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NORTH WOODS BLK 3 LT 3
Northwoods Block 3 Lot 3 #051-731-37 Municipality of Anchorage Development Services Department _ "°`• Building Safety Division ...... '-- On-Site Water and Wastewater Program, 4700 S. Bragaw SC P.O. Box 196650 Anchorage, AK 995196650 Paye' Of? www.d.anchorage.ak.us (907) 3417904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. 5W0g60y.3 PID Number. as/ —731-37 No": 5ci M Seo u r Wastewater System: []New ❑ Upgrade 5544411/ AIVIL4 t ABSORPTION z s FIELD ODMTma D&M-Trillldl Da.a O DnMw: LEGAL DESCRIPTION, Sal RnnF Taa Depal hmaq.�l7aec FI aiaalc la aaeawaan: WMNI•Weaedn O.a� Gawnd e..an pqc r FI. Top: P-W S.caon: FA a00s0 y.h mD^r V+ar FI. Well: ❑ New ❑ Upgrade C.a.r.w.a naarow D"°""°'""°"1`"" FI. FI. v noxn PnM.. A B. C Tod W W1: CasW ax 1 Tad Pa Mate at u e k c Fl Fr Sax wales L": , Dw nw.ex FI S ; o vera: sa ac caa+q nley+aeaw ral.la: TANK GPM FI. n SEPARATION DISTANCES QSeptic [3 Holding ❑S.T.EP. ❑Other. To Septic Absorption Lift Holding liwte ' �� 1 COW Ftom Tank Station Tank SewerWle iP Ga. well I •f //F��ie/w 'W ` ._ �' 1�! `�" p/�' DIG ^aco.IwN.as: c'[ sW.aaawal« t M- LIFT STATION La line � Fa tw, S( IQ 1.'Rano an'Wrae npl..ler wrmu N. Cwn Drain UI � e Low Perp YiY. Ftp bepK "WrbmeaW Ft ' 0[d :bak BENCH MARK LoowlaC W,alPx�c pp I�nia2nn4TT)L0 n/c t_ K•2E `'l'r'.13:? . NeT I,vsT4l.� ,p C.flEao)v� ... .... � _ L irk �.. '•1; .:. � 5&S ENGINEERING a.,.:tilr Inspections performed by. 770Yt Eagle River Loop Rud, N�204 3' aces: t �—Ll-/�5 ✓ r ?� •ww •� Ju.., • .. .. ... 20°wo Development Services Department Approval w ... .. ... • RORERTT C. COWAN Q � t 8,� Reviewed and approved by: Date:,I t/,< IRo 13001 ' !_ •i�, r .. �,• .,�'� PERMIT No. SW040043 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 • Telephone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 3, BLOCK 3, NORTHWOODS S/D P.I.D. No. 051-731-37 McMANUS DRIVE -- — 15' UTILITY EASEMENT --------------- ----------------------- EXISTING BED 3 SUMP is I pW LA WQ 3 TMT D811 & D L2' TSM •STI I TH#1 3 NEW 1000 II GALLON HDPE FCO SEPTIC TANK EXISTING 3 BEDROOM 1 LOT 2 HOUSE LOT 4 4 SEPT` 11441, ATHB2 C AREA SEPTIC C AREA r - 40• pSCALE: 10 A t / ' A 4 ROBERT C. COWAN 14 LOT 41 LOT 40 �'��;�, �;r8%D1 PERMIT No. SW040043 PACE 3 OF 3 Municipalit of Anchorage DEPARTMENT OF HEA�.TH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 3, BLOCK 3, NORTHWOODS S/D P.I.D. NO. 051-731-37 ST1 ST2 100.0' FINAL GRADE 2" INSULATION NEW 97 4' 1000 GALLON POLYETHYLENE 97.1' SEPTIC TANK A B FCO 12.5 6.0 ST1 9.0 15.0 -§T _2 9.0 18.5 TMT 8.5 20.5 N. T. S. D_BL 1 10.0 21.0 .� DBL2 10.5 22.0 B =OFFSET FROM HOUSE E + �•7 t� O hf ROBERT C. COWAN �S p �? C! CE 8801 X11 11;r��.::i� �-.•�" MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water d Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW040043 Legal Description: NORTH WOODS BLK 3 LT'.3 Date Issued: Apr 05, 2004 Expiration Date: Apr 05, 2005 Parcel ID: 051-731-37 Design Engineer: 0003 S & S Engineering Site Address: 022444 MCMANUS DR Owner Name: SAM BENAVIDES Lot Size: 20000 SQ. FT. Owner Address: 22444 McMANUS DRIVE Total Bedrooms: 3 Permit Bedrooms: 3 CHUGIAK , AK 99567 - This permit Is for the construction of: ❑ Disposal Field ❑? Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be In accordance with: 1. The attached approved design. 2. All requirements specified In Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 3/0¢ SFr FtiG. tgrf5O-IOFlJ OES/�.v ADGiaG i9B.to/�Piio.� 1K 1 L U PG R i1 V F 7`D Received By: Issued By. Date: Date: J v Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.enchorage.ak.us (907) 343.7904 ON -.SITE SEWERMELL PERMITttr'P!_'t=i.ii��i FOR A SINGLE FAMILY DWELLING Parcel I.D. 05-1 — 73 .._ -37 Permit Number SWO¢0043 Property owner(s) Sa✓✓t Rerinyl kt Day phone 695– 1023 Mailing address (1) 1'V l5G SfTE -his;liAg address (2) Legal description (Lot, Block & Sub'd.) Zip Legal description (Section, Township & Range) Lot Size—P 0. ow Acre q.Ft. Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade 0 THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 1 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. S d, S ENGINEERING 17034 Eagle River Loop Road No. 204 (Signature of property owner or authorized agent) Permit Fees: y GD .o Waiver Fees: Date of Payment: y /1 1/0 / Date of Payment: Receipt Number: 0 't 9 °I 4 7 Receipt Number: (Rev. 12100) S& April 21, 2004 ROBERT C. COWAN, P.E. CML ENGINEERS (907)694.2979 FAX (907)694-1211 I1EkTMAUrH0AITM MUNICIPALITY OF ANCHORAGE APPALS Development Services Department P.O. Box 196650 Anchorage, AK 99519 SEWER&WATER UAIN D(TENSION4 REFERENCE: Lot 3; Block 3; Northwoods Subdivision SEWER& WATER It is requested that you issue a design change to permit PSW040043. The change the wsm`nON request is the installation of a new drainfield to serve the existing three bedroom dwelling on the referenced property. ENGPNEERwosTLnES The existing septic tank was replaced on 4/12/04 with a new 1000 gallon HDPE septic ANOMPORTS tank. While replacing the septic tank, the septic field was determined to be in failure. A test hole was excavated in the vicinity of the proposed drainf ield, and a percolation test was performed. The approximate location of the test hole is located on the attached site WE11"SPEGTKK+ plan.'At the time of excavation (4/12/04) water was found at 6 feet. After 10 days of aPwwTEsr monitoring, ground water was found at 4.5 feet. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve SITE PUNS areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. ROADOESIGN If you require additional information, please contact us. Sincerely, SOLMST PERCOLATION Robert C. Cowan, P.E. TEST RCC/bjj Enclosure STRI.CR/W,& MECNANIOM. NSPECRONS ONSITE WASTEWATER OSPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 I" = 40' DESIGN SITE-PLAN SkAi a 8 I J\otno� C) .wa• I Ol x x r Om A:E N inn cy`c N S 0 0 -0 r C7 rr, mro g m m m •'I m -�cNN Am N N O 0) n 0 prNNO�N�"� y N <Dm� ,end per' ^ �tiv / r? n o n cn\N� N " vs C" > r r to N D m I•-� I •v O t= =. D n II �rrn d rAin�, D I pm O 0p L4 ll// v I Om I NO 0-0 C7 �mN I DZ p0 r`r Z K O O '� I Z n � I oo 11 K pN d I "�. 0o A m � Ln .8, O In0 y y aNo Lx mam wwv7 , tirC� _ m� D IV mmo I I i M. ^� Zym'o I m .11'/JTp (7 w y�0_0m I I [.v S Bozo I I n w w mmfo I I I 7 p rmA a Nti29 may�y- I O N I a I I Y Oa c) l Z I J O AA mX ; m I I I O y ooN - • • o I �//�� I r> 00 x m0? O I Vl I 2n U) Om XZ O � �<4{ ori i FAon mf EXISTING I npmil .J- ��o !)RIVEWAY I � I . z ' o$ ~ 05>1 w00 D W WI I �KNI 0.. ZO� KOp � AZ I I <n r I 0NA I Ln M Ow ym 1� I N �i'i• rnyj QA o T' m qX • --~ o> ASL :!r :�'•, Municipality of Anchorage Blasi�o�s Development Services Department a .» - Building Safety DMslort ����crri�ra ae.r Ort -Site Water and Wastewater Program %"«'••'•ROBE 4700 South Bragaw St C. COWAN ROBERT G COWAN P.O. Boz 190850 Anchorage, AK 99419-0850 C, CE -8801 �i (907)34�9011te ,l�ti; •-....«.........� �J Soils Log - Percolation Test Performed For. 1 —02 % a/ V I �'i � Date Performed: 41 IS I o L Legal Description: -or 91 /Jow" t jov o s S I => - Depth Ott 1 a 2- ' 'O 3. 4- 0'. 4�i310� s- 6- L) ' 1 IT, v`t 7. C p g. - -31- 18- 17- 18- WAS WAS GROUND WATI ENCOUNTERED7 IF YES, AT WHAT DEP Depth to Water Ath Monkodrrgi r•eKUc IIUNrrwre 1 0. � try ) PERC HOLE DIAMETER TEST RUN BETWEEN — T7—FT AND FT COMMENTS PERFORMED BY: •7j C*-V,(.atzr P,3 6(2 CERTIFY THAT THIS TEST WA PERFORMED IN ACCOR NCE WITH ALL STATE AND MUNICIP GUI ELINES IN EFFECT ON THIS DATE. DATE: 11/11/0#/ Blasi�o�s ����crri�ra r•eKUc IIUNrrwre 1 0. � try ) PERC HOLE DIAMETER TEST RUN BETWEEN — T7—FT AND FT COMMENTS PERFORMED BY: •7j C*-V,(.atzr P,3 6(2 CERTIFY THAT THIS TEST WA PERFORMED IN ACCOR NCE WITH ALL STATE AND MUNICIP GUI ELINES IN EFFECT ON THIS DATE. DATE: 11/11/0#/ S& IEALTHAUHIONTY APPROVAS SEWER & WATER MANDMISIOM SEWER & WATER PancnoN ENCREERM STUDIES ANOREPORTS WELLNSPEcrroN & PLOW TEST STEFLANS [ Sal TEST PEROOLAHON TEST STRUCTURAL & LIECIAVO X NSnCTDNs ONSITE WASTEWATER OSPOSALMTI7A DE31GH ROBERT C. COWAN, P.E. CML ENGINEERS (907)6942979 ON-SITE WASTEWATER DISPOSAL SYSTEM FAx(907)694-1211 CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot 3, Block 3, Northwoods Subdivision April 21, 2004 GENERAL: 1. The scope of this project includes the installation of a pump basin and a pressurized drainfield to serve the existing three 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 underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. 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. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 17034 NORTH EAGLE RNER LOOP • SURE 204 • EAGLE RNER, ALASKA 99577 Page 2 Lot 3, Bbd 3, NOM'T ods Subdivs Apd 21, 2004 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 foundation. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCIUDRAINFIELD INSTALLATION: 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. Once the gravel is installed, the distribution pipe is to be installed level with the holes faced downward. The distribution piping is to be of PVC (ASTM D3034 or equal). All joints are to be solvent cemented. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. 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. 4. 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. The 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. 5. 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. MININIUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. Page 3 Lot 3. Block 3, Nortwoods SubAtion Apra 21. 2004 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 I-II or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. 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 specifications applies. Page 4 Lot 3. Blade 3. No twoods Subdivision Apri 21. 2004 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, pits, 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 any way 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.A. 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 ROBERTC. COWAN, P.E. ROBERTA. SHAFER P.E. CML ENGINEERS (907)694-2979 March 31, 2004 Fax (sol) 694-1211 W.ALTNAVTH0FM MUNICIPALITY OF ANCHORAGE APPROM3 Development Services Department P.O. Box 196650 Anchorage, AK 99519 SEWER&WATER MVNEMNSKM REFERENCE: Lot 3; Block 3; Northwoods Subdivision SEWERAWATER It is requested that you issue a permit to replace the failed septic tank with a new MPECTM 1000 gallon minimum septic tank, to serve the existing three bedroom dwelling on the referenced property. ENOWERM SrUMs The existing septic tank has partially voided with a depression over it, indicating that the AWREPORTS tank has failed. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve WM*rPECNON areas or drainage patterns by the installation of the proposed septic system. The &FWWTEST construction of this system will not prevent any future development on any of the adjacent properties. ATE n,AS If you require additional information, please contact us. Sincerely, RovoEsIGH *Roert ?Aowa-n.-, E. SM NEST RCC/bjj Enclosure PERCCLATIGN TEST STRUCTL4Ma MECNAMCAI. lbPECTIGNS ONSITE WASTEWATER GISPOSALSYSTEM CESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER ALASKA 99577 111 = 401 DESIGN SITE -PLAN yQo � OU naa : 9 I I o r�� L I _a `ern c.yz D 8 0 1'1 I � osi I � W C r r Czo I I m Fos~ "o I D o C" I I m G7 O � n y o =oma I 7 ` '7 N Dm vA XII I N CJ 'v/ I I 3 z (1fnN Cnti Z ~ Z ~ a :7 Lf) W I O om zx o aT r 0r o - o I 1-3= U. ^ 1^Zou on zs IIIII W I O H W O O DRIVEW Y I O I A v W \: W�W O • I '00 z Z JC=p I A n �..J I _ z ti oy1 I I =cA - I <:N O y o"o I W CA D m M f� �'t" I D I N I o om, I F-1 ~ ••:tr 1111 I k 'l�f,^�•1 a�CF I tl v: i s ' �� o =-J MUNICIPALITY OF ANCHORAGE 6 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME �y P ONE —2X3 ` 0KJ1jEW O UPGRADE MAILING ADDRESS LEGAL DESCRIPTION !✓ell J / v /f,�/�, l✓ r4 AIIAi L0,J S LOCATION NO. OF BEDROOM DISTANCE TO: Well ` Absortjtieri e Dwellin� t PEfttD'j IT�fV / (� sz ` Uy w F Manufacturer Mate No. of compartmenls .� G � rn Ligons . pit al �� IF HOMEMADE: Inside length Width Liquid depth o y DISTANCE TO: Well ! Dwelling PERMIT NO. J0z /V = z F Manufacturer Material Liquid capacity in gallons O DISTANCE TO: Well Foundation Nearest lot line PERMIT NO. W = J W z No. of lines Length of e ch *me Total length of lines Trench width Distance between lines f„ z w inches I— Top of tile to finish grade Material beneath tile Total effective absorption area ❑ inches LU Length Width ,� Depth J PE I Nllggl i Type of crib Crib diameter Crib depth Total effective absorption�aga,.,,- W �� CC ll 0 LU DISTANCE TO: Well�l H / — A- Building f-yndap�� i✓ Nearest lot lineZ .� _ J Class yp�th•�,1 Driller Distanc to I1t lin PERMIT NO. J li//%V W DISTANCE TO: Building fou dation Sewer line Septic tank - Absorption area(s) OTHER PIPE MATERIALS y SOI L TEST RATING %) INSTALI R a f 4e REMARKS e , MUNICIPALIT F NC ORA p� wc�Y. DEPT.HE/LTi \I- AL OT CTI N ENV17ONVE DATE LEGAL i .._..---- 77-013 (Rev. 3/78) P! P -A 1 1/ ��I "'r, �_ 0 �� �-.���� �F-:::g PC�� DEPF���TMENT �r/HEHLTH FIND ENYI�ONM�NT�L ��OTECTI�� 825 'L/ STREET/ HNCfi8RHGE^ HI 99501 � 264-4720 �� i EE F ���Me 1� �,ERMIT N[1 ( 810881 ) HPPLICHNT OBOX D/ CHU6IHK 688 I1 LOCHTION NORTHWOODS S/D LECJ HL LOT ] BLK ] NQRTHWOODS S/D LOT SIZE 20000 SQU8RE FEET TYPE OF '=-.OIL. HBSORPTION SYSTEM IS: DRHINFIELD MHXIMUM NUMBER OF BEDROOMS SQIL RHTING 280 THE REQUIRED SIZE SOIL HBSORPTION SYSTEM IS: / ���-T- �C����� ��� �������� ������� 10;__ THE LENGTH DIMENSION 'THE �E LENGTH (IN FEEF T T) OF' TRENCH OR DRHINFIELD. THE DEPTH OF H TRENCH OR PIT IS THE DISTHWCE BETWEEN THE SURFHCE QF THE GROUND HND THE BOTTOM OF THE EXCAVATION (IN FEET), ��� ������� �1��� 1�� �. ��� �����, THE GRHYEL DEPTH IS THE MINIMUM DEPTH OF QRHYEL BETWEEN THE QUTFHL1 PIPE AND THE BOTTOM OF THE EXCHVHTION (IM FEET) P EE C! k- 9 1 F�! FE. E> EE:, PA _T_ 1 97-1 IF- F1 r -A I���� �P-ED CD'l �������� PERMIT APPLICANT HAS THE RESPONSIBILITY TQ INFORM THIS DEPHRTMENT DLRINQ THE INSTHLLHTION INSPECTIONS OF HNY WELLS HDJRCENT TO THIS PROPERTY HND THE NUMBER OF RESIDENCES THHT THE WELL WILL SERVE -I- 1A ��� 1 PA!�3 F-"� E: C-1-7- I CK I F�!! FE"., Cn GHCKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION HND HPPROVHL BY THI5 DEPHRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND HNY ON-SITE SEWAGE DISPOSHL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM fl PUBLIC WELL DEPENDING' UPON THE TYPE OF PUBLIC, NELL MINIMU�� DISTHNCE FROM H PRIVHTE WELL TO H PRIVHTE SENER LINE I�� 25 FEET AN TO H COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY HPPLY. SPECIFICATIONS AND CONSTRUCTION DIHGRHMS ARE AVAILABLE TO IN�UF.,E PROPER IN�THLLHTION. -r -r E� H=:m 1 F:�, KC, �C-_' E-_ vel E--3 E� !F�. IL^ �_�Fv��� I CERTIFY THAT' 1: I HM FHMILIHR WITH THE REQUIREMENTS FOR ON-SITE SEWERS HND WELLS AS 5ET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTHLL THE SYSTEM IM HCCORDW-4CE WITH THE CO[)ES ]� I UWDERSTH��D THAT' THE ON-SITE SEWER SYSTEM MHY REQUIRE ENLHRQEMENT IF THE RESIDENCE IS R INCLUDE MORE THRN ] BEDROOMS, � SIGNED:___���-_�����������`___-___-_-^___~�__^~.~~ HPPLICHNT SKHGGS CONSTRUCTION �&JarG. /n���»+ wl � "- � '-~ � ~vm+�6k ^ 4m / O & E ENG-iJEERING & DEVELOFAENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 ° Russell Oyster Earl Ellis 694-2774 SOIL LOG 688-2280 Performed for: Name: j 7-;�F G/ /V z' - `-5 /</)6ev 5 C�-"l-crS7 Tel. No. 4615- 2 "T3 / Mailing Address: �)' �� )6 r 4f /-/o,=r i� ice' 4P—' 1 S� -, Legal Description: /r _ 1� �:��i� /`/i/�Tff Depth (feet) P/' 4;�- / Soil Characteristics 0 1 /1�L:c-r o>e- 2 3- 4— Ole 4 6 12 7 8 9 10 PLOT PLAN /lV 12 13 PERC.TEST _ 16 { CSF At too Ground Y c • a`� Ground Water Encountered: Yes No If yes, what depth ® �TH e Proposed Installation: Seepage Pit- Drain Field- 2 ield / �/ � •• aa°e eo.e •a.*� ��°ate• Comments: it/.s ✓ �'� �9 ' Earl P. Ellis / °e NO. 1745-E e I in 02-0 Z -e ©e 124- 00 00 10 PLOT PLAN /lV 12 13 PERC.TEST _ 16 { CSF At too Ground Y c • a`� Ground Water Encountered: Yes No If yes, what depth ® �TH e Proposed Installation: Seepage Pit- Drain Field- 2 ield / �/ � •• aa°e eo.e •a.*� ��°ate• Comments: it/.s ✓ �'� �9 ' Earl P. Ellis / °e NO. 1745-E e 5. LEGAL DESCRIPTION L. - RECEIVED INSPECTION APPOINTMENTS STREET LOCATION TIME TIME I TIME G. TYPE OF RESIDENCE DATE DATE DATE INSPECTORINSPECTOR ❑ MULTIPLE FAMILY INSPECTOR 7. WATER SUPPLY MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. Or I-r:;A. ;I & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL Pa �TFCIION 825 L Street • Anchorage, Alaska 99501 A since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY ENVIRONMENTAL SANITATION DIVISION 8. SEWAGE DISPOSAL SYSTEM Telephone 264.4720 INDIVIDUAL/ON-SITE** REQUEST FOR APPROVAL OF INDIVIDUAL R E C � I E �� WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER PHONE MAILING ADDRESS�T�/�� -6104_ -1-1-7 i-) '/C? ^7 PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS _T_1_ INSTITUTION PHONE MAILING ADDRESS 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION STREET LOCATION G. TYPE OF RESIDENCE NUMBER OF BEDROOMS / Lz: SINGLE FAMILY ❑ One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six 7. WATER SUPPLY ❑ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY Cir_ NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. /2-UlU (Hev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE f l SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE E� THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL r COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM TXINDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA 4. DISTANCES WELL T0: MATERIAL. Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS APPROVEDFOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY UBMIT TAL SEP 15 2015 GC �U • Municipality of AnclMgg Stw = A . >u On -Site Water and Wastewater Program (907)343-7904 sr err Certificate of On -Site Systems Approval Parcell.D. 051-731-37 Expiration Date: s -.z s-- L7 1. GENERAL INFORMATION Complete legal description North Woods, Block 3, Lot 3 Location (site address) 22444 McManus Dr. Current Prooertv owner(s) Susan Benavides Dav Dhone Mailing address Real Estate Agent PO Box 670195 Chugiak, AK 99567 2. TYPE OF DWELLING: Fx1 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 IX Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System 0 Public Sewer ❑ WaiverNariance request Received by: i �/1% vv Date: ( LIo��U1s COSA to be released to the eng n er, unless otherwise requested by the engineer. COSA Fee $ 6A(o— Waiver Fee $ Date of Payment `Z 11taf,51 Date of Payment Receipt Number D aZ J 8! Receipt Number COSA# 65U5 -1St$ 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. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SI NATURE System #1 Approved for 3 bedrooms System #2 Approved for bedrooms Disapproved Date 8/28/2015 Conditional approval for bedrooms, with the following stipulations: By: Original Certificate Date: — / J The uni ' ali o chorage 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. ATTACHMENTS: COSA Checklist X Septic System Advisory Well Flow Advisory COSAbluesheet ('- ., c Nitrate Advisory Arsenic Advisory Other If more than 1 septic system is on the lot: COSA Checklist # of I Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: Noith Woods, Block 3, Lot 3 Parcel ID: 051-731-37 A. WELL DATA Well type Public If A, B, or C provide PWSID # AWWU Well Log (Y/N) Date completed Sanitary seal (Y/N) _ Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level Well production g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic ug/L Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/HDPE Tank size 1,000 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Depression over tank (Y/N) N Date of pumping 11/4/2014 Pumper JR's Pumping ft. 9.p -m. Collected by: Date installed 4/12/2004 Cleanouts (Y/N) Y High water alarm (Y/N) N C. ABSORPTION FIELD DATA Date installed 11/15/1981 Soil rating (g.p.d./ft2 or ft2/bdrm) 280 SF/BR System type Bed Length 50 ft. Width 30 ft. Gravel below pipe lV ft. Total depth .3 Eff. absorption area 1,500 ftz Monitoring tube Y Depression over field N Date of adequacy test 8/25/2015 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test Q2. in. Water added 500 gal. New depth in. Elapsed Time: 80 min. Final fluid depth _ID'(2k in. Absorption rate >=,450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons _ in. "Pump off" level at_ Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Manhole/Access (Y/N) in. High water alarm level at in. Meets alarm & circuit requirements? Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleafint Sewer /septic service line Holding tank Animal containment'ar&s Manure/animalez8rorage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Absorption field 5+ Water main 10+ Water service line 10+ Surface water 10CY+ Wells on adjacent'lots 200+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water Service line 10+ Surface water 100+ Curtain drain 50+ Wells on adjacent lots 200+ F. COMMENTS G. ENGINI!'R'S CERTIFICATION I certify that 1 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 Steven -R. Pannone Date $/28/2015 COSA canary sheet 2-6-15.doc Water main 10+ Driveway, parking/vehicle storage110+ N Found 5/8" Rebar — 0 3 0 0 0 0 0 LOT 2 z 7' Wood Shed (No Foundation) LOT 41 NOTE: Dimensions are measured to the wood trim. MCMANUS DRIVE 1 15' Utility Easement Clean Out (TYp•) 0 0 [7 1—Level Wood Frame Residence Walk Landing 1 Wood Shed (No Foundation LOT 3 BLOCK 3 LOT 40 N Z 0 SCALE 1 " = 20' 0' 10' 20' 40' I hereby certify that an accurate survey of the following described Oe��AL tll + property: ❑F'•A:9S�� LOT NORT3, BLOCK 3H WOODS UBDIVISION (79-195) IH ••• • "r*I was made on —_ September 9, 2015 and that the improvement; ;,,, ,,,, •„ 0 situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no Kansa•lnl anikof �: Kar¢be improvements on the property lying adjacent thereto encroach on re � '+ the premises in question and that there are no roadways, Na. 3143-S ;',: transmission lines or other visible easements on said property except 1�+' as indicated hereon. Easements other than those shown on the ��� record plat may not appear on this drawing. Anchorage Alaska, this 14th day of September 2015. 1 LOT 4 Chain Link Fence LOT 39 1..i N N r W UJ x