HomeMy WebLinkAboutPROSPECT HEIGHTS #1 BLK 5 LT 5Municipality of Anchorage Page 1 of 3
Building Safety Division
Onsite Water and Wastewater Program
4700 South Bragaw Street
P.O. Bar 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: 9W020276 PID Number: 015-091-29
Name:
Wastewater System: Upgrade
Bob QI and
Address:
9500 Slalom Drive Anchors e, AK 99516
ABSORPTION FIELD
Phone: Number of Bedrooms:
5j' Wide Trench
Three 3
LEGAL DESCRIPTION
Soil Raring:
Total Depth from original grade:
1.2 GPD/Ft2
10 Ft.
Block: Lot Subdivision:
Depth to pipe bottom frau original grade:
Gravel depth beneath pipe:
5 5 Prospect; Hei hto No. 1
4 Ft.
6 Ft.
Township: Range: Section:
Fill added above original grade:
Gravel Length:
- Ft.
40 Ft.
Well: Existing
Gravel width:
Numberof lines:
Distance between lines:
3 Ft.
1
Ft.
Clwsdication (Private, A, B, C):
Total Depth:
Cased to:
Total absorption area:
Pipe Material:
Ft.
Ft.
480 Ft2
ASTM D3034 PVC
Driller.
Dale Drilled:
Static Water Level:
Installer
Date Installed:
Ft.
Acres e 5 5temo
b)15-16/2002
Yield:
PumpSetat:
Casing HeightAbove Ground:
TANK
GPM
Ft.
FL
SEPARATION DISTANCES
0 Septic ❑ Holding ❑ S.T.E.P. ❑ Other:
To
Septic
Absorption
Lift
Holding
ublic.(Privdte
Manufacturer.
Capacity in Gallons:
FronI
Tank
Field
Station
Tank
Sewer Line
Anchorage Tank
1,000
Well
>109
>109
N/A
N/A
>25'
Material:
Steel
Number of Compartments:
Two 2
Surface water
>100'
>100'
N/A
N/A
LIFT STATION — NONE ON LOT
Sim:Manufacturer:
Lot Line
>5'
>19
N/A
N/A
Gal_
>5'
>10'
N/A
N/A
"Pump on" level at:
'Pump ofr level at
High water alarm at
Foundaha,
in.
in.
in.
Drain
None
Noted
Pump Make 8 Model
Electrical Inspections performed by:
Curtain
Remarks:
BENCH MARK
Existin Septic Tank and Absorption Pit Pumped Crushed
Location and Description:
and Buried On Site.
Front Door Concrete 5too .
Assumed Elevation:
100.0 Ft.
Engineer's Stamp
F - q4
.............
.
...r.....49th........ .i.�
Inspections performed by: MEA Dates: tat 8/15/2002
0 i
s....-•--•--
MICHAEL E. ANDERSON
ndn
2 8/16/2002
;
��0 •:., No.
f Health and Human Services pp�ro3 approval
CE -4381 •.•'���'��
0�#.'+a1:�„.....
and
:���
Reviewed approved by �a ate)
Municipality of Anchorage Page 2 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904
On-Site Wastewater Disposal System or Well Inspection Report
Permit Number. SW020276
PID No. 015-091-29
A B `?S7
S1 89.2 79.6 80
S2 94.6 84.8
Ml 149.5 140.7
C4 150.2 138.6
C5 151.8 145.7
00 F0c
000 w��
5
C5
M1
C4 S2
sl
Three Well Off`
Bedroom
Home
36SSs
NOTE: Not a Surveyed As-Built. Locations Not Exact.
PLAN AS-BUILT
SCALE 1"= 60' e... .....�
•• MICHAEL E. ANDERSON •••j
No. cEaseI
•••��� j0.'OFES51.....
LOT 5, BLOCK 5, PROSPECT HEIGHTS SUBDIVISION NO. 1 h�,,,r•.•
Municipality of Anchorage Page 3 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
Permit Number: SW020276 PID No.: 015-091-29
EPS INSULATION
CU CU M
U 0 86.5 0 U U
n eq, n I n n n
1000 Gallon
U f H U
U
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & 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: SW020276
Legal Description: PROSPECT HEIGHTS #1 BLK 5 LT 5
Design Engineer: 0014 Anderson Engineering
Owner Name: Bob Olpand
Owner Address: 9500 SLALOM DRIVE
ANCHORAGE , AK 99516-1056
Date Issued: Aug 06, 2002
Expiration Date: Aug 06, 2003
Parcel ID: 015-091-29
Site Address: 009500 SLALOM DR
Lot Size: 118483 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
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.
Received By:
Issued By:
Date: c�
Date: 'F - �n ° c0 '-?-
Municipality of Anchorage
NAGS B4i
Development Services Department
Building Safety Division _ x
On -Site Water and Wastewater Program s a'F �IT Y
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 015.091-29 Permit Number SW 6.2 0 a 76
Property owner(s) Bob Olpand Day phone 522.7773
Mailing address (1) 9500 Slalom Drive Anchorage, AK 99516
Mailing address
Zip Code
Legal description (Lot, Block & Sub'd.) Lot 5, Block 5, Prospect Heights Subdivision No.1
Legal description (Section, Township & Range)
Lot Size ji� q.Ft.
L(g� Acres
THIS APPLICATION IS FOR:
Number of Bedrooms Three (3)
Sewer Only ❑ Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
/f d
Permit Fees: ` (® - Waiver Fees:
Date of Payment: ')'2° ` .ham Date of Payment:
Receipt Number:c� ✓�� Receipt Number:
(Rev. 12/00)
ANDERSON ENGINEERING
P.O. 60X: 240773.:....
:ANCHORAGE,'.AK ,99524
522 7773 522-6?.79:.(FAX)
July 28, 2002
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 5, Block 5, Prospect Heights Subdivision No. 1
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The existing absorption crib on the subject lot has failed and is beginning to collapse
and must be replaced to prevent property damage and a possible health problem. We
are therefore requesting a permit be issued for the construction of a new septic system
to serve the three-bedroom home. The attached Site Plan and backup documentation
identify the location and configuration of the new septic system and the parameters
used in the design. Also identified on the plans are the test hole locations and the
locations of the existing system and wells on this and adjacent lots. Drainage arrows
are also shown and current drainage patterns will be maintained after construction.
The test holes placed near the location of the proposed absorption trench indicated silty
sand with some gravel and a percolation rate of less than 1 minute per inch. We are
using an average application rate of 1.2 gallons per minute per square foot to design
the new absorption trench. No groundwater was found during the placement of the test
holes and none has been noted since. We are therefore proposing to construct a 3'
wide deep absorption trench with 6' of drain field rock beneath the distribution pipe.
The total depth of the trench will be 9.5' with the distribution line at 3.5' below the
surface. The total length of the trench will be 35'.
The ground surface on the lot slopes as shown on the attached Site Plan with fairly
shallow slopes in the front of the lot just off Slalom Drive. A bluff drop off exists just
above the location of the new septic tank and trench. The new septic tank and
absorption trench will be constructed in a fairly shallow area below the bluff in
conformance with Municipal requirements and parallel to ground contours where
possible. All components of the new trench will be constructed a minimum of 100' from
the well on this and adjacent lots. The system will also be constructed a minimum of
100' from any surface water in the area.
If the system is constructed in accordance with our design the following statements
apply:
Lot 5, Block 5, Prospect Heights No. 1
July 28, 2002
Page Two
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,
44t-�j 7� Q
Michael E. Anderson, P.E.
Attachments
F 49th
MICHAEL E. ANDERSON
._ Nn fF-4iR1 _
f'?Of ESStCt i
of
0
.A)
0
THIS
I
AREA SYSTEM PLAN
SCALE 1" = 100'
C
RE
M
! � TFL2
S� 35' Longg X 3'
X 6' Effecti
Absorption
1, 00 1
S� is
e
SCOPE OF WORK:
Tank / shed
V-4� P,
Existing
Well n
I. Pump, Crush and Backfill Existing Septic Tank. `
2. Pump, Crush and Backfill Existing Absorption Crib..
3. Intercept Existing Sewer Service Line Near Foundation.
4. Place Foundation Cleanout.
5. Place New 1,000 Gallon Septic Tank.
6. Construct New 35' Long X 3' Wide X 6' Effective
Depth Absorption Trench.
7. Regrade All Disturbed Areas.
8. Revegetate Area As Required.
SITE PLAN
SCALE 1" = 60'
LOT 5, BLOCK 5, PROSPECT HEIGHTS
SUBDIVISION NO. 1
DESIGN FACTORS:
Three Bedroom Home
Perc. Rate: 1 Min./Inch
Avg. Application Rate: 1.2 GPD/SF
SYSTEM REQUIREMENTS:
Deep Trench System
1,000 Gallon Septic Tank
6' Drain Field Rock
3 Bedrooms X 150 GPD 11.2 GPD/SF = 375 SF of Absorption Area
375 SF/12 SF/LF = 31.25 LF Trench Length
Therefore: Construct an Absorption Trench 35' in Length by 3' Wide With 6' of Drainfield
Rock Beneath the Distribution Lateral. Distribution Lateral to Be Placed 3.5' Below Existing
Ground . Total Depth of Trench to Be 9.5' Below Existing Surface. Cover Over Septic
Tank a Minimum of 4' or 2" of Insulation and 2' of Cover
3'
6"
6'
Natural
Backf ill
Geotextile
Fabric
4Vn
CP?c�ieauge 40)
74-6—Drainfield Rock
3'
9 4x
TYPICAL DEEP TRENCH SECTION
(NO SCALE)
NOTE: Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock.
Minimum 10' From Lot Line.
Minimum 4' Separation From Groundwater.
Minimum 100' Separation From Wells in the Area.
Minimum 10' Separation From Water Service Line.
111
49th
MICHAEL E. ANDERSON
% No. CE -4381 = s
PFS................ ���
Municipality of Anchorage
Development Services Department/On-Site Water and Wastewater Program
4700 South Bragaw, P.O. Box 196650, Anchorage, AK 99516-6650
SOILS LOG - PERCOLATION TEST
Performed For: Bob Olpand Date Performed:
Legal Description: Lot 5 Block 5 Prospect Heights Phase 1
SLOPE SITE PLAN
OG/PT
TESTHOLE NO. 1
0
0
Silty Gravel
with
Sand
GM Was Groundwater
Encountered? No
If Yes, What Depth?
Depth to Water
After Monitoring None
Date: 7127/02
Bottom of
Hole
S
L
O
P
E
............ .ry
.. 49th
MICHAc I E. ANDERSON C^
No. CE -4381
#1FPF ' •............. • O Fri
7/15/02 �� � "ROF �S o'- �
See Site Plan
Reading
Date Gross
Timo
Net
Time
Depth To
l/Jo4cr
Net
hrnn
�r
1
15 -Jul 12:01
.75"
2
12:11
10
Dry
10.25"
3
12:12
.625"
4
12:22
10
Dry
10.375'
5
12:23
.75"
6
12:33
10
Dry
10.25'
Perc. Rate: 1 MindInch Perc. Hole Diameter: 6"
Test Run Between 5 Ft. and 6 Ft.
Comments: Percolation Cavity Presoaked Prior to Testing.
Performed By: Mike Anderson. I, Michael E. Anderson Certify That This Test Was Performed
In Accordance With All State and Municipal Guidelines In Effect On This Date: 7128102
Municipality of Anchorage
Development Services Department/On-Site Water and Wastewater Program
4700 South Bragaw, P.O. Box 196650, Anchorage, AK 99516-6650
SOILS LOG - PERCOLATION TEST
Performed For. Bob Olpand Date Performed: 7/15/02
Legal Description: Lot 5. Block 5. Prospect Heights, Phase 1
SLOPE SITE PLAN
1OG/PT
2
3
4
5
6
7
18
19
TESTHOLE NO. 2
Silty Gravel
with
Sand
GM
See Site Plan
..49th ...
..•..
n: MICHAEL E. ANDERSON a
:4
� No. cE-4381 2
♦♦ *
tim:ROf ESS10N'i�'
Was Groundwater
Encountered? No S _
If Yes, What Depth? L
Depth to Water O
After Monitoring None P
Date: 7127102 E
Bottom of
Hole
Perc. Rate: 1 Min./Inch Pere. Hole Diameter: 6"
7 Test Run Between 5 Ft. and 6 Ft.
Comments: Percolation Cavity Presoaked Prior to Testing. Same Soil as Test Hole No. 1
Performed By: Mike Anderson. I, Michael E. Anderson Certify That This Test Was Performed
In Accordance With All State and Municipal Guidelines In Effect On This Date: 7128102
Reading
Date Gross
Time
Net
Time
Depth To
Water
Net
Drop
1
15 -Jul 12:05
.75"
2
12:15
10
Dry
10.25'
3
12:16
1"
4
12:26
10
Dry
10"
5
12:27
1"
6
12:37
10
Dry
10"
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 5, BLOCK 5, PROSPECT HEIGHTS SUBDIVISION NO. 1
GENERAL:
1. The scope of this project includes the pumping, crushing and
backfilling of the existing septic tank and absorption crib on the lot and
the procurement and placement of a new 1,000 gallon septic tank at
the location shown on the site plan and the construction of a 35' long
by 3' wide by 6' effective depth absorption trench also shown on the
Site Plan. The total depth of the trench will be 9.5' below existing
ground and the distribution pipe will be placed at 3.5' below the
surface. All components of the absorption trench must be constructed
a minimum of 100' from the well on this and all adjacent lots. A
minimum of 4' of fill must be placed atop the septic tank and 3' of fill
atop the absorption trench. In lieu of fill 2" of direct bury insulation
may be placed with 2' of fill atop the insulation.
2. Construction shall be in accordance with the approved site plan,
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 all underground utility
locates and for the layout of the septic system and verification of the
location of all lot lines.
4. Unless specifically agreed otherwise, the contractor shall be
responsible for final grading areas subsequently depressed from soil
settling. Property owner shall be responsible for revegetation of
affected areas unless specifically agreed otherwise.
5. Contractors installing wastewater disposal systems must be certified
by the Municipal Department of Health and Human Services for
system installations. Owners installing their own systems must receive
prior approval from D.H.H.S. before beginning system installation.
SEPTIC TANK INSTALLATION
1. The 1,000 gallon septic tank must be procured from an approved
septic tank manufacturer and installed at the location shown.
2. A septic tank is to be constructed by a certified septic tank
manufacturer. Construction shall include two 4" cleanouts for pumping
access.
3. The septic tank shall be sufficiently bedded to prevent settling or
shifting of the tank.
4. All standpipes on the septic tank shall extend a minimum of 12 inches
above final grade.
5. Tanks installed without 4' of cover shall have a minimum of 2" of direct
burial insulation.
Lot 5, Block 5, Prospect Heights No. 1
July 28, 2002
Page 2 of 2
6. A foundation cleanout shall be installed one to four feet from the
building foundation. Two cleanouts are required between the tank and
the drainfield.
7. Final grading over the tank shall be such that a positive slope exists
away from the septic tank.
DRAINFIELD CONSTRUCTION:
1. The drainfield shall be constructed to the dimensions shown on the
design. The bottom of the trench shall be within 2" of level.
2. Distribution piping must be placed level with perforations down atop a
level bed of drainfield rock. Rock should then be placed over the pipe
to provide a minimum of 2" of cover.
3. A silt barrier or geotextile fabric must be placed between the drainfield
rock and the natural soil backfill.
4. Monitor tubes must be 4" in diameter and installed at the locations
shown on the design. The portion below ground must be perforated.
5. Contractor shall verify the septic tank and drainfield are a minimum
100' away from any private water wells in the area, 150' from a Class
"C" Well or 200' from any community well.
6. Direct bury insulation must be placed over the distribution system if
less than 3' of backfill depth is available. Finish grade over the trench
must be mounded to prevent settlement or depressions.
7. Grade area surrounding the absorption trench to drain away.
8. A minimum 2' of accepting soil is required below the drainfield rock for
a 5' wide trench. Contractor shall verify this condition prior to
placement of the rock. All pockets of unacceptable materials must be
removed and replaced.
MATERIAL SPECIFICATIONS:
1. Septic tanks must be constructed by a municipally approved septic
tank manufacturer.
2. The following pipe materials are approved for use in septic system
installations in the Municipality of Anchorage:
Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated
and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and
ASTM D2662 or A.B.S. (perforated and solid).
3. Insulation shall be at least 2" thick extruded direct burial polystyrene
(Dow Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings
(Caulder, Fernco, or equal).
Lot 5, Block 5, Prospect Heights No. 1
July 28, 2002
Page 3 of 3
5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed
between the final drain rock layer and the native soil layer.
6. All drain rock shall be .5" to 2.5" in diameter with less than 3%passing
the #200 sieve.
INSPECTIONS:
Municipal Ordinance requires a minimum of two inspections. These
inspections must be conducted under the supervision of a professional
engineer registered in the State of Alaska. The first inspection must be
conducted after the excavation of trenches, beds or pits and before the
installation of any gravel. A septic tank may be set in place, but may not
be backfilled.
The second inspection must be conducted after the placement of the
geotextile fabric, gravel, distribution piping, standpipes, cleanouts and
insulation. No backfill should be in place at the time of inspection.
Contractor shall provide a copy of all field survey layout and construction
notes for use in preparing the certified as -built of the completed system.
GRATER ANCHORAGE AREA BOROyrHHEALTH n
327 EAGLE ST. ANCHORAGE, ALASKAN N� 9 99501 279.2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAI SYSTFAA
NAME,/ MAILING
f97Y ADDRESS %!% PHONE --
LOCATION LEGAL DESCRIPTION��L.�S
SEPTIC TANK:
DISTANCE FROM WELL _ `% /
MATERIAL S%�"�Z
NUMBER OF
COMPARTMENTS
LIQUID CAPACITY
.STJ-.��-�
l✓G /J�/ /j/G��,2'��'�
LIQUID
GALLONS.
INSIDE LENGTH
�� INSIDE WIDTH
DEPTH �—
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS/ OUTSIDE DIAMETER �`� OR WIDTH �� / LENGTH �� / DEPTH ,
LINING MATERIAL_yG ���/�% �iY�.YIo / . DISTANCE FROM WELL / BUILDING FOUNDATION
NEAREST LOT LINED TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT.
TILE DRAIN FIELD:/y�/0
DISTANCE FROM WELL NEAREST LOT LINE_
NUMBER OF A:Af
DISTANCE BETWEEN LINES TRENCH WIDTH
ABSORPTION SQ. FT. LENGTH OF EACH LINE
TOTAL LENGTH
OF LINES
IN. TOTAL EFFECTIVE
DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE
WELL: /�G/�%r������
- G�/hbl�� DISTANCE FROM / WATER
TYPE
DEPTH ,BUILDING FOUNDATION. �� �`' SAMPLE NEAREST
LOT LINE /C� `� NEAREST /f TANKC S / SEEPAGE �• OTHER _
SEWER LINE, SYSTEM �U CESSPOOL������ ,SOURCES
DISTANCES:
DIAGRAM OF SYSTEM
DATE �z/ �% �J�� APPROVED
�� ert ei unmry ��
GREATER ANCHORAGE AREA BORVUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. -/
3500 TUDOR ROAD POUCH 6-650
~ ANCHORAGE, ALASKA 99502
TELEPHONE 279.8686
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT
NAME OF APPLICANT/%� G--� MAILING ADDRESS ��e ����� ��� - HONE
INSTALLATION LOCATION
LEGAL DESCRIPTION �� - /_-fG a �4ef
INSTALLATION OF: SEPTIC TANK
SEEPAGE PIT
DRAIN FIELD OTHER
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
TO BE INSTALLED BY
SOIL TEST RESULTS �G�//r/� NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE
TYPE SEEPAGE �.�✓Z/�j'- C'J
SEEPAGE AREA SIZE TYPE .-/
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK 5 /
�0 /
FOUNDATION TO SEEPAGE PIT DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK SEEPAGE PIT C2 / DRAIN FIELD —
TO NEAREST LOT LINE.
L / /
WELL TO SEPTIC TANK �✓U SEEPAGE PIT
DRAIN FIELD
WATER MAIN TO SEPTIC TANK ,L
DRAIN FIELD
ALSO CONSIDER AREA WELLS.
SEEPAGE PIT
SEPTIC TANK,, SEEPAGE PIT ,�--, DRAIN FIELD LJ ,
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
f
EALTH AUTHORITY
OR
LICENSED DESIGNER
DIAGRAM OF SYSTEM
1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE A///ggREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE 7� APPLICANT'S SIGNATURE.
('RrAVEP ANTCIHORP,,:-t AREA BG "mi
HEALTH DEPAYUMENT CASE ii
32"' EAGLE STREET
AXCFORAGr, ALAPYA 99-501
Performed For 0
Date Performed
Legal Description, Lot
T.ScK
This Form Reports a� Scl I s -qLOP, Ei
Percolatlon
Depth
11
r eet Soil
c' j P c6,/" 17 A
Ile c/ cl
Ile
(.,r
117
o , c
Location Sketch
Was Ground Water Encountered? Yo
If Yes, At What Peptl,
Proposed Instal.tater Draln "ieJ.0"
Dec -ch Of Inlet
I To EMt;7T-=,f Pit 0- Trenc=41"' i
Test Performed Bv:- ("c
Data Certified By:
Ze-I
D �17�-Z A; 7
„.T
June 22, 1971
Alaska Mutual 5svings and Loan
5th and p street
Anchorages Alaska 99501
subjects On—Site suer 5yst era! •Yater Supply for Let 5
Blick 5os}aect };eight itabdivision Addition ate. 1•
Dear Sire
The subject lot is of adequate size to accomodate an on -silo
water supply and $oilon-site sewage disposal System, pending a
test and a paymit for con
shouldbeo problem installing the rn.site$Sewer ion ro
se
myste:n
The well should supply an adequte amount of petable water if
constructed to gorauah sneci.ficatiDns.
ai ncere X y,
Jobin R. Lee, P,.S.
Sanitarian
ccs lir. Robert Opland
1p
Certificate of On -Site Systems Approval
Parcel I.D. 015-091-29
Legal description Prospect Heights #1 Block 5 Lot 5
Site address 9500 Slalom Dr Anchorage AK
Current property owner(s) Voloshin
Expiration Date: Z° 3
X The On-site system(s) is/are approved for 3 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
Original Certificate Date: 1 L 3
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of
Anchorage, Development Services Department (DSD) issues COSAs based upon
representations provided by an independent professional engineer. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory X
Tank Age Advisory X Arsenic Advisory
Other
COSA Approval_June 2022
�1.1�UNMPQUTY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 015-091-29
Complete legal description PROSPECT HEIGHTS #1
Location (site address) 9500 SLALOM DR ANCH AK
Current property owner(s) VOLOSHIN
2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS
BLK5LT5
Day phone
3. TYPE OF WATER SUPPLY: X Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ❑ Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: ❑■ Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: X Steel ❑ Plastic ❑ Concrete ❑ Fiberglass
Age 2002 - See advisory if steel older than 20 years
7 ZO YF 6P -s
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: OF
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee $ Waiver Fee $
Date of Payment Date of Payment
COSA # Waiver #
COSA Application_ June 2022
Septic 'Wank Advisory
Certificate of On -Site Systems Approval #OSC 221571
Subdivision: Prospect Heights #1 Block 5 Lot 5
Starting at 20 years of age the MOA issues Advisory's for steel septic tanks The septic tank for
this COSA / property is 20 years old. A leaking septic tank may be a source of contamination to
the aquifer. Typical replacement costs range from $10,000 to $15,000
This advisory must be attached to all copies of the subject Certificate of On -Site Systems
Approval.
This is an example of a 16 -year-old septic tank in failure and should be replaced.
Mailing Address P O�Box 196650��` Anchoraon
ge, Alaska 99519 6650 *www muni org
Nitrate Advisory
Certificate of On -Site Systems Approval # OSC221571
Subdivision: Prospect Heights #1 Block 5 Lot 5
A water sample revealed a nitrate concentration of 7.12- milligrams per liter
(mg/Q. The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Please see the attached "Nitrate Fact Sheet" for important
information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
1
Marling Address P O Box 196650 *Anchorage, Alaska995196650 *www muni org n
>.r
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate
is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of
ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the
oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners,
food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years but is
associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of
young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood
stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the
concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered
from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home
water treatment systems such as softening, or iron filtration does not readily remove nitrate. The best
method for limiting nitrate in well water is source control. This can include avoiding overdosing of
fertilizer near the well and maintaining good separation distances between septic tank leach fields and
the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged
ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a
spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect
the activity of nitrate in water. This laboratory uses several different wet chemical methods approved
under the public water supply laboratory certification program. They also have test kits available, which
the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test kit results
against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend
using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.
�� Ma�lmg Address P O Box 196650 * Anchorage,�Alaska 99519 6650 *www muni org
COSA Checklist
Legal Description: PROSPECT HEIGHTS #1, BLK 5, LOT 5
Parcel ID: 015-091-29
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled *UN Total depth **>40'+ ft
Cased to UN ft
H Sanitary seal is functioning correctly
N Wires are properly protected
Casing height (above ground) 22 in.
Date of flow test for COSA 9/23/22
Well production at time of test 4+ gpm
Water storage tank volume 0 gallons
Well disinfected for coliform test? ❑ Yes N No
0 Coliform bacteria is Negative
Nitrate 7.12 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L X Arsenic less than MRL (ND)
Collected by MNA
Static water level at beginning of test 55.2 ft. Date 12/27/22, 2ND TEST
Comments 'WELL DRILLING AROUND 1971 PER MOA RECORDS, "TOTAL DEPTH >90'
B. TANK DATA
Measured operating fluid level in septic tank 48
Date of pumping 7/27/22
❑ Required maintenance completed, if AWWTS
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed) 8/15/02
0 ALL standpipes present per record drawing
Total measured depth from grade 10.5 ft (max)
Measured depth to pipe invert from grade 4.5 ft (min)
❑ N/A — pressurized field.
❑ Per record drawings, field is insulated.
❑0 Monitor tubes go to bottom of effective.
If not, state depth into effective
❑ Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months)
If yes, enter date
Com ments/Deficiencies:
COSA Checklist June 2022
C. LIFT STATION
❑ Required maintenance completed
Age of lift station _ years
Lift station material
Comments:
Adequacy test date 9/23/22
Results Q Pass
Fluid depth prior to test 20 in
Water added 450+ gal
New fluid depth 25 in
Elapsed time 1440 min
Final fluid depth 20 in
Absorption rate 450+ gpd
FIELD STATUS — POST RECOVERY
Effective depth (per record drawings) 72 in
Effective depth used 25 in
Effective depth remaining 47 in
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100'
no Yes if No _ ft
Neighboring Tank > 100' Fol Yes if No _ ft
Absorption Field on Lot > 100' E Yes if No _ ft
Community Sewer Manhole/Cleanout > 100'
Q Yes if No _ ft
Private Sewer/Septic Line > 25' QYes if No _ ft
Holding Tank > 100'❑ Yes if No ft
Neighboring Absorption Fields > 100' Animal Containment > 50' Q Yes if No _ ft
Ri Yes if No _ ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' EYes if No _ ft Q Yes if No _ ft
0 N/A — Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10' 0 Yes if No _ ft Surface Water > 100' O Yes if No _ ft
Tank to Property Line > 5'
Q Yes
if No _ ft
Field to Property Line > 10'
Yes
if No _ ft
Water Main > 10'
Yes
if No _ ft
Water Service Line > 10'
Yes
if No _ It
F. ENGINEER'S COMMENTS
Wells on Adjacent Lots:
Private Wells > 100'
Community Wells > 200'
ElYes ifNo_ft
Yes if No _ It
If tank or field is under driveway comment below
G. CERTIFICATION & 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, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm M N Pr Phone 727-8864
Engineer's Printed Name 1'4 /\I l- 12 � Date /4lq(73
•57,• MICHAELN. LRSC•4 f'
C,
>469
�OarpLGTfSoI `®®
COSA Checklist June 2022
fefty Oriffing, Inc
14
Hefty Drilling Inc.
3540 Akula Dr. Anchorage, AK 99516
(907)345-0593
heftydrilling@aol.com - e-mail
www.heftydrilling.com - website
Well Camera Inspection Report
Well Cased 40'+- Ile
Casing breaks or leaks above 40'— NO
Well head stick up 18" - %r 5
Condition of well cap & conduit -
Comments:
Inspected by:
..gib.... Lro.S.....
SOOOL
Date: 1-5-12S
Site: q `5 0 v � 10 e ,�
742
OF A,Cgs�OpG
V 49 TH*
SHANE A. HOLT
LS -6914
0 d
pAD
THE/NFORMAT/ON HEREON IS FOR THE USE OFLEND/NG INSTITUTIONS SPECIFICALLY TO SHOWANY
f es S ionak �'a�o
�O�000�0o
CONFLICTS BETWEEN EX/ST/NG STRUCTURESAND PLATTED LOT LINES AND/OR EASEMENTS, AND IS
NOT TO BE USED FOR POSIT/ONING ADDITIONAL STRUCTURES, IMPROVEMENTS OR FENCEL/NES.
EASEMENTS OFRECORD, OTHER THAN THOSEAPPEARING ON THERECORD PLAT, ARE NOTSHOWN
HEREON (UNLESS INDICATED)
NOTE FENCELINES THAT MAYAPPEAR DN THIS DRAW/NG ARENOT TO BE USED TO DETERMNE
PROPERTYLINESORPOSIT/ONADDIT/ONAL IMPROVEMENTS.
ANYPA VING SHOWN HEREON MA YBEAPPROXIMA TEDUE TO EXCESSIVESNOWAND70R ICE
NOTE. UTLLITYEASEMENTSARF ALSO AVAILABLEFOR HORSEBACK
RIDING, HIKING, AND SKIING
AS -BUILT SURVEY 1" -50'
NO CORNERS SET THIS DATE
I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY
OF THE FOLLOWING DESCRIBED PROPERTY
LOT 5 BLOCKS PROSPECT HEIGHTSADD'N 9
ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE
VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN
THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS
EXIST OTHER THAN NOTED.
DATED AT ANCHORAGE,ALASKA THIS 29TH DAY OF
AUGUST , 2022 HOLT LAND SURVEYING
9309 GROVER DRIVE
ANCHORAGE,AK 99507
,15603 226 75 223-8615 3750GCINET