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HomeMy WebLinkAboutT11N R3W SEC 2 SE4 SW4 NW4 NW4Onsite File n S r` x f 4 F ZA { 4 ;-eY F=iSittSY�%'x` 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: OSP111293 PID Number: 020-042-03 ❑ New 0 Upgrade Name: KIM BARETT ABSORPTION FIELD ❑ Deep Trench [7] Shallow Trench ❑ Bed ❑ Mound Address 15910 ELIZABETH ST. ANCHORAGE, AK ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 1 0GPD/SF 6 Ft. LEGAL DESCRIPTION Depth to pipe invert from original gradeGravel 3.5 Ft. depth beneath pipe 0.5 FL Subdivision Block Lot o i (4i J Fill added above original grade 1-2 Ft, Gravel length 30 Ft. Township Range Section ' , a 11N '7 yv 2 Gravel widthBeds: 6Ft. 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 450 Ftp 3 10FL well 100'+ 100'+ 100'+ NA 25'+ TANK ❑ septic O S.T.E.P. ❑ Holding ❑ Other Manufacturer ANCHORAGE TANK Capacity 1250Ga1. Surface Water 100'+ 100'+ 100'+ NA Material STEEL Number of compartments 2 Lot Line 5'+ 10' 5'+ NA NA Foundation 51+ 10'+ 51+ NA LIFT STATION Manufacturer ANCHORAGE TANK Capacity 1250Gal. Curtain Drain 1 50'+ 50'+ 50'+ NA Pump on level at Pump off level at High water alarm at Remarks EXISTING SYSTEM ABONDON PER MOA I S" -FA( in. 20° -F%&T-in. 1H.5 fAGT-.in. REQUIREMENTS Pump make and model Electrical Inspections performed by ORENCO MUNI PIPE MATERIAL Housetotank 3034 Tank to SCH 40 drainfield Installer EAGLE GLACIER EXCAVATING Drainfield SCH 40 CO/MT F810 Inspector LARS SPURKLAND BENCHMARK (Assumed elevation) 100ft Inspdates: V' 10/27/11 10/31/11 Location and description 2- BOTTOM SIDING NE CORNER SHOP 3" 4,h COMMUNITY DEVELOPMENT DEPARTMENT APPROVALq ®F it r ��••.....�qs�'� Conditional Approval: Date j CID, 1 i...49 H !` � I� WE SPURKLAND:-;��7.� 715 D �cr� P Approved ;6 -'/ Date�1\F�ROF:E Inspection Report1-1-12.doe/ SLOPE - 10% INSTALLED 3 -BEDROOM SEPTIC SYSTEM 1250 GALLON STEP TANK BURIAL RATING 10 FEET LENGTH 3 x 30 FEET WIDTH 5 FEET DEPTH 6 FEET MOA APPROVED FILTER SAND 2 FEET ROCK 0.5 FEET EFFECTIVE COVER 4 FEET ST. MH SLG.°E- LEVEL LEVEL I LEVEL SWING TIES A 8 DF. MT. C 22' 20' DF. MT. D 45.5' 45' DF. MT. E 35.5' 21.5' DF. MT. F 57' 49.5' DF. MT. G 67.5' 55' U SWING TIES 1 2 ST. MH 9' 33.5' 4LLt0 7OUNUAIIUN DUAN UUI EXISTING SEPTIC U UIREM£NTS SLOPE ^ 109 HOUSE LEVEL II Q �� W � II Well \ N \3\W T12 SECE ' es 0 25 50 75 100 les 150 SCALE., 1' = 50 FT ��11�,,:'��pN��••• SPURKLAND ENGINEERING TI1N T- SEC 2 SE4 SN'4 NW4 NOV SEPTIC SYSTEM ASBUILT 203 W 15TH[ AVENUE ANCH. AK. 99501 J !!I WKIM BARETT DATE: NOV. 30, 2011 (aur) om-"Fv 19010 €t1PADCrH SrATCT, ANO"OMAO€, All 88910 "Err, 211 efflo 3P3® PERMIT #3SPI11293 PID # 020-042-03 T12NR3WS2SE4SW4SCI00.DWG TR. EL rs. TRENCH /3 Slit Barr/erlMon/tor, 8T. TR. ELCK=988" iS ELEY.=953' 8T. 2' Filter Sand NO SCALE 0 0l 0 1250 GAL STEP TANK 0 z Trench #1 5' Wide 10' Burial Rating 30' Long 0 6' Deep o Trench #3 0.5' Sewer Rock a 4' Cover 3 Ll 5' Wide 6 w Trench #2 30' Long 5' Wide 6' Deep 30' Long 2' Filter Sand 6' Deep 0.5' Sewer Rock 2' Filter Sand 4' Cover 0.5' Sewer Rock 4' Cover c ` c V m m U C O U C O a C o a bj M � 10' ia O Z A S 0 1 0 TR. EL rs. TRENCH /3 Slit Barr/erlMon/tor, 8T. TR. ELCK=988" iS ELEY.=953' 8T. 2' Filter Sand NO SCALE 0 0l 0 1250 GAL STEP TANK 0 z Trench #1 5' Wide 10' Burial Rating 30' Long 6' Deep o 2' Filter Sand 0.5' Sewer Rock a 4' Cover 3 Ll 6 w tA TRENCH i1 c raceraano TEST HOLE NO SCALE 2' Filter Sand H2O £LEV.=85.5' ND SCALE B.O.H. £LEV.-84.5' Bench Mark Drainfield Bottom Siding NE Corner Shop, Bench Mork Tank Shop Floor Slab. Assumed Elevation of 100 feel 1250 GAL STEP TANK ISPURKLAND ENGINEERING I I -'--V R3W SEC 2 SE4 SW4 NOV NW4 I SEPTIC SYSTEM ASRUILT I 203 W15th Ave DATE, NDv. 30, 2011 Anchorage Ak 99501 T 10V KIM BARRATT 279-3916 .1.:0 ELIZ48ETH ST., ANCHORAGE, AK 99516 SHEET; 3/3 GRIDS 3238 I PERMIT j OSP 111293 PID / 020-042-03 T12NR3WS3D3.DWG 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: OSP111293 Tax Code Number: 02004203000 Work Type: Septic Upgrade Permit Effective Dates: October 14, 2011 to October 13, 2012 Design Engineer: SPURKLAND ENGINEERING Subdivision: T11N R3W SEC 2 Site Legal Address: T11 N R3W SEC 2 SE4 SW4 NW4 NW4 G:3238 Owner/Address: LAWLOR TIMOTHY D PO BOX 91763 ANCHORAGE AK 995091763 Site Mailing Address: 15910 ELIZABETH ST, Anchorage Lot Size in Sq Ft: 108900 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 Bv: '_ (yj I Issued By: '�4 4l I i u( e / t5"2 Date: / V ` J — %r MUNICIPALITY OF ANCHORAGE Community Development Department Development Services Division On -Site Water & Wastewater Program Mayor Dan Sullivan ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. cZe G4L s Propertyowner(s) Kim BA2rcgTT Phone: 907-343-7904 Fax: 907-343-7997 Day phone Mailing address 391, O�E��o, (ilv1, ,Qn �arUue� �V iy5c Site address 091c fit' TA sE T R SfPeli L)J3rcoe A 1Y51 f Legal description (Sub'd., Block & Lot) 1 R'V i'0W 5 s Fq S ✓ y N �L; y ;V �u { Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms ; THIS APPLICATION IS FOR: THIS APPLICATION IS AN: (® all that apply) Initial ❑ Absorption Field Septic Tank Upgrade Holding Tank ❑ Renewal ❑ Privy ❑ Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: M I certify that the above information is correct. I further certify that this application is being made for alSingle Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of Oroperty owner or authorized agent) Permit/Rush Fees: S )G Date of Payment: (L _ 1 �_2)— Receipt Number: buknIq G'), Permit No. C';'�) P ma -t ) Waiver Fees: Date of Payment: Receipt Number: Waiver No. GABuilding\On Site\Forms\Client FormsTennit App_010411.doc (Rev. 1/11) Environmental Consulting and Design SEPTIC SYSTEM DESIGN T12N R3W SEC 2 SE4 SW4 NW4 NW4 Municipality of Anchorage October 7, 2011 Development Services Department On Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519 Subject: Septic System Installation Permit 15910 Elizabeth St. Ladies and Gentlemen: I am writing to request a permit to upgrade the septic system for the above referenced property. The proposed system is designed for a 3 -bedroom single-family residence. The existing system is undocumented and the owner would like to upgrade it. A soils log, design calculations, a site plan, design drawings and construction specifications are enclosed for your review. Design Calcs: Groundwater was observed at a depth of 15 feet below ground surface (Oct. 6, 2011) Soil Rating. From Testhole (6/22/11) <t min/in =1.0 gal per sq.ft./day No. of Bedrooms 3 Required Area per Bedroom: 150/ 1.0 =150 sq.ft. Total area required: 150 x 3 = 450 sgft System: The proposed system consists of a 1250 gallon STEP tank and a shallow trench absorption field. The absorption field will consist of 3 trenches 30 feet long, 5 feet wide with 2 feet of filter sand and 0.5 foot (450 sq.ft. effective) of sewer rock. Soils: A test hole was excavated on June 22, 2011. See the attached soil logs. Ground water was monitored for through Oct. 6"', 2011. Ground water was observed at 16 feet on the day of excavation and at 15 feet below the ground surface on Oct. 6"'. Surface Water: No surface waters were observed within one hundred feet of the proposed septic system upgrade. Topography: The lot slopes to the west at approximately 10 %. The area of the proposed absorption is generally level over the length of each trench. Waivers: None 203 West 15`h Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net Environmental Consulting and Design The installation of this septic system will not prevent wells and septic systems from being installed on the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. If you have any questions or concerns, please contact me at 279-3916. Sincerely, LOVn Lars Spurkland, P.S. Spurkland Engineering 203 West 15u' Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net I S�� I E P t� G I I I G 9R Lot 1 I P Z NO WILL OR SEPTIC SYSTEMS WITlI IN 100 $ Lot 2 I \ I I � 12 R DARNES Lot 2 a^ R.3 SE I I H I I EAST 160TH AVE. -- — —I — — — — — — — — - — — —— - — — — — — — — — — - r — — — — — — — — — — — — — — — — 1I MANN S / D — � — — Lot 1 4, NOTE. THIS 1S NOT A SURVEYED PLAT. WELL B SEPTIC LOCATIONS TAKEN FROM ON-SITE WATER AND WASTE WATER DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE APPROXIMATE. 50 0 50 100 150 200 250 300 SCALE, 1' = 100 FT SPURKLAND ENGINEERING I I T12N RI W SEC 2 SE4 SW4 NW4 NW4 I I SEPTIC SYSTEM DESIGN 203 W 15TH. AVENUE KIM BARETT DATE. • OCT. 7, 2011 9071279 39161 11510 ELIZALIEM STREET, ANCHORAGE, AK' 551101 5HEM 1/3 GNID: 72M PERMIT #DSP1110XX PID # 020-042-03 T12NR3WS2SE4SW4SC100.DWG N� mac\ s SLOPE - 107 INSTALL 3 -BEDROOM SEPTIC SYSTEM 1250 GALLON STEP TANK BURIAL RATING 10 FEET LENGTH 3 x 30 FEET WIDTH 5 FEET DEPTH 6 FEET MOA APPROVED FILTER SAND 2 FEET ROCK 0.5 FEET EFFECTIVE COVER 4 fEET SLOPE - LEVEL. STING SEPTIC C REOUIREMENTS SLOPE ^' 10ALL'VEL a L W Well \ \3W SEC2 I T 1 2 1 LEVEL LEVET. SPURKLAND ENGINEERING I I T12N RI W SEC 2 SP S#4 NG NW4 I I SEPTIC SYSTEM DESIGN 203 W 15TH AVENUE KIM BARETT DATE: OCT. 7, 2011 ANCH. AK. 99501 (907) 279-3916 15910 ELIZABETH STREET, ANCHORAGE, AK 99516 SHEET 2/3 GRID: 3238 PERMIT #OSPIIIXXX PID # 020-042-03 T12NR3WS2SE4SW4SCl00.DWG O Trench #3 OO o 0 5' Wide Trench #2 + 30' Long 5' vide a 6' Deep 30' Long 1250 GAL STEP TANK 2' Filter Sand 6' Deep Trench #1 10' Burial Rating o", 0.5' Sewer Rock 2' Fitter Sand 30' Long 4' Cover 0,5' Sewer Rock 6' Deep o ` 4' Cover � 2' Fitter Sand -G m r m 0,5' Sewer Rock a 4' Cover 3 o c � b y ® N �,p�+��� lA ? z �F .OPE . -•� 49••% �...:............. ......... ........ LARS URKLAND• ••�j •� 0 o 1 O No c -11500 ES�� �•� TEST HOLE TRENCH ELEVATION (TYP.) E.G. ELEV.= Silt Barrier Monitor 4' Cover 0.5' Septic Rock Effective H2O ELEV.= 2' Filter Sand NO SCALE 1250 GAL STEP TANK B.O.H. £LEY.= Bench Mark Assumed Elevation of 100 feet SPURKLAND ENGINEERING T12N R3W SEC ,2 8V SM NW4 NWS 86PTiE SYgTEM BESF6N 203 W15th Ave Anchorage Ak 99501 KIM BARRATT DATE, OCT, 7, 2011 279-3916 15910 ELIZABETH ST., ANCHORAGE, AK 99516 SHEETi 3/3 GRID: 3238 PERMIT j OSPXXXXX PID j 020-042-03 T12NR3WS3D3.DW0 Municipality of Anchorage Development Services Department Building Safety Division - On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.ci.anchoraae. ak. us (907) 343-7904 Soils Log - Percolation Test Performed For: kim BRR6T- Date Perfo Legal Description: TMI13W .Sect •9Eq SLJ4 .NL+%i AIW` Township, Range, Section: Depth 17-1 Da COMMENTS 0,o, H Site Plan Reading WAS GROUND WATER YQ�j Gross Time ENCOUNTERED? SAnCT G,^aJo1 s IF YES, AT WHAT DEPTH? i b L Depth to Water After P Monitoring? E G Z6 I 0,o, H Site Plan Reading Date Gross Time Net Time Depth to Water Net Drop G Z6 I Z:Yr7 m 8 m+', (0 ri I; 2144t30 `1:30 (v r, ZLSOzo i0 „ ,00',L PERCOLATION RATE 41 (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN _Lj _ FT AND_FT PERFORMED BY: LQS S'Z aft I �-j�,J Uyl(JV. CERTIFY THAT THIS TEST WA PERFORMED IN ACCORDANCE ITH ALLSTATE AND MUNICIPAL GUIDEIIINES IN EFFECT ON THIS DATE. DATE: & Z- I1 • Municipality g of Anchorage • On-Site Water and Wastewater Programhg�i \— (907) 343-7904 Qom � 6 Certificate of On-Site Systems Approva. Parcel I.D. 020-042-03 Expiration Date: .` % • 1. GENERAL INFORMATION: Complete legal description T11 N, R3W,Section 2, SE4, SW4, NW4, NW4 Location (site address) 15910 Elizabeth Street `Anchorage, AK 99516 Current Property owner(s) Kim Barrett Day phone 345-4900 Mailing address Real Estate Agent Mike McClain Day phone 227-1533 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well n Community ❑ Public Water System n Public Sewer ❑ WaiverNariance request for: Distance: i Received by: Date: 3 1,1:9-/Ig COSA to be released to the engineer, unless otherwise requested by the engineer. ash COSA Fee $ �J -1 3 I ° o CO Waiver Fee $ Date of Payment I Date of Payment Receipt Number 0'9)el2-i Receipt Number COSA# to 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: ? I 2J( 000oo�.�D In conducting this evaluation,GEG provided an engineering evaluation of the well and/or septic system o*z. OF C 004 in accordance with the guidelines and regulations established by the Municipality of Anchorage and o c ... industry practices. The reported results describe the condition of the system/s on the date/s of the ' • evaluation. Separation distances were measured to readily identifiable features. Hidden defects or .• qtr �� �O O encroachments may exist that were not identified during the evaluation. The operational life of all wells * 49 * 0 and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials andVA workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,andVA are outside the control of GEG. Satisfactory test results do not guarantee future performance of the ey or ess.•• system/s;therefore, GEG makes no warranty(express or implied)regarding the future performance of (/ • C —79 3 •• v OD the well or septic system. GEG makes no representation whether an alternative well or septic system ?'P. .��ep can be installed on the property in the event either of the current systems fail to perform adequately in V t •,. • . /4�.. o.Ao the future. The content of this report is for the sole benefit of the person/party that retained GEG to 10ear o r es sit) perform the evaluation. Reliance upon the information provided in this report by any other person or �OOoOoo party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD�SIGNATURE ` System #1 Approved for 3 bedrooms System #2 Approved for bedrooms Disapproved \( OF Conditional approval for _ bedrooms, with thp\Wowing sti 'ons: ON-SITE • WATER AND P1 . WASTEWATER o• t PROGRAM 9,0 r /f gym Original Certificate Date: 2-7 H 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet_10-i 0-12.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: T11N, R3W, Section 2, SE4, SW4, NW4, NW4 Parcel ID: 020-042-03 A. WELL DATA *Per State of Alaska DNR records (see attached) Well type Private If A, B, or C provide PWSID# N/A Well Log (Y/N) No Date completed 1961(?) Sanitary seal (Y/N) Yes Wires properly protected (Y/N) Yes Total depth *160 ft. Cased to Unk ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 3/5/2018 Static water level \t,le\\ \-oo' ft. 11.3 ft. No Well production / g.p.m. 4.3+ g.p.m. WATER SAMPLE RESULTS: *Antimony Coliform Neg colonies/100 ml. Nitrate 1.82 mg./L. Collected by: GEG, Ltd. Arsenic: <5 ug./L. Date of sample: 3/5/2018 & *3/23/201$ B. SEPTIC/HOLDING TANK DATA *See A+ Home Services maintenance log (attached) Tank Type/Material STEP/Steel Date installed 10/27-31/2011 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Yes Foundation cleanout (Y/N) Yes Depression over tank (Y/N) No High water alarm (Y/N) Date of pumping 3/13/2018 Pumper A+ Home Services C. ABSORPTION FIELD DATA *Below Existing Grade West/Mid/East Date installed 10/27-31/11 Soil rating Tp.d./f or ft2/bdrm) 1.0 System type Shallow Trench Length 3 © 30' (90 Total)ft. Width 5/5/5 ft. Gravel below pipe 0.5 ft. Total depth*5.6+/*5+/*4.7+ft. Eff. absorption area 450 ft2 Monitoring tubeYes Depression over field No Date of adequacy test 3/5/2018 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added**704 gal. New depth 0 in. Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) None Known If yes, give date — **Water distributed into all three trenches throughout test (310 gallons in East trench, 190 gallons in middle trench, 204 gallons in West trench) *Second compartment of 1250 gallon STEP tank D. LIFT STATION **See A+ Home Services maintenance log (attached) Date installed 10/27-31/2011 Size in gallons *416 Manhole/Access (Y/N) ** "Pump on" level at ** in. "Pump off" level at ** in. High water alarm level at ** in. Datum ** 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'+ 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 **5'+ Curtain drain None Known Wells on adjacent lots 100'+ F. COMMENTS *Per as—built, 10' separation to property line from pipe. Assumed 10' separation per 2012 inspection report. **5'+ per as—built. Snow piled over septic area/driveway, could not confirm separation on site. �o��p‘\\ G. ENGINEER'S CERTIFICATION o,�� OF.ii e�s04 / -:.'.. Ok... ' --'1)/1 I certify that I have determined through field inspections and ( • 497 0a review of Municipal records that the above systems are inVA � conformance with MOA COSA guidelines in effect on this 0 date. ! y Gar ess•' Engineer's Printed Name JEFFREY A. GARNESS co_O %, , CE 9 mp e Date 3/Va /S �k•/- ..**43:(41.6.0,c5‘,p • � 4ed rofessl000�' %D,00�„ #AECC884 (Rev. 11/05) 03/17/2018 05: 52 8686770 APLIJS PAGE 01 N'`\� r°� + c3 MUNICIPALITY OF ANCHORAGE �i'(--,-1..,_,..---------- , i.'• ) ......----,,,,,,. Phone: 907-31131 7904 Development Services Department Fax: 907-3r':� 7997 On-Site Water & Wastewater Section Lift Station/Pump Vault -,-Maintenance Log Owner Street Address • „ ` „s. She` 1- _. f Phone :_2).L45 •4°I O o Legal DeSc. 71 In ;3L.) PID S,E'a sw*I n n i Septic�tlk; _. -Sludge level 0C inches -Pumping: required Lt1Q *Pumping completed �. J:.a Lift station: � � -Effluent filter cleaned (I DQ / . -Pump basket cleaned t II9 : r-7,-s_ -Control floats cleaned .115/ -Proper float settings confirmed 0___ELQ -Operation satisfactory � 11Ca Alarm $y t iflCtelli,AQ -Dedicated electrical alarm circuit yes no -Audible and visual alarm inside dwelling -Alarm system operation - ' f, •i, a• i „.01,• JVLariholeiliSg[ -Ground water intrusion at riser to tank connection -Ground water intrusion around pipe penetrations ye.g) -Weep hole functional I.. no -Manhole lid: Functional p,. Q Insulated es no Properly Secured C.a, Our -All manufacturer required inspections and maintenance completed _Q Comments; '—iReiol.ae.e.c -Pa-,a<1... ra ,e.1•r 1i-1~t- 01Prrvn Maintenatio Provides: Technician L0.1- v- a-/4c - Date of maintenance/5..-i,. r I Company P I-- M-6 rye ser✓ '' • Signature_ Date13.',.:)Ar..6 Mailing Address: P 0. Box 196650 Anchorage, Alaska 99 51 9-6650 • www.muni.orq • I1 I I -.- I _a a) Lot 1 I Unsubdivided 0 L _ _ ____ d I N v) ILot 2 N90'00'00"E 330.00' w U) 00 ® , 1 ,,,0..20....,. , ) Garage ?q so'/%• o � / i Lift Station M ,/ / J -/ o Gravel O 2nd r'rStoryo�� Drive O W odDec \\3\ `5.7 110 Covered Porch — -;•'` 2nd Story 1-4 11'5 �. w i 2' Overhang I'`5) 95' CO 2story Wood Frame Residential Building LO N ® i'`) p •=1" Qo O u) o �1.OF A4'N N z '"S. `1'q`•�1 o ( 49IH r\ -.-v N Z Lot 2 fD �j��� � Unsubdivided `V •,Thomas'/H. Dreyer•. to NIP,. �l S-766-225...Jam•' A �QA„O4 ssiono�,� • E. 160th Ave. N90'00'00"E 330.00' I -I-' Lot 2 I 0I N 1 Lot 1 Lot 2A (I) 1 w S4 Ordered by Kim Barrett Legal Description: Legend: As Built • SE1/4, SW1/4, NW1/4, NW1/4 of Well Iron Pipe Group Sec 2, T 11N, R3 W, S.M. Septic Survey Certification: I hereby certify that a Mortgagee's Land Surveying Inspection was performed on the described property. Land Development Consultants Notes: Subdivision Specialists 1. It is the owner's responsibility to determine the existence Construction Surveying of any easements, covenants, or restriction which are not on the recorded subdivision plat. This asbuilt shall not be used Torn H Dreyer, P.L.S. for construction or for establishing property lines. 124 E 7th Avenue 2. Distances are to the nearest foot. Anchorage, Alaska 99501 Checked by. THD Drawn by. AK Scale 1" = 60' Grid 3237 (907) 306-8104 Tom064AK.c0rn Job 2011-77 Field Book: 108 Plat BLM Date: 3/21/2018 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.muni.org/onsite (907)343-7904 Parcel I.D. CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING 020-042-03 '7.'GENERAL INFORMATION A/ 931 Complete legal description .« C2 COSA4 a(c C')'�UV7 Expiration Date: K,) SE4 SW4 NW4 NW4 Location (site address) 15910 ELIZABETH ST., ANCHORAGE, AK 99516 Current Property owner(s) KIM BARETT Mailing address Lending agency Mailing address Real Estate Agent Mailing Address WTI Day phone 345-4900 4ai ,�a u54— �e� Day phone Unless otherwise requested, COSA will be held by DSD for pickup. Day phone 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. 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 Spurkland Enginneering Address 203 W. 15th Ave., Ste 202, Anchorage, AK 99501 Phone 279-3916 Engineer's Printed Name Lars Spurkland Date 1!24/12 P�Ft OF Algs,'f +1 9TH 9I 5. DSD SIGNATURE 'j{ is Approved for bedrooms. Disapproved. �j1 Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other By: _ `' 1 Original Certificate Date:_3 J I (RW. 11/05) Municipality of Anchorage Development Services Department x g Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: T 12N Rlu1 Sec. Z 9E4 5W4 NW4 AIW4 Parcel ID: 0Zo-0%Z-03 A. WELL DATA Well type0i 6 If A, B, or C provide PWSID # = Well Log (YM) Al Date completed 44 own Sanitary seal (Y/N) li Wires properly protected (Y/N) y Total depth >130 ft. Cased to 'M ft. Casing height (above ground) 1 12 in. FROM WELL LOG AT INSPECTION Date of test Lmknow n 6 2z ll Static water level anknown ft. 9 ft. Well production �%Aylown g.p.m. -7.5 g.p.m. WATER SAMPLE RESULTS: 1 Coliform ���colonies/100 mL Nitrate 2.04 mg/L Collected by: LA_ M S�r0gv%0 Arsenic: 5.IY ug/L date of sample: 11 Z+ q/ IZ�igI NA 61 ZS/+( B. SEPTIC/HOLDING TANK DATA Tank Type/Material !n TAn STEP S tJ Date installed 1013+1 11 Tank size 1150 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y_ Depression over tank (Y/N) A/ High water alarm (Y/N) i Date of pumping A/ew Pumper —' C. ABSORPTION FIELD DATA Date installed 10 127 111 Soil rating (g.p.d./ft2 or fe/bdrm) 1.0 System type S I' AI" IrfAc Length 3 X 30 ft. Width 3X 5 ft. Gravel below pipe 0. S ft. Total depth � ft. Eff. absorption area 450 fe Monitoring tube Y Depression over field Al Date of adequacy test Neuf Results (Pass/Fall) — 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) I If yes, give date D. LIFT STATION Date installed D 3i fl Size in gallons 1250 Manhole/Access (Y/N) "Pump on" level at, � in. Datum U. a ?tiaPylk,lt E. SEPARATION DISTANCES a "Pump off" level at 20 in. High water alarm level at ILLS in. Cycles tested A/cw Meets alarm & circuit requirements? Y SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot too'+ Absorption field on lot 1001+ Public sewer main NA Sewer /septic service line 2 S + Animal containment areas so' + On adjacent lots [CO t+ On adjacent lots i0o%+ Public sewer manhole/cleanout A/A Holding tank IVA- Manure/animal excrete storage areas 1001+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: t Building foundation 5 t+ Property line 5 t+ Absorption Feld S + Water main A/A Water service line 10I+ Surface water f00'+ CNA Wells on adjacent lots 100 4 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Properly line to t Building foundation 101+ Water main /dA !'� t Water Service line 10 + Surface water IOl) + l/v,0, Driveway, parking/vehicle storage 5 Curtain drain 50`+ (A/.0) Wells on adjacent lots IDD 1+ F. COMMENTS G. ENGINEER'S CERTIFICATION V ®F A� ®,l I certify that I have determined through field inspections and review of Municipal records that the above systems are in CO11 conformance with MOA COSA guidelines in effect on this date. 00 ... 0 Engineer's Printed Name Lg1 I as SmurY�iraNrySPURKItiD.rt Date (h�lR � 15 0 till.. COSA Fee $ 4q Waiver Fee $ Date of Payment `�(la Date of Payment Receipt Number, Receipt Number (Rev. 4110)