HomeMy WebLinkAboutT12N R3W SEC 33 LT 128 N100' OF E133'T12N R3W
SEC 33
Lot 128
N 100' of
El 33 1
#018-262-11
Municipality of Anchorage Page 1 or 3
Development Services Department
Building Safety Division - On-Site Water and Wastewater Program
4700 South Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6050
www.cl.anchorege.sk.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. SWO50160
PID Number. 018-262-11
Nr
Paul Drummond & Dennis Elrod
Wastewater System: Upgrade
Addau
14710 Elmore Road Anchorage, AK 99516
ABSORPTION FIELD
561.6225
N Two 2)
Deep Trench
LEGAL DESCRIPTION
SoA RaO,q
T" Dpin aan a,gx ars
.45 Gpose
10 Ft.
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GravN eePlh DerwlnpP
Lot 12B N100' of E133'
3
7
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33
0 to 2 Ft.
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686 Fe
ASTM 3034 PVC
Drwar
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Salic Wa1r Laval
Ft
Acreage Systems
7120/2005
Yi
ewvsmw
C".V AI Grw,n
TANK
GPM
FI.
FI
SEPARATION DISTANCES
® Septic ❑ Holding ❑ S.T.E.P. ❑ Other.
To
I Septic
Absorption
Lift
Holding
lublidPrivate
From
Tank
Field
Station
Tank
Sewer LM
Anchorage Tank
1,000
Waa
>100,
>100'
N/A
NIA
>25'
Steel
Two (2)
smn wra
>100'
>100'
NIA
N/A
LIFT STATION — NONE ON LOT
to LOW
>5'
5'
NIA
NIA
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>5'
>10'
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wpm'
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ti
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aryMala MWN
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BENCH MARK
Existing bepfl-M-nTPUM-ped, crushedac i e , ExistingAbseFittion
as w
Pit Pumped and 123GkAlled with
cand
Northeast Porch Column Concrete Footing.
100.0 Ft
Insulation Placed Over Entire bystem.
Engineer's Stamp
'♦♦♦���aaaaa
♦ U 44
Inspections performed by: MEA
Dates: 1" 7/20/2005
49tF1 a,
2n 7120/2005%.'�`
i
Department of Health
and Human Services approval
:� L 4'C.,L E Ao aS"Y �
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Reviewed and approved by:*c/�t- Q
t% - 0� Dater
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444a�ES5t��♦•♦•
een•���•
Municipality of Anchorage Page 2 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 995196655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
PID No. 018.262-11
Permit Number. SVM50160
THE NORTH 100' OF THE EAST 133' OF BLM LOT 128
LOCATED WITHIN THE NE 1/4, SECTION 33, T12N, R3W. S.M., ALASKA
CONTAINING 13,284 S.F., MORE OR LESS
N 8732'53'E 132.81•
• • ■-1—Y—X-1
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sl
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IQi eex Two
= Bedroom
Home
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S1 31.9 44.7
S2 37.4 48.6
C4 35.0 50.9
M1 44.1 49.6
C5 43.2 46.5
49th 'ir}
AEL E. ANDERSON
No. CE -4381 p'
v 6 -ec
PLAN AS -BUILT
SCALE 1' = 30'
50'
NTS
Municipality of Anchorage Page 3 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage. AK. 99519-6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
Permit Number: SWO50160
PID No. 018-262-11
a
N
=
U 1 E U
Of
49th
PROFILE AS -BUILT mm
1^ L MR]MEL E. ANDERSON
• C No. EE-I3et
Smie: r -1o• �0 ••..4.7-o3` °C
Permit Number: SWO50160
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water 6 Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Jun 02, 2005
Expiration Date: Jun 02, 2006
Parcel ID: 018-262-11
Legal Description: T12N R3W SEC 33 LT 128 N100' OF E133'
Design Engineer: 0014 Anderson Engineering Site Address: 014710 ELMORE ST
Owner Name: PAUL DRUMMOND & DENNIS ELROD Lot Size: 13300 SO. FT.
Owner Address: 14710 ELMORE RD Total Bedrooms: 2 Permit Bedrooms: 2
ANCHORAGE. AK 99516-4158
This permit is for the construction of:
Q Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy
All construction must be In accordance with:
1. The attached approved design.
❑ Private Well ❑ Water Storage
2. All requirements specked in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations (18AAC80 ).
3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 (24 hours). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Date:
Issued By\� Date: G L e
Municipality of Anchorage
-� Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
S. ...
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.cl.anchorage.ak.us
(907)343-7904
ON-SITE SEWERMELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 018.262.11 Permit Number SW
Property owner(s) Paul Drummond and Dennis Elrod Day phone 561.6225
Mailing address (1)14710 Elmore Road Anchorage, AK 99516
Mailing address (2) 14710 Elmore Road Zip Code
Legal description (Lot, Block & Sub'd.) NE-Poriien Lot 128, Section 33, T12N, R3W H tfhn' PF E133'
Legal description (Section, Township & Range)
Lot Size /3, 'r -)Vo _Acrej Sq.Ft.
THIS APPLICATION IS FOR:
Number of Bedrooms Two (2)
Sewer Only ❑ Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade ED
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool . ❑
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 owner or authorized agent)
Permit Fees: Af r160'e- Waiver Fees: d /75-'
Date of Payment: -0S Date of Payment:
S- 23-0s—
Receipt Number: Receipt Number:
_p1
(Rev. 12/00)
y yyy Municipality of Anchorage
o �1A.Ie
4 , M. Box I90'(Z0 • Anchonlge, Alaska VA19-6 M) • Telephone (!X)7)343 KUM • Fa% (!N)7) 343.82(N)
47M Ilnlgaw Strcct • Anchomgc, Alaska !E6M)7
�I�mmnnl.org
Mayor Mark ITc#icl�
Building Safely Divislon
June 7, 2005
Michael E. Anderson
Anderson Engineering
P.O. Box 240773
Anchorage, AK 99524
Subject: Waiver Request for T12N R3W SEC 33 LT 128 N100' OF E133'
Waiver Request WR#: 050039
Parcel ID # 018-262-I1
SW050160
Dear Michael E. Anderson:
Your request for a waiver of the required 10 feet horizontal separation from the
absorption field to property line has been approved. The approved separation distance is
1.0 feet.
This waiver approval applies to the existing absorption field to property line separation
only. Any future upgrade to the on-site wastewater disposal system will require all
separation distances be met or another approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-7904.
Sincerely,
J oodall
ivll Engineer
On -Site Water & Wastewater Program
Community, Security, Prosperity
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 995196650
www.ci.anchorage.al:.us
(907)343-7904
Waiver Review Worksheet
WR#:050039 PID#:018-262-11 HA1Permit# SWO50160
Date Received: June 7, 2005
Legal Description: T12N R3W SEC 33 LT 128 N100' OF E133'
Engineer.
Michael E. Anderson
Anderson Engineering
P.O. Box 240773
Anchorage, AK 99524
Applicant: Paul Drummond 8 Dennis Elrod
Waiver Requested: 1 Foot Lot Line Waiver from North Property Line
Criteria: Geology
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Total:
Points:
go .... .... onewasesson ... sommenessesso .... mosene......
Waiver Is Granted: X
List Conditions or Reasons for above:
Waiver is not Granted.
Date: 8!2105 By: Joe Goodall
Name of Reviewer
,..................................weesse......e.....@bases...........sess
Rec#: MM Amount: $175 Date Paid: 6f712005
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-67791F
MEMO
DATE: 5/27/2005
TO: Joe Goodall
WITH: MoAIOnSite Water and Wastewater
FROM: Mike Anderson
SUBJECT: NE Portion Lot 128, Section 33, T12N, R3W
Septic System Construction Permit
Attached is a drawing showing the location of the wells on properties adjacent to the
subject lot. None of the protective radii for the wells encroach on the proposed septic
system. The location of the new septic system will not impact wells or septic systems
on adjacent lots.
Thank you and let me know if you have additional questions.
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AREA MAP = ' < . I.....
;.....
SCALE 1"= 100' OX •i""`L ���.;
; 4iCWEl E.IwaEnSan f
I
Elmore Road
48' Long x 3' Hide
x7.Effective Depth
Absorption Trench
5
K
K 1,OOQ C011r�n
Ic Tan
^'
Kep
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o
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THt
Existing Seepage Pit
Pump, Remove Contamin ted
Soil and Fill with Sand.
33'
N
N
1
K
O
Two Bedroom
Home
NE Portion
Lot 128
Section 33,
T12N, R3W
Existing Well
.......... ♦♦♦♦♦
��OPgE,....
SITE PLAN
a.....r............. ....•...ti....i.....
SCALE 1' = 20'.�>.../✓..!'.....,�.�:.1
;.rV
MICIMEL E N10CRSQV: � �
I�`i i
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 FAX
May 22, 2005
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: NE Portion Lot 128, Section 33, T12N, R3W
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The existing absorption pit on the subject lot has failed and must be upgraded. We are
therefore requesting a permit be issued for the upgrade of the septic system to
accommodate the two-bedroom home on the lot. The attached Site Plan and backup
documentation identify the location and configuration of the existing and proposed
septic systems. Also identified on the plans are the locations of the existing well. No
conflicts exist between the proposed septic system and the wells on adjacent lots. A
new 1,000 -gallon septic tank will be installed outside the 100' radius of the existing well.
Drainage arrows are shown indicating the current drainage patterns. The drainage
patterns will be maintained after construction. The existing topography of the lot is
fairly flat and the only available area outside the 100' protective radius of the well will be
used for the septic system upgrade.
The test hole placed on the lot indicated clean to silty gravel from 1' to 5' below the
surface. The material became more silty below this depth. The percolation rate was
determined to be 12 minutes per inch above 5' and 40 minutes per inch below. We are
designing the new system utilizing the slower percolation rate. The existing seepage pit
will be pumped, demolished and filled with sand. Excess contaminated soil will be
removed and buried onsite at least 100' from the well and more than 10' from the new
absorption trench. The distribution pipe in the trench will be placed at 3' below the
surface with the total depth at 10'.
The ground surface on the lot slopes from west to east at less than 2%. The new
trench will be constructed parallel with the slope as much as possible in conformance
with Municipal requirements. The new septic system will be constructed a minimum of
NE Portion Lot 128, Section 33, T12N, R3W
May 22, 2005
Page Two
100' from the existing well and any surface water in the area.
If the system is constructed in accordance with our design the following statements
apply:
I. The system, if constructed as designed, will have no adverse impact on the wells
in the area or those to be constructed in the future.
2. The system, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
3. The system, if constructed as designed, will have no adverse impact on reserve
space, either surface or subsurface, on any lots located in the area.
4. The system, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
Sincerely,, ' P, c
yll�
Michael E. Anderson, P.E.
Attachments
WCNAEL E. AMJERSON
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 (F
May 22, 2005
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: NE Portion Lot 128, Section 33, T12N, R3W
Separation Distance Waiver
Absorption Trench to Lot Line
Dear On Site Services Engineer.
The existing absorption pit on the subject lot has failed and must be replaced. The lot
is very small with a usable surface area of 10,000 square feet. The protective radius for
the well on the lot utilizes the majority of the surface area. The only area available for a
septic system is within 1' of the lot line abutting Elmore Road and within 1' of the north
property line for this lot. Placing the absorption trench at this location will not conflict
with wells or septic systems on adjacent lots. We therefore recommend a waiver be
issued allowing the new trench to be constructed at 4' from the north property line.
Sincerely,
W%ate Z&.J�
Michael E. Anderson, P.E.
1
49th _
WCHAEL E. ANDERSON
Elmore Road
48' Long x 3' W de
x 7' Effective Depth
Absorption Trench
5'
K
N 1.00Q CallZn
L c Ton
® Existing Seepage Pit
THt Pump, Remove Contomin ted
Soil and Fill with Sand.
33'
K
ti
K1
O
Two Bedroom
Home
NE Portion Lot 128
Section 33, T12N, R3W Existing Well
.......... ...,
SITE PLAN 49th'.,'••
SCALE 1' = 20'
•� SMIUNEL L ARpERSVI E
•��Jyi,:4;•'No. CEH381
�
•1•fL•'• �i
NE Portion Lot 128
SECTION 33, T12N, R3W
DESIGN FACTORS:
Two Bedroom Home
Perc. Rate: 12 to 40 Min./inch
Application Rate: .45 GPD/SF (Average)
SYSTEM REQUIREMENTS:
Deep Trench System
1,000 Gallon Septic Tank
7' Drainfield Rock
2 Bedrooms X 150 GPD/.45 GPD/SF (Application Rate) = 666.67 SF Absorption Area
666.67 SF/14 SF/LF = 47.6 LF Trench Length
THEREFORE: Construct a 48' Long x 3' Wide x 7' Effective Depth Aborption Trench at the
Flow Line Elevation in Trench to be 3' Below Original Ground Surface. Total Depth to be
10' Below Existing Ground. Provide 3' of Cover Over Trench and 4' Over Tank or Provide
2" of Insulation and 2' of Cover. Maintain 100' Separation Between Existing Wells in the Area
and the Absorption Trench and Septic Tank.
Natural
2'6" Backfill
Geotextile
Fabric
6" n 4" Perforated
PVC (Holes Down)
7'0"
3'
Drainfield Rock
TYPICAL DEEP TRENCH SECTION
(NO SCALE)
NOTE: Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock.
Minimum 4' Separation From Groundwater.
Minimum 100' Separation From Private Wells in the Area.
Minimum 100' Separation From Surface Water or Streams.
Minimum 10' Separation From Water Service Line.
Performed For..
Legal Descriplion:
Municipality of Anchorage b �r,�Ncw �eALj' y{t
Development Services Department�••w t1g Ih y�'V • fi °s
Building Safety Division .<; fj••••jr•••!0:
On -She Water and Wastewater Program
' 4700 South Bragaw St.
P.O. Boz 195650 Anchorage, AK 99519-6550 •' ml EL E. ANDERSON: v
www.ci.anchoraae sk.us CE -4381 - eO
C � r
(907)34}7904 i sJ� ••Y '%•Z-�'$-,it���
Soils Log - Percolation Test' c�eCp peoiisslolot..
Dale Performed:.') IZ`jc,-r
Township, Range, Section: 37
Sift Plan
COMMENTS
WASGROUNDWATER •' '
ENCOUNTERED'/ IBJ
5
IF YES, AT WHAT DEPTH? G .
Depth to Water After
P
Monitoring? E
Dale
Reading •
•' Date
O�
Net Time
Depth fo Water
Net Drop
z.
0cb
C•t' ,
3
lo:y
3i
/p
2.-75
5
{b
Municipality of Anchorage b �r,�Ncw �eALj' y{t
Development Services Department�••w t1g Ih y�'V • fi °s
Building Safety Division .<; fj••••jr•••!0:
On -She Water and Wastewater Program
' 4700 South Bragaw St.
P.O. Boz 195650 Anchorage, AK 99519-6550 •' ml EL E. ANDERSON: v
www.ci.anchoraae sk.us CE -4381 - eO
C � r
(907)34}7904 i sJ� ••Y '%•Z-�'$-,it���
Soils Log - Percolation Test' c�eCp peoiisslolot..
Dale Performed:.') IZ`jc,-r
Township, Range, Section: 37
Sift Plan
COMMENTS
WASGROUNDWATER •' '
ENCOUNTERED'/ IBJ
5
IF YES, AT WHAT DEPTH? G .
Depth to Water After
P
Monitoring? E
Dale
Reading •
•' Date
Gross Time •
Net Time
Depth fo Water
Net Drop
lo:y
3i
L3
2.-75
Cl. q4
-Z:.ro
PERCOLATION RATE Iti I^+^N• hl PERO HOLE L)"ETEK /.
TEST RUN BETWEEN 3 FT "ANDFT
PERFORMED 6Y: " I rY CERTIFY THAT THIS TEST WAS
PERFORMED 114 ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: S - ZZT Or
Performed For.,
Legal Description:
9
O
Municipality of Arichorage
Development Services Department
Building Safety Division
On -She Water and Wastewater Program
' 4700 South Bragaw St.
P.O. Box 195650 Anchorage, AK 99519-6650
www el.anchoraoe. sk.us
(907) 343.7904
r
Soils Log - PercolationTest"
13-/e
14v
15- /
15-
17-
i s-
19-
20 -
COMMENTS test- Gbv444 W
Date Performed:
Township, Range, Section: S} . '
Stl• Plan
i
WAS GROUND WATER
•• Date
Gross Time •
Net Time
Depth to Water
Net Drop
Vm, .
117.
ENCOUNTERED] '
,: 55
3a
51''
5
• ao
4,9
r M
IF YES,AT WHAT DEPTH! L
Depth to Water After D
P
Monitoring7 E
Date:
Reading ,
•• Date
Gross Time •
Net Time
Depth to Water
Net Drop
Vm, .
117.
-
,: 55
3a
51''
• ao
4,9
r M
PERCOLATION RATE PERC HOLE DKMETER (P'"
TESTRUN BETWEEN fi.�� FT 'AND '7_ o FT
PERFORMED BY:� I %y�ttA-V'�'CG�'4+�—�ERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 5'7Z -�'r
ONSITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: NE PORTION LOT 128, SECTION 33, T12N, R3W
GENERAL:
The scope of this project includes the demolition of the existing seepage pit
on the lot to include pumping, excavation and removal of contaminated soil
and backfilling with sand. It also includes the procurement and placement of
a new 1,000 -gallon septic tank at the location shown on the Site Plan. Work
also includes the construction of a new 48' long X 3' wide X 7' effective depth
absorption trench at the location also shown on the Site Plan. The
distribution line in the trench will be placed at 3' below the existing ground
surface. Total depth of the trench will be 10' below the existing ground
surface. The new absorption trench and septic tank must be placed a
minimum of 100' from the wells in the area. A minimum of 100' must
separate any surface water in the area and the septic tank and absorption
trench.
2. Construction shall be in accordance with the approved site plan, design
drawings, Municipal Permit with any special provisions or conditions, and all
applicable State and Municipal Wastewater Disposal Regulations.
3. The Contractor shall be responsible for obtaining all underground utility
locates and for the layout of the septic system and verification of the location
of all lot lines. The Contractor must also verify the location of wells in the
area and assure that the separation distances are met.
4. Unless specifically agreed otherwise, the contractor shall be responsible for
final grading areas subsequently depressed from soil settling. Property
owner shall be responsible for revegetation of affected areas unless
specifically agreed otherwise.
5. Contractors installing wastewater disposal systems must be certified by the
Municipal Department of Health and Human Services for system installations.
Owners installing their own systems must receive prior approval from
D.H.H.S. before beginning system installation.
SEPTIC TANK INSTALLATION
1. A new 1,000 -gallon septic tank must be procured from an approved source
and installed at the location shown.
2. A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shall include two 4" cleanouts for pumping access.
NE -Portion Lot 128, Section 33, T1 2N, R3W
May 22, 2005
Page 2 of 3
3. The septic tank shall be sufficiently bedded to prevent settling or shifting of
the tank.
4. All standpipes on the septic tank shall extend a minimum of 12 inches above
final grade.
5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial
insulation.
6. A foundation cleanout shall be installed one to four feet from the building
foundation. Two cleanouts are required between the tank and the drainfield.
7. Final grading over the tank shall be such that a positive slope exists away
from the septic tank.
DRAINFIELD CONSTRUCTION:
1. The drainfield shall be constructed to the dimensions shown on the design.
The bottom of the trench shall be within 2" of level.
2. Distribution piping must be placed level with perforations down atop a level
bed of drainfield rock. Rock should then be placed over the pipe to provide a
minimum of 2" of cover.
3. A silt barrier or geotextile fabric must be placed between the drainfield rock
and the natural soil backfill.
4. Monitor tubes must be 4" in diameter and installed at the locations shown on
the design. The portion below ground must be perforated.
5. Contractor shall verify the septic tank and drainfield area minimum 100' away
from any private water wells in the area, 150' from a Class "C" Well or 200'
from any community well.
6. Direct bury insulation must be placed over the distribution system if less than
3' of backfill depth is available. Finish grade over the trench must be
mounded to prevent settlement or depressions.
7. Grade area surrounding the absorption trench to drain away.
8. A minimum 2' of accepting soil is required below the drainfield rock for a 5'
wide trench. Contractor shall verify this condition prior to placement of the
rock. All pockets of unacceptable materials must be removed and replaced.
NE Portion Lot 128, Section 33, T12N, R3W
May 22, 2005
Page 3 of 3
MATERIAL SPECIFICATIONS:
1. Septic tanks must be constructed by a municipally approved septic tank
manufacturer.
2. The following pipe materials are approved for use in septic system
installations in the Municipality of Anchorage:
Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and
solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662
or A.B.S. (perforated and solid).
3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow
Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings
(Caulder, Femco, or equal).
5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed
between the final drain rock layer and the native soil layer.
6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the
#200 sieve.
INSPECTIONS:
Municipal Ordinance requires a minimum of two inspections. These inspections
must be conducted under the supervision of a professional engineer registered
in the State of Alaska. The first inspection must be conducted after the
excavation of trenches, beds or pits and before the installation of any gravel. A
septic tank may be set in place, but may not be backfilled.
The second inspection must be conducted after the placement of the geotextile
fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No
backfill should be in place at the time of inspection.
Contractor shall provide a copy of all field survey layout and construction notes
for use in preparing the certified as -built of the completed system.
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET
To: ANDERSON ENGINEERING
Legal description: T12N R3W SEC 33 LOT 128
The attached paperwork has been reviewed and Is being returned for the following reasons:
❑ Original signature or stamp missing on
❑ Calculation error in design.
❑ Additional soils information needed.
❑ Water monitoring results inadequate.
❑ Discrepancy in information submitted.
❑ Topographic information missing or inadequate.
❑ Incomplete; missing
❑ Incomplete; missing
❑ Additional adequacy test information needed.
❑ Water sample unacceptable. _
❑ Measured/proposed distances/dimensions missing.
❑ Locations of all soils, percolation and water monitoring tests not shown.
❑ Proposed system too deep for soils information submitted.
❑ Well log required.
❑ Omission in narrative.
❑ Insufficient rill over tank or field.—
El Other. THE SITE PLAN NEED TO SHOW MEASURED DISTANCES TO ALL WASTEWATER DISPOSAL SYSTEMS,
WELLS SURFACE WATER OR DRAINAGE COURSES ROADS PROPERTY LINES AND STRUCTURES WITHIN 200
FEET OF THE LOCATION OF ANY EXISTING OR PROPOSED ON-SITE WASTEWATER DISPOSAL SYSTEMS.
Name of reviewer: JOE GOODALL
Date: 5/24/2005
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK
L�ird�f/�l!/1A/rdEG
Municipality of Anchorage
• Development Services Department 41,
Building Safety DivisionOn-Site Water and Wastewater Program `4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 018.262.11 HAA#�L� S7�
Expiration Date: 44/__fy/�rnc�
1. GENERAL INFORMATION /
Complete legal description Lot 128 N100' of E133' T12N RX Section 33
Location (site address or directions) 14710 Elmore Road
Current Property owner(s) Paul Drummond & Dennis Elrod Day phone 561.6225
Mailing address 1 �7 E �f0`ui (►,c f%�A !�%�- 9709
Lending agency Day phone
Mailing address
Real Estate Agent
Mailing Address
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
Two 2
Day phone
TYPE OF WASTEWATER DISPOSAL:
®
Individual On-site
❑
Individual Holding tank
❑
❑
Community On-site
❑
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single family on-site wastewater disposal andlor water
supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority 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 less than 30 days old. (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 Health Authority 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 Anderson Engineering Phone 522.7773
Address P.O. Box 240773 Anchorage. AK 99524
Engineer's Printed Name Michael E. Anderson, P.E. Date 917/2005
5. DSD SIGNATURE
�L Approved for bedrooms.
Disapproved.
.' 49th
L ANMASCH
CE -4391
Conditional approval for bedrooms, with the following stipulations:
/ LkOW 1111011W.
HAA Checklist
Septic System Advisory
Well Flow Advisory
X Maintenance Agreements
Supplemental Engineer's Report
Other
By: L Original Certificate Date: -4
9
(Rev. 12M)
Municipality of Anchorage
' Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
47W South Bragaw, SL
P.O. Box 198050 Anchorage, AK 99519-850
www.d.anehorage.ek.us
(907)343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: Let 128 N1W of E133' T12N R W exton 33 Parcel ID:_ 01&282.11
A. WELL DATA
Well type Eft2 if A, B, or C provide PWSIO ri _ Well Log (Y!N) Y
Date completed MVI Sanitary awl (YIN) y Wires properly protected (YM) Y __
Total depth _ LfL Cased to 1Lfl. Casing height (above round
FROM WELL LOG AT INSPECTION
Date of test 4=78 _ 917f100S_
Static water level 38 R _ 72 it.
Well production 4 g.p.m. 1.5
— 9 -p.m -
WATER SAMPLE RESULTS:
C011110an -1—colonies/1 00 ml. Nitrate 4,,L mgA.
Other bacteria --L colonies/1 00 ml.
Date of sample: X1005 Collected by
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material 88V"C tsel
Tank size 1.000 gal.
Foundation deanout (Y/N).y
Date of pumping
C. ABSORPTION FIELD DATA
Number of Compartments j
Depression over tank (YIN) )y
09 -1a 11 1� �
Date Installed S120C1005
Cleanouts (YIN)Y
High water alarm (YM) N
Date installed ZQWZW Soil rating (g.p.d V or fl=Ibdrm) AS GPDMF System type jR2M Trench
Length A9 R Width 1it Gravel below pipe 1fL
Total depth M2 it ER. absorption area 0 fe Monitoring lube y Depression over field N
Date of adequacy test Results (Pass/Fall) 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 >= 9-p.d.
Any rejuvenation treatment (past 12 mo.) (YM & type) N If yes, give date
D. LIFT STATION
Date installed
'Pump on' level at _ In.
Datum
Size in gallons
'Pump ofr level at _ In.
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/0ft station on lot _ MW
Absorption field on lot >1W
Public sewer main NIA
Manhole/Access (Y/N)
High water alarm level at
Meets alarm a Bradt requiremimts?
On adjacent lots 3700'
On adjacent lots _3100'
Public sewer manhole/cleanout WA
Sewer /septic service line _ >2S Holding tank WA
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation _ >T Property line _?I Absorption field >S
Water main >111' Water service line >III' Surface water >t00'
Wells on adjacent lots 3100'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line S Building foundation >S Water main 319'
Water Service line >10' Surface water MW Driveway, part inokehide storage >2S
Curtain drain None Noted Wells on adjacent lots 1W
F. COMMENTS
G. ENGINEER'S CERTIFICATION el*?- •OF sAl '00.
I certify that 1 have detemUned through field krspections and
review of Munk ipal records that the above systems are in a f 49th
conformance with MOA HAA guldeHnes in effect on fhls date. '
Engineer's Printed Name Michael E. Anderson, P.E. �0, c
Data 91712005 �4j?
HAA Fee $ 430 a
Date of Payment 9 -9 -05 -
Receipt
-9-oSReceipt Number Pl7 3 G 7 3
(Rev. 19/00)
Waiver Fee $
Date of Payment
Receipt Number
In
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THE NORTH 100' OF THE EAST 133' OF BLM LOT 128
LOCATED WITHIN THE NE 1/4, SECTION 33, T12N, R3W, S.M., ALASKA
CONTAINING 13,284 S.F., MORE OR LESS
N 89.32'55"E 132.81'
N 89°34'13"E 132.81' '
A S- B U I LT
Y—X—Y—Y—Y—x—Y—Y—Y—Y—Y—Y—Y—Y—Y—Y—Y
1
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GASTALDI LAND "
ENCROACHMENTS EXIST EXCEPT AS INDICATED.
SURVEYING, LLC
R IS THE RESPONSIBILITY OF THE OWNER TO
JEFF A. GASTALDI, R.LS.
DETERMINE THE EXISTENCE OF ANY EASEMENTS,
4726 WEST BOTH AVENUE
� I
ANCHORAGE, ALASKA 99502
APPS ON THE RECORDED SUBDIVISION PLAT.
PHONE 248-5454
%
GRID
DATE
HEREON BE USED FOR CONSTRUCTION OR FOR
• • N
8/12/2005
ESTABLISHING BOUNDARY OR FENCE LINES.
SEPTIC SYSTEM I
ANCHORAGE RECORDING DISTRICT, ALASKA
F.B.
JOB NO.
05-09
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GASTALDI LAND "
ENCROACHMENTS EXIST EXCEPT AS INDICATED.
SURVEYING, LLC
R IS THE RESPONSIBILITY OF THE OWNER TO
JEFF A. GASTALDI, R.LS.
DETERMINE THE EXISTENCE OF ANY EASEMENTS,
4726 WEST BOTH AVENUE
COVENANTS OR RESTRICTIONS WHICH DO NOT
ANCHORAGE, ALASKA 99502
APPS ON THE RECORDED SUBDIVISION PLAT.
PHONE 248-5454
UNDER NO CIRCUMSTANCES SHOULD ANY DATA
GRID
DATE
HEREON BE USED FOR CONSTRUCTION OR FOR
3035
8/12/2005
ESTABLISHING BOUNDARY OR FENCE LINES.
ANCHORAGE RECORDING DISTRICT, ALASKA
F.B.
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05-09
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Owner: Address:
WellLocation• / 7In F /I A,fr
Well Information:
Total Depth: Depth of Casing:$ Screen Ecom=To:
Casing Size: 6 ' Screen Diam: ^ Screen Slot:
Remarks,
Pump Information
intake Depth: Pump Size Air Line Depth:
Static Water Leveh - 7a , Av. Discharge—. �GPM; Alax Drawdwn: Jii2r
Pump On
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Time
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Municipality of Anchorage
4l B
• Development Services Department 4
Building Safety Division
On -Site Water and Wastewater Program s"r"
4700 Elmore 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 �+l �1
Parcel I.D. o6 -aha- I COSA# V iolyp
Expiration Date:
1. GENERAL INFORMATION
Complete legal description T12N R3W Sec, 33 N too' E 1331 Lei IZt3
Location (site address) H-40 Elmore Road
Current Property owner(s) Chris Day phone 403- 39ig
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
—19110 £l. ore R,».A .Ani Ak 9951 t,
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 K
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
Address
Engineer's Printed Name
5. DSD SIGNATURE
_� Approved for _ bedrooms.
Disapproved.
Phone 2_14-341(o
Date a 15 0
E SPUR KLANOD
.PURg;� /
/til.• 15
Conditional approval for bedrooms, with the following stipulations:
Attachments:
COSA Checklist X Arsenic Advisory
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: Original Certificate Date: 2-O
(Rev.1 VOS)
Municipality of Anchorage
I' Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Elmore 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: _ -(12 N R3 W 541.-33 Ld IV& Al ICd E X331 Parcel ID:_ OI S- 4 &Q - I
A. WELL DATA
Well type 26&.Tt: If A, 8, or C provide PWSID # _ Well Log (YIN) Af"
Date completed Uokn wn Sanitary seal (Y/N) Wires properly protected (Y/N) _Y
Total depth 15A ft. Cased to 158 ft. Casing height (above ground) I"Z+ in.
FROM WELL LOG AT INSPECTION
Date of test 5r 6 12 2ocs)
Static water level unkAo. . It. 91 ft.
Well production _Unkncwrn g.p.m. I,I' g.p.m.
WATER SAMPLE RESULTS:
Coliform _colonies/100 mL Nitrate ND mg/L Other bacteria _ colonies/100 mL
Arsenic: /VD ug/L date of sample: SLI oy Collected by: A[tS
B. SEPTIC/HOLDING TANK DATA
TankType/Material Anchcr^l TAnk/ 51fel Date installed '*0105
Tank size too0 : gal.* Number of Compartments Cleanouts (YIN) i
Foundation cleanout (Y/N) it Depression over tank (Y/N) ni High water alarm (Y/N) A/
Date of pumping b 1 0 Pumper ff'4ua. A
C. ABSORPTION FIELD DATA
Date installed zo k5 Soil rating (g.p.d./fe or ft2/bdrm) 6.95 System type DEE v Tar me -H
Length 49 ft. Width 3 ft. Gravel below pipe 7 ft.
Total depth ILS ft. EH. absorption area LLft' Monitoring tube Depression over field IV
Date of adequacy test b 9 o Results (Pass/Fail) Piss For _' bedrooms
Fluid depth in absorption field before test S_ in. Water added1000 gal. New depth_BL in.
Elapsed Time: T60 min. Final fluid depth !a in. Absorption rate >= 3co g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) ML nt Kron n If yes, give date
D. LIFT STATION
Date Installed Size in gallons Manhole/Access (Y/N)
'Pump on' level a _ in. 'Pump off" level at in. High water alarm leve in.
Datum Cycles t is Meets alarm rcuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
r
Septic tank/lift station on lot + IOD
Absorption field on lot + 100'
Public sewer main N/A
Sewer /septic service line { 'LS t
Animal containment areas AIA
On adjacent lots a lao
On adjacent lots + JUot
Public sewer manhole/cleanout N
Holding tank NIA
Manurelanimal excrete storage areas N.O.
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
1
Building foundation + 6 Property line+S Absorption field + S
r
Water main NSA Water service line + 25 Surface water N, D.
Wells on adjacent lots +IDDM
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line + 10 Building foundation +to Water main NSA
i
Water Service line + S t Surface water _ MO. Driveway, parking/vehicle storage S +
Curtain drain N O, Wells on adjacent lots + 100
r
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that 1 have determined through field inspections and ✓ y�� S'F9�r
review of Municipal records that the above systems are in 49TH
conformance with MOA COSA guidelines in effect on this date. i " ' w' s'.
Engineer's Printed Name ARc Snuzk�o �` LAA E: SPURKLA 'D
Date61ISIo9
lt,
COSA Fees —I I O
Date of Payment C, Aw
Receipt Number 071�-�5 7
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
SCS ReLa
Client Name
Project Name/N
Client Sample ID
Matrix
Sample Remarks:
1091811001
Tobben Spurkland P.E.
T12NR3W Sec33 L128
T12N R3W Sec33 L128
Drinking Water
Printed Date/rime
Collected Datemme
Received Date/rime
Technical Director
05/19/2009 10:44
051072009 16:20
05/072009 16:40
Stephen C. Ede
Allowable Prep Analysis
Pa uncter Results PQL Units 6lethod Comainer ID Limits Date Date
[nit
Metals by ICP/MS
Arsenic
Waters Department
Total Nitrate Nitritc-N
Microbiology Laboratory
Colony Count
Total Coliform
Fecal Coliform
ND 5.00 ug/L EP200.8 C (<IO) 05/13/09 05'1509 NRB
ND
0.100 mg/L
SN120450ONO3-F
B
(<10)
05/13/09
1DL
0
col'100mL
SN1209222B
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05.108.'09,
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S%1209222B
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05 08 09
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05/08/09
DLC
THE NORTH 100' OF THE EAST 133' OF BLM LOT 128
LOCATED WITHIN THE NE 1/4, SECTION 33, T12N, R3W, S.M., ALASKA
CONTAINING 13,284 S.F., MORE OR LESS
roz.or-
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AS -6 U _1 L _T_
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
GASTALDI LAND
PROPERTY DEPICTED ABOVE AND THAT NO
ENCROACHMENTS EXIST EXCEPT AS INDICATED.
SURVEYING,
SURVEYING, LLC
NG, LCR.L
IT IS THE RESPONSIBILITY OF THE OWNER TO
JEFF A.
DETERMINE THE EXISTENCE OF ANY EASEMENTS,'
2000 E. DOWLING RD., SUITE 8
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
3035
6/9/2009
ESTABLISHING BOUNDARY OR FENCE LINES.
ANCHORAGE RECORDING DISTRICT, ALASKA
F.B.
JOB NO.
05-09
BLM128
NOTE: NO CORNERS SET THIS DATE.
E
50'
NTS
wl
Of
01
J
w,
1 11=20'