HomeMy WebLinkAboutT12N R3W SEC 27 LT 2 S2TI 2N R3W
Sec . 27
Lot 2 52
#017-051-19
Municipality of Anchorage p„
Development Services Department
Building Safety Division . V
On-Site Water and Wastewater Program, 4700 Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650 Page 1 of 3
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: OSP111036 PID Number:—95*991%48— C) -
Name:
Wastewater System: ® New ❑ Upgrade
Address:
5647 CANNON WOODS ROAD ANCHORAGE 99516
ABSORPTION FIELD
Phone: Number of Bedrooms:
❑ Deep Trench ® Shallow Trench ❑ Bed ❑ Mound ❑ Other:
LEGAL DESCRIPTION
Soil Rating:
Total Depth from original grade:
0.8 GPD/Ft'
0.5 Ft.
Block: Lot: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe:
2S2
+.5 Ft.
1.0 Ft.
Township: Range: Section:
Fill added above original grade:
Gravel Length:
3.0 Ft.
100 Ft.
Well: ❑ New ❑ Upgrade
Gravel width:
Number of lines:
Distance between lines:
5.0 Ft.
2
15 Ft.
Classification (Private, A, B, C):
Total Depth:
Cased to:
Total absorption area:
Pipe Material:
Private E
Ft.
40+ Ft.
574.7 Ft2
3034 PVC
Driller:
Date Drilled:
Static Water Level:
Installer:
Date Installed:
23 Ft.
A+ Home Services
6/2/2011
Yield:
7+
Pump Set at:
Casing Height Above Ground:
TANK
GPM
Ft.
1.5 Ft.
SEPARATION DISTANCES
❑ Septic ❑ Holding ® S.T.E.P. ❑ Other:
To
Septic
Absorption
Lift
Holding
ublic/Private
Manufacturer:
Capacity:
From
Tank
Field
Station
Tank
Sewer Line
Anchorage Tank
1250 Gal.
Well
110.2
108.4
50'
Material:
Steel
Number of Compartments:
2
Surface Water
100+
100+
LIFT STATION
Lot Line
74.6
52.0
Size:
250 Gal.
Manufacturer:
Orenco/Anchorage Tank
Foundation
10+
10+
/ \
"Pump on" level at:
+40 ;n.
"Pump off' level at:
+36 in.
High water alarm at:
+45 in.
Curtain Drain
50+
50+
Pump Make & Model
Electrical Inspections performed by:
P2005-1
Ed's Electric
Remarks:
Existing well cameral by Aarrow Pump and Well.
BENCH MARK
Location and Description:
Deck
Assumed Elevation:
100.0 Ft.
Engineer's Stamp
Inspections performed by: PANNONE ENG. SVC, LLC Dates: 1St 6/3/2011
0F•• q�� ��♦
2"d 6/7/2011
Development Services Department ApprovalAll
..�P�E .
�,.• ' •.`5����0
.
Conditional Approval Date:=
49TH
.......
Ponnone�'�i
A
�'
♦1 0.� No. CE 81 49 �' i
�S �
��1�•j`�l
Reviewed and approved by: C Date:
(Rev. 04/06)
�o .�
r �� AV
k���
i
I
I
SHED
I
I M
I � �
g 3BR HOUSE
I (E)
WELL (E) 1
NO PERFORATIONS FOUND
TO A DEPTH OF 40 FEET.
I
I UG�
I 1 10.2
� I �
I
/108.4 ss
EXISTING 1000g
SEPTIC TANK
ABANDONED PER CODE -N° co
EXISTING DRAINFIELD
ABANDONED IN PLACE
REMOVED PORTION WITHIN 10' OF NEW FIELD
AND REPLACED WITH CLEAN FILL
50' BLM EASEMENT
100' OFFSET 136.1
TO RABBIT CREEK
RABBIT CREEK
a
N
K
O
Z
wJ
I
NEW 1250g S.T.E.P. TANK
TEST PIT -1
(ACTUAL SIZE SHOWN)
PERC TEST
0.0 %
=s
rt� 43.3
I
NEW DRAIN FIELD
52.0 (2 EA.) 50LFxl'EDx5'W, 3.5'TD
SOILS TEST SHALL BE NO CLOSER
THAN 5' TO THE PROPOSED FIELD
NOTES: Date
RECORD DRAWING PANNONE ENG SVC, LLC :+'
P.O. BOX 100217 ANCHORAGE, AK 99510 ��G OF'4�'4�,lll 6/8/11
1
PHONE (907) 272-8218 FAX (907) 272-8211 * . TH *�0 Scale/ 1"=50'
"' — ...... P.I.D. NO
T12N, R3W, SEC 27, LOT 2, S2 / 017-051-19
ABBY & JACQUELYN WOLVERTON Steven R. Pannone PERMIT NO.
5647 CANNON WOODS ROAD �,,1'Fcs, CE 8149/ OSP111036
PLAN ANCHORAGE, AK 99516 it �� ' • • • ' P�•-'- Sheet
�` PROFESSION 2 OF 3
A
B
FC
21.0
14.7
T1
69.2
40.8
LS
78.0
43.3
M 1
109.3
83.2
M2
70.3
54.4
M3
119.0
95.9
M4
78.5
65.5
i
I
I
SHED
I
I M
I � �
g 3BR HOUSE
I (E)
WELL (E) 1
NO PERFORATIONS FOUND
TO A DEPTH OF 40 FEET.
I
I UG�
I 1 10.2
� I �
I
/108.4 ss
EXISTING 1000g
SEPTIC TANK
ABANDONED PER CODE -N° co
EXISTING DRAINFIELD
ABANDONED IN PLACE
REMOVED PORTION WITHIN 10' OF NEW FIELD
AND REPLACED WITH CLEAN FILL
50' BLM EASEMENT
100' OFFSET 136.1
TO RABBIT CREEK
RABBIT CREEK
a
N
K
O
Z
wJ
I
NEW 1250g S.T.E.P. TANK
TEST PIT -1
(ACTUAL SIZE SHOWN)
PERC TEST
0.0 %
=s
rt� 43.3
I
NEW DRAIN FIELD
52.0 (2 EA.) 50LFxl'EDx5'W, 3.5'TD
SOILS TEST SHALL BE NO CLOSER
THAN 5' TO THE PROPOSED FIELD
NOTES: Date
RECORD DRAWING PANNONE ENG SVC, LLC :+'
P.O. BOX 100217 ANCHORAGE, AK 99510 ��G OF'4�'4�,lll 6/8/11
1
PHONE (907) 272-8218 FAX (907) 272-8211 * . TH *�0 Scale/ 1"=50'
"' — ...... P.I.D. NO
T12N, R3W, SEC 27, LOT 2, S2 / 017-051-19
ABBY & JACQUELYN WOLVERTON Steven R. Pannone PERMIT NO.
5647 CANNON WOODS ROAD �,,1'Fcs, CE 8149/ OSP111036
PLAN ANCHORAGE, AK 99516 it �� ' • • • ' P�•-'- Sheet
�` PROFESSION 2 OF 3
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE
STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE
WASTEWATER DISPOSAL SYSTEMS.
2. ALL WORK WAS IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS.
3. SCOPE OF WORK: INSTALLED NEW 1250 GALLON S.T.E.P. TANK, AND NEW SOIL ABSORPTION SYSTEM. DOCUMENTED
WELL.
4. GROUNDWATER WAS OBSERVED AT 8.5 FEET BELOW EXISTING GRADE DURING EXCAVATION OF THE SOIL TEST HOLE. AN
APPARENT WATER TABLE WAS NOT OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 4.5 FEET BELOW EXISTING
GRADE.
�INSULATION
1 Y4" 0 PERF PIPE 6" TOPSOIL AND VEGETATION
HOLES ® 24" O.C.
TH1 96.9
GM/ML 410 �5.0
GROUNDWATER OBSERVED
AT 4.5' (92.4)
-7.5
E
-10 fis.s w
BOH m p
F Z
� W
O =
f- U
O w
2
Z
0,
!
FILTER FABRIC -2. 2.0
DUCTILE IRON PIPE
~0
96. (NORTH)
-197.4 (SOUTH)
O
FOUNDATION CLEAN OUT
¢ 0
TANK CLEAN OUT NO.
1-
101.1(N
Z w a
96.4 (SOUTH)
N
99.9(S
O U
DOUBLE CLEAN OUT
LL
DIVERTER VALVE
FS
U
= O
OF U Z
w
Z wQ
98.6
_____
97.4
a
5.0
ss
s1 6 NEW 1250 g
S.T.E.P.
TANK
DESIGN PARAMETERS
PRIMARY/RESERVE SEPTIC SYSTEM
NO. BEDROOM: 3 (450 gpd)
TANK SIZE: 12508 S.T.E.P.
PERC RATE = 1-5 MPI
SOIL RATING: 0.8 GPD/SF
AREA ROD: 562.5 SF
SYS. TYPE: WIDE TRENCH 1.0' E.D.
RF: 0.87
MIN LENGTH: 97.9 LF
USED:
(2 EA.) 50 LF X 5' WIDE, 1.0' E.D.,
3.5' TD, 0.5' FROM O.G.
TOTAL AREA: 574.7 SF
101.1 (NORTH)
J99.9 (SOUTH)
FILTER FABRIC -2. 2.0
DUCTILE IRON PIPE
TH
96. (NORTH)
-197.4 (SOUTH)
FC
FOUNDATION CLEAN OUT
DRAIN ROCK
TANK CLEAN OUT NO.
97,6 (NORTH)
10.0
M#
96.4 (SOUTH)
MIN
RIGID INSULATION
NOTE: ADD SAND AS NECESSARY
DOUBLE CLEAN OUT
TO LEVEL DRAIN FIELD
DIVERTER VALVE
FS
w
mp
~ W 0
= O
OF U Z
w
Z wQ
O U
2 Q
11
(2EA.) TRENCH - SEE DESIGN
PROFILE
ABBREVIATIONS
CU
COPPER
DIP
DUCTILE IRON PIPE
TH
TEST HOLE
FC
FOUNDATION CLEAN OUT
T#
TANK CLEAN OUT NO.
C#
CLEAN OUT NO.
M#
MONITOR TUBE NO.
R. 1.
RIGID INSULATION
DCO
DOUBLE CLEAN OUT
DV
DIVERTER VALVE
FS
FLOW SPLITTER
Y4"" Dia Per! Pipe
101.1 (NORTH)
99.9 (SOUTH)
98.6 (NORTH)
97.4 (SOUTH)
_97.6 (NORTH)
36.9 (ORIGINAL GRADE) 96.4 (SOUTH)
LEGEND
W WATERLINE/
WELL RADIUS
SS NEW SEPTIC
NOTES:PAMONE
ENG SVC, LLC
P.O. BOX 100217 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211
►��`'� 4'kslll
°F A�g
/�G>�P '�y�+
TH * f/
%017-051-19
VAS�twven RPannone
o#,�F�. CE 8149 1
(i>iIF�PROFESSIo'0�
Date
x/8/11
RECORD DRAWING
scale
NTS
T12N, R3W, SEC 27, LOT 2, S2
ABBY & JACQUELYN WOLVERTON
5647 CANNON WOODS ROAD
ANCHORAGE, AK 99516_
P.I.D. NO
PERMIT NO.
OSP111036
DESIGN DETAILS
sheet
3 OF 3
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
TEST HOLE 1
OR ORGANICS
SILTY SAND
GM/ AND GRAVEL
ML W/POCKETS
OF SILT
�L— 4/28/2011
5/19/2011
Gp/ — 4/4/2011
SM �_ 3/28/2011
GRAVELAND
SILTY SAND
BOH (MOIST)
DATE PERFORMED: 3/28/11
SOILS LOG - PERCOLATION TEST
SLOPE
X
TH
WAS GROUND WA -
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
DEPTH TO WATER
MONITORING? -E
DATE: 4/-
READING DATE
CLOCK
TIME
NETTIME
WATER
LEVEL
READING
NET DROP
1 3/28/11
12:35
--
1.88
--
2
12:45
10 MIN
5.01
3.13
3
12:45
--
1.88
--
4
12:55
10 MIN
4.88
3.00
5
12:55
--
1.88
—
6 11:05
10 MIN
4.84
2.96
PEROLATION RATE 3.4 (min/inch) PERC HOLE DIAMETER 6 inches
TEST RUN BETWEEN 3 FT AND 4 FT
COMMENTS: Test hole excavated by A+ HOME SERVICES. Prec hole was presoaked.
Test run for one hour. Last 3 readings reported
PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST.
NOTES:
PAMONE ENG SVC, LLC
P.O. BOX 102954 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211
����
.� OF A�. 'kl
?'�� ""' '4S 11
j co 49 TM �y*+t
/
r S'teven 'R' Pannone w
���<c�s• CE 8149��
�l1T%)0* p��-"�
�`� OF SSIow
Date
FOR CONSTRUCTION
ScaNTS
T12N, RM, SEC 27, LOT 2, S2
ABBY &JACQUELYN WOLVERTON
5647 CANNON WOODS ROAD
ANCHORAGE, AK 99516
P.I.D. NO
017-051-19
PERMIT NO.
OSP111036
SOILS LOG
Sheet
3 OF 3
On -Site Water & Wastewater System Permit
MUNICIPALITY OF ANCHORAGE
nr Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number: OSP111036
Tax Code Number: 01705119000
Work Type: WellSeptic Upgrade
Permit Effective Dates: April 22, 2011 to April 21, 2012
Design Engineer: PANNONE ENGINEERING SERVICE
Subdivision: T1 2N R3W SEC 27
Site Legal Address: T12N R3W SEC 27 LT 2 S2 G:2937
ent
1'. epartixaenr
Owner/Address: WOLVERTON ABBY 50% &
WOLVERTON JACQUELYN A 50% 5647 CANNON WOODS ROAD ANCHORAGE AK 99516452
Site Mailing Address: 5647 CANNON WOODS RD, 27, Anchorage Lot Size in Sq Ft: 108900
Total Bedrooms: 3
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank N Privy Y Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Special Provisions: Soils tests shall be no closer than 5 feet to the proposed drainfield.
Special Provisions: The well shall be documented. A camera shall be used to check for
perforations in the casing.
�1'mlil C61 veor�lf,,,J� 44
Received By:
� r
Issued
7 z�r
On -Site Water & Wastewater Program
Mayor Dan Sullivan
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel
Property owner(s)��;'}" / ����;<�� L�-�t : a Day phone
Mailing address �Zo"91( ��w�z 1 � -f iCc>'1ri
Site address !�_64% %
Legal description (Sub'd., Block & Lot)
Legal description (Township, Range & Section)
Lot Size o c'i vo Sq. Ft. Number of Bedrooms _5
THIS APPLICATION IS FOR:
THIS APPLICATION IS AN:
(M all that apply)
Absorption Field ®
Initial ❑
Septic Tank❑ \*
Upgrade
Holding Tank F_]
Renewal ❑
Privy ❑
Private Well 0
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
I certify that the above information is correct. I further certify that this application is being made
for a Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property ow
er or autnonzea agent)
Permit/ -Rush Fees: Waiver Fees:
Date of Payment: E Date of Payment:
Receipt Number: u ` t Receipt Number:
Permit No._,� Waiver No.
GABuilding\On Site\Forms\Client Forms\Permit App_01 041 1.doc
(Rev. 1 /11)
Pannone Engineering Services LLC
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: steve@panengak.com
April 21, 2011
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
4700 S. Bragaw Street
P. O. Box 196650
Anchorage, Alaska 99519
Subject: T12N, R3W, Sec 27, Lot 2, S2
Septic System Permit Upgrade Request
Ladies and Gentlemen:
I am writing to request a permit to construct an upgraded septic system be issued for this property. The
proposed systems will serve an existing three-bedroom house. Currently the lot is developed. The lot is
served by a private well that is undocumented. The existing septic system is undocumented and in failure.
The lot to the west is served by a private well, and the other surrounding lots are undeveloped.
1. Soils. A single test hole was excavated by Pannone Engineering Service in March of 2011. See the
soil log attached. Ground water was monitored for seven days. No ground water was monitored to a depth
of 8.5 feet below ground level after the monitoring period. Bedrock was not encountered in the test hole. It is
my opinion, based on the results of the percolation tests and overall soils appearance; an application rate of
0.8 gallons/day/square feet should be used, using a 1,250 gallon S.T.E.P. tank and bed type drain field.
2. Soil Absorption System Design.
a. See Sheet 2 of the design package
3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and the
existing drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water
and drainage ditches.
4. Topography: The topography in the area is relatively flat. There is a high area at the location of the
proposed drain field with a slope of approximately 1 percent to the southwest, and 3 percent to the east.
5. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification
that the review is complete and that there are no further comments is received from MoA On -Site
Department, the note will be removed and "Issued for Construction" drawings will be issued.
_,�
__)21 _ Ai
Page 2 of 2
6. Well: We will inspect the well and document it as part of the record drawings.
The proposed installation will not affect the future development of the surrounding or existing lots. There
are no wells or septic systems within 100 feet of the proposed septic location.
If you have any questions or concerns, please contact me at 272-8218.
Sincerely,
G. Scott Crowther, P.E.
Civil Engineer
Attachments:
f 2w
A a K S..
r_
GO 2-
j SHED I
� II
O •-
I
~ U
�41
I /
I/ \
3BR HOUSE ,
WELL (E) (E)
TO BE DOCUMENTED
CAMERA WILL BE USED TO CHECK
FOR PERFORATIONS IN THE CASING zi
j 1250g S.T.E.P. TANK (P)
I UG I
I
s I 3�
116.2 TEST PIT -1
100.9 (ACTUAL SIZE SHOWN)
EXISTING 1000g 10,0 PERC TEST
i\ SEPTIC TANK %
ABANDON PER CODE �I
L- _ _-- EXISTING DRAINFIELD 36.9 --
ABANDON IN PLACE
I
1250g S.T.E.P. TANK (P) PRIMARY FIELD (P)
50' BLM EASEMENT W W 6\° 50.0 (2 EA.) 50LFxl'EDx5'W, 3.5'TD
, SOILS TEST SHALL BE NO CLOSER
THAN 5' TO THE PROPOSED FIELD
100' OFFSET 139.7
TO RABBIT CREEK
RABBIT CREEK
NOTES: PAMONE ENG SVC, LLC�`"`I ' Date
FOR CONSTRUCTION ,: OFA1 5/31/11
P.O. BOX 100217 ANCHORAGE, AK 99510 � '�� • - • • " •'qS li
Scale
PHONE PHONE (907) 272-8218 FAX (907) 272-8211 /co •
449R*7-7:*�� 1"=50'
P.I.D. NO
T1 2N, R3W, SEC 27, LOT 2, S2 . , , , , ,
Steven R. Pannone PERMIT N0.
ABBY & JACQUELYN WOLVERTON CE 8149
5647 CANNON WOODS ROAD �� s 1� OSP111036
PLAN ANCHORAGE, AK 99516 �llT��' P�� Sheet
ll PROFESSION
���""� 1 OF 3
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF
ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF
ON—SITE WASTEWATER DISPOSAL SYSTEMS.
2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS.
3. SCOPE OF WORK: INSTALL NEW 1250 GALLON S.T.E.P. TANK, AND NEW SOIL ABSORPTION SYSTEM. DOCUMENT WELL.
4. GROUNDWATER WAS OBSERVED AT 8.5 FEET BELOW EXISTING GRADE DURING EXCAVATION OF THE SOIL TEST HOLE. IF
AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 4.5 FEET BELOW EXISTING GRADE,
NOTIFY THE ENGINEER IMMEDIATELY.
T"I
—0.5 ----�.$— �5.
GM/ML
GROUNDWATER OBSERVED
AT 4.5•
—7.5
GP/SM
—10 BOH
W
m ❑
� Z
F W
O =
F_ Q
O u
� Q
Z
Z
F
~ 0
O O F
Z
❑ W zi
¢ U
U LL
LJLU
4.0
_7 NEW 1250 g
S.T.E.P.
TANK
DESIGN PARAMETERS
PRIMARY/RESERVE SEPTIC SYSTEM
NO. BEDROOM: 3 (450 gpd)
TANK SIZE: 1250g S.T.E.P.
PERC RATE = 1-5 MPI
SOIL RATING: 0.8 GPD/SF
AREA RQD: 562.5 SF
SYS. TYPE: WIDE TRENCH 1.0' E.D.
RF: 0.87
MIN LENGTH: 97.9 LF
USE:
(2 EA.) 50 LF X 5' WIDE, 1.0' E.D.,
3.5' TD, 0.5' FROM O.G.
TOTAL AREA: 574.7 SF
1 Ya" 0 PERF PIPE
Y," HOLES ® 24" O.C.
.TER FABRIC
DRAIN ROCK
_10.0
\ MIN
6" TOPSOIL AND VEGETATION
NOTE: ADD SAND AS NECESSARY
TO LEVEL DRAIN FIELD
1 Y,"" Dia Perf Pipe
� II
(2EA.) TRENCH - SEE DESIGN
PROFILE
ABBREVIATIONS
CU
COPPER
DIP
DUCTILE IRON PIPE
TH
TEST HOLE
FC
FOUNDATION CLEAN OUT
T#
TANK CLEAN OUT NO.
C#
CLEAN OUT NO.
M#
MONITOR TUBE NO.
R.I.
RIGID INSULATION
DCO
DOUBLE CLEAN OUT
DV
DIVERTER VALVE
FS
FLOW SPLITTER
LEGEND
W WATER LINE/
WELL RADIUS
SS NEW SEPTIC
NOTES:
PAMONE ENG SVC, LTC
P.O. BOX 100217 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211
��t���\\\
OF qL ll
j co TM
/ tl
S'teve'n ' :Pannone %PERMIT
r��F/s CE 8149
� �
;113
�I�PFp PSG
�kl \ PROFESSION
Date
5/31/11
FOR CONSTRUCTION
Scale� NTS
T12N, R3W, SEC 27, LOT 2, S2r.;�
ABBY & JACQUELYN WOLVERTON
5647 CANNON WOODS ROAD
ANCHORAGE, AK 99516
P.I.D. NO
017-051-19
NO.
OSP111036
DESIGN DETAILS
Sheet
2 OF 3
Dc—`tment of Health and Environment,= Protection
2516 E. Tudor Road
` Anchorage, Alaska 99507
276-2221 l
tiOILS LOG PP 110I,ATION 'I PST
Performed for p J,te P rfnlre,i
" c, Ay_e_s- - -- - -
Legal Description: �% Lo _�_, S��_ ZJr/Z�/+21f!,S.�YL_�2: ocre5l____
This form reports: Soils log _� __ Percolation
Depth
Feet ;
1
G P
`brown td/y Sondy drove/ wifh -
—
_
_ __
2 -
------
r04-17dCd Cobb/CS- 76 1Z05;Z&
- /D --
----ice .. __
-
- ---
3'
ML
�n-
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17 dry
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12 - — bofi6m o{ hole
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Was ground water encountered? _ �Q If yes, at wiat depth? _- --_-- -
Reading
Date
Gross Time
Net Time
------
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----ice .. __
-
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-.
_ . _..
_ _ _ __._
Depth to water Net (trop'
/.G2" (61/7 nne/ivt
q ffw-r- by s ouyh' -
Percolation rate �� s.2� (*�- T
-Proposed installation: e page Pit Draiu field w
Depth of Inlet Depth to bottom of pit or trench 75'
COMMENTS: 2ablri_f . ere&� _azo% --
- -'- ,
Performed - ertified By��� _ I } �atc:
[i(� -040 (f,/-9i1a
51-a u§�se / /S=am �•5 t ir$
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
Parcell.D. o17 -o51 -1g
1. GENERAL INFORMATION
Complete legal description TsaN RiW. Sec 27 Lot z Sz
Location (site address) 5647 Cannon Woods Road
COSA # 0 S G 12 I3 Q.2—
Expiration
2Expiration Date: Z 0 — .2 % — f ?s
Current Property owner(s) Brian & Tiffany McCorison Day phone
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
5647 Cannon Woods Rd. Anchorage, AK 99Si6
Unless otherwise requested, COSA will be held by DSD for pickup.
2.. NUMBER OF BEDROOMS: I
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage ❑
Community Class Well ❑
Public Water System ❑
Day phone
Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
ED
Individual Holding Tank
❑
Community On-site
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of 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 272-8228
Address P.O. Box 200227 Anchorage, AK 9952o
Engineer's Printed Name Steven R. Pannone, P.E. Date ZO&I2
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 bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
wan Lnecl<ust A Arsenic Advisory
Septic System Advisory Maintenance Agreements
Well Flow Advisory Supplemental Engineer's Report
Nitrate Advisory Other
By Original Certificate Date: 7-27—/2—
(Rev.
2%`/2(Rev. 71
Municipality of Anchorage E
Development Services Department °
Building Safety Division
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: T22N. RaW. Sec 27. Lot 2 52 Parcel ID: o2Z-062-20
A. WELL DATA
Well type Private
Date completed
Total depth ft.
Date of test
Static water level
Well production
If A, B, or C provide PWSID #
Sanitary seal (Y/N) Y_
Cased to 40+ ft.
FROM WELL LOG
WATER SAMPLE RESULTS:
ft.
Coliform Neu_colonies/100 mL Nitrate o.a7:t mg/L
Well Log (Y/N)
Wires properly protected (Y/N) Y
Casing height (above ground) 28 in.
AT INSPECTION
6/7/2022
III
Arsenic: ND ug/I Date of sample: 7/2-3/2022 Collected by: DRM
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic / steel Date installed 6/7/2o22
Tank size 225o S.T.E.P. 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 7/20/2022 Pumper Northland Pumping Service, Inc
C. ABSORPTION FIELD DATA
Date installed 6/-V2022 Soil rating (g.p.d./fe or ft2/bdrm) o.8 GPD/5F System type Wide Trench
Length Zoo ft. Width
ft. Gravel below pipe 2 ft.
Total depth 3,S ft. Eff. absorption area 574.7 ft' Monitoring tube Y Depression over field N
Date of adequacy test 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 617/2012 Size in gallons 25o Manhole/Access (YIN) Y
"Pump on" level at r4,3 in. "Pump off' level at 4o in. High water alarm level at 45 - in.
Datum Bottom Cycles tested New Meets alarm & circuit requirements? Y
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 110.2
Absorption field on lot 208.4
Public sewer main 75+
Sewer /septic service line zS+
Animal containment areas co+
On adjacent lots ioo+
On adjacent lots ioo+
Public sewer manhole/cleanout zoo+
Holding tank ioo+
Manure/animal excrete storage areas ioo+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation zo+ Property line 24.6 Absorption field zo.o
Water main zo+ Water service line aS+ Surface water zoo+
Wells on adjacent lots zoo+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line Sz.o Building foundation zo+ Water main 75+
Water Service line zo+ Surface water zoo+ Driveway, parking/vehicle storage zo+
Curtain drain so+ Wells on adjacent lots zoo+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that t have determined through field inspections and : s'
review of Municipal records that the above systems are in
p Y i.....s.. ... .... ........`s...
conformance with MOA COSA guidelines in effect on this date.
..................... ...............%;.ryryry
Engineer's Printed Name Steven R. Pannone :Steven R. Pannone
P.E. ♦ q
♦ No. CE 8149 '�
Date 7/2-412012
11, I
COSA Fee $ 6
ri^�
Date of Payment
Receipt Number X1000_
(Rev. 11105)
Waiver Fee $
Date of Payment
Receipt Number
AAROW PUMP & WEll SFRviu, LLC �� � 'K "
is ,\., E
il� u
P.O. Box 110496 No9483
Anchorage, AK 99511
Office: (907) 346-9355 • Fax (907) 333.8976
Eagle River: (907) 622-9335
_ CUSTOMER ,JOB SITE
(^
NVOICE DKE tELL DEP11' SvIlL CM OR<Ik 7,ED PUMP C3TFt SALESPceSOI ,
.;:'QUANTITY
DESCRIPTION PRICE AMOUNT
HOURS
RATE AMOUNT TOTAL MATERIAL
TOTALLABOR
r
PAY THIS AMOUNT p
ThankYou
!!% SIGNATURE
0 Hereby Acknowledge the Satisfactory Completion of the Above, Described Work and agree that if above work is not paid for iq 90 days) agree to. allow Aarow
Pump & Well Service, L.L.C. the riga to remove unpaid for equipment and charge for labor already performed & labor to remove unpaid for equipment,}
TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE.
SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNT&
Municipality of Anchorage
• Development Services Department �� �G,�
Building Safety Division d
On -Site Water and Wastewater Program a F e T Y vn
4700 Bragaw Streetjj
t
j P.O. Box 196650 S
Anchorage, AK 99519-6650 1J
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING J
Parcel I.D. o17-o5i-1g COSA # i�kj. 'k
Expiration Date: 9-17
1. GENERAL INFORMATION
Complete legal description T12N, RAW, Sec 27, Lot i Sz
Location (site address) 5647 Cannon Woods Road
Current Property owner(s) Abby & Jacquelyn Wolverton Day phone
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
5647 Cannon Woods Rd, Anchorage, AK 99516
Day phone
Day phone
Unless otherwise requested, COSA will be held by DSD for pickup.
11V --'NUMBER OF BEDROOMS:
3.: TYPE,,OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well,
®
Individual On-site
individual Water Storage
❑
Individual Holding Tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of 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 Guideline for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional -,arid 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 272-8218
Address _P.O. Box 100217, Anchorage, AK gg510
Engineer's Printed Name _Steven R. Pannone, P.E. _ Date 6/8/2011
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 fluctuate
0f
that may during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the this
..��P� .................. '9`S♦1��
�,.•''
evaluator of system. All systems eventually fail and
♦�
satisfactory test results do not guarantee future performance of the system, nor do they guarantee thatAV
' 49 rH ♦
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
•:,Steven
requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed
Any
♦ R. Pannone: i
♦�0�s°•.,�•
above. reliance upon or use of this report by any other person or party is not authorized nor will it
No. CE 8149 •,• AV
AV
confer any legal right whatsoever.
5. DSD SIGNATURE
��...•°1'�
���,�c�.•`
Approved for bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Y OF
WATER AND �
WASTEWATER
041
Attachments
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By ZZ/Original Certificate Date:
(Rev. 11{
Municipality of Anchorage *AE
Development Services DepartmentBuilding Safety Division 1.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: T12N, 113W, Sec 27, Lot 2 S2 Parcel ID: 017-051-19
A. WELL DATA
Well type Private If A, B, or C provide PWSID #
Date completed Sanitary seal (Y/N) Y
Total depth ft. Cased to _4g+_ft.
FROM WELL LOG
Date of test
Static water level ft.
Well Log (Y%N) N
Wires properly protected (Y/N) Y
Casing height (above ground) 18 in.
AT INSPECTION
6/7ho11
23 ft.
Well production g.p.m. 7.0+ 9.p -m.
WATER SAMPLE RESULTS:
Coliform Neg_colonies/100 mL Nitrate 0.929 mg/L
Arsenic: ND ug/I Date of sample: 3/2812011 Collected by: DRM
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/ Steel Date installed _6/7 2o11
Tank size 1250 S.T.E.P. 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
C. ABSORPTION FIELD DATA
Pumper
Date installed 6 g= Soil rating (g.p.d./ft2 or ft2/bdrm) o.8 GPD/SF System type Wide Trench
Length ioo ft. Width 5 ft. Gravel below pipe 1 ft.
Total depth 3.5 ft. Eff. absorption area 574.7 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 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
"Pump on" level at
Datum
Size in gallons
in. "Pump off' level at in.
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 13.0.2
Absorption field on lot zo8.4
Public sewer main 75+
Sewer /septic service line 25+
Animal containment areas So+
Manhole/Access (Y/N)
High water alarm level at in.
Meets alarm & circuit requirements?
On adjacent lots zoo+
On adjacent lots soo+
Public sewer manhole/cleanout soo+
Holding tank zoo+
Manure/animal excrete storage areas zoo+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 3.o+ Property line 24.6 Absorption field a&o
Water main 3.o+ Water service line 2S+ Surface water zoo+
Wells on adjacent lots zoo+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 52.0 Building foundation 3.o+ Water main 75+
Water Service line zo+ Surface water ioo+ Driveway, parking/vehicle storage 3.o+
Curtain drain So+ Wells on adjacent lots zoo+
F. COMMENTS
New Septic Svstem.
G. ENGINEER'S CERTIFICATION.��P,Ur... ♦♦
1 certify that I have determined through field inspections and : 49TH
;••'''•••';
review of Municipal records that the above systems are in �.....n.. , , ....R...
conformance with MOA COSA guidelines in effect on this date. ;_
....;.................................;.
�7 Steven R. Pannon"77,
Engineer's Printed Name _ Steven R. Pannone. P.E. ♦ �
♦ % •. No. CE 8149 ���
Date 6/8/1011 •#,Oj •••••'•••.............••�°�:_•�
COSA Fee $ 95b 4X1771
Date of Payment _O to
Receipt Number 0
(Rev. 11/05)
�F'ee u,— 5b
Date of Payment %
Receipt Number O 2 J-7gIi3
Aarow Pump & Well Service LLC
(907)346-9355
Inspection Report
5647 Cannon Woods Rd.
Well on this property is cased to 80" plus. In 2000 we heavily chlorinated the well, developed
it with air and installed a 6" liner to the bottom of well. Formation packers were installed at 79'
and 75' with bentonite chips above the packers. This work was done to attempt to remediate an
iron problem.
Brian R. Wille
Aarow Pump & Well Service LLC
1 11=50'
CANNON WOODS ROAD —
UT 1LSI LOT
LOCATED WITHIN THE SE/R1/ , SECTION 27,, Tl 2N, R3W, SM, ALASKA
CONTAINING 2.5 ACRES, MORE OR LESS
S 89057'02"E 330.33'
50' PATENT ROADWAY RESERVE
US PATENT 1197101
F— — — — -- — — -- — — — — — — — — — — — — — — — — — — --
A ZD '-" ti U
I L
I
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
PROPERTY DEPICTED ABOVE AND THAT NO
GASTALDI LAND
ENCROACHMENTS EXIST EXCEPT AS INDICATED.
SURVEYING, LLC
IT IS THE RESPONSIBILITY OF THE OWNER TO
JEFF A. GASTALDI, R,L, S.
DETERMINE THE EXISTENCE OF ANY EASEMENTS,
2000 E. DOWLING RD., SUITE S
COVENANTS OR RESTRICTIONS WHICH DO NOT
ANCHORAGE, ALASKA 99507
APPEAR ON THE RECORDED SUBDIVISION PLAT.
PHONE 248-5454
UNDER NO CIRCUMSTANCES SHOULD ANY DATA
GRID
DATE
HEREON BE USED FOR CONSTRUCTION OR FOR
2937
I 6/16/2011
ESTABLISHING BOUNDARY OR FENCE LINES.
ANCHORAGE RECORDING DISTRICT, ALASKA
F.B.JOB No.
09-08 S12. NOTE; NO CORNERS SET THIS DATE.
OF
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