIN)
Date completed _ Sanitary seal (YIN) _ Wires properly protected (YIN)
Total depth ft. Cased to ft. Casing height (above ground) in.
FROM WELL LOG AT INSPECTION
Date of test
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 5/5/2012
Tank size 1,250 gal. Number of Compartments TWO Cleanouts (YIN) Y
Foundation cleanout (YIN) Y Depression over tank (YIN) N High water alarm (YIN) N
Date of pumping New Construction Pumper
C. ABSORPTION FIELD DATA
Date installed 5/6-9112 Soil rating (g.p.d./ft2 or ftZ/bdrm).8 GPD/SF System type Deep Trench
Length 50 ft. Width 3 ft. Gravel below pipe 8 ft.
Total depth 15 ft. Eff. absorption area 800 ft' 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.PA.
Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date
D. LIFT STATION
Date installed
"Pump on" level at _ in.
Size in gallons
"Pump off" level at _ in.
Datum Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
Absorption field on lot
Public sewer main
Manhole/Access (YIN) _
High water alarm level at
Meets alarm & circuit requirements?
On adjacent lots
On adjacent lots
Public sewer manhole/cleanout
Sewer /septic service line Holding tank
Animal containment areas Manure/animal excrete storage areas
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'
Wells on adjacent lots >100'
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 >100'
F. COMMENTS: Property is Served by AWWU Water System.
G. ENGINEER'S CERTIFICATION
l certify that l have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name Michael E. Anderson, P.E.
Date 9/13/2012
COSA Fee $ is 5 +
Date of Payment O t 11111
Receipt Number b*q0%%
(Rev. 11105) ©L c t 311 (a-( _
a * ••• 491H
Waiver Fee $ _
Date of Payment
Receipt Number
rQ9 6-AND6t50fy0
�v
PROFESSt0Np
X,
1 `40'
FENCE (APX)
PLAT NO. 2006-13
WARD SUBDIVISION
LOT 2
40,262 S.F.
N 89°51'06"E 134.00'
10' T. & E. ESMT.
----------------------
I
I
x
I
� � t
a
O
O
r7 r
N
� SEPTIC SYSTEM _
M
O
O �
Z
f
•
43.9'
10.7
EXISTING BUILDING
CONC. WALK 1
CONC. WALK A.C. DRIVE
ro
/* CONC.
N 89'51'10"E 134.00'
O
r7
PENNY ROSE CIRCLE
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 DATE
2222 9/6/2012
F. B. JOB NO.
12-04 WARD2
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.
t •.�' OF ALAS'*
■AV C0 * 49 TH••••�,
■........................
r....................... ..■
0 , : Jeffery A. Gastaidio` ■
W 0- •. LS -6091 J Y����
• ��'O'�••... •.. "•�aS.I
p