HomeMy WebLinkAboutASPEN RIDGE BLK 1 LT 5
(Hev U5/U2/16)
Municipality of Anchorage
On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3
ON-SITE
WASTEWATER INSPECTION REPORT
Permit Number: OSP201319
PID Number: 017-093-05
Dwelling: ® Single Family (SF)
❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑® Upgrade
Name
Donald & Lin May
ABSORPTION FIELD
❑ Deep Trench ❑® Wide Trench ❑ Bed ❑ Mound
Site Address
6601 Aspen Circle Anchorage, AK 99516
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
244-1946
4
1.2 GPD/SF
8.0 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
4.0 Ft.
Gravel depth beneath pipe
4.0 Ft.
Subdivision
Block Lot
Aspen Ridge
1 5
Fill added above original grade
0.5 Ft.
Gravel length
50.0 Ft.
Township Range Section
Gravel width
5.0 Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
500 Ft2
1
Ft.
Well
>100'
>100'
N/A
N/A
>25'
TANK ❑® Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer Capacity
Greer 1,250 Gal.
Surface Water
> 100'
>1 00'
N/A
N/A
Material
Number of compartments
Lot Line
>5'
>10'
N/A
N/A
NA
Plastic
2
Foundation
>1 0'
>1 0'
N/A
N/A
ILIFT STATION
Manufacturer
Capacity
Remarks
Gal.
Alarm location
Electrical installed by
PIPE MATERIAL House to tank D3034 Tank to
drainfield D3034
Installer
Denali Excavating
I
Drainfield D3034 CO/MTD3034
Inspector J. Mlllette / L. Tidwell
BENCH MARK (Assumed elevation) 100 ft
InspectionI51 8/20/20
n 8/21/20
Location and description
dates:2
Bottom of siding @ Point A.
3rd
4,h
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
Conditional Approval:
Date
P,: "' �� `f ',Z
_4�
a. p...°....:....
. .. ..............�.
t,tiCHAEL E° ANDERSON "X
., _. ,' `�
Septic System
Approved
Date
��
0�-��°> si3/20
o>.>.•°'<
Note: this approv
does not include well permit requirements.
(Hev U5/U2/16)
EXISTING ABSORPTION
TRENCH CONNECTED WITH
FLOW DIVERTER VALVE.
1"=50'
50' LONG x 5' WIDE x 4'
EFFECTIVE DEPTH
ABSORPTION TRENCHE.
4-BDRM HOME
CO - CLEANOUT
2CO - DOUBLE CLEANOUT
FCO - FOUNDATION CLEANOUT
FS - FLOW SPLITTER VALVE
FD - FLOW DIVERTER VALVE
MH - MANHOLE
MT - MONITORING TUBE
SV - SEPTIC VENT
TH - TEST HOLE
LEGEND
PERMIT # OSP201319 PID # 017-093-05
ASPEN RIDGE, BLOCK 1, LOT 5
A B
MH 22.0
SV 23.6
2CO 25.0
A
B
DV 27.1
CO1 34.6
MT1 35.3
CO2 65.4
37.2
40.9
42.3
44.1
62.3
62.2
46.29/2/20
FEET
0 50 100
10' DRAINAGE EASEMENTS
10' T&E EASEMENTS
10' UTILITY EASEMENT
30' RESERVED R.O.W. EASEMENT
SHED
FD
2COSV MH
EXISTING WELL
NEW 1,250 GALLON SEPTIC
TANK w/20" MANWAY.
EXISTING SEPTIC TANK
DECOMMISSIONED IN PLACE
PER MOA CODE.8508458
5
5
860
TH85
TH82
TH1
CO1
CO2MT2
MT1
PLAN AS-BUILT
MT2 64.547.0
FCO
PROFILE AS-BUILT
(NO SCALE)
94.2
89.1
94.8
98.8FCOMH SV8/31/20
1250 GAL
SEPTIC TANK
97.3 FINISH GRADE
50'
DRAINFIELD ROCKMT
TH#1NO GROUNDWATER 8/28/20
88.8
92.8 COCO82.8
88.8
92.8
96.8 ORIGINAL GRADE MT2CO94.0
PERMIT # OSP201319 PID # 017-093-05
ASPEN RIDGE, BLOCK 1, LOT 5
*NO ML LAYER WAS ENCOUNTERED AT CONSTRUCTION.
TRENCH WAS INSPECTED BY THE MOA & DESIGN ENGINEER.
� 30' RESERVED
R.O.W. EASEMENT
Lot 3 I II Lot 5
Fauw, pwµ, I X10' UTILITY EASEMENT
N 89 5834"E 92.05,
10' T&E EASEMENTS
Lot 4
a
W
Lot 5 0
l0
Lot 6
FUU,�r7 AWMI
M �1
HOUSE DETAIL
Scale: 1" = 30'
Lot
5
52,570
S.F.
o=
U
a -A
0Q 2
0
Lot
6
m
a �
15.7
x7 9 SHED �
w/ RAMP
O
3�1 q
CHARr y FENCE LINK /
\ry 3� qe
�0.
7
7
0, n
2.0'x5. 1'
OCANT N
L • /
RETAINING WALL
�6'S•
CANT
EPTIC
I - - - r_�
2.0'x5.2'
—WELL 1,uT
PIPES
1.6' 4," �� 7
100' PROTECTIVE
WELL RADIUS
56'22"W 197.67
S
82'
5i�
10' DRAINAGE EASEMENT
cat
O'
9
tip° `r'o
` `FN
Lot 4 C/ /
Lot j RCl E�
i
PLOT PLAN AS BUILT _X_ SCALE —11 = 60__ GRID _ SW 3039__ Project No.
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & A s s o c i a f e s, inc. (907) 522-6476 Phone 000O�pO�
(907) 522-4625 Fax oo
Professional Land Surveyors kenOlangsurvey.com c OF.q,�90r���
jonothanOlangsurvey.com DoP ,.•l) �O
I hereby certify that I have surveyed the following described property: QOM '
LOT 5, BLOCK 1, ASPEN RIDGE SUBDIVISION (PLAT No. 82-198) oe 49TH v*�
Anchorage Recording. District, Alaska, and that the improvements situated thereon are
within the property lines and do not encroach onto the property adjacent thereto, that 0 1
no improvements on the property lying adjacent thereto encroach on the surveyed �O z 1: . KEN. . . LANG
premises and that there are no roadways, transmission lines or other visible �, p o G
easements on said property except as Indicated hereon. Qa s { Z S"
.. LS -5202.'' gJp�
Dated this the _� __— Day of __5� tete ��e� __, _�2O_, at Anchorage, Alaska 4p'0pR'"•••••..NOo
400 aFfSSIONA� 'o
It is the responsibility of the owner to determine the existence of any easements, �DOp000�
covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963
OF MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program'(
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 r
nZ" 1 http://www.muni.org/onsite f
De pa1,tIII ent
NCH OR NG6
On -Site Wastewater Disposal System Permit
Permit Number: OSP201319 Effective Date: 8/20/2020
Work Type: Septic Upgrade Expiration Date: 8/20/2021
Tax Code Number: 01709305000
Site Legal Address: ASPEN RIDGE BLK 1 LT 5 G:3039
Site Mailing Address: 6601 ASPEN RIDGE CIR, Anchorage
Owner: MAY DONALD F & LIN I Lot Size in Sq Ft: 52570
Design Engineer: FORGE ENGINEERING Total Bedrooms: 4
This permit is for the construction of:
Q Disposal Field Q Septic Tank Holding Tank Privy Private Well 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
Special Provisions:
1. During construction, confirm that both ends of the trench will be within the the GM layer and not within a
ML layer.
2. 7 day groundwater monitoring is required. Construction may proceed at your own risk before the 7 day
water monitoring is complete.
Please submit stamped and signed results with the As -built Inspection Report. If the results require a design
change, construction of the system will stop pending On -Site review and approval.
Received By: Date:
Issued By: Date:
8/20/20
MUNICIPALITY OF
Community Development Department
Development Services Division
On -Site Water & Wastewater Program
ANCHORAGE
•jam' j
Phone: 907-343-7904
Fax: 907-343-7997
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 017-093-05
Property owner(s) Donald & Lin May
Mailing address 6601 Aspen Circle Anchorage, AK 99516
Day phone 244-1946
Site address Same
Legal description (Sub'd., Block & Lot) Aspen Ridge, Block 1, Lot 5
Legal description (Township, Range & Section)
Lot Size 52,570 Sq. Ft. Number of Bedrooms
Four (4)
APPLICATION IS FOR: APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field ❑X Initial ❑
Single Family (SF) ❑
(w/wo AD U)
Septic Tank ❑X Upgrade ❑X
Duplex (D) ❑
Holding Tank ❑ Renewal ❑
Multiple Dwellings ❑
Privy ❑
(SF and/or D)
Private Well ❑
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 Fees471 y COV iI3 Waiver Fees:
Date of Payment: /Z _3 12 D Date of Payment:
Receipt Number: X559_615 Receipt Number:
Permit No. 0S 1PZ0151 t Waiver No.
Permit App_-'- : ..:c
PO BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
August 14, 2020
MOA Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
Subject: Aspen Ridge, Block 1, Lot 5 – 6601 Aspen Ridge Circle
Septic System Design
Dear On-Site Services Engineer:
The septic system on the subject lot has failed and must be replaced. We are submitting this permit
application for the construction of a new septic system to serve the home. The attached site plan
identifies the location of the home and the existing well along with the existing and proposed septic
systems.
No conflicts exist between this proposed septic system and any other well or septic system on
adjacent lots. The ground surface on the lot slopes to the west at grades approaching 20%. No
slopes greater than 25% are found within 50’ of the proposed absorption trench. Surface contour
lines are shown indicating direction of flow. Storm water flow will not impact the proposed septic
system.
The absorption trench upgrade is based on a test hole placed recently. The locations of the test hole
is shown on the site plan along with two placed in 1982 and 1985. Our test hole varies significantly
from those two holes in that no silt lenses were encountered. The absorption rate of the soil is
based on a percolation test performed and not a visual analysis. We have designed the septic
system upgrade based on our test hole information. Water monitoring will also be completed on
the new test hole to verify the lack of groundwater. If conditions found in the field during
construction vary from our test hole data we will seek a change order before continuing.
A drainage easement is found at the south property line. No surface water is found in this area
nor has any been noted since our study of this lot began. Discussions with the owner of the
property further indicate no surface water has been noted in this area.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201319, Deb Wockenfuss, 08/20/20
Wells on this and adjacent lots are shown. The new septic system will be a minimum of 100’ from
the well on this lot and 100’ from all wells on adjacent lots and any surface water.
Please refer to the attached plan sheet for the septic design. If this design is followed, there will be
no adverse impacts to adjacent properties.
Sincerely,
Michael E. Anderson, P.E
8/19/20
EXISTING ABSORPTION TRENCH
TO BE CONNECTED WITH FLOW
DIVERTER VALVE.
1"=50'
50' LONG x 5' WIDE x 4'
EFFECTIVE DEPTH
ABSORPTION TRENCHE.
4-BDRM HOME
NOTE:
NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE
PROPOSED SEPTIC SYSTEM
ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS
PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC
SYSTEMS.
CO - CLEANOUT
2CO - DOUBLE CLEANOUT
FCO - FOUNDATION CLEANOUT
FS - FLOW SPLITTER VALVE
FD - FLOW DIVERTER VALVE
MH - MANHOLE
MT - MONITORING TUBE
SV - SEPTIC VENT
TH - TEST HOLE
LEGEND
ASPEN RIDGE, BLOCK 1, LOT 5
8/19/20 FEET
0 50 100
10' DRAINAGE EASEMENTS
10' T&E EASEMENTS
10' UTILITY EASEMENT
30' RESERVED R.O.W. EASEMENT
SHED
FD 2COSV
MH
EXISTING WELL
NEW 1,250 GALLON SEPTIC
TANK w/20" MANWAY.
DECOMMISSION EXISITNG
SEPTIC TANK PER U.P.C.8508458
5
5
860
TH85
FCO
TH82
TH1
CO
CO
MT
MT
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201319, Deb Wockenfuss, 08/20/20
ASPEN RIDGE, BLOCK 1, LOT 5
DESIGN FACTORS: SYSTEM REQUIREMENTS:
600 GPD PEAK FLOW
PERK RATE: 2.1 MIN/IN
APPLICATION RATE: 1.2 GPD/SF
5' WIDE TRENCH SYSTEM
1,250 GALLON SEPTIC TANK
TYPICAL TRENCH SECTION
(NO SCALE)
4" PERFORATED PVC (HOLES DOWN)
DRAINFIELD ROCK
5'
6"
6"
3.5'
4'
NOTES:
1. GRADE AREA OVER TRENCH TO DRAIN AWAY
2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2'
WITH 2" OF INSULATION
3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER
THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY
BOTTOM OF TRENCH: 8' BELOW GRADE
FLOW LINE ELEVATION: 4' BELOW GRADE
TOP OF TRENCH: 0.5' ABOVE GRADE
600 GPD / 1.2 GPD/SF /5' WIDE * .5 (RED. FACTOR) = 50 LF TRENCH REQ. (50 LF SPECIFIED)
8/19/20
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201319, Deb Wockenfuss, 08/20/20
LEGAL DESCRIPTION:
PERFORMED FOR:
DATE:
PARCEL ID#:
SOILS LOG AND PERCOLATION TEST
TECHNICIAN:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
DEPTH
(feet)
PROJECT No.:
TEST HOLE 1
SLOPE
SLOPE
SITE PLAN
DATE READING GROSS TIME(minutes)NET TIME(minutes)
DEPTH toWATER NET DROP
PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH)
TEST RUN BETWEEN: FT. and FT.
COMMENTS:
(inches)(inches)
Aspen Ridge, Block 1, Lot 5
8/19/20
L. Tidwell
DATE OF MONITORING:
WAS GROUND WATER ENCOUNTERED?
DEPTH TO WATER AFTER MONITORING:
IF YES @ WHAT DEPTH?-
2.1 6
4 5
017-093-05
Don & Lin May
12:47/12:57
---
1
2
3
4
5
6
5-10/16
12:59/1:09
1:11/1:21
1:22/1:32
1:37/1:47
1:48/1:58
2' OG
Professional Engineers Stamp:
9/2/20
3/8-11/16
no
None
8/28/20
SILTY GRAVEL - GM
NO SILT LAYERS ENCOUNTERED
BOH
3/8-4/16
3/8-3/16
3/8-3/16
3/7-15/16
3/7-14/16
5-4/16
5-3/16
5-3/16
4-15/16
4-14/16
10
10
10
10
10
10
Feb 18 19 10:55a Anchorage Well .x Pump Ser 907243074'2
P.
�.- Develophwnt Services Department
Buiidibig 1'5�cfety Division
tan -S. #e Wafer & Wastewater Program a
v / 4700 Elmore Road -r
P.C. Box I^66,50 s -
A4arfi 8egfch Anchorage, AV, 99507 .5 A F E r y
Mazof :view IT 111 .8r<t/onsire \ ✓ r
,907) 343-7904
Pump Installation Log
Well Drilling Permit Nurnlrcr;
Paireel Identification Ntiakbvr:_ 621 `%- 0� 3- 0 j
Oyel) L5
Punzp Installation Date:
Pump Intake Depth Below 'i op of Well Casing: 95 -/feet
Pump "M an ufactnrrr's _`ti ajue: ) GL•� le" _°�
pomp MOdel:f t�� S"
rr
Pump Size r ' �' hp
t
If PRtless adapter Burial Depth: t feet
Date of Issue:
Property Owner Name cue Addrfms:
Pitless Adapter i47,anyifaeturer=s -N ame.,�111.s 47L,—
Pidess Adapter Installer:
lVell Disinfected Upon Cam-pleticon? _ Y4L,:;1. ! No
'-fethod of Disinfection:
Comments:
Pump Installer'. arae:
P
Attention: The ptunp installer s'tti4?i plxrvide ,,Lp112t?p ;I]�tal',ezion ing to the DSD within 30 days o`ptimp installation.
MUNICIPALITY OF ANCHORAGE
' DE 1TMENT OF HEALTH AND HUMAN SER' -=S
, Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name DISTANCES
Pyramid Excavating ~ Tfl SEPTIC ABSORPTION
AddressFROM -'"'--C." WELL
;Box 110690 Anchorage, AK 99511 "" TANK FIELD
Phone(s) 345-4893 [ Permit No.860010 lNO' O` Bedr°°ms 4 WELL not in not in
LEGALO£SCRIPTION LOT LINE 76 ' 32' not in
Lot [ Block Subdivision
5I 1 Aspen Ridqe FOUNDATION not in not in
Township, Range, Section approx 15 approx 49 not in
T12N R3W Sec 3 5 AS-BUILT DIAGRAM (Show location of well, septic system, property hnes, foundat,on,
driveway, water bodies, etc.)
SEPT,C [] .O.D,.G ' \
Manufacturer Capacity ~n gallons k
Anchorage Tank 1500
Material No. of Compartments
Steel 2
TYPE OF SYSTEM
~xTRENCH [] BED [] W. DRAIN [] OTHER
Depth to p~pe bottom from 7oral depth from original grade 'l
ongmal grade 5 ' FT 10 ' . FT~
Fill added above original grade Gravel depth beneath p~pe
0 ' -3 ' FT 5 ' FT
Gravel length Gravel width
114 ' FT 3 ' FT
Totamabso~pbonarea Distance between hnes 'X k~ )~'
1140 sqft SOFT NA FT. ¢, )[~ r; /
Installer Date Installed ~ ~ '
Pyramid Excavating 1/8 a 1/10/86
~ PRIVATE ~ OTHER (Identify)-, ~ [ (
Classification (A,BiC) Total Depth Cased to
Installe, 1/1 O-NUT IN Date Installed: .,,
REMARKS: *Terrain rises slightly to north : ', ..::. ~:.
Total depth 13' at north end Soil stra~
remain at constant elevation. E~on
GTF-200 fabric, 2" burial grade high Inspec~ns~fl~edb,: "
-density insulation over tank. ~ ~-'(~~ :
I _ cedify that this inspection was peflormed according lo all
Municipal an, State Duiaelines in elfec, on this date: ....
Health Depadment Approval:~ ~"
72-013 (3/85)
DEI:::'ARTMI.E:IXlT OF HEAI.../I'H AND ENVIFd]NMEIq]"AL PIROTE[]T'I[]N
8,-.;,J L o I R EET, ANCHL)RAGE, Al< 9950.1.
2.64-4'720
F:'EF:~M I '1" I',10 ."
.OATE!: ISSUEED:
AF::'PL, I [::AN'T:
COIqTACT F'HONE,
860() 1()
01 / ()7 / 86
F'YRAMID EXCAVATING
BOX 110690
ANCHORAGE, AK 995i 1
345-4893
I....EE~AL. DESCR I P:
SUBDIVISION: ASPEN R~DOE
SEC'TION: 35 TOWNSHIP: 12N
1.21'A (SQ.FI". OR ACRES)
ASPEN RIDGE CIRCI_.E
4
LOT: 5 BLOCk:: 1
RANGE: 3W
I....isted,l.nelc~w are the options availabl, e to you in designing .youP septic
system. Choose t. he op'Lion that best [its your site.
DIS:I:::'TH TO F'IF'E BOTTOM ('Fl".)
GRAVE:L, DIEF:'I"H (FT,)
T'Ol"AL DEPI"H (F"T',)
[3RAVE!:L.. WIDTH (F:'T,)
E~RAVE:I.. L. ENGTH (F:'T.)
GRAVEl .... VOI...LJME (CU.'YDS.)
T'ANI< SIZE
SOIl .... RATING (SQ.F:'T'. /BR)
5.0 6.0 5.0
5.0 O. 5 3.0
10.0 6.5 8.0
2.5 28.0 5 .. ()
3.3,,0 ** 53.0 132.0 **'
57.6 55.0 85.6
~2'.5(). 0 ** 1,250.0 ** 1,2.50.0 **
281 246 28 1
GRAVEL. LE:NGTH > '75 F:T. IREQUIRES MULTIF:'I...E IRUNS (NOT EXCE!:EDING '75 FT.. 'EACI4)
TAI'dI< MUSI' HAVE AT L. EAST TWO COMF'ARTMENTS
I (::el~'Li~'y that:
1,, I am J'amiliar' wi'Lb the Pequir'ements ~'o~~ on-site seweps and wells as se'L
£o~'Lh by the Mun:Lcipal. i'Ly o[' Anchor'age. (MOA) and the State o[' Alaska.
2. I will :Lnstall the system in ac'cor, danc:e with all MOA codes arid r'egulat:Lons,
and :i.n c~.omF.)~iarlce wit. h the design cpiteria oJ' this pepmit.
3,, I will adhere to all MOA arid State of Alaska r'equir, ements J'ap ~..he se'L back
d:i. stances J'r-om ar~y existing well, wastewa, teP disposal system of publ:i.c
sewePage system on this or' any adjacent of neapby lot.
4 bedr'ooms ar'id
4,, I under'stand 'Lha'L thlis per'mit is valid for a maximum
ally enlaPgemer'rL will require an addi~.ional per'mit,
]:F A I.,:II:::'T STA'T'IOIq IS INS'T'ALL..ED IN AN AREA COVERED BY MOA BUILDIIqG CODES:,
'T'HEIq (:1.) AN I:::. I..,. I:: L, II"~.I.t.,,AL. F':'ERMIT AND INSPIE]CTION MUST BE OBTAINED; (.2) AS-BUII..TS
W]:L,.I .... Iq[IT BE AF'F::'ROVED WIT'HOU'T' AIq E]_EC'T'RICA. I .... INSI::'ECT'tON RE]::'OF¢'T'; AIqD (3) "['HIE].
IE:LECTIRICAI .... WI]IRK MUST BE DONE: BY A L...ICE:tqSED Et....E:CT'R]:CIAIq.
/
PERFORMED FOR: D,~,~
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
DATE PERFORMED:
(ENGI )
LEGAL DESCRIPT,ON:4$p~=~/ /~ Z'~ ~/ Township, Range, Section: ~"'/ZlfJ~ ~ 14j'~ ~'~ .~...~'-'
SLOPE SITE PLAN
t~dKb'7~ ~ TH/~I 57~T~
IF YES, AT WHAT
DEPTH?
Depth Io Water Alter ,,,/~
Monitoring? /v//l~ Date:
s
L
Reading Date Gross Net ~t'/q) Depth to (~) Net ~?
Time Time Water Drop
_ . ~,~z ~,1~
PERCOLATION RATE Z'~',/7 (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN '""~ ~) FTAND '~"'"' EFT
J~ ~' ~ CERTIFY THAT THIS TEST WAS PERFORMED IN
PERFORMED BY: ~F~~ '
72-008 (Rev. 4/85)
::/0 ~- . LITH_ o
/
O/A~
~ =50'
c/f cc
Lot
Anchor/age Recording Preclnct,'-/~laska
/_or 4
LOT SURVEY CERTIFICATION
I hereby certify that I have surveyed the property shown and described
hereon,and that the Improvements situated thereon are wlthln the prop-
erty lines and do not overlap o~ encroach on adjacent property and that no
improvements on adjacent property overlap or encroach on the premises
in question and that there are no roadways, utility lines or other visible
easements on said property except as indicated hereon. .
· LEGEND
~) = Brass capped monument recovered
o = Iron pipe and/or ret)ar recovered
o = 2x2 hubl~ tack recovered
· · -- 5J8"x :50" rebar set this surve7
Scale /# ,
Ref.
e,vA ~701~
Prepared by:
(907)279-~200
t?. L.. BUT?OIV
Register, ed land Surveyor
519 ~ E/ghfh Ave. Anchorage, Alosl~o 99501
· Propr~y~of:
Mun c p
Anchorage
P.O. ,""'~X 196650
ANC,, wRAGE, ALASKA 99519-6650
(907) 264-4111
TONY KNOWLES,
MA YOIR
DEPARTMENT OF HEALTH & HUMAN SERVICES
January 9, 1987
Pine Mountain Development Company
200 West 34th Avenue
Anchorage, Alaska 99503
Subject:
Lot 5 Block 1 Aspen Ridge Subdivision
On-site Well Permit ~860242
A permit issued by this Department for an individual well
and/or on-site sewer system has expired as of December 31,
1986.
Permits are issued on a calendar year basis by authority
of Municipal Ordinance. A new permit must be obtained from
this Department for any well and/or on-site sewer system not
installed by the expiration date.
If you have drilled the well, a well log needs to be sent to
this Department for documentation of the installation and to
close the permit.
If a private engineer inspected the installation of the on-site
sewer system the original as-built inspection report (three part
form) must be sent to this office for review and approval, and
for documentation.
If there are any further questions, please call this office
at 264-4744.
Sincerely,
/R.W5 Robinson
Program Manager
On-site Services
RWR/1 jw
enc: copy of permit
F'ERMIT NO:
DATE ISSUE:D:
DEF:'ARTMENT OF' HEALTI-~ AND Et',IVIRONMENT'AL PF~O'I"EC]"IC]i',I
82'.5 L S'I"REET, ANCHC)RAGE, Al< 9950:1.
264-4'720
860242
()7/21/86
A F::' P L I C A N T:
A D D R E S S:
COIq'I"AC:YT' F:'HC)NE:
P I NE MC]UN"I"A I N DEV. CG
200 W 34TH AVE;
ANCHORAGE, At',:: 99503
345-4715
L. EC'!iAL.. DI!!i:SCR I P:
L..OT SIZE:
SUBDIVISION, ASIZ'EN RIDGE
SEC'I" I C)N:..:,":"~::',.~ TOWNSH I P:
4;'";,560 (S6!, F:'T. OR ACRES)
LOT: 5 BLOCK
12N RANGE:: 3W
AF:'F:'L :[ CANT:
I S!i'3t..JED BY
I cer"L:~fy that:
t. :f. am £am:i. liar with t. he r'equirements for on-site sewer's and wells as set
for'th by the Municipality of Anchor'age (MOA) and the State of' Alaska.
2.,, I will install {he sys'Lem in accc~r'clanc:e wit. h all MC:)A c:odes and r'egulat:i.c~ns,
and in c:ompliance with t. he design c:riter:i.a of t. his per'mit,,
· ..:,I will adher'e t.~::~ all MOA and State of Alaska r. equir'ements for' the set back
distar~ces fr'om any exis'L:i, ng well, wa.=t, ewa{.E~- ~ .... ~" disposal sys'Lem oi" publ:i.c
sewer'age system on 'Lhis of any adjacer~t or nea~-by lcd:.
F [[,1~ M(IIJNIA[N l)~ V ['t]
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
Parcel I.D. 017-093-05
1. GENERAL INFORMATION
Expiration Date: ,'-'? 2 z0
Complete legal description Aspen Ridge, Block 1, Lot 5
Location (site address) 6601 Aspen Ridge Circle Anchorage, AK
Current property owner(s) Donald & Lin May
Mailing address
Real estate agent
Day phone (907) 244-1946
6601 Aspen Ridge Circle, Anchorage, AK 99516
2. TYPE OF DWELLING:
0 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
5C
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 $ 3�Jlo czv `�` i�� Waiver Fee $
Date of Payment 9 o2 0,9 C) Date of Payment
Receipt Number O V7D6 Receipt Number
COSA# ()SCD -b19&`1 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. I acknowledge that On -Site staff may visit the site to verify the information submitted.
Name of Firm Forge Engineering Phone (907) 522-7773
Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503
Engineer's Printed Name Michael E. Anderson, P.E. Date 9/1/2020
r
®®OFP�� ..A�g6,2.
®,r 49th ....
6. DSD SIGNATURE ® - """ I"
C^--
LX System #1 Approved for 0®7A"............L E. ......SON:'w
�'� bedrooms :MICHAEL E. ANDERSON
NO. CE -4381 �®
System #2 Approved for bedrooms ®®��F�;••.,•.. g/1/20 .••'
,,
Disapproved°moi®���®5®®®®®®
Conditional approval for bedrooms, with the following stipulations:
i
S{TE
WATER AND
WASTEv\. oz;
DD r4k AM
JJJ j)CNT�SERv�1�1\
By: " Original Certificate Date: V -Z,17_0
The Municipality of Anchorage evelopment 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
Septic System Advisory
Well Flow Advisory
COSA Checklist blue sheet
X Nitrate Advisory
Arsenic Advisory
Other
COSA Checklist yellow sheet
COSA Checklist
Legal Description: Parcel ID:
If more than 1 septic system on lot: COSA Checklist # of 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 of Sample
Comments __________________________________________________________________________________
B. TANK DATA
Age of tank(s) years
Tank type/material
Measured operating fluid level in septic tank
Standpipes/foundation cleanout per record drawing
Date of pumping
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
Monitor tubes go to bottom of effective. If not, state
depth into effective
Code-required soil cover over field
System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced gallons
Adequacy test date
Results Pass For bedrooms
Fluid depth prior to test in
Water added gal
New depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
Any rejuvenation treatment (past 12 months)
If yes, enter date
Comments/Deficiencies:
Aspen Ridge, Block 1, Lot 5 017-093-05
1.56
07/01/86 None
600
600
>24 FORGE ENGINEERING
9/1/20
90
8/5/20
Well flow test done by Anchorage Well & Pump Services.
<1
SEPTIC/PLASTIC
New
New Construction - 8/20/20 Gravity Flow.
5' Wide Trench
8/21/20 New Construction
8.5
4.5
N/A
COSA Checklist yellow sheet
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 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
From Septic/Holding Tank on Lot to:(Please enter distances if less than required)
Building Foundations > 10’Yes if No ft
Property Line > 5’Yes if No ft
Absorption Field > 5’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 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
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
If absorption field is under driveway comment below
Wells on Adjacent Lots:
Private Wells > 100’Yes if No ft
Community Wells > 200’Yes if No ft
F. ENGINEER’S 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.
9/3/20
✔✔
✔
✔
✔
✔
✔
✔
✔✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
Septic System constructed 8/20/20.
✔
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date _,~/~./~/~
GENERAL INFORMATION
(a)
(b)
(c)
Legal Description (include lot, block, subdivis_ioo, section, township, range)
Location (address or directions)
_ . .:.-i, .* - ~,~ - /. .
Applicant Name ~ ~ ~/~ Telephone: Home ,~ ~- ~ ~ Business ~
Applicant is (check one): Lending Institution B · Owner/builde~uyer ~ Other ~ (explain);
(d) Lending Institution A'/'~._~k'~' ~""~"'" '/~'-"",~ Telephone
Address '/,~ ,/ /---~ '~ ~f'~- ~.-"-4~~- ~li~,/;,~, ,'~'~.~'~ ~
(e) Real Estate Company and Agent /~ ~ //
Address
Telephone
(f) Mail the HAA to the following address:
-r-F;
TYPE OF RES~E
Single-Family~ Multi-Family ~ Other
Number of Bedrooms
Individual Well~r Community[] Public []
Note: If community well system, must have written confirmation from the state Department of Environmental Conservation
attesting to the legality and status. ~: -"- ~ ~ '
SEWA~>~POSAL
Onsite,4~ Public [] Community [] Holding Tank [] "
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page I of 2 72-025 (11/84)
5. ENGINEERING FIRM PROVIDIN,., INSPECTIONS, TESTS, FILE SEARCH, D~,A 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 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection.
Nameof Firm ,~-~'~.~",~, ~-~J~,~/ Telephone ,..~..~.~_ ~c~,~'~_
Address ~.~ ~)~1~ A~, ~ ~J} /~
Date ~//~
--/'-- I
Engineer's Seal
Approved for /'~--~ ~-~-bedrooms by/'~~ ~ /~.,//~' ~ _JLA_~v~..0 ~ate
Approved ~.-~"'~ Disapproved~/ ' / Conditional
Terms of Conditional Approval
'CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the r~presentations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska~ The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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,
Page 2 of 2
72-025 (11/84)
WELL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
MUNiCiPALITY OF ANCHORAGe..
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
CHECKLIST- FEBRUARY 1984
264-472O
IVED
Well Classification ~ If A, B, C, D.E.C. Approved(~l)
Well Log Present~/N)~ Date Completed ~ Yield
...~..~-~--# of Grouting ,~.'~o ·
Total Depth Cased to ~ Depth
Static Water Level ~&~) · Pump Set A't '
Casing Height Above Ground 2, .-~ ~
Electrical Wiring in Conduit(~N)
Separation Distances from Well:
Sanitary Seal on Casing ~N) v
Depression Around Wellhead (Y~:),
Water Sam pie Collected by
Water Sample Test Results
Comments
To Septic/Holding Tank on Lot _~,~*'~' ; On Adjoining Lots -~'
To Nearest Edge of Absorption Field on Lot _,~=a,,~_--· On Adjoining Lots /'.._~--~ ·
To Nearest Public Sewer Line J~, To Nearest Public Sewer
Cleanout/Manhole J~Ao To Nearest Sewer Service Line on Lot
--
B. SEPTIC/HOLDING TANK DATA
Date Installed ~
Stand pipes~llN)
Depression over Tank (Y/~
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well J_,_,_,_,~/~
To Property Line 7~, ~
To Water Main/Service Line .,~:.~_ - r
Course .~_- ,
Size ~ No. of Corn partments
Air-tight Caps<:~N) ~ Foundation Cleanout~N)
Date Last Pumped ~.,),~'
'for
Temporary Holding Tank Permit (Y/N)
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Comments
Page I of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field ~.~ '
Type of System Design
Length of Field //~¢~'
Square Feet of Absorption Area
Depression over Field (Y/([~ .~-~;)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well /~,.~
To Building Foundation 7~
Lot
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
De pth of Field J~ ·
Gravel Bed Thickness ~'~/
Standpipes Present ~N)
Date of Last Adequacy Test
To Property Line .'~'~-.'
To Existing or Abandoned System on
; On Adjoining Lots _//,~ ¢
To Cutbank (if present)
Comments
D. LIFT STATION
Date Installed
Size in Gallons
"Pump 0~~..~.
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
~during Adequacy Test. Meets MOA
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I ha_ye chect~l~d..verified, or conformed to all MOA apd HAA guidelines in
Signed ~-'-g ~')~(J- ' Date
Company ~___,..~, ~/~ MOA No.7~ --
Receipt No.
Date of Payment
Amount: $ ¢ ~' ~
Page 2 of 2
72-026 {11/84)
effect on the date of this inspection.
Engineer's Seal
