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HomeMy WebLinkAboutAIKENS LT 1Aikens Lot 1 #051-154-62 Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page 1 of 1 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP-121290 PID Number: 051-154-62-000 Dwelling:❑ Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: X New ❑ Upgrade Name: Kubitz, Cody ABSORPTION FIELD ❑ Deep Trench ❑R Shallow Trench ❑ Bed ❑ Mound Address 18124 Meadow Creek Dr., Eagle Rvr, Arl AK ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 907.746.2757 4 1.0 3.5 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3.0 Ft Gravel depth beneath pipe O 5 Ft Subdivision Block Lot Aikens Lot 1 Fill added above original grade 3.0 Ft. Gravel length 120 Township Range Section Ft. Gravel width 5 Ft. Beds: Number of 1 Lines Distance between lines na Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From I Tank Field Tank Line 600 Ft' 2 10 Ft. well 111 119 NA NA >25 TANK Septic ❑ S.T.E.P. EI Holding [I Other Manufacturer Anchorage Tank Capacity 1250 Gal. Surface NA NA NA NA Material Number of compartments Lot Line 70.5 41.1 NA NANA Steel 2 Foundation 1234.5 NA NA LIFT STATION Manufacturer Capacity Curtain Drain NA NA NA NA NA NA Gal. Remarks 2 -inches of rigid insulation extruded Pump on level at NA Pump off level at NA Highalarm at install over the entire septic system. in. in in. Pump makeand model NA Electrical Inspections performed by NA Installer PIPE MATERIAL House to tankQB$rrw:l tl a n kto PVC Fisher Bros. Exc. Drainfield PVC .3o3 CO/MT PV Inspector C. L P . BENCHMARK (Assumed elevation) 248.9 ft Ins ecti sn t= 10/15 J,2 ° 1 O/16(1, �t C, j. date3`° Location and description 2 10/21 Ja a'" 12/1 la Top of Foundation Wall MMUNITYDEV LOPM ARTMENTAPPROVAL Engineer's Stamp %S OF O F At 111 Conditional Approval: Date ?q• .•- Sf��, i*• 49T ... 00 40i 13 Z C • Charles A. ear =W ,�'�j.•• CE10480 Approved Date r=4o' S�P�E ❑F° A`q ��D� 49TH °° Charles A. Leet CE 10480 ?ROFESSI��?�d, RE)tORD DRAWING US Gov Lot 125 LOT 1 AIKENS TBM Elev. 248.9 Top Foundation H U) Double Clean Out LOT 2 AIKENS 0_ r U LU W U ALASKA RIM ENGINEERING, INC. 9131 E. FRONTAGE ROAD, SUITE 1 PALMER, AK 99645 PH: (907)745-0222 : FAX: (907)746-0222 EMAIL: akrim®alaskarim.com : WEB: www.claskarim.com W0: 12-00351 PAGE: 1 Conventional Single Family Residential LOT 1, ARENS, SUBDIVISION. 02012 SWING TIES DESCRIPTION BLDG CRNR A BLDG CRNR B BLDG CRNR C FDCO 26.8 22 STI 30 24.6 ST2 34 29.3 DBLCO1 41 36.6 DBLCO2 42.5 38 MTI 66 35.1 col 67.8 37.3 MT4 35.5 63 C04 37.8 62 MT2 77.6 52.0 CO2 79.3 54.6 MT3 53 73.3 CO3 51 70.3 WELL 92.3 71.5 0_ r U LU W U ALASKA RIM ENGINEERING, INC. 9131 E. FRONTAGE ROAD, SUITE 1 PALMER, AK 99645 PH: (907)745-0222 : FAX: (907)746-0222 EMAIL: akrim®alaskarim.com : WEB: www.claskarim.com W0: 12-00351 PAGE: 1 Conventional Single Family Residential LOT 1, ARENS, SUBDIVISION. 02012 soil absorption system see Design Sheet 4 ❑F °AC,q �aad o° 4TH 9d�o o° o o o'�.. .°p Charles A. Leet ;`�� r °•° CE 10480 `fid 00o A\ RECORD DRAWING capped vents dbl clean foundation foundation cleanout 246.2 4—inch Anchorage Tank steel septic tank Invert in 245.9 Invert out 245.7 Finish grade 250.5 0 SEPTIC SYSTEM PROFILE 2—INCHES OF RIGID INSULATION OVER ENTIRE SEPTIC SYSTEM ALASKA RIM ENGINEERING, INC. 9131 E. FRONTAGE ROAD, SUITE 1. PALMER, AK 99645 PH: (907)745-0222 : FAX: (907)746-0222 EMAIL: akrimQalaskarim.com : WEB: www.alaskarim.com ~ W0: 12-00351 ARE PAGE: ?a Englnae�s: Planner: suwarrs 1 SCALE: NTS Conventional Single Family Residential LOT 1, AIKENS, SUBDIVISION. @2012 geotextile 911 sewer rock RECORD DRAWING finish gi ori inal RIGID DtsuuTTOR earth cover pipe avert 246.9' DRAIN FIELD DETAIL RECORD DRAWING This record drawing represents the as—oovetruoted oonditim of tits lmprovemavts documentedaomio obevum end�obtendim dth e inrtenar, thin data appears reasonable and roprssenta that the project was eonstrueted in general conformance with current is AAC 72 regulattom end ADEC policies. °OE V49_ 9`�T �!_°°°°°H °°'�^^°°°�°°°°°°a°.°ao°° e°° °° Charles A. Leet o>� f CE 10480 QlIn PROFEHMID !P c" -meet aad un� hbed Se kerb gramdwdwnter 249 remavenble cap origin round DRAIN FIELD SECTION Groundwater separation distance 4—feet Elev. 244.8 — 240.1 Based on October measurements Total Depth of System Original grade to bottom of Rock 3.5 Elev 248.3 — 244.8 AS CONSTRUCTED 244.8 sewer coupn g �o$��� I � ��i a iCvtmervela tea In sneer rook MONITOR TUBE DETAIL ALASKA RIM ENGINEERING, INC. 9131 E. FRONTAGE ROAD, SUITE 1 PALMER, AK 99645 PH: (907)745-0222.: FAX: (907)746-0222 EMAIL: akrim@olaskarim.com : WEB: www.alaskarim.com W0: 12-00351 PAGE: 1 Conventional Single LOT 1, AIKENS, SUBDIVISION. _E: NTS I Family Residential DESIGN DATE Q.e42^Z-L—U l'j 02012 Oct 09 12 09:26a Wheaton Water Wells. Inc. 907376-2030 p.1 VV3WMA ZW"w VVIk `ER Vsi'ELLSt, INC_ PO Bos 871218, VVeL M91l AH 99687 40907> 376 -?.A41 SELL LOG'r Name: Hall Quality Homes Address: P.O. Box 1987 City: Palmer State: AIS Zip Code: 99645 Well Site: Aikens Lot: 1 Block: Additional: Nell Depth: 101 ft. From: To: Formation: Below Ground: 99 ft. 0 9 sand, gravel Above Ground: 2 ft. 9 78 silt, gravel 78 80 gravel, silt, water ial/Min: 15 80 82 silt itatic Level: 68 ft. 82 101 gravel, silt, water -asine: 6" ID Steel Pipe: none none none Depth: 29+ )evelop. Method: Air Jse of Well: Residential )rilling Method: Rotary Fluids Used: none 'ump Installed: none none WATER QUALITY TESTING Coliform O C01/110mL Nitrates 0.11 A mg/l Arsenic ND ug1L Pate Drilled: 10-2-2012 Driller: Ben Mattson Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Mark Begich Anchorage, AK 99507 Mayor www.muni.org/onsite (907)343-7904 Pump Installation Log Well Drilling Permit Number: SW OSP121290 Date of Issue• 9-27-12 Parcel Identification Number: 05115462000 Legal Description Property Owner Name & Address: Aikens Lot 1 Cody W. Kubifz 18124 Meadow Creek Drive Eagle River, AK 99577 11 Pump Installation Date: 11-28-12 Pump Intake Depth Below Top of Well Casing: 90 feet Pump Manufacturer's Name: Goulds Pump Model: 10SBO5412CL Pump Size 1/2 hp _ _ r- Pitless Adapter Burial Depth: 12 feet Pitless Adapter Manufacturer's Name: Campbell B10 Pitless Adapter Installer: unknown Well Disinfected Upon Completion? 0 Yes ❑ No Method of Disinfection: Chlorine recirculation Comments: Wheaton Water Well, Inc. (907)3762041 Pump Installer Name: Wheaton Water Well, Inc. - .1190(N. Wasilla-Fishhook Road Wasilla, AK 99654 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. C 01 ALASKA RIM ENGINEERING, INC. . ENGINEERS —PI ANNERS — SURVEV'ORS 4131 E.1matage RakA Patmer,AbOa 9964$. Telepbooe J"7) 743-0222 Fax 1907) 746.9222 .. off"eat. WWWAlaskarim.com.. RE: Lot 1 Aikens Subject: Change Order Request Dear Mr. Crewdson; On October 11, 2012, a site visit was conducted to collect elevation data for the footing and to monitor the groundwater. Benchmark During the original site investigation, the northeast property corner of the lot was selected to be the project benchmark. The project benchmark used, has an elevation of 251.5 feet, set by the project surveyor. The septic design for the project has based its elevations on this benchmark. Groundwater On October 11, 201;1 went to the site to measure.the depth of the groundwater, The using a typical steel retractable tape measure the groundwater depth was determined to be 4'- 4"(4.3') above the bottom of the 'test hole. The bottom of test holes elevation was previously determine during design to be 235.1 feet. Based on the bottom elevation of 235.1 the ground water on October 12, 2012 is 239.8 feet. This is slightly less than the 240.1 feet used in the design. On -Site Water & Wastewater 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: OSP121290 Tax Code Number: 05115462000 Work Type: WellSeptic Initial Permit Effective Dates: September 27, 2012 to September 27, 2013 Design Engineer: ALASKA RIM ENGINEERING Subdivision: AIKENS Site Legal Address: AIKENS LT 1 GA257 Owner/Address: KUBITZ CODY W 18124 MEADOW CREEK DR EAGLE RIVER AK 995778251 Site Mailing Address: 20032 SCENIC DR, Chugiak Lot Size in Sq Ft: Total Bedrooms: This permit is for the construction of: A 4) _/-/ 2- P.ov 1011411'a l:Gcv 45011 4 Y Disposal Field Y Septic Tank N Holding Tank N Privy Y Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorac Disposal Regulations (18AAC72) and 3. The wastewater code requires inspect Department at least 2 hours prior to e 4. From October 15 to April 15, a subsur A. Open and Close on the same day. B. Covered, sealed, and heated to pre 5 and 15.65 and the State of Alaska Wastewater AC80). (C engineer must notify the Development Services on by calling (907) 343-7904 (24 hours). :r construction during freezing weather must either: C o 1 nv �;.e.s 44 dm-,4,� e l kb,� o f a titi• I ; Received Z Issued By: A✓� Date: ?/z7// 2 Parcel I.D. Property Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw, St. P.O. Box 196650 Anchorage, AK 99519.6650 www.muni.orglonsite (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING 051-15482.000 Selway Corp., dba Hall Quality Homes 10-00;+21 CSM OS )° ID1-apt 0 Number SW phone (907) 746-2757 Mailing address (1) P.O. Box 1987 by?- Mailing yt Mailing address (2) Palmer, AK Zip Code 99645 Legal description (Lot, Block & Sub'd.) Lot 1, Aikens Subdivision Legal description (Section, Township & Range) Lot Size 45,011 sf Acres/Sq.Ft. Number of Bedrooms 4 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well 0 Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 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 Fees: S 2J O— Y a.00 Well Waiver Fees: _ Date of Payment: _©I "1 I a C.� Date of Payment: Receipt Number. GN Receipt Number: (Rev. 12100) ALASKA RIM ENGINEERING, INC. ENGINEERS—PLANNERS—SURVEYORS 9131 E. Frontage Road Palmer, Alaska 99645 Telephone (907) 745-0222 Fax (907) 746-0222 Online at: www.alaskarimxom August 27, 2012 Mr. James A. Crewdson, P.E. On -Site Services Program MOA Dept of Health & Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 RE: Lot 1, Aikens Subdivision Subject: Permit Request — Design Narrative Dear Mr. Crewdson: The owner of the above referenced lot is proposing a four-bedroom single family residence. We are requesting a plan review and a permit to install a well and septic system to serve the proposed development. Soils Two test holes were excavated and four percolation tests were performed by Alaska Rim Engineering, Inc. on August 20, 2012. The approximate location of the test holes is located on the attached site plan and is identified as TH #1 and TH #2. The soils were visually rate SW with cobbles. The percolation tests indicates the perk was faster than one minute per inch. Based on the perk results the use of an application rate of 1.2 gal/day/sft was selected. This is consistent with other work on the Lot 2 Aikens. On August 27, 2012, the monitoring tubes were checked, groundwater was observed in both monitoring tube. Topography The area around the septic field is basically flat with drainage to the southwest. Drain Field Design The dwelling proposed is a four-bedroom, with an estimated daily wastewater flow rate of 600 gallons per day. The wastewater application rate from the perk test is 1.2 gal/day/sft. The required absorption area is 500 square feet. Proposed is a wide drain field (five wide) with 24 -inches of gravel and a length of 100 feet. The reduction factor for a wide drain field with 24 -inches below the pipe is 0.7, therefore the constructed length drain field will be 70 feet. Enclosed are drawings of the proposed system. ALASKA RIM ENGINEERING, INC Lot 1 Aikens Subdivision Charles A. Leet Surrounding Properties There are no water wells within 100 feet of the proposed septic system. This property and its neighboring lots are on private wells. Surface Waters There is no surface water within 100 feet of the proposed upgrades. We do not anticipate any adverse effects on the neighboring, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. This subdivision is server by a community water system. Should you have any questions or comments please do not hesitate to contact me by telephone or email chuck@alaskarim.com. Sincerely, '%""t NI-pF At A ska Rim Engineering, Inc. I y• 49TH • F � • a les A. Leet, P.E.rles A. m : �•z�1ze Project Engineer ��i s •. ChaCE 0400teet Encl: Permit Application 111,11 SAO, Permit fees Soil Logs(2) — Percolation Tests (4) Site Plan (3) Cc: Client AK Rim File # 12-00351 ALASKA RIM ENGINEERING, INC Engineers... Planners... Surveyors LOT 2 CH25ex LOT 1 On Mw v T L N 656 5M 515 Z =W Is Po ut 126 WTI ANtIIIs 6� IF LOT z MIMIT M b� 1'=too' NOTES: 1. ALL CONSTRUCTION OF THE ON-SITE WASTEWATER DISPOSAL SYSTEM SHALL BE IN ACCORDANCE WITH THE REQUIREMENTS AND SPECIFICATIONS OF AMC 15.65. 2. ALL COMPONENTS, PARTS, AND MATERIALS SHALL BE IN ACCORDANCE WITH MDA STANDARDS AND SPECIFICATIONS. 3. THE DWELLING LOCATION AND FINISHED FLOOR ELEVATION ARE PROPOSED. -z -� OF o 49TH? A..,,,..,,, e,,,,,,»,>. Charles A. Leet n�PFn a*..104801. S 0 ALASKA RIM ENGINEERING, INC. 9131 E. FRONTAGE ROAD, SUITE 1 PALMER, AK 99645 PH: (907)745-0222 : FAX: (907)746-0222 EMAIL: akrim@alaskarim.com : WEB: www.claskarim.com W0: 12-00351 PAGE: 1 Engirwirs: Planners: Surveyors Conventional Single Family Residential LOT 1, AIKENS, SUBDIVISION. 02012 89D 57M 51S E 300.00 CLEANOUT (TYP; Pgg PTQA TH t r=4o• .6-1% 5 US Gov Lot 125 & I y4ERTl DOUBLE CLEAN OUT 89D 57M 51S W 299.99 OF colo [TH Charles A. Leet 10480 /?***' *' ` ��Vtiq�c LOT 1 AIKENS M7 0 STEEL 6-1% LOT 2 AIKENS Of 0 U z w U (n ALASKA RIM ENGINEERING, INC. 9131 E. FRONTAGE ROAD, SUITE 1 PALMER, AK 99645 PH: (907)745-0222 : FAX: (907)746-0222 EMAIL: akrim@alaskarim.com : WEB: www.aloskarim.com W0: 12-00351 PAGE: 2 Conventional Single Family Residential LOT 1, AIKENS, SUBDIVISION. 02012 soil absorption system see Design Sheet 4 OF A�q ��dt 49T HOe 4 ° ,sa, °.°..°°°°°°°°°°°°°° Charles A'Leet e`er CE 10480 b PROFESSI��P�cp" , capped vents dbl clean out . foundation cleanout Il 10' 2' 4—inch F & I 1250 Gallon Greer Steel septic tank Invert in 246.3 Invert out 246.2 Bottom of tank 241.56 Finish grade 250.5 SEPTIC SYSTEM PROFILE ALASKA RIM ENGINEERING, INC. 9131 E. FRONTAGE ROAD, SUITE 1 PALMER, AK 99645 PH: (907)745-0222 : FAX: (907)746-0222 EMAIL: okrim@alaskarim.com : WEB: www.alaskarim.com W0: 12-00351 Conventional Single Family Residential LOT 1, AIKENS, SUBDIVISION. 02012 Cod install monitor tube N at eaoh and of dreinfleld perforated PVC see Note I 1 -toot mss. ..�f.,s.a. sewer rock install clean out at each and of draivfisld /// /// O qq�,,o D00 �0 o�oO� 0pd` o� \ 000 000 Oa X Oo \ 5' v�0�0 0 00�000� O .opao X �osn��000 Vv ohY \ _-G, —0 60' DRAIN FIELD perforated PVC PLAN VIEW hO(holes �d town) SECTION X—X finish grade ELEV. > 250 and EIEV. 248.2 - 2 removeable cap permeable earth $ A07riginel ground geotertIle cover ig pipe invert Iop of rock 248.1 non -perforated w o �0� sewer _i;oa,_,I;sij fiction, of ro f PVC above sewer rock 0 i m - 4" PVC drain pipe, w/ holes down _ _ _18ter eavd_ u 9 9 a CAL T T o� 000 X00 ��o0`�c undisturbed 0 v psewer rook,(` 0 earth �0o 0o�c 0 �o seasonal high ELEV. 240.1 f�ri/f'd groundwater m 0 can 00o�1oCb off, o O�o0 ���Ooo pltog lz� im ermeable in r �0 4" PVC perforated 0�� 0 e 8" intervals in sewer rook DRAIN FIELD DETAIL BED SECTION MONITOR TUBE Groundwater separation DETAIL distance B -feat Elev. 245.1 - MA Total Depth of System Original grade to bottom of Rook 3.2 Elev 248.9 - 248.1 ��oDDDDp� ALASKA RIM ENGINEERING, INC. ❑E 9131 E. FRONTAGE ROAD, SUITE 1 PALMER, AK 99645 S, /,9D� PH: (907)745-0222: FAX: (907)746-0222 a 49TH EMAIL: akrim@alaskarim.com WEB: www.alaskarim.com W0: 12-00351 (A;+E _T PAGE: 4 EnSCALE: NTS Charles A. Leet o>�d girNrer: Planners: Surveyor CE 10480 Conventional Single Family Residential Q�FPF� °°°°°,° ° QQ j/�'ROFHS1ISAdcz7 LOT 1, AIKENS, SUBDIVISION. �� VOODOO s (n(� DESIGN DATE 0201 21 og ! !, - |�i� � . :§•: }�\ IN a a � I�B � ` I| )zo ) � / k e # I ! i � . :§•: }�\ IN ) � / k e # I ! i � 2 � @ )zo ■ 2° 2 7§ A 2 ) � / k e # I ! i � I Municipality of Anchorage Development Services Department Building Safety Division �. On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Soils Log - Percolation Test (1) Performed For: Hall Quality Home D Legal Description: Lot 1 Aikens Subdivision O 1 11. 12- 13- 14- 15- 16- 17- 18- 19- 20- Depth Township, Range, Section: nan ©0PEA - IN,o S z I S6�' I o%EIIB,tt`` `E7 '� SaL , CoZobie� g N �. •: ��- Csw� �it�G�e� a WAS GROUND WATER Y ENCOUNTERED? L V T s IF YES, AT WHAT DEPTH? l L �Depth to Water After e_�V_�p—z1-Z6I Za I , E Y, .fs- t_ `'1 /9s /2v r2 R.. 1 PERCOLATION RATE C-pT-.L (minutegino) PERC HOLE DIAMETER �`— TEST RUN BETWEEN FT AND GFT COMMENTS Wa_ryI (zt, Ireo .aw --I25 o Ffz/Be . PERFORMED BY: Chanes A. Leet i Charles A. Leet, P.E XV,;` CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: August 28, 2012 Municipality of Anchorage Development Services Department Building Safety Division yr Onsite Waterand Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907) 343-7904 Soils Log - Percolation Test (?- .%'?OFESS%0" Performed For: Hall Quality Home Date Performed: August 21, 2012 Legal Description: Lot 1 Aikens Subdivision Township, Range, Section: Slope Site Plan Depth 2 3- 4- _ 6- 7- 8- 9- 12-, 13- 14- 15- 16- 17- 18- 6-7-8-g-12- 13- 14- 15- 16- 17- 18- COMMENTS COMMENTS 0 WAS GROUND WATER ENCOUNTERED? t��J S 5 i\ ��Gra ko- IF VES, AT WHAT DEPTH? 4— 0 L �l "`ill Depth W Water AfteO P Monitoring? r E V 91 1 Z S /za —z- V.. z_ PERCOLATION RATE (minuteMach) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT PERFORMED BY: Charles A. Leet I Charles A. Leet, P.E. CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: August 28, 2012 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.ci.anchorage.a k. us (907) 343-7904 ptE p FL46S #0 C12rH Soils Log - Percolation Test_—tr3 ��`"rF•. {� j �I� l.Tsfo Performed For: (1,1 \ QtX� I i`�( 4r_v Ae� Date Performed: Legal Description: Lc, -r L F� FE 5 Township, Range, Section: 2- 11 1 1F2 WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT DEPTH? L Depth to Water After o P Monitoring? e Date: Charles A. Leet CE10490 �A Site Plan PERCOLATION RATE i Inp (minuteaa c) PERC HOLE DIAMETER TEST RUN BETWEEN (,-,V FT AND FT PERFORMED BY: 01&Aes N. Le�� I AL1, (j p6 !-1"'L A CERTIFY THAT THIS TEST/ WA J1 PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Gam` Ll �j(L Performed For. Legal Description: 11 12- 13 - 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.ci.anchoraae.ak. us (907) 343-7904 II II J� Soils '` Log - Percolation Test Q1l ()ttG^l� 1a1 U6ro eS Date Township, Range, Section: Site Plan WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water After Monitoring? Date: PERCOLATION RATE (mir�uteelmh) PERC HOLE DIAMETER TEST RUN BETWEEN I S FT AND �FT PERFORMED BY: 0 i'A nwlw5 !-) � ��- I PERFORMED IN ACCO ANCE WITH ALL STATE AND MUNICIPAL 5 �-Y • L,t3tX CERTIFY THAT THIS TEST WA IN EFFECT ON THIS DATE. DATE: Z f lZO/L • Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval Parcel I.D. W-1 54-62000 1. GENERAL INFORMATION Complete legal description Aikens, Lot 1 Location (site address) 20032 Scenic Dr. Chugiak Expiration Date: Current Property owner(s) Cody KUbitZ Day phone Mailing address 18124 Meadow Creek Dr., Eagle River, Anchorage, AK 99577-8251 Real Estate Agent 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone OK ctyenf i- �Lk 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ,® Individual 9 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for:. COSA to be engineer, unless otherwise requested by the engineer. COSA Fee $ 65 yew it-sbF g Date of Payment 3L/,p 19 Receipt Number a�s3 COSA #— psC-13)05y Waiver Fee $ Date of Payment Receipt Number 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 an"We codes, ordinances, and regulations in effect at the time of installation. Name of Firm Alaska Rim Engineering, Inc. Phone 907.745.0222 Address 9131 E. Frontage Rd. Palmer AK 99645 Engineers Printed Name Charles A. Leet 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Date 2/22/2013 Conditional approval for bedrooms, with the following By: Original Certificate Date: Z 28 l3 The Municipality of Anchorage evelopmenl 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 engineers work. 7. ATTACHMENTS:�- COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSANNesheet( 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: Aikens, Lot 1 Parcel ID: 05115462000 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 10/2/12 Sanitary seal (Y/N) Y Total depth 101 ft Cased to 101 ft FROM WELL LOG Date of test 10/2/2012 Static water level 68 Well production 15 WATER SAMPLE RESULTS ft. Coliform ABSENT colonies/100 mL Nitrate 0.112 mg/L Arsenic ND ug/L Date of sample: 2/12/2013 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1250 gal. Number of Compartments 2 Foundation cleanout (Y/N) y Date of pumping New C. ABSORPTION FIELD DATA Date installed 10/16/12 Depression over tank (Y/N) no Pumper NA Soil rating (g.p.d./ftz or ftz/bdrm) 1_0 Well Log (Y/N) y Wires properly protected (Y/N) Y Casing height (above ground) 24 in. AT INSPECTION ft. g.p.m. Collected by: C. Leet bate installed 10/15-21/2012 Cleanouts(Y/N) High water alarm (Y/N) NA System type Shallow Trench Length 2-60 ft. Width 5 ft. Gravel below pipe .5 ft. Total depth 3.5 ft. Eff. absorption area 600 ft2 Monitoring tube yeS Depression over field no Date of adequacy test NA Results (Pass/Fail) NA For NA bedrooms Fluid depth in absorption field before test NA in. Water added NA gal. New depth NA in. Elapsed Time: NA min. Final fluid depth NA in. Absorption rate , NS g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NA If yes, give date NA D. LIFT STATION Date installed "Pump on" level at Datum in. "Pump off' level at E. SEPARATION DISTANCES WELL ON LOT TO: Cycles tested Septic tank/lift station on lot >100 Absorption field on lot 119 Public sewer main NA Sewer /septic service line >25 Animal containment areas >100 Manhole/Access (Y/N) alarm level at Meets alarm & circuit On adjacent lots > 100 On adjacent lots >100 Public sewer manhole/cleanout >100 Holding tank >75 Manure/animal excrete storage areas >100 SEPTIC/HOLDING TANK ON LOT TO: Building foundation 12 Property line 70.5 Water main >100 Water service line >10 Wells on adjacent lots >100 ABSORPTION FIELD ON LOT TO: Property line 41 .1 Building foundation >10 Water Service line >10 Surface water >100 Curtain drain >50 Wells on adjacent lots >100 F. COMMENTS G. ENGINEER'S CERTIFICATION / certify that / 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 Charles A. Leet Date 9 (A r71-,2 b 13 COSA brown sheet 10-10-12.doc Absorption field >5 Surface water >100 Water main >10 Driveway, parking/vehicle storage >10 in. 2 § I I I ? rrl \ o � CA SCENIC DR § o & y\) ' � ' : (? 2 § I I I ? rrl \ o � CA SCENIC DR §