HomeMy WebLinkAboutT12N R3W SEC 33 LT 107T12N R3W
Sec 33
Lot 107
#018-252-12
Municipality of Anchorage
On'-Site Water and Wastewater Program · (907) 343-7904 Page
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: ~.~ I~'~t "¢~¢~' PID Number: ~f~
Dwelling: ~ Single Family (SF) ~ Duplex (D) ~ Multiple (SF and/or D) Project: ~ New ~ Upgrade
~" k~ ~a//, ~BSORPTION FIELD
Address ~ Deep Trench ~ Shallow Trench ~ Bed ~ Mound
~ Other
Phone Total depth from original grade
Number~Bedrooms 3oilRating ~t ~ GPD/SF ~' ~ Ft
LE6AL DESCRIPTION }epth to pipe inve~ from original grade Grovel depth beneath pipe
Subdivision Block Lot ~ I ~ Ft. ~¢ ¢ Ft
~ ~ Fill added above original grade Gravel length
Township Range Section ~. 0 Ft. ~ ~ Ft
f~ ~ ~ Gravel ~dth Beds: Number of Lines Distance be~een lines
SEPARATION DISTANCES ~, O Ft ~ ¢ Ft
To Septic Absorption LiEStation Holding Sewer To~l absorption area Number of trenches D~st. be~eentrenches
From Tank Field/ Tank Line ~ ~ ~ F¢ / ~ Ft
Well '00'~ t~¢~ ~ ~ ~,,~ TANK ~Septic~S.T.E.P.~Holding~Other
Sudace Water ~¢1~ I~ Material Number of ~mpaKments
NA
LIFT STATION
Foundation ¢~1~ [ Of~ ~ ~ Manufacturer ~ Gal.
Cu~ainDmin ~k. rW~ ~
Remarks ~,~[,~ ~rf ,,*h4( Pump on level at ~elat Highwateralarmat
~ J ~ ~ in. in.
~l~ ~ ~ /~ ~ Pum~dmodel Electri~llnspectionspe~ormedby
[nsbller PIPE MATERIAL House to tank
Inspector ~11 &~ ~Z &~V4¢~ ¢.~ . BENCHMARK (Assumed elevation)
Inspection I,t ~/~ ~/i Lo~tion and description
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
Conditional Approvah = Date ~"
Inspection Repo~_9-1-12.doc '
Permit No. 0SP151307
Page 2 of 2
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchora9e, Alaska 99519-6650 Telephone: 545-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: T12N, R3W, SEC .33 , LOT 107
PID No.: 018-252-12
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NEW 1500 GALLON TANK
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BENCH AT STAIR
FCO
~ EXISTING CRIB PUMPED A ED
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\"",,,,, //'] / / /
/ ·
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. · ASBUILT
.. / SCALE: 1"=30'
::::::::::::::::::::::::::::
Permit Number:
Tax Code Number:
Work Type:
On-Site Wastewater Disposal System Permit
OSP151307
01825212000
Septic
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
Upgrade
Permit Effective Dates: September 04, 2015 to September 03, 2016
Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING
Subdivision: T12N R3W SEC 33
Site Legal Address: T12N R3W SEC 33 LT 107 G:3034
Owner/Address: HALL WAYNE A
PO BOX 874974 WASILLA AK 996874974
Department
Site Mailing Address: 3132 NUGGET LN, Anchorage
Lot Size in Sq Ft: 108900
Total Bedrooms: 3
This permit is for the construction of:
Y DisPosal Field N 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 By:
Issued By:
Community Development Department
Development Services Division
On-Site Water & Wastewater Program
MUNICIPALITY OF ANCHORAG
Phone:
Fax:907,343-7997
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D.
Property owner(s)
Mailing address
Day phone
Site address
Legal description (Sub'd., Block & Lot)
Legal description (Township, Range & Section) ~'~2.~
LotSize /¢~'~¢~(..,) Sq. Ft. Number of Bedrooms "~
APPLICATION IS FOR:
([] all that apply~
Absorptio n F~/et~ ~
Septic Tank(,_~ ~
Holding Tank ~
Privy ~
Private Well ~
Water Storage ~
APPLICATION IS AN: TYPE OF DWELLING:
Single Family (SF)
Initial
(w/we ADU)
Upgrade ~ Duplex (D)
Renewal []
Multiple Dwellings
(SF and/or D)
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Sign~erty owner or authorized agent)
Permit/Rush Fees:
Date of Payment:
Receipt Number:
Permit No. O~u¢
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
Sept. 2, 2015
Municipalities of Anchorage
Departments of Health and Human Services
P.O. Box 196650
Anchorage, Alaska 99519-6650
Fax 249-7847
Re~
Leg~:
Septic replacement
T12N, R3W, Sec 33, Lot 107
To Whom it may concern:
This is a request for a new septic system on the above referenced lot. The soils consist of poorly
graded gravels for 11 leer then changed to silty sand for the remaining depth of the test hole. No
water was observed in the test hole during the excavation or after the 7 day monitoring period. The
perc rate was 2 minutes per inch with an application rate of 1.2 GPD/SF which means the length is
38 feet by 5 feet effective. The crib system will be removed and a new tank installed outside the
well radius, see the plan. ~
The lot slopes to the south at about 3-5 percent, with no cut banks or open water within
the proposed design but thdre is a slope 50 feet to the south see the site plan.
As can be seen the site plan the lot is large and will not impact any of the surrounding neighbors.
Sincereff~
MichadN. Anderson, P.E.
4661Natrona Avenue
Anchorage, Alaska 99516
Phone 727-8864
Fax 345-1391
~MOUND OVER
3 BDRM X 150 = 450 GPD
SOILS ~ 450/1.2 -- .375 GPD 1.o_ \ /~LTER FABRIC
375 GA/10 = 38' -4,0-' ~ ~4"~ PiPE
~SEWER ROCK
(1) TRENCH GP
8' DEEP 11.o __ -9
5.0' EFFECTIVE sP
2.0' WIDE 12'°' I
38' LONG 18_
i SEPT1C FIELD SECTION
/ \ \ \ 3S BLU ~S~M
I ¢ i T12N,R3W,SEC33.LOT 107 T12N,R3W,SEC33,LOT 107
I PROPeRlY uNe~ I
.... \ / PROPER'Fl UNE
~ SEPTIC
T12N, R3W SEC 33 LOT107 ~"~:' 4~ITH
4601
NATRON^ ^V£
WEL /' /
EXISTING TANK TO ~ ~
DECOMMISSIONED
PI
EXIgTING RIBTO BE ",. ~ ~
.. ~.- ~" "~'~
T12N, R3W SEC 33 LOT 107
Anchorage, Alaska ".-.,,", ....................
~i;(~UICHAEL N. ANDERSONy,/~'
Michael N. Anderson, P.E. DATE: 9/3/2015
(907) 727-8864/F^X: (907) 345-1391 SCALE:
4700 Elmore Road
P,O. Box 196650 Anchorage, AK 99507
Performed For:
Legal Description:
Municipality of Anchorage
Development Services Department
On-Site Water and Wastewater Program
8-
9-
10-
12-
13-
15-
16-
19-
20-
~ ~ Ni[CHAEL N, ANDERSON
www. ci.anchoraqe.ak.us
(907) 343-7904 iI ~ *. ,'' ,~
It.~-a_ . ..... ,./~ _
Log- Percolation Test t~iJ~St?~ j
//
~¢ ~ ~ Township, Range, Section:
Slope Site Plan
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT DEPTH?
Depth to Water After
Monltorlttg? Date:
S
L
O
P
E
Reading Date Gross Time Net Time Depth to Water Net Drop
PERCOLATION RATE ~ (minutes/~nch) PERC HOLE DIAMETER
TEST RUN BETWEEN ~ FT AND ~ FT
PERFORMED BY: f~ ~[- ~/('~ J CERTIFY THAT THIS TEST~W/~S
PERFORMED IN ACCORDANCE WITH, ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~ ~///_,~
Mumclpahty of Anchorage
On-Site Water and Wastewater Progran~
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 018-252-12 ? ~
1.
Expiration Date:
GENERAL INFORMATION
Complete legal description T12N, R3W, SEC 33, LOT 107
Location (site address) 3'132 NUGGET LANE, ANCH, AK 99516
Current Property owner(s) WAYNE HALL
Mailing address P.O. BOX 847974, WASILLA, AK 99687
Day phone
Real Estate Agent
2. TYPE OF DWELLING: [] Single Family(w/we ADU)
[] Duplex
[] Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
4. 'P(PE OF WATER SUPPLY:
~ Individual Well []
·: ' IhdMddal water Storage []
C'°r~rn~nity Class __ Well []
Public Water System []
TYPE OF WASTEWATER DISPOSAL:
Individual []
Holding Tank []
Community []
Public Sewer []
Waiver/Variance request for:
Distance:
Received by:
COSA to be released to the engineer, unless otherwise requested by the engineer.
Date:
COSA Fee $
Date of Payment
Receipt Number
COSA #
Waiver Fee $
Date of Payment
Receipt Number
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 Approv:al 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/er 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 (~f Film MIKE N ANDERSON, P.E. Phone 727-8864
Address 4661 NATRONA AVE.
Engineer's Printed Name MIKE N ANDERSON, PE Date 09/15/15
6. DSD ,~GNATURE
System #1 Approved for
System #2 Approved for
Disapproved. ·
Conditional approval for
~.'. -- · ~..l ..... '.~.'t
bedrooms.
od,oom .
'
bedrooms, with the following stipulations:
By:
The . Iopment 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 professfonal engineer's work.
Original Certificate Date: ~ :'/~ -'/, ~
ATTACHMENTS:
COSA Checklist
Septic System Advisory
Well Flow Advisory
COSA blue sheet_10-10-12.doc
X
Nitrate Advisory
Arsenic Advisory
Other
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: TI2N, R3W~ SEC 33, LOT 107
A. WELL DATA
Well type Private
Date completed ~950'S
Total depth 31 ft.
Date of test
Static water level
Well production
If A, B, or C provide PWSID #
Sanitary seal (Y/N)_Y
Cased to 31 ft.
FROM WELL LOG
Parcel ID: 018-252-12
ft.
g.p.m.
Well Log (Y/N) N
Wires properly protected (Y/N) Y
Casing height (above ground) SEE NOTE
AT INSPECTION
9/2/2015
24+ ft.
5+ g,p.m.
WATER SAMPLE RESULTS.:
Coliform · NEG colonies/100 mL Nitrate 3.39 mg/L
Arsenic:, ND ug/L Date of sample: $/16/2015
Collected by: OARNESS.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC / STEEL
Tank size 1000 gal.
Foundation cleanout (Y/N) Y.
Date of Pumping NEW
Number of Compartments 2_
Depression over tank (Y/N) N
Pumper NEW
Date installed 915120t5
Cleanouts (Y/N) Y
High water alarm (Y/N) N
ABSORPTION FIELD DATA- 1985 SYSTEM TESTED
Date installed 9/5t2015 Sbil rating (g.p.d./ft2 or ft2/bdrm)
Length 32 f~.
Total depth 9.__[5 ft.
Width 2 ft.
Eft. absorption area 384+._ft~
System type DEEP TRENCH
Gravel below pipe 6.0 ft.
Monitoring tube Y Depression over field _N
Date of adequacy test NEW Results (Pass/Fail) NEW For 3__ bedrooms
Fluid depth'in absorption field before test NEW in. Water added NEW gal. New depth NEW
Elapsed Time: NEW .min. Final fluid depth NEW in. Absorption rate >= NEW g,p.d.
Any rejuvenation treatment (past 12 mo.) (y/N & type) UNKNOWN If yes, give date
in.
D. LIFT STATION
Date installed
"Pump on~ level at__
Datum
Size in gallons
in. "Pump off" level at__
Cycles tested __
Manhole/Access (Y/N)
in. High water alarm level at__
Meets alarm & circuit requirements?
in,
SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100'+
Absorption field on lot 100'+
Public sewer main 75'+
Sewer/septic service line 50'+
Animal containment areas 100'+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+
Water main 100'+
Wells on adjacent lots 100'+ '
ABSORPTION FIELD ON LOT TO:
Property line 10'+
Water Service line 10'+
Curtain drain 50'+ (None Known)
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout 100'+
Holding tank NA
Manure/animal excrete storage areas 100'+
Property line 5'+
Water service line 10'+
Absorption field 5'+
Surface water 100'+
Building foundation 10'+
Surface water 100'+
Wells on adjacent lots '100'+
Water main 10'+
Driveway, parking/vehicle storage 10'+
F. COMMENTS
WELL WAS EXTENDED ABOVE E~Y 907 WATER WORKS, WELL DRILLED IN THE 1950'S THEREFORE 31' DEPTH OK.
G. ENGINEER'S CERTIFICATION
I certify that I have determined through fie/d inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidefines in effect on this date.
Engineer's Printed Name ~r[[,~ N. AN])]~RSON~ ~PE
Date 00115/2015
COSA canary sheet_2-6-15.doc
I;