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HomeMy WebLinkAboutBIRCH TREE ESTATES BLK 1 LT 18 Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181309 PID Number: 017-141-20 Dwelling: E Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ❑■ Upgrade Name: Keith & Janice Washburn ABSORPTION FIELD Address ❑ Deep Trench ❑■ Shallow Trench ❑ Bed ❑ Mound 5161 Metz Court Anchorage, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 748-6556 4 1.2 GPD/SF 3.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 2.5 Ft. 0.5 Ft. Birch Tree Estates 1 18 Fill added above original grade Gravel length Township Range Section 0.15-0.35 Ft. 2 x 50 Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES 5.0 Ft. 6+ Ft. To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist.between trenches From Tank Field Tank Line 500 Ft2 2 Ft. Well >100' >100' N/A N/A >25' TANK ❑Septic I]S.T.E.P. 0 Holding 0 Other Manufacturer Capacity Surface Water >100' >100' N/A N/A Anchorage Tank 1500 Gal. Material Number of compartments Lot Line >10' >10' N/A N/A Steel 2 NA LIFT STATION Foundation >10' >10' N/A N/A Manufacturer Capacity Curtain Drain None Noted Orenco/Anchorage Tank 1500 Gal. Pump on level at Pump off level at High water alarm at Remarks 13 in. 25 in. 11 in. Pump make and model Electrical Inspections performed by PF2005 MOA PIPE MATERIAL House to tank D3034Tank to D3034 Installer drainfield A+ Home Services Drainfield D3034 CO/MT D3034 Inspector J. Millette BENCH MARK (Assumed elevation) 100 ft Inspe ction 1st 9/12/18 2nd 9/12/18 Location and description da aro 4th Bottom of garage man door COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL .tt�\\\‘°F ALAI` kt Conditional Approval: Date _ A%xT.. •• .. •.4 4--- T *:49Th f' '*r,/ •i�� •• : Benj. , in Schiller : i�Fc•. C 12592 .•(` .� Approve. �/imi _ - Date 7-2-0 le 4k ROFES`OL- Inspection Report_9-1-12.doc BIRCH TREE ESTATES, BLOCK 1 , LOT 18 PERMIT # OSP181309 PID # 017-141 -20 o N LL CO CO — — f- 1 00.85 — 96.3 �`-- 96.55 2I 95.65 1500 GAL SEPTIC TANK 1r �-'--- 91.45 99.45 FINISH GRADE i/— 99.3 ORIGINAL GRADE l ,. — INSULATION 96.8 it DRAINFIELD ROCK '1 96.8 - 96.3 50.0' 96.3 -----"") I �� GROUNDWATER @ 90.3 9/4/18 89.3 co *k I H 99.65 FINISH GRADE 2 99.3 ORIGINAL GRADE 2 ir/ t— INSULATION 96.8 DRAINFIELD ROCK ---- .1 h— 96.8 � -- 96.3 50.0' 96.3 —ter 41...-- \ 9i j49111 i *ll /r. B •njam• in Schiller ••:e./ - - PROFILE AS-BUILT , ,, .F�. CE 12592 ���•�. RGE (NO SCALE) kI�FdPROfESS10`�A`� BIRCH TREE ESTATES, BLOCK 1 , LOT 18 PERMIT # OSP181309 PID # 017-141-20 ` I LOT 4 ,1 . \ LOT 17 N. N � .. N / 4-BDRM HO N f Z w Q \ LOT 18 - - 1 J • 0• 1 � � f . Q \ m -+- - 10.5 «, . w f MT3 Tt / H D 1— I N I S • o f \ LOT 3 \ , cMH' OFS / 1,500 GALLON S.T.E.P.TANK 11 L t i I ' — —I ,--- 6.b ® 1� , r:ra T2 EXISTING WELL N,A i I / .\ \ \ 2-5c \L__ONG x 5'WIDE x 6" \ 13.2 / EFFECTIVE DEPTH ABSORPTION \ / / TRENCHES TO BE CONSTRUCTED \ / 10'FROM ALL PROPERTY LINES. f I \ / / EXISTING WELL 1// I \\LOT 19 f f �A \ � ® I ��/ I I I FORGE , fHGHEEPiHG . , / ,,,,, ��‘\ A B LEGEND G• ,1/4.41A sit FCO 26.8 4.4 CO CLEANOUT Avg.-Avkt: `�, !F9V, EL 35.0 _ 15.0 2C0-DOUBLE CLEANOUT diR1 /\ *0/ SV1 36.0 , 18.2 FCO-FOUNDATION CLEANOUT ' ••• SV2 43.0 26.0 FS-FLOW SPLITTER VALVE / ... ... MH 45.0 28.0 / : Benja in Schiller • MT1 33.5 29.2 MT-MONITORING TUBE vO fF•••••• CE 12592 �`�.� 0 50 100 - SV-SEPTIC VENT vi%l• se9+7z0+e • / - E - - FEET MT2 81.7 71.9 l,epe;•..... ONP\'�.�r MT3 44.9 48.4 TH-TEST HOLE `��\"`� 1'=50 MT4 85.5 75.3 EL-ELECTRICAL INSP.PORT 9//z/hs, Bot_( ,F �,,c'.°_`'ry MUNICIPALITY OF ANCHORAGE VC‘inr i On-Site Water& Wastewater Program w yam. PO Box 196650 4700 Elmore Road • Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 , �, http://www.muni.org/onsite • ' fir. it• mennt 4 CHORP:' On-Site Wastewater Disposal System Permit Permit Number: OSP181309 Effective Date: 9/7/2018 Work Type: Septic Upgrade Expiration Date: 9/7/2019 Tax Code Number: 01714120000 Site Legal Address: BIRCH TREE ESTATES BLK 1 LT 18 G:3037 Site Mailing Address: 5131 METZ CT, Anchorage Owner: WASHBURN KEITH D & JANICE C Lot Size in Sq Ft: 30905 Design Engineer: FORGE ENGINEERING Total Bedrooms: 4 This permit is for the construction of: 0 Disposal Field 2 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing bdat91,.0 11 1% CO # I isest -1-o ST EC 4 PreSS Zed Received By: Date: � p�� Issued By: Q. CjzU Date: • mf 0 Russco MUNICIPALITY OF ANCHORA 8 9 zo '' � RUSH)( rOS2O \ Community Development Department P • •-: 907-343-7904 Development Services Division • =:• 907-343-7997 w On-Site Water& Wastewater Program h ON-SITE SEWER/WELL PERMIT A4PL$CATIONF Parcel I.D. 017-141-20 Property owner(s) Keith & Janice Washburn Day phone Mailing address 51$1 Metz Court Anchorage, AK 99516 Site address Same Legal description (Sub'd., Block & Lot) Birch Tree Estates, Block 1, Lot 18 Legal description (Township, Range& Section) Lot Size 30,905 Sq. Ft. Number of Bedrooms Four (4) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (EI all that apply) Absorption Field IXI Initial I I Single Family (SF) X (w/wo ADU) Septic Tank n Upgrade U Duplex (D) Holding Tank 17 Renewal U Multiple Dwellings Privy (—I (SF and/or D) Private Well U Water Storage THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: R tom'Lo Waiver Fees: Date of Payment: q/0/18 Date of Payment: Receipt Number: OCi 135 Receipt Number: Permit No. OSP/&13O9 Waiver No. Permit App__'-: ::...c; 4/ Mop �) ' GE E N G I N E E R I N G PO BOX 240773 ANCHORAGE,AK 99524 522-7773 677-7766(FAX) September 4. 2018 Municipality of Anchorage Development Services Dept.- On-Site Water& Wastewater Program 4700 Elmore Rd Anchorage,AK 99507 Subject: Birch Tree Estates,Block 1, Lot 18—5131 Metz Court Septic System Design and Permit Application Dear On-Site Services Engineer: The septic system on the subject lot is leaking and must be replaced prior to the issuance of a COSA for the property. The attached site plan identifies the location of the home and the existing well and septic system along with the proposed septic system. No conflicts exist between the proposed system and any other well or septic system,whether on this lot or adjacent lots. The ground surface on the lot slopes toward the west at a shallow grade. Drainage arrows and surface ground contours are shown on the site plan indicating the grade and direction of flow. Stormwater drainage will not impact this septic system. The new trenches will be constructed parallel to the slope as much as possible. Wells on this and adjacent lots are shown. The new system will be a minimum of 100' from all wells and surface water, and more than 10' from all lot lines. The trenches will be constructed a minimum of 6' apart and 6' from the existing absorption trench. Please refer to the attached test hole log from the system file and the plan and profile sheets for the septic design.If this design is followed,there will be no adverse impacts to adjacent properties. Sincerely, r��OF A�gs>,i • 1 Michael E. Anderson, P.E. *.49 rH %\ r . Michael E.Anderson . f+PF• 4381-E •••`Q� $�c�1T„;•. 9/4/18 •��c,��� k). :° 0 pREESSICN+���~ � BIRCH TREE ESTATES, BLOCK 1 , LOT 18 C°4t l ' " I� 1 (/\\\) \ I \ \ - ) `\ ( \` LOT 4 i .j ) \ \ LOT 17 \\ I� - - - - _ \ \\ 1 10,1\$<E EASEMENT l v. 1 10'UTILI EASEMENT \ \ / N LOT \N REMOVE PIPES FROM EXIS NG — --Al ABSORPTION TRENCI ND T 4-BORN HO ABANDON IN PLACE. XA TI / LOCATION UNKF 0 N.1�_ I // PLACE F60. �` 1' \\\ M -,off r, �� . , H \ \ \ EXISTING 1,250 1 \ N 1 mil MT HV� GALLON SEPTI NK. ( \ 1 LOT 3 \ Q f 1,500 GALLON S.T.E.P. I FS TANK.CON&TRtJCTA–RII 1 I l C C OF 5'' FROM DECK SUPPO T. y mo H / 0 I d I N I Mn MT 10' I / EXISTING WELL/ \I\ ( I 2-50 LONG x 5',WIDE x 6P \ / 1 / EFFEtT1YE-D PTH SORPTION I I \ 7RENCIJ-IES TO BE CONSTRUCTED I \ / 1 / / 10'FROM ALL PROPERTY LINES. I I / f/ \ EXISTING WELL // NOW: \\ LOT 19 I A DECOMMISSION EXISTING SEPT TNK IN ® // I = a . 4 ACCPRDANCE WITH MUNICIPAL CODES ` L - 1- , I ;[r ^,j AGE \ ` _ f '_, `"',,,1 ENGIN[E t t N G ( \ I I / NbTE: \ / �,���\mt` NO SLOPES>25%WITHIN 50'OR SURFACE WATER WITHIN 100'OF THE LEGEND /i P, •�OF •AC,q��iI, PROPOSED SEPTIC SYSTEM CO-CLEANOUT .9 0 2C0-DOUBLE CLEANOUT j*:49 ZH /\ .*I, ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS FCO-FOUNDATION CLEANOUT •• _�••) ••��` ••• •,• / PROPERTY ARE SHOWN.NO CONFLICTS WITH WELLS OR SEPTIC 4 �`�"-"'" SYSTEMS. FS-FLOW SPLITTER VALVE Michael E.Anderson : / 0 50 100 MT MONITORING TUBE ,rO�F•• 4831-E '�i SV-SEPTIC VENT 1ils�F��oP 9-11-1g..••��� FEET TH-TEST HOLE ‘1���`�`���+ 1"=50' CONTOUR INTERVAL 5' BIRCH TREE ESTATES, BLOCK 1 , LOT 18 DESIGN FACTORS: SYSTEM REQUIREMENTS: 600 GPD PEAK FLOW 5-WIDE TRENCH SYSTEM PERK RATE: <5 MIN/IN 1,500-GAL S.T.E.P TANK APPLICATION RATE: 1.2 GPD/SF 600 GPD/ 1.2 GPD/SF / 5' WIDE * 1.0 REDUCTION = 100 LF TRENCH REQUIRED (100 LF SPECIFIED) BOTTOM OF TRENCH: 3' BELOW GRADE FLOW LINE ELEVATION: 2.5' BELOW GRADE TOP OF TRENCH: 0.5'ABOVE GRADE 6" 1=111=111:=I 61 11=1 11-1 i t—I I(— — I 1=1 11=1 11=1 11=1 11=1 1 1=115E1 11=1 I 1E111 I-III=III=III=III=Ill=111=III=111=III-1 GEOTEXTILE FABRIC 2, o„ 11l 1 1=111=1I I=111=1I I=II1=II I-1I I— & 2" INSULATION I= I I—I 11=1 11=1 11=1 11=1 I I-1 11= I i I-111=111=III=111-1 = 6 6„ '=•='=•='• ' • • • • • ° • • • • •' • ' 1.25" PERFORATED PVC { (HOLES DOWN) 15-3/16" HOLES PER LATERAL @ 3.33' SPACING 5' DRAINFIELD ROCK AtfoRGE G t E E P N G TYPICAL DEEP TRENCH SECTION (NO SCALE) 3:3/49111._ gecQ:•• 4 91o� /*:49 N /\ NOTES: �... ... .. f .. . .�.4 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' / . Michael E.Anderson .. • WITH 2" OF INSULATION ��'F�isT•. 4831-E• •...*�`cr/ 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER IIFpPROF ESSIONP\��� THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY \\������~ .4,• (sssesi,� MUNICIPALITY OF ANCHORAGE ���„:\...• F••........ ♦♦♦ DEVELOPMENT SERVICES DEPARTMENT (').0.' , "••:,y♦♦• 41 4700 ELMORE ROAD ANCHORAGE, AK 99519-6650 j ?' 49th 1 rr 1 j • SOILS LOG AND PERCOLATION TEST 00,t.:,,MICHAEL E. ANDERSON l t�; ♦♦,�J,f.. No. CE-4381 r C�=a LEGAL DESCRIPTION: BIRCH TREE ESTATES BI L18 ♦j♦,S FOp9:6.. ...18.,P��.. PERFORMED FOR: KEITH WASHBURN •,�Ilt.:5:����• Professional Engineers Stamp: DATE: 8/28/18 PROJECT No.: PARCEL ID#: 017-141-20 TECHNICIAN: J. WILLIAMS DEPTH TEST HOLE 1 (feet) 1 SLOPE SITE PLAN 2.5' OG/PT 5 _'. •' ;i% SEE SITE PLAN 6 ---F:::: ::;;, ' ''l j 7 Vr:=%'•'f'`^' SANDY SILTY GRAVEL :;;;:: GM 8 °. ".. .,fY; : 9 :,. ; ; ,',. :t:, , 10 .7 y .•.,`,.• WAS GROUND WATER ENCOUNTERED? YE S B.O.H. IF YES @ WHAT DEPTH? 9' 1 I DEPTH OF WATER AFTER MONITORING' 9' DATE OF MONITORING: 9/4/18 12- GROSS TIME NET TIME DEPTH TO NET DROP 13 DATE READING (MINUTES) (MINUTES) WATER (INCHES) (INCHES) 14 8/28 TEST HOLE PRESOAKED PRIOR TO TESTING: 15 1 7:52/8:02 10 1 4 17 4 5 2 2 8:04/8:14 10 1 417,6 5 A 16 17 3 8:15/8:25 10 14/716 5,s 4 8:27/8:37 10 14/74 52 18 5 8:39/8:49 10 1 4/716 5 s 19 6 8:51/9:01 10 14/716 516 20 PERCOLATION RATE: 1.84 (MIN/INCH) PERC. HOLE DIA. (INCHES) TEST RUN BETWEEN: 3 FT. and 4 FT. COMMENTS: TWO TESTS WERE CONDUCTED THEN RESTARTED WHEN RATE SLOWED. N o ,\ \ 1 \ 11 Lot 17 I I N 79.36'45"E 170.79' / 10' T&E EASEMENT 10' UTILITY EASEMENT L=32.18' R=50.00' c,+ • Lot 18 0 ASPHALT 30,905 s.f. -.• PAVEMENT W 24,8, ,\, '1 — ------ ------- W 45.2' • 2S s 78.7' 9 X39 2 STORY J RESIDENCE 70'2" WOODEN PATIO O m ryo O COVERED ENTRY o / ^i 8Z N y.... �� 3 OO 4.1' x 10.3' CANT O O / o a? 2.0' x 8.0' CANT aili�62" 0 .-. rn SEPTIC 4.0' x 19.3' CANT m PIPES 1°Ck tih m W1.4' CANT 2�0' r O 6.0' X 16.1' rn I b0- / WOOD SHED D O N / CD `4) O I CO WELL—\ cD PD l 30.00' S 89'43'44"W 177.89' I \ I \ Lot 19 PLOT PLAN AS BUILT X SCALE 1" = 30' GRID SW 3037 Protect No. 18-427/A1 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates Inc . (907) 522-6476 Phone (907) 522-4625 Fax 000p�Op�� Professional Land Surveyors kenOlangsurvey.com — OF Ae �, Y JonathanOlangsurvey.com 0'`� I herebycertifythat I haves • a��P. . ,,.- 4O surveyed the followingdescribed property: • Lot 18, Block 1, BIRCHTREE ESTATES (Plat No. 71-215) p p 1* :: 49TH �*�O Seward Recording District, Alaska, and that the Improvements situated thereon are within a the property lines and do not encroach onto the property adjacent thereto, that no DA D improvements on the property lying adjacent thereto encroach on the surveyed premises vA KENNETH G. LANG Q and that there are no roadways, transmission lines or other visible �, o easements on said property except as indicated hereon. o�`%•••. S-520 • J O Dated this the Day of , , at Anchorage, Alaska Q ,oR �'"•••••' N.0 ,c ' OQ° SIGNAL‘.);„,=,It is the responsibility of the owner to determine the existence of any easements, `Opppoo<z). covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963 . ~UNICIPALITY OF ANCHORAGE Hea .t and Environmental Protec on Fourth Floor West 825 L Street Anchorage, Alaska 99501 264-4720 ,.LNE~PECTIOI'~ REPORT ON-SITE SEWAGE DISPOSAL SYSTEM . SEPTIC TANK: FROM WELL_ INSIDE LENGTH MANUFACTURER 'NS'~;E W'DTH MATERIAL LIQUID DEPTH NUMBER OF COMPARTMENTS __ LIQUID CAPACITY/~r3-QGALLON$. DISTANCE FROM WELL FOUNDATION ~ of Lines NEAREST LOT LINE_.~:; / TOTALoF LINELENC~TH~/'7~:) ~/4___TRENCH WIDTH'~---~IN. T~O, TAL EFFECTIVE DEPTtt: 7d/ TOP OF TILE 7-0 FINISH GRADE DISTANCE BETWEEN LINES SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER /_ f,~ MATERIAL BENEATH TILE IN. ABOVE TILE IN. SEEPAGE PIT: Log Crib Rings BUILDING FOLJNDATION __ DIAMETER ~ OR WIDTH ..... Crib Size: DIAMETER .... NEAREST LOT LINE . . LENGTH _, DEPTH DEPTH_ DISTANCE FROM: WELL TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ,SQ. FT. Well ~F Class: /00! Depth: Well Distance To: Lot Line Bldg: Sewer Line: Pipe Materials: ~I. + ¢~~ # of Bedrooms: Installer: Remarks: ~ ,,, .~ ~ ~/l/lt-ll_..i.l~f~ ~:: J F'RL J T"'r' ~3F RI'-.IF:HCIE;Fli2iE j~' ~.~.~F_'RF.:TMENT. C" tERLTH FIND ENVI.??NMENTFIL ~F'r'--'TECTION ~'~L-~ ~/" f ~-..,.~25,."L -~TREET, FtNt':HORR~JE, FIK 99. .... · - . . I-4ibb RI"-.IE':, ,-JI"4--S Z Ti SE&..IEE: F~~ ~.~..1 F'EF.'NIT [40 ,:' 77663 :' r ,r~ FIF'F'LIr:RNT L',t4~ ROBINSON 2.~eo BLLIEBERRY 9950-1 ~-.z-'r~. L.C,C:FIT I ON ME-T~ CT ~>..t4~Th R',,,'E / _.._~__ , LEGRL L±8 B-1 E:IRCHTREE EST LOT SIZE ,,, ,. , ,,, ,. / T.rFE ,-,F Sf",IL RBSORBTION S,STEM IS: TREN,"':H MR',:.-': I MIJM THE REQUIRED SIZE OF THE SOIL FIBSORPTION SYSTEM IS: [:, E F"-F H= "--~ L. EN'STH=~ '-~ E: R'-.-' i L [':,E F'-r H= 3: THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRFIINFIELD. THE DEPTH OF FI TRENCH OR PIT IS THE DISTFINCE BETWEEN THE SURFRCE OF THE GROUND FIND THE BOTTOM OF THE E×CFIVFITION (IN FEET;,, THERE IS NO SET N IDTH FOR TRENCHES. THE 6RRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE EXCRVRTION (IN FEET::,. E;EL-;-.!I_i I F-."EE:, SEF"T I C: TR/-.IF--':: $ I ZE= :1258 ,SFILL_C~I'-.IS PR£:~:::Rt]E PLRNT CIPTZIFJt4 R PFICKFIGE PLFIN'f MRY BE INSTRLLED RT THE PERMITTEE'S OPTION SUBJECT TO THE FOLLOWING CONDITIONS:. ~. EITHER R CLRSS I OR II NSF RPPROVED PLFINT MFIY BE INSTFILLED. 2. R CONTINUOUS MFIINTENFINCE FIGREEMENT IS REQUIRED. IF R MFIINTENFINCE RGREEMENT IS NOT KEPT CURRENT YOU MFIY BE REQUIRED TO ENLRRGE THE SOIL.. RQSORPTION SYSTEM FIND?OR YOU MRY BE SUBJECT TO PROSECUTION. T&qC~ (2) I f-~_"~.F"EIDTImD/-~'_-~ REdE E~EI;!IJ I E:E[:, BRCKFIL.LING OF FINY SYSTEM WITHOUT FINFIL INSPECTION FIND RPPROVFIL BY THIS DEPRRTblENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTFINCE BETWEEN FI WELL AND RNY ON-SITE SEWRGE DISPOSFIL SYSTEM IS t00 FEET FOR FI PRIVFITE WELL OR 200 FEET FOR FI PUBLIC WELL. ,WELL. LOGS RRE REQUIRED FIND MUST BE RETURNED TO THE DEPFIRTMENT WITHIN ~0 DFIYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MFIY RPPLY. SPECIFICFITIONS RND CONSTRUCTION DIFIGRRMS RRE FIVFIILFIBLE TO INSURE PROPER INSTRL. LRTION. F" EE.' I'-11 'T E:'-=:P I F.'ES [':.,EC:Er. IE:EE' __=-:-:1.. I CERTIFY THRT i: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS FIND HELLS RS SET FORTH BY THE MUNICIPFILITY OF FINCHORFIGE. 2: I WILL_ INSTRLL THE S~STEM IN FICCORDFINCE WITH THE CODES. ~: I UNDERSTRND THFIT THE ON-SITE SEWER SYSTEM MFIY REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN 4 BEDROOMS. ~F'PL I~C:RNT LYNir, e' ROBINSON V3:. 0 MUNMPAUTY OF Development Services Department ' On -Site Water & Wastewater Section Parcel I.D. 017-141-20 Certificate of On -Site Systems Approval Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: 11-2—G-2-000 1. GENERAL INFORMATION Complete legal description BIRCH TREE ESTATES BLOCK 1, LOT 18 Location (site address) 5131 METZ COURT, ANCHORAGE, AK 99516 Current property owner(s) MICHAEL & SHAWNA BRANCATO Day phone Mailing address Real estate agent 5131 METZ COURT. ANCHORAGE. AK 99516 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ q 1 a 150 cob I t Date of Payment FS 1 -abO, Receipt Number 18 1 2Z Receipt Number COSA # 0 5 CZ,0 1 H y Z Waiver # Waiver Fee $ Date of Payment 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 8/17/2020 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any estimate of how long a system will function satisfactory /��g�Q:' • . .'�,9 �)� for current or future occupants or guarantee that no unseen encroachments, deficiencies or f discrepancies exist can be given by First Water Consulting & FWr.S *� lli •* �� .... .......:— DSD SIGNATURECurtis Huffman System #1 Approved for bedrooms•CE 128991 .����� F�Fo .8/,1,712_0�� System #2 Approved for bedrooms �`�\ROFESS1* Disapproved Conditional approval for bedrooms, with the following stipulation Y OF�rr�� WATER ANn Ir Original Certificate Date: 1 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Legal Description: BIRCH TREE ESTATES BLOCK 1 LOT 18 Parcel ID: 017-141-20 If more than 1 septic system on lot: COSA Checklist # _of A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 10/21/1977 Total depth 106 ft Cased to UNKNOWN ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 7/15/2020 Static water level at beginning of test 62 ft. Well production at time of test 2.5 gpm Comments B. TANK DATA Age of tank(s) 2 years Tank type/material STEP / STEEL Measured operating fluid level in septic tank *FLOAT ® Standpipes/foundation cleanout per record drawing Date of pumping 7/15/2020 D. ABSORPTION FIELD DATA Which system tested (date installed) 9/12/2018 ® ALL standpipes present per record drawing Total measured depth from grade 3.1+ ft (max) Measured depth to pipe invert from grade ft (min) ® N/A — pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective Structure served by this system Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate 0.259 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by FWES Date of Sample 8/17/2020 C. LIFT STATION ® Required maintenance completed Age of lift station 2 years Lift station material STEEL Comments: *BETWEEN ON/OFF FLOAT LEVELS Adequacy test date 7/15/2020 Results N Pass For 4 bedrooms Fluid depth prior to test 0 / 2 in Water added 600 gal New depth 0 / 3 in Elapsed time 30 min ® Code -required soil cover over field Final fluid depth 0 / 2 in ❑ System presoaked Absorption rate 600 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: F, E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ® Yes if No Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' Water Service Line > 10' ® Yes Animal Containment > 50' ® Yes if No ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ® Yes if No _ Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No _ Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No . Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No —ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that 1 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. or- TH ....: . . .... • ....t..�.... • Curtis Huffman ��� ��c�•.• CE 128991 •. ���� P 0FESS 0W -"--,� ft ft ft ft ft ft ft ft MUNICIPALITY Development Services Department Phone: 907-343-7904 .. _.. - On -Site Water & Wastewater Section Fax: 907-343-7997 Owner Phone Septic Tank: -Sludge level inches Lift station: Lift Station/Pump Vault Maintenance Log Street Address -3-131 m p_-� .2 Legal Desc. PID Pumping: required -Pump basket cleaned es no -Control floats cleaned es no -Operation satisfactory es no Alarm System: -Pumping completed Ono -Effluent filter cleaned es no -Proper float settings confirmed es no !STo .jam -Dedicated electrical alarm circuit e no -Audible and visual alarm inside dwelling es no -Alarm system operation satisfacto ' not satisfactorV Manhole Riser -Ground water intrusion at riser to tank connection yes no *Ground water intrusion around pipe penetrationses no -weep hole functional ye no -Manhole lid: Functional e no insulated ,(esno Properly Securedes no Other -All manufacturer required inspections Iand maintenance completed �g no Comments: ............... .-,_-1--1_111-' ................................................... ..........................................................I......................... ........................................................................I....._ .............................I................................................ ......... .............. ........................ ........... I..................... Maintenance Provider: Technician _ Lor -f'!,) Company '5N, Q \j Date of maintenance j % ,�j ',Z� __1' I— Signature Date 7 l)A� rr MUNICIPALITY OF ANCHORAGE 6344{(((��c; 891077 Development Services Department ' p p ryIrra ,,. � Phone: 907-343-7904 On-Site Water & Wastewater Section G Fax: 907-343-7997 SEP r 'ZUld Certificate of On-Site Syst- s Approval ti 6 w Parcel I.D. 017-141-20 Expi `;'\ 1. GENERAL INFORMATION Complete legal description Birch Tree Estates Block 1 Lot 18 Location (site address) 5131 Metz Court Current property owner(s) Janice Sc Keith Washburn Day phone Mailing address 5131 Metz Court, Anchorage, AK 99516 Real estate agent Brandi Sullivan Day phone 907-232-9504 2. TYPE OF DWELLING: Ix I Single Family (w/wo ADU) fl Duplex 7 Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic Ix I Water Storage n Holding Tank ❑ Community Well Community n Public Water System n Public Sewer Waiver request for: Distance: Received by: �/} % ore, Date: "//W f COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ aa.sz Waiver Fee $ Date of Payment 61/113 CGS Date of Payment Receipt Number Cd 6,8W) Receipt Number COSA// C��J� j�c�Rq Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Forge Engineering Phone 907-522-7773 Address 1399 W. 34th Ave Suite 203, Anchorage AK 99503 Engineer's Printed Name Benjamin Schiller, P.E. Date 9/17/18 *6 6. DSD SIGNATURE •�r �• •••• •• X) System #1 Approved for `f bedrooms Benja In Schiller i P•. .•moi � F . c �zsp �r System #2 Approved for bedrooms `ljl`\\\�UO Disapproved Conditional approval for bedrooms, with the following stipulations: ON-SITE :13o WATER AND WASTEvvA R m PROGRAM o v SERVICCP -IF _. By:' v•-•- � / Original Certificate Date: - 20 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: Birch Tree Estates, Block 1 , Lot 18 Parcel ID: 017-141-20 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 10/21/77 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y 106 4 Unknown 26 Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test 10/21/77 9/13/18 Static water level 56 ft 63 ft. Well production 5 g.p.m. 2.15 g.p.m. WATER SAMPLE RESULTS: Coliform Neg colonies/100 mL Nitrate .386 mg/L Arsenic ND ug/L Date of sample: 8/10/18 Collected by: Forge Engineering B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEP/Steel Date installed 9/12/18 Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) Y Date of pumping Pumper New Tank C. ABSORPTION FIELD DATA Date installed 9/12/1$ Soil rating (g.p.d./ft2 or ft2/bdrm) 1.2 g.p.d./ft System type Trench Length 2 x 50 ft. Width 5.0 ft. Gravel below pipe 0.5 ft. Total depth 3.1/3.3 ft. Eff. absorption area 500 ft2 Monitoring tube Y Depression over field N Date of adequacy test New Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth . in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed 9/12/18 Size in gallons 1500 Manhole/Access (Y/N) Y "Pump on" level at 13 in. "Pump off" level at 25 in. High water alarm level at 1 1 in. Datum Top of pump cageCycles tested New Meets alarm&circuit requirements? Y E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot >100' On adjacent lots >100' Absorption field on lot >100'100' On adjacent lots >100' Public sewer main '75' Public sewer manhole/cleanout '100' Sewer/septic service line '25' Holding tank >100' Animal containment areas 'S0' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: 10' '5' >5' Building foundation Property line Absorption field Water main >10'10' Water service line >10'10' Surface water >100' Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: >10' >10' 0 > ' Property line Building foundation Water main 10' Water Service line >10Surface water '100 Driveway, parking/vehicle storage ' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS G. ENGINEER'S CERTIFICATION `-��\\�1‘ I certify that I have determined through field inspections and "4:•'. V-% review of Municipal records that the above systems are in g. 9 vit i• / conformance with MOA COSA guidelines in effect on this date. ?H Benjamin Schiller, P.E. Engineer's Printed NameBenja n Schiller Date 9/17/18 ,+�l��lFq£OF5�NP . �// A ROF ,S10 �.� COSA brown sheet 10-10-12.doc N \ \ \` I ► I Lot 17 I I I36'45"E 170.79' N 79. / 10' T&E EASEMENT 10' UTILITY EASEMENT L=32.18' \jai'l- R=50.00' Lot 18 0 ASPHALT 30,905 s.f. -4- PAVEMENT W / -- V) 45.2' - / o 78.7' 2 STORY / . WOODEN PATIO 4' OD HI m cs o COVERED ENTRY O O Z 'N.'1. / 07'00, 4 -0 O 4.1' x 10.3' CANT O I O O m -I rn 0 rn 4.0' x 19.3' CANT m 1.4' CANT r bee'r W , r O 2.0' x 8.0' 6.0' X 16.1' m I 00 / CANT WOOD SHED > D 0 NJ SEPTIC N PIPES I cn S n r0 M N MANHOHO LE 0 ACO WELL Co. \\\1 PJ \ S 89'43'44"W 177.89' 30.00' I \ Lot 19 PLOT PLAN AS BUILT X SCALE 1" = 30' GRID _ SW 3037_ Project No. 18-427/A2 _ 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates , Inc . (907) 522-6476 Phone �Qoo0p.� (907) 522-4625 Fax '5::. o OF A / 0'4 Professional Land Surveyors kenOlangsurvey.com <,9 jonathanOlangsurvey.com , , ::16At, I hereby certify that I have surveyed the following described property: Lot 18, Block 1, BIRCHTREE ESTATES (Plat No. 71-215) � *;' 49TH �� ..*�,, Seward Recording District, Alaska, and that the improvements situated thereon are within VA the property lines and do not encroach onto the property adjacent thereto, that no Jt improvements on the property lying adjacent thereto encroach on the surveyed premises •• •I• ; �� and that there are no roadways, transmission lines or other visible Q�, KENNET G. r o easements on said property except as Indicated hereon. OQ�s v(l,�•C t$ ••'• , •rt OQ,l(b '•.�S-5202.••• GP, Dated this the _ . ,-` Day of S591-0;"t 'C— 1 , at Anchorage, Alaska Q ,o •••••' foo 40oR0�SSI0NAk-10 It is the responsibility of the owner to determine the existence of any easements, 0�0400�''' covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963 MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lOt, block, subdivision, section, township, range) Location (address or directions) (b) Property owner Mailing Address (c) Lending Institution Mailing Address '~--,~'T- ~ Telephone' (home) :~¥~-o~5G Business ~'~ ~o,/t,~~ Telephone ~/~- ~- ~-~ (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to ,;he following address: (or check here Fl, if hold for pick up.) List contact person and day phone number below: TYPE OF RESIDENCE Single-Family ~. Number of bedrooms LT/ WATER SUPPLY Individual Well 'E~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. SEWAGE DISPOSAL On-site ~ Public [] Community [] Holding Tank [] Note: I~ community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Rev, 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION_ As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional end 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. NameofFirm %/0~,~1 ~:¢~v-~--~'~-~l~ Telephone Address ~' ~ ~'~ ~/ / ~'- Date ~/~ 6. DHHS APPROVAL Appr0,~;ed for ___~---' Approved ~'~'"- . Disapproved Conditional Date / / Terms of Conditional Approval The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph ,5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev, 7/88) Back Page 2 of 2 ~ MUNICIPALITY OF ANCHORAGE (MOA) ~ I 'A~i,~".~, ,~(~ Health Authority Approval (HAA) · *,¢ ¢,.\-V~~~' "",,, 5\O~ CHECKLIST - FEBRUARY 1984 .,~,~,o .~ ~';~ ~' 343-4744 , ~~''0¢~'~' ,,3~~ Legal Description: LOT I~ ~/ If~, B, C, D.E.C. Approved (Y/N~ ~ Well Log Present ( Date Completed Yield ~ ~ _ Total Depth ~ Cased to ~Depth of Grouting ~ H~ Static Water Level ~ ~ ~ Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Y ~/'"' SEPARATION DISTANCES FROM WELL: /- To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot 115 Pump Set At 74 ~'' Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) Y ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by ~,.~ Water Sample Test Results J~ ~'~--~/~', Comments To Nearest Public Sewer Cleanout/Manhole N/A, ;Date B. SEPTIC/HOLDING TANK.DATA Date Installed ~'/~'7 Size ~ No. of Compartments Standpipes (Y/N) C~/~/.~ y""- Air-tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well To Property Line To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course ...... Foundation Clean/out ()~/N) Date Last pumped Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field Comments 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~/"~ "~ Width of Field Square Feet of Absortion Area Type of System Design Length of Field Depth of Field Gravel Bed Thickness Statndpipes Present (Y/N) .Depression over Field (Y/N) ~1~ Date of,~~,uacy Test Results of Last AdequacyL,T__e~s~:Z'~. o~'- '~ ~//~ SEPARATION DISTANCE FROM ABSOR.P~I-ELD:.' ............ To Water-Supply Well I 11~ v ...~- To Property Line To Building Foundation .~ o ~ To Existing or Abandoned System on Lot r'///A ~ ; On Adjoining Lots ~ To Water Main/Service Line ~> ~ J To Cutback (if present) ~,~- To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area ~ * Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Company Date MOA No. Receipt No. (~' ~//'-~ ~ Date of Payment Amount: $ 72-026 (Rev. 7/88) Back Receipt No. Waiver Fee: $ Date of Payment Engineer's Seal Page 2 of 2 ~ ' ' MUNICIPALITY OF ANCHORAGE MUNICIPALITY j ~k~,' .,~,~_~.i~- - : m . ~ ': ''11 , ~I~'~T 0F HEALTH & ~, m ~ DEPARTMENTOF HEALTH~ ENVIRONMENTAL PROTECT~ ' ~ ~ ...... ~, - // ~ I ~ - - -2-L--tre t --nch ra · -laska 99501 ~IRONMENTAL Pr~l~; ~m . -. o, (~1 ~ ~"V' RONME~;~ L EN ~' ~E ER' NG D' V'S'ON aa" 24 1970 I  I'e phone 25 ,-4720 ~ EOU EST FOR APPROVAL Of INDIVIDUAL WATER AND S ~lR EC~ON~: 0omptete all parts on page 1. Incomplete reques~ will no~ be preened. Please allow ten {10} days ~or processing. Steven Kremer I 344-68'65 ERA Box 324 X Anchorage, Alaska 99507 " ' ' ' ' MMON~ ' " NHN Metz Court- Anchorage, Alaska 99502 ~44-6865 K BbYER ' ........ PHONE ' MAILING ADDRESS , r . 612 W. ~2nd Anchorage, Alaska 99503 The Lomas & Nettleton Co. O~ ~ ~s~) I 274-7661 44~9 Business Park Blvd. Anchorage, Alaska 99503 4. REALTOR/AGENT I ' : - ~/~ · . . ~ ._ , I ' r~ SIN L~ FAMILY [] One ~ Four [] Other I [] Two [] Five Ir [] MULTIPLE FAMILY [] Three [] Six 17: WAT.R SU.PLV .........." ] ' [] INDIVIDUAL* *ATTACH WELL LOG. A well log is required for all wells drilled I [] COMMUNITY since June 1975. For wells drilled priorto that date, give wel I ' [] PUB LIC UTI LITY depth (attach log if availab e.) I 8. SEWAGE-DISI~OSALS+ST'EM~ "..... 1C~' '/~1 ....... [] INDIVI DUAL ON S TE** If ~nd v due/on-s te, gwe nstat at on date I [] PUBLIC UT L TY b' this De artment I_ ' Y'~ P ' NOTE: THE INS'PECTION FEE MUST ACCOMPANY EACH' REQUEST BEFORE PRocESsING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: NUMBER OF BEDROOMS 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON -SITE []PUBLIC UTILITY Connection Verified []Sept~ Ta~nk or [] Holding Tank Size: i~ If Tank is homemade give dimensions: [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SlX PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER SOl LS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line MATERIAL ~ Septic/Holding Tank IAbsorption Area [] OTHER ISewer Line J Nearest Lot Line 5. COMMENTS ~ APPROVED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED ~ DATE BY~ LEGAL DESCRIPTION 72-010 (Rev. 3/78) MUNICIPALITY OF ANCHORAGE Department of Health and Environmental Protection 825 L Street, Anchorage, Alaska 99501 264-4720 -i.~---'C~equest for Approval of Individual Sewer and Water Facilities Property Owner: Arnold L. Robinson Mailing Address: 2100 Blueberry Anchorage~ Alaska Phone: 277-9032 Name of Buyer: Steven S. Kremer & Anne M. Kremer .~ .... ~----~-% Mailing Address: 194 Ocean Park Drive Anchorage~ Alaska Pho -' Lending Institution: First National Bank of Anchorage Mailing Address: P.O. Box 720 Anchora~e~ Alaska Phone: 276-6300 ex~, 490 Realtor/Agent: NONE Mailing Address: Phone: Se Legal Description: Lot 18 Block 1 Birch Tree Estates Street Location: NHN Metz Court Anchorage, Alaska Single FamilY Residence: (X) Number of Bedrooms:. 4 Multiple Family Residence: ( ) Number of Bedrooms: Water Supply: *Individual Well ~) If Individual Well, well depth If Community System, name of system Public/Community System ( ) 8. Sewage Disposal System: On-site System (X) Public System ( ) *NOTE: 3/77 If On-site System, date of installation: A well log is required on ALL wells drilled since K~tty February 21, 1~J78 m.M H,~. 851505 Robinson Construct io~ 2100 Blueberry Anchorage, Alaska Attention: Mr. Lynn Subject: Adequacy 'F~s on ~]xist;ng Sanii. a:y ;~,~.,.~r System, Lot 18, Block 1, Birch 'I:'~..: E's'~!~:; Subdivisi~;~, Anc. i~l'age, Alaska Dear Mr, Robinson: At your request of Fei':.l,'uary 6. i978, wr: condL,.::I, ed a test of the new and unused septic system on r'.:e above described Prior to performing the test !he dry sy':,tem was filled on February 15, 1978 with clear water by Isae~¢'s Septic Fank Pumplm] Service by entering water through the septic tank standpipe. A total of 4,000 gallons was pumped into the system o¥~-;r about a four hour p~'_,riod, filling the 1250 gallon tank and the leachfield.. The filled sys[em was ~.~Ilowed a stabilizat;on period of: 24 hours. Then on February 16, 1978 we i.~erforn~ed a drainfield aduquac:y test. During this test the liquid leve,; in t. he septic tank was mo,,itored as water was added to the system. Thc measurements are summarized in the following table: Time Liquid Lc:vel Below Top Total Gallons o.,f.. ,_',~;_L.? ~_z~d p__i~?_ A d d e d 10:O0 6.9' lO:12 6.7' 10:18 6.7' 10:30 6.7' 10:41 6.7' IO:56 6.7' ll:lO 6.7' 25 5O lO0 150 225 300 The meter used during the test was a Rockwell 5/8" standard water meter which had previously been calibrated by R&M Consultants, Inc. If the 4 bedroom residence on the property is to house 8 people, the average load on the system can be .expected to be 600 gallons per day or 0.42 gallons per minute. During the test, the system accepted 300 gallons in 70 minutes. This indicates an average effluent acceptance rate of approximately 4.29 gallons per minute at the tlme of the test. February 21, 1978 Robinson Construction Page -2- The new house on the lot has never been occupied; however, we belleve that the prior filling of the system established a near normal degree of saturation. We, therefore, conclude that the system will dispose of effluent at an adequate rate for a 4 bedroom residence. We appreciate this opportunity to be of service to you. Please contact us If you have any questions concerning this test or if we can be of additional service. Very truly yours, I~&M CJ~NSULTANTS, INC. Gary ~l(. Smith Senior Geologist Jim McCaslin Brown, Ph.D. Head, Earth Science Dept. GAS/JMB/gld REKY SIGNED DATE J SIGNED Redi~orm e 4S 469 SEND PARTS 1 AND 3 WITH CARBON INTACT. ~ PolyPak(SOset$)4P469 PART 3 WILL BE RETURNED WITH REPLY. January 25, 1978 Arnold Robinson 2100 Blueberry Road Anahorage, Alaska 99503 Subject= Lot 18 Block i Birch Tree Estates Subdivision Before this department may send approval to the lending agency, a percolation test will need to be performed to determine the adequacy of the sewer system. The two(~) firms in Anchorage who perform the test are, J.M.L. Engineering, 344-8042, or R & M Engineering, 279-0483. If there are ~ny further questions, please contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Sanitarian RCP/lJh Anchorage (907) 279 25]] G£Ol?(;f: M .gUALI MA YOR D£f'ARTMI~N ¥ Ot Ill]AL 1 tt Arql) t~tqVlt1ON%![!N'¥Al, lqi()lt (:ll()N O~ber 5, 197/~7 Robinson Construction 2100 Blueberry Anchorage, Alaska 99503 (825 "l "G1r~et) S~ject: Lot 18 Block 1 Birch Tree Estates Subdivision The sewer system located on the subject lot can not be approved at this time. Before final approval can be granted several items will need to be completed' (1) The sumps at the end of the trenchs must be solid pipe above the gravel. (2) There must be a cleanout installed between the tank and the beginning of the trench. (3) We never received a letter from the excavator and the homeowner stating there was no water in the trench prior to gravel backfill. Therefore, we can not approve the first(lst) inspection and after the first(lst) inspection is made and approved, a second(2nd) inspection will be required. If there are any further questions, please contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Sanitarian RCP/ljh