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HomeMy WebLinkAboutCOLONIAL PARK BLK 3 LT 6 N2Colonial Park Block 3 Lot 6 N2 #050-301-25 Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://Www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP121217 PID Number: 050-301-25 ❑ New 2 Upgrade Name: Richard & Karen Nosich ABSORPTION FIELD ❑ Deep Trench ❑✓ Shallow Trench ❑ Bed ❑ Mound Address 19810 Second Street, Eagle River, AK 99577 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 1.2 GPD/sF 7 0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3.0 Ft. Gravel depth beneath pipe 4.OFt. Subdivision Block Lot Colonial Park 3 6 N2 Fill added above original grade 0 Ft. Gravel length 1 40.0 Ft. Township Range Section Gravel width 5.0 Ft. Beds: Number of Lines N/A Distance between lines I N/A Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area I Number of trenches Dist. between trenches From Tank Field Tank Line 400.0 Ft= 1 N/A Ft, Well 107.1 102.5 N/A N/A 97.0 TANK p Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity 1000Gal. Surface Water 100+ 100+ N/A N/A Material Number of compartments Lot Line 19.7 8.3 N/A N/A Steel 2 NA Foundation 24.4 40.4 N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain N/A N/A N/A N/A N/A Gal. Remarks Pump on level at in. Pump off level at in. High water alarm at in. Pump make and model Electrical Inspections performed by Installer PIPE MATERIAL House to tank Tank to 3034 drainfeld 3034 JR's Septic Pumping Drainfeld 3034 CO/MT 3034 Inspector Steven R. Pannone BENCH MARK (Assumed elevation) 100ft Inspection1" g/4/2012 dates: 2m 9/6/2012 Location and description 3" 9/6/2012 4"' Corner of concrete parking slab COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp 'S OP A/- Conditional Approval: Date � • • • �4�p1�� 'G. 7•I='k�� yj• Meven .R. •pa W *tae' CE 8149 ApprovedDated ..... . j h apo - -,-, SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION WAS 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 WAS IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. 3. SCOPE OF WORK: INSTALLED NEW 1000g SEPTIC TANK AND SOIL ABSORPTION SYSTEM. 4. GROUNDWATER WAS OBSERVED AT A DEPTH OF 13.0' AS EVIDENCED BY THE SOIL TEST HOLE. AN APPARENT WATER TABLE WAS NOT OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 13.0 FEET BELOW EXISTING GRADE. FRIGID INSUUTION 90 0 0 H. Ed m I 99.9 4.0 95.4 NEW 1000g SEPTIC TANK DESIGN PARAMETERS PRIMARY/RESERVE SEPTIC SYSTEM NO. BEDROOM: 3 (450 gpd) TANK SIZE: 1000g PERC RATE = 1.4 MPI SOIL RATING: 1.2 GPD/SF AREA ROD: 375 SF SYS. TYPE: WIDE TRENCH 4.0' E.D. RF: 0.50 MIN LENGTH: 37.5 LF 0 DRAIN PIPE 11N ROCK V ABOVE PIPE INV TH-1 OR 97.1 -1.D 2.5 J— 0.5' T 94.1 SW/ 4.O DRAIN ROCK CW - 90.1 —to.o BN 6.0SECTION -13.0 a �-84.1-1 -14.0 BOH 83.1 w m z z a 5 u � mo U � z o V Z USED: 40LF X 5.0' WIDE, 4.0' E.D., 7.0' TO TOTAL AREA: 400.0 SF NOTES: DRAWING DESIGN DETAILS PROFILE LEGEND —W— WATER LINE/ WELL RADIUS — SS — NEW SEPTIC m INSUTATKIN S ER FABRICt qzq NN ROCK 8" ABOVE PIPE INV U TRENCH SEE DESIGN PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 COLONIAL PARK, BLOCK 3, LOT 6 N2 RICHARD & KAREN NOSICH SECOND STREET EAGLE O RIVER, AK 99577 ABBREVIATIONS CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R.I. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BFG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE *: 41 Date �t 10/3/2012 Scale NTS P.I.D. NO 77 OW, 050-301-25 irie / PERMIT NO. Sheet /�uf CJJN, �4 3 OF 3 ` � e SECOND STREET; 1 /\F' / / Y ' DRAIN FIELD (E)1NFAILURE / ABANDONED PER CODE REMOVED ANY PART WITHIN f/1V'OFUPGRADED DRAIN FIELD NEW UPGRADED U DRAIN FIELD 44 Tl 25.9 44.3 T2 32.1 50.9 Dcl 34.6 53.3 DC2 35.6 5Z3 Cl 42.8 59.2 mi 42.6 58.8 C2 637 866 10OOg SEPTIC TANK (E) CO NEW UPGRADED U DRAIN FIELD 44 102.5 113.4 Cl 10OOg SEPTIC TANK (E) CO ABANDONED PER CODE 2 INSTALLED DCO HOUSE 103.2 INV NN 6 10' UTILITY EASEMEN 10' UTILITY EASEMENT NOTES: PAMONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 A� Date 10/3/2012 RECORD DRAWNG Scale COLONIAL PARK, BLOCK 3, LOT 6 N2 050-301-25 19810 SECOND STREET ..t CE 1 OSP1 21217 PLAN On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP121217 Tax Code Number: 05030125000 Work Type: Septic Upgrade Permit Effective Dates: August 08, 2012 to August 08, 2013 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: COLONIAL PARK Site Legal Address: COLONIAL PARK BLK 3 LT 6 N2 G:0055 Owner/Address: NOSICH RICHARD A & KAREN 19810 2ND STREET EAGLE RIVER AK 995778427 Site Mailing Address: 19810 SECOND ST, Eagle River Lot Size in Sq Ft: 17820 Total Bedrooms: 3 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: The permit includes waiver OSP1212118, allowing the absorption field to be one foot minimum from the property line. Received Issued By: (D Municipality of Anchorage Development Services Division On -Site Water and Wastewater Program meet s Department **** VARIANCE/WAIVER REVIEW **** Waiver#: OSP121218 COSA#: _ Permit#: OSP121217 PID#: 050-301-25 Legal Description: Colonial Park, Block 3. Lot 6 N2 Engineer: PES Applicant: Richard & Karen Nosich 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 1.0 feet. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ® The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of non -objection have been received from the owner(s) of the affected adjacent property. ❑ Adjacent properties are not affected by this waiver. .................................................. a . . . . . . . . . a . . . . . . . . . 0........ Waiver is Granted: X Waiver is not Granted: Date: Oda Approved by: Name of Reviewer ..............•.... a........................• •.•............................... Rec#: 03607G Amount: $200.00 Date Paid: 7/26/2012 **** VARIANCEIWAIVER REVIEW **** MUNICIPALITY F Community Development Department t Development Services Division On -Site Water & Wastewater Program i ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Phone: 907-343-7904 Fax: 907-343-7997 Parcel I.D. 090,. & (- Z!�— Property owner(s) F\t0419,ee Day phone Mailing address Kje6iO 'Zy bTk,-eT ,P\IoeP, 4K jy�77 Site address Iq-la S eoyo sT2 r Legal description (Sub'd., Block & Lot) C-ot-o.-JtIN- Pr921e ! C acs "3 GoT 4/z Legal description (Township, Range & Section) Lot Size 17, "6'rr Sq. Ft. Number of Bedrooms THIS APPLICATION IS FOR: THIS APPLICATION IS AN: (M all that apply) Initial ElAbsorption Field Septic Tank Upgrade Tank ❑ Renewal ElHolding Privy ❑ Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Z -OT G i ✓ -ft} /}I�iS[)QP7tD F1C`Le� 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. re or property owner or autnonzeo agent) Permit/Rush Fees: 53 0 w Date of Payment: 2' 2L Ml Receipt Number: O,�(nOwn Permit No. asPlala/1 Waiver Fees: (d Date of Payment: /;?6L/a Receipt Number: rjzlP U74 Waiver No. 65 P/ a/a t'? G\Bui1ding%0n SiteTorms\Client FormsTermit App_010411.doc (Rev. 1A 1) Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@oanengak.com August 2, 2012 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: Colonial Park, Block 3, Lot 6 N2 Septic System Permit Upgrade Request Ladies and Gentlemen: I am writing to request a permit to construct an upgrade system be issued for this property. The proposed systems will serve an existing three (3) bedroom house. Currently the lot is developed. The existing drain field is in failure and will be abandoned per code. The new drain field will be built in approximately the same location; any part of the existing field within 10' of the new drain field will be removed. The lot is served by a private well that is located over 100' from the new system. The surrounding lots are also served private wells that are located over 100' from the new system. 1. Soils. One test hole was excavated by Pannone Engineering Services in July, 2012, and the ground water was monitored for seven days. Ground water was monitored at a depth of 13.0' below grade. Bedrock was not encountered. It is my opinion, based on the results of the percolation tests and overall soils appearance; an application rate of 1.2 gallons/day/square feet should be used for a conventional wastewater system. 2. Soil Absorption System Design. a. See Sheet 2 of the design package 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The drain field will be installed in a relatively flat area on the lower portion of the lot. S. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On -Site k4 ding: P,0, Box 100217,. Anchol ago, AK 99510-0217 Physical: 332 East I0anor, Anchorage., AK 99501 Telephone: {9071 272-5218 FAX: (907) 272-8211 Page 2 of 2 Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of the surrounding or existing lots. There are nVwells 0rseptic systems within 1OOfeet Ofthe proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R.Pannone, P.E. Ovvner/CivilEnQineer Attachments -Soils Log -Septic System Design &1a||ing:P.O.Box lD8%17.Anchorage, AK9B51Q-0217 phydom|: 3]ZList Manor Ave, Anc})pra&e,AK99SD1 Telephone: (907) 272-8218 FAX: (907) 272-8211 NOTE: ALL WELL RADII WITHIN 20' OF THE SEPTIC TANK OR DRAINFIELD SHALL BE STAKED BY A LISCENSED SURVEYOR � g WELL (E) M —AA I/ DRAINFIELD (E) IN FAILURE 103.0 ABANDON PER CODE -- REMOVE ANY PART WITHIN \ \ SECOND STREET 10' OF UPGRADE DRAIN FIELD ------ UPGRADE DRAIN FIELD (P) o 40LF, 5'W, 4'ED, 7.0'TD a 103.7 s1 We t WELL (E) ... _.. 105.8 w �..... TH-1 116.5 WELL (E) o 1000g SEPTIC TANK (E) 10.4 - ABANDON PER CODE 1000g SEPTIC TANK (P) INSTALL DCO 3BR HOUSE (E) �7y S1 108.8 \ W� ��- W W I\N/ 6 100.4 W w 10' UTILITY EASEMENT ' 10' UTILITY EASEMENT 3 41 WELL (E) '7 _ NOTES: PANNONE ING SVC LLC OF A ��l �.'qkl Date a/s/2ot2 FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 (�• -A 1 /�g�Q !yf� 49TH *�/ /.... / ,Steven • Scale 1"=50' COLONIAL PARK, BLOCK 3, LOT 6 N2 P.I.D. NO 0-301-25 RICHARD & KAREN NOSICH 19810 SECOND STREET EAGLE RIVER, AK 99577 .'Pann Orme / / l�P�� . GE 8149 i ���f0� PERMIT No. osPlzlzn Sheet PLAN l� �OFESSIO��-` 1 OF 3 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: WELL RADII FLAGGING. INSTALL NEW 1000g SEPTIC TANK AND SOIL ABSORPTION SYSTEM. 4. GROUNDWATER WAS OBSERVED AT A DEPTH OF 13.0' AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 13.0 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. RIGID INSULATION FILTER FABRIC 4° 0 GRAIN PIPE / ORl N ROCK 5" ABOVE PIPE INV TH-2 4.0 wim Gly/ GRAIN ROCK —5.0--1 —10.0-6.0 SN SECTION —13.0 CL —14.0 e,,,, DESIGN PARAMETERS PRIMARY/RESERVE SEPTIC SYSTEM NO. BEDROOM: 3 (450 gpd) TANK SIZE: 1000g PERC RATE = 1.4 MPI SOIL RATING: 1.2 GPD/SF AREA ROD: 375 SF SYS. TYPE: WIDE TRENCH 4.0' E.D. RF: 0.50 MIN LENGTH: 37.5 LF USE: 40LF X 5.0' WIDE, 4.0' E.D., 7.0' TD TOTAL AREA: 400.0 SF LEGEND W WATER LINE/ WELL RADIUS SS — NEW SEPTIC m 0 0 _ V V O� V U O � I ER FABRIC Z AIN ROCK 6' ABOVE PIPE INV O U 3 1000g CLEAN OUT NO. M# MONITOR TUBE NO. R. 1. SEPTIC DCO DOUBLE CLEAN OUT .4 ' TANK (P) FS FLOW SPLITTER BFG BELOW FINISH GRADE PROFILE ORIGINAL GRADE DESIGN PARAMETERS PRIMARY/RESERVE SEPTIC SYSTEM NO. BEDROOM: 3 (450 gpd) TANK SIZE: 1000g PERC RATE = 1.4 MPI SOIL RATING: 1.2 GPD/SF AREA ROD: 375 SF SYS. TYPE: WIDE TRENCH 4.0' E.D. RF: 0.50 MIN LENGTH: 37.5 LF USE: 40LF X 5.0' WIDE, 4.0' E.D., 7.0' TD TOTAL AREA: 400.0 SF LEGEND W WATER LINE/ WELL RADIUS SS — NEW SEPTIC TRENCH SEE DESIGN :::: _ •i ! CU m INSULATION _ TH p ZzG ER FABRIC Z AIN ROCK 6' ABOVE PIPE INV U TRENCH SEE DESIGN :::: _ •i ! CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R. 1. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BFG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE NOTES: PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 .��\\, OF A� �� ""' .; li /rGj�P .YScale j*:49TtH ..... .. .. .:.. • • • • • •. • • Ste R. onnone ? �n� CE 8149 .��� t1 c l`'�FESS(O�P��'� Date 97672012 FOR CONSTRUCTION NTS COLONIAL PARK, BLOCK 3, LOT 6 N2 RICHARD &KAREN NOSICH 19810 SECOND STREET EAGLE RIVER, AK 99577 P.I.D. NO 050-301-25 PERMIT NO. OSP121217 DESIGN DETAILS sheet 2 OF 3 TEST HOLE OR ORGANICS 2 3 4 SW/ GRAY SAND 5 GW AND GRAVEL 6 7 8 9 10 11 SOILS LOG - PERCOLATION TEST SITE PLAN SLOPE X TH _. SECOND STREET 5 >Q 't 3 WELL (E) o' 0 L3BR OUSE _.. (E) SLOPE —w— �—TH-1 TH X READING SM SILTY SAND 2 NET DROP 1 13 --- , 7!24/2012 _ CL 2 GRAY/ BLUE WAS GROUND WATER 14 CLAYEY SILT ENCOUNTERED? N BOH 15 1:29 IF YES, AT WHAT 16 --- DEPTH? -DRY-' 17 8MIN DEPTH TO WATER AFTER MONITORING? -13.0'- 18 5 DATE: 7124112 --- DATE PERFORMED: 7117/12 6 _. SECOND STREET 5 >Q 't 3 WELL (E) o' 0 L3BR OUSE _.. (E) SLOPE —w— �—TH-1 TH X READING DATE CLOCK NETTIME WATERTIME LEVEL READING NET DROP 1 7117112 1:24 --- 3.63 --- 2 1:29 5 MIN 9.65 (DRY) 6.02 3 1:29 --- 3.63 --- 4 1:37 8MIN 9.65 (DRY) 6.02 5 1:37 --- 3.63 -- 6 1 1:45:30 1 8.5 MIN19.65(DRY)6=02 PEROLATION RATE 1.4 (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 3 FT AND 4 FT N11 COMMENTS: Test hole excavated by FLINTSTONE ENTERPRISES. Prec hole was presoaked. Test run for at least one hour. Last 3 readings reported 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. NOTES: Ppgo�ENSVC, r(���Date 6/6/2012FOR CONSTRUCTION P.O. 104 ANCHORAGE, 99510 PHONE (907) 272-8218 FAX (907) 272-8211 //rg�p 9+�+ Scale NTS *:.... ... :* P.I.D. NO COLONIAL PARK, BLOCK 3, LOT 6 N2 050-301-25 RICHARD & KAREN NOSICH Steven R. Pannome PERMIT No. 19810 SECOND STREET '�9c'• CE 8149 % OSP121217 SOILS LOG EAGLE RIVER, AK 99577 f�� �A� ••••• aSsik�� sheet 3 OF 3 *y ' by ooc co. ObsSULLI"N. WATER WELLS P.O. 00X 272, CHUGIAK, ALASKA 09567 • TELEPHONE 68&2759 OWNER OF LAND Lr NA.CG 4U A# 0 ADDRESS LEGAL DESCRIPTI01'}., `� '2 DATE • Started •� ' Ended -- PERMIT NUMBER KIND OF FORMATION: DEPTH OF WELL 3 O STATIC LEVEL OF WATER FT. DRAW DOWN FT. GALS. PER HR /0 KIND OF CASING 6 4- O Q -7- Ekv.- D' From Ft. I,_a Ft. ilE<du edE l/ From 't Fl. 111-L36' Ft. Tice -1T Sf-J'7 From Ft. to ('+ Ft. ' / Cod K4 From,/ 6 Ft. to-2Y—Ft. CY-4 i�1:7 611?AlyeL. From L34 a Ft. to 3 °7� Ft. yoV From 12:� Ft. to L� Ft. , From Ft. to Ft. From .- ft io Ft From Ft. to -!JL Ft. From Ft. lo—Ft- From o Ft_ From Ft. to n �--Ft. f'SOJ<__ From Ft. to Ft. From r `1 Ft. taQ L_..Ft. %� P%1AI f From Ft. to Ft. From Ft. to Ft. i9OV L,0t=g .Sr From Ft. to Ft. From `� F Lj� - t940" ` t. to Ft S�, From Ft. to . Ft. _ a -• From Ft. to p Ft. G'� From Ft. to Ft. From Ft.to Ft. From ' Q' Ft. to -R& Ft. Srlry' 0 c From Ft. to Ft. £ Ab J4 oc:A' S From:) X l Ft. to27 . F[. T/C H r `t R'O From -' i Ft. toz %a Ft. /7'Al�l 2' -2 From .r" �Ft, to 7'/ v h J'r�'� ' • 3©�Ft. MISCL. INFORMATION: From From Ft. to—Ft. From S. Ft. to Ft. 71 From -Ft. to Ft, From o Ft. Ft. to—Ft.— From Ft. to Ft. From Ft. to Ft. N From Ft. DRILLER'S NAME -1-- • Municipality of And On -Site Water and Wastewater F (907)343-7904 Parcel I.D. 050-301-25 1 Certificate of On -Site Systems Ap 31 ZCi6 Expiration Date: (^ 1 —f GENERAL INFORMATION Complete legal description Colonial Park, Block 3, Lot 6 N2 Location (site address) 19810 Second Dr. Current Property owners) Richard & Karen NOSIch Day phone Mailing address Real Estate Agent 19810 Second St. Eagle River, AK 99577 2. TYPE OF DWELLING: 0 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: TYPE OF WASTEWATER DISPOSAL: Individual Well (] Individual Fx� Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance Received by: Date: q10112Cjb ms, nmess COSA to be released to a e4erwisvequested by the engineer. COSA Fee $ / Waiver Fee $ _ Date of Payment Date of Payment Receipt Number O Receipt Number COSA# 05C)Gl165' Waiver# t 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixnd as of the validation date shown below. I verify that my investigation, based on procedures outlined in the Certificate of On-Sile'Sys s"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 thetimeof 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. Name of Firm Pannone Engineering Services LLC Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Phone (907)272-8218 Date 3/31/2016 d-onl ik • Steven R. �a none *4. CE -8149` Conditional approval for bedrooms, with the following stipulations: Original Certificate Date: —/ — The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSAbluesheet r If more than 1 septhp system is on the,lot: CMA'Checklist# + of i Structure served by.this system Certificate of On-Site Systems Approval Checklist Legal Description: Colonial Park, Block 3, Lot.6 N2 Parcel ID:050-301-25 A. WELL DATA Well type Private If A, B, or provide PWSID # Well Log (YIN) Y Date completed 4/1 /1982 -Sanitary seal (YIN) Y Wires properly protected (Y/N) Y Total depth 330 ft.- Cased to.330 ft. Casing height(above ground) 12+ in. FROM WELL LOG: AT INSPECTION Date of test 4/1/1982 3/22/2016 Static water level 290 ft 295 Well production 10 9-P.M. 5.3+ 9- p.m-WATER SAMPLE RESULTS: Coliform Neg: colonies/100 mL Nitrate 3.66. mg/L Arsenic ND ug/L Date of sample: 3/22/2016 Collected by: PBS`` B. SEPTIC/HOLDING TANK DATA Tank.Type/Material, Septic/Steel Date installed 9/6/2012 . Tanksize1,000 gal NumberofCompartments 2- Cleanouts(Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N)' N High water alarm (YIN) N Date of pumping 3/22/2016 Pumper,JR'S Pumping C. ABSORPTION FIELD DATA Date instailed 9/6-/2012 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.2 GPD/SF System:type Shallow Trench Length 40 ` ft. Width 5 ft. Gravel below pipe 4.. ft. Total depth- 9'2 , r� ",4r: absorption area 400 ft2 - Monitoring tube Y_ Depression over field,!N Date of adequaoyiest � X201 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in abs .rption field befere test 13 in. Water added 463 gal. New deptks 21 in. 170 Elapsed Tirhe: min. Final fluid depth 13 in. Absorption rate >= 450+' d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. LIFT STATION. Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off" level at in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION bISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100+ On adjacent lots 100+ Absorption field on lot 100+ On adjacent lots 100+ Public sewer main 75+ Public sewer manhole/cleanout 100+ Sewer /septic service line 25+ Holding tank 100+ Animal containment areas ` 50+ Manure%animal excrete storage areas, 00+ SEPTICIHOLDING TANK ON LOT TO: Building foundation 5+ Property line } Absorption field 5+ Water main 10+ Water service fine 10+ Surface water 100+ Wells on adjacent lots. 100 ABSORPTION FIELD ON LOT TO: Property line 1 Building foundation 10+ Water main 10+ Water Service line �+ Surface water 100+ Driveway, parking/vehicle storage. 10+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS *Waiver on file WR#OSP121218 G. ENGINEER'S CERTIFICATION - ry I certify that I have determined through ireld'inspecfions and review of Municipal records thatJh,®, above systems are in conformance with MOA.COSA guidelines in effect on this date. e Engineer's Printed Name Steven Pannone:${even annai.: • • Date 3/31/2016CE ' 814 COSA canary sheet_2-6-15.doc - �89's�-oo.� i3z o0 . Y 0-mWxttu n ASSuUMB5 LAN 5MVEXIAG 694-0829 I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE:� Z FOLLOWING h t'fl/i9 gED PROPERTY: '/llam� DATE zo A' Q % OF ;A AND THAT NO ENCRHNiENTS FAUST t7CCEPT AS .'`t ;_ t �U.' *8 INDICATED. IT IS THE RESPONSIBILITY OF THE H i . r — OWNER TO DETERMINE THE EXISTENCE OF ANY GRID EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- Daene m A a per$ VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FS: i � L5- 18 '4F ANY DATA HEREON BE USED FOR" CONSTRUCTION �3�z7 �`� �1�`�S+T �' A OF FENCE LIN OR FOR ESTABLISHING BOUND- " ARY LINES. DRAWN-° R• •1i�a r. g