HomeMy WebLinkAboutDEARMOUN #2 BLK 1 LT 5t)earmoun #2
Block 1
Lot 5
#018-401-25
p —
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: OSP141176
PID Number: 050-581-22 ❑� New ❑ Upgrade
Name:
Calvin L. Chinnis
ABSORPTION FIELD
❑ Deep Trench ❑✓ Shallow Trench ❑ Bed ❑ Mound
Address
6858 Brittany Rock Way Anchorage, AK 99504
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
4
6 GPDfsf
3.5 Ft,
LEGAL DESCRIPTION
Depth to pipe invert from original grade
1 Ft.
Gravel depth beneath pipe
2.5 Ft.
Subdivision. -
Block Lot
DeArmoun No. 2
1 5
Fill added above original grade
2-8 Ft.
Gravel length
128 Ft.
Township Range Section
Gravel width
5Ft.
Beds: Number of Lines
Distance between lines
SEPARATION DISTANCES
Ft.
To
Septic
AbsorptiontLISewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Line
1,000Ft2
Two
>10Ft.
Well
>200'
>200'>25�
TANK 0 Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Tank
Capacity
1,500Ga1.
Surface Water
>100'
>100'Anchorage
Material
Number of compartments
Lot Line
>5'
>10'
Steel
Three
NAFoundation
>5'>10'LIFT
STATION
Manufacturer
Capacity
Curtain Drain
None
NotedAnchorageTank/Orenco
1,500Ga1.
Remarks
Pump on level at
40 in.
Pump off level at
44 in.
High water alarm at
46 in.
Pump make and model
OSI P2005-11
Electrical Inspections performed by
Municipality of Anchorage
Installer
PIPE MATERIAL Housetotank D3034 Tankto D3034
drainpfield
Richie Excavating
Drainfield HDPE F'8L1U MT D3034
Inspector MEA
BENCH MARK (Assumed elevation) 100.0ft
Inspection.�
dates: t 5114/14 2"
5/15/14
Location and description
p
3`tl 3/16/15 4'h
Back Deck.
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
+
OF ttt
,*,t�E q4
��•••••• 9Ss!
Conditional Approval:
Date
�<P'
�•.y
TH06
� •................................
A, MICHAEL E. ANDERSON :I-
I-
CE
CE - 4381
�tt'Ijpe`
ApprovedDate
3- o'/
>•�4'+
1 --tion Re o 1 12�dodf
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Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT Page 2 of 3
4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904
Permit Number: OSP141176 PID NO.: 018-401-25
I\S2
PLAT N0. 70-352
M2MOUN SUBDIVISION, NO. 2
LOT 5, BLOCK 1
15,727 S.F.(R)
15,753 S.F.(C)
rtncs p�v�0
A Bs1 10.7' 22.6's2 1a.a 19.3'MH 20.3' t8.7'O MI 40.0' 26.8'M2 103.5' 82.9'o�r'Pj M3 41.2' 16.6'M4 88.0' 64urNal M1 •ALTERNATE SIAdvantex Treatment System
with a 26' Long x 5' Wide x
2.5' Effective Depth Absorption
Trench.
00
49th
MICHAEL E. ANDERSON
No. CE -4381
Water Service
Four Bedroom
Home
5 89'56'00"E 114.92'(R)
SITE
QIF pp
J
MATTHEWS DRIVE
PLAN
SCALE 1" = 30'
LEGEND
MT - Monitor Tube
FCO - Foundation Clean Out
TH - Test Hole
CO - Clean Out
2CO - Double Clean Out
MH - Man Hole
SV - Septic Vent
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
Permit Number: OSP141176
N
� U1
Existing Finishe
Ground round
1,500 Gallon
STEP Tank
4.6
Page 3 of 3
PID No. 018-401-25
x
~ .2
5-15-14 WEST TRENCH
19 - 5116" Diameter Holes @ 4.0'
11 - 5116" Diameter Holes @ 4.0'
EAST TRENCH
PROFILE AS -BUILT
No Scale
95.1
W .
P.O. Box 196650 0 4700 Elmore Road
Anchorage Alaska 99519-6650 0 (907) 343-7904 0 Fax (907) 343-7997
http:/lwww. mu ni.org/Onsite
Development Services Division
On -Site Water and Wastewater Program
n�ent
t
DeP
1� Fh
ttment
**** VARIANCE/WAIVER REVIEW ****
Waiver#: OSV151007 COSA#:OSCIS1096 Permit#:OSP141176
PID#: 018-401-25
Legal Description: DeArmoun #2. Block 1, Lot 5
Engineer: Anderson Engineering
Applicant: Calvin Chinnis
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 5.0 feet.
This waiver approval applies to the existing 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
-''ace
aujaceiit property.
❑ Adjacent properties are not affected by this waiver.
..............................................................................1
Waiver is Granted: X Waiver is not Granted:
Date: 3 Approved by:
ame of Reviewer
.............................................. ke ...............................
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766'(FAX)
March 11, 2015
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Lot 5, Block 1, DeArmoun Subdivision No. 2
Separation Distance Waiver
Absorption Trench to Lot Line
Dear On Site Services Engineer:
A new absorption system was recently placed on Lot 5, Block 1, DeArmoun Subdivision
No. 2. The northern property line was not clearly marked and the absorption trenches
were constructed 5' from the property line. The trench locations do not impact the
property to the north as they are more than 50' from the septic system on that property.
All lots in the subdivision are served by a community Class A Well more than 200' from
the septic systems. We recommend a waiver be issued allowing the trench to remain 5'
from the north property line.
Sincerely,
Michael E. Anderson, P.E.
MICHAEL E. ANDERSON
6. No. CE -4381
On -Site Wastewater Disposal System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number: OSP141176
Tax Code Number: 01840125000
Work Type: Septic Initial
Permit Effective Dates: June 23, 2014 to June 23, 2015
Design Engineer: ANDERSON ENGINEERING
Subdivision: DEARMOUN #2
Site Legal Address: DEARMOUN #2 BILK 1 LT 5 G:2935
Owner/Address: CHINNIS CALVIN L
6858 BRITTANY ROCK WAY ANCHORAGE AK 995043998
Site Mailing Address: 3641 MATTHEWS DR, Anchorage
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank
Lot Size in Sq Ft: 15727
Total Bedrooms: 4
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.
Receiv,
Issued
MUNICIPALITY OF ANCHOViSLOITTAL
JUN 0 5 2014
Community Development Department Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On -Site Water & Wastewater Program
ON-SITE SEWERIWELL PERMIT APPLICATION
Parcel I.D. 018-401-25
Property owner(s) Calvin and Maria Chinnis Day phone 727-5259
Mailing address 16858 Brittany Rock Way Anchorage, AK 99504
Site address Matthews Drive Anchorage, AK 99516
Legal description (Sub'd., Block & Lot) DeArmoun #2, Block 1, Lot 5
Legal description (Township, Range & Section)
Lot Size 15,727 Sq. Ft.
APPLICATION IS FOR:
(® all that apply)
Absorption Field
Ej
Septic Tank
Q
Holding Tank
❑
Privy
❑
Private Well
❑
Water Storage
❑
Number of Bedrooms Four (4)
APPLICATION IS AN:
TYPE OF DWELLING:
Initial 0
Single Family (SF) 0
(w/wo ADU)
Upgrade ❑
Duplex (D) El❑
Renewal
Multiple Dwellings ❑
(SF and/or D)
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Dis tance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
rratcell
Permit/Rush Fees: — Waiver Fees:
Date of Payment: (0 15_11q Date of Payment:
Receipt Number: ✓� 0tJy� q rh Receipt Number:
(5r
Permit No. j'7 jj1 1p Waiver No.
Permit App_9-1-12.doc
June 4, 2014
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 5, Block 1, DeArmoun Subdivision No. 2
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of the subject lot 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 currently served by a Class A
Water System. The attached Site Plan and backup documentation identify the location
and configuration of the proposed septic system along with the alternate site. Also
identified on the plans are the existing 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 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
indicate the presence of silty sand with some gravel (SM). The percolation rate of the
material was determined to be 19 minutes per inch. Groundwater was found during the
placement of the test hole at 14' below the surface and rose to 8' during the monitoring
period. An application rate of .6 gallons per day per square foot was used in the
design of the absorption system. We are proposing to place a new 1,500 -gallon STEP
tank and 2 new 63' and 55' long by 5' wide by 2.5' effective depth absorption trenches
to treat and dispose of the effluent generated in the house. The elevation of the
distribution line in the absorption trenches will be 1' below the existing ground surface
and the total depth will be 3.5' below ground. 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 west at a
very shallow grade. The new trenches 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 100' from all wells and any surface water and 10' the
Lot 5, Block 1, DeArmoun Subdivision No. 2
June 4, 2014
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, ss
Michael E. Anderson, P.E.
Attachments
3
49th
..............................................
��E'_N[CNAEL E. ANDERSONONP.
3
7 8 0
Septic Area
_MATTHEWS
5
0
City WaterandSewer
....... -x........ F ...... --....
Jt
7
10
10
\ Class�A Well
\ O
2 8 9
1
DEARM❑UN ROAD
AREA MAP
SCALE 1' = 100'
=191111
1151
Septic Area
it
:I
II
6
I
1I-
Y
8
Y'
a
a
0
u
4
VACANT
j
i
Q
3
49th
..............................................
��E'_N[CNAEL E. ANDERSONONP.
3
7 8 0
Septic Area
_MATTHEWS
5
0
City WaterandSewer
....... -x........ F ...... --....
Jt
7
10
10
\ Class�A Well
\ O
2 8 9
1
DEARM❑UN ROAD
AREA MAP
SCALE 1' = 100'
=191111
1151
2-3%
2`39.
TH1
DE ARMOUN SUBDIVISION, NO. 2
PLAT NO. 70-352
LOT 5, BLOCK 1
15,727 S.F.(R)
15,753 S.F.(C)
128' (73' & 55') Total Length
x 5' Wide x 2.5' Effective
Depth Absorption Trenches.
h SCJ
2�J% Ci. S
N
J
m 11,
Brl
I
Alt. 22^J%
Site
1
®2�J%
TH2
1,500 Gallon
/,STEP Tank
Four Bedroom
Home
S 89'58'00"E 1
NOTE:
No Areas or Excessive Slope
or Surface Water are Within
100' of Any Part of the New
Septic System.
A T RNAT IT
Advantex Treatment System
with a 26' Long x 5' Wide x
2.5' Effective Depth Absorption
Trench.
Wc[er —Se
SITE PLAN
SCALE 1' = 30'
MATTHEWS DRIVE
LEGEND
MT - Monitor Tube
FCO - Foundation Clean Out
TH - Test Hole
CO - Clean Out
2CO - Double Clean Out
MH - Mon Hole
SV - Septic Vent
N
2-3%
W
2 2
MT
o
b
I
z z
,
2`39.
TH1
DE ARMOUN SUBDIVISION, NO. 2
PLAT NO. 70-352
LOT 5, BLOCK 1
15,727 S.F.(R)
15,753 S.F.(C)
128' (73' & 55') Total Length
x 5' Wide x 2.5' Effective
Depth Absorption Trenches.
h SCJ
2�J% Ci. S
N
J
m 11,
Brl
I
Alt. 22^J%
Site
1
®2�J%
TH2
1,500 Gallon
/,STEP Tank
Four Bedroom
Home
S 89'58'00"E 1
NOTE:
No Areas or Excessive Slope
or Surface Water are Within
100' of Any Part of the New
Septic System.
A T RNAT IT
Advantex Treatment System
with a 26' Long x 5' Wide x
2.5' Effective Depth Absorption
Trench.
Wc[er —Se
SITE PLAN
SCALE 1' = 30'
MATTHEWS DRIVE
LEGEND
MT - Monitor Tube
FCO - Foundation Clean Out
TH - Test Hole
CO - Clean Out
2CO - Double Clean Out
MH - Mon Hole
SV - Septic Vent
LOT 5, BLOCK 1, DEARMOUN SUBDIVISION NO. 2
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Four Bedroom Home 5' Wide Trench System
Perc. Rate: 19 Min./Inch 1,500 Gallon STEP Tank
Application Rate: .6 GPD/SF 2.5' Drainfield Rock
3 Bedrooms X 150 GPD/1.2 GPD/SFApplication Rate) = 375 SF Absorption Area
375 SF/5 SF/LF-.5 (Red. Factor) = 34.5 LF Trench Length
THEREFORE: Construct a 63' and 55' Long x 5' Wide x 2.5' Effective Depth Aborption Trench at the
Location Shown. Flow Line Elevation in Trenches to be 1' Below Original Ground Surface. Total Depth
to be 3.5' 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.
Mi
2'6"
Natural
Backfill
5'
Geotextile Fabric
1" Perforated
PVC (Holes Down)
30 - 3/16" Diameter
Holes @ 4' Spacing
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.
Minimum200' Separation From Class A Well in the Area.
Minimum 100' Separation From Surface Water or Streams.
Minimum 10' Separation From Water Service Line.
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 ELMORE ROAD ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: DE ARMOUN No. 2 LOT 5 BLOCK I
PERFORMED FOR: CHRIS HOUGHTON
DATE: 5/14/20 IL, PROJECT No.:
PARCELID#: TECHNICIAN: JB
DEPTH TEST HOLE 1
(feet)
1 OB/OG
2
3
4
5
6 SM/GM
7
8
9
II
14
15
16
17
18
19
COMMENTS
BOH @ 13.5'
SLOPE
27'
WAS GROUND WATER ENCOUND? r cI "
IF YES @ WHAT EPTH?
DEPTH OF WATER AFTER MOMT G: 7.5'
DATE OF MONIT RANG: 5/15/14
6/3/14
130'
v
491
Pm&.i..o
R
S
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH To
WATER
(INCHES)
NET DROP
(INCHES)
TEST HOLE PRESOAKED PRIOR TO TESTING:
6/3
1
2:20
3"
2
2:50
30
4.375"
1.375"
3
2:51
2.5"
4
3:21
30
3.375"
0.875"
5
3:22
2.5"
6
3:52
30
3.25"77075"
PERCOLATION RATE: 40 (MIN/INCH) PERC. HOLE DIA. 11 (INCHES)
TEST RUN BETWEEN: 4 FT. and 5 FT.
TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. I, BENJAMIN SCHILLER, CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 6/3/2014
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 ELMORE ROAD ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: DE ARMOUN No. 2 LOT 5 BLOCK I
PERFORMED FOR: CHRIS HOUGHTON
DATE: 5/14/2014 PROJECT No.:
PARCEL ID#: TECHNICIAN: A. HARALA
DFPTH TEST HOLE 2
(feet)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
1033INUMN&Y
SM/GM
BOH @ 17.0'
WAS GROUND WATER ENCOUNTERED? NO
49th
MICHAEL E. ANDERSON
Professional
IF YES @ WHAT DEPTH?
8.0'
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH OF WATER AFTER MONITOANG
8.0'
L
TEST HOLE PRESOAKED PRIOR TO TESTING:
5/14
1
D
CO=
DATEOFMONTT:
5 /15/14
p
2
21:22
6/3/14
'rte
1.50"
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH TO
WATER
(INCHES)
NET DROP
(INCHES)
TEST HOLE PRESOAKED PRIOR TO TESTING:
5/14
1
20:52
2.25"
2
21:22
30
3.75"
1.50"
3
21:23
2.13"
4
21:53
30
3.63"
1.50"
5
21:54
2.00"
6
22:24
30
3.50"
1.50"
PERCOLATION RATE: 20 (MINANCH) PERC. HOLE DIA.—.6—(INCHES)
TEST RUN BETWEEN: 4 FT. and 5 FT.
TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. I, BENJAMIN SCHILLER, CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATA- 6/3/2014
E
• Municipality of Anchorage
On -Site Water and Wastewater Program
(907)343-7904
Certificate of On -Site Systems Approval
Parcel I.D. 018-401-25 Expiration Date:
1. GENERAL INFORMATION
Complete legal description DeArmoun #2, Block 1, Lot 5
Location (site address) 3641 Matthews Drive Anchorage, AK 99516
Current Property owner(s) Calvin & Marla Chlnnis Day phone
Mailing address 6839 Peck Avenue Anchorage, AK 99504
Real Estate Agent Day phone
2. TYPE OF DWELLING:
Single Family (wlwo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: Four
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
❑
Individual
Q
Individual Water Storage
❑
Holding Tank
❑
Community Class A Well
El
Community
❑
Public Water System
❑
Public Sewer
❑
WaiverNariance request for �� ` �� t V V ` - Distance: 5
Date: l2a / -'5--
otherwise requested by the engineer.
COSA Fee $ �� •(ay" / Waiver Fee $ ) 1 s
Date of Payment f (i � �S C Date of Payment I! f a h S
Receipt Number �it�i�a �Receipt Number
6uy6q G
COSA4 C)� L� f0-l(� r4o Waiver# 0-W
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
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E.
Phone
Date
522-7773
A .a v
4g T11
DSD SIGNATURE
V System #1 Approved for bedrooms 40 c MICHAEL
CE-e4AN
3£3pER oh` `
4
System #2 Approved for bedrooms ®OpTF9f.; • j •-/s; .���`��
Disapproved ®440 OFESSV�o
Conditional approval for bedrooms, with the following stipulations:
By: (� . j Original Certificate Date:
Thn orage Development Services Division (DSD) issues Certificates of Or 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 sbeel r
If more than t septic system is on the lot:
COSA Checklist # _ _of
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description: DeArmoun #2, Block 1, Lot 5 Parcel ID:018-401-25
A. WELL DATA
Well type Class A If A, B, or C provide PWSID # 211936 Well Log (Y/N)
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
Static water level ft.
Well production g.p.m.
WATER SAMPLE RESULTS:
Coliform colonies/100 ml Nitrate mg/L
Arsenic ug/L Date of sample:
B. SEPTIC/HOLDING TANK DATA
TankType/Material STEP/Steel
Tank size 1,500 gal. Number of Compartments 3
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N
Date of pumping New Const. Pumper
C. ABSORPTION FIELD DATA
ft.
g.p.m.
Collected by:
Date installed 5/14/14
Cleanouts (Y/N) Y
High water alarm (Y/N)
Date installed 5/15/14 Soil rating (g.p.d.e or ftZ/bdrm) •6 GPD/SF System type 5' Wide
Length 128 ft. Width 5 ft. Gravel below pipe 2.5 ft.
Total depth 5'5-11 ft. EYE absorption area 1,000 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 No Add On Manhole - Gravity Flow to Absorption Trench.
Date installed
5/14/14 Size in gallons 1,500 Manhole/Access (YIN) Y
, I It 40 in "Pump ofP' level at 44 in. High water alarm level at 46
Pump on eve a
Datum Bottom of Tank Cycles tested New Const. Meets alarm & circuit requirements? Y
E. SEPARATION DISTANCES - Lot served by Public Water System and Class A Well.
WELL ON LOT TO:
Septic tank/lift station on lot
Absorption field on lot
Public sewer main
Sewer /septic service line
Animal containment areas
SEPTIC/HOLDING TANK ON LOT TO
On adjacent lots
On adjacent lots
Public sewer manhole/cleanout
Holding tank
Manure/animal excrete storage areas
Building foundation >5' Property line >5'Absorption feel
Water main >10' Water service line >10' Surface water
Wells on adjacent lots >200'
ABSORPTION FIELD ON LOT TO:
Property line >10' Building foundation >10'
P
Water Service line >10' Surface water
>100'
1
Curtain drain
None Noted wells on adjacent lots >200'
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name Michael E. Anderson, P.E.
Date 3/18/2015
COSA brown sheet 10-10-12.doc
Water main
d >51
>100'
>10'
Driveway, parkingtvehicle storage > 10'
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PLAT NO. 70-352
DE ARMOUN SUBDIVISION,
LOT 5, BLOCK 1
15,727 S.F.(R)
15,753 S.F.(C)
NO. 2
GASTALDI LAND
SURVEYING, LLC
JEFF A. GASTALDI, R.L.S.
2000 E DOWLING RD., SUITE P
ANCHORAGE, ALASKA 99507
PHONE 248-5454
GRID DATE
SW2935 2/5/2015
F.B. JOB NO.
14-06 DA251
I HEREBY CERTIFY THAT 1 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
.EGEND
iASS CAP MONUMENT
X 30" REBAR WITH YELLOW
;AP STAMPED "LS -6091"
)IMENSION PER PLAT NO. 70-352
) DIMENSION THIS SURVEY
ED DIMENSION THIS SURVEY
MATTHEWS DRIVE
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