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HomeMy WebLinkAboutFASSLER LT 6Fassler Lot 06 #051-531-37 Municipality of Anchorage Page 1 of 3 Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: 5W020444 PID Number: 051-531-37 Name: Wastewater System: New MM&M Contractin Address: ABSORPTION FIELD P.O. Box 670495 Chu iak, AK 99567 Phone: Number of Bedrooms: Deep Trench 688-1236 Three 3 LEGAL DESCRIPTION boll Rating: Total Depthromonglna gra e: .6 GPD/FP 10.0 Ft. Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: 6 FaSeler 5ubdivioion 3.0 Ft. 7 Ft. Township: Range: Section: Fill added above original grace: Gravel Length: 1 Ft. 54 Ft. Well: New Gravel width: Number of lines: Distance between lines: 3 F,. 1 1 N/A Ft. Classification (Private, A, B, Ck Total Depth: Cased to: Total absorption area: Pipe Material: Private 200 Ft. 157 Ft. 756 F(' A5TM P3034 PVC Driller. Date Drilled: Static Water Level: Installer: Date Installed: Sullivan Water Wells 10/29/2001 145 Ft. MM&M Contractin 11/15/2002 Yield: Pump set at: Casing eight Above Ground: TANK I GPM FL �2 Ft. SEPARATION DISTANCES ® Septic 0 Holding S.T.E.P. Other: To Septic Absorption Lift Holding DubllclPrivate, anti curer: spat yin a ons: From Tank Field Station Tank Sewer Line Anchorage Tank 1,000 Well >100' >100' N/A N/A >25' stens: 5tee1 umber w uompamnents.— Two 2 Surface Water >100' >100' N/A N/A LIFT STATION — NONE ON LOT a . an Lot Une >51 >10' N/A N/A Gal. Foundation >5' >10' N/A N/A umpon eve a: "Pump off' eve a: Highwater alarm at: m. in. in. Curtain Drain None Noted Pump Make &Model Electrical Inspections performed by: Remarks: BENCH MARK 2" Insulation Over 5e tic Tank. Location and Uescription: To of Foundation Wall. Assumed Elevation: 100.0 Ft. ngineers Stamp waaaq� O•�E OF Oki, ♦♦♦ a ' 49th Inspections performed by: MEA Dates: 1 11/15/02 ... """' .. ""' ""'00 2nd ♦'A..................................... ♦♦ G� MICHAEL ;E ANDERSDN 11/15/02 Department of Health and Human Services approval ♦♦♦ �•. No. CE-4381 r7i ♦♦♦���ROFEss�:�•• Reviewed and approved by: /Date: (R., asst aaaao� ►1 4700 South Bragaw S On -Site Wastewater Number: SW020444 S1 S2 C3 M1 C4 fell A B 9.1 47.7 8.2 44.0 12.1 41.2 54.9 52.7 63.2 59.7 of Anchorage Page 2 of 3 VICES DEPARTMENT forage, AK. 99519-6655 - 343-7904 sty tem or Well Inspection Report PID No.,051-531-37. Three Bedroom Home m W ._ 00 to O` Co d moa read ,des �o 4 PLAN AS -BUILT SCALE 1' = 40' LOT 15, BLOCK 5, KNIK VIEW ESTATES MICHAEL E. ANDER N , No. m4wi Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: SW020444 -F PID No. 051-531-37 Cn 2 v U F U PROFILE AS -BUILT Scale: 1" = 10' AEL E. ANDERSON No. CE -4381 - p ARCTIC PUMP S WELL INC. Jim Sultimu4 CPI NJ 11KN 111) N) or,7 K im. 1 fAR-25to 'ell Decommissioning Log North "fl T: Lol - On -+z Narw: SiUnalur4,--: Jilt) Sullivnn wr.'.i Ci31 1xxjfiarr Use, the tfw-e bc)cx v A&Ion in's of Ktx prajmrqAiathLnpL the kWring ims: [err %"Itr willb 4vm 'fit; [Wo. MY • TiA o wparne swing ck dig lamx-i rnr w Owoil Omit ri tim tht &mL% Nate: ,irclic PLMF A wd)hr ;,we ) re f �frni �Ilhrwl>, til'1 "`'� '5;;W p PI) Ilnx 1'gYi�a) yN I yd Ilk Legal ,Arkin. -ss: suhdivkiort: h bsk:r 33]km:k: E -OL: 6 % ll 1 13 Section Lm; tin-snz 'w'trrtr,� � a±+xh;ricr f`r+!lyd+lry tuttl�n! xflnrmrwr Performing cik w�e11+9�,eummissi�itg;: .}nil d. VlIiVoll CsarrYliut7�. ,Avli{ Ploy Well, life. Ii well lk�rnn dignin��}?ut �,_'}1.4,7, hialiJrdGktr�Ird3cyr�rira: IMNK 3iMAR.] 6e❑ �-❑ �,`� l"mulum: List 1bgr1 xr belo"Au prua�..kk-xahptr.ing olific property:hrwmg IM lkftring idcros: fk m"1T6"it1rrr+i %Of Otikr wairr wxlls nn tbv mgv±rr T V,,t uperme �fng iie dist�cxs fx �� x=rll saH.r,ai nn tlfe �awfrq� Nm: iw ,winpie disionm strafl lw. rnrsr.ve l: Faprir ehlrrr pemtanem �aueiurcs.•nr the prc +c?ty tunnn; �I r k rt � Itfe �e MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Renewal Date Issued: Nov 01. 2002 Expiration Date: Nov 01, 2003 Permit Number: SW020444 Parcel ID: 051-531-37 Legal Description: FASSLER LT 6 Design Engineer: 0014 Anderson Engineering Site Address: 021254 MONRON ST Owner Name: MM&M Contracting Lot Size: 24065 SQ. FT. Owner Address: PO Box 670495 Total Bedrooms: 3 Permit Bedrooms: 3 Chugiak , AK 99567 - This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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 ( 1BAAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Date: //-4-8z— Issued By: (' —1 Date:// r s'L Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWERNVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-531-37 Permit Number SW Property owner(s) MM&M Contracting Day phone 688.1236 Mailing address (1) P.O. Box 670495 Chugiak, AK 99567 Mailing address Legal description (Lot, Block & Sub'd.) Lot 6, Fassler Subdivision Legal description (Section, Township & Range) Lot Size 24,065 SF Acres/Sq.Ft. THIS APPLICATION IS FOR: Code Number of Bedrooms Three (3) Sewer Only ® Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: 4,90 'V Waiver Fees: Date of Payment: Receipt Number: (Rev. 12100) /0-50 _ oz, 175'3 z;. Date of Payment: Receipt Number: AIV, [01zukiIfllhyy DATE: October 29, 2001 TO: Jeff Poet �, FROM: Mike Anderson, P.E. '"U- SUBJECT: Lot 6, Fassler Subdivision Well and Septic System Construction Permit No. SW010443 Well Location Revision The owner of Lot 6, Fassler Subdivision intends to relocate the well proposed for Lot 6, Fassler Subdivision to improve the chances of finding water. The attached drawings show the location of the new well and its 100' protective radius. The location of other wells and septic systems in the area are also shown and are not affected by the relocation of the well. The septic system for the lot will also have to be moved to the location shown. Additional test hole information will be forwarded to you prior to the construction of the new septic system and modifications to the design if necessary. Please review the proposed relocation of the well and advise if further information is required. We intend to place the well soon so construction of the house proposed for the lot can begin. Thank you for your prompt review of the this modification and please let me know if you have any questions or additional information is required. MEMORANDUM DATE: October 29, 2002 TO: Dan Roth FROM: Mike Anderson, P.E SUBJECT: Lot 6, Fassler Subdivison Septic System Construction Permit No. SWO10443 Permit Renewal We are hereby applying to renew the septic system construction permit for Lot 6, Fassler Subdivision. The well was placed on the lot on October 29, 2001, at the revised location as noted in our memo to you dated October 29, 2001. A copy of the well log is enclosed for your review. Please reissue the permit for the septic system construction only. Thank you and please call if you have any questions raw .•I 0 172.91 A 31.33 ® S89 57'19"E 204.24 TY)Abs ting Well 0% Lo g ' Wide E e ve Deptt p n Trench Thre,er',PO0 Gallgrf Septic Tank 1 SITE PLAN SCALE 1" = 30' MICHAEL E. ANDERSON ._ NO.E-4331 Ell UnsubdiVided (Vacant) £0 jj1oN i .c � St �0 3.6 FAS 1�� o �OIr.aS 2� 9 NU IR C 1ol 339'�t roto �1 �`-53�•',Tts L z s 3 - ^� e,�.shJ �;.a �z�a �t h . � I ,1 o y� F��•1 bb / / � � � ,, D'o-� �vV - 33 � .�� / �7HIS PROJECT � t 1 _ fi1 / /b/ b" - / ._-------- — p 3 /eo.ee // �,o�_cz I �223.33 hfE 967.67 MEADOW RIDGE' ---�j "E ST/ 566 119-E5. _ _ _ _ /- w Ali 1W - '� yo As I / t l• � O� b t I Gs AREA MAP SCALE 1" =100''- 3 C1 S LOT 5 Three Bedroom 0% TH1 1,000 Gall O 111 Septi T 8' L 3' W'de XO 80 or p ion Wench N LOT e - b , - �1 1 M m P. 4� UNDEVELOPED P. y rt ltrrna e �C Si. Srp� Aj k M N I O S�BOND NOM�eP/ / x q SITE PLAN l C .. i SCALE 1" = 30' dA�'�yF •. �� MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM 1 WATER SUPPLY PERMIT Initial Permit Number: SWO10443 "Tk"A ' Design Engineer: 0014 Anderson Engineering Owner Name: MM&M Contracting Owner Address: PO Box 670495 Chugiak , AK 99567 - Date Issued: Oct 18, 2001 Expiration Date: Oct 18, 2002 Parcel ID: 051-531-37 Site Address: Lot Size: 24065 SQ. FT. Total Bedrooms:3 Permit Bedrooms: 3 This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well ❑ 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 engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. /0-2(0-01 14✓RN it r Nr.! a �/D �� f►�jo0� lI rn�t�I O t+ /f/�v'fli w`st c.®rker �.><' l07' 7''o�S�+'�+1� �'• /� Ht x� saw �� �tiz«koL �4 ftlf Received By: Issued By: Date: Date: �G --/8 — C/ MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Permit Number: SWO10443 Legal Description: FASSLER LT 6 Design Engineer: 0014 Anderson Engineering Owner Name: MM&M Contracting Owner Address: PO Box 670495 Chugiak , AK 99567- Date Issued: Oct 18, 2001 Expiration Date: Oct 18, 2002 ParcelID: 051-531-37 Site Address: Lot Size: 24065 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy All construction must be in accordance with: 1. The attached approved design. 0 Private Well ❑ Water Storage 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. R Received By: Issued By: Date: t� O L Date: October 10, 2001 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 6, Fassler Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 6, Fassler Subdivision intends to construct a new three-bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new well and septic system to serve the proposed home. The attached Site Plan and backup documentation identify the location and configuration of the new septic system and the parameters used in the design. Also identified on the plans are the location of the new well on the lot and the test hole location. Existing drainage patterns are shown and will not be altered by the development of the lot. Two test holes were placed near the location of the proposed absorption trench. These test holes indicate well graded to poorly graded gravel with silt and some cobbles near the location of the new absorption trench. Percolation tests in the material resulted in rates of between 11 and 18 minutes per inch. No groundwater was found during the placement of the test holes and none was noted during the monitoring period. We are therefore proposing to place a deep absorption trench system with 8' of gravel beneath the distribution pipe. The total depth of the trench will be 11'. The distribution pipe will be placed at 3' below the ground surface to provide sufficient drop from the septic tank to the absorption trench. The total length of the new absorption trench will be 48'. The ground surface on the lot slopes as shown on the attached Site Plan with very little to no slope near the proposed septic system site. The new absorption trench will be constructed on a fairly flat surface in conformance with Municipal requirements and parallel to ground contours where possible. All components of the new septic system will be constructed 10' from the water service and water main easement on the lot. If the system is constructed in accordance with our design 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 Lot 6, Fassler Subdivision October 10, 2001 Page Two 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 reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, OF Michael E. Anderson, P.E. ��P• A. a Attachments 491-9 WCHAEt E. ANDERMN =f�f ci CE .4381 414 44� ROFESSION°"©� U_nsubdivided (Vacant) .x, � ♦i { ."iii. a.��I /iT. �c 9�' 6A l.o �•� y� j�3o— 1 IIIII Saab co ` FAS ER, is -.9 -ST •-_ K:S r -i-- $9_ _ `°. Q � C4 IR 0 33 bib p �o` i � l39•ST'f5 I .Za } � ^' oq� 3' 'n0 CtE �{ N ♦ �.. Z gg I p `�� •� / �r I y �oA\ 30 33 I PROJECTf IS -� + �N ; A 9 / ME 95).67 MEADOW RIDGE' (--I:AS—TT7506 (72-56jMJ E.1 33 ♦�• � A w / ♦ � � 1� M1M1 1 / S � � � ♦ I ,l RJ ✓7 'J 9 - - -'. AREA MAP"`°"' SCALE 1" = 100'= c °. CL ;i - MEMORANDUM DATE: October 17, 2001 TO: Dan Roth FROM: Mike Anderson, P.E. SUBJECT: Lot 6, Fassler Subdivision Septic System Construction Permit I have revised the Site Plan for the new septic system for Lot 6, Fassler Subdivision in accordance with our conversation yesterday. The test holes have been more accurately placed on plan. The absorption trench will be constructed within the 30' radius of either Test Hole Nos. 1 or 2. The total depth of the trench will be 7' as the depth of Test Hole No. 1 is only 16'. The length of the trench has been extended to 54'. In addition, dimensions have been added between the proposed house and the new trench and the lot line and the proposed alternate site. Please let me know if you have any questions or additional information is required LOT 5 X 8,' EfiectiveWDepth Absorption Trench ' TH2 I Al Three Bedroom 1 i —� 33 0% LOT 6 9 Proposed Well Alternat Site / TH1 UNDEVELOPED pO ROPO +`n { THF f' v sa JJ SITE PLAN'C" e. 1t'O s ^ SCALE I" =30' LOT 6, FASSLER SUBDIVISION DESIGN FACTORS: Three Bedroom Home Perc. Rate: 18 Min./inch Avg. Application Rate- .6 GPDISF SYSTEM REQUIREMENTS: Deep Trench System � 1,000 Gallon Septic Tank 7' Drain Field Rock 3 Bedrooms X 150 GPD /.6 GPD/SF = 750 SF of Absorption Area 750 SF/14 SF/LF = 53.5 LF Trench Length Therefore: Construct An Absorption Trench 54' in Length by 3' Wide With 8' of Drainfield Rock Beneath the Distribution Lateral. Distribution Lateral to Be Placed 3' Below Existing Ground. Total Depth of Trench to. Be 10' from Existing Surface. Mound Over Trench if Necessary to Provide Minimum Cover of 3'. TYPICAL DEEP TRENCH SECTION (NO SCALE)" - NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 10' Separation From Lot Line. Minimum 4' Separation From Groundwater. Minimum 100' Separation From Wells in the Area. 2. :. Natural 2'6" Backfill. : Geotextile •...':`'6..'::�.' ..-. Fabric: .O "4" Perfotated ' PVC ISlots .Down). 7' Drainfield^ .7 r y%••• X. TYPICAL DEEP TRENCH SECTION (NO SCALE)" - NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 10' Separation From Lot Line. Minimum 4' Separation From Groundwater. Minimum 100' Separation From Wells in the Area. 2 3 4 5 6 7 8 9 15 17 Municipality of Anchorage m�/�� • i:: Development Services Department/Building Safety Division ° 691. Onsite Water and Wastewater Program 0r 49 ......%]....... :...... 4700 South Bragaw Street Anch., AK 99519 6a.S } �. SOILS LOG - PERCOLATION TEST PROJECT #: a MICHAEL E. ANDERSCNa. w � V0130 �{� J , CE -4381 PERFORMED FOR: PAUL MYERS / MM&M CONSTRUCTION DATE4j {J�t1ED;.. 44�%P�YE.S.SI LEGAL DESCRIPTION: LOT 6. FASSLER SUED. TEST HOLE # 1 SILTY GRAVELS W/ COBBLES & BOULDERS GP -GM M COMMENTS: WAS GROUNDWATER ENCOUNTERED? IF YES, WHAT DEPTH? DEPTH OF WATER AFTER MONITORING: DATE: SLOPE 0% None 10/9/01 CITG PI ANI S L 0 5% •25% P o% E READING DATE GROSS TIME NET TIME DEPTH OF WATER NET DROP Start 9/25/01 1540 12•• 1 16:00 30 9.25" 2.75" Recharge :01 1175•• 2 :31 30 9• 2.75" Recharge :32 12- 3 17:02 30 9_S•• 2.5" PERC RATE: 11-25 MIN./INCH PERC. HOLE DIAMETER: 6' TEST RUN BETWEEN3.5 FT. AND 4.5 T. TEST PERFORMED BY: T.L. KIMBROUGH I, MICHAEL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: ID - /0 — D t "P OF +a(�°�� s Municipality of Anchorage Development Services DepartmenflBuilding Safety Division 4 9TH Onsite Water and Wastewater Program ee....... �.],.,.,.,..�.� �... :...rr 4700 South Bragaw Street Anch., AK 99519 ®. ^45y SOILS LOG- PERCOLATION TEST 14 A MICHAEL E ANDERSON ,rte PROJECT #: V0130 ®Q Jl, CE -4381 PERFORMED FOR: PAUL MYERS / MM&M CONSTRUCTION DATE®:••' � o Brrccl0 v+ LEGAL I 2 DESCRIPTION: LOT 6, FASSLER SDBD. TEST HOLE # 2 SLOPE DEPTH OF WATER 3 Start 9/25/01 15:60 4 9" 0% 1 16:10 SILTY GRAVELS 5 1.75" W/ COBBLES & BOULDERS :11 GP -GM 6 2 :61 7 8.75- 1.51' 8 :62 10" WAS GROUNDWATER 9 30 ENCOUNTERED? NO 10 BOH IF YES, WHAT DEPTH? . DEPTH OF WATER None AFTER MONITORING: DATE: 10/9/01 17 E. COMMENTS: SITE PLAN TH #2 0 TH #1 0 N S L 0S% >25 P 0% E READING DATE GROSS TIME NET TIME DEPTH OF WATER NET DROP Start 9/25/01 15:60 9" 1 16:10 30 7.25• 1.75" Recharge :11 1025" 2 :61 30 8.75- 1.51' Recharge 1 :62 10" 3 17:12 30 8.25" 1.75" PERC RATE: 1— MIN./INCH PERC. HOLE DIAMETER: 6' TEST RUN BETWEEN35 FT. AND 6.5 FT. TEST PERFORMED BY: T.L. KIMBROUGH I, MICHAEL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: / 0 - / 0 ^ 0 I'llE • Municipality of Anchorage a On -Site Water and Wastewater Program (907)343-7904 s,EET, Certificate of On -Site Systems Approval Parcel I.D. 051-531-37 Expiration Date: 10-7-15- 1. D"%-15- 1. GENERAL INFORMATION Complete legal description Fassler, Lot 6 Location (site address) 21255 Monron Street Chugiak, AK 99567 Current Property owner(s) Arleen Myers Day phone 688-1236 Mailing address P.O. Box 670351 Chugiak, AK 99567 Real Estate Agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADu) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Three 4. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class A Well I] Public Water System ❑ Waiver/Variance request Received by: TYPE OF WASTEWATER DISPOSAL: Individual Holding Tank ❑ Community ❑ Public Sewer ❑ COSA to be released to the engineer, unless otherwise requested by the engineer. Date. `r COSA Fee $ 06,40 Waiver Fee $ Date of Payment 16.25113 Date of Payment Receipt Number <i0 9c2 Receipt Number COSA# 06a 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 Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE System #1 Approved for J bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms Date 10/25/2013 bedrooms, with the following �ivn lt% OF g e �p 49 T WCHAEC i•o CE -4381 g��� stipulatr�� By: vr/ //--a,�f_ Original Certificate Date: 11-1,13 The unioi ali f nchorage 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 5 . j . 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: FBsSler, Lot 6 A. WELL DATA Dawn Water System Well type Date completed Total depth ft. Date of test If A, B, or C provide PWSID # Sanitary seal (Y/N)_ Cased to ft. FROM WELL LOG Static water level Well production WATER SAMPLE RESULTS: Coliform colonies/100 mL ft. 9 -P.M. Nitrate mg/L Arsenic ug/L Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1,000 gal. Number of Compartments 2 Parcel ID: 051-531-37 Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) in. AT INSPECTION ft. g.p.m. Collected by: Date installed 11/15/02 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 10/28/2013 Pumper JRs Pumping C. ABSORPTION FIELD DATA Date installed 11/15/02 Soil rating (g.p.d./ftZ or ftZ/bdrm) .6 GPD/SF System type Deep Trench Length 54 ft. Width 3 ft. Gravel below pipe 7 ft. Total depth 11 ft. Eff. absorption area 756 ft2 Monitoring tube Y Depression over field N Date of adequacy test 10/7/13 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 12 in. Water added 450 gal. New depth 30 in. Elapsed Time: 1,440 min. Final fluid depth 12 in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date D. LIFT STATION Date installed "Pump on" level at in. Datum E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot _ Public sewer main Sewer /septic service line Animal containment areas Size in gallons _ "Pump off"level at Cycles tested in. Manhole/Access (YIN) _ High water alarm level at Meets alarm & circuit requirements? On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Water main >10' Water service line >10' Wells on adjacent lots >100' Absorption field >5' Surface water >100' ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water main N/A Water Service line >10 Surface water >100 Driveway, parking/vehicle storage >10 Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS Well on lot was recently abandoned in accordance with Municipal Code. Lot is now served by the Dawn Water System. G. ENGINEER'S CERTIFICATION / certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. Date 10/25/2013 -COSA brown sheet -1 0-10-1 2.doc O aA41CHAEL E. P.`•�^E°SOM1 �• CE -4381 ►®®��o®®® 2 o ®�4 in. Parcel I.D. 051-531-37 6�$9 5 Municipality of AnchZg,;F ' On -Site Water and Wastewater Pr m (907) 343-7904 ac, 2 5 2016 Certificate of On -Site Systems 1. GENERAL INFORMATION Complete legal description Fassler, Lot 6 Expiration Location (site address) 21255 Monron Street Chugiak, AK 99567 Current Property owner(s) Patricia Dorman Day phone 398-4193 Mailing address Real Estate Agent 12110 Business Blvd., #407 Eagle River, AK 99577 Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Three 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual X Individual Water Storage ❑ Holding Tank ❑ Community Class A Well Il Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: (1,U%A,LIA �GJiQi Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ M Date of Payment litkl% Receipt Number 03ACIG COSA# AL)OIOI 039S Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems 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 Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the Phone 522-7773 Date 8/25/2016 OF A-71 A B : vim , �Jh`J[ 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 professionalcivil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. r, 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory} Well Flow Advisory COSAbluesheet f ': c Other. �.,. If more than I septic system is on the lot: COSA Checklist # Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: FaSSler, Lott,6 Parcel ID: 051 -531 -37 `r A. WELL DATA 'D rV v QTCV� S)IS Well type If A, B, or C provide PWSID # Well Log (Y/N) Date completed Sanitary seal (Y/N)_ Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG Date of test Static water level ft. Well production g.p,m, WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic ug/L Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel AT INSPECTION ft. Collected by: Date installed 11/15/02 Tanksize 1,000 gal. Number of -Compartments 2 Cleanouts(YIN) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 5/19/16 Pumper Sanitary Pumpers C. ABSORPTION FIELD DATA Date installed 11/15/02 Soil rating (g.p.d./ftz or ft2/bdrm) .6 GPD/SF Length 54 ft. Width 3 ft. Total depth System type Deep Trench Gravel below pipe 7 ft. ft. EfF. absorption area ft' Monitoring tube Y Depression over field N Date of adequacy test 8/6/16 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 41.5 in. Water added 685 gal. New depth 48 in. Elapsed Time: 45 min. Final fluid depth 41.5 in. Absorption rate , 450 g p d Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed "Pump on" level at in. Datum E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot _ Absorption field on lot Public sewer main Size in gallons_ "Pump off"level at Cycles tested _ Sewer /septic service line Animal containment areas SEPTIC/HOLDING TANK ON LOT TO: >5' >5' Manhole/Access (Y/N) in. High water alarm level Meets alarm & circuit requirements? On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas Building foundation Property line Water main >10, Water service line >10 Wells on adjacent lots >100, ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10, Water Service line > Surface water >100' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS Lot is served by the Dawn Water System. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. Date 8/25/2016 COSA brown sheet 10-10-12.doc Absorption fief Surface water d >5, >100' Water main >10' Driveway, parking/vehicle storage > 10' Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. _05t-531-37 HAA Expiration Date: /40 ®-3 1. GENERAL INFORMATION Complete legal description J_o_t 6�Easie�divislon Location (site address or directions) M� Zat HnmP" P.ad Road Current Property owner(s) Day phone 6j -1236 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System Day phone Day phone TYPE OF WASTEWATER DISPOSAL: ® Individual On-site ❑ Individual Holding tank EJ ❑ Community On-site ❑ ❑ Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Authority 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 now water sample r€sults leers than 30 days old. (Certificates , may be --issued for a pe^od of up to one ye r 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 Health Authority 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 AndPlaon Eng n Pring Phone F -7773 Engineer's Printed Name Michael E AndPrSon. P.F Date x/912003 f ,MICHAEL I- ANDERSON �1 s ; No. CE -4381 .: 5. DSD SIGNATURE ���� •.., E —1� Approved for 3 bedrooms. 114iill-Nm T �:� Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments tate and Municipal Codes. There are nitrates present. It is suggested that periodic testing be performed to insure the wells continued suitability. Current nitrate concentration is 6.03 mg/1. EPA maximum concentration is,10.0 mg/1. More infor- mation on nitrates is available from the On -Site Services Program, at 343-7904. Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other C3 By: Original Certificate Date:- -- Municipality of Anchoragex< •` ' ` Development Services Department >Tx Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 6. Fassler Subdivision Parcel ID: 051.533.7 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 10/2912001 Sanitary seal (Y/N) y Total depth 200 ft. Cased to 157 ft. FROM WELL LOG Date of test Static water level Well production g.p.m. 10129/2001 WATER SAMPLE RESULTS: 145 ft. Well Log (Y/N) Wires properly protected (Y/N) Y Casing height (above ground) >24 in. AT INSPECTION ft. 9.10 -m - Coliform 0 colonies/100 ml. Nitrate 6.03 mg./I. Other bacteria 0 colonies/100 ml. Date of sample: 6/2512003 Collected by: T.L. Kimbrouah B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1.000 gal. Number of Compartments 2 Foundation cleanout (YIN) Y Depression over tank (Y/N) N Date of pumping C. ABSORPTION FIELD DATA Pumper New Construction Date installed 11/1512002 Cleanouts(Y/N) High water alarm (Y/N) N Date installed 1 1 /15/02 Soil rating (g.p.d./ft2 or ft2/bdrm) .6 GPD/SF System type Deep Trench Length 54 ft. Width 3 ft. Gravel below pipe 7 ft. Total depth 11 ft. Eff. absorption area 756 ft Monitoring tube Y Depression over field N Date of adequacy test Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test _ in. Water added_ gal. New depth_ in. Elapsed Time: _ min. Final fluid depth _ in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed "Pump on" level at _ in. Datum E. SEPARATION DISTANCES Size in gallons "Pump off" level at —in. Cycles tested Manhole/Access (YIN) High water alarm level at Meets alarm & circuit requirements? in. --- SEP-ARATK7N-DISTANCES-FROM"WEtt-ON-LOl`TO-------------------------- -- Septic tank/lift station on lot >100' Absorption field on lot >100' Public sewer main NIA Sewer /septic service line >25' On adjacent lots >100' On adjacent lots >100' Public sewer manhole/cleanout NIA Holding tank NIA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line>6 Absorption field >5' Water main >10' Water service line >10' Surface water >100' Wells on adjacent lots >100' SEPARATION DISTANCE FROM 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 >25' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through held inspections and 94t., review of Municipal records that the above systems are in 49th conformance with MOA HAA guidelines in effect on this date. ♦ NICMEL•E. AN➢l1 I N Engineer's Printed Name Michael E. Anderson. P.E. % No, CE -4381 Date 7/912003 R7rcrcci�i HAA Fee $ 3 7 J Waiver Fee $ _ Date of Payment 2-10 J 3 Date of Payment i Receipt Number i 5 Receipt Number, (Rev. 12/00) ROM : COUNTRY REALTY PHONE NO. 90768e:1238 -AA Fn A A, 4u 49th cert C. Johnson Jul. 09 2003 08:24AM P1 AS -BUILT I hereby certify thatI'have surveyed the following described pmPgrty::t_ "A Anchorage Recording Precinct, Alaska, and.that the -irnprove- ments situated thereon are within the propeity lines and do not overlap or enciGach on the property -lying adjacent themtq, that no impxoverribms on property lyingadjacent thereto encroach on the premises in question and that there are no roadways; transmission lines or anter visible easements on said property except as iiidicated hereon- 7!y Difted at Eagle Rivek, Alaska ROBMT C. JOHNSON � GQ;;.. SCALE; Registered Land Surveyor W. 8WLS 111. 341! Box,77-0456, tagle River, Alaska 99577 Phone (907) 694-2543 fa 31 6 SS M -w Drilling, Inc. +P.o. Box 110378+Aechmo.9e, AK 99511+ *11564 FEB •907-345-4000 • 907-345-3287 Fax* AV Job No.: 63176 Project No.; WA Permit No. SW030252 +Welt Dena: Gromudwater WdtAs-AlgHt do Lop-DeenariRe conetrvetioa + Use afWee — Domestic +J7ek ago: 12V +C sft s -- V +Ceeof Tia 128.5` +mooff eL A 53 Stool oarW V APRomy +WeRceerralm- Oyoa! X Serer _ PCVWWW _ Memok +SaeeNPajartke dzw* m Now +G►,ownsex (1)Swk No.8bwAoeiteg mft + Ne" +WellDeetltpmww medwd• Awswp !Vita: +Stmlc wWb kwd 0WZ) 11arb9 +Wdf,yWower 10 Sa%wpawnlwk(GPMYt&Vomp# 4.fer 1 Gams wM 25' of*RWAME (D)f ew made krd (SWL). +Me w* SubmwsihPeey3 +DereefDerp Lba. 24hmery2006 +Dae of oanrpkbAw 28 AU9u5t 2003 +primp h Wes LAE DWb in fed from mP -Debt of form dos site of materiid, color aed berdeest: 0 TO 2 Casing stickup 2 TO 25 CoWley gravel 25 TO 37 S.0 clay: sandy Existing Well 37 TO 43 . Sandy gravel: wet 43 TO 56 Silty vel 56 TO 61 Water vel: sandy, , flowhi&Would I cleanup after quake 61 TO 68 As above 68 TO 112 Silty vel: dry, gra3dTmn 112 TO 128.5 Water sand and gravel TO TO TO TO Jtv 4 TO' TO moons l M=roe If. 1M TO .liw..� hmo 43P_/LS-