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HomeMy WebLinkAboutT12N R3W SEC 33 LT 215B Onsite File T12N R3W Sec 33 Lot 2158 PID# 018 - 331 - 20 The modified western (see permit) field may not be tested for a future COSH without installing an AWWTS. S' T12N R3W SEC33, LOT 215B PERMIT # OSP181021 PID # 018-331-20 I TRENCH ABANDONED IN PLACE.CLEANOUT / AND MONITORING TUBE PULLED LATERAL DISCONNECTED TO I FINAL TRENCH.DOUBLE I / CLEANOUT REMOVED. I 8162C / REMAINING TRENCH CANNOT BE / TESTED FOR A COSA W/O AN 7 • 1 LOT 215A ADVANTEX SYSTEM I - / • 4pX04 CO2'‘ — . 'o1 °� — - \ \,t. DV . ' \\, -#Rr1° EXISTING 1000-GAL <��i o ' � y v„ 0 CO SEPTIC TANK • SHED - s \\\ \\\ / �� ��\ o © A B C .. ` \ CO3, ,Z' FCO 4.3 26.6 �� \ �� — SV1 12.5 32.3 H ''' CO5• ©_ R SV2 10.9 38.2 �A \ ��� DV 11.1- 39.4 i,� �� 001 15.4 � 31.4 CO2....7 29.9 48.4 F- I MT1 21.3 39.2 W CO3 27.8 14.4 \ W C04 46.5 52.2 /W MT2 38.6 41.8 \. / ,_ Asphalt C05 44.2 10.5 `\ (i) TRENCH TO BE CO6 62.0 59.3 1 I USED AS AN MT3 52.5 45.0 ALTERNATE SITE -i LOT 2158 WITH ADVANTEX 0 \-- SYSTEM 0 3'Road&Public Utility R.O.W. Q \ LOT 215C (n - - - - I - - 1 EXISTING WELL DORA AVENUE NOTE: �������‘\ NO SLOPES>25%WITHIN 50'OR SURFACE WATER WITHIN 100'OF THE LEGEND /r�P�OFA•-.041l+ PROPOSED SEPTIC SYSTEM CO CLEANOUT / ••• / .. +9 ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS 200 DOUBLE CLEANOUT *• TH /` �* r, PROPERTY ARE SHOWN.NO CONFLICTS WITH WELLS OR SEPTIC FCO-FOUNDATION CLEANOUT SYSTEMS. DV-FLOW DIVERTER VALVE •' MH-MANHOLE . r - Benja Schiller 0 40 80 • • MT-MONITORING TUBE r�PF's'• �E12p92,.•.•<i FEET 1'\0:..1AOFESS10Na���+ SV-SEPTIC VENT \\�N"``�� 1"=40' TH TEST HOLE • ""'Y(....2,„,:40.... ' MUNICIPALITY OF ANCHORAGE .n,en; ��r On-Site Water&Wastewater Program PO Box 196650 4700 Elmore Road �o i Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 r.` http://www.muni.org/onsite I eparhnunr Q Hck ONAGE On-Site Wastewater Disposal System Permit Permit Number: OSP181021 Effective Date: 3/7/2018 Work Type: Septic Upgrade Expiration Date: 3/7/2019 Tax Code Number: 01833120000 Site Legal Address: T12N R3W SEC 33 LT 215B G:3135 Site Mailing Address: 3621 DORA AVE, Anchorage Owner: GALES CRAIG & LORI LIV TRUST Lot Size in Sq Ft: 22500 Design Engineer: FORGE ENGINEERING Total Bedrooms: 3 This permit is for the construction of: 0 Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing CO "Ir 1 5eco 4Glary wil( "jeeot /-tw5 . 3/g/s Received By: tiejffilUrA !�� Date: 3/74i iU� Issued By: ibi(/t) Date: 5/00 PLA115 MUNICIPALITY OF ANC RAGE Community Development Department _ Phone: 907-343-7904 Development Services Division : y Fax: 907-343-7997 On-Site Water& Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 018-331-20 Property owner(s) Craig & Lori Gales Day phone Mailing address 62615 Erickson Rd, Bend, OR 97701 Site address 3621 Dora Ave, Anchorage, AK 99516 Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) T12N R3W SEC33 Lot 215B Lot Size 22,500 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (El all that apply) Absorption Field X Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank H Upgrade 0 Duplex (D) E Holding Tank ❑ Renewal ❑ Multiple Dwellings I Privy [ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR: Field to lot line, garage foundation Distance: 3' / 5' I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. t:--0.-- (Signature of property owner or authorized agent) Permit/Rush Fees: t!(p9 Waiver Fees: (215- Date SDate of Payment: P4 /i g Date of Payment: 02.1 aa`rg Receipt Number: 6,93(05.1) Receipt Number: Oen(.AD /� Permit No. V c'pi g on) Waiver No. 06V/'/()O(/ 1\ 140T EP LA-h!S Permit App__ ::...c LR C 0 // IF maw GE ' ENGINEERING PO BOX 240773 • ANCHORAGE,AK 99524 522-7773 677-7766(FAX) March 8, 2018 Municipality of Anchorage Development Services Dept- On-Site Water& Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: T12N R3W SEC33, Lot 215B—3621 Dora Ave Septic system extension and permit application Dear On-Site Services Engineer: The owner of the above lot is selling their property with a 3-bedroom home on it.The property has an existing well and septic system, including 2 sets of absorption trenches with a valve that can switch between them. However, at some point in the recent past, a garage was built over a portion of one of the septic trenches. We are submitting this application and design to abandon that last trench. When this system was built, both the primary and alternate trenches were constructed. Both sets were adequate on their own to handle the effluent from a 3-bedroom home. This second set of trenches has a combined 107 LF of trench, at 5' effective depth,for a total absorption area of 1070 SF. The soils rating for the current conventional system is 0.45 GPM/SF. With the second trench abandoned,the remaining trench is 51' long,for a total absorption area of 510 SF.This is sufficient as an alternate site only with an advanced Category III wastewater system, with a soils rating of 2.0 GPM/SF. We propose excavating down to where the flow splits off at the third trench. We will cap the lateral leading to the last trench and abandon that in place. The monitoring tube and remaining cleanout will be removed. This will leave one set of trenches that can be tested for a COSA, along with a trench that can be designated as an alternate with the installation of an Advantex system (or equivalent). Sincerely, OF \ l %P • • ` 9.**1"71# f*. 49TM /\ •*1// Benjamin Schiller, PE t ...al �.- . . � Benja chiller e • CE 12592 ..•f. � 1 'PROFE ` SSIO0 T12N R3W SEC33, LOT 2156 Co REMOVE MONITORING TUBE AND CLEANOUT ABANDON TRENCH UNCOVER FLOW SPLITTER I DISCONNECT LATERAL TO LAST TRENCH :'0,62,::: REMAINING TRENCH CANNOT BE I.• TESTED FOR A COSA W/O AN I LOT 215A ADVANTEX SYSTEM e \\\\ • \\\\\ \\�\��-- EXISTING 1000-GAL \\\ \o \1 \� SEPTIC TANK \ \ SHED \�•l \\\\ \\ \\ \ \\ O qf' - /44\\;:kh..... • H- I ; N'<i . . LU U.J I- 0-t Asphalt CO TRENCH TO BE 1 I USED AS AN i ALTERNATE SITE w J LOT 215BWITH ADVANTEX Q \ I SYSTEM 3'Road&Public Utility R.O.W. (n - - - - I EXISTING WELL DORA AVENUE NOTE: �..t7\\\`l NO SLOPES>25%WITHIN 50'OR SURFACE WATER WITHIN 100'OF THE LEGEND �.:�P . 4 4.ktr PROPOSED SEPTIC SYSTEM CO CLEANOUT g 9 I 2C0-DOUBLE CLEANOUT *:'�'M /\ •*f, ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS / PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC FCO-FOUNDATION CLEANOUT d . SYSTEMS. FS-FLOW SPLITTER VALVE �/ '. Benja ' .hiller• : j 0 40 80 MH-MANHOLE <4 MT-MONITORING TUBE tf�FGsr•. CE 8.092 .•'�^!/ = = = = FEET ,klF9di'.ESSION*V4 1"=40' SV SEPTIC VENT \1�\\"`�� TH-TEST HOLE . Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: .~/.,~ ~'<~ o-..~, PID Number: Name: ~ ~[~ Wastewater System: ~ New D Upgrade AOdress~.~. ~r ~X~ ABSORPTION FIELD Phone: No. of~drooms: ~ Deep Trench ~ Shallow Trench ~ Bed ~ Mound D Other Total Depth from original grade; LEGAL DESCRIPTION S°ilRating: O.¢~' GPD/Sq. Fi. Lot: Block: Subdiv~ion: Depth to pipe bosom from original grade: Gravel depth beneath pipe ~/~ ~ /'~ Et. ~ Ft. Township:~/~ ~ Rangz~' ~ Sect,~ ~ Fill Added above original/. ~' grade: Ft. Gravel ,egh5 . Ft. WELL: ~New D Upgrade Gravel width: ~ /Ft. Numberof~lines: Distancebe~een/~ fin~:Ft. Cla~ificatipn (Private, A,B,C): Total Depth: Cased TO: Total absorption area: Pipe material: ~1 ~ / /~ Ft. // [ Ft. [ ~ ~ SQ. Ft. D~ , Date Drilled: Static Water Level: I~tat[er: ,, , ~,~ ~& ~ ~ Ft. M~g-~/ ~ Dat~n~all~;. Yield: ' Casing Height Above Ground: / 0 GPM ,umpSetat: Ft. ~ Ft. TANK SEPARATION DISTANCES ~Septic u Holding a S:T.E.P. To Septic Absorption Lift Holding =ubi[c/Privat( Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~ ~ ~g~ WelV /~t~ [OOE'~ ~ ~ ~/~ M~ ' NumberofCompa~ments: Sudace Water /~'~ /~-~ /~ LIFT STATION Manufacturer: Line Remarks: ~-~ ~ 7~¢~ *~/~ BENCH ~ARK Locati n and Description: Assumed Elevation: inspections performed by: /~k ~)m,¢~'~Oates:lst ~ ~,~~~.. ~ 2nd Department of Health and Human Se~ices approval Reviewed and approved by: _~~~' Date:/2 -17- ~7 72-013 (Rev. 9/91) MOA 25 Municipality of Anchorage Page DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site.Wastewater Disposal System and/or Well Inspection Report · Name: ~ ~ /~ WaStewater System: ~New ~ Upgrade Phone: No. of B~rooms: ~DeepTrench ~ Shallow Trench ~ Bed ~ Mound ~ Other Soil Rating; Total Depth f~ginal grade: LEGAL DESCRIPTION ~,~ ~/s~. ~t. Lot~/~ BIock:.~ Subdiv~ion: Depth to pipe boffom/, ~fr°m/original grade: Ft. Gravel dept~neath. ~ pipe Ft. Township;~/~ ~ Ra n~: Sect~ Fill added above/,o/original grade: Ft.Gravel le~:~ Ft. WE LL: Q New ~ U pg rude ~ Gravel width~ / Ft. Number~of lines: Distance/~e~een~ lines:Fb Classification (Private, A,B,C}: Total Depth: ~ased To: Total absorption area: Pipe material: Driller: ~ate Origed: StagcWater Level: Installer: Date installed: /SEPARATION DISTANCES ~ Septic ~ Hold[ng~/~ S.T.E.P. To Septic Absorpt(on Lift Holding =ublic/Pdvat( Manufacturer: ~ Capacityin gallons: From Tan~ Field Station Tank Sewer Lines WeW [~/~ ~ ~ ~/'~ ~ Number°fC°mpadments: Sudace I Water /~/'4 / / 1~/'~ LIFT STATION Lot Line ~, ~,~/ ~ ~ ~ 8,zeingellons: Manufacturer: Foundation ~i ~ ~/¢ ~ ~ ~ "Pump on" leve~~off" level at: High water alarm at: Cu~ain Drain ~A ~ ~ ~ ~ ~odel Electrical Inspections pedormed by: Remarks: ~ ~ /~s'~¢~ , ~¢/;~¢ BENCH MARK . Locat[ n and Description: ENGIN~L 2nd ~. Department of Health an~ ~uman Se~ices approval Reviewed and approved by: ~ · Date:/2-/~-~7 72-013 (Rev. 9/91) MOA 25 AS ]}U].LT INSPECT]'BN I WASTEWATER ]3][SPBSAL SYSTEiVl ~-L~]~..~.iSB, SEC. 33, T~BN, RSW, S,H, II ~Iii~.,~~-~/ ~ ~ ..~ o~ DEPTH~ m~.~.~,o,G~AVCL TRENCH ]]] 5.6' III 51' /co IV 5.0' Iv i~ I~ I ~ ~ cm 15.4 31,4 -- NOTE: EACH CO~ ~9.9 48,4 I SPLm~ TO I~ ~?~ Tm ~ ~BN - SLAB AT CmS a7.8 ~ ~ DIVIDE ~ FLD I < ~l lRENCHEg / DWELLING NT~ 38,6 41,8 I ~ ~l ~ c~ 44,~ ~o,$ -- I i ~ cB6 62,0 59,3 MT3 52,5 45,0 SCALE: 1' = $0'1 I I ~ .I WELL co7 63.4 ss,2 - ~ CB8 88,3 80,5 -- ~ ........ MT4 73.6 57.7 - I_~A AVENUE ST2 ~0.9 ~- I TYPICAL TRENCH CROSS SECTION FINISHED GDADE TH ~2 TH al NOT TO SCALE TRENCH ELEVATIONS: B,M, ASSUMED 100,0 FINISHED GRADE ORIGINAL GRADE TRENCH I 104.45 96.11 104.5 106.77 TRENCH Il 100.89 92,85 100.89 104,23 TRENCH III 98.9 93,22 98.8 101,01 TRENCH IV 96.35 91.35 96.37 98.44 PREPARED FOR: MICHAEL N. ANDERSON 14250 N, GOLDEN VIEW DR. CRAIG GALES ANCHORAGE, ALASKA 99516 P.D. BOX 242892 345-3377/FAX 345-1391 ANCHORAGE, ALASKA 99524 IDR^W]N6 ~t PERFORMED FOR: LEGAL DESCRIPTION: 3 6- 7 8 9- 10~ 12- 13 14 16 17 18- 19- 20- Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST SLOPE WAS GROUND WATER ENCOUNTERED? '~/~0 IF YES, AT WHAT DEPTH? Date: i ~'~ ~' SITE PLAN Gross Net DeDth to Net Reading Date Time Time Water DroD ~ 'l~ I 'l~" PERCOLATION RATE ~-{O {m,nutes/mcn} PERC HOLE DIAMETER TEST RUN BETWEEN ~t FT AND FT PERFORMED BY: /~(~ ' ~- ~v~-~5 ~t ~ i CERTIFY THAT THIS TEST WAS PERFORMED iN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. ~ATE: [/'~44 ~--' *LOCATION OF WELL BOROUGH LOCATION/SKETCH: DEPTHS MEASURED FROM:.:~casing top I~ground surface BOREHOLE DATA: Depth Material Type and Color From To STATE OF ALASKA DEPARTMENT DF NATURAL RESOURCES DIVISION OF MINING & WATER MGMT WATER WELL RECORD WELL OWNER: WELL D~ DATE O~F COMPLETION Depth of hole - Depth of casing, ~ ;~.~ /'~ ~ DEPTH TO STATIC WATER LEVEL: 3 ~ . ft below "~ top of casing [] ground surface ete: .2 , METHOD OF DRILLING: {~ air rotary ~ cable tool ~ other USE OF WELL: ~[, domestic [-I irrigation [] monitor [] public supply [] other CASING STICK-UP: ~ . ft. Diam: ~_~_in. to///ft Casing type: ~'~ ~ in. tO WELL INTAKE OPENING TYPE: [] open end/~screened [] perforated [] open hole OepthB of openings: / /0 to //5---- SCREEN TY PE'~-4~ Slot/Mesh Size: Diam: ~ '~' r in. Length: ~._~ ft GRAVEL PACK TYPE: Volume used: Depth to top; GROUT TYPE: Volume: Depth: from ft to DEVELOPMENT METHOD: Duration: r~ ~ ft IG LEVEL AND YIELD: ft after hfs pumping ~"~.~ gpm PUMP INTAKE DEPTH: ft Horsepower: __ WELL DISINFECTED UPON COMPLETION? []~YES [] NO CONTRACTOR~ INFORMATIO~N: ~. REMARKS: ~gnature of Aumorized Resprese~ve Date · 36010FcMININGst, Suite & 800WATER MGMT ANCHO~GE AK 99503-5935 Phone 1907)269-8639, Fax (907)562-1384 November 15, 1997 Michael Anderson P. E. 14250 Golden View Drive Anchorage, AK 99516 (907) 345-3377 home (907) 345-1391 fax Department of Health and Human Services On-Site Services Section P. O. Box 6650 Anchorage, AK 99519-6650 ATTN: Jim Cross, P.E. Re: Lot 215 B Section.:~rl2N, R3W, Dill-IS Permit # SW 950036 Dear Jim The above referenced property is owned by Craig Gales. The engineer for the design and inspection was Mark Wright P.E. who now resides in Colorado. The three bedroom system was installed by my self in the fall of 1995 with Mark Wright doing the inspections. The dates of call-ins for inspections are noted on the DI~IS permit. Soon after the excavation was completed MarkWright had a car accident which affected him severely in the head and neck area. For personal reasons Mark moved to Colorado so his wife, who was also injured in the accident, could be with her family and help with the recovery period. Therefore the system as-built has gone unfinished for 2 years. The owner was building the house himself and therefore didn't need it until now. A new well permit ~vas issued this spring due to the old one expiring. As of October 1, 1997 the house was finished and the owner needs the as-built completed. Mark Wright ?viii not be able to complete the as-built. Since I installed the system and put Mark Wright together with Craig I feel responsible that the system gets completed. I realize the potential conflict of interest here for me but nobody knows the system like I do or wants to stamp this system without the inspections during installation. It is my opinion that the system meets all DH]IS regulations and will function as designed. The owner has authorized me to complete the inspection report ami obtain final approval from DHHS. The following is a list of items which provide additional information for the reviewer of this inspection report: 1. The soil logs needed to be revised to shmv 1 foot of overburden NOT 2.5 feet. The test holes were done during January of 1995, when a great deal of snmv covered the ground, and this might explain the discrepancy. The maximum overburden found after excavating for the foundation and installing the septic system was no more than one foot. The soil log on the adjacent lot to the north svas checked and showed I foot of overburden. 2. The clean-out of trench number II (the second trench of the primary systen0 is approximately 5.4 feet from the foundation which is less than the 10 foot minimum allowed. The septic system was installed first and then the foundation was staked. When I realized the error it was too late to move the foundation due to required zoning set-backs on the otimr side of the house to the property line. The I0 foot offset is required so that the foundation wall when parallel, will not encroach on the absorption area as the effluent travels down and out from the distribution pipe. This system is almost perpendicular to the building foundation thus not a concern for the absorption of the effluent. With the pipe at the slab elevation and 6 feet away I don't foresee any adverse impacts. 3. The septic permit was issued with a 5 feet waiver to the property line and should be in the DHHS file. 4. The primary and secondary systems were both installed at the same time due to the slow perc (45 minutes/inch). A dlverter was installed after the tank then each set of trenches has a Z200 splitter to give even flow to each trench as shown on the as-built inspection report. 5. The new well was place opposite where the permit showed it being placed. This was done just for ease of installation for the driller. The surrounding lots ~vill not be affected by this move. The neighbor directly to the east was notified and had no objections, the distance to his septle was 130 feet plus. The owner to the south was not affected due to the road easement bet~veen the tnvo lots. 6. The house has only been occupied since the first of October, 1997, which has been stated on the as- built. I trust this information will be of assistance in reviewing and approving this report. Please feel free to call me if you have additional questions. You may reach me at 345-3377/CELL 244-9055. PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHOP~AGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT ~ER:SW950036 DATE ISSUED: 3/30/95 DESIGN ENGINEERrD%7,~-ZZ COMPA~Y.~a ~cV~ LOQA~h~,~.EXPIRATION DATE: 3/30/96 OWNER N~E:GALES C~IG O~ER ~DRESS:2900 WEST 33 RD AVE - Q~~D~ ~CHO~GE, AK. 99517 ~~L qq~q ~%q~ PARCEL ID:01833120 LEGAL DESCRIPTION: T12N R3W SEC 33 LT 215B LOT SIZE: 22500 (SQ. FT.) ~/MBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).. 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED ~ CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: WR 950010 GRANTS A 5.0 FOOT LOT LINE WAIVER. DEPTH OF THE T~ENCH MUST NOT~XCEED 7.5 RECEIVED BY: THE TOTAL FEET. March 15, 1995 Department of Health and Human Services Anchorage Alaska James Mark Wright P.E. 2900 West 33rd Ave. Anchorage Alaska 99517 (907) 243-4361 RE: On-site sewer system permit request for Lot 215B, A3 Subdivision of B.L.M. Lot 215, SE 1/4, Sec. 33, T12N, R3~V, So Mo Dear DHHS, This is a request for an on-site wastewater disposal system permit. No onsite system presently exists (new residence). The existing systems on surrounding lots appear to be performing adequately. Two test pits were excavated and a percolation test preformed in each with an average percolation rate of 47 min/inch. No impacts to the surrounding properties are foreseen. Due to the small lot area I anticipate that it will be necessary to encroach upon the 10' lot line setback to the north. A waiver is requested. The owner intends to install both the primary and secondary systems at the same time. Valves isolating both systems will be installed. Flow splitters similar to Zabel Z200 Flow Divider to split the flow between the absorption trenches are recommended. The topography of the area is sloping from the north east to the south west at about 5% - 10%. The lot footprint is 150' by 150' for an area of 22,484 square feet. ~o Sincerely, Rick Mystrom, Mayor Municipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 March 30, 1995 James Mark Wright, P.E. 2900 W. 33rd Avenue Anchorage, AK 99517 Subje~: Waiver Request for: Lot 215B, T12N, R3W, Section 33 Waiver Approval: # WR950010 Dear Mr. Wright: Your request for waiver(s) of the required 10 foot horizontal separation of an absorption field to a lot line has been approved. The approved separation distance(s) are: Absorption Field to Property Line 5 feet This waiver approval appties to the existing absorption field to lot line separation only. Any future upgrades to either will require all separation distances be met or another approval be obtained from this department. Sincerely, ~ Robert W. Robinson Civil Engineer On-Site Services kb MUNICIPALITY OF ANCHORAGm Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR~ WR950010 PID~ 018-331-20 HA~ Permit ~ SW950036 Date Received: 3-23-95 Legal Description: Lot 215B, T12N, R3W, Section 33 Engineer: Applicant: James Mark Wright, P.E. 2900 W. 33rd Avenue Craiq Gales Waiver Requested: Absorption Field to Proper~y T.~ - 5 f~t Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: ~x Waiver is NOT Granted: Date: ~L~.~/~~ BY:/Name of Rev,iewer Rec #: 00760 (#1362) Amount: $. 115.00 Date Paid: 3-23-95 Permit. No. Page ~-- of ~r~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DMSION P.O. Box 196650, Anchorage, Alaska 99519-6650- Telephone: 343-474-4 On-Site Wsstewater Dispoeal System and/or Well Inspection Report SUBDIVISION OF- B.L.M. LOT 215; LOT 215B Legol Description: SE 1//4, SEC..33, T12N, R32, S.M. PID No. RESERVE SEPTIC SYSTEM -- MONITORING TUBE / PERC EST 14g. ag' SCALE 1"=50' WELL N 90'00'00", SUBDIVISION OF B.L.M. LOT ~15 LOT 2158 SE 1/4 SE.g~33' T12N R32j S.M. 56' 4" CLEAN I min. 56' %-4" CLEAN OUT PLAN VIEW -- 4"CLEAN OUT FROM SEPTIC TANK -- 4"CLEAN OUT ~NITORING TUBES 32 LIN. FT. -" S = 0.0%, ELEVATION PERFORATE MIN. COVER -- FILTERFABRIC ~ FROM SEPTIC PIPE TANK 4.,5 SECTION FILTER FABRIC 4" PERFORATED PIPE DRAIN ROCK SUBDIVISION OF B.LM. LOT 215, LOT 215B SE 1/4-, SEC. 53, T12N, R52, S.M. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: ~ ¢~ T ,~./~5--.~ r / 2 3 4 5~ 6, 7- 8- 9 10 11 14 17- 18- 19~ 20 L,~,Township, Range, Section: ¢ ~ //,",~, ~ ~- SLOPE $1T~ PLAN WAS GROUND WATER ENCOUNTERED? DEPTH? P Oept~ Io Walef After Reading Date Time Time Water Drop PERCOLATION RATE ~-'-'~ (mpnules,qncl~l PERC HOLE DIAMETER TEST RUN BETWEEN 7 FT AND ~ FT .~OMMENTS ,.~, ~/~. ~ ACCORDANCE WITH ALL STATE ANO MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. CERTIFY THAT THIS TEST WAS PERFORMED IN DAT~ I/~- ~/q~ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: DATE PERFORMEr I 2 3 4 5 6 7 8 9- 10- 11 Township, Range, Section: ~'~ ~ :~..3. "J"-Iz-~,/~ f~2_) ~.,,~ 2.~~''-' SLOPE "SITE PLAN/ " '~3- 14- 15- 16- 17 18 19 20 ENCOUNTERED? S IF YES, AT WHAT ~) DEPTH? p E Depth lo wa~ef Alter Gro~ Net Del3th to Net Reading Date Time Time Water Drol~ PERCOLATION RATE ~:~ (m,nutes/~ncl~) PERC HOLE DIAMETER TEST RUN BETWEEN 7 FT AND 0 Fl' 3OMMENTS , PERFORMEDSY; ,/~"~/'~'/~ jr~ r, ~ /~ ~ ,~ -. / CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELIN~EFFECT ON THIS DATE. DATE ,/14404 8°Municipality of Anchora °� On-Site Water and Wastewater Pro rani (907) 343-7904 SAFETY Certificate of On-Site Systems Approxi`' I2: Parcel I.D. 018-331-20 Expiration Date: 1. GENERAL INFORMATION Complete legal description T12N R3W SEC 33 LT 215B Location (site address) 3621 Dora Ave Current Property owner(s) Craig & Lori Gales Living Trust Day phone 907-441-5742 Mailing address 62615 Erickson Rd. Bend, OR 97701 Real Estate Agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Q Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: l ,�.. /1/717;> Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 5-.Xe Waiver Fee $ Date of Payment /02)61/7 Date of Payment Receipt Number 60 Receipt Number COSA# 00CJ9-1557' Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Forge Engineering Phone 907-522-7773 Address 1399 W. 34th Ave. Suite 203 Anchorage, AK 99503 Engineer's Printed Name Benjamin Schiller Date 11/28/17 Ale 0)f*:49TM i •.* 6. D D.SIGNATURE \i _ �S stem #1 Approved for bedrooms ��•�'. Benjamin Schiller System #2 Approved for bedrooms �#116 , cLAI�2 02 P.•,,U"�� Air Disapproved tt` $��`"- Conditional approval for bedrooms, with the following stipulations: V�4P�\�Y,OF�� O ON SITE 'P�. WATER AND WASTEWATER z= PROGRAM - Oo4. 66 g �1:�1�✓� Original Certificate Date: al I The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet_f c If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: T12N R3W SEC 33 LT 215B Parcel ID: 018-331-20 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 2/15/96 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 115 ft. Cased to 111 ft. Casing height (above ground) 28 in. FROM WELL LOG AT INSPECTION Date of test 2/15/96 11/15/17 Static water level 37 ft. 23.2 ft. Well production 10 gpm 4.2 g.p.m. WATER SAMPLE RESULTS: t� Coliform NrIJ colonies/100 mL Nitrate r\(Yrr mg/L Arsenic aD ug/L Date of sample: )(•a Q - 1 7 Collected by: f e V B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed Sept 1995 Tank size 1000 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) N Date of pumping 6/30/17 Pumper Northland Pumping C. ABSORPTION FIELD DATA Date installed Sept 1995 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.45 GPD/SF System type Deep Trench Length 21/42 ft. Width 3.0 ft. Gravel below pipe 8.0 ft. Total depth 10.5/12 ft. Eff. absorption area 1008 ft2 Monitoring tube Y Depression over field N Date of adequacy test 11/15/17 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 63/0 in. Water added 328/382 gal. New depth 90/20 in. Elapsed Time: 1440 min. Final fluid depth 70/0 in. Absorption rate >= 450 g p d N Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at _ in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot >100' On adjacent lots >100' Absorption field on lot >100' On adjacent lots >100' Public sewer main >75' Public sewer manhole/cleanout >100' Sewer/septic service line >25' Holding tank >75' Animal containment areas >50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: >5' >5' >5' Building foundation Property line Absorption field 100' Water main >10Water service line >10 Surface water > Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line >10Building foundation >10 Water main 1_ 0 Water Service line >10Surface water >1 00 Driveway, parking/vehicle storage > Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS There are 2 systems with a diverter valve. Both systems were tested and passed. Second set of trenches was dry and absorbed 600 gallons in 24-hour period. G. ENGINEER'S CERTIFICATION �„.�,NXVi i` _4 c 9F 44-414 I certify that I have determined through field inspections andP qf-t review of Municipal records that the above systems are in /O.•' '9t�� conformance with MOA COSA guidelines in effect on this date. / *=�49 I! fX '•* r Benjamin Schiller r to Engineer's Printed Name ., To' ► r Date 11/28/17 . , Bena�i Schiller : #,70,,,,,,,::. C .2492 . ':-`-r ! '� �- ,‘A&VYi`OrESS'JSI\\-4 COSA brown sheet 10-10-12.doc I I 8162C LOT 215A I 30 EAST 149.89 A I ,Y o ;/ h o lY o 'Y h A-7 d : 0 0,....: o O j o Wood fence o f 0 - 38.8 o I i ^� G Window well(typ) 3o I- ' a Septr• c Pet access ramp o y�0 13.1- ' gent lirp) 105).. �`��o� I- o I ./.."..... ....... , ' ::0 Sop Ret• .wall b' ., 47, o �� o I tam \ .0 o �'� •- ^ • LOT 215C 63 CO < 1-.....-k:Cf)/.1::.:;•1:'::%::.'',..Iapo 'a:4•f:.:-..}';.`','., f` z _ Z Asphalt .i LOT : ,0 • .: .t:. I i 5 ,; \-- ..,-..:,...,:,,.:.,.....A,..--.:.-...... 3' Road& Public Utility R.O.W. s.'_ Well 30 L .: ° - EAST 149.89 -: '� .; — — 17f ,.r;" - o • - co o co DORA AVENUE Recertified 8-13-97 11-16-17 1`z,....1/4%.•`1,1 AS-BUILT NO CORNERS SET THIS DATE A. OF .A� I, I hereby certify that I have performed a Mortgagee's inspection Q'.• 1,.5 of the following described property: LOT 2158, 49th * ‘fr- .--7 1, SECTION 33,T12N, R3W. S.M.AK >,: '.> / t / Anchorage Recording Precinct,Alaska,and that the / �,. ,� improvements situated thereon are within the property lines / r / and do not overlap or encroach on the property lying >/,�, .Fred Wal a tka , o / adjacent thereto,that no improvements on the property lying ��F•• 3255 — S •.•o��� adjacent thereto encroach on the premises in question and Pt 5 that there are no roadways,transmission lines or other oRO• • • '��9 visible easements on said property except as indicated SCALE: 1"= 30' 1 ' l \FSSIONA`+`� hereon. \N.\ Dated at Anchorage,Alaska EASEMENTS OF RECORD,OTHER THAN this 8th day of APRIL 1997. THOSE SHOWN ON THE RECORDED FRED WALATKA&ASSOCIATES,L.L.C. PLAT ARE NOT SHOWN HEREON Fb 06-3, pg 54 Engineers and Surveyors UNLESS OTHERWISE NOTED. FB 17-11, pg 33 BE 907-248-1666 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. -" GENERAL INFORMATION ' ComPlete legal description MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 _,,N t~.Ot,~A~-t~ AL SERVICES DIVISION 343-4744 Location (site address or directions) Property owne~' Mailing addreSS ~' Lending agency Mailing'address Agent ~: Address Day phone Day phone Day phone Unless otherwise requested, HAA' will be held for pickup. NUMBER OF BEDROOMS: ~ TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest-' lng to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-O25 (Rev. 1/91) Front MOA#21 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 of this Health Authority Approval application 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. Address 1,4 ~ Engineer's signature DHHS SIGNATURE Approved for -~ Disapproved. Conditional approval for bedrooms. A" ..? bedrooms, with the following stipulations: Additional Comments Date -The Mur~iciPality of Anbhorage Department of Health and Human Services (DHHS) issues Health Authority Approval certificate§;:based only upon the representations given in paragraph 5 above by an independent professional engine, er registered in the State of Alaska. The DH HS does this as a courtesy to p u rchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or an.alyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineerfs work. Municipality of Anchorage ,,uN ~,~^u~ o~ ANC~O~'~.",Z~'~, ~;,,iVIROI~/IENTAL SERVICES ptVlS DEPARTMENT OF HEALTH & HUMAN SERVICES -. ~) Enwronmental Services Diws~on ~0V '1 9 1997 825 L Street Room 502 · Anchorage, Alaska 99501 ° (907) 343-4744.._,., RECEiVp-U Health Authority Approval Checklist Legal Description: '~ILA/5"~ , '~-~-~ --~z~,~bt] Parcel I.D.: 0/~ -- ,~3 / - ~ A. WELL DATA Well type Log present (WN) Total depth ! / Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed ;~ ~'/~'~ ~ (o Cased to / / / / Casing height (above ground) FROM WELL LOG Wires properly protected (Y/N) AT INSPECTION Date of test ~ -/~-~/~' Static water level ~ '? f Well production //D g.p.m. ,-~ WATER SAMPLE RESULTS: Coliform ~- Date of sample: /~_ Nitrate ¢. / Other bacteria Collected by: 5. ~). B. SEPTIC/HOLDING TANK DATA Date installed ~_ c]~ Tank size //~ Number of Compartments ~ Cleanouts (WN) y Foundation cleanout (Y/N) y Depression (Y/N) /~ High water alarm (Y/N) /~J Date of Pumping '~-- ~'~ Pumper C. ABSORPTION FIELD DATA /~ ~ ~~ ~ O~, ~ /0~ Date installed ~ ~ Soil rating (g.p.d./fl~ or ff~/bdrm) ~ ~' ~ System type ~ L c~. /~ · Width Gravel thickness below pipe . Total depth. / gO ~ ~ Monitoring Tube present ~/N)~ Depression over field (Y/N) Effective absorption area /o ~g ~ Date of adequacy test ~ ~ Results (Pass/Fail) For bedrooms ;::io;i;e~ (past 12 months) (~ (i.) .u.s~ i, yes,/Ab.rpti;~~ g.p.d. 72-026 (Rev. 3/96) D. LIFT STATION Date installed Manhole/Access (Y/N) .~-~'"Pump on" level at* "Pump off" level at* High water alarm..J~-~ *Datum C8¢d1~ tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line On adjacent lots /'¢¢ /'C- On adjacent lots /¢'~) Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation '~'/'¢ Properly line ,~ / Absorption field ./ .Z '~I'~ Water main/service line -~ Sudace water/drainage ~ 1~ Wells on adjacent lots F. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Properly line ---~- / Building foundation Water main/service line Surface water / 42-d /:..L Driveway, parking/vehicle storage area /0 / Curtain drain /~"'~/-~- Wells on adjacent lots /¢~'0 ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records.,~.~th~Eb(~c_'~ms are in conformance with MOA ~AA/guidelines in effect on this date. ~..'" /x HAA Fee $ ¢-~/~)' ~ Date of Payment 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number