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HomeMy WebLinkAboutT15N R1W SEC 9 LT 88 S2T15N R1W Sec 9 Lot 88 52 #051 - 104 - 40 Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 1 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP 171305 PID Number:0511044° Dwelling: ❑■ Single Family(SF) ❑ Duplex(D) ❑ Multiple(SF and/or D) Project: El New ❑ Upgrade Name: DAN JEZWINSKI ABSORPTION FIELD Address ❑ Deep Trench ❑■ Shallow Trench ❑ Bed ❑ Mound 20515 WHITE BIRCH ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 5014542756 5 1.2 GPD/SF 6.95 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 2.9 Ft.4.05 Ft. 88 S2 Fill added above original grade Gravel length Township Range Section 0.4 Ft.65 Ft. 15N 1W 9 Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES 5 Ft..-- -- Ft. To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist.between trenches From Tank Field Tank Line 650 Ft2 1 -- Ft. Well +100 +100 -- __ +25 TANK ®Septic ❑S.T.E.P. ❑Holding ❑Other Manufacturer Capacity Surface Water +100 +100 -- -- ANCHORAGE TANK 1500 Gal. Material Number of compartments Lot Line +5 +10 -- -- STEEL 2 NA Foundation 5 +10 -- -- LIFT STATION Manufacturer Capacity Curtain Drain -- +50 -- -- -- -- Gal. Remarks old well decomissioned Pump on level at Pump off level at High water alarm at old septic system not encountered._ -- in. -- in. -- in. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank 3034 Tank to 3034 Installer drainfield GUARANTEED SVCS Drainfield 3034 CO/MT3034 Inspector CHARLES BALZARINI BENCH MARK (Assumed elevation)100 ft Inspection , Location and description dates: 1' 10/12/17 2nd 10/12/17 P10/13/17 4th TOP OF FOUNDATION COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp''0‘��1IIit' -- Q��' �F• • A L •S'f Conditional Approval: Date . • ' ki� •• l‘ ,.,. .•... , il Charles G.ga�ar : i f �, C�•) ,� Approved �— Date ".1�g v.v4, -p �• Inspection Report_9-1-12.doc FENCE SWING TIES �� I A B 7 �� ?. A�gs�,+ C 24.2 42 ,..1-'4":- D 50.6 44.2 //CO • ••y Or E 43.6 97.5 / *• `'9TH * J/ • 5x65 DRAINFIELD / •• _ r 4' EFFECTIVE NEW 1500 STEEL F CHARLES G BALZARIt�II Ai SEPTIC TANK rtAl'F�•, CE•13854 • •, (l 1,PROFESSIO�P�' r LEGEND 0 CLEANOUT C :, • MONITOR TUBE V TEST HOLE / HODS\ B /1/ - :M TOP OF \ FOUNDATION / \ / \ / �O O- ! N I ••'G\ i S \ ( 0 1 WP LL 1 I PI AN - SCAI E. 1" = 30' i +100.0' TOP FOUNDATION ONITOR TUBE BLUE BOARD INSULATIO gg.5 \ AND 2" INSULATION FILTER FABRIC 98.2 FINISHED GRADE TESTHOLE +3' COVER „ COVER i 97.8'ORIG. GRADE I- 94.9 1500 GAL TANK 90.85 I,I;I;I;I,;i; ',i 94.9 INVER \ 96.06 96.73 4"0 DISTRIBUTION PIPE 90.85 NO GROUNDWATER 4.05' EFFECTIVE SEWER ROCK SCHEMATIC ELEVATION - SCALE: NTS B.O.H 81.8' LEGAL DESCRIPTION: T15N R1W SEC 9 LOT 88 S2 C&M ENGINEERING SERVICES OWNER: RANDY ROLOFF DATE:11/12/17 REV: II DRAWN: CB REF: 907-854-5558 SEPTIC RECORD DRAWING S 89'59' 41 330.30' • e,, of 1lecoesstonc$ 0 ,.., ®2 =' et ,.`well I Crow oc 46' T Septic O _1........ ..,_,. _ I 6 Sri,a� O _ _ Septic 3 Septic VD Q! I wt A4ve iri ` C 65' a 1-.4 I Exiling iv YY tact ...ID 4N N ,__-- —113'~ 'm.•1.t 1$ 13, J `rCiriP 12. y step - House k, SO''. 1 b ''.1,1 6'x26' 3 Deck ie S1/2, BLM Lct 88 3 b d _ I -1 o Y --OH Electrh'TeIe Un. N 0 ,i o 2 I, g z ��. td I Z L-Utraty pose 49 Tel Pedal I Chain Unk Fence - -_ __ _-Wit---a-- S 89'59' W 330.30' �.,- . OF a<q'll I, _ (9.•-• -. 9 '/, Asbuilt of Concrete foundation only I hereby certify that I have surveyed the following described ; * " 49 DJ - * „ property:S 1/2 of BLM Lot 88,Sec.9.T. 15 N.,R. 1 1V.,S.M.,Alaska rik P. as depicted on Township Plat:"1. i5 \l.,R. I W.,S.M..Alaska ; . Dependent Resurvey and Subdivision.and that no encroachments / �, hony P. Boneta.:152 exist except as indicated hereon. This As-built will only show the icl • i, &S-10393 easements that appear in Patient No. 1221612:under no circumstances i, 7/,-/jI�. . .. ,.z.-:- should flthis data dary or ih ire llines.used for the construction or establishing X1111 iix` \` `,_.;:- of . a zs :A) Sec.9,T. 15 N..R. 1 W.,S.M.,Alaska SHEET APB Land Surveying South Half BLM Lot 88 ASBUILT SURVEY , ......FELT As Depicted on:Township Plat Jezwn ski Dan J&Kattuyn i / 12204 East Prince of Peace Drive l"=50• Dependent Resurvey and Subdivision 306 Bunnell Street of EagleasRiver,Alaska 99577 Accepted May 13. 1955 Anchorage,Alaska 99508 / (907)227-1361 Surveyed:July 17.2018 GRID: NV41358 / 1 DRAt TED: RWR f CHECKED: 1 , //53 S M-VV DRILLING, Inc. • --Z: r%'• --I-Z.- — IQ" CI .:.c 3 5-•-• ..C2..)P.O.Box 4-1728 • 2811 Dawson ,_.4.,0 ...4 . E I -1-.-41- ' 19 A C 907-279-1741 t. 1 SI '' 5 c•-ID o, ANCHORAGE ALASKA 99509 tot ALI vi 149 .z.13-z( 0 Z. . DRILLING LOG .. rzt... i -1;•• Well Owner Judy Lane Use of Well . i.v I I Location (address of: Township, Range, Section, if known; or distance main road • •,4.. ‘ Sky 1,88. 6.a 9, 71%, milt_ $ome .': • • z.. Birchwoc.idloop .. White Birth Rd area _ . Size of casing 6 Depth'of Hole 302 feet Cased to 37 feet --. .,'-•.; 7. Static water leveL._.24ft. (gizmo (below) land surface. Finish of well (check one) open end ( X ); i " . - w Screen ( - ); Perforated ( ). - n• . . Sono - Describe screen or perforation ...... Well pumping pumping test at_a___gallons per (121111) (minute) for 1 hours with ...,r•v•Inft 1-. ft .-:.., .... of drawdown froth static leveL 1 . t.;•• _ • .•, Date of completion__,..&May-19745L te----. ' ... .... S. . • , ' .or's*W • _LOG WELL , . ,•,- • ....:.,itv.;1 . • Depth in feet from. • ,. - . -- • ` -ground surface , Give details of torn penetrated,size of material,color and hardness ,•). A TO__.....2 •--- •(II ity • •-... . , . , ., ,_‘•,. , ..___2TO_ALL,....L7.. ftspndy ilre val . - • . i" e- ' ' - • i ' '• - -:, :;.i.-..:4) f • 4•1' - ; • . . .:1 6,,••••.it'r...r.,It t.4 •-••••,..4 _ . , ' ..' •••444: -....: ILL—,TO15--_. ---.- At,+y arsirils Imbt = 1-',4-• • •,:, '••„it 9.15 TO.....ite.-- .te Ailty Or•Tel s dry *-41.. ......._24_70_21).---- 7--_ - - o3o.>1 • , PoreidAir _ , . , • ,.. ./ , . .., 9__Ta._..411._,_ * Sitritr Mil' „ '' ' ..' • •i: Li,/ ... , f \ •-roo.-:. .. ' • \, . ---P—TO—kel•-!&.•-•-•:, -'4::?„1.-- liess.+hairtad ._:__5&__TOO2--. -2 : . - . . A . . ,..- r.. . _. . - .._ . . . ..., .:4".r • S' . . -, Star seeps'ibrout1Witt.• TO____:.:....-$,-...- . - ., _. 1 ....c. . ' A ht. 1 . 1 • - . I....-2 ,,..., •- •, . . ::44,--4, . •,is....---.;).,• • - • •.: ••• • 1 ./ 4 ,. -It: :qv,e . '•'1‘-'ro , . . • • .._. -Tcy .-- ---- - . .t.,_(•, ,. . 4._ ,.. . . TO -....-- . . . - - TO - .• — .4 •• •• i. • . . .,•••••',, . ,-1- - ..' . . aaLids'ecp• - . _ . 2--:State . - MUNICIPALITY OF ANCHORAGE t� nr On-Site Water& Wastewater Program ', Pp Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 , ' httpalwww.muni.orglonsite j' ' Dc harttiivia SNCHOPPGE On-Site Water & Wastewater System Permit Permit Number: OSP171305 Effective Date: 10/10/2017 Work Type: WellSeptic Renewal Expiration Date: 10/10/2018 Tax Code Number: 05110440000 1 o11 Z J a 4 `r Site Legal Address: T15N R1 W SEC 9 LT 88 S2 G:1358 Site Mailing Address: 20515 WHITE BIRCH RD, Chugiak Owner: JEZWINSKI DAN J & KATHRYN Lot Size in Sq Ft: 54450 Design Engineer: NORTH RIM ENGINEERING Total Bedrooms: 5 This permit is for the construction of: ❑ Disposal Field ECJ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall 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 shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: 1. The abandoned well located near the back of the lot is to be decommissioned prior to Inspection Report approval. 2. The location of the previous septic field is unknown. If, during construction, the field is located, construction of the system will stop and a design change submitted to On-Site for review and approval. !0//7 C►1g.9e d + 5'w,dc, ''CO 63' /off , RA" Is' Ok far aX ca.v44i to pec /,, Received By: Date: Issued By: , „ / L /r � " Date: /�/roe' eu.511 '1t/ U ,NACOP LlTY OF NCHOF AGE C // -i-7 iti ` - -- •07- 3-7904 Community Development Department i--� - - --- Development Services Division '` �, Fax: 907-343-7997 On-Site Water & Wastewater Program a OCT 0 , ON-SITE SEWERIWELL PERMIT APPLI• L ON�� <� " !, •>,, Parcel I.D. ° r/- /0 (/' YO o f - .-- '2 ? r Property owner(s) � ire z z-,..z-,...1s i, / Day phone Mailing address a v r, c Lv 6, ;t zj. -c 4 - -'4e Q '- 3j Site address I / 5 A/ 6 1 Lt/ SCC f L.% f'd, S, /3 S-g Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) n s v If ' `"" Jec 5 c /) 17.z Lot Size TY, YTO Sq. Ft. Number of Bedrooms APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ® Initial ❑ Single Family (SF) 7 (w/wo ADU) Septic Tank 7 Upgrade ❑ Duplex (D) ❑ Holding Tank ❑ Renewal E, 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 pr owner or authorized agent) Permit/Rush Fees: ee3 IMw Waiver Fees: Date of Payment: 161q/19- Date of Payment: Receipt Number: Receipt Number: Permit No. 050/7130;,) Waiver No. 1 Permit App_9-1-12.doc Dear Reviewer, We are requesting renewal of permit number OSP161246, a permit previously issued on Oct 4 2016. We understand that the septic tank was partially installed on 10/7/17, which was 3 days after the permit expiration. The tank will be exposed and inspected prior to the required tank inspection. The department has expressed concern over some of the owner supplied materials currently on site. As always, materials not meeting specifications will be rejected. We have verified that substantive changes to the site and surrounding areas that would impact the installation of this septic system, have not been made. The previously approved design appears to be adequate and we are requesting the permit be re-issued. Sincerely, CharlesBalz. ' i, PE On-Site Wastewater Disposal System Permit n,cnr .S' `O • t!� MUNICIPALITY OF ANCHORAGE I Development Services Department r' On-Site Water& Wastewater Program ` 4700 Elmore Road, PO Box 196650 1 apartment Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP161246 Tax Code Number: 05110440000 Work Type: Septic Initial Permit Effective Dates: October 04, 2016 to October 04. 2017 Design Engineer: NORTH RIM ENGINEERING Subdivision: T15N R1W SEC 9 Site Legal Address: T15N R1W SEC 9 LT 88 S2 G:1358 Owner/Address: JEZWINSKI DAN J & KATHRYN 306 BUNNELL STREET ANCHORAGE AK 995082323 Site Mailing Address: 20515 WHITE BIRCH RD, Chugiak Lot Size in Sq Ft: 54450 Total Bedrooms: 5 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Date: /4215 g Issued By: 7'efittea eUL1K(/ Date: 0/4//.20 i 6 MUNICIPALITY OF i4 NCHORAGE ?tilt-'-d Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On-Site Water&Wastewater Program ON-SITE SEWERNVELL PERMIT APPLICATION /O4f 4716 Parcel I.D. 0 5I - Agee- 0 Property owner(s) TEZ'WiAls/f/ Day phone 2 '/q'— 36/6 Mailing address 306 S3VAIN ELI- -37— Site 7Site address Z O51S VL/(y/TE 5/gel' RA Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) Try N if/frtl SE C. 7 ,,y- ..Si?-, Lot Size s"L4 z/SO Sq. Ft. Number of Bedrooms 5 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field B Initial 4 Single Family(SF) J (w/wo ADU) Septic Tank )gliUpgrade ❑ Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy El (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE I WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. C --,.* -- (Signature of property owner ora orized agent) Permit/Rush Fees: rj 64 Waiver Fees: Date of Payment: / 3d6 Date of Payment: Receipt Number: 05'3396 Receipt Number: Permit No. 65P/6/ZW Waiver No. Permit App_9-1-12.doc hJCRTFI M F NCIN11 Rl['Jc. MEMO Steve Eng, PE, PH P.O. Box 770724, Eagle River AK 99577 (907) 694-7028 SteveEngPE@gmail.com Date: 8/29/16 Number of Pages: ,- To: MOA On-Site Services Subject: T15N R1W Section 9 Lot 88 S2 Septic System Design & Existing Water Well A new house is planned with new septic system and water well. The design is for a 5-bedroom septic system. A soil test revealed excellent soil, consistent with other soil tests in the area. The design calls for a deep trench, and a new septic tank. The entire subdivision is on private water wells and septic systems. The terrain slopes to the northwest at about 1 %at the new trench site. The existing water well will be utilized. Separation has been maintained with the design. s Please review the 5 bedroom wastewater system design for the new/bedroom home. I have included design plans & specs, design guidelines, & soil tests. If there is need for additional information or clarification please give me a call. Thanks-Steve r\ERTI- IM ENGINEERING T15N R1 W Section9, Lot 88 S2 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: Design is for a new 5-bedroom septic system; serving a new 5-bedroom, single family home. This is a mostly developed subdivision. These lots are large and are served by private wells and septic systems. No adverse impacts are expected from trench/tank construction. An existing water well will be utilized.No conflicts to the other lots will take place by this septic system construction. The easements are located on the drawing and are not encroached upon. An application rate of 1.2 GPD/FT2. Trench Length =625 FT2/6'x 2 = 52' trench. A new 1500 gallon septic tank will be installed. The existing well is located on the drawing. A slight slope exists toward the northwest. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications(AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • Two compartment,New 1500 gallon septic tank. Install new Double Cleanouts. • 5' minimum between the tank and trench. 10' to property lines. • 3' of cover or insulation is required for trench;2" Minimum thickness for insulation can substitute for 1' cover. • Tank& solid pipe must be set on well compacted, stable soil. • 4 inch diameter cleanouts with airtight caps are required l' to 4' from foundation wall, prior to any 90 degree bend in 4 inch line, in each tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10' from the tank positioned to provide cleanout access towards the tank and towards the absorption field. • All cleanouts must extend to at least ground level. • In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron. • Trench to be placed level, minimum of 4' to groundwater, 6' to bedrock from drain-rock. • Drain rock to be V2 inch to 2 1/2 inch screened. Drain rock to be distributed uniformly throughout the trench. • Perforated pipe to be installed level with perforations down. • Silt barrier(filter fabric) to be installed above the drain rock. • Smeared trench sides must be raked or scarified before drain rock placement. • Backfill over drain rock must not be less than 36". • The finish grade must be mounded to promote drainage away from trench. • Insulation must be placed over any pipe installed under driveways or parking areas. • Approved pipe materials include cast iron, PVC ASTM D3034,PVC ASTM F789, ABS ASTM D2661, • Sewer Service Line is minimum 2% slope. . s, .t • Septic Tank to be pumped every two years or when required. - OF • Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HU �' 1 • r,ems 1 A Com' DESIGN NOTES: 1. Total Depth of Trench is 10'. Terrain Slightly Slopes Northwest. 2. Sewer Service Line minimum 2% slope. 3. Privote Water Wells. 4. Check Well/Septic Separation Prior To Construction. 5. Check Drainage/Septic Separation Prior To Construction. 6. Locate Previous Septic Tank/Absorption Trench & Decommission Per UPC. 7. Fire—Damaged Previous Residence To Be Removed & Properly Disposed Of. oI ''. Slope cc u -.1Z. Slope L \ a, -1.Z.. Slope s Septic System 3 F10 ___52_, Q TH blew Trench --.1Slope 4 1 ' Slope ,Alternate Trench r dpij--...' \ Slope New 1500 f DCO Gallon 1Pw Septic Tank 4y I co -2.Z: Slope o I, ` Well No Conflicts To w I Well/Septic E / a, Slope 5 Bdrm VI 6 \ W 3 0 o! 0 Septic System ��.....x�11 - --- 1' = 50' �� °Fk T15N R1W SECTION 9 NOR THR/M e..... PLAN ENGINEERING ..:49 *. LOT 88 S2 PD Sox 770724 ,�.w LAYOUT Eagle River. Alaska 99577 a WASTEWATER DESIGN 907.694. 7028 SYSTEM 10/3/16of 3 Foundation Cleanout / Tank Cleanouts Fin ^amide Opposing Cleanouts Between Septic Tank & Trench 4 Foot Cover or Equal c --- ..�� r To New Trench 1500 Gallon Steel Mounded Cover To Match Terrain 'Anchorage Tank' Dr Equal Monitor Tube Solid Pipe leanout DESIGN NOTES: • 1. 5-Bedroom Septic System Design. Original Ground 2. Septic Tank & Solid Pipe to be Placed on Compacted, Filter Fabric �� Stable Soil, Free from Boulders, ., 3. Sewer Service Line is Minimum 2% Slope & 3' Cover. '::':: != =. ht Couplings. �' POO:ft0:� 4, Water-Ti 9P: .._._..: 5. See Specification Sheet. %; is::::::::: 6. All Work To Conform to Municipality of Anchorage (AMC) 6' ! -,----•:'= S❑ILS LOG - PERCOLATION TEST \C2TESIM Date Performed: 8/22/16 ENGINEERING Performed For: Dan Jezwinski Legal Description: T15N R1W Section 9 Lot 88 S2 DEPTH (FEET) lip 1 - a:r.,� ms. Organic T.H. Location: See Attached Design pop2 - - v.. AL vy=-l't�3 - `3 ai ` 4 - ` ,,�,.,.,..,4 S M San d :.; `.�,5,' - w/ Gravel 5 - ''Zr��� 4 1rs^&� ' Low Silt .. Groundwater? No 7 - ;;� F Depth -- 8 - '=° Water Depth bli-9 - �;ti. 0.4 After Monitoring.None Date: 8/29/16 10 - ;= �_ # Date Gross Time Net Time Depth Net Drop 11 - 1 8/29 0 -- 7" -- 'g`"`,.1.-i::,-";-12 8/29 10 10 min. 10.5' 3.5' 13 - •` '" 3 8/29 12 -- 7' -- 14 ".''.7'. ' 4 8/29 22 10 min, .. ..,..T y4 10,5' 3.5' .,....,,,1:!:,,..,.:..1.:::, 15 - ';" ;. 5 8/29 25 -- 7' -- 16 `?'~ "'-' " 6 8/29 35 10 min. 10,5" 3.5' 17 - 7 8/29 37 -- 7" -- 18 - 8 8/29 47 10 min. 10.5' 3.5' 19 - 9 8/29 50 -- 7' -- 20 - 10 8/29 60 10 min. 10.5' 3.5' 21 - Percolation Rate 3 min./inch Perc Hole Diameter 6' Test Run Between 4' and 5' Comments: Presoaked. Measured to nearest 1/1Eth inch. Performed By NorthRirn Eng. I CERTIFY THAT THIS TEST WAS Performed in Accordance with All State/Municipal Guidelines in Effect ON THIS DATE, DATE: 8/22/16 NORTHRIM ;��.4 TESTH❑LE LOG TH ENGINEERING ;* :49m '` • • PO Box 770724 I =: A •� Eagle 907694.7028 Alaska 99577 I4`#+,..' ._�i ff6 .' GEOTECHNICAL _ _ _ 15ate: - 8/22/16 M -W MULLING, Inc. P. O. Box 4-1728 a 2811 Dawson A C 907-279-1741 ANCHORAGE, ALASKA 99509 Well Owner Judy Lenm Use of Well Location (address of: Township, Range, Section, if known; or distance main road Size of casing epth of Hol ?."^ feet Cased to..... ....17 feet Static water level I: ft. (?j;�(?yg) (below) land surface. Finish of well (check one) open end Screen Perforated Describe screen or perforation N on 0 Well pumping test atgallons per (hblitl) (minute) for --- 4, -----hours with ft. of drawdown from static level. Date of completion P. TO. TO mter sempo t'n-ro.-Eho,,it. —TO- -TO-- -TO— TO <Xrclle' TO— TO— TO i,--'&yne E:. 't"'es4wbar 3 — Contractor WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness r' TO 2 -P—TO- 10 .4 TO J -214—TO Tb.- 7A A- Cl -'A TO. TO mter sempo t'n-ro.-Eho,,it. —TO- -TO-- -TO— TO <Xrclle' TO— TO— TO i,--'&yne E:. 't"'es4wbar 3 — Contractor On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP161246 Tax Code Number: 05110440000 Work Type: Septic Initial Permit Effective Dates: October 04, 2016 to October 04, 2017 Design Engineer: NORTH RIM ENGINEERING Subdivision: T15N R1W SEC 9 Site Legal Address: T15N R1W SEC 9 LT 88 S2 G:1358 Owner/Address: JEZWINSKI DAN J & KATHRYN 306 BUNNELL STREET ANCHORAGE AK 995082323 Site Mailing Address: 20515 WHITE BIRCH RD, Chugiak Lot Size in Sq Ft: 54450 Total Bedrooms: 5 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: cS-Cc Date: L6/ 1/4( Date: I0 y 201 MUNICIPALITY OF ANCHORAGE Community Development Department Development Services Division On -Site Water & Wastewater Program Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER WELL PERMIT APPLICATION /oY 5/0 Parcel I.D. 0 51— Aelt — Property owner(s) TErW/,t/S'/df Mailing address 30S SVNN,ELL Site address .2O 5/S tN/f iTF_ Legal description (Sub'd., Block & Lot) Day phone 2 36/6 f3/Re/, ,PG Legal description (Township, Range & Section) 77 S /f/(� Lot Size S -Lt, c/SO Sq. Ft. Number of Bedrooms 5 APPLICATION IS FOR: APPLICATION IS AN: (® all that apply) Absorption Field Septic Tank Holding Tank Privy Private Well Water Storage PEI E Initial Upgrade Renewal sec? 4Re TYPE OF DWELLING: Single Family (SF) (w/wo ADU) Duplex (D) 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. %'(Signature of property owner or a (prizedagent) Permit/Rush Fees: r - 64 Waiver Fees: Date of Payment: 3OA Receipt Number. 05'539b Permit No. 0S,7ep/TiW Perrnit App_9-1-12.doc Date of Payment: Receipt Number: Waiver No. TH-RIM ENGINEERING MEMO Steve Eng, PE, PH P.O. Box 770724, Eagle River AK 99577 (907) 694-7028 SteveEngPE@gmail.com Date: 8/29/16 To: MOA On -Site Services Subject: T15N R1W Section 9 Lot 88 S2 Septic System Design & Existing Water Well Number of Pages: s A new house is planned with new septic system and water well. The design is for a 5 -bedroom septic system. A soil test revealed excellent soil, consistent with other soil tests in the area. The design calls for a deep trench, and a new septic tank. The entire subdivision is on private water wells and septic systems. The terrain slopes to the northwest at about 1 % at the new trench site. The existing water well will be utilized. Separation has been maintained with the design. S Please review the 5 bedroom wastewater system design for the new/bedroom home. I have included design plans & specs, design guidelines, & soil tests. If there is need for additional information or clarification please give me a call. Thanks -Steve THkIM ftl?INEERING T15N R1W Section9, Lot 88 S2 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: Design is for a new 5 -bedroom septic system; serving a new 5 -bedroom, single family home. This is a mostly developed subdivision. These lots are large and are served by private wells and septic systems. No adverse impacts are expected from trench/tank construction. An existing water well will be utilized. No conflicts to the other lots will take place by this septic system construction. The easements are located on the drawing and are not encroached upon. An application rate of 1.2 GPD/FT2. Trench Length = 625 FT2/6'x 2 = 52' trench. A new 1500 gallon septic tank will be installed. The existing well is located on the drawing. A slight slope exists toward the northwest. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • Two compartment, New 1500 gallon septic tank. Install new Double Cleanouts. • 5' minimum between the tank and trench. 10' to property lines. • 3' of cover or insulation is required for trench; 2" Minimum thickness for insulation can substitute for 1' cover. • Tank & solid pipe must be set on well compacted, stable soil. • 4 inch diameter cleanouts with airtight caps are required 1' to 4' from foundation wall, prior to any 90 degree bend in 4 inch line, in each tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10' from the tank positioned to provide cleanout access towards the tank and towards the absorption field. • All cleanouts must extend to at least ground level. • In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron. • Trench to be placed level, minimum of 4' to groundwater, 6' to bedrock from drain -rock. • Drain rock to be '/2 inch to 2' /2 inch screened. Drain rock to be distributed uniformly throughout the trench. • Perforated pipe to be installed level with perforations down. • Silt barrier (filter fabric) to be installed above the drain rock. • Smeared trench sides must be raked or scarified before drain rock placement. • Backfill over drain rock must not be less than 36". • The finish grade must be mounded to promote drainage away from trench. • Insulation must be placed over any pipe installed under driveways or parking areas. • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, • Sewer Service Line is minimum 2% slope. • Septic Tank to be pumped every two years or when required. • Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI/ S u L to DESIGN NOTES: 1. Total Depth of Trench is 10'. Terrain Slightly Slopes Northwest. 2. Sewer Service Line minimum 2% slope. 3. Private Water Wells. 4. Check Well/Septic Separation Prior To Construction. 5. Check Drainage/Septic Separation Prior To Construction. 6. Locate Previous Septic Tank/Absorption Trench & Decommission Per UPC. 7. Fire—Damaged Previous Residence To Be Removed & Properly Disposed Of. Slope 10 4 Slope Septic System Slope ROW Easement PW Gy Well Slope TH Slope DCO fco Slope 5 Bdrm ___New Trench Alternate Trench 1SSlope New 1500 Gallon Septic Tank Slope / No Conflicts To Well/Septic Septic System NOR THRI M ENGINEERING PO Box 770724 Eagle River. Alaska 99577 907.694.7028 T15N R1W SECTI❑N 9 LOT 88 S2 WASTEWATER DESIGN SEPTIC SYSTEM 1" = 50' PLAN LAYOUT Dale:T: 10/3/16 12 of 3 <-1 3 O L d N a 3 U O i o d d W d L L rn+' L O a\ z H W 3 " cL ( z 1— - J iQ cu O U d 3 o O U OW W i "0' O p C 4' 6 U /- C Wm O - d d - L 3 L3 O Cr S W U O C L �¢o M df F O H a a, n, a o 0o U O > { + d N d U csL 111 -C2 73 EL Ol Ol J -151- O WON.VI E L O3 ++ fcs NV U & asp +°•_ C51-- >,� O 4 NO'S £ N 3 L -0 (I- arc L 0_ 01 :1) LJ O Q £ °�- O i adSW OAU-rVI 3Ol Vl 1. _ 5 i-' U O L \ UI £ O L S F" N > .51—�nI- o0 x o£,3v' a) ▪ d0) +> _ c _p- U W a+. 3 +'N Ol N d n1 cncu vitu #• :al l81 0 • N (133 W V1 SEPTIC SYSTEM / • ♦� Ntitinteri W 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 n� qq S❑ILS LOG - PERC❑LATI❑N TEST RTHRIM Date Performed: 8/22/16 pNGINEERJNEERING Performed For: Dan Jezwinski Legal Description: T15N R1W Section 9 Lot 88 S2 DEPTH (FEET) Organic T.H. Location: See Attached Design SM Sand w/ Gravel Low Silt FVti�s Groundwater? No Depth Water Depth After Monitorinq,None Date: 8/29/16 # Date Gross Time Net Time Depth Net Drop 1 8/29 0 -- 7" -- 2 8/29 10 10 min. 10,5° 3,5" 3 8/29 12 -- 7" -- 4 8/29 22 10 min, 10,5" 3,5" 5 8/29 25 -- 7" -- 6 8/29 35 10 min, 10,5" 3.5" 7 8/29 37 -- 7' -- 8 8/29 47 10 min. 10.5" 3,5" 9 8/29 50 -- 7" -- 10 8/29 60 10 min. 10,5" 3.5" Percolation Rate 3 rain,/inch Perc Hole Diameter 6' Test Run Between 4' and 5' Comments: Presoaked, Measured to nearest 1/16th inch. Performed By NorthRim Fng I ../S—E CERTIFY THAT THIS TEST WAS Performed in Accordance with All State/Municipal Guidelines in Effect ON THIS DATE, DATE: 8/22/16 NORTHRIM ENGINEERING PO Box 770724 I Eagle River, Alaska 99577 907.694.7028 iossermot * 49I11 . * TESTH❑LE LOG GE❑TECHNICAL TH Dote: !SHEET: 8/22/16 II wet; igti N IAwit GREATER ANCHORAGE AREA BOROUGH - DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM PERMIT NO APPLICATION AND PERMIT �`; Ce? /1 .Tr>; 6v1.)44,-; NAME OF APPLICANT MAILING ADDRESS it PHONE INSTALLATION LOCATION i ' ( (- '/j (E `6) s ems. q ! S 211 l l,/° S• its SEEPAGE PIT / AIN FIELD LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH SOIL TEST RESULTS COMPLETION DATE ANTICIPATED r/t1-YYM cileg TO BE INSTALLED BY Y , OTHER NOTE, THIS PER IS NOT ALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRE DEPARTMENT OF ENVIRONMENTAL QUALITY AU BACKPI ORITY W ING OF AY SYSTEMITH. IT FINAL INSPECTION BY THE BE SUBJE TO PROS U . N. SEPTIC TANK SIZE lfi611e £ a, TYPE->/ C 1 MINIMUM DISTANCES, REQUIREMENT'S / FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT G,Q % AC SEPTIC TANK TO SEEPAGE PIT WALL Q / / SEPTIC TANK - ` SEEPAGE PIT - AREA S4E/`/I //f\ k 7 it'',�I TVE DIAGRAM OF SYSTEM D- IN FIEL TO NEAREST} -OT LIN �fII✓4rI TA % WELL TO SEPTIC TANK DRAIN FIELD WATER MAIN TO SEPTIC TANK SEEPAGE PIT �6 SEEPAGE PIT DRAIN FIELD SEPTIC TANK, SEEPAGE PIT TO RIVER, LAKE. STREAM. /EC DRAIN FIELD CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION ZYt I CERTIFY THAT 1 AM FA DESCRIBED SYSTEM DATE 672 FORM Nq(j -OI6 OR LICENSED DESIGNER R WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NQ. 4-58 NDTHAT THE ABOVE 1- ? ? 2, DANCE WITH SAID CODE. APPLICANT'S SIGNATUR GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street ANCHORAGE, ALASKA 99503 Case N Performed For Tay L9J/S Dated Performed MAI 29,1973 Legal Description: Lots Block — laic<••' '^n s%,Lor88,secr,,npyjRiw, This Form Reports Soils Log x. Percolation Test - Soil Test Must Be Logged To 4' Below Proposed Seepage System - Depth Feet Soil Characteristics 1-- 2-- 3-- 4- 5- 6- 7- 8-- 9-- 10-- 11-- 12-- 13-- 14-- 15 2- 3-- 4- 5- 6- 7- 8- 9- 10- 11- 12- 13- 14- 15 SW WELL GRADED= SAN' & GRAVEL SP POORLAY GRADED'. SANDS WELL GRADED GRAVEL AND SAND` Was Ground Water Encountered? No If Yes, At What Depth? (Op Reading Date Gross — —--_ Tinie j Net Time 4 Depth to H2O Net Drop] — — — Percolation Rate Minute Proposed Installation; Seepage Pit Drain Field Depth of Inlet 93'_ Q"' Depth to Bottom of Pit or Trench 1(0 COMMENTS: RECOMMEND AT LEAST 98 SQUARE FEET OF SURFACE AREA PER DED:RROM PLANNED FnR R RRACF- OF RFERELME Test Performed 13Y HAROLD EIDE, GEoeoGisT Date Certified BY: Date: "MAY ?.21"1973 PAU Bs A" 11-1111._. AT-' 'V !Li liNBIC: F.^ o��11-7.ii� DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2516 E. TUDOR RD., HNCHORHGE, HK. 99507 276 2221 PERMIT NO. ( 77054 ) APPLICANT JOHN WILSON LOCHTI0N WHITE BIRCH RD LEGAL S1/2 SEC 9 T15N R1W GEN DEL EAGLE RIVER LOT S(ZE 55000 SOUHRE FEET MINIMUM DISTHNCE BETWEEN H WELL AND ANY Om -SITE SEWAGE DIsPOSHL SYSTEM IS 100 FEET FOR H PRIVATE' WELL.OR 200 FEET FOR H PUBLIC WELL WELL LOGS HRE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. SPECIFICHTIONS AND CONSTRUCTION DIAGRAMS ARE. AVAILABLE TO INSURE PROPER lNSTHLLHTIUN 11::'"" II: ::11:: ���:11" o� ����� I CERTIFY THAT I AN FHMILIHR WITH THE REQUIREMENTS FOR SEWER, AND HFLL� FORTH BY THE MUNICIPALITY OF ANCHORAGE, 2: I WILL L THE SYSTEM IN ACCORDANCE WITH THF CODES SIGNED-_ HPPCHNT , SnN 1::.( SET GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received ci3a G ---15 Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by: Mailing Address: `.2 Lk ��je, �_� Phone: r-.?) r-1 - <lS It 2. Property Owner: Phone: `?, - 3 Mailing Address: 3. Legal Descriptio : )asit. 4. Location: ,3-k_z21-..e..-3 5. Type of facility to be inspected'ojxe—L_ No. of bedrooms 6. Well Data: A. Type C. Construction 7. Sewage Disposal System: A. Installed B. Instal r C. Septic Tank: 1. Size D. Seepage Pit: 1. Absorption Area E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank , Absorption area , Sewer Lines , Nearest lot line , Other contamination B. Depth D. Bacterial Analysis 2. Manufacturer 2. Material B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages ,, GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Cof b; 2-7 - A )9, 445 1. Approval requested by: 799 »IE S L,/ l�%S 7,/9NNE/2 — tLigCoc<iA4/ ?r4L-ions (21y -n' SnA Mailing Address: '3 y3 _cONIF/3CF, /i/Cir/r4 Phone: 33`5 `!s// a,� ''i 2. Property Owner: TO hi* ,IND T"U D/j If COd/ Phone: adc' 9,) Mailing Address: _STAR AT C fl UG -// 9k1 /< 3. Legal Description: S 4 4 07 h`5 St c '/ T!flV R RJ Sy k4412-1) iliF/a/D//44/ 4. Location: it,„) ri /% iC fjl ft e /4 R D . C HU(J$ /< 5. Type of facility to be inspected %pf}/LE/ Lr»NTD No. of bedrooms -- 6. Well Data: A. Type bfr1 LL F -I), B. Depth .3 e)a C. Construction D. Bacterial Analysis rh 7. Sewage Disposal System: 2 A. Installed _ �' B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank , Absorption area , Sewer Lines s, Nearest lot line , Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages Page 2 of two pages - Reo• st for Approval of Individual S )r & Water Facilities Legal Description CB\I 7L_1 9/9/7 • Comments /1-0/9/t) 1411A/7q kik)/ A), `Zigg/reJ7 GJ/Tif Sig ikti Preot,vo DtYd oF Approved ei,o Ce .714eo a i /! Get p/ cT14 s to 7/9 7-2,0 TSS kV49 4 rift S 1 IVU /yeti Je441 finial OCO • /3 Date Disapproved Approval ,Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED EQ -034 (1/74) Date • • AC. ' 8V, •� Municipality of Anchorage On-Site Water and Wastewater Program (907) 343-7904 SA Cry • Certificate of On-Site Systems Approval Parcel I.D. O 11 0 0 Expiration Date: I i - (a —1 1. GENERAL INFORMATION p� Complete legal description T15 N P. I )CC -N f � Location (site address) 3051 S kA/ jirrL Current Property owner(s) L)A 2 iV2A/ f<1 Day phone Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well [J Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System Cl Public Sewer ❑ WaiverNariance request for: i'`-0'J' Distance: Received by: Date: t /1b(it COSA to be relea•-• •the engineer,unless otherwise requested by the engineer. COSA Fee $ (Vg •130 Waiver Fee $ Date of Payment s3 �(e` t' Date of Payment Receipt Number 63,L Receipt Number COSA# 05 f71a" Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm f✓vlAyUtN• e-I:ZPV _ Phone 9-)c1-f• 5.555 Addresso J'— ;U i.-f"/A t= Engineer's Printed Name �H �'�� irL:?elv---- Date 1 OF AL • ,q• k _s - .LI.• TM •. 3 ��9 6. DSD SIGNATURE • ' X( System #1 Approved for )bedrooms . . . System#2 Approved for bedrooms • 'LES G BALZARI•Nt� c<` • CE-13854 • `.,szi Disapproved �sle.••7,4,!6'!% .•'�v �k‘ /PFDpROFSSki0\*-,.�' Conditional approval for bedrooms, with the following s:i ?,'1046-tz-.,- -'� b. ON-SITE �y WATER AND . v WAS TEWATER c. 71 OGRAM \\�, • By: 1^--- Al/ Original Certificate Date: O -I G- IE 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 E c If more than 1 septic system is on the lot: COSA Checklist# 1 of1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: T I ll/ a W 56-7C9 L `8S 5(9.. Parcel ID: do) 10 Li Y O A. WELL DATA Well type p yre If A, B, or C provide PWSID# Well Log &I) /ES Date c•y�Jleted _ Sanitary seal (al) yes Wires properly protected Vl) y6:5 73 Total dept!. Cased to 37 ft. Casing height(above ground),?\y in. FROM WFI I LOG l( AT INSPECTION Date of test • r--2-7 3 -7/ 0//q Static water level 9.14 ft. 65 ft. Well production ,. g.p.m. 0 g.p.m. WATER SAMPLE RESULTS: Coliform AJt1 colonies/100 mL Nitrate A/1) mg/L ©?' /1�S ✓1 EA/62A 4 —NG. Arsenic AI� ug/L Date of sample: �"`� Collected by: �� B. SEPTIC/HOLDING TANK DATA Tank Type/Material G t Prae/57te(_. Date installed 10/12 X17 Tank size Ir � gal. Number of Compartments a Cleanouts FY'N) )�5 Foundation cleanout O//N)1E5 Depression over tank (Y6)MO High water alarm (Y® Ala Date of pumping /✓/ A Pumper //vA/F C. ABSORPTION FIELD DATA Date installed iC9A I/17 Soil rating (g.p.d./ft2 f ) i • 6, System type5P '--- Length 65 ft. Width S ft. Gravel below pipe 1;-+ ft. Total depth 7, 5 ft. Eff. absorption area t 5O ft2 Monitoring tube r/€5 Depression over field AVO Date of adequacy test 4014 tiIA) Results ,Ci ail) 55 For bedrooms Fluid depth in absorption field before test la in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth s in. Absorption rate >= g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/&type) 'JO If yes, give date AJ/h D. LIFT STATION Date installed /40 LT1=f 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 -41C7V On adjacent lots 4 t OD Absorption field on lot -4 WO On adjacent lots 1O G Public sewer main {-10) Public sewer manhole/cleanout /yo Sewer/septic service line .4 a5 Holding tank '1. 1&70 Animal containment areas 41090 Manure/animal excrete storage areas t 100 SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5 Property line 4' S Absorption field t S Water main + lC)/ Water service line -t Lc7 Surface water 4 l ck Wells on adjacent lots 4 /OG ABSORPTION FIELD ON LOT TO: Property line (.U- Building foundation 4/0 Water main .4 10 c- Water Service line 4 10' Surface water +/VC Driveway, parking/vehicle storage ♦ Curtain drain '4 90 Wells on adjacent lots 4 F. COMMENTS Moo'?Ers wRp5, 7t—y 3 P)EI> 12 cool, 5 -1-26 D FOR S +q t r'RAMS, (4.64-TE-/Z_ 5,c7A (dz. 04A Bt E6 4{cJwj��S (./tom 61Zol- i - 5 73E( G. ENGINEER'S CERTIFICATION ,( OF ALAmy ; 41/41,,k I certify that I have determined through field inspections and j�Q`�.• I •'v4'-�4 review of Municipal records that the above systems are in DC7 •"57 A conformance with MOA COSA guidelines in effect on this date. * • • 9TH ••* �j Engineer's Printed Name 6-1A-R(-t 5 hAtG2941z,Pyr • • • •,• • •. I/ •/� � Date ? ��f10 ' ' •400,/• ' ' RLES G BALZARIN1 # /' • # FG,• E-13854 • g,`�PROFESSI4N�4+ COSA canary sheet_2-6-15.doc MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT ;• ` ,�` 907-343-7904 On-Site Water and Wastewater Section ` j1 Fax: 343-7997 www.muni.org/onsite Well Water Advisory Certificate of On-Site Systems Approval # osc181392 Subdivision: T15N R1W Sec. 9 , Lot: 88 S2 This well's productivity was determined to be .62 gallons per minute. The minimum well productivity required under (AMC 15.55) for a 5-bedroom residence is .52 gallons per minute or 150 gallons per day per bedroom. Although the subject well currently exceeds this minimum requirement, the production capacity can fluctuate. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. Mailing Address: P. 0. Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org