HomeMy WebLinkAboutDUKE & DUCHESS BLK 2 LT 3Duke &
Duchess
Block 2
Lot 3
#051-221-56
Municipality of Anchorage
On-Site Water and Wastewater Program • (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP141417 PID Number: 051-221-56
Dwelling: N Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑E New ❑ Upgrade
Name:
J. A. Sartin
ABSORPTION FIELD
❑ Deep Trench N Shallow Trench ❑ Bed ❑ Mound
Address
1231 W. Northern Lights #842 Anch., AK 99503
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
3
1.2 GPD/SF
5.5 Ft,
LEGAL DESCRIPTION
Depth to pipe invert from original grade
3.5 Ft.
Gravel depth beneath pipe
2 Ft.
Subdivision Block Lot
Duke & Duchess 2 3
Fill added above original grade
0-.5 Ft.
Gravel length
55 Ft.
Township Range Section
Gravel width
5 Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
AbsorptionHolding
Lift Station
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
393 Ftp
1
Ft.
Well
>100,
>100,
>100,
>75'
>25'
TANK ❑O Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Anchorage Tank
Capacity
1,000 Gal.
Surface Water
>100'
>100'
>100'
NA
Material
Steel
Number of compartments
Two
Lot Line
>5'
>10'
>5'
NA
NA
Foundation
>5'
>10'
>5'
NA
LIFT STATION
Manufacturer
Capacity
Gal.
Curtain Drain
None
Noted
Pump on level at
Pump off level at
High water alarm at
Remarks
in.
in.
in.
Pump make and model
Electrical Inspections performed by
PIPE MATERIAL House to tank D3034 Tankto
drainfield D3034
Installer
Northern Excavation
Draintield D3034 caMT
Inspector A. Harala
BENCHMARK (Assumed elevation) 100.0 ft
Inspectiones: �2/10/15 2/10/15
Location and description
2n°
6/8/15 4'h
Front Deck.
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
EWWW
�E.F.;q(�S��1
Conditional Approval: Date
���PO
r�
so 4gT '
... ... .... ., ....
i................................
%*.MICHAEL E. ANDERSON
I�"yl,•� CE-4381 •'fir
AW
Approved,,,& Date w ".2a-/
Inspection Report_9-1a2.d6c(/
Municipality of Anchorage
DEVEOPMENTSERVICES DEPARTMENT
4700 Elmore Road Anchorage;`AK.-99519-6655 - 343-7904
Permit Number: OSP141417
DUKE
Page 2 of 3
PID NO.: 051-221-56
8c DU I HESS SUBDIVISION
LOT, 3, BLOCK 2
1 47,260 S.F.
BEND NG BIRO =--_
-_ H DRI
s�Oo 5 SNOW STORAG _
E EASEMENT
W.
Q:
19
O
A p O
52 12.9' 29.1'
Mt 39.1' 57_4' �
C5 44.2' 63.5'
(V
O
O
O
O
LEGEND Z
FCO — Foundation Clean Out
TH - Test Hole
S1 - Septic Vent
MT - Monitor Tube
CO - Clean Out
49th
AEL E. ANDERSON
No. CE -4361
6-23-15 [
i
r
1
i
i
T. IpEE BEDROOM
� Hp4iE
i
pgernA>,e.S�r
I
I
' I
1
S89°58'35"E 230.35
Existin
Well
LOT 2, BLOCK 2
PLAN AS QUILT
SCALE 1" = 50'
Municipality. of -Anchor
DEVEOPMENT SERVICES—IDI
4700 Elmore Road Anchorage, AK 99
On -Site Wastewater Disposal System or
Permit Number: OSP141417
FME+ T
655 - 343-7904
99.3
N UU
�Erisi'n� fi she
.cu�l� rcand
L L
11500 Ga for
.. 7 SepticTon!t: - jI
x.95 _/ ! 95.1
07
M
H
Page 3 of 3
PID No. 051-221-56
CJ
PROFILE AS -LB ..1ILi'
No scala �...-------- —
Municipality of Anchorage
ONSITE WATER & WASTEWATER PROGRAM
CHANGE ORDER
PERMIT # OSP141417
PID No: 51-221-56
SUED Duke & Duchess TRACT.
CONTACT PERSON Michael E. Anderson, P.E. PHONE 522-7773
FAX 677-7766
BLOCK 2 LOT 3
PLEASE GIVE A DESCRIPTION OF THE CHANGE: The clean gravel soils were found to extend only to a depth of 9'
below grade. The effective depth of the trench was reduced to 2' from W to provide more area for percolation of
effluent. The length was extended to a total Of 55'. A three bedroom home with an application rate of 1.2
GPD/SF and a .7 Reduction Factor for a 2' Effective Depth requires a length of 52.5'
CUSTOMER
On -Site
Reviewer:
APPROVED (date)
Comments Review
Issued Time
(date) (hours)
TOTAL HOURS
HOURLY RATE 4;140
TOTAL TO BE PAID
DATE PAID
RECEIPT #
LOT 3, BLOCK 2, DUKE AND DUCHESS SUBDIVISION
DESIGN FACTORS: SYSTEMREQUIREMENTS:
Three Bedroom Home 5'' Wide Trench System
Perc. Rate: 1-5 Min./Inch 1,000 Gallon Septic Tank
Application Rate: 1.2 GPD/SF 2' Drainfield Rock
3 Bedrooms * 150 GPD/Bedroom = 450 SF Absor tion Area
450 SF/1.2 GPD/SF/5 SF (Width) *.7 (Red. Factor= 52.5 LF Trench Length
THEREFORE: Construct a 53' Long x 5' Wide x 2' Effective Depth Absorption Trench.
Flow Line Elevation in Trench to be 3' Below Original Ground Surface. Total Depth to be
5' Below Existing Ground. Provide 3' Cover Over Absorption Trench and 4' Cover Over
Septic Tank.
5'
f�
TYPICAL 5' WIDE TRENCH SECTIONOF •..,
(NO SCALE)���p(E..........:�.q
NOTE: Grade Area Over Trench to Drain Away. :;' 49m
Minimum 6' Separation From Bedrock. :....` ...........
Minimum 4' Separation From Groundwater. i
• .............................`4l.
Minimum 100' Separation From Private Wells in the Area. ��, micHnELe.,woeRsoN
Minimum 100' Separation From Surface Water or Streams. No. CEA381
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: DUKES AND DUTCHESS BLOCK 2 LOT 3
PERFORMED FOR: SCOTT PEPPERS
DATE: 2/10/15 PROJECT No.:
PARCEL ID#: TECHNICIAN: AH
DEPTH
(feet)
1 —
2 —
3 —
4 —
5-
6-
7-
8-
9 10-
11-
12-
13-
15
0-
11-
12-
13-
15
16
17
18
19
TEST HOLE A
OB/OG
SILTY SAND
WITH GRAVEL
SM/GM
BOH @ 16'
WAS GROUND WATER ENCOUNTERED? No
SITE PLAN
SEE SITE PLAN
i
Y
a
IF YES @ WHAT DEPTH?
S
GROSS TIMEJ
(MINUTES)
DEPTH OF WATER AFTER MONITORING:
LO
NET DROP
(INCHES)
TEST HOLE PRESOAKED PRIOR TO TESTING:
7
DATE OF MONITORING:
P
10
0.75"/6.75"
6.00"
DATE
READING
GROSS TIMEJ
(MINUTES)
NET TIME
(MINUTES)
DWgTER
(INCHES)
NET DROP
(INCHES)
TEST HOLE PRESOAKED PRIOR TO TESTING:
2/10
1
10:12/10:22
10
0.75"/6.75"
6.00"
2
10:23/10:33
10
1.00"P7.00"
6.00"
3
10:34/10:44
10
0s0v6.50"
6.00"
4
10:45/10:55
10
1.00"/7.00"
6,00"
5
10:56/11:06
10
i m,r.00"
6.00"
6
11:07/11:17
10
0.75"/6.75"
6.00"
PERCOLATION RATE: 1.7 (MIN/INCH) PERC. HOLE DIA.. 6n (INCHES)
TEST RUN BETWEEN: 4 FT. and 5 FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. PERCOLATION 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: 6/23/15
Certified Drilling Lae
DOC CO dba
4BALL & COLE -
ULLIVAN WATER WELLS
P.O. Box 670269, Chuglak, AK 89567 688-2759
OWNER OF LAND: Peppers Construction
ADDRESS: 10224 Eagle View Dr, Eagle River, AK 99577
LEGAL DESCRIPTION Duke & Duchess Blk 2 Lot 3
DATE. 10-27-14
PERMIT NUMBER: OSP141417 DATE OF ISSUE: 10.7-14
TAX IDENTIFICATION NUMBER 05122156000
Is well located at approved permit location: Eyes ONo
Method of Drilling ®air rotary ❑cable tool
Depth of Well: 500 feet
Casing Type: steel Wall thickness .250 inches
Diameter. 6 inches, depth 44 feet
liner type None
Static Water Level: 75 feet
Recovery Rate 10 Lj gpm gph
Method of Testing air
Well Intake Opening Type: open end pen hole
❑ Screened Start feet Stopped
❑ Perforations Start feet Stopped
Grout Type: Bentonite volume: 120 lbs
Depth: from 2 Feet, to 42 feet
Well Disinfected Upon Completion: M;;;Qno
Method of Disinfection: Chlorine SO PPM
Comments:
Depth
Fran
To
0
2
Casing Stickup
2
4
Overburden
4
23
Silty sand & gravel
23
34
Bedrock brown
34
268
Bedrock green hard
268
271
Bedrock green w/ fractures
271
320
Bedrock green W/ quartz
320
462
Bedrock green hard
462
474
Bedrock brown
474
500
Bedrock green hard
Drillers Name: Cole Sullivan
A7TENTION. It is the responsibility of the property owner to submit a copy of the well log to the proper authority.
Municipality of Anchorage: Department of Neaith & Human Services and/or Department of Environmental Conservation.
MatSu Borough: Department of Environmental Conservation.
TO/T0 39Vd Sb3dd3d 0896V69L06 90:VT 9TOZ/6T/90
ARCTIC PUMP & WELL INC.
Jim Sullivan
PO Box 770197
wam Eagle River, AK 99577
uirt a sm�c - (907) 688-2510
(907) 243-2282
Pump Installation Log
`Well Drilling Permit Number: osp141417
Parcel Identification Number: 05122156000
Date Of Issue: 10/7/2014
Wednesday, December 03, 2014
Legal Description Duke and Duchess B2 L3
Property Owner Name Address:
Peppers Construction
Lot: 3
10224 West Frontage
Block: 2
Eagle River AK 99577
Pump Installaion Date: 12/1/2014
Pump Intake Depth Below Top of Well Casing: 476 Feet
Pump Manufacturer's Name Franklin
Pump Model: 7JR1 S4 -2W230
Pump Size: 1 HP
Pitless Adapter Burial Depth: 14 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.
Wednesday, December 03, 2014
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: OSP141417
Tax Code Number: 05122156000
Work Type: WellSeptic Initial
Permit Effective Dates: October 07, 2014 to October 07, 2015
Design Engineer: ANDERSON ENGINEERING
Subdivision: DUKE & DUCHESS
Site Legal Address: DUKE & DUCHESS BLK 2 LT 3 G:1057
Owner/Address: SARTIN J A
1231 W NORTHERN LIGHTS BLVD #842 ANCHORAGE AK 995032337
Site Mailing Address: Lot Size in Sq Ft: 47260
Total Bedrooms: 3
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:
Date: to I�f
Date: �o l
Municipality of Anchorage
P.O. Box 196650 • 4700 Elmore Road
Development Services Division
On -Site Water and Wastewater Proaram
went
llepartment
**** VARIANCE/WAIVER REVIEW ****
Waiver#: OSP141450 COSA#: Permit#:OSP141417
PID#: 051-221-56
Legal Description: Duke & Duchess Block 2 Lot 3
Engineer: Anderson Engineering
Applicant: J. A Sartin
Your request for a waiver of the required 50 feet horizontal separation from the absorption field
to the excessive slope has been approved. The approved separation distance is 16.0 feet for the
primary field and 31.0 feet for the alternate field.
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 nonobjection have been received from the owner(s) of the affected
adjacent property.
® Adjacent properties are not affected by this waiver.
...............................................................................
Waiver is Granted: X Waiver is not Granted:
Date: %aq Approved by: /N
Name of RevieweK
........................................................... ........... 0......
**** VARIANCEIWAIVER REVIEW ****
MUNICIPALITY OF ANCHORAGE
Community Development Department
Phone: 907-343-7904
Development Services Division _
Fax: 907-343-7997
On -Site Water & Wastewater Program
ON-SITE SEWERIWELL PERMIT APPLICATION
051-221-56
Parcel I.D. {
Property owner(s) J_ A. Sartin Day phone
Mailing address 1231 Northern Lights Blvd., Suite 842 Anchorage, AK 99503
Site address NHN Bending Birch Drive Chugiak, AK 99567
Legal description (Sub'd., Block & Lot) Duke & Duchess, Block 2, Lot 3
Legal description (Township, Range & Section)
Lot Size 47,260 Sq. Ft. Number of Bedrooms Three (3)
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(® all that apply)
Absorption Field 0 Initial 0 Single Family (SF)
❑
Septic Tank 0 Upgrade ❑ (w/wo ADU)
(D)
Holding Tank El Renewal❑
ElRenewal
Multiple Dwellings
Privy ❑
❑
(SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE ( WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: n/ jr 4 — Waiver Fees: Z I i
Date of Payment: A! % / 1 U Date of Payment: Z�Z / Lf
Receipt Number:o(o`5 7(c Receipt Number: Off I � % G
Permit No. O5P1t I/Y1? Waiver No. 0.S e) `t ( 4 .50
Permit App_9-1-12.doc
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 FAX
September 25, 2014
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 3, Block 2, Duke and Duchess Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 3, Block 2, Duke and Duchess Subdivision intends to construct a new
three-bedroom home on the lot. We are therefore requesting a permit be issued for the
construction of a new well and septic system to accommodate the home. The attached
Site Plan and backup documentation identify the location and configuration of the
proposed well and septic system along with the alternate site. Also identified on the
plans are the existing wells and septic systems on surrounding lots. No conflicts exist
between the proposed septic system and well or septic systems and wells 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.
A test hole was placed on the lot in the area of the absorption trench and alternate site.
The logs indicate silty sand with gravel (SM/GM) in the zone specified for the absorption
trench. The percolation rate of the soil was determined to be 1.6 minutes per inch. No
groundwater was found during the placement of the test hole and none developed
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
1,000 -gallon septic tank and a 38' 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 6' below the surface as the trench will be
located uphill from the tank and the total depth will be 10'. 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 northwest.
The new trenches will be constructed parallel with the contours of the slope as much as
Lot 3, Block 2, Duke and Duchess Subdivision
September 25, 2014
Page Two
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
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,
Michael E. Anderson, P.E.
Attachments
`. 49th
`_
MICHAEL E. ANDERSON
No. CE -4381
PROF_SS
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 FAX
October 3, 2014
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 3, Block 2, Duke and Duchess Subdivision
Absorption Trench to Slope Waiver
Alternate Site
Dear Onsite Services Engineer:
Lot 3, Block 2, Duke and Duchess Subdivision has limited area for construction of a
septic system due to steep slopes and an aerial electrical easement crossing the
middle of the lot. The west end of the primary absorption trench is situated slightly more
than 16' from a break in grade greater than 25%. The alternate site is 31' from the
break. The distribution line in the trenches will be constructed at 6' below grade to
provide gravity flow. We are therefore applying for a waiver allowing placement of the
absorption trenches at the location shown.
Soils in the area are very good for the treatment and absorption of septic effluent. The
majority of absorption will be down and migration will be minimal. The imaginary 25%
slope from 2.5' above the distribution line does not daylight. We therefore recommend
a waiver be issued allowing placement of the absorption trench at 16' and 31' from a
slope greater than 25%.
Sincerely,
Michael E. Anderson, P.E.
Attachment
!I
CONTOUR IN
LEGEND
FCO — Founc
TH — Test H
SV — Septic
MT — Monitoi
CO — Clean
DUKE & DUCHESS SUBDIVISION
LOT 3, BLOCK 2
47,260 S.F.
r 49th
..................... 604...
n MICHAEL E. ANDERSON
��up ?, N0. CE -4381 �
LOT 2, BLOCK 2
SITE PLAN
SCALE 1" = 50'
,
,
,
,
No Conflicts with Wells
or Septic Systems on
Adjacent Lots.
No Surface Water Within 100'
of the Proposed Septic
System. Breaks in Grade >25
% Are Shown.
LOT 3, BLOCK 2, DUKE AND DUCHESS SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS
Three Bedroom Home 5' Wide Trench System
Perc. Rate: 1-5 Min./Inch 1,000 Gallon Septic Tank
Application Rate: 1.2 GPD/SF 4' Drainfield Rock
3 Bedrooms * 150 GPD/Bedroom = 450 SF Absor tion Area
450 SF/1.2 GPD/SF/5 SF (Width) *.5 (Red. Factor= 37.5 LF Trench Length
THEREFORE: Construct a 38' Long x 5' Wide x 4' Effective Depth Absorption Trench.
Flow Line Elevation in Trench to be 6' Below Original Ground Surface. Total Depth to be
10' Below Existing Ground. Provide 3' Cover Over Absorption Trench and 4' Cover Over
Septic Tank.
5'
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. s r
Minimum 100' Separation From Private Wells in the Area. i""`
Minimum 100' Separation From Surface Water or Streams: tic
MICHAEL E. ANDERSON
No. CE -4391
M
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: DUKES AND DUTCHESS BLOCK 2 LOT 3
PERFORMED FOR: SCOTT PEPPERS _
DATE: 8/6/2014 PROJECT No.:
PARCEL ID#: TECHNICIAN: JB
DEPTH TEST HOLE 1
(feel)
14-
15-
16--
NO
OB/OG
111111111111
DEPTH OF WA TER AFTER MO
GROSS TIME
(MINUTES)
2
DEPTH To
(INCHES) ATER
N(INCHROP
3
TEST HOLE PRESOAKED PRIOR TO TESTING:
8/6/14
4
3:20/3:30
10
5
6.2 5 "
SILTY SAND
2
3:31/3:41
WITH GRAVEL
6
C.25"
SM/GM
7
3:42/3:52
10
8
6,25"
9
3:53/4:03
10
10-
011-
6,25"
11-
4:04/4:14
10
141516 BOH @ 16'
17-
18-
19-
SITE
71819
WAS GROUND WATER ENCOUNTERED?
NO
IF YES ¢ WH
DAT F
DEPTH OF WA TER AFTER MO
GROSS TIME
(MINUTES)
DATE OF MO
DEPTH To
(INCHES) ATER
49th
MICHAEL E. ANDERSON
NO. CE -4381
SITE PLAN
SEE SITE PEAN
A"CDER IT19 J
MTORING: NONE O
NIT ORING: 9/Z�"�� P
E
- �
DAT F
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH To
(INCHES) ATER
N(INCHROP
TEST HOLE PRESOAKED PRIOR TO TESTING:
8/6/14
1
3:20/3:30
10
5.00"/11.25
6.2 5 "
2
3:31/3:41
10
4.75'/11.00"
C.25"
3
3:42/3:52
10
5.00"/11.25"
6,25"
4
3:53/4:03
10
5.00"/11.25'
6,25"
5
4:04/4:14
10
4.75'711 .00"
6.25"
6
4:15/4:25
10
5:00"/] 1.25"
6.25"
PERCOLATION RATE: 1.6 (MIN/INCH) PERC. HOLE DIA. 6H (INCHES)
TEST RUN BETWEEN: 4 FT. and 5 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: 9/26/2014
RUS`
Parcel I.D. 051-221-56
." RC1SHi
a U4 . & i� 2Lt15
Municipality of Anchorage a ,
On -Site Water and Wastewater Program
(907) 343-7904
Certificate of On -Site Systems Approval
Expiration Date:
1. GENERAL INFORMATION
Complete legal description Duke & Duchess, Block 2, Lot 3
Location (site address) 18220 Bending Birch Drive Chugiak, AK 99567
Current Property owner(s) J. A. Sartln Day phone
Mailing address
Real Estate Agent
1231 W. Northern Lights, Blvd. #842 Anch., AK 99503
2. TYPE OF DWELLING:
E] Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: Three
Day phone,
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
0
Individual
Q
Individual Water Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
WaiverNariance request for: - Distance:
Received b � Date: L — 2 3'f(�—
COSA to be released to the_,4neer, unless otherwisP`requ4sted by the engineer,
COSA Fee $ /I I. (A Waiver Fee $
Date of Payment %a�231f 5 Date of Payment
Receipt Number 01 ba G'7 Receipt Number
COSA # (3 50 51362 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 Oh -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 oh -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 522-7773
6. DSD SIGNATURE , „ 4 , ..,t
/ N, r.........0
_1z System #1 Approved for bedrooms r^ MICHAE FNt)E250N
System #2 Approved for
Disapproved
Conditional approval for
bedrooms
bedrooms, with the following stipulations:
By:�: _ Original Certificate Date: �'oC3'�
The ma f Anchor evelopment Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the representation rven 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 ('- I• c
If more than 1 septic system is on the lot:
COSA Checklist # _of _
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description: Duke & Duchess, Block 2, Lot 3
A. WELL DATA
Well type Private If A, B, or C provide PWSID #
Date completed 10/27/14 Sanitary seal (YIN) Y
Total depth 500 ft. Cased to 44 ft
FROM WELL LOG
Date of test 10/27/14
Static water level IS LS ft.
Well production 10 \S g.p.m.
WATER SAMPLE RESULTS
Parcel ID: 051-221-56
Well Log (YIN) Y
Wires properly protected (YIN) Y
Casing height (above ground) >18 in.
AT INSPECTION
Coliform 0 colonies/100 mL Nitrate '127 mg/L
Arsenic ND ug/L Date of sample: 5/28/15 Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel
Tank size 11000 gal. Number of Compartments 2
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N
Date of pumping New Const. Pumper
C. ABSORPTION FIELD DATA
In
g:p.m.
J.S.
Date installed 2/10/15
Cleanouts(Y/N) Y
High water alarm (YIN) N
Date installed 2/10/15 Soil rating (g.p.d.lft2 or ft2/bdrm) 1.2 GPD/SF System type 5' Wide
Length 55' ft. Width 5' ft. Gravel below pipe 2' ft.
Total depth 6 ft. Eff. absorption area 393 fe Monitoring tube Y Depression over field N
Date of adequacy test New Const. Results (Pass/Fail) For—bedrooms
i
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) N If yes, give date _
D. LIFT STATION No Add On Manhole - Gravity Flow to Absorption Trench.
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump oft' level at in. High water alarm level at in.
Datum Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot > 100' On adjacent lots >1 00'
Absorption field on lot >1 00' On adjacent lots >1 00'
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'
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >5 Property line >5' 5'
Absorption field >
Water main > 10'
Water service line >10' Surface water > 100'
Wells on adjacent lots >100'
ABSORPTION FIELD ON LOT TO:
Property line >10' Building foundation >10' Water main
N/A
r r r
Water Service line > Surface water >100' Driveway, parking/vehicle storage > 10
Curtain drain Norte Noted Wells on adjacent lots >100'
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that 1 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 6/18/2415
COSA brown sheet 10-10-.12.doc
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I HEREBY CERTIFY -THAT I HAVE SURVEYED THE .SCALE �� . , a�'��►°`gya
FOLLOWING DESCRIBED PROPERTY: OF a
4'YOGl11r✓�.L3 �'� 2 DATE-, At y�
AND THAT NO ENGR(NrCNMENT�S EXIS�f EXCEPT AS s�a��r- y . ' ' •'�
INDICATED. 1T IS THE RESPONSIBILITY OF THE rn LV
OWNER TO DETERMINE THE EXISTENCE OF ANY. '"" ...0
EASEMENTS, COVENANTS; OR RESTRICTIONS 1414�11�vs7
WHICH DO NOT APPEAR ON THE RECORDED SUBDI-
VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD F6` lsX •_ L5- a" g
ANY DATA HEREON BE USED FOR CONSTRUCTION
OF FENCE LINES, OR FOR ESTABLISHING BDUND-kixjal ��'
WNs
ARY LINES. Di?A���