HomeMy WebLinkAboutKASILOF HILLS BLK 3 LT 2ASr Municipality of Anchorage Page ? of 4 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 ® Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: O T,W970282 PID Number: �1 6192 — Name: George W. Skladal Wastewater System: New ❑ Upgrade Address: 9210 vanguard Drive Anchorage, AK 99507 ABSORPTION FIELD Phone: 344-5678 No. of Bedrooms: Trench C]Shallow Trench 13Bed ❑ Mound C1Other LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: GPD/Sq, Ft. Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe 2A 3 Kasiloff Hills 3.9Ft. 8 Ft. Township: Range: Section: Fill added above original grade: Gravel length: •> AO Ft. /0S Ft. WELL: New ❑ Upgrade ' Gravel width: Number of lines: Distance between lines: I L 5> 3. Ft. -' Ft. Classification (Private, A,B,C): Total Depth: i Cased To: Total absorption area: Pipe material;..# /v 7i.3o9 , Ft. Ft. SD. Ft. –a/O Driller: Alpine Date Drilled: 12/15/9 Static Water Level: 48' Installer: NCl Data installed: Ft. /�0/�/ G. Yield:2.5 Pump Set at: Casing Height Above Ground: 2 TANK GPM Ft. Ft. SEPARATION DISTANCES Septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Litt Holding F==Private Manufacturer. Capacity in gallons: From Tank Field Station Tank Sewer Linea AAkq, 7,-41q / 501C, Well, / (� / Materia Number of Compartments: Surface Water y/co' foo' LIFT STATION /`f A Lot Line r� Size in gallons: Manufacturer: Foundation q ,5� L y/ "Pump on" level at: rip off" level at: High water alarm at: Curtain ` Pump Make d el Electrical Inspections performed by: Drain N1 Remarks: BENCH MARK Location and Description: Lower Floor, concrete slab Assumed Elevation: 100.0 Ft ENG�6R6p�.:�ff L #p p �q q I1. y O p / ._r ..C��{. • • -0T �96 jai • a TJ •" 0, V. Inspections performed by: — Dates: 1s ' ,F!1!C c;. .... o 2nd 1, .. :;. ��� MICHAEL E ANDEI180ida.°� r Department of Beal and uman Servi es approval P�%' 4381-f= c>=` AVN, Reviewed and approved by: ; L 7[;4 _ Datel—iv i 9 1%�C Permit No. aW=288 Page- 2 of 4 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.C. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: LT 2A, BLK 3 Kasilof Hills PID No.: 01 51 61 92 A \ 94 Tf�l MICHAEL' ANDEFlSCi 381- E rtlOroi`yl'`i`a� 1" = 20' Permit No. SW970288 page 3 _of 4 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: I!T 2A, BLK 3 Kasilof Hills PIC) No.: 01 51 61 92 �1 Zabel Z-200 flow splitter 77 - _ .y�� V!Vr Uv, ldilA\!•11A%hV�11Aa•V _. 1 , 500 ggal. -- ti� SepTank O o V, 2 ELEVATION .AS -BLT I if oil T S i�' d ih\ \,\i\+\/\.\\�•\ \\ l V YIN \ 0\' 11V,\\r1 1\Kr\1 s1\\r \' o "i\µ i • j\� tII � g� geotextile fabric> ° ,p o c O 9 • e P V '° ° s n e l0 D V S E P I. C 6. R O C K v 0 E , D °° 6 e °.� D 1, c c e c n• n n t.. o. c . ^ f c C O °c e e s°D•,� a „Y r \ ... MICHAELE. ANDESt, csxn 4381 -E r SP1 Septic Pump, compartment 1 �\ -. C Clean Out MT Monitor Tube Permit No. SW970288 Page _ 4 of 4 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.Q. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description V4 LT 2A, BLK 3 Kasilof Hill -s -_10/ lc� F� <-'i° iv1!f,;fIA�L G �ANDEf15C� �s ' ��'�'�" 43E31•� •� 1 ^r n r PID No 01 51 61 92 A I i Munk#anty of Anchorage C* -D DEPARTMENT OF HEALTH 8t HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION 'PEST PERFORMED FOR: Spinell Homes DATE PER LEGAL DESCRIPTION: LcT ? ��o�r'c 3 Township, Range. Section: DEPTH ��-- /�✓f�/�-�/�� /I���`S SLOPE CC 1 ofs�oG_ a 3 4 5 6 7 8 9 10 it 12 13 14 15 16 17 18 19 20 WAS GROUND WATER / ENCOUNTERED? �V S IF YES. AT WHAT L O DEPTH? E oto to WSW un /vv wMan lq? W--tm Bate � y. M1011AEL F. Ati06 ia(A ¢"3r;� Reeding Date Grose Time Net? Time Depth to Water Net Drop 19 150 /37 4S /Z: /0 /ZL// .I,- /Z - 3/5- zo. :Z� / 3B PERCOLATION RATE S (minutevinch) PERC HOLE DIAMETER _ZL_ / // TEST RUN BETWEEN re_ FT AND FT COMMENTS Tl$ 7' G�/i h r✓;r S %rc S=- Z a M} 13. l 0 C7J Te/ c_A'c_ PERFORMED BY: �e 1 ��_' CEATIFYTHAT THI TEqT WAS PERFORMED IN ACCCROANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: !� 17—MAR—BB 11.14 PROM•EPINELL HOMES INC ID -9073441976 PACE 1/1 „ ... .. 1+1 nriw.' •+.'acv"..n,r•;n: r:;u X +• STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES DIVISION OF MINING '& WATER MGMT LOCATION OF WELL WATER WELL RECORD `, saAouca .. LOT . SCOCK ' SEG-FION QUM 4 TOVYN4N" iNlvag rcr; in ^.._ CIN' ❑E MUMIAN r.. CIW - LOCA710N/SKETCH:. WELL OWNER _•._}T .^JSP,,.- ._ -.. _ _ v..C•." ': M:.i: _ .., .. ... DE"TH$MEASURED FROM:Ocaing top bground s6rfacc WELL DEpIFI .. _ _... D BOREffOLE DATA:. -:.,• -• ' - Depth of hWd: . _.� ATE OF COMPLETION Depth" Depth o! casing: f�ii-ft - Material Type and Color From To, P _ ;. g-�--- _ _ DEPTH TO STATIC WAi'ER LEVEL: ground belto a+, _ P Of casing ® �. r- '�. .'c . >r' �: >". '�r+•u::r - rwr�.r >•,:�.;,-: ��:-� • ;�; ••. g d surface ow D 1 ate ' it aa` METHOD dFDR1LLING: fair ro ... - .'� ❑ �•-�� �1 Dine tary cable tool !rte. F Gin -- ��:W<�•. +:��A...Y' y .."-1 �;- .r .. :': N.. OF WE1. i" .domestic': -o . c C irrigation Q monitor: :� C7 pubfici suppi ' 0 a h i;•v .•:f.:.�,rj"'�i::ji: - »t"' y." 1Y� 4%.`^ n, . _ ... r.: �':yy!:'': %(rc _ .'-Y`•P ^.L- ':�'t,..`.,: ,.+1JINGIV^ .u. . -.,..: -... ^'or_ft. Diam .:p in. to 6 C ft e� n:. Casing tYPe i.•iA '�j(%T`YYi :. {�_ — .t , _ _ in. to =; ft WELLINTAKE OP, en en o s:,... � a o screened ra..� P .,;ave if .: i:'^'^.w Arial i."'%" .: � w i •rr ,:. i...r _.y F: �.`. .•.xM, " _z "{; Depths of openings^ `: to 2, ` SCREEN TYPE a Siot/m, esh rze.nm^_,,.M_{, :�Lcn x.: ft 5V 4 GRAVEL PACK TYPE' r u>' Volume %-`'i;;.=•;:,.., �- •. . DeptF li ttop.,. mi-�— --. �. ,;�'c z :r :.- OUT i YPI+E`?G•2e dle" s ,k D . ..;: .N.:�s: �ra:y, _�':' _ ° ePtfi. froiri:::a. .:::..r._ ft to- -- _�r'•:O..K:ii•�N-'"�i!':{,'IS";"s:Kj v �''•'<.: t. J.i.'lr s:. - — ft ,:11k' �., • >K'J 1. r�__µ„ ..D :.... .. '-a�',r '.•- ��: s: ' DEVELOPMENT MEI'HQDt '��'�C§� ��'•:� - _ ,•..,, .. _ ,i�..•� a- may;. .... r..:. _ ' : .Aq7: s,: • �, s=;::.• _ � ' � `: .ted..••':...:..... '• ... a � .nYs.::{+�..a�:,5.`�:. 1,1 •!:W,��:.�:` {K{Ftiif:�i :f`:w�ie�.�. .rip wai'l.:?::.':.;•.. '�' ..�y' ;y Lam. �� :.`4 .Y ` tV4 � �r. '• h rr 4 ::�r. 1N .. ..� `; ,.:d _ .. .. J': .�. >'�a� .wy.,,,��- -'':c•AC ".•J! ' AND � tr` .....�...':.... .:...' �- . +W = 'S.:..'ri.• ;•� ' >.:n .: `yT?/•i •T��?Y- ,�.} . �. ink,• p •� ':: .. ..`� -411 .. 1z In +[i.'iY`.•' UMP 1KE `;.k .,n, x: p INTAKEDFPTH.. �> .,; _ u:. _ .... J�orsepower. __ : � , WELL DISINFECTED UPON ;;f1::. , . j Fs • :'y.. • - - :.> COMPLETION? YES L� NO OR INFO TION' 7� =" . ;;';, ;�', ':'�=..:. y M_ , a::' •<,: 'a r: .� : •=`'A-.`. N: P, � . }.f _.'.',; ._?.4. ^,L �r: �eeffry�����i���pr� (Q: �r7.: '•>xs:�..:�"'1�.-'�.`r.. ':.: � r ', ` r`'...+•- :::rli"•�. M.' rfxyl•r.:.'+. l.Y•1. w :,,, i n'N. 1_ 'c I t1l" '.n Y• ♦ �rf� �YC.'' Y .r%. �F��ST rR w'Y'U y�'' l! I r r i i.. _ ... _� '.. PLEASE MAIL WlIITE DOPY QLOG TO... uthorized Resp ntauve. Dem t DNR/DIVISION OF MINING, & WATER MGMT ti rT , •'S`'F'ix �:.ux _.F's. Y of e o - n �+ �. � •�.. �r.� - 3601 C st, Suite goo ANC,HOHAGE AK 99503-593 •Ja•;_. "' .�i�" I'll ``!-•%^ c�iiar .• }':"., ._�. one 19671762-25 u Ftok WY MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW970288 DESIGN ENGINEER:ANDERSON ENGINEERING OWNER NAME:SKLADAL GEORGE W OWNER ADDRESS:9210 VANGUARD DRIVE ANCHORAGE, ALASKA 99507 PARCEL ID:01516192 LEGAL DESCRIPTION: KASILOF HILLS BLK 3 LT 2A LOT SIZE: 55403 (SQ. FT.) NUMBER OF BEDROOMS: 5 THIS PERMIT: 5 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 8/29/97 EXPIRATION DATE: 8/29/98 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 ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: -m� F, at" -4V ` DATE: ci `Z G9% ISSUED BY: DATE: (o Pry t DATE: TO: FROM: MEMORANDUM September 25, 1997 Anthony Kim, MOA- DHH�Sj) Mike Anderson, P.E. SUBJECT: Lot 2A, Block 2, Kasiloff Hills Subdivision Well Relocation Permit No. SW970288 RECEIVED SEP ?. 5 1997 Municipality of /anchorage [)ept.1-Iealth & Human Services The owner of the subject lot intends to move the well from the location originally permitted to that shown on the attached Site Plan and Area Map. The area originally proposed will require construction of a road to provide access to the drilling rig. Many large trees will be destroyed and much of the wilderness appearance of the landscape of the lot will be demolished. The well can be constructed at the new location with no impact to adjacent lots or to the separation distance to the septic system and reserve area. We therefore request the permit be modified to allow the placement of the well at the new location. Please let me know if you have any questions. �A- ', \ \\ air ZG \ 1 1 \ 77 Ve,II ,/ . 4k I-PT hp R .. 00 \4cLL JO Le � s a9 •'� g'—l� e � ' \ \ roll :�►�! 01 r R O d Arm �: I � — — : �� — � � �� — — Wil• �,. _. — x �I AREA MAP SCALE 1" = 100' P ]0 l���7 I ,0.10 °•••a 1•m ��,•7p SO a 30' *��► , �? �. -� aoo_ — I I SNEBANOF i u LOT 2A, BLOCK 3, KASILOF HILLS 1 tt V r�SITE PLAN SCALE 1" 50' A-,,--, -, \ - August 5, 1997 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: Lot 2A, Block 3, Kasilof Hills Subdivision Septic System Design Impacts to Adjacent Properties Dear On Site Services Engineer: We hereby apply for a permit to construct a well and septic system on Lot 2A, Block 3, Kasilof Hills Subdivision. The attached site plan and backup documentation identify the location, size and components of the new well and septic system proposed to serve the new 5 bedroom home to be constructed on the lot. Testholes placed in the area of the proposed absorption trench revealed a silty gravel material with a percolation rate of 53 to 54 minutes per inch. No groundwater was noted during excavation nor during the ensuing monitoring period. The ground surface of the lot slopes from east to west at a grade ranging from 3% to 5%. The surface of the ground in the area of the new trench is fairly flat. The lot is of sufficient size so that no encroachments w i I I exist between the septic system and all wells on the lot or in the area. If the system is constructed as designed 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 reserved space, either surface or subsurface, on any lots located in the area. Lot 2A, Block 3, Kasilof Hills August 5, 1997 Page Two 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern w i I I be maintained. Sincerely, Michael E. Anderson, P.E. Attachments AL R� �°d s a�o•ortp / y Q I I o Is L.as�.i% a. C� � Ir -54714— ,.Fu�A�i }�rur7�rsa'�©��Fr'I._ n �— m• — — got0 AneMr [.nl � AREA Rfi A D SCALE 1" s 100'45, o to Mtn •S�`+1" p7RVID r.r0V tMI V. JoJO . 0150.!9 SHEBANOF LOT 2A, BLOCK 3, KASILdF HILLS SII I IV t t j Cc 4 / " PROPOSED WELL v i t I,V I I 1 V \\ r � \ SITE PLAN SCALE 1" 50' v 91I Ti..l \ CV � I EFFS LANG X -� ABS pR pT101 y IF RNC SPiu p H ft �... - 1,500 SEPTfC TgMKN SYSTEM PLAN NO SCALE° �. Mp►vfTpq *rue, �.� .��',�• cru f!;a LOT 15, BLOCK 2, CINERAMA TERRACE SUBDIVISION DESIGN FACTORS: Five Bedroom Home Perc. Rate: 53 Min./Inch Application Rate: . 45 GPD/SF SYSTEM REQUIREMENTS: Deep Trench System 1,500 Gallon Septic Tank 8' Gravel Beneath Pipe 5 Bedrooms X 150 GPD = 750 Gallons Per Day 750 GPD/.45 GPD/SF = 1,667 SF 1,667 SF/ 16 SF/LF (Absorption Area) = 105 LF Total Length of Bed Therefore: Construct a Deep Trench System With 1 Lateral 105' i n Length with 8' of Rock Beneath Distribution Pipe. Place Splitter Valve and Enter Trench in 2 Locations. Distribution Piping to be Placed at 3.5' Below Ground Level. —fj le BAULaILL 3 6a rax Le 320 "s FAalbc� 6" TYPICAL DEEP TRENCH SECTION (NO SCALE) NOTE: Minimum 4' Separation From Ground Water Grade Area to Drain Away. r'ilk o �.r Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST •c�n.y uvuq , PERFORMED FOR: Spinell Homes DATE PERFORMED: LEGAL DESCRIPTION: Le, 7- Z�L.Township, Range, Section:AIG _ ���>�LD/�/� SLOPE SITE P �m �� �rl�U FT 2 Net Time Depth to Water Net Drop -1 7 I; 0 .1 3- 11 4- 48 0 1'7 3 8- 9 9- 10 10- 11 11 12- 21B 13- 14- 15- 15• 16- 1s 116, d 17-, 16 .°• 19. 20 N WAS GROUND WATER / ENCOUNTERED? V S IF YES, AT WHAT L DEPTH? p E ReW to WSW Alta ua F1 mbring? —�203w-8 S R D Reading Date Groff Time Net Time Depth to Water Net Drop -1 7 I; 0 .1 11 0 1'7 3 PERCOLATION RATE �s (mmutesimah) PERC HOLE DIAMETER /Z TEST RUN BETWEEN --(P— FT AND :Z FT COMMENTS iCIA ✓�.—j� �ew PERFORMED BY: " I �"ti � �'�-�ER TSI Y THAT THIS T T WAS PERFORMED IN AccoRnANcr WITH ALL STATE ANn MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: e� L� .r Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: Spinell HOR1OS DATE PER LEGAL DESCRIPTION: Lc% 2A, 64-oc-Icz 3 Township, Range, Section DEPTH SLOPE I���J I 1 (FEETI 2 7 9 / 10 o 13 -i o / WAS GROUND WATER / ENCOUNTERED? S IF YES, AT WHAT L DEPTH? � p E OEM to Wela Ada Na S $ R % Monbi,Ing? r/'a`W Oats SITE Reading Date Gross Time Net Time Depth to Water Net Drop z o 97 /z- i S-// 20, r— R ,,B / 13 'Ell 20 2 PERCOLATION RATE S3 (minutes/inch) PERC HOLE DIAMETER J TEST RUN BETWEEN �i FT AND FT COMMENTS 74"':57 G�j i'/7rS arc S PERFORMED BY: I EFiTNFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:"1 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 2A, BLOCK 3, KASILOF HILLS SUBDIVISION GENERAL: 1. The scope of this project includes the the procurement and installation of a new 1,500 gallon septic tank. It also includes the construction of a new 105' long by 8' effective depth deep absorption trench. The distribution pipe in the trench to be placed 3.5' below the existing ground surface. A splitter valve will be placed downstream from the septic tank and the trench entered in two locations. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining a I I underground utility locates and for the layout of the septic system and verification of the location of all lot lines. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION A new 1,500 gallon septic tank must be procured from an approved source and installed at the location shown on the Site Plan. Lot 2A, Block 3, Kasilof Hills August 5, 1997 Page Two 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIEL.D CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. Lot 2A, Block 3, Kasilof Hills August 5, 1997 Page Three 5. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trenches to drain away. 8. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. MATERIAL. SPECIFICATIONS: 1. Septic tanks must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). Lot 2A, Block 3, Kasilof Hills August 5, 1997 Page Four 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: A minimum of two inspections are required by Municipal Ordinance. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. y jug 7� ti Municipality of Ancho a eSEP 2 6 2016 On -Site Water and Wastewater Progr (907) 343-7904 ��6 Certificate of On -Site Systems Approval Parcel I.D. 015-161-92 1. GENERAL INFORMATION Expiration Date: ^` Complete legal description Kasilof Hills, Block 3, Lot 2A Location (site address) 11000 Kasilof Blvd. Current Property owner(s) Kaercher, John & Terra Day phone Mailing address 11000 Kasilof Blvd. Anchorage, AK 99507 Real Estate Agent 2. TYPE OF DWELLING: i] Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Q Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for:. COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Date of Payment Receipt Number C60A6"5G COSA# oSClt'oN 5 - Waiver Fee $ Date of Payment. Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affiA0- heretq;a .d as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site System; 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 watersupply 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 analysisofthe 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 local 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 sale benefit of the owner listed above. - Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE System #1 Approved for j bedrooms System #2 Approved for bedrooms Disapproved Date _9126/2016 Conditional approval for bedrooms, with the following stipulations: By: �1� Original Certificate Date: 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 blue sheet f - :., 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: Kasilof Hills, Block 3, Lot 2A Parcel ID: 015-161-92 A. WELL DATA Well type Private If A, B, or C provide PWSID # Well Log (Y/N) Y Date completed 1 2/1 511 997 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 265 ft. Cased to 60 ft. Casing height (above ground) 18+ in. FROM WELL LOG AT INSPECTION Date of test 12/15/1997 9/14/201$ Static water level 48 ft 4.3 ft. Well production 2.5 g.p.m. 0:9 WATER SAMPLE RESULTS: Coliform Reel colonies/100 mL Nitrate �_ mg/L Arsenic ug/L Date of sample: 9/9/2016 Collected by: PES B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 9/28-30/1997 Tank size 1,500 gal.: Number of Compartments' 2 Cleanouts (Y/N) Y" Foundation cleanout (Y/N) Y Depression over tank (YM) N High water alarm (Y/N) N Data of pumping 9/7/2016 Pumper Isaacs Pumping Service C. 'ABSORPTION FIELD DATA site as+sal 2' o.a5 GPDISF Deep Trench Date installed Soil rating (g.p.d./ft or ftzlbdrm) System type Length 105 _ ft. Width 3 5 ft. Gravel below pipe ft. Total depth 10'8 ft. ,cif; absorption area 1'680 ft2 Monitoring tube Y Depression over field N Date of,adoquacy test, 9/14/2016 Results (Pass/Fail) PASS for 5 bedrooms Fluid depth in absorption field before test in. Water added 801 gal. _ New depth 0 in. Elapsed Time: 110 min. Final fluid depth 0* in. Absorption rate >= 750+ g.p.d. Any rejuvenation treatment (past 12 mo.} (Y/N & type) No If yes, give date L. ■ D. LIFT STATION Date installed Size in gallons 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 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 100+ Animal containment areas 50+ Manure/animal excrete storage areas 100+ 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+ _ 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 10+ _ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS *Monitor tube does not extend to bottom of field. Appears to extend into the top 4.5 feet of the effective depth.& G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and �b�P 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 Pannone}Dna: Date 9/26/2016 y CE -8149 COSA canary sheet_2.6-15.doc Municipality of Anchorage a Development Services Department ti z Building Safety Division s.A.F E'ry On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # osc161445 During a recent COSA on-site inspection and test of the potable water supply well on Block 3, Lot 2A of Kasilof Hills subdivision, the well's productivity was determined to be 0.9 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 5 -bedroom residence is 0.52 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. 19 111 40' 73-138 KASILOF HILLS SM. LOT ., BLOCK 3 $6,403 S.F. • 0 is nWL MfWCTM As -WAX AS—BU I l koraplt rsr till lio 1 k4V4 twra>tta 164 presort$ ")fat" aptra a;a JAN At 4MIA4•6i LAW "VEYWO ssatrtaksa+lls filial alga## as Lkslattai• 4611 A. taasftiaLe tl.L.L f3 Li Lha ris(FaRt LkLL II} of tm tyAis to 4726 U61 411136 Aro. 64waw*a rift skitifAta ti 49Y •aRmaRit. A414}Fsf"o. Al"AL.4loar 04m,11"ta tr rat►fittlaktithialt 4a-x*i POW 94*4 54 t«pMtr tk Rho f"ar ltll *V*4Lvlsl#■ �plpl. U"10At st�tant3nRtsa tAtois aAY lafa W11D IIAN kkttul as 9440 iar oasltwilgh ar !ir 7iSii tgj f�7 srlt Mli#?t # odory al tgaafi iiraa. AMC}LCRA9E R1if-0�IDt!!G alililtL�l, t1-RSF�S Mv rye+fir tr�c INA 06 Sam y A.6gaih{il + At a. Y��rrnzMtpt E'�",.,eb�� 4 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 01516192 HAA # �A A 98 QO'D Fn: n9 ���„� 1. GENERAL INFORMATION Complete legal description Lot 2A, Block 3, Kasilof Hills Subdivision Location (site address or directions) Property owner George W. Skladal Day phone 344-5678 Mailing address 9210 Vanguard Drive Anchorage, AK 99507 Lending agency Mailing address Agent _ Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 5 3. TYPE OF WATER SUPPLY: Individual well XXX Community well Public water Day phone Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 flAUNICIPALlrr tJUi' off at�cftc r.�r, ; 6R 4 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 01516192 HAA # �A A 98 QO'D Fn: n9 ���„� 1. GENERAL INFORMATION Complete legal description Lot 2A, Block 3, Kasilof Hills Subdivision Location (site address or directions) Property owner George W. Skladal Day phone 344-5678 Mailing address 9210 Vanguard Drive Anchorage, AK 99507 Lending agency Mailing address Agent _ Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 5 3. TYPE OF WATER SUPPLY: Individual well XXX Community well Public water Day phone Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Anderson Engineering Phone 522-7773 Address P.O. Box 240773 CC //AjJnchorage, AK 99524 Engineer's signature �� & Lc�_. Date March 1 8 , 1998 6. DHHS SIGNATURE Approved for _ bedrooms. Disapproved. Conditional approval for Additional Comments bedrooms, with the following stipulations: Date4-A2—/6 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA 1121 F'N��iu�rfdreiPnury u�,lruc,rrurt��r, 1f � fnl. SFpUq,ti.y f791r')Sfi: "! Municipality of Anchorage RiVI ] C*D DEPARTMENT OF HEALTH & HUMAN SERVICES i Environmental Services Division m = 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343- 44'». Health Authority Approval Checklist Legal Description: Lot 2A, Block 3, Kasifof Hills Parcel I.D.:_ 01 51 6192 A. WELL DATA Well type Private If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level n Y 12/15/97 Date completed Cased to 6 0 ' Y FROM WELL LOG 12/15/97 48' Well production WATER SAMPLE RESULTS: Coliform 0 2.5 g.p.m. Nitrate _ Casing height (above ground) Wires properly protected (Y/N) AT INSPECTION Other bacteria Date of sample: _ Collected by: A. Harala B. SEPTIC/HOLDING TANK DATA 1 2' a Date installed 9 /28 / 9 7 Tank size 1 , 500 Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression (Y/N) N High water alarm (Y/N) N Date of Pumping New _ Pumper Construction C. ABSORPTION FIELD DATA Date installed 9/30/97 - Soil rating (g.p.d./ft2 or ft2/bdrm) • 45 System type. Deep Trench Length 105' Width 3.5' Gravel thickness below pipe 81 Total depth 1 3 ' Effective absorption area 1 , 680 Simonitoring Tube present (Y/N) Y Depression over field (Y/N) N _ Date of adequacy test New Const. Results (Pass/Fail) Pass For 5 bedrooms Fluid depth in absorption field before test (in.); Immediately after_ gal. water added (in.): Fluid depth (ins) Minutes later: Absorption rate = _g.p.d. Peroxide treatment (past 12 months) (Y/N) If yes, give date; 72-026 (Rev. 3/96)` D. LIFT STATION - None on Lot Date installed Manhole/Access (Y/N) High water alarm level at* _ Cycles tested E. SEPARATION DISTANCES Size in gallons "Pump on" level at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot >100' >100' "Pump off" level at* On adjacent lots >100' On adjacent lots >100' Public sewer main Miles Public sewer manhole/cleanout Miles Sewer /septic service line U10, Lift station None on Lot SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation >5' Property line >5' Absorption field >5' Water main/service line > 10Surface water/drainage > 1 00' Wells on adjacent lots > 10 0 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line > 10 Building foundation > 10 , Water main/service line > 1 0' Surface water > 10 0 Driveway, parking/vehicle storage area > 10 Curtain drain None on Lot Wells on adjacent lots > 10 0 , F. ENGINEER'S CERTIFICATION 1 certify that I have determined thru field inspections and review of Municipal records tftatbdve systems are in conformance with MOAHAA guidelines in effect on this date. Signature Engineer's Name Michael E. Anderson, P.E. atsg- ,J Date March 18, 1998';CHA,FLC•A��lJl+MMI -' X3131-� , HAA Fee $ 3 0 0 a d Date of Payment 3 t ? — %?— Receipt Number 0,15:2 2 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number