HomeMy WebLinkAboutKASILOF HILLS BLK 8 LT 6KasI*Iof Hills
Block 8
Lot 6
#015-132-09
Municipality of Anchorage
On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP161244 PID Number: 015-132-09-000
Dwelling: ❑■ Single Family(SF) ❑ Duplex(D) ❑ Multiple(SF and/or D) Project: ❑■ New ❑ Upgrade
Name:
Adam Jensen ABSORPTION FIELD
Address ❑■ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound
PO Box 111846, Anchorage, AK 99511 ❑ Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
230-3409 4 0.8 GPD/SF 10.5 Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot 3.5 Ft. 7 Ft.
Kasilof Hills Sub 8 6 Fill added above original grade Gravel length
Township Range Section 0-1 Ft. 54 Ft.
Gravel width Beds: Number of Lines Distance between lines
SEPARATION DISTANCES 3 Ft. - Ft.
To Septic Absorption
Lift Station
Holding Sewer Total absorption area Number of trenches Dist.between trenches
From Tank Field Tank Line 756 Fe, 1 N/A Ft.
Well >100' >100' >100' NA >25' TANK E I Septic ❑ S.T.E.P. ❑ Holding ❑Other
Manufacturer Capacity
Surface Water >100' >100' >100' NA Anchorage Tank 1 ,250 Gal.
Material Number of compartments
Lot Line >5' >5' >5' NA Steel Two
Foundation >5' >10' >5' NA NA LIFT STATION
Manufacturer Capacity
Curtain Drain None Gal.
Pump on level at Pump off level at High water alarm at
Remarks
in. in. in.
Pump make and model Electrical Inspections performed by
PIPE MATERIAL House to tank D3034 Tank to D3034
Installer drainfield
Red Dog Excavation Drainfield D3034 CO/MT D3034
Inspector Anderson Engineering BENCH MARK (Assumed elevation) 100.0 ft
Inspection Location and description
dates: 1s� 11/7/16 2'� 11/8116
3rd 4th Highest Point on Large Boulder SW of Trench.
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL ...n-, OF A� �
Conditional Approval: Date ••6,7.: R .'f`
'*; 49TH f.,,,,4 .....7 •*i
silt
DD„ E. A -
�E-4381 `4':
.
App e !IN\ 1,--c-gl'%-- Date (2.--QT"/"/ 11%;#0F,5` ���
Inspection Report_9-1-12.doc
Municipality of Anchorage Page 2 of 3
DEVEOPMENT SERVICES DEPARTMENT
Permit No.: OSP161244 4700 Bragaw Street Anchorage, AK. 99519-6655 - 343-7904
On-Site Wastewater Disposal System or Well Inspection Report PID No. 015-132-09
KASILOF HILLS SUBDIVISION
LOT 6, BLOCK 8 I
I I
Lot 12 I Lot 7 I 30
N89°00'00" W 192.97 I
a)
>
Well i � L
A B ®� 0 I
/1
S1 68.8' 70.2' E. / O
S2 76.1' 77.8' O C5 l
C4 94.5' 84.6' E
C5 77.8' 98.3' O M2 / / O
Mt 92.2' 85.5' 0 (t] / in s.
M2 75.8' 94.1' O W AlteSrniteate / /
/ TH/0s1
d)
Lot13 a - FCO Four
Z OT M1 Bedroom W I
Home -
C. O
O
O
O do O
Boulder TBM Z
Highest Point El. 100.0
L
- _
_ _ _ _ _ 10' Utility Easement
N89°00'00" W 190.35 •�.��� "'��•'+
I ��
Lot 14 I I 30 .• . .•••........q '••`9.•
I Lot 5 %G'•'/ ,1— ••
LEGEND I I � :� �� •�:
�r•..�4r 49th
M1 — Monitor Tube •
� �`'�`� �- �
FCO — Foundation Clean Out ,S C•; MICHAEL E.ANDERSON
TH — Test Hole ••%:•, Na. CE-4381 ��
PLAN AS—BUILT S<°"P.... ----74.7"..<",
C4 — Clean Out SCALE 1"=40' •.•�� �ssi�igi,
Municipality of Anchorage Page 3 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-6655- 343-7904
On-Site Wastewater Disposal System or Well Inspection Report
Permit Number: OSP161244 PID No. 015-132-09
Finished Grade
Existing Ground
1ài
) ( 00
I
I
1,250 Gallon 1�
Septic Tank 1
96.75 97.6
= N Lo
U g I— g U
7 - 99.9 - -
Finished Grade /
Existing Ground
Geotextile Fabric
96.4 \ Drainfield Rock ~,,,, 96.4
89.4 No Groundwater 89.4
- 11-7-16
I
54' (Trench Length)
41
•
1_ y
' 49th f iN • •
• I`
% 2
PROFILE AS BUILT •/� ••
MICHAEL E.ANDERSON ..#
`���' NO. CE-4361
No Scale ••N' F SSI, � `
igtri11w �s��
MUNICIPALITY OF ANCHORAGE iogr�rrriiii
,� �
DEVELOPMENT SERVICES DEPARTMENT ���r F:......• ••., N.
4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650 L ;'...49th °t♦#t
SOILS LOG — PERCOLATION TEST y44.- ` }}},,,
•
Icy';MICHAEL E. ANDERSON ;j
LEGAL DESCRIPTION: LOT 6, BLOCK 8, KASILOF HILLS SUBDIVISION • as
�* °. CE-4381
PERFORMED FOR: ERIC TREVITHICK
....k.:;;; snik... ••••,0.--4;
PERFORMED
DATE: 6/12/16 PROJECT No.: .Missal"
PARCEL ID#: TECHNICIAN: J. MILLETTE Professional Engineers Stamp:
DEPTH TEST HOLE # 1
(feet)
,7/ OL/OG SLOPE SITE PLAN
1
2
.. e e 4
d
3 N
m
m
4 ° e • U
,r..
5 — e ,
z ;EE SITE PLAN
6 —/'
s
d y
7R SILTY GRAVEL WITH SAND
A
8 GW/GM
. <20% SILT
9
WAS GROUND WATER ENCOUNTERED? No
10
IF YES @ WHAT DEPTH''
DEPTH OF WATER AFTER MONITORING: NONE SEE SITE PLAN
11- • DATE OF MONITORING: 6/20/201(?
•M
12 .* ••°' DEPTH To
13 : _ DATE READING GRO S TES)TIME NETUTEST ) WATER NETDROP
(INCHES)
14 ,...4'.4 6/12 TEST HOLE PRESOAKED PRIOR TO TESTING:
15 '.» . ` 1 2:08 1.25"
2:38 30 3.75" 2.50"
4BOH 17' 3 2:39 1.38"
1 4 3:09 30 3.88" 2.50"
18— 5 3:10 1.25"
19— f 6 3:40 30 3.75" 2.50"
20
PERCOLATION RATE: 12 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN: 4.0 FT. and 5.0 FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST HOLE DEEPENED TO 17' ON 11/7/16 TO VERIFY
LACK OF BEDROCK.
TEST PERFORMED BY ANDERSON ENGINEERING TECHNICIANS. I,MICHAEL E.ANDERSON CERTIFY THAT
THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON
THIS DATE: 6/27/16
. Development Services Department
•
• .7 Building Safety Division ,o. e,,
I'll On-Site Water & Wastewater Program `�
4700 Elmore Road =
P.O. Box 196650 Anchorage,AK 99507 �' c ETV
Mark Begich
Mayor wyrw,muni.arq/onSite
(907)343-7904
Well Log
Permit Number: OSP161244 Date of Issue:Sep. 10, 2016
Date Started: 5-31-17 Date Completed:6-2-17 Is well located at approved permit location?U Yes U No
Legal Description: Kasilof Hills BLK81T6 G:2541
Property Owner Name& Address: Jensen Adam Site: 10740 Stroganoff Dr.
P.O. Box 111846
Anchorage,AK 99511
Borehole Data: Depth (ft) Method of Drilling LJ air rotary U cable tool
Soil Type,Thickness&Water Strata From To Casingtype:steel —
_ 3P •
stickup 1 0 2 -1 Wall Thickness:_250 inches
fill — __ 2 20 Diameter 6 inches Depth: 30 feet
t Liner Type: PVC
sand &gravel 20 30 Diameter: 4.5 inches Depth: 25'to 305'
bedrock 30 305 Casing stickup above ground:—2 _feet
Static water level(from ground level):__45_feet
Pumping level:__ _ feet after
__ hours pumping gpm
__— ____ ___ __ Recovery Rate: 1_ gpm
Method of Testing: airlift.
' _ Well Intake Opening Type:
1-1 Open End RI Open Hole
WATER Q • ITY TESTING n Screened Start feet Stopped feet
• '• ••• L..,r :-. , i i —— -- n Perforations Start___ feet Stopped_"_feet
Nitrates_ •Q mg/L - . (grout Type: Bentonite— Volume:granules
Arsenic NP J Depth: 20' Start 0 feet Stopped 20 _feet
Pump: Intake Depth 290 feet
Pump size 3/4 hp Brand Name Webtroi
Well Disinfected Upon Completion? n Yes[1 No
Method of Disinfection:chlorine tablets
______- _____ Due to shallow-bedrock,4.5" liner was
Comments:grouted into the 6" casing per muni code.
___.. Well Driller: Hefty Drilling, Inc.
-- -------- 3540 Akula Dr.
Water Sample Results: ---- ---
Anchorage, AK 99516
Arsenic: ___ug/L ---
Nitrates:
_Nitrates: _mg/L
Total Coliform Bacteria: colonies/100mL .
Other Bacteria: co1/100m1,
Attention: The well driller shall provide a well log to DSD within 30 days of completion.
w
Development Services Department
Building Safety Division •
On-Site Water & Wastewater Program o}G ,e
4700 Elmore Road ui
.
P.O. Box 196650 ` La l I I c
Mark Begich Anchorage, AK 99507 SA ETY
Mayor www.muni.org/onsite
(907)343-7904
Pump Installation Log
Well Drilling Permit Number: 16 1.21Date of Issue: 5'Q. /0, 20 '
Parcel Identification Number: 5 rtt `. /0714o ST r.)50.--1 or( pc,
Legal Description Property Owner Name& Address:
45114 Was S1V LT ( .){n 5eu) A 1:14.
6;2541 p,v' 4a* in 9k(t,
_ it'fc5 ( ,41( 195?)
Pump Installation Date: -. 1 7
Pump Intake Depth Below Top of Well Casing 90 feet
Pump Manufacturer's Name: W{64G,1
Pump Model: 751 e--, .2 30v. .2 u,
Pump Size 7/y hp
Pitless Adapter Burial Depth: /d feet
1
Pitless Adapter Manufacturer's Name: (e*ij jl 1510
Pitless Adapter Installer: VA
Well Disinfected Upon Completion? Yes H No
Method of Disinfection: CI f,i;a L
Comments: f
Pump Installer Name: bhnh V4
7
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
A
On -Site Water & Wastewater 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: OSP161244
Tax Code Number: 01513209000
Work Type: WellSeptic Initial
Permit Effective Dates: September 10, 2016 to September 10, 2017
Design Engineer: ANDERSON ENGINEERING
Subdivision: KASILOF HILLS
Site Legal Address: KASILOF HILLS BLK 8 LT 6 G:2541
Owner/Address: JENSEN ADAM
PO BOX 111846 ANCHORAGE AK 995111846
Site Mailing Address: 10740 Stroganof DR, Anchorage Lot Size in Sq Ft: 28744
Total Bedrooms: 4
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank N Privy Y 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.
A test hole completed to a minimum depth of 16' is required prior to construction.
Received
Issued By
Municipality of Anchorage S
o�.i,:����������
P.O. Box 196650 • 4700 Elmore Road
Anchnraae. Alaska 9951MR50 ® I9071 343-79!14 • Fax (9071 343-7997
Development Services Division
On -Site Water and Wastewater Program
**** VARIANCE/WAIVER REVIEW ****
Waiver#: OSV161104 COSA#: Permit#: osa161244
PID#: 015-132-09
Legal Description: Kasilof Hills Block 8 Lot 6
Engineer: Anderson Engineering
Applicant: Adam Jensen
Your request for a waiver of the required 50 feet horizontal separation from the absorption field
to the excessive slope has been approved. The approved separation distance is 0.0 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 nonobjection have been received from the owner(s) of the affected
adjacent property.
® Adjacent properties are not affected by this waiver.
...............................................................................
Waiver is Granted: X Waiver is not Granted:
Date: Id �� Approved by:
Name of Reviewer
............................................................ .................
**** VARIANCE/WAIVER REVIEW ****
MUNICIPALITY OF
Community Development Department
Development Services. Division
On -Site Water & Wastewater Program
ANCHORAGE RUSH!
ON-SITE SEWER/WELL PERMIT APPLICA
Parcel I.D. 015-132-09
Property owner(s) Adam Jensen
Mailing address P.O. Box 111846 Anchorage, AK 99511
Site address 10740 Stroganof Drive Anchorage, AK 99516
Phone: 907-343-7904
F 6 07 48 "2- 97
h
N ° RUSH! A�
a AUG 2 9 2016
Day phone
Legal description (Sub'd., Block & Lot) Kasilof Hills, Block 8, Lot 6
Legal description (Township, Range & Section)
Lot Size 28,744 Sq. Ft. Number of Bedrooms Four (4)
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(® all that apply)
Absorption Field
Fx�
Initial 0 Single Family (SF)
Septic Tank
Q
Upgrade F-1(w/wo ADU)
Holding Tank
ElRenewal
Duplex (D)
ElMultiple
Privy
❑
Dwellings
(SF and/or D)
Private Well 0
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or
Permit/Rush Fees: 412% f2_ V. (/0 Waiver Fees: Zl5+ JZct
Date of Payment: $1$0�/(p Date of Payment: 013/ 714
Receipt Number:
Permit No. 5P/1.4ati
Permit App_9-1-12.doc
T
Receipt Number: C2Z3?7G
Waiver No. 051/16/10 q
x❑
t
ANDERSON ENGINEERING
P.O.BOX 240773
ANCHORAGE, AK 99524
5224773 677-7766 FAX
August 26, 2016
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 6, Block 8, Kasilof Hills Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer
The owner of Lot 6, Block 8, Kasilof Hills Subdivision intends to construct a new four-
bedroom home on the lot. We are therefore requesting a permit be issued for the
construction of a new well and septic system to accommodate the home. The attached
Site Plan and backup documentation identify the location and configuration of the
proposed well and septic system along with the alternate site. Also identified on the
plans are the existing wells and septic systems on surrounding lots. No conflicts exist
between the proposed septic system and well or septic systems and wells on adjacent
lots. Drainage arrows and surface contours are shown on the site plan showing the
grade and direction of flow on the lot. The drainage pattern will not be changed as a
result of this project.
The test hole placed on the lot in the area of the absorption trench and alternate site
indicate silty gravel with sand (GW/GM). The percolation rate of the soil was
determined to be from 12 minutes per inch. No groundwater was found during the
placement of the test hole and none was noted during the monitoring period. An
application rate of .8 gallons per day per square foot was used in the design of the
absorption system. We are proposing to place a new 1,250 -gallon septic tank and a 54'
long by 3' wide by 7' effective depth absorption trench to treat and dispose of the
effluent generated in the house. The elevation of the distribution line in the absorption
trench will be 3' below the surface and the total depth will be 10'. A minimum of 3' of fill
or 2" of insulation and 2' of fill will be placed over the absorption trench and 4' over the
septic tank.
The ground surface on the lot in the area of the septic system is on a slope greater than
25% The slope then continues to the west at grades less than 25%, but eventually
Lot 6, Block 8, Kasilof Hills Subdivision
August 26, 2016
Page Two
steepens toward the property line. The new trench will be constructed parallel with the
slope as much as possible in conformance with Municipal requirements. The new
septic system will be constructed a minimum of 100' from all wells and any surface
water and 10' the proposed and existing water services in the area.
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
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.
Sincerellyy, ® a
Michael E. Anderson, P.E.
Attachments
V 49th wr'v V
MICHAEL E. ANDERSON
NO. CE -4381 .
10
11
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_KASIILyOF HILLS SUBDIVISION
/ �OT 6, BLOCK 8 /
MICHAEL E. ANDERSON f)t,-i
NO. CSE -4381A R
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'•. yf�i w
o STROGANOFCD
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LOT 6, BLOCK 8, KASILOF HILLS SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Four Bedroom House Deep Trench System
Perc. Rate: 6-15 Min./Inch 1,250 Gallon Septic Tank
Application Rate: .8 GPD/SF 7' Drainfield Rock
4 Bedrooms X 150 GPD/.8 GPD/SF (Application Rate) = 750 SF Absorption Area
750 SF/16 SF/LF = 53.57 LF Trench Length
THEREFORE: Construct a New 54' Long x 3' Wide x 7' Effective Depth Absorption Trench.
Flow Line Elevation in Trench to be 3' Below Original Ground Surface. Total Depth to be
10' Below Existing Ground. Place 2" of Insulation and 2' of Cover Over Absorption Trench
or Provide 3' of Cover Over Trench. Place 4' of Cover Over Septic Tank.
Place Topsoil &
Revegetate Disturbed Area
Natural
2'6" Backfill Geotextile Fabric
6" I 4" Perforated
t PVC (Holes Down)
7'0"
3'
Drainfield Rock
TYPICAL DEEP TRENCH SECTION
(NO SCALE)
NOTE: Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock. i 1 49th
......... . .
Minimum 4' Separation From Groundwater. i
�....... ................. ................
Minimum 100' Separation From Wells in the Area. I. micHne e.nNoeasoN <'@
Minimum 100' Separation From Surface Water or Streams. f�� .. No. CE -4381 _.
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
August 31, 2016
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 6, Block 8, Kasilof Hills Subdivision
Absorption Trench to Slope Waiver
Dear Onsite Services Engineer:
Lot 6, Block 8, Kasilof Hills Subdivision has limited area for construction of a septic
system due to steep surface slopes t and the placement of the well. The most suitable
area is at the location shown on the Site Plan which is on a slope greater than 25%.
The ground suface slope flattens to the west to less than 25% and the imaginary 25%
slope from the edge of the trench and 2.5' above the flow line for both the primary and
alternate sites does not daylight for 35'.
The soil encountered in the test hole is silty gravel with sand (GW/GM) which is very
good for the absorption of septic effluent. Most of the effluent absorption will be down
with little or no migration of effluent to occur toward the steep slope. We hereby
request the waiver be issued allowing the primary and alternate site to be constructed
on a slope greater than 25%.
Sincerely, Q
Michael E. Anderson, P.E.
'9'
0• 49th 111�_°
MICHAEL E. ANDERSON
No CE -4381
Attachment
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
•J�� OF '�/
E
NET TIM(MINUTES)
EPTATH To
DWER
(INCHES)
�•'
6/12
4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650
��
1
49th
SOILS LOG - PERCOLATION TEST
',".... "" "' ' ""`'"'
/..................... I.... ..... r
MICHAEL E. ANDERSON j
/1�1
2:38
LEGAL DESCRIPTION: LOT 6, BLOCK 8, KASILOF HILLS SUBDIVISION
NNoo. CE -4381 '~�
�..
3.75"
PERFORMED FOR: ERIC TREVITHICK
1�M`A! .. ...... •••
♦�r�r
DATE: 6/12/16 PROJECT No.:
���••
PARCEL ID#: TECHNICIAN: J. MILLETTE Profession al Stam:
DEPTH
TEST HOLE # 1
(feet)
3:09
30
3.88"
OL/OG
J
Z� SLOPE
SITE PLAN
2
1.25"
3
Q.
6
3:40
m
3.75"
4
m
a
5
' < z
SEE SITE PLAN
6
<. '
du
7'e
SILTY GRAVEL WITH SAND
8
GW/GM
9
4 <
d' e <20% SILT
10
.e ` P WAS GROUND WATER ENCOUNTERED? No
d IF YES @ WHAT DEPTH
' DEPTH OF WATER AFTER MONITORING: NONE
0
1 I
^' DATE OF MONITORING: 6/20/9016
SEE SITE PLAN
12
e d:.
13
e.
a
DATE READING
e .:
(MINUTES)
14
15
e e BOH
16
17
18
19
20
PERCOLATION RATE:
12 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN::
4_0 FT. and 5_0 FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST
PERFORMED BY ANDERSON ENGINEERING TECHNICIANS.
1, MICHAEL E. ANDERSON CERTIFY THAT
THIS
TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE
AND MUNICIPLE GUIDELINES IN EFFECT ON
THIS
DATE: 6/25/16
GROSS TIME
E
NET TIM(MINUTES)
EPTATH To
DWER
(INCHES)
NET
(INDROP
CHES)
6/12
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
2:08
1.25"
2
2:38
30
3.75"
2.50"
3
2:39
1.38"
4
3:09
30
3.88"
2.50"
5
3:10
1.25"
6
3:40
30
3.75"
2.50"
0
• 6 ? 8 9 7p
•-2c.7 Municipality of Anchora t.e X 9 7 ''
On-Site Water and Wastewater Progr.^ -fi
(907)343-7904 s .,� E T Y
I JUN 29 2017
Certificate of On-Site Systems A ,.val
Parcel I.D. 015-132-09 Expiration`Da 01 s 8 L =� ii
1. GENERAL INFORMATION
Complete legal description Kasilof Hills, Block 8, Lot 6
Location (site address) 10740 Stroganof Drive Anchorage, AK 99516
Current Property owner(s) Adam Jensen Day phone 230-3409
Mailing address P.O. Box 111846 Anchorage, AK 99511
Real Estate Agent Day phone
2. TYPE OF DWELLING:
O Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: Four
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community El
Public Water System ❑ Public Sewer ❑
WaiverNariance request for. Distance:
Received by: Date: 67 AO 7
COSA to be released to the engine unless otherwise requested by the engineer.
COSA Fee $ (o1 + 141 . = 1114x? Waiver Fee $
Date of Payment 0,111 Date of Payment
Receipt Number of (4(o Receipt Number
COSA# OSCl1 12-L ( 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 PO Box 240773, Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E. Date 6/27/2017 ��
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6. DSD SIGNATURE x >
ySystem #1 Approved for l bedrooms °' Mlcs;?_.[i: E. ANDERSON: s
System #2 Approved for bedrooms .�;J�egfo-..'", 0.Z.;S:Z1%\t"::±::
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Disapproved y�
Conditional approval for bedrooms, with the following stipulations:
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ON-SITE ,
WATER AND
WASTEWATER
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Cor nr..,,,, 'C
B<_______
y 1 Original Certificate Date: ^a9^ ll
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet c
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: Kasilof Hills, Block 8, Lot 6 Parcel ID: 015-132-09
A. WELL DATA
Well type Private If A. B, or C provide PWSID# Well Log (YIN) Y
Date completed 6/2/17 Sanitary seal (Y/N) Y Wires properly protected (YIN) Y
Total depth 305 ft. Cased to 30 ft. Casing height(above ground) >18 8 in.
FROM WELL LOG AT INSPECTION
Date of test 6/2/17
Static water level 45 ft. ft.
Well production 1 '0 g.p.m. g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mL Nitrate ND mg IL
Arsenic 691 ug/L Date of sample: 6/15/17 Collected by: And. Engineering
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel Date installed 11/7/2016
Tank size 1 °250 gal. Number of Compartments 2 Cleanouts(Y/N)
Y
Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N
Date of pumping Pumper New Construction
C. ABSORPTION FIELD DATA
Date installed
11/8/16 Soil rating (g.p.d./ft2 or ft2/bdrm) .8 GPD/SF System type Deep Trench
Length 54 ft. Width 3 ft. Gravel below pipe 7 ft.
Total depth 10.5 ft. Eff. absorption area 756 ft2 Monitoring tube Y Depression over field N
Date of adequacy test New Const. Results (Pass/Fail) For 4 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.
N
Any rejuvenation treatment (past 12 mo.)(Y/N & type) If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access(YIN)
"Pump on" level at in. "Pump off'level at in. High water alarm level at in.
Datum Cycles tested Meets alarm &circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot >100' On adjacent lots >1 00'
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 >75'
Animal containment areas >50' Manure/animal excrete storage areas >100'
SEPTIC/HOLDING TANK ON LOT TO:
>5' >5' >5'
Building foundation Property line Absorption field
Water main >10' Water service line >10' Surface water >100'
Wells on adjacent lots 100'
ABSORPTION FIELD ON LOT TO:
Property line >10 Building foundation >10 Water main >
>10'
Water Service line >10 Surface water ��00' Driveway, parking/vehicle storage
Curtain drain None Noted Wells on adjacent lots >100'
F. COMMENTS
G. ENGINEER'S CERTIFICATION .`r�o,,,�IL%
I certify that I have determined through field inspections and ��.OF 44"0.
'4e�'
review of Municipal records that the above systems are in 1�<P•'� �l< ,• .'fc*+
conformance with MOA COSA guidelines in effect on this date. r, 49 TH .`
Engineer's Printed Name
Michael E. Anderson, P.E. h• •�� •• �••••s
s
Date 6/27/2017 .�70, •MICHAEL E. ANDERSON .
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COSA brown sheet 10-10-12.doc
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Lot 14 I I 30 AS-BUILT NO CORNERS SET THIS DATE
Lot 5 I ---
I hereby certify that I have performed a Mortgagee's inspection
" ••N-X%X X % 1 I of the following described property: LOT 6, BLOCK 8,
�e. OF •A, 9 1, KASILOF HILLS SUBDIVISION
�,,,,v.:•air i S� I Anchorage Recording District.Alaska,and that the
:?. 49th �•:9 �/
/ /\ , improvements situated thereon are within the property lines
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and do not overlap or encroach on the property lying
c• 41'. adjacent thereto,that no improvements on the property lying
SCALE: 1"= 40' •• •••• / adjacent thereto encroach on the premises in question and
A�^ •.Brett A. Wilmot .,o / that there are no roadways,transmission lines or other
s • • Iv s visible easements on said property except as indicated
rF• 112392- LS •• �e — hereon.
EASEMENTS OF RECORD, OTHER THAN
9Fo•0 • ., . • . • ',,o Dated at Anchorage,Alaska
THOSE SHOWN ON THE RECORDED 1 , �FfSSIONA� �� this 14th day of JUNE 2017.
PLAT ARE NOT SHOWN HEREON. l%'tN.� ` FRED WALATKA&ASSOCIATES
FB 16-1 pg. 45-46 BE Engineers and Surveyors
(907-248-1666)