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Home My WebLink AboutDRAKE BLK 1 LT 5Block i Lot 5 WAWA T.Aj M S MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: _______________ Date of Issue: ____-____-____ Parcel Identification Number: ____-____-____ Legal Description Block Lot Property Owner Name & Address: Pump Installation Date: _____-_____-_____ Pump Intake Depth Below Top of Well Casing: __________ feet Pump Manufacturer’s Name: ___________________________ Pump Model: _____________________________________ Pump Size: ____________hp Pitless Adapter Burial Depth: _________ feet Pitless Adapter Manufacturer’s Name: ________________________ Pitless Adapter Installer: ____________________________ Well Disinfected Upon Completion? XX Yes No Method of Disinfection: _____________________________ Comments: Pump Installer Name: __________________________________ Company: ___________________________________________ Mailing Address: ______________________________________ City: ___________________ State: __________Zip: _________ Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. Municipality of AnchOrage Page DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~(/c[c~ ~:) 1 L~' PID Number: Name: ~&~ [~ .~ b~ Wastewater System: D New ~Upgrade Address: I ~ ~l ~ ~~ %~ ABSORPTION FIELD LEGAL DESCRIPTION SoilRating: I.A GPD/Sq.F' Tota[ Depth from ori~nal grade: !Lot: Block: Subdiv~ion: Depth to pipe bo~om from or~al grade: Gravel depth beneath pipe Township: ~ Range: Section: Fill added above original grade: Gravel length: O - [ ~. ~ ~ ~t. I Number of lines: ~ Distan~ ~nlines: WELL: B New ~ Upgrade Gravelwldth: ~ Ft. JI ' Ft. Clarification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: Ft. ~t. Driller: DateDrilled: StaticWaterLevel:Ft. Installer: ~ SEPARATION DISTANCES ~eptic ~ Holding ~ S.T.E.P. TO Septic Abso~tion Lift Holding =ubl~c/PrivateManufacturer: Capacity in gallons: Matedah Number of Compa~ments: Su~ace w~t~ ~/ ~ LIFT STATJON LOt ~ ~5 Size in g~ll°ns: I Manufacturer; Line Foundation j~ ~ "Pump °n' lave] at: I"Pump °~velat: IHigh water alarm at: Cu~ain ~) Pump Make & MoSel I Electr[~l I ns~cbons pedormed by Drain I Remarks: BENCH MARK I A~um~ Elevati°n: } ~O ' 0 ~ :.' ,' ENGJN~E~;~S~L Inspections pedormed by: Dates: 1st Depadment of Heal.and Human Se~ices approval Reviewed and apProved by: ~Date: 72-~13 (Rev. 9/91 ) MOA 25 I I N TOBBEN SPURKLAND P.E. 205 W ISTN. AVENUE ANON. AK. 9950! F907) 279-5916 SCALE: I': 50 FF, / -- Well STANDARD SEPTIC SYSTEM: \ r~ 5 FT EFFECTIVE ROCK E n ~ I ~ FT DOVER .~~3_ ~q~ ~C~ ~ SWING TIES: B ~ ~ AD 5g BD 62. 7 AE 64 BE 67,4 [ LOT 5 BLOCK 1 DRAKE S/D 12510 GANDER STREET MARIAN t. HAGZUND Well BENCH MARK: BOTTOM SIDING ASSUMED ELEVATION IO0. OO FT [ SEPTIC SYSTEM AS BUILT DATE: JULY 10, 1999 SHEET: 2/5 GRID: 2854 PERMIT # SV99145 PID # 017 461-05 DRAO1051, D~/6 S t;ano/~o/ £' Vide ,10' Long 9' ~eep ~0' £e~,en ~ock 4' Cover NO SCALE Monitor ~ C{eonouts /~ 3' Cover 92.0 ~ -- 92.0 87.0 5,0 Pt oW £eptJc Rock Effective ND SCALE ANCHORAGE lANK Q . ~ IE 94.$9 1000 gal septic tank INSULAT£D TOP 0£ TANK JTQBBEN SPURKLAND P,E, &03 X415th Ave Anchopo. ge Ak 99501 PERMIT ,// SW990145 LOT 1 BLOCK 5 DRAKE S/D 12510 GANDER NEAL HAGLUND SEPTIC, SYSTEM SCHEMATIC DATE: JULY I0, 1999 SHEET, .~/.~' GRID: 2834 PARCEL ID // 017-461-05 DRAOIO55. DWG MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jun 17, 1999 Expiration Date: Jun 16, 2000 Permit Number: SW990145 Legal Description: DRAKE BLK I LT 5 Design Engineer: 0007 Tobben Spurkland, PE Owner Name: Marian Haglund Owner Address: 12510 GANDER STREET ANCHORAGE , AK 99516-2717 Pamel ID: 017-461-05 Site Address: 012510 GANDER ST Lot Size: 89807 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] SepticTank [] 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 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. 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN LOT 5 BLOCK 1 DRAKE S/D NEAL HAGLUND Municipality of Anchorage Department of Health and Social Services 820 1 Street Anchorage, Alaska 99501 June 5, 1999 We are submitting an application for the upgrade of the septic system for this lot. The submittal consists of three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the septic system is subject to this permit application, (sheet 2/3), and a schematic ofthe septic system, (sheet 3/3). Soil logs and percolation tests of applicable testholes are also enclosed. The septic system design is based on the following: The cesspool is collapsed, but there is no evidence of liquid in the cavity. A single person has lived in the residence for the last several years, with a minimum of water usage. If there is no evidence of contaminated soil, the proposed trench will be located as shown. If soil contamination is found, the trench will be relocated ten feet to the north. Ground Water at 13 1~. Use Standard Trench Soil Rating. From Testhole 05/20/99 <1 min/in - 1.2 gal per sq.fffday No. of Bedrooms 3 Requimd Area per Bedroom: 150/1.2 = 125 sq.ft. Total area required: 125 x 3- 375 sqf~ Bottom Rock At 9 feet Top Rock At 4 feet Rock Depth 5 feet Total Trench Length 375 / 10 - 37.5 fL USE 40 LF SYSTEM CONFIGURATION STANDARD TRENCH TOTAL LENGTH 40 FT TOTAL WIDTH 2 FT TOTAL DEPTH 9 FT ROCK DEPTH 5 FT COVER 4 FT SEPTIC TANK 1000 GAL The installation of this septic system will not prevent wells from being installed on the adjacent lots. There am no developed or natural surfac9 / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoffwill not result from this installation. L~F-6-- -- LBT 5 I I I I T£E££ I I I P/E£GANS££ A VENUE LOT I 49~h ' ~lP[elI LOT 3 L~T 4 + ~ell 50 I 100 150 SqALE, l' = 100 FL DSO $00 TOBBEN SPURI(LAND P.E. 20,5 lq 15TH. AVENUE ANCH. AK. 99501 (907) 279-5916 LOT 5 BLOCK ] DRAKE 12510 GANDER STREET MARIAN L. HAGLUND SEPTIC SYSTEM DESIGN DATE: APRIL 27, 1999 SHEET: I/5 GRID: 2854 PEI~M[? # Piti # 0i7-46! 05 fl£ADIOSLD~/5 N £CALD ]" : 50 FL ~)- ~Yell STANDARD SEPTIC SYSTEM: I000 GAL SEPTIC TANK STANDARD 9 FT TOTAL DEPTH 5 FT EFFECTIVE ROCK + ~el] COLLAPSED CESSPOOL'O0~ NO ACCUMULATED SZ~J~E OR ~/ATER TOBBEN SPURKLAND P.E. 205 Y/ 15TH. AVENUE ARCH. AK. 99501 (907) 279-5916 LOT 5 B£OCK 1 DRAKE S/D 12510 GANDER STREET MARIAN L. HAOLUND SEPTIC SYSTEM DES/ON DATE: JUNE 4, 1999 SHEE[: 2/3; GRID: 2854 PERMIT # S~/990XX PID # 017-461-05 DB/~IO51,D~/G P£1~A£Y 1-££NCN S~ondord Trench: c~' 40' Lon9 9' Peep 5,0' Smwer rock 4' Cover REPLACEMENT ~£ENCH NB SCALE 3' Cover IO lO00 90( Septic i, onk --0 5.0 Pt oF ~'eptlc Rock Effective SCALE 1000 90(. septlc tank INSULATE TOP OF TANK TDBB£N SPURKLAND P,E, 803 ~15%h Ave Anchorage Ak 99501 LOT 1 BLOC/( 5 DRAKE S/D 12510 OANDER NEAL HAGLUND SEPTIC SYSTEM SCHEMATIC 9^TE: JUNE ~ 1999 SHEET: GRID: ~4 PERMIT // SW9900XX PARCEL ID ~z XX DRAOlO55. DWG Munl.;i~calJty of Anchorage DEPARTMENT OF '~EALTH & HUMAN SERVICES 825 "L" Street, A~chorage, Alaska 99502-0650 SOILS LOG- PERCOLATION TEST PERFORMED FOR: ~,~ _"~ · EG^,. DES0R,PT,ON: L~'F .5 ~ ~ I~ Pi_ DISCLAIHFR: GrDundwater Past and future presence 1 2 3- 4- 5- 6- 7 8 9 10 11 12 13 14 15~ 16- 17- 18- 19- 20- (ENGINEER'S SEAL) Township, Range, Section: LEVF SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT Monilodno? I 3 Dale: PERCOLATION RATE ~ i (minuteshnch} PERC HOLE DIAMETER __ c~nditiDns indicated are for the dates and/or depth of groundwater can not be shown only. predicted PERFORMED BY: I ACCORDANCE WITH ALL STATE AND MUNICIPAL Gl)!;. ELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) CERTIFY THAT '~HIS TEST WAS PERFORMED IN MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC251035 Parcel ID 017 -461-05 Legal description DRAKE BLK 1 LT 5 site address 12510 GANDER ST Expiration Date: 7/31/2024 Current property owner(s) HAGLUND EUGENE E OR X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or conditions: 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 Service 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 submittal. ATTACHMENTS: COSA Checklist Absorption Field Advisory Tank Age Advisory Other X Well Flow Advisory Nitrate Advisory X Arsenic Advisory MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section ANCHORAGE R US lA Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 017-461-05 Complete legal description Drake Block 1 Lot 5 Location (site address) 12510 Gander Street, Anchorage, AK 99516 Current property owner(s) Neal Haglund Trust Day phone 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: ❑■ 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: ❑■ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 25 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ 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 $ �� -K3 3 0 Waiver Fee $ Date of Payment 3 ✓ �� '% SF 21!516 tae of Payment COSA # S C Z 0' . Waiver # COSA Application—June 2022 COSA Checklist_June 2022 COSA Checklist Legal Description: Parcel ID: 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 Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test?Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank Date of pumping Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field. Per record drawings, field is insulated. 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 Adequacy test date Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) in Effective depth used in Effective depth remaining in Comments/Deficiencies: COSA Checklist_June 2022 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’ Yes if No ft Neighboring Tank > 100’Yes if No ft Absorption Field on Lot > 100’Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’Yes if No ft Holding Tank > 100’Yes if No ft Animal Containment > 50’Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft 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’Yes if No ft Tank to Property Line > 5’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 ft Surface Water > 100’Yes if No ft Wells on Adjacent Lots: Private Wells > 100’Yes if No ft Community Wells > 200’Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS 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 Phone Engineer’s Printed Name Date Benjamin Schiller, P.E. Lot 5, Block 1, Drake Subdivision As Built Land Surveying Land Development Consultants Subdivision Specialists Construction Surveying AEC# 173042 S4 Group 124 E 7th Avenue Anchorage, Alaska 99501 (907) 306-8104 mail@S4AK.com 12/18/2024