HomeMy WebLinkAboutT12N R3W SEC 25 N2SE4NE4SE4NW4T12N R3W SECTION 25 N2.qE4NE4 E4 NW4 #017-013-51 (\" Municipality of Anchorage Development Services Department ti Building Safety Division On -Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page 1 of 3 www.cl.anchorage.ak.us (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SW070009 PID Number: 017.013.51 7taphanipjagor Wastewater System: ❑ New ® Upgrade rick Road 99516 ABSORPTION FIELD m Dep Trwrm O Shale. Trench 0 Bed ❑ Mound D Other Plcro 5-3378 38edroam- Nunbar or LEGAL DESCRIPTION sal italrp Tool Depth lean ageW grade 1.2 pom? 10.2 Ft. Bbd Lot swawsrol. DWh to ppe bonen tree original grade Drawl deph wlwlh pW N2SE4NE4SE4NW4 4.2 Ft. 6.0 FI Townehp Rong, section Fa added above mares gran. crawl Lo glh. 12N 3W 25 1.0 Ft. 40 Fl. Well: ElNew ElUpgrade Drawl wexh Nunbw of Ilea. DlMsncs beMaan I.. 2.5 Fl. 1 0 FI ClesurcNgn (PnrMe, A B. CI" Total Decor Cosa w Total Wwrp on ria Pipe Metered Exist"ci Private Ft. I Ft 480 F123034 PVC Drder Dole Dried SWC Weser L" ketaler. Dee kWWW Fi Flintstone Ent/ Jr's Pump -q 611412007 Yea Pup set n Ca"ng Height Pnova Grana TANK GPM Ft. FI. SEPARATION DISTANCES ® Septic ❑ Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption Lift Holding ubllUPdvate Marasp1ef capacity From Tank Field Station Tank sa%erune Anchors eTank 1000(3•1 V404 103.6 106.9 100+ Material Steel Number a Conp,rtmHwa 2 sulacewMer 67.8 115.2 LIFT STATION 42.6 0.0 lice Maww'.00r Lot Lina Gad Fanaran 25 92.9 'Pep m'arw al. 'Pump or 'Pr IMI al High water.tentM h h in 50+ 5O+ Pump Make a Model Electrical In•psa'an paaaned by Cutin Dreer ""°"� Insulated posttank line under driveway BENCH MARK Loralen and D.. Pl. Top of gas meter Aswn,ea Elavnen 100.0 FL Engineer's Stamp Inspections performed by: PANNONE ENG. SVC, LLC Dates: 1" 611412007 ��..•.�� 2nd 6/1512007 .� ��♦♦ �, P�F..•� •. .5�♦♦ Development Services Department Approval ;r♦i♦ —I, ♦� Conditional Approval Date: 49 r� .... .. ...o j".'�Sleven• P. •Pennon � ii ., No. CE 8749 Reviewed and approved by: �(/. Date: g ' O ♦ 7 . Driveway " eapage it xisrg . I �-S optic Fiefkandone� Existg r I / / / ! LOT UNDEVELOPED I Septic tank \ 1 / / / , NO WELLS OR SEPTICS / •/ W/IN 100 FEET I -------------4 - -- - - - --- + ( + --' --- ------ -- 10' Utiy Easement I, •/ 101.5 1 •\- / 1 100' CREEK EXISTG CREEK + SET-III FUTURE GARAGE • I s , EXISTG 3BR I EXISTG I HOUSE LOT UNDEVELOPED WELL I ` •I WELLS OR SEPTICS INO WAN 100 FEET NEW , //' • 1,000g SEPTIC 103.6 1 / TANK + \ NEW UPGRADE t•� F 40LF x 2W x VED,10TD 100.0 . CONSTRUCTED BERM TO / 1 DV t• DIRECT OVERFLOW AWAY 106. DIC } FROM DRAINAGE TH1 67 6 I A _ 77.2 EXISTG 10008 SEPTIC TANK(I 28. �, /• a \ I y�,}--�- 115.2 ABANDON PER CODE 11 1 EXISTG FIELD IN FAILURE -- DRIVEWAY — �'�� )1. TOBE STALLED + EXISTG I\C2 WELL 123.4 0.0' M2 Mt I ER VALVE. DIVERSTAKE. \ INSTALLED MONITOR TH2 TUBE AT END OF FIELD / LOT UNDEV PED . A / NO WELLS TIFPP� NI / WAN 100 FEET \ E UNDERCAUTI UNDERGROUND GAS LINE INSULATE DISCHARGE LINE UNDER DRIVEWAY WITH FOUR • / SWINGTIES: (4) INCHES RIGID INSULATI N, I CO A B TWO (2) FT WIDE, 20 FT LO FC 26.0 4.7 / EXISTG CREEK / T1 32.9 25.6 / T2 36.3 31.3 / DC 38.3 34.2 / + DV 39.7 35.8 Cl 92.2 92.9 1-1 M1 93.4 93.8C2 116.7123.3M2 ' 118.1 124.8 r RECORD DRAWING 07/04/07 East 130th ve -"""`\\� A( PANNONE ENGINEERING SVC, LL C REVISED Dote 7/4/07 gs+�l'i P.O. BOX 102954 ANCHORAGE, AK 99510070128 7 o COMMENT S Scole i�Pk�OF PHONE (907) 272-8218 FAX (907) 272-8211 070704 RECORD 10" y' TH *I�� 1'=50' ....... N2SE4NE4SE4NW4 T12N R3W S25 DRAWINGS P.I.D.017- N3 st • • / Steven Pa •ne • Stephanie Jeager PERMIT NO. / CE 8149„ 12921 Patrick Road SW070009 ' (I1lfgfa Anchorage, AK 99516 345-3378 DESIGN sheet RO5 0�_ (907) PLAN 2 of 3 r iO r SlIV130 OL££-S4£ (L06) d �I "'us NOIS30 M66>IV'a6eIO43UV 'to- eo-Eo' 6000ZOMSpeon Aouled lZ6Zl j 69183 '••°s 'ON liw83d ja6ea£ alueydalS % ..:. °Y. • d u?A? s.... S ON�'a','d SZS M£a NZU 4MNb3S43N43SZN j S1a 03S IIZS-ZLZ (L06) XV! 8IZ8-ZLZ (L06) 3NOHd ,I�6�,• ;dy�i/ OIS66 NV '30VNOHONV MZ0I X08 '0'd �� S'y • • • • • cod. ioa 03SA3a 311 `OAS DNI2 SSMIDNE HNONNVd LONIL0 SONIMMI ON003N FOUNDATION CLEAN OUT Tn z m m CLEAN OUT o € \I Q V O zm x '. CLEAN OUT rv� s DNERTER VALVE DOUBLE CLEAN OUT r a i rb c F yr Nll T C P m P Z7 _ 1 o V> a CLEAN OUT : ` m �. d O MONITOR TUBE P \ I -n AT EACH END 1. _ F m O CL T m mm ;.: s Z sCr —,ow m D V. S Z D Vf 'm0 ^'!` Z omz O gg mS b N o z a C CL cn Y o z ^r.'-• o z MONITOR TUBE / AT EACH END CLEAN OUT 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 Upgrade Date Issued: Feb 13, 2007 Expiration Date: Feb 13, 2008 Permit Number: SW070009 Parcel ID: 017-013-51 Legal Description: T12N R3W SEC 25 N2SE4NE4SE4NW4 Design Engineer: 0062 PANNONE ENGINEERING SERVI( Site Address: 012921 PATRICK RD Owner Name: STEPHANIE JAEGER Lot Size: 57750 SO. FT. Owner Address: 12921 PATRICK ROAD Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE. AK 99516-3315 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 specked 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 dosed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Date:_01—•I3 0' 0 . - Q Municipality of Anchorage .4 P0. D,•c 19FA50 • Ajwhorugc, Alaska 91MM06N) s Telephone 11 M 33:i OM • Par IfX171333-&_'(X) 4700 11ra gnc Sema • Anchomgc, Alaska 91.N)7 uim..muni.org Mayor Mark Begich Building Safety Division February 13, 2007 Steve Pannone Pannone Engineering P.O. Box 102954 Anchorage, AK 99510 Subject: Waiver Request for T12N R3W See 25 N2 SE4 NE4 SE4 NW4 Waiver Request WR#: 070007 Parcel ID # 017-013-51 SW070009 Dcar Steve Pannone: Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 0.0 feet. In addition, the waiver requests for tank to surface water and absorption field to surface water has been approved. The approved separation distances are 65' for the tank and 75' for the field. This waiver approval applies to the existing and permitted conditions only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, UVV 4__/ Deb Wockenfuss Civil Engineer On -Site Water & Wastewater Program Community, Securitg, Prosperity Municipality of Anchorage Development Services Department Building Safety Division On-Sitc Watcr and Wastewater Program 4700 Bragaw Strcct P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchoragc.ak.us (907)343-7904 Waiver Review Worksheet WR#:070007 PID#:017-013-51 HA1Permit# SW070009 Date Received: February 13, 2007 Legal Description: T12N R3W Sec 25 N2 SE4 NE4 SE4 NW4 Engineer. Steve Pannone Pannone Engineering P.O. Box 102954 Anchorage, AK 99510 Applicant: Stephanie Jaeger Waiver Requested: Lot line, and Tank and Field to Surface Water Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Points: .......................................................................... Waiver is Granted: X Waiver is not Granted: . ... It�7:..7�^•.• �!7•^-airl^tQ .. .F�Gji _,yFTr - .• ' ... Date: 2113107 By:����enfussW�enfuss Name of Reviewer .......................................................................... Rec#: MM Amount: $1M Date Paid: 211372007 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWERMELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcell.D. 017.013.51 Property owner(s) Stephanie j ¢r_� cn Day phone 345.3378 Mailing address12921 Patrick Road Anchorage, AK Zip Code 99516 Site address 12921 Patrick Road Zip Code 99516 Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) N2SE4NE4SE4NW4 _12N R3W S25 Lot Size 57750 Sq. Ft. THIS APPLICATION IS FOR (® all that apply): Absorption Field El Septic Tank 19 Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage Number of Bedrooms 3 THIS APPLICATION IS AN: Initial ❑ Upgrade 19 Renewal ❑ 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. Pannone Engineering Services, LLC (Signature of property owner or authorized agent) Permit/Rush Fees: L -Tin E _ Waiver Fees: 5D Date of Payment: a 0 Date of Payment: Receipt Number: ��� Receipt Number: 5 (Rev. 11/05) Pannone Engineering Services, LLC P.O. Box 102954 Consulting Engineers Anchorage, Alaska, 99510 (907) 272-8218 (907) 272-8211 Fax January 30, 2007 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street Anchorage, Alaska 99519 Subject: N2SE4NE4SENW4 T12N R3W S25 Issued for Construction Drawings Ladies and Gentlemen: The purpose of this letter is to document the items that are being transmitted to you. I have received written notification that your review is complete and that you have no further comments on this design submittal and that you are ready to issue the permit to construct this upgrade septic system. Please find attached to this letter the following: • Issued for Construction design drawings to be attached to the septic system permit to construct. Please contact me at 272-8218 if you have any further questions. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Attachments: Pannone Engineering Services, LLC P.O. Box 102954 Consulting Engineers Anchorage, Alaska, 99510 (907) 272-8218 (907) 272-8211 Fax January28, 2007 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street Anchorage, Alaska 99519 Subject: N2SE4NE4SENW4 T12N R3W S25 Response to Comments Ladies and Gentlemen: I am writing in response to your review comments dated January 23, 2007. I will respond to your comments in the same order as they are presented. oK-Comment: For clarity, please provide an additional site plan without the topo lines. Response: This is not required by code. ✓ Comment: Permits will not be issued with the statement "For MOA review and permitting only, not to be H,# -Y f0 ` used for construction". ems*' "''rResnonse: When written notification from the MoA DSD is received stating that the review is complete and f' "`• that there are no further comments, the note will be removed and "Released for Construction" drawings will be issued. ✓ Comment: Provide pert tests for all soil strata that the system will be in, or document that those strata will be ok and why. Response: Reference Test Hole 1, the lower soil strata were comprised of softer and more porous soils than the upper six to seven feet of soils. Soil at the depths between eight and 17.5 feet are similar in nature to the soils found in Test Hole 2, having a percolation rate of faster than one minute per inch. Comment: 3 bids from certified excavators aie required for the conditional approval. The two bids that were submitted were not from certified excavators. Response: Please find attached the third bid. The two Certified Excavators have submitted their renewal of certifications, which expired on January 1, 2007. Comment: A letter from the title company will be required stating that one and a half times the largest bid has been put escrowed. Response: Required letter is attached. Comment: Provide a monitor tube for the existing trench. Response: A monitor tube will be installed at the end of the existing trench. Note added to Site Plan. Page 2 of 2 If there are no further comments please provide written documentation to such and Construction Drawings will be issued. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Attachments: C:\Work\Letters\N2SE4NE4SE4NW4 T12N R3W 525.002.doc Pannone Engineering Services, LLC Consulting Engineers January 15, 2007 Municipality of Anchorage Development Services Department On -Site Water.& Wastewater Program 4700 S. Bragaw Street P. 0. Box 196650 Anchorage, Alaska 99519 Subject: N2SE4NE4SENW4 T12N R3W S25 Conditional Certificate of Onsite Approval Request Septic System Permit Request Separation Distance Waiver Request Ladies and Gentlemen: P.O. Box 102954 ge, Alaska, 99510 I am writing to request a permit to construct a new septic system be issued for this property and a conditional Certificate of Onsite Approval (COSA) be issued. The proposed systems will serve an existing three-bedroom house. Currently the lot is developed. There is an existing private well and septic system on this lot that is documented, but is filed under a different aliquot part description The record information for this property is filed under E2N2S2NE4SE4NW4 T12N R3W S25, which is an alternate description of this property. The length of the existing drain field corresponds to the record information, as does the well. It is the intention of the Owner to reuse the existing well. Arrow Pump & Well performed a flow lest and inspection to document the well. The results are attached. The existing septic system shall be reused. A diverter valve will be installed between the new tank and the existing field. The surrounding developed lots are served by private water systems. They are located over 100 feet from the proposed soil absorption system. 1. Conditional COSA. The Owner is in the process of selling this property. The existing system was located and inspected. We found that the system was documented under a different description of the property. The system was test for operation and was found that it could not accept the required 150 gallons per bedroom per day (450 gpd). The system is able to absorb approximately 150 gallons per day. The new Owner is a single gentleman with no children. There will be no health risk in approving this Conditional COSA as we will be installing the new system in June. 2. Soils. Two test holes were excavated. See the attached soils logs. Ground water was monitored for seven days. No ground water was monitored to a depth of 17 feet below ground level after the monitoring period. Bedrock was not encountered in the test hole. It is my opinion, based on the results of the percolation tests and overall soils appearance of the soils, an application rate of 1.2 gallons/day/square feet should be used, using a conventional treatment system. 3. Soil Absorption System Design. a. Percolation Rate: 1 to 5 Min Per Inch b. Application Rate: 3 c. Design Flow: 450 gallons per day d. Min. Absorption Area: 375 sf e. Total Depth: 10 feet f. Effective Depth: 6.0 feet Page 2 of 2 g. Width: 2 feet h. Reduction Factor: 0.0 i. Minimum Length: 31.25 feet j. Design.Length: 35 feet k. Effective Absorption Area: 420 sf I. Septic Tank Size: 1,000 gallon 4. Surface Water: There is surface water within 100 feet of the proposed septic tank and the existing drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. I am requesting that a waiver be issued to install the new septic tank as close as 65 feet to the existing drainage way. See Item 6 below. 5. Topography: The average topography in the area of the proposed septic system is approximately 10- 15 percent based on the survey plot plan. The proposed installation will be greater than 50 feet from the shoulder of the steep slopes. 6. Separation Distance Waivers. We request the following waivers: o Surface water waiver: Tank to surface water to 65 feet. Existing Drain Field to Surface Water to 75 feet. A berm will be constructed to direct the possible overflowing septage overland a distance of over 100 feet before it contacts the surface water. o Lot line waiver: Field to lot line to zero (0) feet. The lot to the south is undeveloped. A recent test hole (see attached) shows that the soils are very good and proves that there is adequate room on the lot to install both a primary and reserve septic system. The issuance of this waiver will not adversely affect the development of the southern lot. The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells or septic systems within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Attachments: C:\Work\Letters\N2SE4NE4SE4NW4 T12N R3W S25.00l.doc %GE\GE� ,UNDEVELOPED ExlsrG Z EAST 130TH AVE FOR EXIST'G SEPTIC is FA OF A/ �Lgs�11 rGjFy�� *: 4 • *,� Steven R • •.' • CE 8149 �,�� +1 `fi • tri007 ,. '� 11�F�f�oROFESSIOH*�Sneel PANNONE ENGINEERING SVC, LLC P.O. BOX 102954 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 REVISED Dole 1/15/07 Scoie 1'_ 100' N2SE4NE4sE4NW4 T12N R3W S25 Stephanie Jeager 12921 Patrick Road Anchorage, AK 99516 (907) 345-3378 P.I.D. NO 017-013-51 No. swo7—PERMI.xxx SITE PLAN t or 6 Ddveway ' Exist. j eap�D/e Fitif xisrg eptic Fie \ r Ilandone� "/ / Exlstg ' LOT UNDEVELOPED + Septic tank \ I / / / NO WELLS OR SEPTICS •%� I`� / / / WAN 100 FEET I 11: 10' Utility Easement ` I. r 1015 t / r I I 100' REEK EXIST•G CREEK I SET-11 CK / 1/ 1 FUTURE GARAGE I, I EXIST'G 3BR I EXIST•G I HOUSE ' LOT UNDEVELOPED 'NO WELLS OR SEPTICS WELL 100 FEET I PROPOSED SWAN I ��' , 1.000g SEPTIC \PROPOSEDUPGRADE 100.8 FC TANK �•� 35LF x 2W x VED, 10'rD 100.0 / CONSTRUCT BERM T O /♦ �4 \ / e • DIRECT OVERFLOW AWAY 105.6 TmF" DC 68,9 __1 FROM DRAINAGE �. T1 I I t :I 76EXIST'G t000g SEPTIC TANK _ 45. '1 ABANDON I' PER CODE 1l ____'_`_ -- DRIVEWAY 120,0 EXIST'G FIELD IN FAILURE I TO BE REUSED. INSTALL r^ 0 I DIVERTER VALVE. r\ STAKE. INSTALL MONITOR \ ll�.,LOT TH2 TUBE AT END OF FIELD 126.7 / UNO LOPED . A / NO WELLS 0 PTIFS CAUTION! 1 / WAN 100 FEET \ UNDERGROUND GAS LINE / \ / EXIST•G INSULATE DISCHARGE LINE I WELL / / UNDER DRIVEWAY WITH FOUR (4) INCHES RIGID INSULATI N, / 1�TWO (2) FT WIDE. 20 FT LO EXIST'G CREEK / I I / 3 � % �w ISSUED FOR CONSTRUCTION 1/30/07 East 130th Ave �PANNONE ENGINEERING SVC, LLC REVISED Dote 70128 PER Mo OFA(..S" to P.O. BOX 102954 ANCHORAGE, AK 99510 1/15/07 COMMENTS Scole i�Q;•' t t pj. PHONE (907) 272-6218 FAX (907) 272-8211 TH *��, '. 1'.50' """' N2SE4NE4SE4NW4 T12N R3W S25 P.I.D. Steven • P none / Stephanie JeagerPERMIT on-o13u-s CE 8149 ��� 12921 Patrick Road swo7xxxx0 DESIGN PLAN �fgEov1f30707 T`•`,' ,"ham 1\' PR r"`—� _ Anchorage, AK 99516 (907) 345-3378 sneer 2 or 6 } Y If10 NV31OR p,Q $ O F go 1110 NV313�jj 0.W \ Z to � S id A ISA N IIID NV310 • NOLLVONf101 ISSUED FOR CONSTRUCTION 1/30/07 OFA(g>t 1110NV310 REV SED Dote s\,1 P.O. BOX 102954 ANCHORAGE, AK 99510 PHONE 272-8218 FAX 272-8211 1/15/07 Scole ON3 HOV3IV (907) (907) asm MOIINOPI U P.Q.D. No .. "' "" N2SE4NE4SE4NW4 T12N R3W S25 " . Steve 'R. P .'ne ' Stephanie Jeager 017-013-51 CE 8119 (l fiFq•. 12921 Patrick Road Anchorage, AK 99516 Sw07:xax0 •1=7.,. = DESIGNshee, (907) 345-3378 DETAILS S of 6 Q ,f) C 4 N:Y'. h N ^ 1. W pp 06 0 'C ID CIN3 HOW IV 38N U0I1NDY1 CE o a Immo NVB7Jqq o U) �w = 1 :1: c 1 :S•S. S: S: S:S: N LL 1 _T �OI I ��JJ11 LL � } Y If10 NV31OR p,Q $ O F go 1110 NV313�jj 0.W \ Z to � S id A ISA N IIID NV310 • NOLLVONf101 ISSUED FOR CONSTRUCTION 1/30/07 OFA(g>t PANNONE ENGINEERING SVC, LLC REV SED Dote s\,1 P.O. BOX 102954 ANCHORAGE, AK 99510 PHONE 272-8218 FAX 272-8211 1/15/07 Scole (907) (907) NTS P.Q.D. No .. "' "" N2SE4NE4SE4NW4 T12N R3W S25 " . Steve 'R. P .'ne ' Stephanie Jeager 017-013-51 CE 8119 (l fiFq•. 12921 Patrick Road Anchorage, AK 99516 Sw07:xax0 •1=7.,. = DESIGNshee, (907) 345-3378 DETAILS S of 6 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK SHALL BE- IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. 3. SCOPE OF WORK: 3 -BEDROOM HOUSE, NEW TANK (1,000 GALLONS), NEW DRAIN FIELD (35LFx2'WIDEx6'EEFFECTIVE DEPTH, 10' TOTAL DEPTH). RECONNECT EXISTING DRAIN FIELD TO NEW TANK VIA THREE-WAY BALL -TYPE DIVERTER VALVE. 4. ABANDON EXISTING SEPTIC TANK PER AND CODE. 5. CONTOUR INTERVAL IS FOUR (4) FOOT AND IS BASED ON 1997 MAPPING. 6. EXIST'G FIELD WAS SNAKED AND CAMERA'D TO DETERMINE LOCATION. A STAKE MARKED "END OF FIELD" WAS PLACED AT THE END AND IS DESIGNATED ON THE PLANS AS 'STAKE'. 7. GROUNDWATER IS NOT EXPECED TO BE ENCOUNTRED DURING EXCAVATION, AS EVIDENCED BY THE SOIL TEST HOLE INFORMATION. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 14 FEET BELOW EXISTING GRADE, NOTIFY THE ENGINEER IMMEDIATELY. DESIGN PARAMETERS. NO. BEDROOM: 3 TANK SIZE: 1,000 gallon PERC. RATE: 1-5 MPI SOIL RATING: 1.2 gpd/SF APPLICATION RATE: 125 SF/BR AREA ROD: 375SF SYS. TYPE: DEEP TRENCH, 6' ED MIN LENGTH: 31.25 LF I E: 35LFx2'WIDE, 6'ED. 10' TD TOTAL AREA: 420 SF PANNONE P.O. I PHONE If LEGEND — — — 100' WELL RADIUS — — — CREEK — — — — — — — 100' CREEK SETBACK BERM ISSUED FOR CONSTRUCTION 1130/07 ENGINEERING SVC, LLC REVISED D1t15/07 K 102954 ANCHORAGE, AK 99510 7) 272-8218 FAX (907) 272-8211 state NTS N2SE4NE4SE4NW4 T12N R3W S25 017—o s-- ieve R• 'crone • • • • Stephanie Jeager CE 8149 12921 Patrick Road PERMIT M7xxxx Yfq,. ?ld00T ,.{� Anchorage, AK 99516 DESIGN sneer I\�``oi¢ssio-�� (907) 345-3378 NOTES 4 of 6 -SOILS LOG - PERCOLATION TEST OF. AC-I PANNONE ENGINEERING SERVICES P.O. BOX 102954 * ' TH ANCHORAGE, AK 99510 "' / (907) 272-8218 Steven R. annone / CE 8149 PERFORMED FOR: Ms. Stephanie Jeager DATE PERFORMED: 01-08-07 it 1130/07 LEGAL DESCRIPTION: N2SE4NE4SE4NW4 T12N R3W S25 OPROFESStONp�' TEST HOLE 1 - --SrTE PUN \ OR Organics SLOPE 1 I 2 Poory Graded 3— Course Sand wl ' \ 4 SPI Trace Sias SM •� THl 5 TEST 7 HOLE GP Gravel Clean S Little to No Fines _ 1' MSA 9- 10 10 GPI poorly Graded • / 11 SP Gravel & MSA Sand 1 / \ 12 \ r 1 13 WAS GROUND WATER SLOPE 14 ENCOUNTERED? N 15 IF YES, AT WHAT TH 1 DEPTH? -NIA- 15 DEPTH TO WATER AFTER 17 MONITORING? Dry 18 BOH DATE: 1/15107 WATER 19 READING CLOCK NET TIME LEVEL NETDROP TME READING 2 30-4 f0 692 337 7 3.01 5.75 4 314 10 8.76 7.01 5 3:14 0 5.27 6 3'.24 10 8.16 2.97 7 3'.24 a 5.141 a 334 10 809 29s 9 3:34 5.17 10 1 344 1 10 8.05 292 11 394 5.20 12 1 351 1 10 8.13 1 2.93 ISSUED FOR CONSTRUCTION 1/30/07 PEROLATION RATE 3.4_(minAnch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 5 FT AND 6 FT COMMENTS: Test hole excavated by BTH Construction. Test Hole was presoaked before pert test. PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. SOILS LOG - PERCOLATION TEST PANNONE ENGINEERING SERVICES P.O. BOX 102954 ANCHORAGE, AK 99510 (907)272-8218 PERFORMED FOR: Ms. Stephanie Jeager DATE PERFORMED: 01-08-07 LEGAL DESCRIPTION: S2SE4NE4SE4NW4 T12N R3W S25 1 2 3 5 8 7 8 9 10 11 12 13 14 15 16 17 18 19 20 TEST HOLE 2 SLOPE 7cp Organics Poorly Graded I Gravel SP/ SM BOH Poorly Graded Sand w/ Some Silt to Silly Sand I TEST HOLE ��P�� OF Akgs�91+i *: 49TM .* �.. .......... Steven R.Pannone CE 8149 �Q WAS GROUND WATER ENCOUNTERED? N IF YES, AT WHAT DEPTH? -N/A- DEPTH TO WATER AFTER MONITORING? Dry DATE: 1/15/07 ISSUED FOR CONSTRUCTION 1/30/07 PEROLATION RATE 0.42 (minfinch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 5 FT AND 6 FT COMMENTS: Test hole excavated by BTH Construction. Test Hole was presoaked before pert test. PERFORMED BY: Steven R. Pannone. P.E. 1 CERTIFY THAT THIS TEST WAS PRRe0PMr.n TN are �('� H.way 10' Utigty Easement r IILOT�PED� 'NO WELLS OR SEPTICS sWIIN 100 FEET PROPOSED UPGRADk 35LF-A 21W x 6TD,107D - n� - DRIVEWAY 1 "�� WELL E,DE® , `ExistgtgTUNDEVELOPED I Septic tank / I / I NO,WELL$ OR SEPTICS , WIIN 100 FEET 101.5 I I II � EXISTG I / WELL i 100.8 1/ 100.0 \ 105: DC • \ v- v FUTURE GARAGE rEXISTG 3BR 1,000g SEPTIC TANK \ CONSTRUCT BERM TO DIRECT OVERFLOW AWAY r FROM DRAINAGE I r EXISTG 1000g SEPTIC TANIC�I ABANDON PER CODE l I DIVERTER VALVE. UNDERGROUND GAS LINE `dA✓ / LOT ELL! LOP ' / NO WELLS OR SEPTIFS INSULATE DISCHARGE LINE WIIN 100 FEET \ UNDER DRIVEWAY WITH FOUR (4) INCHES RIGID INSULATION, / TWO (2 SFT WIDE; 20 FT LONG. EXISTG CREEK \ � I / ` % I 4 r/ M FOR MoA REVIEW AND PERMITTING ONLY NOT TO BE USED.FOR CONSTRUCTION East 130th ve OFA(gS�tl i gyp: •'• ' :(- i �. y �� * 4 TH * % nR an.. .•.•• CEB1I9 j/ �1 °'fif • 111sro7 ,. r '� PANNONE ENGINEERING SVC, LLC P.O. BOX 102954 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 REVISED Dole 1/1s/o� Scale 1'.50' N2SE4NE4SE4NW4 T12N R3W S25 Stephanie Jeager 12921 Patrick Road Anchorage, AK 99516 (907) 345-3378 P.I.D. NO 017-013-57 PERMIT NO. sw07xxxxx DESIGN PLAN Sheet 2 01 6 GR&, ER ANCHORAGE AREA BUJGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSALSYSTEM NAME Bill �{."� MAILING ADDRESS �S A `-TIIY d -y PHONE 341q 31 Z LOCATION T "-'Gk' ' `� • - LEGAL DESCRIPTIONE' I�l� N LS E lk SEVy�W 11q nor SEPTIC TANK: _tea= DISTANCE INUMBER OF FROM WELL 1Vd MANUFACTURER 629? -r .MATERIAL Gj:Se_t COMPARTMENTS --2- INSIDE LENGTH INSIDE WIDTH-.— LIQUID DEPTH J� LIQUID CAPACITYJOD-0 GALLONS. T+EE DRAIN FIELD: TOTAL LENGTH � DISTANCE FROM WELL FOUNDATION_,)_L)__NEARQQEST LOT LINE -20 'f` Or LINES NUMBER OF LINES _L- DISTANCE BETWEEN LINES �J.�TRENCH WIDTH IN. TOTAL EFFECTIVE I ABSORPTION AREA �-�� SO. FT. LENGTH OF EACH LINE �S J DEPTH OF FILTER jj ��)) DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE_l�gd II,�N,..� ABOVE TILE�IN. WELL- 1.^ny 1 N� f`'At4al - TYPE I V I `^'^'CONSTRUCTION `-'�Q'I •DCPTII DISTANCE FROM: BUILDING / NEAREST /r t�NEAREST,(, SEPTIC /,,�- � t/SEEPAGE IO,r' FOUNDATION , LOT LINE �y SEWER LINE-Ih�"I IFt_ TANKL�T SYSTEM 1 T , CESSPOOL �, OTHER SOURCE APPROVED DISAPPROVED DISTANCES: —. INSTALLED BY. lc_�4F) SEWER LINE DEPTH: 5 ` PIPE MATERIAL: LOT SLOPE: REMARKS: SO / REMARKS DIAGRAM OF SYSTEM 5 "7 spy 411Ibump DATC�1:4� APPROVED jawpi r cr 'EIC �Rh � lo'cr /�• a:3o� 31q( -77n GREATER ANCHORAGE AREA BOROUGH J), - j DEPARTMENT OF ENVIRONMENTAL QUALITY PERMITNO. Lp 3330 "C" STREET ANCHORAGE, ALASKA 90503 TELEPHONE Z74-4561 SEWAGE DI?POSAL SYSTEM — APPLICATION AND PERMIT NAME OF APPLICANT iul YI/ J MAILING ADDRESS J ILI-F Ise PC g? PHONE .7' • ,3/r INSTALLATION LOCATION IcO LEGAL DESCRIPTION -- F,� h yz. S yL1 M c 6r $•F YS! 7-(1/1/ Z2W .Sa .2 (- INSTALLATION OF: SEPTIC TANK 4�SEEPAGE PIT DRAIN FIELD OTHER iI TYPE AND SIZE OF FACILITY TO Be SERVED FINANCED THROUGH SOIL TEST RESULTS COMPLETION DATE ANTICIPATED TO BE INSTALLED DY NOTE, THIS PERMIT IS NOT VALID WITHOUT SOIL TEST YINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY .SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. ( SEPTIC TANK SIZE - v'TYPE SEEPAGE ARCA SIZE TYPO MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK - 1 !OUNDATION TO SEEPAGE PIT GRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL 1 SEPTIC TANK SEEPAGE PIT DRAIN FIELD TO NEAREST LOT LINE. lam' HELL TO SEPTIC TANK SEEPAGE PIT III F G I DRAIN FIELD- ALSO CONSIDER AREA WELLS. NATER MAIN TO SEPTIC TANK DRAIN FIELD SEEPAGE PIT IEPTIC TANK, 6Ei ( SEEPAGE PIT DRAIN FIELD V�✓� TO RIVER, LAKE, STREAM. :AST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIS CROSSING GAP OF .XCAVATION 6 FEET INTO UNDISTURBED SOIL. I INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT ITTED WITH AIRTIGHT REMOVABLE CAPS. %RAVEL DACKPILL :ONFORM TO BORG OR LICENSED DESIGNER DIAGRAM OF SYSTEM .ERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE [SCRIBE 6Y5TEM 1814 ACCORDANCE WITH SAID CODE. ta X �� /) \T1, �_ �) �') / APPLICANT'S SIGNATIIRF / \ `w' 1`i Development Services Department perty Owner Name & Address: �a Gull 9irtecw ei.�� 99s�� , Building Safety Division On -Site Water & Wastewater Program Pump Manufacturer's Name: f -ed 1_71_(�_ 4700 Elmore Road ae°GK,`.z t'cy P.O. Box 196650 2i < R P Mark Begich Anchorage, AK 99507 s" E r Y Mayor www.muni.org/onsite - (907)343-7904 Pitless Adapter Installer: Pump Installation Log Well Drilling Permit Number: SW Date of Issue: Well Disinfected Upon Completion? Yes [I No Parcel Identification Number:&(7- -V Method of Disinfect]" caL �33i°llc-)(s Legal DescriptionP 12K 3 w ��ZS YV 2 CCN Nrq sLP Nw perty Owner Name & Address: �a Gull 9irtecw ei.�� 99s�� , Pump Installation Date: Z/2R/C Pump Intake Depth Below Top of Well Casing: 2w feet Pump Manufacturer's Name: f -ed 1_71_(�_ Pump Model:/C A1$S /Z - Pump Size � /Z hp Pitless Adapter Burial Depth: IZ feet Pitless Adapter Manufacturer's Name: Pitless Adapter Installer: Well Disinfected Upon Completion? Yes [I No Method of Disinfect]" caL �33i°llc-)(s Comments: Pump Installer Name: ANCHORAGE WELL & PUMP SERV. 330 EAST 76TM AVENUE ` ANCHORAGE, AK 99518 PHONE: 907-243-0740 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. June 22, 1977 a company. Inc. • 8901 toloff • box 8718 • anchorage. alasko • 99508.r e, TDC No. 77A-170 . O .Mr...Xill BreedlAve_... Star Route A„ Box 3908 .Anchorage, Alaska 99508 _Re: Solls Investigation.£ox:,Sanitary'.Sewex_Systemi'E 1/2, N 1/2, S 1/2, NE 1/4, SE. 1/4,*KW 1/4, T12N, R3W, Section 25 S.M. Dear Mr. Breedlove: At the. request .of. Mr.. Earl.Clabo we h4ve.performed.a:ooils log at the... proposed locat�Qn of the, Sanitary •$ewer. System on .the. subject lot.. Ttie :. investigation complied with those procedures required.by the Municipality of Anchorage, Department of llealth and Environmental Protection. This ;Lnve4tigation, which.was accomplished on June .22, 1977, consisted of a.test.hole.to..a depth of„14 feet:below,ground surface. The test hole was 'excavated with a rubber tired backhoe. .At.the.time of the investigation the site had been stripped of organic material. The ,coils encountered.;Ln the ,test bQU,are.•pbown on the ,test.hole log, enclosed. Ground water was not encountered in the test hole. Subsurface conditions may vary in other parts of the lot. We appreciate the, opportunity to be of service to you. Should you have any questions please call. Very truly yours, THE DRILLING CMIPANY, INC. WP� WILL , . DNGAN `- President WED:la Enel: ale .'.anchorage; fairbonks'• qvo North • T.H. 1 T.H. I 6/22/77 `•,� Silt, -trace to some sand b .ti gravel. :a (ML) 1.5' PQ1e Sandy gravel, trace silt. �0 ((;W) 0 2.5' 0•i Sandy gravel, with silt seams 2 inches to 6 inches tnick /�Y 2.5' — 5.0". . . • Overall classification (CH) i.7.p . 5.0' Sandy gravel with trace of silt with cobbles. (CW) r-'� ale ou 'I Ll " d C -0,0A asO L M P(Rlkl0AC_2 ( CIA- ,ti1bJ\ V..£Jc0,6CM.)�,ML A.t aw,� Q-.kbV 4 v4u,-.� L LOA olaauLwlal tom." ?-Qwonuua 0-^ PICOO 5-h 7 ,iv nD,, 10 y0 ( cr lid/���� .. (D cr 40 �- o °1 re EPWAIS MUNICIPALITY OF ANCHORAGE Development Services Department j Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I. D. 017-013-51 1. GENERAL INFORMATION Expiration Date: I �, 7-1? Complete legal description T1 2N R3W SEC25 N2SE4NE4SE4NW4 Location (site address) 12907 12907 Patrick Road Current property owners) Mailing address Real estate agent Patrick Curley Day phone 10101 HiIIhaven Cir. Anchorage, AK 99507 2. TYPE OF DWELLING: Fx� Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone 4. TYPE OF WATER SUPPLY: SY6 TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic R Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $_ SY6 Date of Payment -41131119 Receipt Number 6-M26 COSA# 115COOS-6 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. Date QD q_7 OF A(, s�.Illi0 /o��P. •.9 }I 6. DSD SIGNATURE System #1 Approved for bedrooms Steven Fc f'eiiriorac F.. CE 8149 System #2 Approved for bedrooms Disapproved ��� o%(IFECbvPti4� Conditional approval for bedrooms, with the following stipulations: .►�llllll l(l(((/i. Original Certificate Date: 9` 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 Checklist blue sheet Legal Description: T12N R3W SEC25; N2 SE4 NE4 SE4 NW4 Parcel ID: 017-013-51 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA FR Well log is filed with Onsite (or attached) Date drilled 6/22/77 Total depth 250 ft Cased to 24.7 ft Al Sanitary seal is functioning correctly © Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 7/23119 Static water level at beginning of test 40.5 ft. Comments B. TANK DATA Age of tank(s) 12 years Tank type/material Measured operating fluid level in septic tank 48" [0-1 Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA Deep Trench Which system tested (date installed) 6//6/07 ® ALL standpipes present per record drawing Total measured depth from grade 10.0 ft (max) Measured depth to pipe invert from grade 4 ft (min) ❑ N/A — pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective ® Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Well production at time of test 0.32 gpm Water storage tank volume n/a gallons Well disinfected for coliform test? ❑ Yes No ® Coliform bacteria is Negative Nitrate 7.6 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L R Arsenic less than MRL (ND) Collected by Pannone Engineering Date of Sample 7/23/19 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 7/23/19 Results ❑✓ Pass For 3 bedrooms Fluid depth prior to test 0/0 in Water added 500 gal New depth 7/14 in Elapsed time 100 min Final fluid depth 0/10 in Absorption rate X450 gpd Any rejuvenation treatment (past 12 months) n/a If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑✓ Yes if No Community Sewer Manhole/Cleanout > 100' ❑✓ Yes if No ft ❑✓ Yes if No Neighboring Tank > 100' ❑ Yes if No ft Private Sewer/Septic Line > 25' i❑ Yes if No Absorption Field on Lot > 100' Yes if No ft Holding Tank > 100' M Yes if No Neighboring Absorption Fields > 100' Surface Water > 100' 0 Yes Animal Containment > 50' ❑✓ Yes if No ❑✓ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' [D Yes if No ft ✓❑ Yes if No ft ft ft ft ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑✓ Yes if No ft Surface Water > 100' ❑ Yes if No 67.8* ft Property Line > 5' ❑✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Yes if No ft Private Wells > 100' Yes if No Water Main > 10' ❑✓ Yes if No ft Community Wells > 200' ❑7 Yes if No _ Water Service Line > 10'✓❑ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' El Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No 0* ft Wells on Adjacent Lots: Water Main > 10' ❑ Yes if No ft Private Wells > 100' ❑ Yes if No Water Service Line > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS *Waiver on file for separation distances 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. 1 �?g COSA Checklist yellow sheet OF A� 40 A a TH ��:�L.I 'l. \✓`1^;`^Jinn k , ft ft ft Nitrate Advisory Certificate of On -Site Systems Approval # OSC191350 Subdivision:T12N R3W Sec,25 N2SE4NE4SE4NW4 A water sample revealed a nitrate concentration of 7.6 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. fir.lbmmml_, Certificate of On -Site Systems Approval # OSC191350 Subdivision: T12N R3W Sec 24 N2SE4NE4SE4NW4 This well's productivity was determined to be .32 gallons per minute. The minimum well productivity required under (AMC 15.55) for a 3 -bedroom residence is .31 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. 'I11, 1., Bailin r µsy ' O Bo X1966 A�c�i r es A�a�s ct�a 9 b6 * iw ur�org � \ Municipality of Anchorage • -• Development Services Department Building Safety Division i On -Site Water and Wastewater Program r 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 017 -013-51 COSA # O W N Expiration Date: / O — / 9 — 4 1. GENERAL INFORMATION Complete legal description N2SE4NE4SE4NW4 T12N R3W S25 Location (site address) 12921 Patrick Road Current Property owner(s) Stephanie Jaeger Day phone 345-3378 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 12921 Patrick Road Anchorage AK 99516 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 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 ❑ Community On-site ❑ 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 Pannone Engineering Services LLC Phone 272.8218 Address P.O. Box 102954 Anchorage AK 99510 Engineer's Printed Name Steven R Pannone, P.E. Date 74-07 Engineers Comments: In conducting an adequacy test, l attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. •����� the operational life of all wells and septic systems depend on the local soil condition, ground water •4 •,•` ( aa�b levels that may fluctuate during the year, and the water usage of the family being served by the system. �P,.• .."....,, , These conditions are outside the control of the evaluator of this system. All systems eventually fail and `'�+'• " 5 # satisfactory test results do not guarantee future performance of the system, nor do they guarantee that P t`?� • �+" p �, there are no hidden defects or encroachments. PES can therefore not provide any warranty for future^^ •"""""'"� performance nor give any estimate of how long the system will continue to meet the operational ..i...".„"..„".T... _...__...... .� requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed i Steven R. onnone+�? above. Any reliance upon or use of this report by any other person or parry is not authorized nor will it �#c. `�: confer any legal right whatsoever. ��'p�.� 5. DSD SIGNATURE e''it, ;Q•`•• Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: —&t �� Original Certificate Date: 7— 16-0 y % Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 198550 Anchorage, AK 99519.5550 www.muni.org/onsits (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: N25E4N_WE4NW4 T12N PZV $25 Parcel ID: 017013,51 A. WELL DATA Well type Private K A, B, or C provide PWSID # _ Date completed 6=977 Sanitary seal (Y/N) yjm Total depth _2K_ft. Cased to 24.1 ft. FROM WELL LOG Date of test M19T7 Static water level 20 ft. Well production 0.75 g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Well Log (Y/N) Yes Wires properly protected (YM) yes Casing height (above ground) min. AT INSPECTION 1/612007 40 ft. Other bacteria colonies/100 mL Arsenic: _ ugfl Date of sample: ifillQQj Collected by: SAL Pannone B. SEPTICIHOLDING TANK DATA Tank TypwMaterial Seotic/Steel Date installed 04/2007 Tank size 1000 gal. Number of Compartments; Cleanouts (Y/N) Foundation ciesnout (YM) ygp Depression over tank (Y/N) 112 High water alarm (Y/N) Na Date of pumping 6M4r= Pumper New Install C. ABSORPTION FIELD DATA Date Installed B1141"07 Soil rating (g.p.d.M2 or ftz/bdrrn) I System type trench Length 40 ft. Width 2.5 ft. Gravel below pipe 5 ft. Total depth jU ft. Eff. absorption area Mftz Monitoring tube ng Depression over field M Date of adequacy test 611412007 Results (Pass/Fad) Pass For 3 bedrooms Fluid depth in absorption field before test Q in. Water addedQ gal. New depthQ in. Elapsed Time: Q min. Final fluid depth Q in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (YM & type) New Install If yes, give date D. UFT STATION Date installed Size In gallons WA Manhole/AccM {T/N) "Pump on" level at _ in. "Pump off' level at _ in. High water alarm level at in. Datum Cycles tested Mests alarm 6 circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankfit t station on lot 109.9 On adjacent lots 101.5 Absoiption field on lot 109.9 On adjacent lots 100►' Public sewer main WA Public sewer manholeldeanout NIA Sewer /septic service line 100* Holding tank 7P Animal containment areas 100+ Manuretanimal excrete storage areas 100+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 25 Property line 42,6 Absorption field 52 Water main WA Water service line SS Surface water 97.9' Wells on adjacent lots 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 0.0 Building foundation 92.9 Water main WA Water Service line Sit+ Surface water 115.2 Driveway, Parkingivehicie storage 1 Curtain drain 50+ Wells on adjacent lots 10M F. COMMENTS G. ENGINEER'S CERTIFICATIONW•� ° � Vit .............. .iF p I ceMfy that I have determined through field inspediam and %1 review Of Municipal records that the above systems are in ; conformance with MOA COSA guidelines in effect on this date. „ "'i"' Engineer's Printed Name Steven R. Pannone. P.E. i .� s> •. <„ r POI`f GP .' e1��P°:, uo cE P149 Date 71112007� -- e4ehd.ES....... lf1 ����• COSA Fee Date of Payment Receipt Number, (Rev. 11105) Waiver Fee $ _ Date of Payment Receipt Number. N�rEr DiS. CoHP. FlAOM �� �>;.m..l rAan'uao•Ie ern.eT f V soA .AuIe .RAOI )F Q 30' ,g0' C. NI u � r � E'X/ST /Nd NOusE WELL V ty f /00•w&Z RaD/us �� SURVEY =MIMIION.+.ter aau��1• . of �.� Prepared by Robert E. Johns, Jr. &Assoc. PLAN nGTAN �E ♦��P..••• 1 (( ••'•' Professional Land Surveyors e+ r e� « �•� ^•`r « ew Idlw AV 1700 BRINK DR, ANCHORAGE. ALASKA 9.F. "r'iie"'�'�'•n a 49th Stale: Rea Loi S.F. Rea Plat fie No, /�'0. •. /0UWATION AS-MLT�••�y/ Awn c ewr a. wrr •wM1 �, ..,.. •�M.. MYl M yrc,. �+ I �.. • • �As A................ Dale SuMyeJ: Drown by CDeCAM by r .r.r�., OBERT E. JDHNS. JR. •�1♦e abone Ii1A: W.O. w..w.. ..,7-17-07 ••, 22"40 6439/7171 uq.A Dsettiplim: FINAL STRUCTURE A¢WMT L Awn c / .••• l ,. J e'w�wn r.a.w A,.www.wMl "w•~wr.,ew', A./.e..e.e.l.o..n.d••#4*01 �• + S SO, NEV.S05 TIN4 �,.r.. :rw� rr+ ^-«-we w'ww• o �haaaaaa�� . T1214 8314 S 25 ❑ wr AAMT SURVEY TYPE SYMBOLS ❑ i,o IUArm AF-WAT .... a SET REBAR ASPHALT DRAINAGE 11 I FUxunuRE AF T 11 ❑ ,AAT a%A„ ... AS T ... LOT MwvEY ... 1pPaMNNY O FOUND REBAR ir-�9 WOWPENCE ..:` CONCRETE s T CO—OA) ASSUMED ELEV. METAL FENCE PLOT PLANS t LOT SURVEYS HATE. ' IT IS THE RESPONSIBILITY OF THE BUILDER OR OWNER, PRIOR TO ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE SHOWN. FENCES. WELLS. SEPTIC CLEAPNOUTS. SIDEWALKS, DRIVEWAYS. TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE CTC., ARE SHOWN IN THEIR APPROXIMATE LOCATION, CHLY. SNOW THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN'AND LOCATED. WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. ALL DISTANCES R ' .n N UNDER NO CIRCUMSTANCES SHOULD AN AS -BUILT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE UNE& THE SURVEYOR TAKES RESPONSIBILITY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL UAOIUTY ONLY FOR THE COST OF THE SURVEY. LISTED CISTA14CES PREVAIL OVER SCALING. REPROOVCTION MAY CAUSE ERRORS IN SCALE ��A%f Municipality of Anchorage • -� Development Services Department *A1 Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 017-013-51 COSA# Expiration Date: 51/3147 1. GENERAL INFORMATION Complete legal description N2SE4NE4SE4NW4. T12N R3W. 525 Location (site address) 12921 Patrick Road Current Property owner(s) Stephanie Day phone 345-3378 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 12921 Patrick Road, Anchorage, AK 99516 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 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 ❑ Community On-site ❑ 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 Pannone Engineering Services, LLC Phone 272-8218 Address P.O. Box 102954, Anchorage, AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date 1-15-07 Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. Ilse reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. �.�r.•a•a• 'Rte operational life of all wells and septic systems depend on the local soil condition, ground water �.� - (DF IV 44 levels that may fluctuate during the year, and the water usage of the family being served by the system ��j These conditions are outside the control of the evaluator of this system All systems eventually fail and : satisfactory test results do not guarantee future performance of the system, nor do they guarantee that�� there are no hidden defects or encroachments. PES can therefore not provide any warranty for future -s. — 00 performance nor give any estimate of how long the system will continue to meet the operational requirements of the MOA DSD. 11c content of this report is for the sole benefit of the owner listed i Ak Steven R. onnone f ow above. Any reliance upon or use of this report by any other person or parry is not authorized nor will it 00 .' . No E 8149 confer any legal right whatsoever. 5. DSD SIGNATURE ��4.ffsstaP'.•' Approved for bedrooms. Disapproved. K Conditional approval for 3 bedrooms, with the following stipulations: A7utr'n escrae� -to eor�5t�u4t et 17e , 1usfe.w ter di do l _. _ ni i r Attachments: COSA Checklist X Arsenic Advisory � Septic System Advisory Maintenance Agre'eg�p�s;i Well Flow Advisory Supplemental Enginee?R�P'b11111 _ Nitrate Advisory _X Other By: Original Certificate Date: Municipality of Anchorage •� Development Services Department Building Safety Division a On-site Water & Wastewater Program 4700 aragaw Street P.O. Boa 196650 Anchorage. AK 99519-6650 www.murd.org/onsite (907) 843-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST A. WELL DATA Well type Private It A. B, or C provide PWSID # Date completed 6127119 7 7 Sanitary seal (YM) yn Total depth 250 ft. Cased to _ 24.7 ft. FROM WELL LOG Date of test 6/27/1977 Static water level 20 ft. Well production 0.75 g.p.m. WATER SAMPLE RESULTS: Well Log (YM) Yes Wires properly protected (YM) yes Casing height (above ground) 24 in. AT INSPECTION 40 ft. O . S g.p.m. Cditurn O coionies/100 mL Nitrate - mg/L Other bacteria O colonies/100 mL Arsenic: t -M uo Date of sample: 118/2007 Collected by: S.R. Pannone B. SEPTICIHOLDING TANK DATA Tank Type/Material Seatie/Steel Date installed 6/29/1977 Tank size 1000 gal. Number of Compartments 2 Cleanouts (YM) Yes Foundation cleanout (YM) W Depression over tank (Y/N) n2 High water alarm (Y/N) n/a Date of pumping 8/25/2006 Pumper Northland C. ABSORPTION FIELD DATA Data Installed 6/29/1977 Soll ratIng (g.p.d./fta or fe/bdnn) 775 System type trench Length 25 ft. Width 3 ft. Gravel below pipe _ S ft. Total depth ]Q ft. EN. absorption area Infe Monitoring tube ag Depression over field no Date of adequacy test 12/26/2006 Results (Pass/Fall) fall For I bedrooms Fluid depth In absorption field before test 12 in. Water addedg" gal. New depth¢S In. Elapsed Time: 1440 min. Final fluid depth ¢Q in. Absorption rate x ISO g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N 3 type) no If yes, give date D. LIFT STATION Date installed "Pump on" level at _ in. Datum Size in gallons N/A Manhole/Access (Y/N) `Pump off* level at _ in. Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAt t station on lot 106 Absorption field on lot 100 Public sewer main N/A Sewer /septic service line 100+ High water alarm level at Meets alarm & circuit requirements? On adjacent lots 101.5 On adjacent kits _tom+ Public sewer manhole/cleanout N/A Holding tank 75+ Animal containment areas 100+ Manure/animal excrete storage areas 100+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 20 Property line 40 Absorption field 10 Water main N/A Water service line 35 Surface water 64, Wells on adjacent lots 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 25 Building foundation _ 30 Water main N/A Water Service line 45 Surface water 76.10 Driveway, parkingNeNcie storage _2 Curtain drain - 50+ Wells on adjacent lots 100+ F. COMMENTS O. ENGINEER'S CERTIFICATION I certify that l have determined through field bspectims and review of Municipal records that the above systems are in { conformance with MOA COSH guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone. P.E. r, Cr ?149 Date 1/15/2007 . ss1�T+�CI.•'' .. � . COSA Fee S 4W Date of Payment 11�Y1 Receipt Number/moo (Rev. 11105) Waiver Fee S Date of Payment Receipt Number in. Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 070014 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on T12N R3W SEC25 N2 SE4 NE4 SE4 NW4. This inspection revealed a nitrate concentration of 5.9 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval.