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Home My WebLink AboutFIRE LAKE LT 3 TR EFire Lake Tr E Lot 3 #051-333-09 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: OSP1.41214 PID Number: 051-333-09 ❑ New ❑✓ Upgrade Sara Benson 18607 Fish Hatchery Road of Bedrooms 3 I Fere Lake, Tract E 3 SEPARATION DISTANCES To From Septic Tank Absorption Field Lift Station Holding Tank Sewer Line Well 109.4 103.1 109.4 N/A 100+ Surface Water 75 57.7 75 N/A Lot Line 75.4 74.0 75.4 N/A NA Foundation 5.0 12.7 5.0 N/A Curtain Drain N/A NIA N/A N/A 3'" 41h Remarks 3SORPTION FIELD ❑ Deep Trench ❑✓ Shallow Trench ❑ Bed ❑✓ Mound ❑ Other iI Rating Total depth from original grade 1.2 GPD/SF 4.d Ft. pth to pipe invert from original grade Gravel depth beneath pipe 1.0 Ft. 3.0 Ft. added above original grade Gravel length 1.5 Ft. 45.0 Ft. avel width Beds: Number of Lines Distance between lines 5.0 Ft N/A N/A Ft i area Number of trenches 388 Fe 1 Septic E) S.T.E.P. ❑ Holding [ C Tank/ Orenco STEEL 'ATION Orenco I 250 'ump on level at jPump off level at lHiqh water alarm at 2 itional Approval: Approved inspection raeport_1-1-1z.aoc Date Date `0 43 in, 40 in. 45 in. Pump make and model P2005 Electrical Inspections performed by PIPE MATERIAL House to tank 3034d Tank 3034Tank to 3034 Installer JR's Septic Pumping Drainfleld 3034 CO/MT 3034 Inspector Pannone Engineering Services BENCHMARK (Assumed elevation) 10011 Inspection is 7/31/2014 a 8/1 /2014 Location and description dates: 2^ Top of slab, outside back door. 3'" 41h COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp itional Approval: Approved inspection raeport_1-1-1z.aoc Date Date `0 G CONSTRUCTED NEW LANDSCAPE BERM TO CREATE MIN 100' PATH FROM ANY PART OF THE DRAIN FIELD FOP, POTENTIAL _ EFFLUENT SPILL TO SURFACE WATER I i 57.7 I � ITH-1 z 66 /# . P/ v P � I J -2A f NOTES. RECORD DRAWING PLAN INSTALLED NEW DRAIN FIELD 45LF x 5.0'W x 3.0'ED x 4.0'TD MAINTAINED 5' MIN SEPARATION TO TEST HOLE \1 B 3BR `T1 HOUSE (E) A AA T2 ABANDON CESSPOOL (E) PER CODE REMOVED ANY PORTION WITHIN 10' OF PROPOSED FIELD AND REPLACED W/ CLEAN NATIVE SOIL OR APPROVED EQUAL � � h 1250g S.T.EP. TANK (P) 1� WILLL (E) 5. E FISH HATCHERY ROAD SEPTIC AREA (E) �� WELL (E) 1 w-_IW—�/ 11 11 \ 3 SEPTIC AREA (E) PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 FIRE LAKE, LOT 3, TRACT E SARA BENSON 18607 FISH HATCHERY ROAD EAGLE RIVER, AN 99577 WELL (E) .C+kq,`Aj, 10/6/2014 *-"4 *.�) 1 —so' P.LD- NO -051-333-09 Steven R. none PERMIT NO. PF. CE 8149 .'<�/� OSP141214 ��s'. ,.•fir I`t%ROEES"` � Sh2 eOF 3 A 6 FC 12.6 18.8 T1 14.5 21.1 -2 T2 18.1 27.3 LS 19.3 29.0 M2 16.2 33.7 57.7 I � ITH-1 z 66 /# . P/ v P � I J -2A f NOTES. RECORD DRAWING PLAN INSTALLED NEW DRAIN FIELD 45LF x 5.0'W x 3.0'ED x 4.0'TD MAINTAINED 5' MIN SEPARATION TO TEST HOLE \1 B 3BR `T1 HOUSE (E) A AA T2 ABANDON CESSPOOL (E) PER CODE REMOVED ANY PORTION WITHIN 10' OF PROPOSED FIELD AND REPLACED W/ CLEAN NATIVE SOIL OR APPROVED EQUAL � � h 1250g S.T.EP. TANK (P) 1� WILLL (E) 5. E FISH HATCHERY ROAD SEPTIC AREA (E) �� WELL (E) 1 w-_IW—�/ 11 11 \ 3 SEPTIC AREA (E) PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 FIRE LAKE, LOT 3, TRACT E SARA BENSON 18607 FISH HATCHERY ROAD EAGLE RIVER, AN 99577 WELL (E) .C+kq,`Aj, 10/6/2014 *-"4 *.�) 1 —so' P.LD- NO -051-333-09 Steven R. none PERMIT NO. PF. CE 8149 .'<�/� OSP141214 ��s'. ,.•fir I`t%ROEES"` � Sh2 eOF 3 SPECIAL PROVISIONS TO SPECIFICATIONS 1 . ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN. CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS AND ATTACHED PES SPECIAL PROVISIONS. 2. SCOPE OF WORK: INSTALLED NEW 1250g S.T.E.P. TANK AND SOIL ABSORPTION SYSTEM, CONSTRUCTED LANDSCAPE BERM 3. GROUNDWATER WAS OBSERVED AT A DEPTH OF 9.0 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. AN APPARENT WATER TABLE WAS NOT OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 9.0 FEET BELOW EXISTING GRADE. BERM PROVIOa%INIMUM F4-6f'COdEia - IBR RIGID INSULATION SWALE 1➢" 0 DRAIN PIPE W/BERM HOLES 18"O.C. C 5, �1ILT FILTER FABRIC 0.5 � MIN S DRAIN ROCK 6' ABOVE PIPE INVERT MIN MIN 99.3 / 2.0 978 ALE SECTION SWALE D 1OR 96.8 -- -.3�� ' -19 10 93.8 I GM/ ORAr DRAIN ROCK 5.0 SM - 93,9 PATy 33CF C 1 X98866 GM 98.3 O SECTION 'A FP Z Z m RICK INSULATION 0, �r-FIVER FABRIC m �4 X. ZQ DRAIN ROCK o' ABOVE PIPE INV r 98,0 00W 1)4" 0 DRAIN PIPE W/ �'�1 /8" HOLES 18" O.C. In 002 I SWALE PLAN 4-0 - TRENCH SEE DESIGN 95.8 1250 g S.T.E.P. TANK (P) PROFILE ABBREVIATIONS COPPER DESIGN PARAMETERS DI N PIPE D IHOLE UPGRADE SEPTIC SYSTEM LEGEND TH TEST NO. BEDROOM: 3 (450 gpd) WATER LINE/ FC FOUNDATION CLEAN OUT TANK SIZE: 1250g S.T.E.P. - W_ WELL RADIUS T# TANK CLEAN OUT NO. PERC RATE = 3.1 MPI SOIL RATING: 1.2 GPD/SF C# CLEAN OUT NO. SS NEW SEPTIC AREA ROD: 375 SF M, MONITOR TUBE NO. � SYS. TYPE: WIDE TRENCH 3.0" E.D. R.I. RIGID INSULATION RF: 0.58 DCO DOUBLE CLEAN OUT MIN LENGTH: 43.5 LF OV DIVERTER VALVE - FS FLOW SPLITTER USED: BFG BELOW FINISH GRADE 45 LF X 5' WIDE, 3.0' E.D., 4.0' TD OG ORIGINAL GRADE TOTAL .AREA: 388 SF FG FINISH GRADE TS&V TOPSOIL & VEGETATE NOTES: PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 —�`o�F, a �� :`(�,. .L.q l`� r S %g�P �9 t�1 j.. 4.. ... .. .*frl Date 10/6/20141 RECORD DRAWING Scale NI TS NO FIRE LAKE, LOT 3, TRACT E 'e'ven '''n' -a3a-o9 SARA BENSON 18607 FISH HATCHERY ROAD St R. an e j 9�„, CE 8149 .j`r% f c, � � +�isT�Fa..•..NPV PERMIT No. OSP141214 Sheet DESIGN DETAILS EAGLE RIVER, AK 99577 �� ROFESSIO 3 OF 3 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: OSP141214 Tax Code Number: 05133309000 Work Type: Septic Upgrade Permit Effective Dates: July 02, 2014 to July 02, 2015 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: FIRE LAKE Site Legal Address: FIRE LAKE LT 3 TR E G:0554 Owner/Address: BENSON SARA 402 GREDING ST BLUFFTON OH 458170000 Site Mailing Address: 18607 FISH HATCHERY RD, Eagle River Lot Size in Sq Ft: 20909 Total Bedrooms: 3 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By By Date ' L Date: ?� V Municipality of iir P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 99519-6650 ! (907) 343-7904 0 Fax (907) 343-7997 http:tlwww.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program Waiver#: OSP141215 COSA#: Permit#:OSPI41214 m.en t a Department PID#: 051-333-09 Legal Description: Fire Lake, Lot 3, Tract E T h i S Q- se.P-N Engineer: PES CLAfl. OfFY-t�ve� p�joeN X%s-�+n,eo`9".'7 io 5 )��ll Same Applicant: Sara Benson us+ IRcAa"iof\S� � berm +0 rvy\. ,t h Zn, p la �� RM C Your request for a waiver of the required 100 feet horizontal separation from the absorption field (�/3olLoLt to the surface water has been approved. The approved separation distance is 50.0 feet. 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 .o�vner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. ■rvvarrrvvverrvvrsvrvarrmvrrervrmrrmevvravrvvrmrrrrrarrvrrrrvvvrrerrrrvrvravvr� Waiver is Granted: X Waiver is not Granted: Date:a� l Approved rb —Reviewer I-r—ame of Reviewer .rrr.r.rrmrm.rr.mr...rr..rr.rr..rrr.rmrrr.rrrrrmmrrrrrmrmr.rrrr..rrrrrrrr..rr.r 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. 051-333-09 Property owner(s) Sara Benson Day phone Mailing address 18607 Fish Hatchery Road, Eagle River, AK 99577 Site address 1$607 Fish Hatchery Road Legal description (Sub'd., Block & Lot) Fire Lake, Lot 3, Tract E Legal description (Township, Range & Section) Lot Size 20,909 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field Q Initial ❑ Single Family (SF) (w/wo ADU) Septic Tank 0 Upgrade 0 Duplex (D) Holding Tank ❑ Renewal ❑ Multiple Dwellings Privy F-1(?F and/or,Q)� Private Well ❑ Water Storage ❑ JUN" 1 9 2014 THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Septic System to Surface Water Distance: 50 I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature property owner or authorized agent) Permit/Rush Fees: 15 1:061 , Waiver Fees: Z Date of Payment (a 6 M Date of Payment: (,I t Receipt Number. 63101 I Receipt Number: C)�ybcl 1 Permit No. 05191 121`1 Waiver No. C�vP/q) 24 5 Permit App__- ❑X Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panengak.com July 1, 2014 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road P. O. Box 196650 Anchorage, Alaska 99519 Subject: Fire Lake, Lot 3, Tract E Septic System Upgrade Permit Request Ladies and Gentlemen: I am writing to request a permit to construct an upgraded septic system be issued for this property. The proposed systems will serve an existing three-bedroom house. Currently the lot is developed. The previous septic system was an undocumented cesspool. The cesspool will be abandoned per code. If any part of the existing cesspool is encountered within 10' of the new field it will be removed along with any biomatted material and replaced with clean native soil or approved equal. The lot is served by a private well, that is located over 100' from this system. There surrounding developed lots are also served by private wells that are over 100' from this system. 1. Soils. A single test hole was excavated by Pannone Engineering Services and the ground water monitored for seven days. Groundwater was monitored to a depth of 9 feet after the seven day monitoring period. Bedrock was not encountered in the test hole. It is my opinion, based on the results of the percolation tests and overall soils appearance; an application rate of 1.2 gallons/day/square feet should be used for a conventional waste water system. 2. Soil Absorption System Design. a. See Sheet 2 of the design package 3. Surface Water: Upper Fire Lake and the stream exiting the lake are located 50.2 and 52.4 feet from the proposed drain field respectively. See waiver request. 4. Topography: The topography in the area generally slopes to the north at approximately 3%-5% in the area of the proposed drain field. 5. Waiver Request: I request a drain field to surface water waiver of 50 feet from the septic system. Mounds will be built to ensure a drainage path that flows a minimum of 100' before any chance of Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East I'Vianor Ave, Anchorage, AK 99501 Telephone: (907) 272-13218 FAX: (907) 272-8211 Page 2 of 2 encountering surface water. Granting this waiver will not impact current or future development on any of the surrounding lots, nor will it impact the water quality of the nearby drainage. 6. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On -Site Department, the note will be removed and `Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells or septic systems within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Attachments -Soils Log -Septic System Design ,sailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 932 Fast Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-9218 FAX: (907) 272-8211 CONSTRUCT LANDSCAPE BERM (P) TO CREATE MIN 100' PATH FROM ANY PART OF THE DRAIN FIELD FOR POTENTIAL INSTALL DRAIN FIELD (P) EFFLUENT SPILL TO SURFACE WATER 45LF x 5.0'W x 3.0'ED x 4.0'TD p .7 MAINTAIN 5' MIN SEPARATION TO TEST HOLE 50.2 , TH-1 ri HOUSE y5 (E) M 52.4 �` 1'` ABANDON CESSPOOL (E) PER CODE REMOVE ANY PORTION WITHIN 10' OF PROPOSED FIELD AND REPLACE W/ CLEAN NATIVE SOIL OR APPROVED EQUAL G� 1250g S T.E.P. TANK (P) \ 101.4 105.1 �� WELL (E) 3 �� a E�` J -2A FISH HATCHERY ROAD N\ �- SEPTIC AREA (E) E WELL (E) WELL (E) / 3 SEPTIC AREA (E) NOTES: �� p0 L1�T/1 CC7! TT! Date FOR CONSTRUCTION P.O. BOI 1`21 INCH JYL' LLC .... .... Is � 7/1 /20t4 P.O. BOX 100217 ANCHORAGE, AK 99570 r�P�• ' S� + Scale PHONE (907) 272-8218 FAX (907) 272-8211 * .49TH *�"=so' � ......... e$ }. t . .... � P.I.D. NO FIRE LAKE, LOT 3, TRACT E �'a `.- — oet-as3-oe SARA BENSON Steven R. Pannone / PERMIT N0. , �P� CE 8149 �� OSP141214 18607 FISH HATCHERY ROAD � c _ PLAN EAGLE RIVER, AK 99577 '�1��.........Sheet ��\9 S9 1 OF 3 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS AND ATTACHED PES SPECIAL PROVISIONS. 2. SCOPE OF WORK: INSTALL NEW 1250g S.T.E.P. TANK AND SOIL ABSORPTION SYSTEM. CONSTRUCT LANDSCAPE BERM 3. GROUNDWATER WAS OBSERVED AT A DEPTH OF 9.0 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 9.0 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. PROVIDE MINIMUM 3' OF COVER OR RIGID INSULATION il'>" 0 DRAIN PIPE W/ /-1/8` HOLES 18" O.C. ,- FILTER FABRIC /'DRAIN ROCK 6" / ABOVE PIPE INVERT LO FIE 3 0<< OR _1.0 mRIGID f O� FC DRAIN ROCK GM/ FILTER FABRIC P 5.0 SM Q —9.01 17 R. 1. a SECTION DOUBLE CLEAN OUT GM BERM SWALE � BERM MIN MIN 0.5' MIN SWALE SECTION Z COPPER Z mRIGID INSOLATION w O� FC O F FILTER FABRIC P QO O Q ¢ R. 1. a ZQ DOUBLE CLEAN OUT DV DRAIN ROCK 6" ABOVE PIPE INV a FS FLOW SPLITTER CL BELOW FINISH GRADE z 1Ya" 0 DRAIN PIPE W/ TI/'1 ORIGINAL GRADE FG FINISH GRADE n /8" HOLES 18" O.C. 1250 g S.T.E.P. TANK (P) DESIGN PARAMETERS UPGRADE SEPTIC SYSTEM NO. BEDROOM: 3 (450 gpd) TANK SIZE: 1250g S.T.E.P. PERC RATE = 3.1 MPI SOIL RATING: 1.2 GPD/SF AREA RCD: 375 SF SYS. TYPE: WIDE TRENCH 3.0' E.D RF: 0.58 MIN LENGTH: 43.5 LF USE: 45 LF X 5' WIDE, 3.0' E.D., 4.0' TD TOTAL AREA: 388 SF TRENCH SEE DESIGN PROFILE LEGEND W WATER LINE/ WELL RADIUS — SS NEW SEPTIC NOTES: PANNONE ENG SVC, LLC FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 FIRE LAKE, LOT 3, TRACT E SARA BENSON 18607 FISH HATCHERY ROAD DESIGN DETAILS EAGLE RIVER, AK 99577 ABBREVIATIONS CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R. 1. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BEG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL & VEGETATE OF. AQ1111 L T;1/2014 /2014 4 TH �* r� NTS P.I.D. NO INC Steven R. Pannone,, . /PERMIT NO IPF.•, CE 8149 .'�/� OSP141214 cAsl • . 111,��1?OFESSIGNP�" Sheet 2 OF 3 TEST HOLE 1 OR ORGANICS 2 3 4 GM/ ROCKY BROWN 5 SM SILTY SAND SOILS LOG - PERCOLATION TEST SLOPE X TH SITEPLAN P� I i 1 TH-1 I 3BR HOUSE V I Sf WAS GROUND WATER ENCOUNTERED? N IF YES, AT WHAT DEPTH? DEPTH TO WATER AFTER MONITORING? -9.0' DATE: 611312014 I I' SLOPE TH X READING HATE CLOCK NET TIME 6 NET DROP 1 616/14 7 --- 5.73 8 10:05 9 9.03 3.30 10 10:05 --- 5.73 GM VERY SILTY 11 10 MIN BLUISH 3.22 BOH GRAVEL 12 5.73 SIDEWALLS 10:25 COLLAPSING 13 3.20 14 15 16 17 18 DATE PERFORMED: 616114 SOILS LOG - PERCOLATION TEST SLOPE X TH SITEPLAN P� I i 1 TH-1 I 3BR HOUSE V I Sf WAS GROUND WATER ENCOUNTERED? N IF YES, AT WHAT DEPTH? DEPTH TO WATER AFTER MONITORING? -9.0' DATE: 611312014 I I' SLOPE TH X READING HATE CLOCK NET TIME WATERTIME LEVEL READING NET DROP 1 616/14 9:55 --- 5.73 --- 10:05 10 MIN 9.03 3.30 s 10:05 --- 5.73 -- 10:15 10 MIN 8.95 3.22 s 10:15 --- 5.73 --- 10:25 1 10 MIN 8.93 3.20 PEROLATION RATE 3.1(min/inch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 4.5 FT AND 5.5 FT COMMENTS: Test hole excavated by JR'S SEPTIC PUMPING. Pere hole was presoaked. Pere test ran for at least 1 hour. Last 3 readings recorded. PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: PANNONE ENG SVC LLC — of A �� Date FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 O C� ' ' Cgs�ll 7/1/2014 PHONE (907) 272-8218 FAX (907) 272-8211 #1 r y*t'� Scale NTS �..... .I)..:.. � FIRE LAKE, LOT 3, TRACT P.I.D. NO E '•<� `a--.�. J051-333-09 Steven R. •R. Pannone SARA BENSON / 1W PERMIT No. PF•, CE 8149 liw OSP141214 18607 FISH HATCHERY ROAD c SOILS LOG EAGLE RIVER, AK 99577 +��Ii�HOESSIONN�� Sheet OF 3 UMMPAUTY OF ANCHORAGE Development Services Department ° Phone: 907-343-7904 On -Site Water & Wastewater Section - Fax: 907-343-7997 Certificate of On -Site Systems Approval Jan 151 a oa 1 Parcel I.D. 051-333-09 Expiration Date: 1. GENERAL INFORMATION Complete legal description Fire Lake, Lot 3, Tract E Location (site address) 18607 Fish Hatchery Rd. Current property owner(s) Dennis & Sharon Anderson Mailing address Real_ estate agent 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day:phone Day,phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer:,,, ❑ Waiver request for: Distance: Received by: �j_— Date: oo r3 -J COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee$ JJ� _ �a 5� Waiver Fee $ Date of Payment to (ate ja (J� C� Date of Payment Receipt Number (50 Receipt Number COSA # �2() l0-1 7� Waiver # p� COVID-19 25% DiC(-r)i it,,, n ►—. 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the focal soil condition, ground water levels that may fluctuate during the year, and.the water usage of the.family being served by.the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. Date C� OF AL,4� � 'sem 6. DSD SIGNATURE System #1 Approved for bedrooms Steven R. Pannone CE 8149 .E System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: IN(�OF trr�r�, WATFR AND LWASTL PATER Z P �� J Jll�Jl� 77N% SEM� By: 6Original Certificate Date: 3D oC da�� q,h0 u-2 Iof i5]�O� 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 Checklist blue sheet Legal Description: Fire Lake L3 Tr E If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled Unknown Total depth Unknown ft Cased to Unknown ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 6/5/2020 Static water level at beginning of test 26.1 ft. Comments B. TANK DATA Age of tank(s) 6 years Tank type/material ITE 11St-1 Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping 6/8/20 D. ABSORPTION FIELD DATA Shallow Trench / Mound Which system tested (date installed) 8/1/2014 ❑ ALL standpipes present per record drawing Total measured depth from grade 5.16 ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field ❑ Monitor t b t b tt f ff Parcel ID: 051-333-09 Structure served by this system 1 Well production at time of test 4.94 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Pannone Engineering Date of Sample 107812020 C. LIFT STATION F0 Required maintenance completed Age of lift station 6 years Lift station material Steel Comments: Adequacy test date 6/5/2020 Results D✓ Pass For 3 bedrooms Fluid depth prior to test 11/9 in Water added 457 gal New depth 12/12 in u es go 0 0 U111 e ective. If not, state E depth into effective lapsed time 40 min IN Code -required soil cover over field Final fluid depth 11/9 in ❑ System presoaked Absorption rate '450 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) _ date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Yes if No 5+ Community Sewer Manhole/Cleanout > 100' M✓ Yes if No ft ✓Cl' Yes if No ft Neighboring Tank > 100' Q✓ Yes if No ft Private Sewer/Septic Line > 25' F71 Yes if No ft Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' P] Yes if No ft Neighboring Absorption Fields > 100' Private Wells > 100' 0 Yes Animal Containment > 50' F/I Yes if No ft M Yes if No ft ft Community Wells > 200' 0 Yes if No ft Water Service Line > 10'✓❑ Manure/Animal Excreta Storage > 100' Yes Community Sewer Main > 75' M/ Yes if No ft R Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' Yes if No 5+ ft Surface Water > 100' ❑ Yes if No 75 ft Property Line > 5' Q Yes if No ft Wells on Adjacent Lots: if No ft Absorption Field > 5' Surface Water > 100' ❑ Yes Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10'✓Q * Waiver on file - OSP141215 Yes if No ft Community Wells > 200' 0 Yes if No ft Water Service Line > 10'✓❑ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Yes if No ft If absorption field is under driveway comment below Property Line > 10' Q Yes if No ft Wells on Adjacent Lots: Water Main > 10' Q Yes if No ft Private Wells > 100' Yes if No Water Service Line > 10' 0 Yes if No ft Community Wells > 200' Q✓ Yes if No Surface Water > 100' ❑ Yes if No 50* ft F. ENGINEER'S COMMENTS * Waiver on file - OSP141215 2014 Landscape berm is still present G. ENGINEER'S CERTIFICATION OF A, -Vlk 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. 62Z�- A, -- Steven R.Pannone Cc 8149 \� %POFESS��Aw COSA Checklist yellow sheet ft ft MUNICIPALI-11-Y Development Services Department r` Phone: 007-33-7904 On -Site Water & Wastewater Section Fax; 907-343-7997 Lift Station/Pump Vault K - �. Owner. � A-"- - :.�,��, .�.Street Address Sec Tank: Sludge level inches Pumping: required e - n -Pumping completed e no Lift station: -Pump basket cleane no Effluent filter cleanede -no -Control floats cleaned �e no ¢Proper float settings confirmed o Operation satisfactory es no alarm §ystem: } Dedicated electrical alarm circ ' e�) no Audible 'nd_uL-ua. r i side dwelling yew no _v te—sto [y•Afar- system o eraon satisfactoryrct sanac0 lcl •�c_ r c : Manhole Riser Ground water intrusion at riser to tank connection es nra -Ground water intrusion around pipe penetrations e n -Weep hole functional es) no -Manhole lid: Functiona esj no Insulate es , o Properly Secured a no Other -All manufacturer required inspections and maintenance complet , e no Comments: Qualified Maintenance Provider: Technician Date of maintenance Company j Signature Date UBMITTA • Municipality o Andforsge14 On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval Parcel I.D. 051-333-09 1. GENERAL INFORMATION Expiration Date: / o >/S_' Complete legal description Fire Lake, Lot 3, Tract E Location (site address) 18607 Fish Hatchery Rd. Current Property owner(s) Sara Benson Day phone Mailing address Real Estate Agent 18607 Fish Hatchery Rd. 2. TYPE OF DWELLING: Fx1 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 17.1 Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for. Distance: Received by: Date: D 6t COSA to be released to the engineer, unle otherwise requested by the engineer. COSA Fee $ Date of Payment (0) $ lig( L1�`vv Receipt Number D\ics � COSA# bb(, 141535 Waiver Fee $ Date of Payment Receipt Number A0=_ .3 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 Pannone Engineering Services LLC Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE Az System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Phone (907) 272-8218 Date 1/15/2014 Conditional approval for bedrooms, with the following stipulations: By: Original Certificate Date: ® ! S 7 The Municipality of An age 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 COSAbluesheM r'- ., If more than 1 septic system is on the lot: COSA Checklist # + of Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: Fire Lake, Lot 3, Tract E Parcel ID: 051-333-09 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed Unknown Sanitary seal (Y/N) Y Total depth Unk ft. Cased to Unk ft. FROM WELL LOG Date of test Unknown Static water level Unknown ft. Well production Unknown 9 - p.m - Well Log (Y/N) N Wires properly protected (Y/N) Y Casing height (above ground) 18+ in. AT INSPECTION 1/14/2014 28 ft. 4.2+ g.p.m. WATER SAMPLE RESULTS: Coliform Neg colonies/100 mL Nitrate ND mg/L Arsenic ND ug/L Date of sample: 9/5/2014 Collected by: PES B. SEPTIC/HOLDING TANK DATA Tank Type/Material S.T.E.P/Steel Tank size 1,250 gal. Number of Compartments 2 Foundation cleanout (YIN) Y Date of pumping New Depression over tank (Y/N) N Pumper Date installed 8/1/2014 Cleanouts(Y/N) Y High water alarm (Y/N) Y C. ABSORPTION FIELD DATA Date installed $/1/2014 Soil rating (g.p.d./ft2 orft2/bdrm) 1.2 GPD/SF System type Wide Trench Length 45 ft. Width 5 ft. Gravel below pipe 3 ft. Total depth 5 ft. Eff. absorption area 388 ft2 Monitoring tube Y Depression over field N Date of adequacy test New Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test New in. Water added New gal. New depth New in. Elapsed Time: New min. Final fluid depth New in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. LIFT STATION Date installed 8/1/2014 "Pump on" level at 43 in Datum Bottom of Tank E. SEPARATION DISTANCES WELL ON LOT TO: Size in gallons 250 "Pump off"level at 40 Cycles tested New Septic tank/lift station on lot 100+ Absorption field on lot 100+ Public sewer main 75+ Sewer /septic service line 25+ Animal containment areas 50+ in. Manhole/Access (Y/N) Y High water alarm level at 45 Meets alarm & circuit requirements? Yes On adjacent lots 100+ On adjacent lots 100+ Public sewer manhole/cleanout 100+ Holding tank 100+ 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: Property line 10+ Building foundation 10+ Water Service line + Surface water 50 Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS * WR# OSP141215 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 Steven R. Pannone Date 10/6/2014 COSA brown sheet -1 0-10-1 2.doc Absorption field 5+ Surface water 100+ Water main 10+ Driveway, parking/vehicle storage 100+ in. o n �•\ Ypy� S 1 ASBUILT � u'zya.�ilLJ Wh�"7 �Ycr� 0 oz's/B'z - Lo CJ I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: AN; 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 SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. o cccran SCALE: "yo OATE- 9/�i :9 GRI ��riS.s'S� FS. �3y-6z DRAWN 0 ,6o%'Qa vk OF.AZ,4 °► r ' Duane Mtrk Seward a