HomeMy WebLinkAboutEKLUTNA GATE FIRST ADDITION BLK 1 LT 7Eklutna Gate
Block !
Lot 7
#051 -761 - 10
Municipality of Anchoz-age ..,.'.4~ ,,,,~.
z.~F
Development Services Department
Building Salely Division
On-Sile Waler and Waslewaler P~ogram, 4700 S Dragaw
P.O. Box 19~650 Anchorage, AK 995t9-6650 Page o[
~ el *nchoreg~.sk.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPEClION REPORT
Permit Number: S~G~O~bO PID Number:
ERL~X~ k INC / ~[~ A~ Wastewaler System: D New ~Upgrade
t¢5~ ~X~t~ ~-~1 ~ ABSORPTION FIELD
LEGAL DESCRIPTION ~"'"~ ~ O
q,~ - o,~ ,,. bO ,,.
Wel~ ~.New ~ Upgrade ~--"~' ~ n. I ~ ,,
~r~¢ r,. ' bOO'+ ,,' ~o3~'[F~o
.__
.. ~, TANK
SEPARATION DISTANCES ~ Seplic ~ Holding ~ S T E.P. ~ Olhe,:
Tank F~M Station Tank S~t~e P~L~ ~ p ~tC~
%~tsAt~g ~z50 ~h~ ~(~ TA~ BENCH MARK
· -.~
,nspeclions performed by: i~ flaskO ~ 2"" ~ ~. ~~,,.~l,..,
Development Serv,ces Departm~ ~va, ,
NO. SW090160. PA¢£ ;3 or 3
Municipali[v of Anchoraue
DEPARTMENT OF ttEALTtt AND HUMAN SERVICES
ENVIRONMENTAI, SERVICES DIVISION
P.O. Box 196650 · Anchorage. Alaska 99519-6650 · Telephone: 343-4744
On-Site h'astewater Disposal System and/or Well Inspection Report
LEGAL LOT 7. BLOCK 1. EKLUTNA GATE S/D E1 P.I.D. NO. 051-761-10
r-FINAL GRADE
99.2' -~ / // ST2-:99.2'
\ /
....... iL- TOP OF T~.Nlx -' 95.8'
[FCO ', 24.5' i 27.5'
L~.M.? , 28.9' I 29.S'
I
,DBLI, 57.5' t 26.6'
MFe~ ~ n ICO1 .L)9.2
(X)2 ': ,)1 7
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water& Wastewater Progrem
4700 South Bregaw Street
P.O. Box 196650, Anchorage, AK 99519-~650
(907) 343-?904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Aug 21, 2009
Expiration Date: Aug 21, 2010
Permit Number: SW090160
Legal Description: EKLUTNA GATE FIRST ADDITION BLK 1 LT 7
Design Engineer: 0003 S & S ENGINEERING Site Address:
Owner Name: EKLUTNA INC. Lot Size: 0 SQ. FT.
Owner Address: 16515 CENTERFIELD DRIVE#100 Total Bedrooms: 0
EAGLE RIVER, AK 99577-7719
Parcel ID: 051-761-10
Permit Bedrooms: 4
This permit is for the construction of:
[] Disposal Field [] Septic Tank [] Holding Tank [] Priw
[] Pdvate 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 pdor 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.
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, Alaska 99507
www. muni.org/onsite
(907) 343-7904
ON-SITE SEWERfVVELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Property owner(s) EKLUTNA INC,
Mailing address 16515 CENTERFIELD DR. #201, EAGLE RIVER, AK
Site address 26034 HARICOT CIRCLE, CHUGIAK, AK
Day phone 696-2828
Zip Code 99577
Zip Code 99577
Legal description (Sub'd., Block & Lot) EKLUTNA GATE S/D ADDITION #1, BLOCK 1, LOT 7
Legal description (Township, Range & Section)
Lot Size Sq. Ft, Number of Bedrooms 4
THIS APPLICATION IS FOR (~;~ all that apply):
Absorption Field
Septic Tank
Holding Tank
Privy
Private Well
Water Storage
I certify that the abov
Single Family Dw~
(Sig nat ute of p~//~y~,.~
Permit/Rush Fees:
Date of Payment:
Receipt Number:.
(Rev. 11/05)
THIS APPLICATION IS AN:
Initial
Upgrade
Renewal
Waiver Fees:
Date of Payment:
Receipt Number:
correct. I further certify that this application is being made for a
Ig a..~nd i~accordance with applicable Municipal Codes.
d agent)/
August 17, 2009
ROBERT C. COWAN .
CIVIL ENGINEERING
PH: 907-694.2979
FAX: 907-E94-1211
MUNICIPALITY OF ANCHORAGE
Development Services Department
P.O. Box 196650
Anchorage, AK 99519
REFERENCE: Lot 7, Block 1, Eklutna Gate Subdivision Addn. Itl
it is requested that you issue a permit to install a new shallow trench and 1300 gallon
IIDPE septic tank septic system to serve the existing four bedroom house on the
referenced properS'.
A test hole was excavated and a percolation test performed. The approximate location of
the test hole is located on the attached site plan. At the time of excavation (8/5/2009) water
was not found. After seven days of monitoring, ground water was not found.
We do not anticipate any adverse effects on neighboring wells, septic systems, reserve
areas or drainage patterns by the installation of the proposed septic system. The
construction of this system will not prevent any future development on any of the adjacent
properties.
Ifyo/y..5.gq~ditional information, please contact us.
Enclosure
15861 S. Birchwood Loop Road - C. huglak, Alaska 99567
SITE-PLAN
DESIGN
\
\
~o ~
1" = 40'
II ~ II
Development SeMces Department ~
On-$Jle Waler and Wa$1ewater Program ......
4700 South Bregaw SI.
P.O. Box J96650 Am:homage. AK 99519~0650
(907) 343-7904 ·
Sods Log - Porcolabon Test
11-
12.
1:3.
1.4-
15-
16-
17.
t8-
20.
4-¸
5-
6-
7-
/
i/
t,~odng? ~
Plan
Munlclpality of Anchorage
Development Services Departmen[
eu,ldi~g Safely
O~-$ite Waler and Wastewaler Program
4700 ~o~Jth ~agaw SL
P.O. Box 19~650 Anchorage. AK 99519-6650
v,,ww, mu ~l. o~ g,'~'~ sit e
~9o?) 343.7904
Soils Log - Percolation Test
7-
8-
9-
10-
11-
12-
13-
15-
16.
17.
18.
/
/
/
/
/
20-
Township. Range. Secllon:
Site Plan
P~RC01.ATIONRATE ~ ~ ~amJ~h~) PERCHOLEDtAMETER
P[RFORMED IN ACCORD~ ~TH ALL STATE AND MUN~~ IN EFFECT ON IHIS DATE. OATE:
ROBERT C. COWAN.
CIVIl. ENGINEERING
PH: 907-694.2979
FAX: 907-694-1211
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES
and
MATERIAL SPECIFICATIONS
REFERENCE: Lot 7; Block I; Eklutna Gate S/D Addn. # 1
August 17, 2009
GENERAL:
The scope of this project includes the installation of a new 1300 gallon tiDPE
septic tank and a shallow septic trench to serve the existing four bedroom
residence located on the referenced property. A flow diverter valve will be
install to allow the existing trench to be used at a later date.
Construction shall be in accordance with the approved site plan and design
drawings, Municipal permit with any special provisions or conditions, and all
applicable State and Municipal Wastewater Disposal Regulations.
The contractor shall be responsible for obtaining any necessary underground
utility locates.
Unless specifically agreed other~vise, the propenS' owner shall be responsible
for final grading areas subsequently depressed from soil settling.
Contractors installing wnstewater disposal systems must be certified by the
Municipal Development Services Department or ADEC if required, for
system installations. Owners installing their own systems must also receive
prior approval from the respective agency.
SEPTIC TANK INSTALLATION:
A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shall include two 4" cleanouts for pumping access. All HDPE
septic tanks are required to have a 4" monitoring pipe installed next to the
tank extending to the bottom of the tank.
15861S. Blrchwood Loop Road - C. hugiak, Alaska 99567
Page 2
Lot 7; Block '1; Eklutna Gate Subdivision Addition #t
August t7, 2009
The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank.
All standpipes on the septic tank shall extend a minimum of 12 inches above final grade.
Septic tanks installed ~ith less than 4 ft. of cover shall be insulated. All tlDPE septic
tanks are required to be covered with a minimum of 2" direct burial insulation, and a
maximum of 4 feet ofcover.
A foundation cleanout shall be installed one to four feet from the building foundation. In
the line between the tank and the leachfield there shall be t~vo adjacent cleanouts (unless
an effluent pumping system exists within the septic tank). These cleanouts shall be
located on undisturbed soil not more than 10 fi. from the tank. The first cleanout, in line,
shall be to clean toward the leachfield. The second cleanout shall be to clean toward the
septic tank.
Final grading over the septic tank shall be such that a positive slope exists away from the
septic tank.
ABSORPTION TRENCII/DRAINFIELD INSTALLATION:
Excavate the proposed trench to the dimensions shown on the design. The bottom of the
excavation shall be xvithin 2 inches of level. If the sidewalls of the excavation become
smeared, they must be raked or scratched (rafted-up) before gravel (sewer rock)
placement.
Once the gravel is installed, the distribution pipe is to be installed level with the
perforations faced doumward. Gravel is then to be placed over the distribution pipe to
provide a minimum of 2 inches of cover over the pipe.
A silt barrier must be installed between the final gravel layer and the native soil backfill.
Ensure the silt barrier covers the entire gravel surface before placing backfill.
Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations
shown on the design, and extend a minimum of 12 inches above final grade. The portion
ofthe monitoring tube extending through the gravel shall be perforated from the bottom of
the trench to the invert ofthe distribution pipe. This is equivalent to the effective depth of
the gravel as noted on the design.
Backfill over the final gravel layer must not be less than twenty-four (24) inches.
Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The
finish grade over the trench must be mounded to prevent the formation of a depression
after settling.
Page 3
Lot 7; Block 1; Eklutna Gate Subdivision Addition #1
August 17t 2009
MINIMUM MATERIAL SPECIFICATIONS:
Any septic tank proposed for installation must be constructed by a Municipal approved
septic tank manufacturer.
The following pipe materials are approved for use in septic system installations in the
Municipality of Anchomge:
Type of Pipe Perforated .Solid
Cast Iron Yes Yes
ASTM D3034 (PVC) Yes Yes
ASTM F810 (HDPE) Yes No
ASTM D2662 (ABS) Yes Yes
Use ora type &pipe other than listed above must be approved by the inspecting engineer.
Insulation shall be at least 2" thick extraded direct burial polystyrene (Doxy Chemical
Company Styrofoam HI or equal).
Septic tank inlets and outlets shall be fittedv,"~th watertight' couphngs' (Caulder, Femco, or
equal).
A permeable nontoxic silt barrier (Typar 3401, Mimfi 140N, or equal) must be installed
between the final leachfield gravel layer and the native soil backfill.
All leachfleld gravel (sewer rock) shall be 0.5"-2.5" screened gravel ~th less than 3%
passing the//200 sieve.
When sand is being used as a filter material, its gradation specifications must conform to
current M.O.A. or D.E.C. requirements, which ever requirement applies.
Page 4
Lot 7; Block t; Eklutna Gate Subdivision Addition #1
August 17~ 2009
INSPECTIONS:
Typically there will be a minimum of three (3) inspections required during the installation of the
wasteaater disposal system. These inspections will occur as follows:
The first inspection must be conducted after the excavation of ditches, pits,
trenches, or beds and before the installation of any grovel. A septic tank may be
set in place, but may not be backfilled before this inspection.
The second inspection must be conducted after the placement of the silt barrier,
gravel, distribution lines, standpipes, cleanouts, and insulation, but before the
placement ofany other backfill.
3. The final inspection is to occur upon final grading of the property.
Often there will be more than these 3 inspections required. Especially with the installation of
multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer
is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-
construction meeting ~vill take place on-site. The inspecting engineer will not coordinate, direct or
control in any way the contractors activities.
The owner shall contract with the contractor to perform the work outlined in these specifications
and plans and in accordance with the attached M.O.A. permit. There will be no contractual
arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be
the owner's representative and will inspect the work as stated above to document the contractors
activities. Final acceptance ofthe contractors ~vork rests with the owner and the M.O.A.
S 8: S Engineering shall have no liability to the owner or to others for acts or omissions of the
contractor or any other persons performing work on this project or the failure of the contractor to
carry out the work in accordance with these construction documents. S & S Engineering's
inspecting engineer will not be responsible for the construction means, methods, techniques,
sequence, procedures or the safety precautions incident to this project.
CONTRACTOR / INSTALLER
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISLON
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
LEGAL DESCRIPTION
LOCATION
DISTANCE TO:
Manufacturer
LiI in gallons IF HOMEMADE: Inside length
Well
DISTANCE TO: ~&
No. of lines Leng~til of each line
Top of tile to finish grade ~/-O
Length
Type of crib
DISTANCE TO:
DISTANCE TO:
Width
Crib d~ elr,~
We. I VI~ '
OTHER
Class
Abso[pti~n a r~e,a
I0' ~
Dwelling
Meteri _/
Width ~ r¥~¢
Foundation I
Total lenoth of lines
Material beneath tile
Material
Nearest~n¢
T r e nc h~)h
PHONE
· -~7~ -c~/~'r/O [] UPGRADE
NO. OF ~,~/ROOMS
PERMIT NO.
No, of ~partments
Liquid depth
PERMIT NO.
Liquid capacity in gallons
PIPE MATERIALS
SOIL TEST RATING ! /^ D
, NSTA L L-/ER~- ~16~''~
REMARKS ~ /
PERMIT NO. _
Depth
inches
Distanc~j~een lines
Total effective absorp~t~o~.~
PERMIT NO.
Crib depth Total effective absorption area
Building foundation Nearest lot line
Driller
Distance to lot line
PERMIT NO.
Sewer line Septic tank Absorption area(s)
APPROVED
72-013 (Rev. 3/78)
DATE
LEGAL
PillJ~4 I CIP~LITY OF' AN~CHOF(~ 'B,E~
DEPARTMENT OF HEAL. TH AND ENVIRONMENTAL .PROTECTION
825 L STREET, ~NCHORAGE, AK 99501
264.-4720
PERMIT NO:
DATE IS,SUED:
840676
08/08/84
APPL I CAN]':
ADDRESS:
CONTACT F'HONE:
COOK INLET HOUSING AUTHORITY
670 W. FIREWEED LN
ANCHORAGE~ AK 99505 ·
272-2140
LEGAL DESCRIP: SUBDIVISION: EKLUTNA'GAT.E ~1 LOT: 7 BLOCK:- 1
SECTION: 24 TOWNSHIP: 16N RANGE: 1W
LOT SIZE: 27079 -(SQ.FT. OR ACRES)
Listed below are the options ava{lable t~ yo[ igning your septic
system, Choose the option that best £its your site.
TREff'qCH E~ED W,. DR;~IN
DEPTH TO PIPE BOTTOM (FT.) 4.0 4.0 4.0
GRAVEL DEPTH (FT.) 4.5 0.5 3.5
TOTAL DEPTH (FT.) 8.5 4.5 7,,5
GRAVEL. WIDTH (FT..) 2.5 20.0 5.0
GRAVEL LENGTH (FT.) 52.0 38.0 54.'0
GRAVEL VOLUME (CU.YDS.) ~ ~
TANK SIZE (GALS) 1~250.0 ~* ].,250.0
SOIL RATING (SQ.FT. /BR) 116 125
*'~ TANK MUST HAVE AT LEAS]' TWO COMPARTMENTS
I certify that:
1. I am familiar with the requirements ~'or on-site sewers and wells as set
£orth by the Municipality o£ Anchorage (MOA) and the State of Alaska.
~. I will instal], the system in accordance with all MOA codes, and regulations,~,
and in compliance with the design criteria of this permit.
3. I ,will adhere to ali MOA and State o£ Alaska requirements £or the se4. back
distances ~rom any existing well.~ wastewater disposal system or public
sewerage-system on this or any adjacent or nearby lot.
4., I understand that this permit is valid ~or a maximum o£ 4 bedrooms and
any enlargement will require an additional permit.
IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES~
THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (~) AS-BUILTS
WILL NOT BE AF[=ROV~ED WITHOUT~N ELECTRICAL INSPECTION REPORT; AND (3) THE
'L. ECTRICAL WO R~~y~/B ' .....
Y,A ,LICENSED ELELTRICIAN.
APPLICANT: COOK ~INLET HOUSING AUTHORITY , , , , '
DA~E:
ALASK n oFImE:FITAL £OFITROL IRC.
~nqin~erimj ~ ~nuironm~ntd $~udics
1984
SOILS FOR EKLUTNA GATE SUBDIVISION
BACKGROUND:
This area lays just east of the Eklutna interchange of the Glen Highway
in the north part of the Municipality of Anchorage. The area is a
general flat plain area and ia located between the Glenn Highway and the
Alaska Railroad. It is a new area that is being subdivided for
additional housing.
Vegetation on the area is predominately large cottonwood interspursed
with spruce. The south portion of the area contains a heavy growth of
spruce and appears to have been formerly cleared. The top soils
consists mostly of organic debris and sand. The under material is made
up of mostly water deposited gravel and sand. Only at the very deep
areas does silty, sandy gravels occurred.
DISCUSSION:
Test were performed in conjunctions with the requirements set forth
"Design Manual for On-Site Waste Water Disposal System" EPA. Testholes
were dug with a Ford rubber tired backhoe on May 1, 1984. Testholes
were not able to be dug deeper than 11 or 12 feet during this test. The
gravel material was very loose and the hole tended'to sluff in with
depth.
The objective of our testing was to determine the soils suitability for
on-site septic system. The important moils classification are:
1). Soil depth ·
Depth to ground water.
3). Soil permeability
The individual testhole soils logs are attached in the appendix.
Shallow soil: Results of our testing indicated that bedrock depth were
not obtained anywhere within the area. From the geolocial formations
available it would appear that bedrock is not a factor in this area.
Soil-Water: None of the test holes showed any ground water. The only
moist soils found were near the 12 foot depth and these were occassional
layers of silty sandy gravels (GM). These soils were slightly moist but
no free water was in that soil structure.
Soils Permeability: All the soils in the area are highly permeable and
should not create any problems with the installation of on-site sewer
systems. In several instances we noticed layera of organic material
(root mass) at depth below that which would normally be be found. It
would appear that this area has been overlaid with gravel several times
in the recent geologic history. The root masses were in sandy material
and we feel that this will not inhibit permeability.
Conclusions: Based upon our soils we feel that all the lots are
1200 ~,Sl 33r~ ~u~nu¢, Suil, B · ~n~mg{, Alosko ~3 · {~7) 276-1361
acceptable for on'~Lte sever systems. Deep trenches or f£ve foot wide
shallow drainfields are recomnended in this area. Because of the
looseness of Eravel a five foot wide shallow alternate maybe necessary
in some cases,
Approved by,
Ph~D~ PE
IV ~3 o~ '00"~
?0, O0
~8C'17~1 from P.K fOUnd in stump
S~ ~or~e~ ~o~ I, Block I ~ ~eco~d
~onces (P80-176) from rebar found
iouth PC of Lot I~ Block I curve
.._~ ~[CI1011 Lille [:SLIT
E_3~295~Ff 4 __
"" 1'£5.00' ': '
(NOg ~ ~,
I00. O0
25
6
18 1 Sq, Ft,
2 7, 0 79 Sq. Ft.
PERFORMED FOR:
MUNICIPALITY OF ANCHORAG~
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
~ ~?.5 L Street, Anchorega, Alaska 99501 264~1720
SOILS LOG - PERCOLATION TEST
-TRT;. n D
~ SOILS LOG
[] PERCOLATION
TEST
D^,E PE.FORMED:__ 5"--/~ ~/
OE~CR,PT,O": Ln'l- '7 F~ Lu T~z~ ~,q't-~. -tN ,t~
LEGAL . · ~LOPE
/
/
\
/
\1
SITE PLAN Lo+ L~q~ t,,.~'-~
10
11
12
13
14-
15-
16--
17
18
19
20
COMMENTS
PERFORMED BY:
72-008 (6/79)
WAS GROUND WATER S
L
ENCOUNTERED? 'J~ O
P
~F YES. AT WHAT
E
DEPTH;'
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
TEST RUN BETWEEN
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
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. o~.-76:~-:~o
1. GENERAL INFORMATION
Complete legal description
Location (site address) 26034 Haricot Circle
Current Property owner(s) Eklutna Inc.
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
Expiration Date:
Eklutna Gate First Addition, Block z, Lot 7
Day phone
z65z5 Centerfield Dr #2oz
Day phone
Day phone
Unless :otherwise requested, COSA will be held by DSD for pickup.
.... 2. ' NUMBER OFBEDROOMS: 4
' 3. TYPE'.OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Well
[] Individual On-site []
[] Individual Holding Tank ['-]
[] Community On-site E~]
[] Public Sewer r-]
Individual Well
Individual Water Storage
Community Class ~
Public Water System
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 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 Pannone Engineering Services, LLC Phone 2_72-8228
Address P.O. Box :[oo2z7, Anchorage, AK 995:[o
Engineer's Printed Name Steven R. Pannone, P.E. Date 7/21/2011
Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in
accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions
encountered at the time of the test, and separation distances measured to readily identifiable features.
The operational life of all wells and septic systems depend on the local soil condition, ground water
levels that may fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of this system. All systems eventually fail and
satisfactory test results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. PES can therefore not provide any warranty for future
performance nor give any estimate of how long the system will continue to meet the operational
requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed
above. Any reliance upon or use of this report by any other person or party is not authorized nor will it
confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for /'7/'' bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
X
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date:
Municipality of Anchorage
Oevel,opment Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www. muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description:
A. WELL DATA
Well type Public
Date completed ~
Total depth
Eklutna Gate First Additionr Block ~r Lot 7
IfA, B, or C provide PWSID # ~
Sanitary seal (Y/N)~
Cased to ft.
I=ROM WELL LOG
Parcel ID: o5=-76=-~o
Date of test
Static water' level
Well production
WATER SAMPLE RESULTS:
Coliform colonies/100 mL
Arsenic: ~ ug/I
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Se_Otic I plastic
'Tank size =.~oo gal.
Foundation cleanout (Y/N) Y
Date of pumping ?f,"l~,o.,i
C. ABSORPTION FIELD DATA
Date installed 91eg20o9
Length 60
Total depth 8,5 ft.
Well Log (Y/N)
Wires properly protected (Y/N)
Casing height (above ground)
AT INSPECTION
ft. ft.
g.p.m, g.p,m.
in.
Nitrate ~ mglL
Date of sample: ~
Collected by:
Date installed ~alcd2oo9
Number of Compartments _= Cleanouts (Y/N) Y
Depression Over tank (Y/N) N High water alarm (Y/N) N
Pumper JR's Septic
Date of adequacy test 713.M~o1., Results (Pass/Fail)
Fluid depth in absorption field before test _o. in.
Elapsed Time: ~.1o min. Final fluid depth _o in.
Any rejuvenation treatment (past 12 mo.) (YIN & type) N
Soil rating (g.p:d./~ or ft2/bdrm) =. GPDISF
ffi Width. 5 ft.
;Eft. absorption area 60o ~ Monitoring tube Y
Pass
System type sharllowTrench
Gravel below pipe ~
Depression over field N
For .~ bedrooms
Water added6oo gal.
Absorption rate >= 6o0+
New deptho in.
g.p.d.
if yes, give date
LIFT STATION
Date installed
"Pump on" level at
Datum
Size in gallons
in. "Pump off' level at ~ in.
Cycles tested
E. SEPARATION DISTANCES
Manhole/Access (Y/N)
High water alarm level at
Meets alarm & circuit requirements?
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
Sewer/septic service line
Animal containment areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5+ Property line ~o+
Water main lO+ Water service line 2~+
Wells on adjacent lots mo+
Public sewer manhole/cleanout
Holding tank
Manure/animal excrete storage areas
Absorption field 5+
Surface water ~oo+
Water main 75+
Driveway, parking/vehicle storage
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line lO+ Building foundation lo+
Surface water ~.oo+
Wells on adjacent lots ~.oo+
Water Service line 25+
Curtain drain 50+
F. COMMENTS
Septic only.
in.
lO+
I certify that l have determined through field inspections and ~'.~....:'~" ~ °~
review of Municipal reCOrds that the above systems are in [ ~...°' 49TH~._~
· . ..... . ~,,,,,&,
conformance w/th MOA COSA gu/defines m effect on this date. ': ~_
..~,~~~ ....... ....m.~,r
· · .St:even
Engineer's Pnnted Name Steven R. Pannone. P E
COSA Fee $ ~0 -- Waiver Fee $
Date of Payment
Receipt Number
(Rev. 11/05)
Date of Payment
Receipt Number
ASBUILT
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
FOLLOWING DESCRIBED PROPERTY:
TS EXIST EXCEPT AS
INDICATED. IT IS THE RESPONS!BILITY OF THE
OWNER TO DETERMINE TH,~ E;(ISTENCE OF ANY
EASEMENTS~ COVENANTS, OR RE,(;TRICTIONS
WHICH DO NOT APPEAR ON THE RECORDED SUBDI-
VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD
ANY DATA HEREON BE USED FOR CONSTRUCTION
OF FENCE LINES, OR FOR ESTABLISHING BOUND- '~i'~A'WN~
ARY LINES,
694-082~