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HomeMy WebLinkAboutTUXEDNI PARK WEST BLK 2 LT 2Tuxedni'O Park West Block 2 Lot 2 #041-022-52 ARCTIC PUMP & WELL INC. Jim Sullivan PO Bax 770197 wiam- Eagle River, AK 99577 wue a man (907) 688-2510 (907) 243-2282 Pump Installation Log Well Drilling Permit Number: osp131216 Parcel Identification Number: 04102252000 Date Of Issue: 8/2/2013 Tuesday, September 03, 2013 Legal Description Tuxedni Park West Property Owner Name Address: Peppers Construction Lot: 2 10224 West Frontage Block: 2 Eagle River AK 99577 Pump Installaion Date: 9/3/2013 Pump Intake Depth Below Top of Well Casing: 309 Feet Pump Manufacturer's Name Franklin Pump Model: Constant Pressure System: 10SDQP 1.5HP Pump Size: 1.5 HP Pitless Adapter Burial Depth: 15 Feet Pitless Adapter Manufacturer's Name S-50 Pitless Adapter Installer: u/k Well Disinfected Upon Completion? Yes Method of Disinfection: Chlorine Comments: Pump Installer Name: Arctic Pump & Well, Inc. Tuesday, September 03, 2013 Inspection Keport_1-1-1zda- 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: OSP131216 PID Number: 041-022-52 ❑✓ New ❑ Upgrade Name: Stephen & Mandi Constantine ABSORPTION FIELD ❑ Deep Trench ❑✓ Shallow Trench ❑Bed ❑Mound Address 17827 Lacey Drive Eagle River, AK 99577 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 1.2 GPD/SF 7.5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3.5 Ft. Gravel depth beneath pipe 1 4.0 Ft. Subdivision Block Lot Tuxedni Park West 2 2 Fill added above original grade 0-1 Ft Gravel length 52 Ft Township Range Section Gravel width 5Ft. Beds: Number of Lines Distance between lines I Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches I From Tank Field Tank Line 520 Fe One Ft. Well >100' >100' N/A N/A >25, TANK ❑p Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity 1 1,250Gal. 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 Housetotank D3034 Tankto drainfield D3034 Dan Green Construction Drainfield F810 C01MT D3034 Inspector A. Harala BENCH MARK (Assumed elevation) 100.0ft Inspection 1• 10/15/13 dates: w z 10/16/13 Location and description 3'" a Garage Slab. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL kill 1 Conditional Approval: Dateso • /•w. n ••• ••• • . ••. %... ..........•................. •CHAR E AWJIRSGN Approved A . Date? 3 0 40 FESSI Inspection Keport_1-1-1zda- PID No.: Municipality of Anchorage vJ DEVEOPMENT SERVICES DEPARTMENT — Foundation Clean Out 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904 Permit Number: OSP131216 TH S1 M1 C4 Page 2 of 3 r� 515 �1 5 233 58 LLJ'1 I I I TUXEDNI PARK WEST SUB. LOT 2, BLOCK 2 87.211 S.F. C4 R21 f TH2 Well Alternate Site Four Bedroom` 1Home ALTERNATE SITE Avantex Treatment System w/10' Long x 5' Wide x 4' Effective Depth Absorption Trench. 6 GPD/SF Application Rate. L GEND 231 �g 5114.4' 8.5' S2 19.9' 15.4' M1 31.5' 39.4' C432.0' 41.7' C547.1' 33.5' W a E" d PLAN AS -BUILT SCALE 1" = 50' d �S� 49th .•'.� MICHAEL E. ANDERSON No. CE -4381 vJ FCO — Foundation Clean Out Q' v TH S1 M1 C4 — Test Hole — Septic Vent — Monitor Tube — Clean Out W a E" d PLAN AS -BUILT SCALE 1" = 50' d �S� 49th .•'.� MICHAEL E. ANDERSON No. CE -4381 Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: OSP131216 n U trf7 U % 102.0 CN 2 H Existing & Finished Grade 101.0 Drainfield Rock Page 3 of 3 PID No. 041-022-52 U No Groundwater � 86.0 93.5 6-17-13 52' (Trench Length) PROFILE AS -BUILT No Scale 97.5 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 DEPTH (feet) 1 - 2 3 4 5 6- 7- 8- 9- 10- 11 12- 13- 1 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: Lot PERFORMED FOR: Scott Block 2. Tuxedni Park DATE: 6/4/13 PROJECT No.: PARCEL ID#: TECHNICIAN: TEST HOLE 2 FFM7 TlI OB/OG GW/GM WELL GRADED GRAVEL WITH SILT B.O.H. WAS GROUND WATER ENCOUNTERED? IF YES @ WH DEPTH OF WATER AFTER MO DATE OF MO SLOPE fiI' 49th �'V •`: AEL E. ANDERSON NITORING AT DEPTH? MONITORING NONE : 6/17/13 GROSS TIME NET TIME DEPTH TO NET DROP DATE READING (MINUTES) (MINUTES) WATER (INCHES) (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 6/4/13 1 2:44 10 1.75'/9.75" 8,00" 2 2:55 10 1.50°/9.50" 8.00" 3 3:07 10 1.50"/9.37" 7.87, 4 3:18 10 1.75"/9.62" 7.87" 5 3:30 10 1.50°/9.37" 7.87" 6 3:41 10 1.62"/9.50" 7.87" PERCOLATION RATE: 1.3 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 3 FT. and 4 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. 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: 6/4/13 PERCOLATION RATE: 1.3 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 3 FT. and 4 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. 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: 6/4/13 Certified Drilling Log DOC CO dba BILL S. COLE 0P.O.Box 670269, 9 ULLIVAN WATER WELLS OWNER OF LAND: Scott Peppers ADDRESS: PO Box 771064 Eagle River 99577 LEGAL DESCRIPTION Tuxedni Park West BILK 2 Lot 2 DATE: 8/22/13 PERMIT NUMBER: 131216 DATE OF ISSUE: $/2/13 TAX IDENTIFICATION NUMBER 04102252000 Is well located at approved permit location: ® Yes ❑ No Method of Drilling: ®air rotary ❑ cable tool Depth of Well: 340ft Casing Type: steel Wall thickness ,025 inches Diameter: 6 inches, depth 104 feet Liner type none Static Water Level: flowing feet Recovery Rate 4 ® gpm ❑ gph Method of Testing Air Well Intake Opening Type: ❑ open end ® open hole ❑ Screened Start feet Stopped ❑ Perforations Start feet Stopped Grout Type: Bentonite chips Volume: Depth: from 0 feet, to 20 feet Well Disinfected Upon Completion: ® yes ❑ no Method of Disinfection: Chlorine 50PPM Comments: Bore Hole Data Depth From To 0 2 Casing stickup 2 5 Overburden 5 10 Sand 10 31 Sand & gravel 31 55 Silty sand & gravel 55 90 Tight silty sand & gravel 90 121 Bedrock yellow 121 146 Bedrock gray - quarts 146 201 Bedrock gray 201 207 Bedrock yellow 207 225 Bedrock gray 225 229 Bedrock broken 4 GPM 229 340 Bedrock gray Drillers Name: Cole Sullivan ATTENTION: It is the responsjpl'ity of the property owner t9 submit a copy of the well log to the proper authority. Municipality of Anchorage: De ment of Health & Human Services and/or Department of Environmental Conservation. Matsu Borough: Department ojrvironmental Conservation. 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: OSP131216 Tax Code Number: 04102252000 Work Type: WellSeptic Permit Effective Dates: August 02, 2013 to August 02, 2014 Design Engineer: ANDERSON ENGINEERING Subdivision: TUXEDNI PARK WEST Site Legal Address: TUXEDNI PARK WEST BLK 2 LT 2 G:2042 Owner/Address: CONSTANTINE STEPHEN B & MANDI B 17827 LACEY DR EAGLE RIVER AK 995778296 Site Mailing Address: Lot Size in Sq Ft: 87211 Total Bedrooms: 4 This permit is for the construction of: 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 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 Issued By MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program �P►Q.9��►9fif1�:71fd1���»:7�lIfs_17M_ • Parcel I.D. 041-022-52 Property owner(s) Scott Peppers Day phone 250-8348 Mailing address 10224 Eagle View Drive Eagle River, AK 99577 Site address Atelier Drive Anchorage, AK 99516 Legal description (Sub'd., Block & Lot) Tuxedni Park West, Block 2, Lot 2 Legal description (Township, Range & Section) Lot Size 87,211 Sq. Ft. APPLICATION IS FOR: (M all that apply) Absorption Field F Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms Four (4) APPLICATION IS AN: TYPE OF DWELLING: Initial 0 Single Family (SF) ❑ (w/wc ADU) Upgrade ❑ Duplex (D) ❑ Renewal El Multiple Dwellings ❑ (SF and/or D) 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. (Signature of property owner or authorized agent) Permit/Rush Fees: 1 -W'S Date of Payment: /y i 1.3 Receipt Number: Permit No. dSP13/;)/10 Permit App_9-1-12.doc Waiver Fees: Date of Payment: Receipt Number: Waiver No. July 18, 2013 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 2, Block 2, Tuxedni Park West Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer The owner of Lot 2, Block 2, Tuxedni Park West Subdivision intends to construct a new four-bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new well and septic system to accommodate the home. The attached Site Plan and backup documentation identify the location and configuration of the proposed well and septic system along with the alternate site. Also identified on the plans are the existing wells and septic systems on surrounding lots. No conflicts exist between the proposed well and septic system and wells or septic systems on adjacent lots. Drainage contours 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 indicate clean poorly graded gravel with some silt (GW/GM). The percolation rate of the soil was determined to be 1.3 minutes per inch. No groundwater was found during the placement of the test holes and none was noted during the monitoring period. An application rate of 1.2 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 50' 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 4' below the surface and the total depth will be 8'. 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 southwest. The new trench will be constructed parallel with the contours of the slope as much as possible in conformance with Municipal requirements. The new septic system will be constructed a minimum of 100' from all wells and any surface water and 10' the Lot 2, Block 2, Tuxedni Park West Subdivision July 18, 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, ry� C-0-J, Michael E. Anderson, P.E. Attachments 49th MICHAEL E. ANDERSON No. CE -4381 � I I I \ I LOT 3 \ I I I I I I O I I I I I , j LOT 2 I A j i \ VACANT .I co i ® I p \ o o z 1 t LOT 1 1 / i ! w \---� NOTE: No Conflicts with Wells or Septic Systems in the Area. .��-`� OF �P ................/.�...1♦i 49th � .��♦♦� ' AREA MAP ' ............................................. . t ';MICHAEL E. ANDERSON �t \ ♦♦.✓f % NO. CE -4381 �\ SCALE 1 " = 80' ♦♦1��'`��'...... ��•� ;'TuX,EpN1 P;AiRK '',WEST SUB. LOT j 2, 'B',LOOIK 2 5g / 87,2n 1 S.F.J233 cj 0C / I iGI / C/) / I ( / S,p6artia*/ / / 2CO IIr m FCOTH2Alternate Site SV SVFour / / Bedroom Home /!r TH 1 ®� 1 50' Long x 5' Wid ! x 4' Effective Dept Prop�ls€d (Absorption Trench W , j , MTi, / tl ALTERNATE SITE Avantex Treatment System w/10' Long x 5�Wide_ x 4' ! / 1 Effective Depth Absorption— Trench. bsorption Trench. 6 GPD/SF Application Rate. LEGEND FCO Fql6dation Clean Out TH — Te4t Hole SV — S*tic Vent MT — Monitor Tube CO — Cler Out� OF X11 49th1� .....::..., SITE PLAN---- ; ................................................ ; 0�_�R';MICHAEL E. ANDERSON SCALE 1 " \ 50' / �� t• NO. CE 4381 '��: LOT 2, BLOCK 2, TUXEDNI PARK WEST SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS Four Bedroom Home 5' Wide Trench System Perc. Rate: 1.3 Min./Inch 1,250 Gallon Septic Tank Application Rate: 1.2 GPD/SF 4' Drainfield Rock 4 Bedrooms X 150 GPD/1.2 GPD/SF (Application Rate) = 500 SF Absorption Area 5000 SF/5 SF/LF*.5 (Red. Factor) = 50 LF Trench Length THEREFORE: Construct a 50' Long x 5' Wide x 4' Effective Depth Absorption Trench at the Location Shown. Flow Line Elevation in Trench to be 4' Below Original Ground Surface. Total Depth to be 8' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption Trench. Maintain 100' Separation from Wells in the Area. Natural Backfill 3'6" Geotextile Fabric 6,, :0: 4" Perforated PVC (Holes Down) 4'0" 5' Drainfield Rock TYPICAL 5' WIDE 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 Wells in the Area. Minimum 100' Separation From Surface Water or Streams. MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 DEPTH (feet) 1- 2 3 4- 5- 6- 7- 8- 9- 10- 11 12- 13- 14- 15- 1 1 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: PERFORMED FOR: DATE: 6, PARCEL ID#: OB/OG PROJECT No.: TECHNICIAN:.TR TEST HOLE 1 GW/GM WELL GRADED GRAVEL WITH SILT WAS GROUND WATER ENCOUNTERED? IF YES rQi WH DEPTH OF WATER AFTER MOM DATE OF MOM it AT DEPTH? TORING: NONE TORING: 6/17/13 GROSS TIME NET TIME DEPTH To NET DROP DATE READING (INCHES) (MINUTES) (MINUTES) WATER (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 6/4/13 1 2:15 10 4.00"/11.50" 7.50" 2 2:26 10 4.13"n 1.50" 7.37" 3 2:37 10 4.25'/11.62° 7.37" 4 2:48 10 4.00"/l1.25' 7.25" 5 3:00 10 4.25"/11.5o" 7.25' 6 3:12 10 4.00'711.zs 7.25" PERCOLATION RATE: 1 4 (MINANCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 3 FT. and 4 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY ANDERSON ENGINEERING. 1, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 6/4/13 PERCOLATION RATE: 1 4 (MINANCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 3 FT. and 4 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY ANDERSON ENGINEERING. 1, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 6/4/13 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: Loi 6, t5IOCK G, 1 uxeuril rarK west PERFORMED FOR: Scott Peppers DATE: 6/4/13 PROJECT No.: PARCEL ID#: TECHNICIAN: JB DEPTH TEST HOLE 2 (feet) SLOPE 3 49th W •@ IAEL E. ANDERSON NO. CE -4381 READING WAS GROUND WATER ENCOUNTERED? NO 10 OB/OG 1 TEST HOLE PRESOAKED PRIOR TO TESTING: IF YES @ WHAT DEPTH? L I 2 DEPTH OF WATER AFTER MONITORING. NONE 0 1.75"/9.75" 3 DATE OF MONITORING: 6/17/13 in 4 10 1.50'/9.50" 5 GW/GM 3:07 10 WELL GRADED GRAVEL 6 WITH SILT 7 10 1.75"/9.62" 8 5 9 10 1.50"/9.37" SLOPE 3 49th W •@ IAEL E. ANDERSON NO. CE -4381 14 15 16 17 18 19 COMMENTS: TEST HOLE PRE SOAKED PRIOR TO DATE READING WAS GROUND WATER ENCOUNTERED? NO 10 DIEPTH TO TER (INCHES) NET DROP (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: IF YES @ WHAT DEPTH? L I 2:44 DEPTH OF WATER AFTER MONITORING. NONE 0 1.75"/9.75" 8,00" DATE OF MONITORING: 6/17/13 in 2:55 10 14 15 16 17 18 19 COMMENTS: TEST HOLE PRE SOAKED PRIOR TO DATE READING GROSS TIMEJ (MINUTES) NET TIME (MINUTES) DIEPTH TO TER (INCHES) NET DROP (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 6/4/13 1 2:44 10 1.75"/9.75" 8,00" 2 2:55 10 1.50'/9.50" 8,00" 3 3:07 10 1.50"/9.37" 7.87' 4 3:18 10 1.75"/9.62" 7.87, 5 3:30 10 1.50"/9.37" 7.87" 6 3:41 10 1.62°/9.50^ 7,87" PERCOLATION RATE: 13 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 3 FT. and 4 FT. TEST PERFORMED BY ANDERSON ENGINEERING. 1, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 6/4/13 61891o �7 ,,,'‘INfili9P r4_ Municipality of Anchor MAY 11 2017 ? °2 On-Site Water and Wastewater Progra ` mil i • - (907) 343-7904 a. ti s. E Y Certificate of On-Site Systems Approva Parcel I.D. 041-022-52 Expiration Date: S2 /5 / 7 1. GENERAL INFORMATION: Complete legal description Tuxedni Park West; Block 2, Lot 2 Location (site address) 9735 Atelier Drive Current Property owner(s) John Sindell Day phone Mailing address 9735 Atelier Drive Real Estate Agent Carrie Schliesina Day phone 250-6199 2. TYPE OF DWELLING: ® 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 EI Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: / 5 . Received by: Date: 6/17- COSA I—V /1 7- COSA to be released to the engineer,unless otherwise requested by the engineer... COSA Fee $ S z(p — Waiver Fee $ Date of Payment GJ I I t 1 11 Date of Payment Receipt Number 5305CO�i Receipt Number COSA# OSC 17 I fl 3 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: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road,Suite 101-Anchorage,Alaska 99507 / Engineer's Printed Name: Jeffrey A. Garness Date: sl,'/ii– QQ�000%�� 0 In conducting this evaluation,GEG provided an engineering evaluation of the well and/or septic system o in accordance with the guidelines and regulations established by the Municipality of Anchorage and •. OF industry practices. The reported results describe the condition of the system/s on the date/s of the p• .•' 'L"•SaA evaluation. Separation distances were measured to readily identifiable features. Hidden defects or O �..�� V encroachments may exist that were not identified during the evaluation. The operational life of all wells * :• 46 T 4� ....-7,,,v0O and septic systems depend upon a variety of variables, including but not limited to, soil conditions, !e groundwater levels (that may fluctuate during the year), quality of construction (materials and Q workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and ,l... . J Q are outside the control of GEG. Satisfactory test results do not guarantee future performance of the f ' :ff t A. Go ness: system/s;therefore, GEG makes no warranty (express or implied) regarding the future performance of V0 0 IE—7.,C • e p� the well or septic system. GEG makes no representation whether an alternative well or septic system 9 I ' .\<-6p can be installed on the property in the event either of the current systems fail to perform adequately in QQ e,, ./1. I <sco the future. The content of this report is for the sole benefit of the person/party that retained GEG to 40 Pa professio�°ao perform the evaluation. Reliance upon the information provided in this report by any other person or ��OOppoQ,,, party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE System #1 Approved for 1-{ bedrooms System #2 Approved for bedrooms Disapproved ��iY OF q, e� Cy0 Conditional approval for bedrooms, with the folloj ig s Jlltifps: '4, WATER AND s".. nt WASTEWATER z co PROGRAM o IA-ti7.rp\f`,('. y:- -- 1n..�. , 11 Original Certificate Date: . -/3 / 7 The Municipality of Anchorage Development 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_10-10-12.doc 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: Tuxedni Park West; Block 2, Lot 2 Parcel ID: 041-022-52 A. WELL DATA *Pumped 1,479 gallons from well in 240 minutes. Well type Private If A. B. or C provide PWSID# N/A Well Log (Y/N) Yes Date completed 8/22/2013 Sanitary seal (Y/N) Yes Wires properly protected (Y/N) Yes Total depth 340 ft. Cased to 104 ft. Casing height (above ground) 18+ in. FROM WELL LOG AT INSPECTION Date of test 8/22/2013 5/3/2017 Static water level Artesian ft. *Artesian ft. Well production _ 4 g.p.m. 3.5+ g.p.m. WATER SAMPLE RESULTS: 33 Coliform L) colonies/100 ml. Nitrate ' g./L. Collected by: GEG. Ltd. Arsenic: NO ug./L. Date of sample: 5/3/2017 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 10/15-16/2013 Tank size 1.250 gal. Number of Compartments 2 Cleanouts (YIN) Yes Foundation cleanout (YIN) Yes Depression over tank (Y/N) No High water alarm (Y/N) N/A Date of pumping 11/22/2016 Pumper Isaac's Pumping Service C. ABSORPTION FIELD DATA *Below Existing Grade Date installed 10/15-16/2013 Soil rating .p.d./f or ft`/bdrm) 1.2 System type Shallow Trench Length _ 52 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth *8-6 ft. Eff. absorption area 520 ft- Monitoring tube Yes Depression over field No Date of adequacy test 5/3/2017 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 0.5 in. Water added 1.479 gal. New depth *3.5 in. Elapsed Time: * min. Final fluid depth *3.5 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN &type) None Known If yes, give date — **375 gallons of water was introduced at the start of the test, causing a 3.5 inch rise in liquid level. An additional 1,104 gallons was introduced over a 180 minute period causing no rise in liquid level. D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off" level at . wa er alarm level at in. I- •- Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 75'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'-i- Property line 5'+ Absorption field 5'+ Water main 10'+ 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 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain None Known Wells on adjacent lots 100'+ F. COMMENTS 4..:;;;:szop G. ENGINEER'S CERTIFICATIONG . OFA , 0 417'- -..--.--• • 6040 I certify that I have determined through field inspections and * 4,4 IU .7*Q0 review of Municipal records that the above systems are in Q r conformance with MOA COSA guidelines in effect on this , .-,..�.-1.,.1.. 64 date. 00 .13 %...161f4A. 070s..: 4 Engineer's Printed Name JEFFREY A. GARNESS Q -. —79 (eit.p Date 52/th Q P • �o �Pr0 f ess)a�°o #AECC844 (Rev. 11/05) • Municipality of Anchorage On -Site Water and Wastewater Progiam X111 (907)343-7904 __; RU Certificate of On -Site Systems Approval , Parcel I.D. 041-022-52 Expiration Date: Q ` 3 0 d 1. GENERAL INFORMATION Complete legal description TUXedni Park West, Block 2, Lot 2 Location (site address) 9735 Atelier Drive Anchorage, AK 99516 Current Property owner(s) John Sindell & Sarah Lavasseur Day phone Mailing address 11700 Woodbourne Drive Anchorage, AK 99516 Real Estate Agent Day phone Elio 2. TYPE OF DWELLING: qk%# KIWMAL 0 Single Family (w/wo ADU) JUL. 3 0 2014 I ❑ Duplex ' ❑ Multiple Dwellings (Single Family and/or Duplex)f j US If J 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request Received by: A A , Date: '31 IL� COSA to be release to thdengineer, unless otherwise requested by the engineer. COSA Fee $ (0 I so qa "�N ; t'_" Waiver Fee $ IL Date of Payment 1 `' ! L `_ Date of Payment Receipt Number ©pp5a��33� ^P� Receipt Number COSA # a5c— Waiver # S. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE System #1 Approved for A bedrooms Phone 522-7773 Date 7/30/14 System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following GE - 4381 pRO Fli SS10N?' ��� By: Original Certificate Date: �' P The l is t chorage Development 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 forerrors 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 # _of _ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Tuxedni Park West, Block 2, Lot 2 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 8/22/13 Sanitary seal (Y/N) Y Total depth 340 ft. Cased to 104 ft FROM WELL LOG Date of test 8/22/13 Static water level 0 ft. Well production 4 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate •142 mg/L Arsenic ND ug/L Date of sample: 7/23/14 Parcel ID: 041-022-52 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) >18 in. AT INSPECTION ft, F! IUM Collected by: Anderson Engrg. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 10/15/13 Tank size 1,250 gal. Number of Compartments 2 Cleanouts (YIN) Foundation cleanout (Y/N) Y Depression over tank (YIN) N High water alarm (Y/N) Date of pumping New Const. Pumper C. ABSORPTION FIELD DATA Y N Date installed 10/16/13 Soil rating (g.p.d./ftz or ftz/bdrm) 1.2 GPD/SF System type 5' Wide Length 52 ft. Width 5 ft. Gravel below pipe 4.0 ft. Total depth 8 ft. Eft, absorption area 520 ftz 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 Datum No Add On Manhole - Gravity Flow to Absorption Trench. Size in gallons _ in. 'Pump off' level at Cycles tested _ E. SEPARATION DISTANCES WELL ON LOT TO: Manhole/Access (Y/N) in. High water alarm level at Meets alarm & circuit requirements? Septic tank/lift station on lot >100' On adjacent lots >100' Absorption field on lot >1 00' On adjacent lots >1 00' Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line >25' Holding tank N/A Animal containment areas >50' Manure/animal excrete storage areas >100, SEPTIC/HOLDING TANK ON LOT TO: Building foundation > Property line >51 Water main > 10, Water service line > 10 Wells on adjacent lots >100, ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water Service line >10' Surface water >100 Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS G. ENGINEER'S CERTIFICATION l certify that t 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 7/30/14 COSA brown sheet 10-10-12.doc Absorption field >5, Surface water >100' Water main N/A Driveway, parking/vehiclestorage > 0 A 46 E. ANDERSON • W j a-4381 ASAI 111 T bblvAbw H L1S6[AUKEE'S LAND SURVEYING 694-0829 1 HEREBY CERTIFY THAT 1 HAVE SURVEYED THE SCALEt, , v�v4 FOLLOWING DESCRIBED PROPERTY r� OF A� r%i(! Z DATE• 4V (�G ...... /� y AND THAT NO ENCROACHMENTS EXIST EXCEPT A5 INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: ' • • ,^aa • •. • EASEMENTS, COVENANTS, OR RESTRICTIONS Z6yZ i WHICH DO NOT APPEAR ON THE RECORDED SUBDI— VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB' i LS -54113 r a ANY DATA HEREON BE USED FOR CONtovTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. DRAWN .G-'� a r: