HomeMy WebLinkAboutELMORE #1 BLK 4 LT 7Elmore #1
Block 4
Lot 7
#018-171-42
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Section � Phone: 907--343.7904
Fax: 907-343-7997
Pump Installation fag
Well Drilling Permit Number:
Parcel Identification Number; Date of Issue: 7
Legal Descxig{ion
t. l More ,gr �
61k Li Lf 7
Pump Installation Date: i _ L2_
Btock Lot Prop peypwner Name & Address:
444
�1 � qls Z ,�p
PMmP intake Depth Below Top of Well Casing: feet
Pump Manufacturer's Name: 0-/
!ro�
Pump Model: ' 3 ZZ--
Pump Size' 4 2
ltp
Pitless Adapter Burial Depth:
------� feet
Pitless Adapter Manufacturer's Name:
Pitless Adapter installer:
Well Disinfected Upon Com letion,
`' Yes ❑ No
Method of Disinfection:
Comments:
Pump Installer Name: ANCHORAGE WELL & PUMP SERVICE
�ompany:
nailing Address:
:ity:
7640 King Street
Anchorage, AK 99518
PH: (907) 243-0740
State:
111i0lu The pump installer shall provide a pomp installation dog to On-site within 30' days ofpump installation.
Municipality of Anchorage
Community Development Department Page 1 of 3
Onsite Water & Wastewater Program
4700 Elmore St. a P.O. Box 196650 Anchorage, AK 99519.6650 a http://wwW.muni.org/onsite a (907)343-7904
ONSITE WASTEWATER INSPECTION REPORT
Permit Number: OSP151276 PID Number: 018-171-42 ® New ❑Upgrade
Nome: CHRISTINE DIAZ
ABSORPTION FIELD
❑ Deep Trench ® Shallow Trench ❑ Bed ❑ Mound
Address:
4801 NATRONA AVE *ANCHORAGE, AK
❑ Other
Phone: No. of Bedrooms:
Sail Raring'
Total Depth from original grade:
(907) 250-1990 2
1.0 GPD/Sq. Ft.
5.0 MAX Ft.
LEGAL DESCRIPTION
Death to pipe invert from original grade:
SEE DWG. rt.
Grovel depth beneath pipes
0.5 ft
Subdivision: Block: Lot:
ELMORE #1 4 7
Fill added above original grade:
grovel length:
SEE DWG. Ft.
60 Ft.
owns Ip: — Doge: _ ec Ion: —
Gravel width:
3eds Number of lines
Distance belweln lines:
5 Ft
—
— Ft.
SEPARATION DISTANCES
Total absorption ane:amber
300
of trenches:
1
Dist. between tranches:
—
To
Septic
Absorption
Lift
Holding
Public/Private
From
Tank
Feld
Station
Tank
Sewer Lines
So. n.
Ft.
Well
too'+
too'+
—
—
25'+
TANK ® Septic ❑ S.T. E. P. []Holding ❑Other
Manufacturer:
capacity.
Surface water
100'+
100'+
-
-
GREER
1000
Gal.
Lot Line
5'+
10•+
—
—
N/A
Material:
STEEL
Number of compartments:
2
Foundation
5'+
10'+ 1
—
—
LIFT STATION
Curtain Drain
NONE KNOWN
Manufacturer: capacity
Cal.
Remarks: THIS SYSTEM IS DESIGNED TO ONLY SE
SERVE
"Pump on" IwN at:
Pump ofl" level ab
H' er alarm at
THE 2 BEDROOM ADU.
Inspections performed by:
PIPE MATERIAL
House to tank D3034 Tank to D3034
drainfield
Installer
WILCO CONTRACTORS
MT
MT D3034 Droinfield D3034 CO
CO/
GEG, Ltd.
BENCH MARK (Assumed elevation)
102.23 Ft.
Inspection
Location and Description`
Dates: 1st 8/31/2015 2nd 8/31/2015
3rd 8/31/2015 4th 9/1/2015
BOTTOM OF TRIM @ POINT A
Community Development Department Approval
EMGSS E"SEAL
ooOF;oo 4�
Conditional approval: Date:
9 H o
....... .. .................
QO .Jef A. Go ness:•
e
a,5�'�Qoo
Approved: A Date: • 17'15
��ea profes5iof D, ,=i,
�04 fes
Inspection Report -1-1-12.doc
'J2MIT NUMBER:
OSP151276
RECORD
DRAWING
PARCEL ID NUMBER:
018-171-42
A B
C
FCO
89.6 55.8
113.6
/
ST1
72.3 70.2
83.5
ST2
DT
69.8 72.8
69.5 72.9
80.2
72.3
\ /
nRl 7
RO 4 7i i
7R O
— — —
— — — —
— —
—
MT1 93.7 90.8 105.1
MT, 1 86.2 1104.0183.3
NEW 2
II
IEXISTING Ely BEDROOM
1 GARAGE C ADU ELMORE SUBDIVISION #1
CONNECTED T LOT 6, BLOCK 4
EXISTING 3 STING HOME GO• /
\ BEDROOM HOME(
FC 2
6XIST1 qG TfNK \ A •`i.�;, �.�
EXISTING TRENC o '•�: .�•'••'+'^. '•�•`�. y_. :
APPROXIMATE LO I
SEWER LINE; INSULATED 4" "�'f •'' • � /VT
TO
OF 1983 T.H THICK 4• WIDE ON CENTER
'. HED
STARK, P.E. 1 BY DOU UNDER DRIVEWAY PER
CONTRACTOR "'. '.•'�
ALTERNATE SITE
NEW 1000 GALLON
._,
CAT III SYSTE I SEPTIC TANK T1 -• :; .•
NEW DRAINFIELD 2 •:r•. •,
GD2 01
J\ 1
MT2 � :.; •'v •
N
-SCA
/ 'NATR❑NA AVENUES =40'
GARNESS ENGINEERING GROUP, Ltd'`'�
.....
...... ...
w=� - CIVIL & ENVIRONMENTAL ENGINEERS
3701 E MOOR ROLO, 9U11E 101 • INOHERAGE. N( 9850) rPHONE W7) 33)-91)9 • FM (907) 338-32 9 • y988a; www.gomeromginaeNe .eom , ..r ... ........................... .0
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ,J f A. rness f 4r
CHRISTINE DIAZ 250-1990 2 OF 3 CE -795
LEGAL DESCRIPTION: DRAWN BY: �� %�C.'•. • , z �� I \
ELMORE #I; BLOCK 4, LOT 7 D„ J,G, 41 PF0 •............. k�
TYPE OF WORK:
DA
� RECORD DRAWING 12/14/2015 ♦+,,I klams �
PERMIT
OSP151276 RECORD DRAWING
T.H.
FINAL GRADE = 98.24-98.39
ST1 ST2
TOP OF TANKTOP OF TANK
AT INLET = 93.80 AT OUTLET = 93.77
7NEW000 GALLONINVERT OF BUNG PTIC TANK INVERT OF BUNG
AT INLET = 93.31 AT OUTLET = 93.02
ORIGINAL GRADE
AT HIGHEST
POINT = 97.00
TOP OFSA
= 92.00
RELATIVE ELEVATION OF
BOTTOM OF T.H. = 83.00
G.W. ENCOUNTERED ® 86.00
BELOW GRADE ON 7/1/2015
MT
' OF M.O.I
APPROVED
5'
FINAL GRADE = 96.45-97.17
FILTER FABRIC
INVERT OF PIPE = 92.50
PARCEL ID NUMBER:
018-171-42
BOTTOM OF TRENCH = 90.00
r
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GARNESS ENGINEERING GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGINEERS -
3701 E. MOOR ROAD. SUfTE 101 • ANCHORAGE. AK 99507 • PHONE (907) 337-6179 • FAX (907) 336-3246 • WEBSRE. —.gam—gi.wing.o
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
CHRISTINE DIAZ 250-1990 3 OF 3
LEGAL DESCRIPTION: DRAWN BY:
ELMORE #1; BLOCK 4, LOT 7 D.J.G.
TYPE OF WORK: DATE:
I.- RECORD DRAWING 9/15/2015
GARNESS ENGINEERING GROUP, Ltd sre
CIVIL &-ENVIRONMENTAL ENGINEERS
December 16, 2015
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
Ref: New Septic System at Elmore #1; Block 4, Lot 7
To whom it may concern:
Per the G.E.G. design drawing, double cleanouts were to be installed as well as a
foundation cleanout. However, during construction only a foundation cleanout was
installed. The installation of a foundation cleanout is all that is required by code when
the length of run from the tank to the drainfield is less than 100'.
If you have any questions, please contact us at 337-6179. Thank you for your
assistance.
3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259
Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessenginee6ng.com
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: OSP151276
Tax Code Number: 01817142000
Work Type: Septic Upgrade
Permit Effective Dates: August 27, 2015 to August 26, 2016
Design Engineer: GARNESS ENGINEERING GROUP LTD
Subdivision: ELMORE #1
Site Legal Address: ELMORE #1 BLK 4 LT 7 G:3036
Owner/Address: DIAZ CHRISTINA &
TUTTLE TOBY T 4801 NATRONA AVE ANCHORAGE AK 995163655
Site Mailing Address: 4801 NATRONA AVE, Anchorage
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank
Lot Size in Sq Ft: 37299
Total Bedrooms: 2
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`c-
9/;2,7"// 5—
Issued By: _ d( iir lX/( - Date: 0 Z? I-<
MUNICIPALITY OF ANCHORAGE
Community Development Department ® Phone: 907-343-7904
Development Services I I Fax: 907- 343-7997
On -Site Water & Wastewater Program
Mayor Dan Sullivan
On -Site Sewer/Well Permit Application
For A Single Family Dwelling
Parcel I.D. 018-171-42
Property owner(s) CHRISTINE DIAZ Day phone ;t!50— ) 990
Mailing address 4801 NATRONA AVE *ANCHORAGE, AK
Site address 4801 NATRONA AVE *ANCHORAGE, AK
Legal description (Sub'd, Block& Lot) ELMORE #1; BLOCK 4, LOT 7
Legal description (Township, Section & Range)
Lot Size
Sq.Ft. Number of Bedrooms 2
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DEWELLING:
(ill that apply)
Initial ❑
Single Family (SF)
Absorption Field
®
(w/wo ADU)
Septic Tank
®
Upgrade
❑
Duplex (D)
❑
Holding Tank
❑
Renewal
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.
GARNESS ENGINEERING GROUP, Ltd.
(Signature of property owner or authorized agent)
Permit/Rush Fees:
Date of Payment: %1,01v5 cksaa,
Receipt Number: oo8taG
Permit No. 01591512.1 to
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
(Rev. 01/11)
GARNESS ENGINEERING GROUP, Ltd
CIVIL & ENVIRONMENTAL EPiGINEER5=�-_� - •..-,:_�:_.
August 26, 2015
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
Ref: Proposed Septic System for Elmore #1; Block 4, Lot 7
To whom it may concern:
The existing house is served by a private well and septic system. The homeowner
would like to build a two bedroom mother-in-law (adu) apartment with a separate septic
system. We are proposing to install a new 1000 gallon septic tank and a shallow trench
type drainfield. One testhole was excavated and the drainfield is designed around the
30' radius of this testhole. Comments regarding the design are summarized as follows:
1. SOILS: See the attached 2015 soil log which shows the soil classifications,
groundwater monitoring, and the percolation test results.
2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications
3. SURFACE WATERS: There are no surface water concerns.
4. TOPOGRAPHY: As can be seen on the attached topography drawing, the average
topography around the proposed drainfield is flat. The road ditch is approximately 4.5
feet deep and 19' south from the testhole to the top of the ditch. We are proposing to
excavate to a depth of 7 feet import 2 feet of sand with 0.5 feet of rock. In short, the top
of the effective will be approximately the same elevation as the bottom of the ditch.
Therefore, we do not believe there to be slope issue.
We are unaware of any adverse impacts this installation would have on adjacent wells
or septic systems. If you have any questions, please contact us at 337-6179. Thank
you for your assistance.
3701 East Tudor Road, Suite 101 *Anchorage, Alaska 99507-1259
Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com
I
10
I I
I I
_ I I
NOTE: THIS IS NOT A SURVEYED PLAT. WELL &
SEPTIC LOCATIONS TAKEN FROM ON-SITE WATER I
AND WASTEWATER DEPARTMENT DOCUMENTATION. I.
ALL LOCATIONS SHOWN ARE APPROXIMATE.
i APP
1 pp WEcc RA lu I I 11 I Wei RO4D uI
I I I l
ELMORE SUBDIVISION #1
lJ SFAnC I I LOT 2, BLOCK 4
Nz
q I i
/ ELMORE SUBDIVISION #1 1' /
/ I LOT 1, BLOCK 4
------�-- ------ ---
— ---I r
I
ELMORE SUBDIVISION #1 I I
7J 1f� LOT 8, BLOCK 4
I I I
� I I
� I I
� I I
I I
/
I
vA-T-RffN-I4LA�\tE-E ---
3
ELMORE SUBDIVISION'
LOT 3, BLOCK 4
/
I �u�
1
ELMORE SUBDIVISION #1
/ LOT 6, BLOCK 4
/
/
\
II lux/
RADIUS I
I ELMORE SUBDIVISION #1
ELMORE SUBDIVISION #1 I LOT 6, BLOCK 6
LOT 4, BLOCK 6
S p \ 1 /ELMORE SUBDIVISION #�
nC — LOT 5, BLOCK i /
I I
I I
— — — — — — — — — — — —1 L — — — — — — — — — — — — —
49
GARNESS ENGINEERING GROUP, Ltd "
"
CIVIL & ENVIRONMENTAL ENGINEERS a
P�3701 E. M" RMA Wn 101 r NIOHOMOE, m 99507 r PHONE (907) 337-8179 r FM (907) 339-3248 r NEgSNE, „n,.9o,neoen9 eroenn9.eom �..� -. ,. r
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:Y
CHRISTINE DIAZ (907)250-1990 2 OF 3 /jCi` J CE -79
LEGAL DESCRIPTION: DRAWN BY: 0 �
•
TYPE MORE #1, BLOCK 4, LOT 7 DATE: 44414111
♦��j�P� ESS
`SITE PLAN 7/21/2015 /��'Inw
OF BEDROOMS: 2 LETTER THAT PERTAINS TO THIS DESIGN. NUMBER OF BEDROOMS: 5 (COMBINED SYSTEM)
PER DAY (GPD): 300 TO OBTAIN A COPY OF THE LETTER GALLONS PER DAY (GPD): 750
'ION RATE/S: <1MIN/INCH CONTACT GEG. BY PROCEEDING FORWARD PERCOLATION RATE/S: VISUAL 85 FY'/BEDROOM
) APPLICATION RATE: 1.0 WITH THIS INSTALLATION, THE ENGINEER, PROPOSED APPLICATION RATE: 6.0 CAT III
DRAINFIELD SQ.FT.: 300 WELL DRILLER, CONTRACTOR AND MINIMUM DRAINFIELD SQ.FI'.: 125 FrPROPERTY OWNER AGREE WT THEY
HAVE READ THESE SPECIFICATIONS AND
IELD DESIGN: I AGREE TO ACCEPT THE TERMS AND ALTERNATE SITE DRAINFIELD DESK
MAWWM I -DEPTH OF EXCAVATION: 7.0 FEET
WIDTH: 5 FEET
LENGTH: 60 FEET
M.O.A. APPROVED SAND FILTER: 2 FEET
EFFECTIVE: 0.5 FEET
REDUCTION FACTOR: N/A
ACTUAL SQ.FT.: 300 FEET
NOTE: THE CONTRACTOR
SHALL HAVE THE SOUTH LOT
LINE, AND ALL PERTINENT
WELL RADII FLAGGED BY A
REGISTERED LAND SURVEYOR
PRIOR TO CONSTRUCTION.
MAXIMUM DEPTH OF EXCAVATION: 7.0 FEET
WIDTH: 5 FEET
LENGTH: 25 FEET
M.O.A. APPROVED SAND FILTER: 2 FEET
EFFECTIVE: 0.5 FEET
REDUCTION FACTOR: N/A
ACTUAL SQ.FT.: 125 FT'
PROPOSED/ LOCATION FOR MOTHER—IN—LAW APARTMENT
LL RADIUS
I — 1
I S I I
GARAGE
`\ `I EXISTING \ '
Iril—YI .. . .
HOME f INST
APPROXIMATE IL
OF 1953 T.H I
STARK, P.E.I
ALTERNATE SI ITE
CAT III SYSTEM
D! ---
INSTALL DOUBLE
CLEANOUTS BEFORE TANK
PROPOSED 1000�
GALLON SEPTIC TANIZ` _
✓�, INSTALL DOUBLE
CLEANOUTS AFTER TANK
PROPOSED DRAINFIELD
11
Nn
ELMORE SUBDIVISION #1
LOT 6, BLOCK 4
/ \
+
e'
4"X4' WIDE INSULATION OVER
"''d.
�'•:�
PORTION OF SEWER LINE THAT IS
UNDER THE DRIVEWAY
V MT \T.H.1 \ T'f
0 n
\ \NATR 0 NA AVE SCALE
GARNESS ENGINEERING GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGINEERS
.1701 E. NOgi ROAD, WIX 101 • N1I910W,GE. M 9950'! r PHONE !9071 O]7-9179 r Ply 19M71 1u_111n r urxnc..,e.............w._..,...�
PREPARED FOR: PHONE NBER: PAGE NUMBER:
CHRSTINE DIAZ (907)2UM50-1990 1 OF 3
LEGAL DESCRIPTION: DRAWN BY:
ELMORE #1; BLOCK 4, LOT 7 D.J.G.
TYPE OF WORK: DATE:
�,_ 40_ SCALE DESIGN 8/25/2015
E2
I
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I 4' CONTOURS
I
'Nnl
__
NOTE: THIS IS NOT A SURVEYED PLAT. WELL &
. SEPTIC LOCATIONS TAKEN FROM ON-SITE WATER I
I
N
AND WASTEWATER DEPARTMENT DOCUMENTATION.
TM
ALL LOCATIONS SHOWN ARE APPROXIMATE.
II \
APPR
J 70 OXOIUS
,I
EL L 0 ,
K'£LL Rq 1U I
£� ADIU
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EL ORE SUBD ISION #1
V Selo, LOT 2, B CC11qq ELMORE ISION #1
/C
qR LOT 3, CK 4
ELMOR SUBDIVISION
Y�
LOT 1, BLOCK 4 / \
-----------�---J
/ 100' I 1
ECL ELMORE UBDIVISION #1
A0J LOT BLOCK 4 I MORE SUBDIVISION #1
T 6, BLOCK 4
I\LJ Vf�l A�I�V 1, ve/IU
100• RA I
ADIU PRG)( T
II R I
I
S ELM'ESUIBIDIV'S'ON #1
II
ELMORE SUBDIVISION #1 y LOCK 6
LOT 4, BLOCK 6
F \ y "ELMORE BDIVISION # (S'oLOT
5, LOCK 6qq -
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---_--_-_ ---_----J L--------- --- -- ----- -
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GARNESS ENGINEERING GROUP, Ltd ,.... 49 „ ,::
' ...,........
s CIVIL & ENVIRONMENTAL ENGINEERSw ` _ / /
3701 E. 10908 ROPD, S011E 101 • ANCHORAGE. Mt 99507. • PHONE (9 331-8179 • FAC 9077) 3 248 ...mmn9neM11 .c //
PREPARED FOR: - PHONE NUMBER: PAGE NUMBER: • , ••„ ...........
• ,••',�
♦ r^ : J ff Gayness r 4) i
CHRISTINE DIAZ (907)250-1990 3 OF 3 _793
y
DRAWN BY: 1123
LEGAL DESCRIPTION: ��♦�j` ••• • �s,•� • C' ��
C-
ELMORE #1; BLOCK 4, LOT 7 D.J.G. `•••...........••.
TYPE
100WORK:
SCALE TOPO DATE: -w
♦+,����.�5����••
GARNESS ENGINEERING GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGINEERS
3701 E TUMA ROA), SUITE 101'ANCHORA ,M1.-PHONE(.O 33I 116' M(SWI 3J83i46'WE Exw,pairessmp✓minpmn
SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: ELMORE #1; BLOCK 4, LOT
PERFORMED FOR: CHRISTINE DIAZ DATE: 7/1/2015
DEPTH
feed __ ORG TEST HOLE #1
LOAM
SOIL CLASSIFICATIONS
19 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 5 FT. AND 6 FT.
20 1 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES ENO
SOILS LOGGED BY: DAVIDGARNESS PERCOLATION TEST PERFORMED BY: DAVID GARNESS
COMMENTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH.
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PER/F�O�?RM/ �ED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: I
m
GP
ML
.}
GM
CIL
4
GC
OL
o.o 0
osw
MH
5
SP
CH
SM
OH
SC
7
F'"°'
;a+
GWDEPTH
TO
DATE
GROUNDWATER
8
•`:3`:5'oz
`.<"'":>
11'
7/1/2015
GJ
12'
7/9!2015
scare
10
>c'.
'�
�
DATE READING
CLOCK
NET TIME
WATER LEVEL
NET DROP
11
�-�
y;
TIME
(MINUTES)
READING
(INCHES)
5'<aTA'-
7/72015 ABSORBED 5 GALLONS OF WATER IN <2MIN 2 TIMES
13
4
a b'
B.O.H.
15
16
17
18
19 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 5 FT. AND 6 FT.
20 1 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES ENO
SOILS LOGGED BY: DAVIDGARNESS PERCOLATION TEST PERFORMED BY: DAVID GARNESS
COMMENTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH.
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PER/F�O�?RM/ �ED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: I
m
MUNICIPALITY OF ANCHORAGE
\\I DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264.4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
PHONE
EW
94U.
,5(��
UPGRADE
MAILINGDRE S
Po 0 Q W 2/ 94 5// - 0,/,
LEGAL DESCRIPTION
G— 7
LOCATION
NO. OF BEDROOMS
Is
Well r
Absorption area
Dwelling /O
PERM!ON9676
U
DISTANCE TO:
5
j�
Y
EaManufacturer
n
Material
No. of partments
WI
�L
Liq. cap:ICitKin-g_ylions
(J (Jb
IF HOMEMADE:
Inside length �—
Width
Liquid depth
d Y
DISTANCE TO:
Well
Dwelling.
PERMIT NO.
=�JV2H
Manta
Material
capaci in
O
Well
Foundation
Nearest lot line
PERMIT N
3a
W =
DISTANCE TO:
.f--
1�- �.d
70,3
_I M W
No. of lines
of e!2 I�
Total length of list's
ab
Trench widths Cj
Distance between Ijn s
C) tie,Length
�S
.'M(es
N
H
Top o rile to finish grade
Material beneath tile Fr
a Ya :ochaa
Total effective a rotio area
o
Length
Width
Depth
PERMIT NO.
W
Q F
Type of crib
Crib diameter
Crib depth
Total effective absorption area
W d
WWell
u'
Building foundation
Nearest lot line
DISTANCE TO:
J
Cl
Depth
Driller
Distance to lot linePERMIT
NO. 30
J
W
Building foundation
Sewer line
Septic tank
Absorptionf
is 3 rgalsl
DISTANCE TO:
OTHER
PIPE MAT IA
SOILTESTRATING
S
INSTALL
r
REMARKS
+
r 3
3
i
.e
APPROVED f DATE LEGAL v"
L? "/ 4
l8-3 3
72-0131Rdv. 3/71 0
Wa^IL tCG Y1a.0 �r►n�,. "
f, n
Date Drilledt a_,a-az
Static Water Level 7r, feet Gallons Per Minute 6
Draw Down N/A feet Total Feet of lasing 112
Tyre Material Drilled:
0 feet to 30 / boulders, rock
vn feet to 65 S ndy elay. ¢ravel
65 feet to 110 red clay, rocks
11n feet to 112 Qravel w/anutfer
to
to
Hefty Drilling
S.H.A. Box 1553 H �fl�aL� Il 1� �IcL
j AnchoragegAlasks %UAT Rzwo A
99547 po, fox Ito, �
�� cro.e SJb A &0 �-1
MUNICIPALITY OF ANCHORAGE
Department Health and Environmenta�rotection
• _ 825 ' Street, Anchorage,'AK. 1501 ' '? �g5
264-4720 X0%14
* * * HANDWRITTEN PERMIT * * *
Permit # i�3d'%W 0 WELL ANDJfV9 ON-SITE SEWER PERMIT
Applicant: NA2c-1) C-01 fk p 32. Mailing Address: P6. ts'� I/o(v 12 57f 5r// -0&12 -
Location: Phone Number: 5 -!o/ -1S'75 CCW.Lt —mresq ) _
Legal Description: ',hof 7 6/6c e j( S/) Lot Size: w 3 7A9s
Type of Soil Absorption System Is•
Trench: Drainfield: Seepage Beds Holding Tank:
Maximum Number of Bedrooms: 3 Soil Rating(sq.ft/br) 8S�
The Required Size of the Soil Absorption System Is:
i
DEPTH �� LENGTH �2P GRAVEL DEPTH .��/�� WIDTH s
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE _ NO 0 GALLONS
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
* *.* TWO(Z) INSPECTIONS ARE REQUIRED
Backfilling of any system without final inspection.and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper.installation.
* * * PERMIT EXPIRES DECEMBER 31, 1 9 3 3 * * *
I'certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the gesidenc,e
�yi}sre o eled to include more that
3.bedrooms.
Signed: o // Issued by: ,(U
Applicant /�/��
Date: /
SWP/024(1/81)
^ 11 SOILS LOG
MUNICIPALITY OF ANCHORAGE r
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
I TEST
'825-L.'Street; Anchorage, Alaska 99501 ; 2644720
SOILS LOG = PERCOLATION TEST
t.�PERFORMEDFOR: J4^1t`04.4) 6rrL:"�' CMIOLE ,AAkL_-- DATE PER FORMED:AiG' Z. 1993
'LEGAL DESCRIPTION:' UT '7 -- ,B LcCX ,4 ..G^W 0T2-F:_S V.3-.. 4-0 PT -;4
SLOPE SITE PLAN
1 DEPTH . ,
(FEET)
3
.44-
J
2-
Net �•
Time
.3-
356
Net
Drop
15-
5-
6
7
9
10-
11
-
12
13-
.44-
J
'7
Net �•
Time
18
Net
Drop
15-
19
} 16
J
'7
Net �•
Time
18
Net
Drop
19
:.490
K0.1814 -E
MARCH 8,1969
■oommmom
MEMENEENNN
MENNEMMMEN
MENNNOMENE
■.■■■■■■■■
MEMENEEN
ENEENNNEEN
ONFREMENNE
ONKEENNNEN
MENNONNE
NEWENNNEE
INEKENSEEN
WAS GROUND WATER NQ - ^'L
ENCOUNTERED? O
P
IF YES, AT WHAT • .. '•.. E
.DEPTH? ...
Reading
,.Date
Gross
Time
Net �•
Time
Depth to
• Water •
Net
Drop
I
WAS GROUND WATER NQ - ^'L
ENCOUNTERED? O
P
IF YES, AT WHAT • .. '•.. E
.DEPTH? ...
Reading
,.Date
Gross
Time
Net �•
Time
Depth to
• Water •
Net
Drop
.. • •PERCOLATION RATE Iminutes/inehl - 4
•
-TEST RUN BETWEEN .FT AND FT' - -
;.: •:COMMENTS' ..
PERFORMED BY: 93•ola •DI7Vli- 'S TrYrtK CERTIFIED BY: 'DOVV :'J'7+fLJS, DATE:' AWU' % /Mr -7 I
72-008 (6/79)
OY6
r
:�
L'Sr
Parcel I.D.
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99507
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
018-171-42
1. GENERAL INFORMATION
Complete legal description Elmore #1 Block 4 Lot 7
COSA# Ose (a I uoa
Expiration Date: 9--2- 3—/a
Location (site address) 4801 Natrona Dr., Anchorage, AK 99516
Current Property owner(s) Harold Miller Day phone 345-2968
Mailing address
Lending agency Day phone
Mailing address
Real Estate Agent Day phone
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER.OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well ,
Individual On-site
(]
Individual Water Storage
❑
Individual Holding Tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval
are valid for 90 days from the date of issue for properties served by,a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued: for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. 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 Spurkland Enginneering
Address 203 W. 15th Ave., Ste 202, Anchorage, AK 99501
Phone 279-3916
Engineer's Printed Name Lars Spurkland Date May 17, 2012
5. DSD SIGNATURE
!/Approved for 3 bedrooms.
Disapproved.
Conditional approval for
- sBOa�
bedrooms, with the following stipulations:
Attachments:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: Original Certificate Date:
(Rev. 11ro5)
Municipality of Anchorage oE�,f 8U G
• Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: ELNtDVOLI BLK 4 LOT-} ParcellD:
A. WELL DATA
Well type PRUT If A, B, or C provide PWSID #= Well Log (Y/N) y
Date completed d 26 $ 3 Sanitary seal (Y/N) y Wires properly protected (Y/N) y
Total depth L I' ft. Cased to 11 Z ft. Casing height (above ground) + Z in.
FROM WELL LOG AT INSPECTION
Date of test _82b 83 5NI 12
Static water level 15 ft, }6 ft.
Well production 6 g.p.m. �O 9•P•m•
WATER SAMPLE RESULTS:
Coliform G colonies/100 mL Nitrate mglL Collected by: AIA %) Aqihppii8o
Arsenic: AfP ug/L date of sample: 5 ? 12.
B. SEPTICIHOLDING TANK DATA
f
Tank Type/Material Swu i j sS eel Date installed ID/5153
Tank size 1000 gal. Number of Compartments Z Cleanouts (Y/N) Y
Foundation cleanout (Y/N) )i Depression over tank (Y/N) N High water alarm (Y/N)
Date of pumping Pumper 1w 5 0in4 selv+('
C. ABSORPTION FIELD DATA ly (( _
Date installed IO 5 Soil rating (g.p.d./it2 or /b —,L System type S611CW IZWO
Length 30 ft. Width S ft. Gravel below pipe 3V2_ ft.
Total depth _b ft. Eff. absorption area 233 ft2 Monitoring tube —I— Depression over field Al
Date of adequacy test 5 ('i f 2 Results (Pass/Fail) PIP For .�:i_ bedrooms
Fluid depth in absorption field before test, in. Water added %� gal. New depth (a in.
Elapsed Time: 15 min. Final fluid depth 4 in. Absorption rate >= 15) g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) /4 If yes, give date —
D. LIFT STATION
Date installed
"Pump on' lev t _ in.
Datum
E. SEPARATION DISTANCES
Size in gallons
"Pump off level at in.
Cycles teste
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100 i+
Absorption field on lot 100 1+
Public sewer main N,A
i
Sewer /septic service line 25 +
Animal containment areas 50 i•
Manhole/Access (Y/N)
High water alarm lev t in.
Meets alarm & . uit requirements?
On adjacent lots 100+
On adjacent lots 100 +
Public sewer manhole/cleanout A/ PA
Holding tank NIA
Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 6 �+ Property line 5 r+ Absorption field 5
M
r i
Water main L A Water service tine 10 + Surface water 100 + ALO.
Wells on adjacent lots 100 +
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10 + Building foundation W+ Water main
/VA
Water Service line 10 Surface water 0D bo Driveway, parking/vehicle storage +
Curtain drain 50+ kp Wells on adjacent lots too +
F. COMMENTS
ANN
G. ENGINEER'S CERTIFICATION f �,�F,.O F• p�1{s l'+,
l cert/fy that I have determined through field inspections and �' g;• 9 'i
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name L ARS SPUD -HANG
5 0
Date �i fl2ol2 ,11 i `Fo'n`
COSA Fee $ LIQ()
Date of PaymentVa �
Receipt Number 05?m C?
(Rev. 4/10)
Waiver Fee $
Date of Payment
Receipt Number
4
♦e4���.1_�. �SF 'fir �!�T3iy.i
/kJfEilltl T 90JARD Ikk
I KEREBY CERTIFY THAT I HAVE SURVEYED) THE
3c ALtF
FOLLOWIN'S DESCRIBED PROPERTY.
—� ..
ACID THAT 1� O !>�1dk6ACHME9TS'Ei5i PcGEPT AS
DATE,
INDICATED IT is THE RESPONSIBILITY OF THE
CA**DR TO DETERMINE THE 6 IVr.ENCE 4F ANY
GRID-
MEN 'S, COVENANTUI OR REff!TPICTjON5
WHICH DSR NOT APPEAR ON T"#1E REGORDEO SU001-
_
�•- �•�
VISION FLAT. € 90ER 140 CIRCUMSTANCES S3• ouLD
✓a' `� `�
ANY DATA HEREON BE USED FOR Cotes tRUCTION
OFFENCE LfNLr.% OR FOR ESTABLISHING 901J 0—
ARY LINES.
LAIqD
-4:0.a4x %%1 .
OF Al%i�
r:
R
-oE
SGS Ref.#
1121526001
Client Name
Anderson Engineering
Project Name/4
Lot 7, Block 4, Elmore No. I
Client Sample ID
Lot 7, Block 4, Elmore No. 1
Matrix
Drinking Water
Sample Remarks:
Printed Date/Time
05/11/2012 13:21
Collected Date/Time
05/07/2012 12:30
Received Date/Time
05/07/2012 13:45
Technical Director
Stephen C. Ede
Allowable Prep Analysis
Parameter Results LOQ Units Method Container ID Limits Date Date Init
Metals by ICP/MS
EP200.8
C
Arsenic
ND
5.00
Waters Department
SM214500NO3-F
B
Total Nitrate/Nitrite-N
0.674
0.100
Microbiology Laboratory
E. Coli
Negative
I
Total Coliform
Negative
1
ug/L
EP200.8
C
(QD)
05/09/12 05/09/12
ACF
mg/L
SM214500NO3-F
B
(<10)
05/10/12
AYC
100mL SM219223B A
100mL SM219223B A
05/07/12 DLC
05/07/12 DLC
204
