HomeMy WebLinkAboutPOTTER HEIGHTS BLK 1 LT 4Potter Heights
Block 1
Lot 4
#020-281-29
Municipality of Anchorage
Community Development Department Page 1 of 3
On -Site Water and Wastewater Program
4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP151115 PID Number: 020-281-29 ❑ New ❑✓ Upgrade
Name:
Joe Earsley
ABSORPTION FIELD
0 Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound
Address
6910 Potter Heights Drive Anchorage, AK 99516
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
3
.6GPD/SF
10 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
2 Ft.
Gravel depth beneath pipe
8.0FL
Subdivision Block Lot
Potter Heights 1 4
Fill added above original grade
1-2 Ft.
Gravel length
50 Ft.
Township Range Section
Gravel width
3Ft.
Beds: Number of Lines
Distance between lines
I Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Lift Station
Tank
Line
800 Fez
One
I Ft.
Well
>100'
>100'
>100'
>75'
>25'
TANK El Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Anchorage Tank
Capacity
1,000Gal.
Surface Water
>100'
>100'
>100'
>100'
Material
Steel
Number of compartments
Two
Lot Line
>5'
>10'
NIA
NIA
NA
Foundation
>5'
>10'
N/A
N/A
LIFT STATION
Manufacturer
Capacity
Gal.
Curtain Drain
None
Noted
Pump on level at
Pump off level at
High water alarm at
RemarksExisting Septic Tank Decommissioned in
in.
in.
in.
Accordance with Municipal Code.
Pump make and model
Electrical Inspections performed by
PIPE MATERIAL House to tank D3034 Tanktofield D3034
drainfield
Installer
G&R Excavating
Dminfeld F810 CO/MT D3034
Inspector MEA
BENCH MARK (Assumed elevation) 100.Oft
Inspection 1�
6/3/15 6/4/15
Location and description
dates: 2nd
Garage Slab.
30 4,h
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
En%RkToL'kV
OF•q�gf�,
.��F-
Q;.• ' S
Conditional Approval: Date
e*: 49TH•••
*....�/
00 ......... ...... .....
j...::Z::f..................
rte„ MICHAEL E. ANDERSON
#I
CE -4381 •:�2�
Approved Date 7'IS'
Ilk `,R`s` v�
Inspection Report l-1-Tg.40c"
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 Elmore Road Anchorage, AK. 99519-8855 - 343-7904
Permit Number. OSP151115 On -Site Wastewater Disposal System or Well Inspection Report
POTTER HEIGHTS
pR►VE
2
LOT 3
43,560 s.f.
Page 3 of 3
PID NO.:020-281-29
50' SCREENING
EASEMENT ___--
NOTE:
Existing Septic Tonk and Absorption
Trench Decommissioned in
Accordance with Municipal Code.
Z\1 'C
O Hi
g$
3
LOT 5
N
ThreeCP
Bedroom \
Home \
DECK \
GARAGE % RST ��7 \,
25' PUBLIC SE T/! ��'
EASEM NT F/�90 LOT 4 yl
43,560 s.f.
10' UTILITY POWER LINES I
EASEMENT WELL I
------ --- -------
-------------
------- ------------
N 89'51'15'W 163.76' N 89'51'15"W 149.06'
•,
P .................. ��i
UNSUBDIV/DED
*20.1P
''
i 49th •i ��
-Li'.
LEGEND
2
LOT 3
43,560 s.f.
Page 3 of 3
PID NO.:020-281-29
50' SCREENING
EASEMENT ___--
NOTE:
Existing Septic Tonk and Absorption
Trench Decommissioned in
Accordance with Municipal Code.
Z\1 'C
O Hi
g$
3
LOT 5
N
ThreeCP
Bedroom \
Home \
DECK \
GARAGE % RST ��7 \,
25' PUBLIC SE T/! ��'
EASEM NT F/�90 LOT 4 yl
43,560 s.f.
10' UTILITY POWER LINES I
EASEMENT WELL I
------ --- -------
-------------
------- ------------
N 89'51'15'W 163.76' N 89'51'15"W 149.06'
•,
P .................. ��i
UNSUBDIV/DED
•
i 49th •i ��
-Li'.
LEGEND
,t (J I _
M1 —
Monitor Tube
MICHAEL E. ANDERSON t
`
°�-�
PLAN A S BUILT
-
FCC
SFoundatio
— Foundation Clean Out
f•'•; No. CE -a381
���•••T�`
TH —
C4 —
Test Hole
Clean Out
��.�
���_
P.Pn.-.�..c(@1P�_'���
SCALE 1" = 50'
2C0
— Double Clean Out
Municipality of Anchorage
Page 3 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904
On-Site Wastewater Disposal System or Well Inspection Report
Permit Number: OSP151115
PID NO.:020-281-29
98.6
U co N U13
emm //FFTnkMWM
- Ground Gmund
YIm latbn
,000 Gallon
1494.75
1 Septic Tank
.6
U F
96.6
95.0
Fnlehad tgetle
Gta7a
2" Insulation & Geotextlle Fabric
93.2 Drainfield Rods
93.2
85.2
79.0 50'(Trench Length)
No Groundwater
10-20-14
q��!�♦♦
..P�.OF
....y...�./...}}...... %th...... /...... ......... .....
%...:..l..r............
PROFILEAS-BUILT
/MICHNo, p438RSON'=
CEE.
♦♦♦ ••.,�, f"!�r••.•.�%.��
No Scale
On -Site Wastewater Disposal System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number:
OSP151115
Tax Code Number:
02028129000
Work Type:
Septic Upgrade
Permit Effective Dates: May 27, 2015 to May 26, 2016
Design Engineer:
ANDERSON ENGINEERING
Subdivision:
POTTER HEIGHTS
Site Legal Address: POTTER HEIGHTS BLK 1 LT 4 G:3639
Owner/Address: EARSLEY JOE & JAMI
6910 POTTER HEIGHTS DRIVE ANCHORAGE AK 995166101
Site Mailing Address: 6910 POTTER HEIGHTS DR, Anchorage
This permit is for the construction of:
Lot Size in Sq Ft: 43560
Total Bedrooms: 3
Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater
Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80).
3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received
Issued By
MUNICIPALITY OF
Community Development Department
Development Services Division
On -Site Water & Wastewater Program
ANCHORAGE
Phone: 907-343-7904
Fax: 907-343-7997
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 020-281-29
Property owner(s) Joe and Jami Earsley Day phone 310-2501
Mailing address 6910 Potter Heights Drive Anchorage, AK 99516
Site address Same
Legal description (Sub'd., Block & Lot) Potter Heights, Block 1, Lot 4
Legal description (Township, Range & Section)
Lot Size 43,560
Sq. Ft.
Number of Bedrooms Three
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑X
Initial F-1
Single Family (SF)
❑X
(w/wo ADU)
Septic Tank
❑X
Upgrade ❑X
Duplex (D)
❑
Holding Tank
❑
Renewal ❑
Multiple Dwellings
❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Dis tance:
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: J`�q
Date of Payment: S t
Receipt Number: ®$�S
Permit No. 051961
Permit App_.:- :'_a,
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 FAX
May 3, 2015
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 4, Block 1, Potter Heights Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer
The existing septic system on Lot 4, Block 1, Potter Heights Subdivision has failed and
must be replaced prior to the issuance of a Certificate of On Site System Approval
(COSA). We are therefore requesting a permit be issued for the construction of a new
septic system to accommodate the home. The attached Site Plan and backup
documentation identify the location and configuration of the proposed septic system
along with the existing system and the existing well. No existing wells or septic systems
are closer than 100' from the proposed septic system as all properties surrounding the
lot are vacant. Lots 3 and 4 are owned by the same parties and the driveway access to
Lot 4 off Potter Heights Drive is currently on Lot 3. Drainage arrows 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 proposed absorption trench indicated
silty sand and gravel (SM/GM) material. The percolation rate of the soil was
determined to be 23 minutes per inch. No groundwater was found during the placement
of the test hole and none was noted during the monitoring period which included a
recent inspection. An application rate of .6 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
STEP tank and 2 - 25' long by 3' wide by 8' effective depth absorption trenches to treat
and dispose of the effluent generated in the house. The elevation of the distribution
line in the absorption trenches will be 2' 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 absorption trenches slopes to the
Lot 4, Block 1, Potter Heights Subdivision
May 25, 2015
Page Two
northeast at approximately 5% to 10%... The new trench will be constructed parallel
with the contours of 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' from 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.
Sincerely,
asL
Michael E. Anderson, P.E.
Attachments
P,••••49th ycI
MICHAEL E. ANDERSON
potter Heights we
__--
10 /;jam-'� •.
50' Screening i
i Easement __ }
% � � � � - SYSTEM REQUIREMENTS'
,
----
"----
--------- � 1,250 Gallon STEP Tank
i- 2-25' Long x 3' Wide
x 8' Effective Depth
`� - _ % - -_- Euisting Absorption Trench. i Absorption Trenches.
Doeommission in Ac
cordgnee�
Municipal Code, j
2-25' Long x 3'
Wide x 8' Effective
- Depth Absorption
Gravel �'•� \\ i �= - Trenches
/ Driveway \! ( LOT 5
_ MT
1
{ ° J VACANT
1, 0 GallonTH1
__ ___-__-___ _ _- , % i,
--- STEP ank H / I /•
't 1 NOTESW:
- - MT t Decommission Existing
FCO ' Septic Tank in Accordance
/ / ',•'I j' / with Municipal Code. Place
/ New 1,250 Gallon STEP
/ Subdrain / Thre�, f / Tank.
outfall i I� 'Bedrdom /
%Home
CONTOUR INTERVAL - 2'
_ \ 1
--✓ / � --------� \ � ���� �% /' k/ LEGEND
-'- LOT/3 5�i / % \ CO - Cleanout
// ! _" MT - Monitor Tube
No Well Or, eptic - — / \ % // meg= ji j SV - Septic Vent
TH -Test Hole
FCO -Foundation Cleanout
FSV - Flow Splitter Valve
�- Ground Slope
LOT 4, BLOCK 1 <i
Garage %% POTTER HEIGHTS
43,560 Sq. Ft.
\ ( Existing
\ \ \
j / V -Well \ \ �.__-_\ ••1 ,•) �
se.- me
/ i i . !"--1�'Tft'I i . Easement,/ / /" i' / j
UNSUBDIVIDED .•�P�.• ' "'' •..• ���j
VACANT 49thJill
-A`Mic��` CTTP PI AN SONG
SCALE 1' = 40'
LOT 4, BLOCK 1, POTTER HEIGHTS SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS
Three Bedroom Home Deep Trench System
Perc. Rate: 23 Min./inch 1,250 Gallon STEP Tank
Application Rate: .6 GPD/SF 8' Drainfield Rock
Pressure Distribution System
3 Bedrooms X 150 GPD/.6 GPDISF (Application Rate) = 750 SF Absorption Area
750 SF/16 SF/LF = 46.8 LF Trench Length
THEREFORE: Construct 2 - 25' Long by 3' Wide by 8' Effective Depth Absorption Trenches
at the Location Shown. Flowline Elevation in the Trench to be 2' Below Original Ground
Surface. Total Depth to be 10' Below Existing Ground. Provide 4' of Cover Over Septic Tank
and 3' Cover Over Absorption Trench. Maintain 100' Separation from Wells in the Area and
20' From Uphill Subsurface Drain.
Natural
Backfill
IV'
Geotextile
Fabric
6" O 1" Perforated
PVC (Holes Down)
30 - 3/16" Holes
@ 1.5' On Center
M
3'
Drainfield Rock
TYPICAL DEEP TRENCH SECTION
(NO SCALE) * (�.OF gC�p1�
NOTE: Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock. ...:: 49th
............
Minimum 4' Separation From Groundwater. • ,�,
Minimum 100' Separation From Wells in the Area. �..........HAEL.........ERSO"""
MICHAEL E. ANDERSON
Minimum 100' Separation From Surface Water or Streams.- •i, ;_ No. IS1111 �,
MUNICIPALITY OF ANCHORAGE
• DEVELOPMENT SERVICES DEPARTMENT
4700 BRAGAW STREET ANCHORAGE, AK 99519-6650
DEPTH
(feet)
1 -
2
3
4
5
6
7
8
9
10-
11
1
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: LOT 4, BLOCK I, POTTER HEIGHTS SUBDIVISION
PERFORMED FOR: JOE EARSLEY
DATE: 10/13/14 PROJECT No.:
PARCEL ID#: TECHNICIAN: A. HARALA
TEST HOLE 1
OB/OG
d
0
d
6
SILTY SAND W/GRAVEL
e
d
a
SM/GM
� d
d
SLOPE
WAS GROUND WATER ENCOUNTERED? NO
rte., ••
49th
E. ANDERSON
SITE PLAN
SEE SHE PLAN e
IF YES @ WHAT DEPTH?
DEPTH OF WATER AFTER MONITORING: NONE 0 5%
DATE OF MONITORING: 10/20/14 r
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH To
WATER
(INCHES)
NET DROP
(INCHES)
TEST HOLE PRESOAKED PRIOR TO TESTING:
10/1
1
2:14
1.88"
2
2:34
30
3.19"
1.31"
3
2:35
1.75"
4
2:55
30
3.06"
1.31"
5
2:56
1.63"
6
3:26
30
2.94"
1.31"
PERCOLATION RATE: 23 (MIN/INCH) PERC. HOLE DIA.. 6 (INCHES)
TEST RUN BETWEEN: 3 FT. and 4 FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 5/8/15
DEFT-IRTME:N•,IT L_,_ , HEAt_. IJ -I AND ENVIRONMENTAL ,__„-ITEC; T I ON•d
F
.- `L.''-IORAGE: AK. -95:1= TEfN.
li-^-ii E-_• t>_.._. L_ H== -_':m e_u e'-4 — °_° 1 —1" E. '=.- Lam' € ^-p E-7 F-: F=- (G= F-'° d"°l T _F
PEh: N I T NC;W_ ;
-� 9 3 0 79 C
APPLICANT SCOTT C=:AH I LL
LOCATICiN
LEGAL. LOT =t Et_.k:: _L POTTEF: Hl
13E Y -JE' RF -IL DEL.I'v'ER'r°
i
LOT SIZE -9,991D99
TYPE OF SC+IL_ ABSORPTION 'SYSTEM IS: C,Rl=iIhiFIEL[j
i' IAr::.Iril_irll NUMBER OF. BE'DI=:C_uCr'1S _OIL RATING ;:':;C;! F=T,`E;F:;T: 85
THE REQUIRED SIZE. OF THE SOIL ABSORPTION SYSTEM I S :
C-" E- 6-" V-rl _.:_ ^ ::� �__ >F �' ^ a W:9 d .- :_ -: a C� iF=° CH IEE F-' T H -a a
SQUARE FEET
•�9-
THE LENGTH DIIIEN'NSION 15 THE LENGTH TN•d FEET'.1 OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF A TREhIC.'H OR PIT IS. THE DISTANCE BETWEEN THE: SURFACE OF THE:
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET).
F -&ii EE " fE=. r-4 � _- F -i (!-^-9 T: Cn -It- 0'-i .0 "' . A�fl _ nom- n �e a l< = E ..
THE GRAVEL. DEPTH I: THE f'IIk'klMl_M DEPTH OF GRAVEL. BETWEEN THE OUTFALL. F'IF'E
.AND THE: BOTTCif'1 OF 'THE E=C°A%JATION'a CIN F'EET::..
11--Z EE CA u I R-" 11= PEA E=_ F- 7- 1 C: `F 2 :� 9'-.911-:; � ;; � -_L fl=_ -d C -d C-4 C i F- L._. i._ fin E, -A'_3
PERK I T ADPL I C.AhIT HAS THE RESPONdS I E. I L I T'r' TO i I,.4FORM THIS DEPARTMENT DURING THE
iNSTALLATIOhl INS5PECTION.,:.3 OF ANY WELLS ADJACEIT TO THIS PROPERTY AND THE:
NUMBER OF' RESIDEN'dC:ES THAT THE. WELL WILL SERVE.
--' -'- - �. °- �. A _ . _ : fl ` F- C -T- _�. ��a �..4 5 f I F�;_ >E__ �: � C- U I it -s:: [H- E -fl
BACKFILLING OF ANY SYSTEN WI-FHOLIT FINAL INSPECTIOki .AI'•D AF'F'F-.'OVAL BY THIS
DEPARTHENT 14It_L. BE SIJB-.'.E=:T TO PROSEC:LITICIN'd.
MINIMUM DIS TANCE. BETWEEN A WELL AhID AN' Y is i'•,I- ITE S EWACiE D I SPO_C,AL SYSTEM IS
.00 FEET FOR A PRI'. ATE WELL OF: 150 , TO 200 FEET FROI'el A PUBLIC: WELL DEPEN•-ID I N• G
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DI:WTH=IN•,ICE. FRI:Jil A PRI'v'ATE IdE'LL. TO A PRI'S'AT'E SEI,JER L-IN'dE I` 25— FEET AN'dD
TO A C:Or' M IN'd'I' I SEWER I.- I k'IE IS 75 FEET.
i. -JELL LOG'S, ARE REQUIRED AND MUST BE PREI+JF;,' ED TO THE DEPARTf9EN•dT 1.41 T HIN DI-I'rS
OF THE WELL C:`C Cf'If='LE• T I Ok'J.
OTHER r ff-,' APPLY. SPECIFICATIONS:, AhID C:OhIS.TRUC:TION DIAGF=:AMS ARE:
RVAILABLE TO Ik'.ISUF.E. PROPER IN•aS•TFIi._L.ATI'Cti';I.
I ._T EFS - I = T i' 11 F•� IEE F ,` -- �L _ f L--
1 CERTIF'r' THAT
1.: I AM FH='MILIAR WITH THE: RE_!LCIF:EMENTS FCvCF: Ok,i—F,ITE _SEkIER:=• AkID WELLS A:= SET
FORTH BY THE '1-9L HN I C I PAL.I T'T OF ANCHORAGE.
: I WILL INSTALL THE :='r':_: i Er'I IN AC:CORDAkIC:E HITH THE C:OCE_,.
I UNDERSTAND D THAT THE Ohl—SITE SEWER SYS TF-.i°l 11A',-' REQUIRE ENLARf EMENT IF' THE
RESIDENCE IS REHODF. L.ED TO INCLUDE: MORE THAN =_ BEDROOr°ISC.
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_ MUNICIPALITY OF ANCHORAGE --
/-,�j 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
(% 4..' - , f L %
PHONE
NEW
UPGRADE
MAILING ADDRESS.
'/ n 1 ++ --
iff LL)42j"
LEGAL DESCRIPTION
Lod
LOCATION
NO. OE.BEDROOMS
U
DISTANCE TO:
W I
GE'1Q 7
Absorption area ,�,
�`
Dwelling
�r
PERYT NO. -
36790
y
wQ
F
Manufacture -
Material f
No. of compartments
U)
Liq. capaci y in gallons
IF HOMEMADE:
Inside length
Width
Liquid depth
r�O
6
DISTANCE TO:
We
Dwelling
PERMIT NO.
2 Z F
Manufacturer
Material
Liquid capacity in gallons
O
DISTANCE TO:
Well
lC7i�
Foundation
l
Nearest I lire
PERM T�, ll
w=
i-
J LL z
No. of Ines
Length of ch fine
Total le th`of lines
Trench, 'dSh
Distance b tween lines
F Z W
%
(C3 inches
4 F
the finish
Mate is beneath tile
Total of ec,l{'v�e absorption area
Top of to grade
oI
nches
._57_
Length
Width
Depth
PERMIT NO.
Lu
a
4 F
Type of crib
Crib diameter
Crib depth
Total effective absorption area
wa
W
W
Well
Building foundation
Nearest lot line
DISTANCE TO:
J
Class
Depth
Driller
Distance to lot line
PERMIT NO.
J
W
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHERAii
-
PIPE MATERIALS
(��ctST
SOIL TEST RATING
(J
INSTALLER
REMARKS
�
G
v
a
APPROVE
DATE LEGAL
119v -7M6 /7/7-s
72-01-rTRev. 3178) ��
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MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 0 PERCOLATION
TEST
825 L. Street, Anchorage, Alaska 99501 284-4720
SOILS LOG - PERCOLATION TEST
PERFORMED FOR: S-1eJe_ Celrr DATE PERFORMED: LAC 16 1� 53�
LEGAL DESCRI PTION: CYC Qi�lS 1� L 1 IDR '-N Q:Z O -I
SSLLOP�E�'����� SITE PLAN
4QE Pr
IF E 10 L) pra n,lic 50.1
I I �
I I
-�• 2,
`�W� clear` .-.e l A.ndre:grn.tl
3 <5ok, S ,4
r zo min I Q� i H
9 s C
10
11
12
13-
314
Gross
14-
Depth to
Net
Reading
%Time
Date
�tt OFA4. A
15
Water
r'<Q 60. ••
•.
16
s C2
%*! 49
N
17
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�A9t�,
Le C. 7Eei L
18
f G�j �. o. 22514
19
�� �PROFESSO"
all
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
25 S
L
O
P
E
s
PERCOLATION RATE (minutes/inch)
// TEST RUN BETWEEN FT AND FT
COMMENTS �.. 1 "C't-� nl Z �e. I rr. -fie A L 1"'I n.� �•� 'w 1� �q
6 5 H C� 5'- i -
PERFORMED BY: a t CERTIFIED BY: DATE:
r
72-008 (6/79) "L � � 7 12�-. _
Gross
Net
Depth to
Net
Reading
%Time
Date
Time
Water
Drop
0 will
V..
C
•��ac,AV
PERCOLATION RATE (minutes/inch)
// TEST RUN BETWEEN FT AND FT
COMMENTS �.. 1 "C't-� nl Z �e. I rr. -fie A L 1"'I n.� �•� 'w 1� �q
6 5 H C� 5'- i -
PERFORMED BY: a t CERTIFIED BY: DATE:
r
72-008 (6/79) "L � � 7 12�-. _
• Municipality of Anchorage _� a
On -Site Water and Wastewater Program
(907) 343-7904-,:...• . s a r ,
-Certificate of On -Site Systen-i! Approval
Parcel I.D. 020-281-29 ExpiratiorT Date: z o ` 7-15-
1.
—15y1. GENERAL INFORMATION
Complete legal description Potter Heights, Block 1, Lot 4
Location (site address) 6910 Potter Heights Drive Anchorage, AK 99516
Current Property owner(s) Joe and Jarni Earsley _ Day phone
Mailing address 6910 Potter Heights Drive . Anchorage, AK 99516
Real Estate Agent Day phone
2. TYPE OF DWELLING:
Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family
and/or Duplex)
3. NUMBER OF BEDROOMS:
Three
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Q
Individual
0
Individual Water Storage
❑
Holding Tank
❑
Community Class Wel!
❑
Community
❑
Public Water System
❑
Public Sewer
❑
WaiverNariance request for:
Distance:
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer. -
COSA Fee $pp� Waiver Fee $
Date of Payment t �j5 U �'y Date of Payment
Receipt Number b�J4o I tit Receipt Number
COSA# 01�)Ci51330 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
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E.
6. DSD SIGNATURE
✓ System #1 Approved for 3 bedrooms
System #2 Approved for
Disapproved
Conditional approval for
bedrooms
Phone 522-7773
Date 7/1/2015
OF•q��e
ir:49TH Vv\ .�
bedrooms, with the following
AEU E. 7ND'ERS0N : � m
GE -4381
By: Original Certificate Date: 7— 7 _ l✓r
The nisi afl fA rage 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 engineers work.
7. ATTACHMENTS:
COSA Checklist
Septic System Advisory
Well Flow Advisory
COSAbluesheetr'- :, C
X
Nitrate Advisory .
Arsenic Advisbry
Other
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: Potter Heights, Block 1, Lot 4
A. WELL DATA
Well type Private If A, B, or C provide PWSID #
Date completed Sanitary seal (Y/N) Y
Total depth >200 ft. Casedto UNKft
FROM WELL LOG
Date of test
Static water level
ft.
Well production 9 -
p.m -WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mL Nitrate 3.96 mg/L
Arsenic N D ug/L Date of sample: 6/9/15
3W� U�ife�01014A§t.c010NA&AITA
Parcel ID: 020-281-29
Well Log (YIN) N
Wires properly protected (Y/N) Y
Casing height (above ground) >18 in.
AT INSPECTION
6/18/15
167 ft.
Collected by: And. Engineering
Tank Type/Material Septic/Steel Date installed 6/3/2015
Tank size 1,000 gal. Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout (YIN) Y Depression over tank (Y/N) N High water alarm (Y/N) _
Date of pumping New Const. Pumper
C. ABSORPTION FIELD DATA
N
Date installed 6/4/15 Soil rating (g.p.d./ft2 or Obdrm) .6 GPD/SF System type Deep Trench
Length 50 ft. Width 3 ft. Gravel below pipe 8 ft.
Total depth 11'5 ft. Eff. absorption area 800 fe Monitoring tube Y Depression over field N
Date of adequacy test New, Const. Results (Pass/Fail) For 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.
Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date
D. LIFT STATION
Date installed Size in gallons_
"Pump on" level at in. "Pump off' level at
Datum Cycles tested _
E. SEPARATION DISTANCES -AWWU Water System
WELL ON LOT TO:
Septic tankilift station on lot
>100'
Absorption field on lot
>100'.
Public sewer main
>75'
Sewer /septic service tine
>25'
Animal containment areas
>50'
SEPTIC/HOLDING TANK ON LOT TO:
Manhole/Access (Y/N)
in. High water alarm level at in.
Meets alarm & circuit requirements?
On adjacent lots >100,
On adjacent lots >100,
Public sewer manhole/cleanout >100'
Holding tank >75'
Manure/animal excrete storage areas >100,
Building foundation >51 Property line >51
Water main >10' Water service line >10'
Wells on adjacent lots >100'
ABSORPTION FIELD ON LOTTO:
Property line >10' Building foundation >10,
Water Service line >10 Surface water >100
Curtain drain None Noted Wells on adjacent lots >100'
F. COMMENTS
G. ENGINEER'S CERTIFICATION
t certify that l 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 Michael E. Anderson, P.E.
Date 7/1/2015
COSA brown sheet 10-10-12.doe
Absorption field
>5'
Surface water >100,
Water main N/A
Driveway, parking/vehicle storage >10'
491 .
IASL E. ANDERSON : s
CE -4381 >
,*ROFESSIb0 ee`
LOT 2
25' PUBLIC USE
EASEMENT
10' UTILITY
EASEMENT
OtE valt A/E
-14 -
PLAYHOUSE
CARPORT
50 SCREENING
J EASEMENT
PIPES
�— aoa
RESIDEN E
LOT 4
43,560 s.f.
N 89`5175 Nle 149.6£
\(NSUBDIVIDED %
[Kai
PLOT PLAN AS BUILT _ X_ SCALE 7" @ 6O' GRID SW 3639 Project No. 75—t84fAl
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Municipality of Anchorage
ONSITE WATER & WASTEWATER PROGRAM
CHANGE ORDER
PERMIT # OSP151115
PID No: 020-281-29 SUBD Potter Heights TRACT BLOCK 1 LOT 4
CONTACT PERSON Michael E. Anderson, P.E. PHONE 522-7773
FAX 677-7766
PLEASE GIVE A DESCRIPTION OF THE CHANGE: The topography of the lot was found to be slightly different than
shown on Lidar data for the area. Sufficient area was found parallel to the contours of the surface to allow a
single 50' long absorption trench rather than 2 - 25' long trenches. The new absorption trench was constructed
parallel to the contours of the slope found on the property. The location was verified by the City inspector.
CUSTOMER SIGNATURE 04..� Z_ OJ—,
On -Site
Reviewer:
APPROVED (date)
)mments Review
Issued Time
(date) (hours)
HOURS
HOURLY RATE $140
TOTAL TO BE PAID
DATE PAID
RECEIPT #