HomeMy WebLinkAboutHYLEN CREST #1 BLK 1 LT 3Hylen Crest
#1
Block 1
Lot 3
#050-472-85
Municipality of Anchorage
Development Services Department
Building Safety Division
- On-Site Water and Wastewater Program, 4700 S. Bragaw SL
P.O. Box 196650 Anchorage. AK 99519-6650 Page 1 of 2
www.cl.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. SWO60127 PID Number. 050472.85
R«"RRY FOSTER
Wastewater System: ❑ New ® Upgrade
A«.772271, ANCHORAGE, A 99577-2271
ABSORPTION FIELD
Ph" NunaN of a.raam.
694-M37 4
® Deep TnnM D sn.nar TrNtT O e.e D «ane O oar.
LEGAL DESCRIPTION
801 RWV
Total Depth ern rpnr areae
0.8 Gpox?
7.9 Ft.
Blau Lr SWrr.m:
D.ph b ppe aaaam from rprW arW.
Gr.wl Apar b~h ppr
1 3 WLEN CREST
1.8 Ft.
6.1 Ft
T"Wary Rrq. s.rrm
Fa a etre rgrw greae
or" L«ym.
14N 1W 8
1.6 Ft.
63 Ft.
Well: ❑New rade
❑ Upg
G ' "N
3
ar realer.
1
D,«. a. U.a...n etre
O
Ft.
Fl
cM.ehralrn (pm«.. A 0. cI
TNN Dept: cue b
7r« st,"p on ere.
Poo M«NW
COMMUNITY WATER
Ft. FL
750FP
ASTM 30 C F810
Oris
DN. Drra SW. WNN L"YgrNr
DN. YrINNd
FL
MARTIN CONSTRUCTION
6/29/2006
Yw
Pumpbel«
C"" M.."M Mw. Gram
TANK
GPM
Fl.
FL
SEPARATION DISTANCES
® Septic ❑ Holding ❑ S.T.E.P. ❑ Other.
To
Septic
Absorption
LIR
Holding
tibirlpavate
ad1if
'y
From
Tank
Field
Station
Tank
Sewer Una
ANCHORAGE TANK
1250 G«
L/.rn.l
Mun�wr a Conp.nmpu
w9l
-
-
-
-
-
STEEL
2
sMracewNN
+100'
+100'
—
—
LIFT STATION
LNLne
+5'
+10'
—
—
NO LIFT G«
ear«
+5'
+10'
—
'Pump on' r"« at
'Pump otr M «
Mph "ler ««m r
Frlura.lrn
N
ti
it,
+50
+50'
Prep MM. a Mea«
Ercmrr erpe pwftm by
Cu. D.
RN
BENCH MARK
Lonbon rm D...plrn
GARAGE FLOOR SLAB
M N
100 Fl
Inspections performed by: CHRISTOPHER R WOOD Dates: 1' 612812006
2ne 6/2912006
Development Services Department Approval
7-31 TOPHER WOOD
,• CE-10387 '
,J
Reviewed and approved by: / Date: - 3 -O6
(an ITNo)
•••`w`E$$I......;Oi�q,'�•tt
Permit No. SW060127
Page 2 of 2
Municipality of Anchorage
DEVELOPMENT SERVICES DEPARTMENT
ON—SITE WATER & WASTEWATER PROGRAM
4700 SOUTH BRAGAW STREET P.O. BOX 196650, ANCHORAGE, AK 99519-6650
On—Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: HYLEN CREST#1 LOT3 BLOCKI 050-472-85
• N
Lot 3 =�
20' DIP SLEEVE
AND INSULATION
z_
z
Li
M
Li
w
HOUSE
Qu
93.2
IIIIIIII
NEW 3'X63'
TRENCH
ELEVATIONS
(NOT TO SCALE)
I
Lot 2 scALE 10
_30•
SWING TIES
L' 1 18.4 1 {1.1
NEW 1250 GAL ID 1 21.8 1 28.4
SEPTIC TANK
117
ASSUMED ELEVATION • 100'
MT -1 1.6' FILL MT -2 1 TH-I
1.5'
TANK 1',016'GRVEL?.sN.V.T.
1,250 Ge
o ° o. 86.7 80.6
88. 92.8 BOTTOM OF T.H.
6/28/2006
:NGiNEER'S SEAL
,0000Op00
�. Q...... �q �t
"diMSTOPHER R. MOOD
CE -10387
,4p�PRpFoo�o
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water 8 Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Date Issued: Jun 05, 2006
Expiration Date: Jun 05, 2007
Permit Number: SWO60127 Parcel ID: 050-472-85
Legal Description: HYLEN CREST #1 BLK 1 LT 3
Design Engineer: 0848 EAGLE RIVER ENGINEERING SEI Site Address: 021008 UPPER LOWLAND AVE
Owner Name: LARRY FOSTER Lot Size: 20000 SO. FT.
Owner Address: PO BOX 772271 Total Bedrooms: 4 Permit Bedrooms: 4
EAGLE RIVER. AK 99577-9513
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 specked 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
1)
Date:
Date: rl
\ Municipality of Anchorage
Development Services Department
Building Safety Division • #(..
On -Site Water and Wastewater Program
" 4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
ON-SITE SEPTIC/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcell.D. n5D-L4q 5 -
Property owner(s) 10.r r v F-0 ssF< r Day phone A,9 -el - OL --1-10
Mailing address PC) lex -7'1 J,�-i l A-uhmmgs , A k- Zip Code
Site address '-1008 L.1 Aa« L CLU ICENrl AV'( . HZZip Code cjcl S-1-7
Legal description (Sub'd, Block & Lot) j::1-ln1,tr0 C. r<S4- 1471 L- 3 61
Legal description (Township, Section & Range) -T 1 A rJ Se (. 8 IZI vJ
Lot Size 3 o, 000 Sq. Ft.
THIS APPLICATION IS FOR (®all that apply):
Absorption Field
Initial
Septic Tank
LAS
Holding Tank
❑
Privy
❑
Private Well
❑
Water Storage
❑
Number of Bedrooms -7
THIS APPLICATION IS AN:
Initial
❑
Upgrade
❑
Renewal
❑
certify that the above information is correct. I further certify that this application is being made for a
Single Family ailing a d 's in accordance with applicable Municipal Codes.
��
(Signature of property owner or authorized agent)
Permit/Rush Fees: kka, W Waiver Fees:
Date ofPayment: 5 31 I �� Date of Payment:
OL)
Receipt Number: 1 Receipt Number:
(Rev. 11105)
Eagle River Engineering Services
Christopher R. Wood, P.E.
10421 VFW RD. Suite 201 (907) 694-5195 tel
Eagle River, AK 99577 (907) 694-3297 fax
May 30, 2006
Dan Roth
Manager, On -Site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Re: IIylen Crest #1 Lot 3 Block I
Narrative & Permit Application
Dear Mr. Roth:
Eagle River Engineering Services (ERES) was contracted to design a new septic system at the
above referenced property. The proposed 4 bedroom septic system will have very limited impact
on adjacent properties for the following reasons:
1. The surrounding developed lots are all connected to the public water system , so
this lot and neighboring lots have room for septic systems and alternate sites
2. Immediate neighboring septic systems arc all +30' distance if not shown, and no
private (or community) wells within 200' of the proposed septic system.
3. This permit is for a septic system only.
4. Drainage will not be affected and is not a major consideration in our design.
5. Slopes are less than 25% in the area of, and adjacent to the proposed leachfield
sites.
Installation of the new deep trench septic system on this lot will not adversely affect the septic
systems or reserve areas on adjacent lots.
If you have any questions please call our office at 6945195.
Sincerely,
EAGLE RIVER ENGINEERING SERVICES
YIOA41
Christopher R. Wood, P.E.
Principal
\2003\06-030SEPTICNARRATI V E
TRACT A
NO WELL+200'
NO SEPTIC +30'
�-
®
— TEST HOLE
•
— MONITOR TUBE
0
— SEWER CLEAN OUT
+
— WELL
— —
— EASEMENT
— PROPOSED LEACH FIEL
EXISTING LEACH FIELD
ORNEWAY
UPPER LOWLAND AVE.
30' f
NO WELL+200'
SEPTIC +30'
ASO. 15 T&E•tl0UND
ASEMENT
r > RNA�P� KEY
L t.3-,:
A ANDON E>
PTIC TAN
ER MOA S�
�I
z
�I
wl
al
w
I
F I
�I
o �
ABANDON
EXISTING
ANDARDS
HOUSE
I&IlLIlilp
30'
9 I Lot 2
NEW 1250 GAL
SEPTIC TANK
y/N 0 NO WELL+200'
0
10' S'
MIN 10'
I MIN
TH-1 1
®1 V
IKtNLH LAT 0 0
NO WELL+200' SEPTIC AREA
NO SEPTIC +30'i1. NO KNOWN SURFACE WATER
o
TRACT 2C2. NO KNOWN CURTAIN DRAINS +100'.
3. NEIGHBORING LOTS SERVICED BY COMMUNITY WATER
WELL/SEPTIC SITE PLAN I
LEGAL: HYLEN CREST#1 LOT 3 BLOCK 1
OWNER: LARRY FOSTER
CONTRACTOR: MARTIN CONSTRUCTION
JOB# 06-030 1 DATE: 5/30/200 SCALE 1 "=30'
EAGLE RIVER ENGINEERING SERVICES
P.O. Box 773294
EAGLE RIVER, AK. 99577
(907) 694-5195 FAX. (907) 694-3297
Eagle River Engineering Services
Christopher R Wood, P.E.
to42t VFW Rd. Suite tot (907) 694-5195 tel
Eagle River, AK 99577 (907) 694-3297 fax
SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM
LEGAL: Hylen Crest NI Lot 3 [stock 1
May 30, 2006
A. GENERAL
1. The well and septic plan is for a 4 bedroom single family residence only.
2. The drawing and or site plan shall be apart of this specification.
3. All materials and workmanship shall meet the Anchorage Department of Ilealth and State Department
of Environmental Conservation requirements.
4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer.
5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet
Municipality of Anchorage, Department of Environmental Conservation requirements.
6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any
adjacent multi -family wells.
7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer
approval.
8. Any remaining open test hole excavations shall be filled and monitor tube removed.
9. It is the responsibility of the contractor to obtain any lot line staking or well radius staking, etc.., by a
licensed surveyor prior to installation of any component of the septic system. Although not required, it
is highly recommended, and is purely the responsibility of the contractor if any component of the
wastewater system is installed too close to any lot line, house foundation, well radius, surface water, or
any other object which the MOA requires specific setback requirements.
B. SEPTIC TANK
1. The sewer piping from the house shall be 4" PVC 3034 laid at 2% grade minimum, and insulated with
2" of burial foam if shallower than 3 ft., with 2 R. minimum. A foundation cleanout shall be installed
within 4' of the house foundation.
2. The septic tank shall be an Anchorage Tank 1,250 gallon 2 chambered septic tank. Contractor may
submit alternate tank and for approval, as long as it meets MOA requirements. Two opposing aflcr-
tank cleanouts shall be installed.
C. TRENCH
1. The trench is to be located as shown on the site plan.
2. The total depth of the initial trench excavation is to be 8' max. relative to existing ground elevation at
ground water monitor tube. The bottom of the trench shall be level, plus or minus 1.5".
3. A 6 foot layer of sewer rock is to be placed over the native sand and gravel. The 4" effluent piping is
to be laid on top of the gravel layer with, with 6" additional gravel added as follows: 4" along sides of
effluent pipe, and 2" of gravel cover over the piping.
4. The completed trench gravel and piping is to be covered with typar fabric material.
5. Soil or combination of soil and extruded board insulation to a depth of+3' or equivalent is to be placed
over the leachfteld. Soil shall be contoured over the trench to prevent runoff from ponding.
Approximately 1.5 feet of fill shall need to be excavated from the slope above the trench, and placed
over the trench, to meet the minimum coverage of 3'.
Continued on next pare
\\Eros\DOCS\WPDOCS\2006\06-030trcnch- spec.doc
Eagle River Engineering
Christopher R. Wood, P.P.
10421 VFW Rd. Suite 201
Eagle River, AK 99577
Continued:
RECOMMENDED LEACHFIELD DIMENSIONS:
Services
(907) 694-5195 tel
(907) 694-3297 fax
TOTAL DEPTII = 8' GRAVEL DEPTH = 6' under effluent pipe, 2" over pipe
TRENCH LENGTH = 63' TRENCH WIDTII = 3'
SOIL RATING = 0.8 GPD/fl? BEDROOM CAPACITY= 3
SEPTIC TANK= 1,250 gallons
EFFLUENT PIPE= 4" diameter of Muni and Engineer approved materials and construction
NOTE: Where septic line crosses water line, there shall be a minimum of 2' of vertical separation.
Sewer line material shall be Schedule 80 pipe with NO splices within 10 feet of the projected
intersection. Sewer line shall be underlain with 2" of blue board insulation In this area as well.
Twenty-four (24) hours notice required for all inspections.
\\Ercs\DOCS\WPDOCS\2006\06.030trcnch- spcc.doc
EAGLE RIVER
ENGINEERING SERVICES
P.O. Box 773294
Eagle River, Alaska 99577
(907)694-5195
ERES Project No.: 06-030
Calculated By: CS
Date: 5/302006
Legal: HYLEN CREST#1 LOT 1 BLOCK 3
Single Family 4 Bedroom Dwelling
Deep Trench Subsurface Wastewater Disposal Field
TEST HOLE 1, 1
Water use at 150 gallons per bedroom = 600 gallons
Percolation rate = 6 minutes per Inch
Wastewater application rate = 0.8 gallons per day per square foot
Required absorption area = 750 square feet
Trench width (W) = 3 feet
Gravel depth (D) = 6 feet
Required length = Required absorption area / 2 / D
Required length= 750 / 2 / 6
Required length - 63 feet
Total Excavation Depth = 8Z feet
$•0' eAik
06-030TRENCHCALC 3:14 PM5/302006
EAGLE RIVER ENGINEERING
10421 VFW RD, SUITE 201
EAGLE RIVER, AK. 99577
(907) 694-5195 FAX: (907) 694-3297
SOILS LOG - PERCOLATION TEST
PERFORMED FOR: LARRY FOSTER DATE PERFORMED 5/17/2006
LEGAL DESCRIPTION: HYLEN CRESTNI LOT 3, BLOCK 1
TEST HOLE N 1 SLOPE
DEPTH F
(FEET)
1
wu
O O.
WELL GRADED
• SAND AND GRAVEL MIX
WELL GRADED SAND
• �,', PATH SOME GRAVEL
16
17
18
19
21
=A,
i
... . .
00
0.1
'.CHRISTOPHER R. WOOD. Q,
"if '. CE -10387
01
,� 1,OFESSI011
TOWNSHIP RANGE SECTION T14N. R1W. SEC.8
ral
PERC TEST RESULTS
READING
DATE
GROSS TIME
NET TIME
.°;°•
NET DROP
1
05/17/2006
12:27
0:00
6'
TIGHT WELL GRADED WAS GROUND WATER
1/2
0
SAND AND GRAVEL MIX ENCOUNTERED? NO
05/17/2006
o'••T.
IF YES AT WHAT DEPTH N/A
12
o
3/4
13
' °•0
DEPTH TO WATER AFTER NONE
12:40
:.•
MONITORING?
9
°, .°
0
14
DATE: 5/31/2006
12:50
is
6'
11
16
17
18
19
21
=A,
i
... . .
00
0.1
'.CHRISTOPHER R. WOOD. Q,
"if '. CE -10387
01
,� 1,OFESSI011
TOWNSHIP RANGE SECTION T14N. R1W. SEC.8
ral
PERC TEST RESULTS
READING
DATE
GROSS TIME
NET TIME
DEPTH TO WATER
NET DROP
1
05/17/2006
12:27
0:00
6'
9
1/2
0
2
05/17/2006
12:37
0:10
6'
11
3/4
2 1/4
3
05/17/2006
12:40
0:00
6'
9
1/2
0
4
05/17/2006
12:50
0:10
6'
11
1/2
2
5
05/17/2006
12:53
0:00
6'
9
1/2
0
6
05/17/2006
1:03
0:10
6'
11
7/16
1 15/16
7
05/17/2006
1:08
0:00
6'
9
1/2
0
8
05/17/2006
1:18
0:10
6'
11
1/4
1 314
9
05/1712008
1:19
0:00
6'
9
tl2
0
10
05/17/200!1
1:29
0:10
6'
11
1/8
1 5/8
11
05/1712006
1 1:30
1 0100
6'
9
1/2
0
12
105117120061
1:40
1 0:10
1 6'
11
1/8
1 1 5/8
PERCOLATION RATE- 6 (MINANCH) FERC HOLE DIAMETER -6'
11136111111:0,12 Iu . :.�
PERCOLATION TEST BY. CHARLES BALZARINI
I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE
AND MUNICIPAL GUIDELI ES IN EFFECT ON THIS DATE. DATE:—E6040
Jun 17 99 12:59p JERRY LEACH (907) 694-8501 p.2
M rem 93:11
Date: 17, June 1999
We hereby notify DHIIS as required by permit of the intent to terralift the
following property.
Lot: 3
Block: I
Subdivision: HYLEN CREST
Address: 21008 Upper Lowland
Engineer Consulted: Yes _X_ No —
KND
Jerry Leach
Alaska Drainfield Restoration
President
RECEIVED
JUN 17 1999
Muniapaliiy ul A"Onorage
Dept. Health & Human Services
MUNICIPALITY OF ANCHORAGE
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
PHONE
NEW
LJ �u - /7
�`l�-2G3�
❑UPGRADE
MAILING ADDRESS
'e - _ v c- e 2 � fz K �`� Si 1
LEGAL DESCRIPTION
LOCATION )
1
NO. OF BEDROOMS
ILI: e / vim.-
.�
Well
Absorption area /
Dwelling o
PERMIT NO.
Uy
DISTANCE TO:
'fi%!/.1/V/�`
S •'E"W-
/Miumaoiz
h Z
Manufacturer
Material
No. of compartments
Z�
N
�a ted'✓�TE:'L
Limy in gallons
IF HOMEMADE:_
Inside length
Width
Liquid depth_
-�
❑ Y
DISTANCE TO:
Well
Dwelling
PERMIT NO.
2
Manufacturer7/7
Material
Liquid capacity in gallons
w
DISTANCE TO:
Well Foundation
^f- CJ /
Nearest lot ling, r
/ .�
PERMIT NO. L
_j LL Z
No. of lines
Length of each I'ne/ Total length of lies
Trench wid,>Jt
Distance between lines �/
Z w
- —
- .� inches
?Q
H
Top of file to finish Material beneath
grade //// 1 / tile
`T
Total effective ab crpt& a ea
��N
❑
-2- '� Z --inches
3 2Z
Length
Width Depth
PERMIT N0.
W
C7
Q H
wa
Type of crib
Crib diameter Crib depth
Total effective absorption area
N
DISTANCE T0:
Well Building foundation
Nearest lot line
Class
Depth D it er
Distance to lot line
PERMIT NO.
w
/F1
_
(�-
J11
DISTANCE TO:
Building foundation Sewer line
Septic tank
Absorption area(s)
OTHER
PIPE MATERIALS
P vc
SOIL TEST RATING
n
INSTALLER
L> e - Ac
REMARKS
C'
c,
P� c c o
V
� V
L
it J'v"a� No. 1457-Fi 1
D
AP VED DATE LEGAL
� � rrr Jc�lral"I. rr�ral
rr� 1�3ilka 69Jei
j '7
�
//j/�
i� i t/
720)(Rev. 3/78)
MUNICIPALITY OF ANCHORAGE
Department f Health and Environmenta Protection
825 Street, Anchorage, AK. .j9501
264-4720
# # HANDWRITTEN PERMIT #
Permit # / WELL AND/OR ON-SITE SEWER PERMIT
Applicant: �Mailing Address:
o
Location: Phone Number:
Legal Description: ��'l �a� (�%St d'✓ Lot Size: 000
Type of Soil Absorption System Is:
Trench: Drainfield: _ Seepage Bed: Holding Tank:
Maximum Number of Bedrooms: Soil Rating(sq.ft/br)��_ 6�
The Required Size of the Soil Absorption System Is:
DEPTH eq LENGTH �/ GRAVEL DEPTH SYZ WIDTH
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE = GALLONS #
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
# # # TWO(2) INSPECTIONS ARE REQUIRED # #
Backfilling of any system without final inspection and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31, 1 9 3 3
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enl ment if
the residence his remodeled to include more t 3 bedroom
Signed: _C,� �(°._ Qet� Issued by
Applican � % �7
Date: /
SWP/024(1/81)
X SOILS LOG
MUNICIPALITY OF ANCHORAGE
o�. DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
625 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
PERFORMED FOR: �� Op, I `-�>'��} f DATE PERFORMED: j
LEGAL DESCRIPTION: (�.w� I U •�G -t _ __
SLOPE SITE PLAN
DEPTH
IFEET)
_ 1
c
4 '
5
6
B ^�=
9
10 _.
12
13
14
15
16-
11
18-
19-
20-
COMMENTS
81920
COMMENTS
PERFORMED BY:
72-008 (6/79)
1 1J
�44401a 0f � 1L0 �7
I�aaarl /A
0
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
ND L - - -
P =
E - -
PERCOLATION RATE _
TEST RUN BETWEEN
CERTIFI
(minutes/inch)
Fl AND ____._,-.-. Fl
DATE:
-1�
Reading
Date
Gross
Net
Depth to
Net
Time
Time
Water
Drop
--
A---
--
—
--
v
d
PERCOLATION RATE _
TEST RUN BETWEEN
CERTIFI
(minutes/inch)
Fl AND ____._,-.-. Fl
DATE:
-1�
<��" 1�C�
Municipality of Anchorage
'�a• •� -
Development Services Department
Building Safety Division '
On -Site Water and Wastewater Program `
4700 Elmore Road S C'T
P.O. Box 196650
Anchorage, AK 99507
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. COSA
Expiration Date:
1. GENERAL INFORMATION
Complete legal description Lor 3, Bloc' t, Hylen crest Subdivision No. t
Location (site address) 21008 Upper Lowland Avenue Eagle River, AK 99577
Current Property owner(s) Mitchell & Christin Hatfield Day phone 694-1013
Mailing address 21008 Upper Lowland Avenue Eagle River, AK 995n
Lending agency Day phone
Mailing address
Real Estate Agent Day phone
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup.
2. • NUMBER OF BEDROOMS: Four (4)
3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ❑ Individual On-site 0
Individual Water Storage ❑ Individual Holding Tank ❑
Community Class Well ❑ Community On-site ❑
Public Water System 2 Public Sewer ❑
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of Onsite Systems Approval
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. 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 Onsite 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-sfte 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.
5. DS, D/SIGNATURE
V Approved for bedrooms.
Disapproved.
Phone 522'T773
Date _5008
Conditional approval for bedrooms, with the following stipulations:
Attachments:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By. /t/0 ��Original.Certificate Date: S—
(Rw. 7LOi)
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99507
www.muni.org/onshe
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: Lot 3, Block 1, Hylen Gest Subdivision No. 1 Parcel ID: 050.472.85
A. WELL DATA
Well type _
Date completed _
Total depth fL
Date of test
Static water level
Well production
If A. B, or C provide PWSID # _
Sanitary seal (YIN)_
Cased to ft.
FROM WELL LOG
WATER SAMPLE RESULTS:
ft.
Coliform colonies/100 mL Nitrate mg/L
Arsenic. _ ugA Date of sample: _
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material septic/steel
Tank size 1.250 gal. Number of Compartments Two
Foundation cleanout (Y/N) Y Depression over tank (YIN) N
Date of pumping 5=008
C. ABSORPTION FIELD DATA
Pumper JR's Pumping
Well Log (Y/N)
Wires property protected (YM)
Casing height (above ground) in.
AT INSPECTION
R
Other bacteria colonies/100 mL
Collected by:'
Date installed 629/06
Cleanouts (YM)
High water alarm (Y/N)
Y
7
Date Installed 6292006 Soil rating (g.p.d.tt2 or feJbdnn).a GPD/SF System type Deep Trench
Length 63 ft Width 3 ft. Gravel below pipe 6.1 ft.
I
Total depth 9. fL Elf. absorption area 768 ftZ Monitoring tube Y Depression overfield N
Date of adequacy test 425/2008 Results (Pass/Fail) Pass For 4 bedrooms
Fluid depth in absorption field before test 14 in. Water added 700 gal.'r New depth 24.5 in.
Elapsed Time: 1.440 min. Final fluid depth 11 in.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N
Absorption rate >= 600 9 p d
If yes, give date
D. LIFT STATION
Date installed Size in gallons
Manhole/Access (YIN)
'Pump on' level at _ in. 'Pump off" level at _in.
High water alar level at in.
Datum Cycles tested
Meets alar & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
On adjacent lots
Absorption field on lot
On adjacent lots
Public sewer main
Public sewer manhole/cleanout
Sewer /septic service line
Holding tank
Animal containment areas None
Manure/animal excrete storage areas None
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >5' Property line>S
Absorption field >S
Water main >10' Water service line
>1(r Surface water
Wells on adjacent lots >200'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line >10' Building foundation
>1a Water main >10'
Water Service line >10' Surface water >t00' Driveway, parking/vehicle storage >29
Curtain drain None Noted Wells on adjacent lots
>200'
F. COMMENTS:
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name Michael E. Anderson, P.E.
Date 5/6/2008
COSA Fee $ q 1'�>o pp
Date of Payment 5 �0 DS
Receipt Number
(Rev. 11/05)
Waiver Fee $ _
Date of Payment
Receipt Number,
�'. MICHAEL,L .AN
+cs� '•G43E
1�,+'o PROFESS'
Septic Test 4 Bedroom
Lot 3, Block 1, Hylen. Crest #1
21008 Upper Lowland Avenue
#050-472-85
A test was conducted at the above address on April25, 2008. The 4 bedroom'L" shaped
deep trench, with new 1250 gallon septic tank was installed on June 29, 2008 by Ross Martin
with Chris Wood as the engineer. The house was occupied at the time of the test.
The 'L" shaped trench is preceded by two after tank. cleanouts and has two monitor tubes,
one (M1) at the beginning of the trench and one (M2) at the 90degree bend in the trench with
a cleanout at the trench end. The deep trenchr was permitted for 63' with. 6.V of sewer rock
beneath the invert. Measurements were taken at all clearioutsprior to the test indicating 5.92'
of sewer rock at M2 and 6.08' of sewer rock at M2. In addition when the inverts of the end of
trench. cleanout and the second after tank cleanout were shot with a hand level and compared
the invert at end of trench cleanout was found to be 3" higher.
14" inches of liquid were found in each monitor tube at the beginning of the test (6.1'
effective). Flow was begun at the foundation cleanout and verified into the tank and out the
second after tank cleanout. Flow was continued into the second after tank cleanout after 3
minutes and continued for 1 hour and 35 minutes. Atotal of 700 gallons were pumped at an
average flow rate of about 6.3 GPM.
Monitor levels rose from Wto 24.5" (10:5")1n M1 and from 14" to 26" (12") in: M2. I' suspect
the distribution pipe was out of level and lowest at the 90 degree bend of the trench so more
water flowed faster towards the second monitor.
Recovery was about 50% during the first 4.5 hours of recovery, 85% after 8.5 hours and
128% after 24 hours. The 24 hour reading indicated a liquid level in M1 of 11" which was 3"
lower than when the test was begun at 14" of liquid.
Pass 4 Bedroom
:flay 06 08 07:28p Stuart Gilbert
907-694-7112 P.1
• _ no/ntltnce ar:00 o0rw.poei
IRs Pu73-dJag �
PO Ao:'r73a1I
EaOk RtM.AX 99517
fSCT,•69�-6a�1
IIIkq,MaormrrtlgL4
Hyien Creat Subdivision
Po Box 773652
Eagle River, AJC 9 9 5 77-36 52
(907)696.6069
Marts Bameflb hm
Crishn Haftid
21008 Upper Lowland Ave
Ea* River. AK 90577
1907) 694-1013
Jeb 154 0 irc 1000g
P.0 IAS r.
T Net 30
saww* Dawn -Dawn •obTYW Repeat
6040 fo{k. mop": 102- -
GOM417sal+: btewartisiraet
Jolbc�n•�1a•,lastServka 00613012006- 10009
I
j I
1 I
Additional Location Comments O Wwh: Gallons Planned: 1000
Coast Story. 3 ear garage wl03 on
house j� Dal.Adusl: /DGD
2seoc In irony Porch - lank 7 jjjjj�]]►►►� Hose Length: 1
access i
Po squares • i eLJ Double Tank:
��. ►.tC[ ? 1 dl 5e.d Sl.�o�. j Pump System:
Barnes inlet. �7
Ago rpr-� BeftsOutlet:
SoMcs Typo Qty Price Each ! Taft? Extension Actual
HCHOA Septic 1 $140.00 ? N0 $140.00 .)—
I NarrramakTotal 18ua4TOW TnTaal Ore"dTaal
Efbn&W Chwp4+: SIAMOD 40.00 410.00 f1,40M
Aetua: ChW94- -a—
A
Smylee Agreement
Number:
M767
Omer Date:
26•Apr-2008
Service Date:
024ay2008 12:0
Technician:
Butch
Jeb 154 0 irc 1000g
P.0 IAS r.
T Net 30
saww* Dawn -Dawn •obTYW Repeat
6040 fo{k. mop": 102- -
GOM417sal+: btewartisiraet
Jolbc�n•�1a•,lastServka 00613012006- 10009
I
j I
1 I
Additional Location Comments O Wwh: Gallons Planned: 1000
Coast Story. 3 ear garage wl03 on
house j� Dal.Adusl: /DGD
2seoc In irony Porch - lank 7 jjjjj�]]►►►� Hose Length: 1
access i
Po squares • i eLJ Double Tank:
��. ►.tC[ ? 1 dl 5e.d Sl.�o�. j Pump System:
Barnes inlet. �7
Ago rpr-� BeftsOutlet:
SoMcs Typo Qty Price Each ! Taft? Extension Actual
HCHOA Septic 1 $140.00 ? N0 $140.00 .)—
I NarrramakTotal 18ua4TOW TnTaal Ore"dTaal
Efbn&W Chwp4+: SIAMOD 40.00 410.00 f1,40M
Aetua: ChW94- -a—
A
f4�
Municipality of Anchorage
Development Services
Departme
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.orglonsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 05'0 - Y 7:z - 23'
1. GENERAL INFORMATION
1-44fz-
COSA #_ O G O -'). R (;
Expiration Date: 7 - 3 - e3 7
Complete legal description 141.1 der, 0reS441:
Location (site address) _D,MA Qr)t2Q_y I C)kXllnY)d b\/e
Current Property owner(s) 10YIw Fos+ -e r Day phone _bG `i - rpU�;l
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
Day phone
Day phone
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
it
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Onsite Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Onsite Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
TYPE OF WASTEWATER DISPOSAL:
13
Individual On-site
/
L�
❑
Individual Holding tank
❑
❑
Community On-site
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Onsite Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Onsite Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. 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 Eagle River Engineering Servi
10421 VFW Rd., Suite 201
Address 1=2918 River, AK 99557
Engineer's Printed Name C by f c+Opp o r wood
5. DSD SIGNATURE
!/f' Approved for 4 bedrooms.
Disapproved.
Phone (oQLI-SICIS
Date L, - 90 - Oto
Conditional approval for bedrooms, with the following stipulations:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
(Rev. 11105(
Arsenic Advisory
Maintenance Agreements
Supplemental Engineers Report
Other
Original Certificate Date: %'' 3, 66
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Bragaw, Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsits
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: e n C r e c + Parcel ID: QSa %f % e1 $ S
A. WELL DATA
Well type commu-i *y If A, B, or C provide PWSID #
Date completed _ Sanitary seal (Y/N) _
Total depth ft. Cased to ft.
FROM WELL LOG
Date of test
Static water level ft.\AO
Well production
WATER SAMPLE
9 -
p.m -
Coliform ies/100 mL Nitrate mg/I_
Ars ' . mgfl Date of sample:
SEPTICIHOLDING TANK DATA
Tank Type/Material _SSe_Dti 1/ S+= e I
Well Log (YIN)
Wires properly protected
Casing height a ground) in.
AT
ft.
9.p -m.
Other bacteria colonies/100 mL
Collected by:
Date installed (o -a CI - o(go
Tank size I a q O gal. Number of Compartments _2L Cleanouts QI) L Q
Foundation cleanout,@N) 40 Depression over tank (Y® no_ High water alarm (YA@ nQ
Date of pumping mai COY)CA-Yt &Pumper A
C. ABSORPTION FIELD DATA
Date installed 1." 21 -DI. Soil rating (g.p.d./f? or±/bdrm) U.% System type +V P Y) CA,
Length (03 ft. Width 3 ft. Gravel below pipe Ln. 1 ft.
Total depth 5_5_ ft. Eft. absorption area J.V ftp Monitoring tube %itn Depression over field �r7
Date of adequacy test o&V Con.4(ruc,1"esults Pas ail) �Z fFoorr __H_ bedrooms
Fluid depth in absorption field before test Q in. Water addedQ gal. New depth 0 in.
Elapsed Time: ,Q, min. Final fluid depth Q in. Absorption rate >= 0 g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) P4UNrC KNdWNIf yes, give date 1%10(6
D. LIFT STATION
Date installed Size in gallons Manhole/Access (YIN)
'Pump on' level at _ in. 'Pump ofr level at� In.�U1 r a rm Ievei at in.
ND \•
Datum es tested Meets alarm & circuit requirements?
SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
Absorption field on lot
Public sewer main
Sewer /septic service line tj
Animal c reas
On adjacent lots
On adjacent lots
Public sewer m ak6 u
Holding tank
Manurelanimal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation + S' Property line ••}LS! Absorption field 'f' S
Water main + 1 O ' Water service line + 10' Surfacewater 4- 100'
Wells on adjacent lots +- 100'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line + 10' Building foundation +101 Water main +1o,
t
Water Service line + O' Surface water 4 1001 Driveway, parkinglvehide storage �L
Curtain drain 1 50 m Wells on adjacent lots -VjQ01
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and 9
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name k-t42L- L'lFRrs'X+P" Q- w%oit ' M p11ERRW000 __
Date
t ••Cr1` ei
COSA Fee s L130 4/ 7� i1�✓ c Z Waiver Fee $
Date of Payment :2— -9 —0 Date of Payment
Receipt Number d 6 Receipt Number
(Rev. 11105)
rba�y>
51t ow.
W
L—OT 3
Zo�000 err
_2 SZ VX- -.;N5
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PLOT.PLAN _ . ASBUILT . - SCALEIl,-3o, GRID *+`N rot Project No. oCO—M I
Lang & Associates, Inc. 11500 Daryl Avenue, Anchorage, Alaska 99515
907 522-6476 Phone
ry
Registered Land Sueyors 9073 522-4625 Fax OF.A
I hereby aertly That I haw wrwysd the following desorit»d proo. '��•• "' ••'Q�1
_lrclt• 3,._fiwci�_l�t.trnl_GR+*�_5U8.�1NiT_N�� ,`Q::' �f-
Mohorop Rseordtnp Da
An Alaska, Dred that the prowmerds sHuafed ' 49�i •'�
therwn ars wMhln the propery Imes Dred do not enor000h onto the property
adlacsnt thereto, that no improwmenh on the propery lytnp adlaoent thereto •'
enaroaoh on the surveyed pr's
nand that then an no roadwayyss, lrnnsmtuIon (Gp .�� •••
Tines or other vhlb�easemenh on sold property exoept as Indloaled hereon. .KENNETH 0. LAN
Dated this the Day of SUNS. at Mchorope, Alaska LS -5202
m WrAlbb ,.•'
It Is the responeiblily of the owner to dehrmine the extshnce of any p�
easements, covenants, or netrIaHons whtoh do not appear on the recorded SegNM-
subdlvtdon plat.
Time
APPLI
INT FILLS OUT UPPER HA ONLY
Property.Owrer /
fl „_ r' / rj,: i%i
:.;' .. �. ;_;i.. i. ::.-/:`-;..
Phone
Mailing Address i
1' - A' ±
-- - l !f Zip Code
J
Buyer
Inspector
Inspector
Address
Zip Code
Lending Institution
I, )
:., �,-) ,;.: /-._" - / ; ' r �� �:
Phone
Address
Zip Code
Realty Co..B Agent
RECEIVED
() APPROVED BEDROOMS 'CONDITIONS OF APPROVAL
Phone
Address
Zip Code
Legal Description
r'a{ )J�
_
,�
� ��M`"`1 tJCeK...n A S
BY:
Soils Rating
Date Sewer Installed
Well To Absorption Area
Street Location
a �
r�
9-) `a �
Ty e of Residence
Septic Tank Size p O U
/Single Family
._
❑ Multiple Family
No. of Bedrooms
-
❑ Other
Water Supply
�
h F- C_
El Individual
1C
ATTACH WELL LOG. A well log is required for all wells drilled since June 1975.
Community
`-e
For wells drilled prior to that date, give well depth (attach log if available).
Public Utility
, RJ
Sewer Disposal
JN" Individual
Year Individual Installed:�t%n.t---
❑ Public Utility
When Connected to Public Utility:
❑ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time
im'e
Time
Time
Date
Date
Date
Date
Inspector
Inspector
Inspector
Inspector
Field Notes: �, �� La,,,� SCu�(�-2
MUNICIPALITY OF ANCHORAGE
DEPT. OF H°/\LTH t.
ENVIRO\,,A`_NTAL PROTcCfION
rs
RECEIVED
() APPROVED BEDROOMS 'CONDITIONS OF APPROVAL
( ) DISAPPROVED
( ) CONDITIONAL PPROVVAAL'
DATE ( d �� 5-S
_
,�
� ��M`"`1 tJCeK...n A S
BY:
Soils Rating
Date Sewer Installed
Well To Absorption Area
Well Log Received
a �
r�
9-) `a �
Well to Tank ��l
Septic Tank Size p O U
72025 QW) ` i.,
Octoljc'C J."), LD".):�
!-'or.ry f.. 0j: i-iClljorj'(-) "N.
hyloon WCOWAt MoCk I., Lot 3
is yj Iniv a 3. for th o ACA :y v h 11 A Ell 1 C Rl 0): sUld Via b 1 V i. QAC! o
ur I j, .1 fol :10%; i ny Amas Wom 1XICII comqU(Itud
,jo You may catki. 2 7 2.5 :3, 3,
"holl th(:�
loted MY, uooll o ) f.- r t 1 c : <-' ui c 3, f !'-Jlol:'e sln�i
p1marm twall this uflicm at 264-5701-,
v.'kA-..)! 10011 t.cil . C I-'! - L L J,'a k-.