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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
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y
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L.as�.i%
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AREA
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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
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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
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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
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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:
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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