HomeMy WebLinkAboutTHE VILLAGES-PINE RIDGE LT 1The Villages -
Pine Ridge
Lot 1
#020-291-38
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
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP131102
PID Number: 020-291-38 Q New ❑ Upgrade
Name:
Benjamin Hagedorn
ABSORPTION FIELD
❑ Deep Trench R1 Shallow Trench ❑ Bed ❑ Mound
Address
6927 Fountain Drive Anchorage, AK 99502
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
727-5259
3
.8 GPOJSF
5.3 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
1.3 Ft.
Gravel depth beneath pipe
4.0 Ft.
Subdivision
Block Lot
The Villages Pine Ridge
1
Fill added above original grade
2-3 Ft.
Gravel length
1 58 Ft.
Township Range Section
Gravel width
5Ft.
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
580 Fe
TWO
>10 Ft.
Well
>100'
>100'
N/A
N/A
>25'
TANK 0 Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Anchorage Tank
Capacity
I 1,000Gal.
Surface Water
>100'
>100'
N/A
N/A
Material
Steel
Number of compartments
Two
Lot Line
>5'
>10'
NIA
N/A
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
ElecUica1 Inspections performed by
Installer
D3034 drainn field D3034
PIPE MATERIAL House to tank Teld
Richie Excavation
Drainfield HDPE CO/MT D3034
Inspector MEA
BENCH MARK (Assumed elevation) 100.0 ft
Inspection r
1a 7/28/13
8/1/13
description
dates:
3" 8/2/13
2-
4`" 814/13
rGaragelab.
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
®Engi`n®lisiSti``
... qS�
Conditional Approval:
Date
!
l�.9 TH a�•�
so 1¢s 6/.
�.eq
...
........
�i Jr�-MCHEL E. AN£P",N?A
a.ry".
CE -4381 ;
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!®®s�eo®®�
Approved
% Date
Inspection Report_1-1-12.doc
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
Permit Number: OSP131102 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904
THE VILLAGES PINE RIDGE SUBDIVISION
LOT 1
41,177 S.F.
Twat 13C
Page 2 of 3
PID NO.: 020-291-38
S 20'05'15'W
21.72'
PLAN AS BUILT
SCALE 1' = 40'
C
at 138A
HENT
EASEMENT
10' UTILITY EASEMENT
a LA
50' SCREENING
►.
EASEMENT
Lot .f
N %1
41,177 s.t.
�o
Setback
WELL
L
100' Stream
Alternat
Three Bedroom
Site
Home
J
.(
0
TH3
C 2
-4 C7; M4
FCO F�
S 7526'53
�p
6
parm v'
27.06'
m
QQo~
4D
C4
1
V $2
Lot 2 as " C6
j
A
6
C
S2
' 26.1'
13.6 30.7
-
_
E4
19.4
37.3
`94•
M1
19.3
37.9
-_
_____
_ — '
C
30.5'
47.0'
-----"
ALTERNATE SITE M2
36.3
28.2'
52.8
BOG
46.3' �°' \
LEGE
N
C7 C7
Advontex Treatment System FSV
41.0'
20.6'
37.3'��.
622'
C5 — Clean Out
with 15' Long x 5' Wide x M3 362'
53.1'
Q\ QG
M1 —
Monitor Tube
4' Effective Depth Absorption Ma
39.5'
61.1' �\
TH —
Test Hole
Trench. Appication Rate 3
FCO
— Foundation Clean Out
GPD/SF.
S1 —
Septic Vent
FSV
— Flow Splitter Volve
S 20'05'15'W
21.72'
PLAN AS BUILT
SCALE 1' = 40'
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: OSP131102 PID No. 020-291-38
90.5 >
N y UU CO
qSepticTank
.4
83.4 Drainfeld Rock
79.4
79.4 1
68.0
Groundwater @ 69.5'
9-5-2010
U F U
'-� 83.4
9-5-2010
PROFILE AS -BUILT
No Scale
83.2
July 16, 2013
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 1, The Villages Pine Ridge Subdivision
Absorption Trench to Lot Line Waiver
Dear Onsite Services Engineer:
Lot 1, The Villages Pine Ridge Subdivision has limited area for construction of a new
septic system and the absorption trenches due to the location of a Class C Well to the
south and a small stream to the north. The westernmost trench must be located 7' from
the property line at the north end. The edge of the trench moves further from the
property line as it progresses south. A drawing showing the location of the new trench
system is attached for your review. Placement of the trench at this location will have no
impact on the adjacent lot.
Sincerely,
Mme- Z -
Michael E. Anderson, P.E.
P•• 49th •••••':
MICHAEL E. ANDERSON
10/19/2013 00:35 907-345-0202 ALPINE DRILLING PAGE 01/01
Alpine Drilling & Enterprises
Well Log
Permit Number: #SW 131102 Date of Issue 5-23-13 Parcel Identification Number: 20291380000
Date Started: 6-20-13 Date Completed: 6-21-13 Is well located at approved permit location? x Yes ❑ No
Legal Deserlption: The villages -Pine Ridge Lot 1
Property Owner Name & Address: Hagedorn Benjamin T & Michell Callie L
6927 Fountain Drive
Anrhnrace_ Alaska 99502
Borehole Data: Depth (ft)
Soil Type, Thickness & Water Strata From To
Stick-up
Organics & silt
Gravelly silt
siltygravel
gravelly silt
bedrock
H2O
H2O
0
1.5
2.5
6
11
42
101
1.5
2.5
6
11
Method of Drilling x air rotary ❑ cable tool
Casing type:is eel
Wall Thickness:. 250 inches
Diameter: 6 inches Depth: 42.5 feet
Liner Type:
Diameter: _ inches Depth: — feet
Vaainu sticknn above eroand: 1.5 feet _
42 Static water level (from ground level): 35 feet
246 Pumping level:_20 feet after
6 hours pumping ? gpm
Recovery Rate: 2 gpm
Method of Testing: air-lift
219 Well Intake Opening Type:
open End x Open Hole
❑ Screened Start feet
❑ Perforations Start feet
Grout Type: bentonite.ranules
Stopped feet
Stopped — feet
Volume:
Pump: Intake Depth — feet
Pump size hp Brand Name
Well Disinfected Upon Completion? x'Yes ❑ No
Method of Disinfection: chlorine tablets I,,
Comments:
Wen Driller: Alpine Drilling & Enterprises
PO Bas 110496
Anchorage Ali 99511
09/23/2013 04:02 907-945-0202 ALPINE DRILLING RAGE 01/01
Development Services Department
Building Safety Division
On -Site Water a Wastewater Program
4700 Elmore Road
P.O. Box 196650
MarkBeglch Anchorage, AK 99507
Mayer W�nSiSe
(907) 943-7904
Pump Installation Lag
Well Drilling Permit Number: SW 13,1ct:f2 Date of Iaxue s29i2013
Parcel Identification Yumber:2os9139e000
Legal Description Property Owner Name &Address-.
The Viaagea - Pine Ridge, Lot I 9anJamin 8 hlfcnehe Hagedorn
6927 Faunt." Dr.
An:hnraga, AK 99802
Date; 12/10,2014
Pump Intake Depth l3elow Top of Well Casing! 235 feet
Pump Manufacturer's Name: Giundtos
Pump Model: 1I e %4y�y �cc ItspP dS Pu it(Dary�ll�
Pump Size I hp
Pitless Adapter Burial Depth: NIA feet
1 Pitless Adapter Manufacturer's Name: N/A
Pitless Adapter Installer: N/A
Well Disinfected Upon Completion? z Yes ❑ No
Method of Disinfection:
Comments:
Pump Installer Name: Aarovr Pump a vials Service, LLC
� 0. amt 110496
Anchorage, AK 59511-0496
n'OE i"tg4
,335 .,, N;�'•
t a,
Sn er-
Attend o!?: Thppun statler shall provide a puma installatton tog to the DSD within 30 days of pump installation.
On -Site Water & Wastewater System Permit
Permit Number: OSP131102
Tax Code Number: 02029138000
Work Type: WellSeptic
Permit Effective Dates: May 23, 2013
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
to May 23, 2014
Design Engineer: ANDERSON ENGINEERING
Subdivision: THE VILLAGES -PINE RIDGE
Site Legal Address: THE VILLAGES -PINE RIDGE LT 1 G:3637
Owner/Address: HAGEDORN BENJAMIN T &
MITCHELL CALLIE L 6927 FOUNTAIN DR ANCHORAGE AK 995022822
Site Mailing Address: 19101 Pine Ridge CIR, Anchorage
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank
Lot Size in Sq Ft: 41177
Total Bedrooms: 3
N Privy Y Private Well N Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater
Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80).
3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received B)
Issued By:
C01 revises 4lA.
C 09 t.
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On -Site Water & Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 020-291-38
Property owner(s) Benjamin Hagedorn & Callie Mitchell Day phone
Mailing address 6927 Fountain Drive Anchorage, AK 99502
Site address 19101 Pine Ridge Circle Anchorage, AK 99516
Legal description (Sub'd., Block & Lot) The Villages Pine Ridge, Lot 1
Legal description (Township, Range & Section)
Lot Size 41,177 Sq. Ft. Number of Bedrooms Three
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
0
Initial R
Single Family (SF)
El
(w/wo ADU)
Septic Tank
ElUpgrade
❑
Duplex
❑
(D)
Holding Tank
F-1Renewal
El
Multiple Dwellings
❑
Privy
❑
(SF and/or D)
Private Well
FxJ
Water Storage
❑
THIS APPLICATION
INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
Permit/Rush Fees: 'S30 1 -
Date of Payment: S'Za8%�D
Receipt Number:
Permit No.
- Pe'IAelaed US�1010oS
Permit App_9-1-12.doc
Waiver Fees: �a
Payment: Date of �r 31 /g
Receipt Number:
Waiver No. USP 131 y 1
Co A
July 16, 2013
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 1, The Villages Pine Ridge Subdivision
Absorption Trench to Lot Line Waiver
Dear Onsite Services Engineer:
Lot 1, The Villages Pine Ridge Subdivision has limited area for construction of a new
septic system and the absorption trenches due to the location of a Class C Well to the
south and a small stream to the north. The westernmost trench must be located 1' from
the property line at the south end. The edge of the trench moves further from the
property line as it progresses north. A drawing showing the location of the new trench
system is attached for your review. Placement of the trench at this location will have no
impact on the adjacent lot.
Sincerely, �
Michael E. Anderson, P.E.
Nr,
July 16, 2013
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 1, The Villages Pine Ridge Subdivision
Absorption Trench to Slope Contour Waiver
Dear Onsite Services Engineer:
Lot 1, The Villages Pine Ridge Subdivision has limited area for construction of a new
septic system and the absorption trenches cannot be placed entirely parallel to the
ground contours due to the location of a Class C Well to the south. The new trenches
will be 3.5' below the ground surface at the south end and 3' below the surface at the
north end and located entirely in the percolation zone identified for the system. A
drawing showing the location of the new trench system is attached for your review. The
variance from parallel to the contours is slight and we hereby request a waiver be
issued allowing .the trenches to be placed other than parallel to the existing ground
contours.
Sincerely,
Michael E. Anderson, P.E.
49th_ .':.
MICHAEL E. ANDERSON
No CE -4381
Coa
Municipality of Anchorage e1`ftp,,tme�nt'-
P.O. Box 196650 • 4700 Elmore Road 4Anchorage Alaska 99519-6650 • (907) 343-7904 •Fax (907) 343-7997
http://www.muni.org/Onsite
Development Services Division
On -Site Water and Wastewater Program
**** VARIANCE/WAIVER REVIEW ****
Waiver#: OSP131241 COSA#: Permit#:OSP131102
PID#:020-291-38
Legal Description: The Villages - Pine Ridge, Lot 1
Engineer: Anderson Engineering
Applicant: Benjamin Hagedorn & Callie Mitchell
Your request for a waiver of the required 10 feet horizontal separation from the absorption field
to the property line has been approved. The approved separation distance is 1.0 foot.
Your request for a waiver of the absorption field slope orientation requirement has been
approved.
This waiver approval applies to the proposed absorption field only. Any future upgrade to the
on-site wastewater disposal system will require all separation distances be met or another
approval from this department.
® The affected adjacent property owner(s) have been given a 7 day notice regarding this
waiver.
❑ Notarized letter(s) of non -objection have been received from the owner(s) of the affected
adjacent property.
❑ Adjacent properties are not affected by this waiver.
...............................................................................
Waiver is Granted: X Waiver is not Granted:
Date: Approved b .
Name of Reviewer
............................ a .............. ..•..............................�
Rec#:01�aa9 Amount: $200.00 Date Paid: 31 13
**** VARIANCEMAIVER REVIEW ****
MEMORANDUM
DATE: May 13, 2013
TO: Jay Crewdsen, P.E.
FROM: Mike Anderson, P.E.
vo...""''ALY 14 2013
SUBJECT: Lot 1, Block 12, The Villages Pine Ridge Subdivision
Well and Septic System Permit
This design and permit application was originally submitted in late April of 2010.
Comments were issued which were never addressed as the owner of the lot was
unable to secure financing for the project. We are now resubmitting the design and
permit application with the well and septic locations modified to reflect additional soils
exploration work. We assume the fees paid with the original permit application are
acceptable for this application. A copy of the original permit application is attached.
May 13, 2013
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 1, The Villages Pine Ridge
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 1, The Villages Pine Ridge intends to construct a new three-bedroom
home on the lot. We are therefore requesting a permit be issued for the construction of
a new well and septic system to accommodate the home. The attached Site Plan and
backup documentation identify the location and configuration of the proposed well and
septic system along with the alternate site. 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 poorly graded gravel with silt (GP/GM) material. The percolation rate of the
soil was determined to be between 4 and 10 minutes per inch. Groundwater was found
during the placement of the test holes at 14' to 15' below the surface and was recently
noted at 14' 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 1,000 -gallon septic tank and a 58' long by 5' wide by 4' effective depth
absorption trench to treat and dispose of the effluent generated in the house. The
elevation of the distribution line in the absorption trench will be 5.0' below the surface
and the total depth will be 9.0'. 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 varies, but slopes at 15% to 20% in the southwest
quadrant of the lot. The new trench will be constructed parallel with the contours of the
slope and will remain in the zone of the absorptive material. The new septic system will
be constructed a minimum of 100' from all wells and any surface water and 10' the
Lot 1, The Villages Pine Ridge Subdivision
May 13, 2013
Page Two
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, ,
9V� z
Michael E. Anderson, P.E.
Attachments
0
MICHAEL E. ANDERSON
1. No. CE -4381 .
0
/ ,1
1 ,1 ,
%
- - - - ----------- ---
1 � 1 '
13A
, p
„
Undeveloped
4
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---------------
-----------------
---------------------------
OF
--------------
,
,
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49th � ..... ' AREA MAP
�;M[CHAEL E. ANIIERSON'j= SCALE 1° = 100'
�� f•t, NO. CE -4381 �1,�
Co
THE VILLAGES PINE RIDGE SUBDIVISION
LOT 1 111
1 41,177 S.F.
1 1 ,.L
Tract 13C O
N
653E
Tract 13B 1 T52 / 1X1
5' A.T.U. 1
ass / / 1 EASEMENT
�10' lfilLltt EASEMENT /
Pouxo sem, sEa�n1 50' SCREENING 1
/ EASEMENT
Lot 1
41,177 s.f.
I
Go. stream Setback I T
Alternate --Ia-T F.
M 5
Site TH3 E. EL 813
® CI
Grp 1,000 Gallon
Lot 2 Wo Septic Tank
iN4
2-29' Lan x 5'0Wide \
N.a x 4' Effective Depth
o Absorption Trenches -_ja�
�rsz
LEGEND
CO —
Clean Out
MT —
Monitor Tube
TH —
Test Hole
FCO
— Foundation Clean Out
SV —
Septic Vent
FSV
— Flow Splitter Valve
Existing
Class C Well
M1
C2
THS
20 LF. - 18' CMP
SITE
ALTERNATE SITE
Advantex Treatment System
with 15' Lang x 5' Wide x
4' Effective Depth Absorption
Trench. Appication Rate 3
GPD/SF.
PLAN
SCALE 1" = 40'
TIM - TCP OF 5/8" REW
n1v 100.00 ASSUMEO
L It
yd 4i9th�
...........................................
FT '. MICHAEL E. ANDERSON :
1 lw
0
1
BBA
J
{T
B9$
p
G
1
Proposed
CM>AE
1 Well _
1
EL 80.0
®
Bedroom
1
ie.e 11
11
1 E�
SITE
ALTERNATE SITE
Advantex Treatment System
with 15' Lang x 5' Wide x
4' Effective Depth Absorption
Trench. Appication Rate 3
GPD/SF.
PLAN
SCALE 1" = 40'
TIM - TCP OF 5/8" REW
n1v 100.00 ASSUMEO
L It
yd 4i9th�
...........................................
FT '. MICHAEL E. ANDERSON :
Performed For:
Legal Description:
k-'J.9"
V
2-
3-
4- �f�
5- `° t
6 -
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
_ :.u_.tsni_i<Iroe_at_.u_Z
(907) 343-7904
,t 49TH
AFL E. ANDERSON
CE -4381 :
Sd3-Irk
Soils Log - Percolation Test
9'
Date
WAS GROUND WATER
Net Time
Depth to a4ter
ENCOUNTERED?[
5
IF YES, AT WHAT DEPTH? P L
Depth to Water Aker D
11 -
Monitoring? / IrJ!�'.O E
12-
Date: { 9it a
1a
� 1 F
`
14-
15-
X®-
16-
17-
18-
19-
Reading
16-
17-18-
19-
Range, Section:
Reading
Date
Gross Time
Net Time
Depth to a4ter
Ne�Dr
5-(e
7r
15'°jI t6'IS
c 3� 9:3"
2.ny "
!
r�nwur, i 1.ry rov a Lf- (minutesflnch) PERC HOLE DIAMETER
TEST RUN BETWEEN_ �j, I" FT AND�FT
COMMENTS '�'r� {?�[y.; �aIT
PERFORMED BY: /4 iz_ I CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
Municipality of Anchorage
R'S ,
Development Services Department
P.-.4
i9
Building Safety Division
Y
r91�
On -Site Water and Wastewater Program
• 4196 Elmore Road
00 ........«.
'j p 2.t,
P.O. Box 196650 Anchorage,
_22"... _
�"' '°"' ..
AK 99507
E. ANDI
im„ fMMHAEL
(907) 343-7904
CE - 4381
' s-ta -�
��+'F0
Soils Log - Percolation Test
PRottss o`
Performed For: b'g d k(e Peored:Date
�i
•'� Il �'lg
nship, Range, Section-
s
L
0
P
E
Reading
Date
Gross"Time
Net Time
Depth to Water
Net Drop d
� I to
I10N1J
/
11i�&°3p
3o Mlfs
Il.v°
77.V''Dtr
7
11�o
L
U
! 3
c MIWs
r A7, t V inonumwincn7 �t FERC HOLE DIAMETER
TEST RUN BETWEEN tj FT AND S-4FT
COMMENTSt:Sa�,l,'Ps
PERFORMED BY: A- H&Wi' I CERTIFY THAT THIS TEST WAS
PERFORMED IN AC60RDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
Performed For:
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. ar�hornc;;.aI;;,:s
(907) 343-7904
Soils Log - Percolation Test
Legal Description:
rl
Date
Range, Section:
1
1
WAS GROUND WATER
Date
ENCOUNTERED?
Net Time
Depth to Water
S
IF YES, AT WHAT DEPTH?
Y. K L
Depth to Water After
Monitoring?
`/ O
Date:
*: 49TH a! a
AEL-E •ANDERSON :&
CE -4381 T��a
Site Plan
Reading
Date
Gross Time
Net Time
Depth to Water
Net Drop
z
t� z1
Flubs
9 b6'
3.W
s
11
�1idsIZ
b
?iotl(44
BIZ`
3�3t`
PERCOLATION RATE (minOeOrm) PERC HOLE DIAMETER :za
TEST RUN BETWEEN Sp FT AND FT —�
COMMENTS
PERFORMED BY:`rl., I CERTIFY THATTHIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
OF 44 4#
Municipality of Anchorage ;' INEER'S L'• rV— 0
Development Services Department o *� 49Z *�♦
Building Safety Division /..., ... ... .. '
On -Site Water and Wastewater Program ♦ ������� �• • ••••
...... ...
4700-Scuth aragaw SL --- __ .- , - - O � :..... L E ANDERSON I ...
P.O. Bax 196650 Anchorage, AK 99519-6650 ♦ �,. 4, m
www.ci.anchoraae.ek.us ♦♦ �3 f• CE -4381
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(907) 343-7904 - S .^� •,.F -ZR, -4Q,. ���w FOP••....• A�
Soils Log - Percolation Test
Performed For. Benjamin Hagedorn C)ao- Q� 1- 3g Date Performed: I __ 1
THE VILLAGES -Pine Ridge Lot 1
Legal Description: - g .'ownship, Range, Section:
...Slone
IPA-,
17-
18 -
COMMENTS
WAS GROUND WATER
ENCOUNTERED?
_, t S
IF YES, AT WHAT DEPTH?. 1% OL
Depth, to Water After
l� E
Monitoring?
� i•
Reading
Date
Gross Time
Net Time Depth to Water Net Drop
IL z$ .
r� .� t� I- no l✓.I z t1
to:30
$s10 i
PERCOLATION RATE '
TEST RUN BETWEEN i
(minutesrinch) PERC HOLE DIAMETER?
FT .ANDFT_
PERFORMED BY: CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
Legal Description: THE VILLAGES Pine Ridge Lot 1 ownship, Range, Section:
I t Slope _ —
I-
2-
3-
4-
5-
12-
13-
14-
15-
16,
-
2-
3-
4-
5-
R&
Date Gross Time
Munic.ipaiity of Anchorage
,® c
Development Services Department
i
- Building Safety Division
-_-�- ---. Ort Water Wastewater Program–
0....
0,[;,
-Site and
4700 South Bragaw St.
I c
P.O. Boz 196650 Anchorage, AK 99519-6650
www.ci.anchoraoe.ak.us
(907) 343-7904
Soils Log --.Percolation Test
19-
a
Performed For: Beniamin Haaedorn
Date Performed: -
Legal Description: THE VILLAGES Pine Ridge Lot 1 ownship, Range, Section:
I t Slope _ —
I-
2-
3-
4-
5-
12-
13-
14-
15-
16,
-
2-
3-
4-
5-
R&
WAS GROUND WATER
ENCOUNTERED?
S
IFYES, AT WHAT DEPTH? .–=–.
0
Depth to Water ARer
Monitoring ?
Date:- I3 1O
®®eor,pt
OF .44 008
=NGINE •••LS�.yy®�
4918
4EL E ANDERSON
•
CE -4381
Reading
Date Gross Time
Net Time
Depth to Water
12-13-14-
15-
16-.
17-
18-
19-
a
20 -
COMMENTS
6srrn
WAS GROUND WATER
ENCOUNTERED?
S
IFYES, AT WHAT DEPTH? .–=–.
0
Depth to Water ARer
Monitoring ?
Date:- I3 1O
®®eor,pt
OF .44 008
=NGINE •••LS�.yy®�
4918
4EL E ANDERSON
•
CE -4381
Reading
Date Gross Time
Net Time
Depth to Water
Net Drop
a
Iv'•�jb°3a
'Go.� t�
)44`F
�.
u
F r
PERCOLATION RATE ' ' (minuwsrinoh) ' PERC HOLE DIAMETER Q,1
TEST RUN BETWEEN �' r FT AND, 4
FT
PERFORMED BY: - I CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
Parcel I.D. 020-291-38
Municipality of Anchorage
On -Site Water and Wastewater Program
(907) 343-7904
_ a
0' sp ETY
•
Certificate of On -Site Systems Ai 4
Oki
Expir i Date:.
FEB 6 2014
1. GENERAL INFORMATION
Complete legal description The Vliiage&Pine Ridge, Lot 1
Location (Site address) 19101 Pine Ridge Court Anchorage, AK 99516
Current Property owner(s) Benjamin Hagedorn Day phone
Mailing address 6927 Fountain Drive Anchorage, AK 99502
Real Estate Agent
2. TYPE OF DWELLING:
Day phone
0 Single Family (w/wo ADU) - i
❑
Duplexg�•
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: Three
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual
i]
Individual Water Storage ❑
Holding Tank
❑
Community Class Well ❑
Community
❑
Public Water System ❑
Public Sewer
❑
WaiverNariance request for:
Distance:
Received by: �: �' %`
Date:s
'COSA to be releast'to the; engineer, unless otherwise requested by
the engineer.
COSA Fee $1 l .�a,
Waiver Fee $
Date of Payment [a�IN
Date of Payment
/
Receipt Number
Receipt Number
COSA# 06Clwa -
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.
Name of Firm Anderson Engineering Phone
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E.
522-7773
Date 2/6/2014
®Pads
�F y
6. DSD SIGNATUREr==>•o
l�bedrooms
System #1 Approved for bedrooms�°°°°��A�
System #2 Approved for bedrooms®® ✓r CE -ct?P"
Disapproved
Conditional approval for bedrooms, with the following stipulations
By: Original Certificate Date:
The Muhal�Jbf A horse Development Services Division DSD issues Certificates of On -Site Systems Approval COSH based only
Ff hr 9 P (DSD) Y PP I ) Y
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
COSAbWesheet f 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: The Villages Pine Ridge, Lot 1 Parcel ID: 020-291-38
A. WELL DATA
Well type Private If A, B, or C provide PWSID # Well Log (Y/N) Y
Date completed 6/21/13 Sanitary seal (Y/N) Y Wires properly protected (YIN) Y
Total depth 219 ft. Cased to 42.5 ft. Casing height (above ground) >18 in.
Date of test
Static water level
FROM WELL LOG
6/21/13
35
Well production 2
WATER SAMPLE RESULTS:
ft.
Coliform 0 colonies/100 mL Nitrate ND mg/L
Arsenic ND ug/L Date of sample: 1/21/14
B. SEPTICIHOLDING TANK DATA
Tank Type/Material Septic/Steel
Tank size 1,000 gal. Number of Compartments 2
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N
Date of pumping New Const. Pumper
AT INSPECTION
ft.
g.p.m.
Collected by: Anderson Engrg.
Date installed 7/28/13
Cleanouts (Y/N) Y
High water alarm (Y/N) N
C. ABSORPTION FIELD DATA
Date installed 8/1/13 Soil rating (g.p.d./ftz or ft2/bdrm) .8 GPD/SF System type 5' Wide
Length 58 ft. Width 5 ft. Gravel below pipe 4 ft.
Total depth 7-8 ft. Eff. absorption area 580 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.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date
D. LIFT STATION
Date installed
"Pump on" level at
Datum
Size in gallons _
in. "Pump off" level at
Cycles tested _
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot
Absorption field on lot
Public sewer main NIA
>100'
>100'
Sewer /septic service line >25'
Animal containment areas >50'
in.
Manhole/Access (Y/N) _
High water alarm level at
Meets alarm & circuit requirements?
On adjacent lots >100'
On adjacent lots >1 00'
Public sewer manhole/cleanout _
Holding tank N/A
N/A
Manure/animal excrete storage areas >100'
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >5' Property line >5'
Water main >10, Water service line >
10,
Wells on adjacent lots >100'
ABSORPTION FIELD ON LOT TO:
7'**
Property line Building foundation >10,
Water Service line >10' Surface water >100'
Curtain drain None Noted Wells on adjacent lots >100'
F. COMMENTS
***See Lot Line Waiver.
Absorption field
>5'
Surface water >100'
Water main N/A
Driveway, parking/vehicle storage >10,
in.
G. ENGINEER'S CERTIFICATION�"6a� ��$F
I certify that / have determined through field inspections and Q4,
review of Municipal records that the above systems are in &)e ®Of
conformance with MOA COSA guidelines in effect on this date. / py r✓ n
Engineer's Printed Name Michael E. Anderson, P.E.
L .... ...............
2/6/2014 ®®m a MKIRAD. E. Amoeasr N .°
Date CE - 438t
COSA brown sheet 10-10-12.doc
/S�EN�C
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PLOT PLAN AS BUILT i SCALE 1" = 30' GRID SW 3637 Project No. 13-042
Lang & Associates, inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049
(907) 522-6476 Phone opp4
Registered Land Surveyors (907) 522-4625 Fax aQ`��F C0p�4
kglongis*alaska.net / jclangls®alasko.net g
�v�`C� .,.....A 904o
I hereby certify that I have surveyed the following described property:
LOT 1, THE VILLAGES — PINE RIDGE (Plat No. 79-255) 0* 49?H LV
Anchorage Recording District, Alaska, and that the improvements situated thereon are �....:..... g ,,,, ..
within the property lines and do not encroach onto the property adjacent thereto, that 0
no improvements on the property lying adjacent thereto encroach on the surveyed Q
premises and that there are no roadways, transmission lines or other visible D A"' "'
easements on said property except as indicated hereon. �O �, '. KENNETH LAN
Q4sia'•• LS -5202
Dated this the V5' Day of ,2�, at Anchorage, Alaska Q�tap'•.'��(3��—;,.••'�5op�
It is the responsibility of the owner to determine the existence of any easements, 4�QROFFSSIgNA� �o�
covenants, or restrictions which do not appear on the recorded subdivision plat. ��Op000a