HomeMy WebLinkAboutNINA LT 1Nina
Lot 1
#051-092-57
Municipality of Anchorage
i\ Development Services Department
Building Safety Division
\ On -Site Water and Wastewater Program, 4700 Bragaw St.
P.O. Box 196650 Anchorage, AK 99579-6650 Page of
www.ci.anchorage.ek.us (907) 343.7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: .S 10 D CO PID Number: OS/— O 92- S %
"a"" /A
K15 ! fYO/I• PSOA.)
Wastewater System: 0 New ❑ Upgrade
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ABSORPTION FIELD
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LEGAL DESCRIPTION
Soi Rating 1. u GpoI r`
Tota Depm rmm onprW aWe / Ft.
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Pump Set hC•Nrle
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GPM
UA1d.A>:'N FL
FL
SEPARATION DISTANCES
J&Septic ❑ Holding ❑ S.T.E.P. ❑ Other.
To
SepticAbsorption
Lilt
Holding
umiconvate
aa""'
apaaq
From
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Sewer Line
250 GN
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9 1�7E�Q10.%..
S Dates: 1"��_b_
Engineer's Stamp
Inspections performed by:
Development Services Department Approval
' "a t- r
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/ �c% il� Date:3-�-07
A / NT T
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ConditionalApproval/�
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Reviewed and approved by:
PERMIT NO. SW060284
PACE 2 OF 3
Municipality of Anchoraqe
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 •Anchorage, Ataska 99519-6650 • Telephone 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LEGAL LOT 1 NINA S/D P.I.D. NO. 051-092-57
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SCALE: 1 40'
100'
WELL RADIUS
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LOT 2
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PERMIT NO. SW060284
PAGE 3 of 3
Municipalit of Anchorage
DEPARTMENT OF HEATH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 *Anchorage, Alaska 99519-6650 • Telerhone 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LEGAL LOT 1 NINA S/D P.I.D. No. 051-092-57
ST1
FINAL GRADE
S
94 I NEW 1250
GALLON
SEPTIC TANK
CO1
MT1 Cn02n1T2 C01 = 96.5'
II II CO2 = 97.7' �1T3
II II -FINAL GRADE -
mm
94.7'
CO3
NIT4 CO3 = 96.6'
C04 = 96.8'
ESAND
C93.2' 03 92.7'
CO2 = 93.3' `SRS C04 = 92.6'
SAND
92.7--'KIT2 = 92.7' NIT4 = 92.1'
MT3 = 92.1'
WATER FOUND @ 88.1'
83.7' B.O.H.
ffm
N. T. S.
PERMIT NO. SW060284
PACE 2 OF 3
Municipalit of Anchora e
DEPARTMENT OF HEATH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Te'lephone 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LEGAL LOT 1, NINA S/D P.I.D. NO. 051-092-57
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sCALE: 1' - 40'
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WELL RADIUS
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PERMIT NO. SW060284
PAGE 3 of 3
Municipality of Anchorae
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.D. Box 196650 *Anchorage, Alaska 99519-6650 • Telephone 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LEGAL LOT 1, NINA S/D P.I.D. NO. 051-092-57
FINAL GRADE
MT1
MT1 = 92.7
ST1
ST2
94 9'/"'I NEW 1250
GALLON
SEPTIC TANK
CO1
7�d
TC01 = 96.2MT3
CO2 = 98.2'
FINAL GRADE-�.
C01 = 93.2'
CO2 = 93.3'
MT2 = 92.7'
MT3 = 92.1'
98.3'
94.7'
CO3
WATER FOUND Q 88.1'
83.7' B.O.H.
MT4IC03 = 95.9'
C04 = 96.3'
CO3 = 92.7'
C04 = 92.6'
b1T4 = 92.1'
K T. S.
Mar 01 07 08:16a Jim Sullivan 907 P.1
Development Services Department
Building Safety Division
s +� On -Site Water & Wastewater Program
.r 4700 Bragaw Street
P.O. Box 196650
M.rk 8e9kh Anchorage, AK 99519-6650
M,yor r.M~Lem/o "q
(907)343-7904
-Pump11''Installation Log
Well Drilling Permit Number. SV1'_Q ;W Date of Issue:
Dbe
..wl lArntifirffien lVmnri '0S(—tai �2 F —5 T. ,.� , ... ,_ ..
Leel Descriptio
Pump ismanation Dow./Q-E3-2
Pump Intake Depth Below Top of Well Casing: S�_ fat
Pump Maadwhuer's Name: 0__,�
I Punip Model: 4 3-0
Prmp size /6- hp
Pltless Adapter Dnrisl Depth: /d feet
Pitkss Adapter Manufaeturer'i Name: QM=''_
ftl ss Adapter Installer. Ar*0'a-Voo
Well Disinfected Upon Compktion? [� Ya ❑ No
Method of Disinfection: ti4 kc+{s
Commrnts:
Prop Installer Name: ")(Mirc �r+y- 4..e r*w //
Property Owner Name A Address:
LvM Cm••s�s..�-r...s
ear cry
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
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4
ear cry
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
39'S35
ACE WATER WELL DRILLING
A subsidiary ojACE Ventures, Inc
P.O. Box 520090
1167 N. Knapp Dr
Big Lake, Ak. 99652
(907) 357-7987 fax (907) 376-7987 (907) 354-1398 cell
Well Owner: WM Construction
Location: Lot I Nina Estates An 20633 Crabtree Street
Date of Completion: 10-21-06 lob N 06-106
Size of Casing: 6" Depth of hole: 193 feet
Static Water Level: 38 feet below land surface.
Use of Well: Domestic
Drilling Method: Air Rotary
Cased to: 190 feet
Finisb of Well (X) Opcn End (X) Grout/Seal ( ) Screen/Liner ( X ) Perforated
Describe screen, seal, or perforation, 2 z W bags medium bentonite trout seal —top damp
Perforated from 42 to 48 fat
Well Pumping Test at 10 Gallons per ( )bow (X ) minute.
Suggested Pump setting depth: 170 feet from lop of easing.
Method of disinfection: Chlorine tablets
Depth in feet from casing
to
Details of Forrnations/sizetcolor/ etc
0 to 2 feet
Casing stick up
2 to 15 feet
Silty vel and cobbles
15 to 45 feet
Hard pan
45 to 52 feet
Silty sandy gravel—dam
52 to 140 feet
Silty cls
140 to 178 feet
Silty clay and gravel
178 to 190 feet
Silty sand and Zravel
190 to 193 feet
Bedrock
piN:;tG�1 c r^tit.
W 1410-40
�rs
F.R
J
a.
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water 8 Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519.6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT
Initial
Permit Number: SWO60284
Legal Description: NINA LOT 1
Design Engineer: 0003 S & S Engineering
Owner Name: MIKE THOMPSON
Owner Address: PO BOX 4042
PALMER. AK 99645-
Date Issued:
Expiration Date:
25, 2006
25, 2007
Parcel ID: 051-092-57
Site Address: 20633 CRABTREE STREET
Lot Size: 45949 SO. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
❑✓ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well ❑ Water Storage
All construction must be in accordance with:
2.
3.
4.
The attached approved design.
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 ).
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).
From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
Received By:
Issued By:
B. Covered, sealed, and heated to prevent freezing.
Date: �/Z-/06
Date: Z"-/. F
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
ON-SITE SEPTICMELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 051on P_ 59:
Property owner(s) A
Mailing
phone 35 / jjg7 7
Zip Code Iq 6
Site address apo l(33 &abflee Sf�ze�' Zip Code
Legal description (Sub'd, Block & Lot)
Legal description (Township, Section & Range)
Lot Size (-15.949 Sq. Ft.
THIS APPLICATION IS FOR (®all that apply)
Absorption Field
Septic Tank
F ■:
S.,6}I
ON-SITE SEPTICMELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 051on P_ 59:
Property owner(s) A
Mailing
phone 35 / jjg7 7
Zip Code Iq 6
Site address apo l(33 &abflee Sf�ze�' Zip Code
Legal description (Sub'd, Block & Lot)
Legal description (Township, Section & Range)
Lot Size (-15.949 Sq. Ft.
THIS APPLICATION IS FOR (®all that apply)
Absorption Field
Septic Tank
Holding Tank
❑
Privy
❑
Private Well
X
Water Storage
❑
Number of Bedrooms I
THIS APPLICATION IS AN:
Initial
Upgrade
Renewal
certify that the above information is correct. I further certify that this application is being made for a
Single Family welling and is in accordance with applicable Municipal Codes.
�e 'n`� S 3 S ENGINEERING
0-
17034 Eagle River Loop Road No. 204
E.nI. Qi sl t
(Signature of property owner or authorized agent)
Permit/Rush
Date of Payment:
Receipt Number:
(Rev. 11105)
J a- Alio :,A 63r
9/a3AC
8 rif 2
Waiver Fees:
Date of Payment:
Receipt Number:
IEALTNAUMOWTY
APPROYALS
SEWERAWATER
SAW E%TENSIWLS
SEWERS WATER
INSPECTION
ENGINEERINGSTLOIES
AND REPORTS
WELL INSPECTION
S FLOW TEST
SITE PLANS
SOLTEST
PERCOLATION
TEST
STRUCTURALS
WCNANICAL
lSPECTONS
ONSITE
WASTEWATER
DSPOSALSYSTEM
DESIGN
ROBERT C. COWAN, P.E.
CML ENGINEERS
(907)694-2979
August 18, 2006 FAX(907)694 1211
MUNICIPALITY OF ANCHORAGE
Development Services Department
P.O. Box 196650
Anchorage, AK 99519
REFERENCE: Lot 1, Nina Subdivision
It is requested that you issue a permit to install a new well and a new septic system to
serve the proposed four bedroom dwelling on the referenced property.
Two test holes were excavated and percolation tests performed. The approximate locations
of the test holes are located on the attached site plan. At the time of excavation (4-27-06)
water was not found. After seven days of monitoring, ground water was found ai 8 feet.
We do not anticipate any adverse effects on neighboring wells, septic syst I s, reserve
areas or drainage patterns by the installation of the proposed septic sysiem. The
construction of this system will not prevent any future development on any of the adjacent
properties.
If you require additional information, please contact us.
Sincerely,
/ R 147"—
Robert C. Cowan, P.E.
RCC/bjj
Enclosure
17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER, ALASKA 99577
V, = 50'
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GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS i GENERAL CONTRACTORS
SOIL LOG PERCOLATION TEST
LEGAL DESCRIPTION: NINA SUBDIVISION; LOT 1,
PERFORMED FOR: JERI h SHANNON TALLANT D)
DEPTH _ _ __ _ ORGANICS
(feet) TEST HOLE 1
1 LI
DEPTH TO
GROUNDWATER
11MINr
SM w/SOME
10
DRY
GRAVEL do
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11
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DATE
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12
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15
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17
'
18
DEPTH TO
GROUNDWATER
DATE
DRY
GOOD
DRY
4/28/2006
DRY
•
11'
5/16/2006
0' I
6-
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6'
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DEPTH TO
GROUNDWATER
DATE
DRY
4/27/2006
DRY
4/28/2006
DRY
5/4/2006
11'
5/16/2006
DATE READING CLOCK
TIME
I
APPROXIMATE
NET DROP
(INCHES)
4/28/2006 1 —
LOCATION1i,
N/�I
—
2 —
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3 —
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DATE READING CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING I
NET DROP
(INCHES)
4/28/2006 1 —
—
6' I
—
2 —
<1
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6-
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—
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19 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. I 6 (INCHES)
TEST RUN BETWEEN 3.0 FT. AND 3.5 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES NO
SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: CALEB CALL
I
COMMENTS:
PERFORMED BY GEC. Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS P RF RMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 5 t 0
S" MQ
GARNESS ENGINEERING GROUP, Ltd. T y
CONSULTANTS i GENERAL CONTRACTORS 4 4
....... .. ...�.. ...........
SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: NINA SUBDIVISION; LOT 1,
PERFORMED FOR: JERI & SHANNON TALLANT Di
DEPTHORGANICS
(feet) TEST HOLE 2
1
DEPTH TO
GROUNDWATER
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5/4/2006
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DEPTH TO
GROUNDWATER
DATE
DRY
4/27/2006
8,0'
4/28/2006
8.0'
5/4/2006
8.0'
5/16/2006
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DATE
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4/28/2006
8.0'
5/4/2006
8.0'
5/16/2006
ICE—i
DATE READING CLOCK
TIME
� IW
APPROXIMATE
NET DROP
(INCHES)
4/28/2006 1 —
LOCATION
6. I
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DATE READING CLOCK
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(MINUTES)
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READING I
NET DROP
(INCHES)
4/28/2006 1 —
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19 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. I 6 (INCHES)
TEST RUN BETWEEN 3.0 FT. AND 3.5 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES 0 NO
SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: CALEB CALL
I
COMMENTS:
PERFORMED BY CEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WASI7 P FORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 3
S&
FEALTHAUTHOWP/
APPROVALS
SEWERSWATER
MANE%TENSIONS
SEWER 6 WATER
INSPECTION
ENGNEERINGSTUOtE5
ANDREPORTS
WELL INSPECTION
8 FLOW TEST
SITE PIANS
SOFTEST
PERCOLATION
TEST
STRUCMULS
MECHANICAL
INSPECTIONS
ONSITE
WASTEWATER
DGPOSAI.S/STEM
OFSIGN
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES
and
MATERIAL SPECIFICATIONS
REFERENCE: Lot 1, Nina Subdivision
August 18, 2006
GENERAL:
CMLENGINEERS
(907)694.2979
FAX(907)694-1211
1. The scope of this project includes the installation of a new 1300 gallon HDPE
septic tank and two septic trenches to serve the proposed four bedroom
residence located on the referenced property.
2. Construction shall be in accordance with the approved site plan and design
drawings, Municipal permit with any special provisions or conditions, and all
applicable State and Municipal Wastewater Disposal Regulations.
3. The contractor shall be responsible for obtaining any necessary i derground
utility locates.
4. Unless specifically agreed otherwise, the property owner shall beresponsible
for final grading areas subsequently depressed from soil settling.
5. Contractors installing wastewater disposal systems must be certified by the
Municipal Development Services Department or ADEC if required, for
system installations. Owners installing their own systems must also receive
prior approval from the respective agency.
SEPTIC TANK INSTALLATION:
1. A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shall include two 4" cleanouts for pumping access.
2. The septic tank shall be sufficiently bedded to prevent settling or shifting of
the tank.
17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER ALASKA 99577
P.E.
Page 2
Lot 1, Nina Subdivision
August 18, 2008
3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade.
4. Septic tanks installed with less than 4 ft. of cover shall be insulated.
5. A foundation cleanout shall be installed one to four feet from the building fouridation. In
the line between the tank and the leachfield there shall be two adjacent cleanouts (unless
an effluent pumping system exists within the septic tank). These cleanouis shall be
located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line,
shall be to clean toward the leachfield. The second cleanout shall be to clean toward the
septic tank.
6. Final grading over the septic tank shall be such that a positive slope exists away from the
septic tank.
ABSORPTION TRENCHIDRAINFIELD INSTALLATION:
1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the
excavation shall be within 2 inches of level. If the sidewalls of the excavation become
smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock)
placement.
2.
3.
4.
5.
Once the gravel is installed, the distribution pipe is to be installed level with the
perforations faced downward. Gravel is then to be placed over the distribuiion pipe to
provide a minimum of 2 inches of cover over the pipe.
A silt barrier must be installed between the final gravel layer and the native soil backfill.
Ensure the silt barrier covers the entire gravel surface before placing backfill.
Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations
shown on the design, and extend a minimum of 12 inches above final grade. IThe portion
of the monitoring tube extending through the gravel shall be perforated from the bottom of
the trench to the invert of the distribution pipe. This is equivalent to the effective depth of
the gravel as noted on the design.
Backfill over the final gravel layer must not be less than twenty-four �(24) inches.
Insulation must be installed when the backfill depth is less than thirty-six (36)'inches. The
finish grade over the trench must be mounded to prevent the formation of a depression
after settling.
Page 3
Lot 1, Nina Subdivision
August18,2006
1%11NI11tU111 MATERIAL SPECIFICATIONS:
1. Any septic tank proposed for installation must be constructed by a Municipal approved
septic tank manufacturer.
2. The following pipe materials are approved for use in septic system installations in the
Municipality of Anchorage:
Type of Pine Perforated Solid
Cast Iron Yes Yes
ASTM D3034 (PVC) Yes Yes
ASTM F810 (HDPE) Yes No
ASTM D2662 (ABS) Yes Yes
Use of a type of pipe other than listed above must be approved by the inspecting engineer.
3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow
Chemical
Company Styrofoam HI or equal).
4.
5.
RN
Septic tank inlets and outlets shall be fitted with watertight couplings (Cauldei, Femco, or
equal).
A permeable nontoxic silt barrier (Typar 3401, Mimfi 140N, or equal) must be installed
between the final leachfield gravel layer and the native soil backfill.
All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3%
passing the #200 sieve.
When sand is being used as a filter material, its gradation specifications must conform to
current M.O.A. or D.E.C. requirements, which ever requirement applies.
Pages 4
Lot 1, Nina Subdivision
August 18, 2008
INSPECTIONS:
Typically there will be a minimum of three (3) inspections required during the installation of the
wastewater disposal system. These inspections will occur as follows:
1. The first inspection must be conducted after the excavation of ditches, its,
trenches, or beds and before the installation of any gravel. A septic tank may be
set in place, but may not be backfilled before this inspection.
2. The second inspection must be conducted after the placement of the silt barrier,
gravel, distribution lines, standpipes, cleanouts, and insulation, but before the
placement of any other backfill.
3. The final inspection is to occur upon final grading of the property.
Often there will be more than these 3 inspections required. Especially with the installation of
multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer
is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre -
construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or
control in anyway the contractors activities.
The owner shall contract with the contractor to perform the work outlined in these specifications
and plans and in accordance with the attached M.O.A. permit. There will be no contractual
arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be
the owner's representative and will inspect the work as stated above to document the contractors
activities. Final acceptance of the contractors work rests with the owner and the M.O IA.
S & S Engineering shall have no liability to the owner or to others for acts or omissions of the
contractor or any other persons performing work on this project or the failure of the contractor to
carry out the work in accordance with these construction documents. S & S Engineering's
inspecting engineer will not be responsible for the construction means, methods; techniques,
sequence, procedures or the safety precautions incident to this project.
CONTRACTOR / INSTALLER
MUNICIPALITY OF ANCHORAGE
ire\\i DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
\ 825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: /" p�� L `// 1 S,1 DATE PERFO$tR
/ L -t- 1 1 J 1-\ a., S'/ [may-- __ \\
LEGAL DESCRIPTION: IV / L. —0 �� eC U / �-5 /�/ A
DEP SLOPE
1
2 d� o
5 t1
c
6
r
7
f
8
10
WAS GROUND WATER s L
i
/ ENCOUNTERED?
12 � i � P
J E —
IF YES, AT WHAT (i
D GJ j DEPTH? Ll
13 1� �''.� O ,
14-
15
4 15
17
18 / 9 1`n t
c;
El SOILS LOG
PERCOLATION
TEST
D: 4 -- 2,3 -9s
IN
20 PERCOLATION RATE_ ° (minutes/inch)
TEST RUN BETWEEN F AND FT
f /AlC ;�f14Gii
Reading
Date
Gross
Time
Net
,Time
Depth to
Water
Net
Drop
_
G
COMME
r /7L/ C
PERFORMED BY. CERTIFIED
F 1 !^ A Y
72-008 (6/79)
DATE:��3 rp
,.
Mol
�.
\y
zoi
L
ac
• Municipality of Anchorage
On -Site Water and Wastewater Program ,
(907)343-7904
Certificate of On -Site Systems Approval 4'
t
Parcel I.D. 051-092-57 Expiration Date:
1. GENERAL INFORMATION
Complete legal description Nina Lot 1
Location (site address) 20633 Carbtree St.
Current Property owner(s) Shannon Tallont Day phone
Mailing address
Real Estate Agent Day phone
2. TYPE OF DWELLING:
El Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or
Duplex)
4
MY 232014
3. NUMBER OF BEDROOMS:
4. TYPE OF WATER SYPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well h'r - - _
Fx�
Individual
Q
Individual Water Storage" 4-� x .
J ❑
Holding Tank
❑
Community Class Well
r❑
Community
❑
Public Water System
❑
Public Sewer
❑
WaiverNariance request for:
Distance:
Received by (� ' !
COSA to be released to the engineer, unless otherwise requested by the engineer
May be released to Reginald Carney or property owner.
Date '
COSA Fee $ 4O q t. bo Waiver Fee $
Date of Payment Z / _I n ' o Date of Payment
U
Receipt Number Receipt Number
COSA # 015G '11 4 12}a 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 Alaska Rim Engineering.lnc. Phone
Address 9131 E Frontage RD. Palmer AK 99654
Engineer's Printed Name
6. DSD SIGNATURE
System #1 Apr
System #2 Apr
Disapproved
Conditional approval for
bedrooms, with the following stipulations:
i
By Original Certificate Date: 6
The nicip ity A rage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the repres ntations 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
Septic System Advisory
Well Flow Advisory
COSA Me sheet f _ c
Nitrate Advisory X
Arsenic Advisory X
Other AS RtAILT.?0M?INC-1 ?6cle'T
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: Nina Lot 1
A. WELL DATA
Well type Private If A, B, or C provide PWSID # N/A
Date completed 10/21/06 Sanitary seal (Y/N) Y
Total depth 193 ft. Cased to 190 ft.
FROM WELL LOG
Date of test 10/21/06
Static water level 38
Well production 10
ft.
g.p.m.
WATER SAMPLE RESULTS:
Coliform absent colonies/100 mL Nitrate 2.98 mg/L
Arsenic <MRL ug/L Date of sample: 4/23/14
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel
Tank size 1250 gal. Number of Compartments 2
Parcel ID: 057-092-57
Well Log (Y/N) Y
Wires properly protected (Y/N) Y
Casing height (above ground) 24 in.
AT INSPECTION
4/29/14
ft.
?!F'F
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N
Date of pumping 5/21/14 Pumper JRs Pumping
C. ABSORPTION FIELD DATA
Collected by: Brandon Jones
Date installed 10/16/06
Cleanouts (Y/N) Y
High water alarm (Y/N) N
Date installed 10/10/06 Soil rating (g.p.d./ftZ orft2/bdrm) 1 .0 System type Shallow Trench
Length 121 total ft Width 5 ft. Gravel below pipe 0.5 ft.
Total depth 6 ft. Eff. absorption area 605 ftZ Monitoring tube Y Depression over field N
Date of adequacy test 4/29/14 Results (Pass/Fail) Pass For 4 bedrooms
Fluid depth in absorption field before test 0 in. Water added 720.5 gal. New depth 0 in.
Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 720.5 g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date
D. LIFT STATION
Date installed N/A
"Pump on" level at N/A
Datum N/A
in.
E. SEPARATION DISTANCES
WELL ON LOT TO:
Size in gallons N/A
"Pump off" level at N/A
Cycles tested N/A
Septic tank/lift station on lot 100'+
Absorption field on lot 100'+
Public sewer main N/A
Sewer /septic service line 25
Animal containment areas 50'+
Manhole/Access (Y/N) N/A
in. High water alarm level at N/A
Meets alarm & circuit requirements? N/A
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Holding tank N/A
Manure/animal excrete storage areas 100'+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 12' Property line 56'
Water main N/A Water service line 10'+
Wells on adjacent lots 100'+
ABSORPTION FIELD ON LOT TO:
Property line 30' Building foundation 33'
Water Service line 10'+ Surface water 100'+
Curtain drain N/A Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA�guidelines in effect on this date.
Engineer's Printed Name —1—lel-10a,7 A C7111<1'1'1
Date_ -:Sl- ;//,/
COSA brown sheet 10-10-12.doc
Absorption field 51+
Surface water 100'
Water main N/A
Driveway, parking/vehicle storage 2'
in.
May 28, 2014
ALASKA RIM ENGINEERING, INC.
Jeff Poet via E -Mail
Municipality of Anchorage
4700 Elmore Road
Anchorage, AK 99519
Re: Nina Lot 1
Subj.: Well Recovery
Dear Mr. Poet:
ENGINEERS—PLANNERS—SURVEYORS
911 E. Frontage Rd.,
Palmer, Alaska 99645
Telephone (907) 745,0222
Fax (907) 746-0222
Online at: www.alaskarim.com
We have reviewed the well flow data for the subject property collected on April 29, 2014. Our
technician, while performing the well flow test, was certain that the home was unoccupied. Based on that
we feel that the only water being taken from the well during the test was the actual test flow,
During the well flow test the water level drawdown in the well totaled 20.8 feet with a total well flow of
720.5 gallons. During the final hour of the test the well flow was 230.3 gallons and the drawdown
increased a total of 2.80 feet.
A 6 -inch well casing has a volume of 1.4688 gallons per lineal foot.
The net drawdown rate during the last hour of the test calculates to be 0.0685 gallons per minute (gpm).
Water was produced from the well during that period at a rate of 3.8383 gpm.
Water removed during the last hour of the test would be the sum of recharge during that period less the
about of drawdown during the same period. This equates to a well recharge (recovery) rate of 3.8383
gpm.
Water removed during the last hour of the test would be the sum of recharge during that period less the
about of drawdown during the same period. This equates to a well recharge (recovery) rate of 3.7698
gpm.
Based on the analysis outlined above the recharge or recovery rate for this well is 3.7 gpm or better
If you have questions, please contact this office.
Sincerely,
ALASKA RIM/EN INEERING, Inc.
;?/
Notman K. GutchAPE,
Managing Director
Cc: File 14-00248
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Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
f
fi ?? ' - tji Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
'C"�'
CERTIFICATE OF ON—SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 0 S/ — oer> — s% COSA #LU()Dtl1
Expiration Date: 40
1. GENERAL INFORMATION
Complete legal description LO T I N/ Al 4 S 1'q
Location (site address)
a O 6 3
3 e 4 A OT ACj
S 7'R if j -r c Nv C-1 IK -
Community On-site
❑
Public Sewer
Current Property owner(s)
fl i xf-
10 0h P S o N
Day phone 3 s` y — // 1"Y 7
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
P -o. /30x yoq; +rALr%to2 px 9QCVS_
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: bI
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 Onsite 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 Onsite 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 Onsite 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 engineers work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, 1 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 5 $ r ENG1N1C'4o 1 Phone Ccfy' x979
Address
Engineer's Printed Name _/PzAiAr C_ Ca &V.4,V Date
5. DSD SIGNATURE
Approved for bedrooms.
Disapproved.
E
.q ROBERT C. COWAN �@
cl�S CE•8801
O
tt�'.�........... ......••���
1t�L
:l.'r.tr p
_ r:LiilSi� _ �.-
Conditional approval for __q— bedrooms, with the following stipulations:
Attachments:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
BY: Original Certificate Date: -Z—/— O %
(Rev. IIMS(
Municipality of Anchorage
• ''° Development Services Department
Building Safety Division
On -Site Water & 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 CHECKLIST
Legal Description:
L OT / A�/n`q
A. WELL DATA
Well type LAivAra
Date completed /0/:2//0(
Total depth E3 ft.
Parcel ID: OS/-Oq�,'S %
If A, B, or C provide PWSID #= Well Log (ON) YE.1
Sanitary seat �irj N) .Y—C J Wires properly protected &N) ' L J
Cased to %ti —0ft. Casing height (above ground) '2 4 in.
FROM WELL LOG
Date of test ( o / 7L / /0 6
Static water level 3 $ ft.
Well production 10 g.p.m.
WATER SAMPLE RESULTS:
Coliform colonies/100 mL Nitrate ',14 mg/L
Arsenic: ug/L date of sample -41— 01
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SQ P T r c / Y7 -i56 -j_ Date installed / O // (. /0 c
Tank size )3S"e gal. Number of Compartments a Cleanoutsg/N) Y'f J
Foundation cleanout &N) YLS Depression over tank (Y& N 0 High water alarm ( fl
Dale of pumping P 1A - Nd w Pumper
AT INSPECTION
I k ft.
g.p.m.
Other bacteria -A—colonies/100 mL
Collected by: S$ S F161tJCEAINC
A, 0
C. ABSORPTION FIELD DATA
_.
S#4 Date installed /0�/ 6 Soil ratin9 or ft?/bdrm) S stemtYPa -E- � N
Length I a. I ]%rALL ft. Width S- ft. Gravel below pipe 0. S -ft.
Total depth %ft. Eff. absorption area L VS fe Monitoring tube Y11 Depression over field P 0
Date of adequacy test N/A Results (Pass/Fail) For � bedrooms
Fluid depth in absorption field7=��
Wateradded_ gal. New depth_ in.
Elapsed Time: _ min. in. Absorption rate >= g.p.d.
Any rejuvenatioor went (past 12 mo.) (Y/N & type) If yes, give date
D. LIFT STATION
Date installed
'Pump on" level at _ in.
E. SEPARATION DISTANCES
Size in gallons
Cycles tested
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAift station on lot / o a i -
Absorption field on lot loo r -f
Public sewer main N 1A
Sewer /septic service line a S /
Animal containment areas / 0 0 r y
High water alarm level at
Meets alarm 8 circuit requirements?
On adjacent lots
r
/ 0 0 4 -
On adjacent lots / D 0 ;L
Public sewer manhole/cleanout PIA
Holding tank V /A
Manure/animal excrete storage areas /O0 �"�
SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO:
Building foundation jar Property line S'6 r Absorption field S r�
Water main N /Q Water service line /o r f Surface water )00,-4
Wells on adjacent lots / 0 0 'f
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
r
Property line 3o r Building foundation 3 3 Water main
r r �
Water Service line /04 Surface water, / 0 0 i Driveway, parking/vehicle storage _1�1
Curtain drain A10- i k� o w.v Wells on adjacent lots / 00 1
4
01.4
F. COMMENTS
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 CO{S�A guidelines in effect on this date.
K
Engineer's Printed Name &.0147, C. CO''r4r✓
Date
COSA Fee
-t lr4s -
Date of Payment
Receipt Number
(Rev. 11105)
Or
n RO.%kr G'LA`NAtJ,. f'.:
CE :8801
Date of Payment A119
Receipt Number 35163
in.
Municipality of Anchorage
Development Services Department
Building Safety Division
_
On -Site Water and Wastewater Program
4700 South Bragaw St.
• P.O. Box 196650 Anchorage, AK 99519-6650
www.cl.anchorage.ak.us
(907)343-7904
ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET
To: S&S Enci
Legal description: Nina Lot 1
The attached paperwork has been reviewed and Is being returned for the following reasons:
1. If a septic tank is not buried or is buried at a depth of four feet or less, the tank must be insulated. check cross-
sectionaldravring.
2. If the backfilled depth over the final gravel layer is less than 36 inches, Insulation must be placed over the top of the
final gravel layer. check cross-sectional drawing.
3. need pump Install log.
Name of reviewer: L
Date: February 28, 2007
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK
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ASBUILT
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I HEREBY CERTIFY THAT I HAVE SURVEYED THE
FOLLOWING DESCRIBED PROPERTY=
.4 - K' -O fliy L$, -
/AND THAT NO ACROACHMENTS EXIST EXCEPT AS
INDICATED. IT IS THE'RESPONSIGILITY OF THE
OWNER TO DETERMINE THE EXISTENCE OF ANY
EASEMENTS, COVENANTS, OR RESTRICTIONS
WHICH DO NOT APPEAR ON THE RECORDED SUBDI-
VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD
ANY DATA HEREON BE USED FOR CONSTRUCTION
OFFENCE LINES, OR FOR ESTABLISHING BOUND-
ARY LINES.
SE4ARD h ASSOCIATES LAND SURVEYING 69,
SCALES / y0i
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