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HomeMy WebLinkAboutTALUS WEST BLK 2 LT 5Talus West
Block 2
Lot 5
#015-201-15
Mar 09 22 06:52p Anchorage Well & Pump Ser
9072430742 p.1
MUNICIPALITY OF ANCHORAGE
Development Services Departmentt
Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Well Drilling Permit Number:
Pump Installation Log
Parcel Identification Number: 015_201 _ 15
Date of Issue:
Legal Description
TALUS WEST
Block
2
Lot
5
Property Owner Name & Address:
RUPERT, CHRISTOPHER R
11935 WILDERNESS DR
ANCHORAGE, AK 99516
Pump Installation Date: e3 _ 07 _ 2022
130
Pump Intake Depth Below Top of Well Casing: feet
BERKELEY
Pump Manufacturer's Name:
Pump Modet: B7 P4J P05221-02
Pump Size: '50 hp
15
Pitless Adapter Burial Depth: feet
�+
MART N ` ON
Pitless Adapter Manufacturer's Name:
Pitless Adapter Installer:
Well Disinfected Upon Completion? �( Yes ❑ No
Method of Disinfection: PELLETS
Comments:
Pump Installer Nam
ANCHORAGE WELL &PUMP SERVICE -
7640 KING STREET
Company:
p Y ANCHORAGE, AK 99518
907-243-0740
Mailing Address:
City: State: Zip:
Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation.
Municipality of Anchorage
Q*1 Development Services Department
Building Safety Division
Onsite Water and Waste%ater Program, 4700 Bragaw St.
P.O. Box 196650 Anchorage. AK 99519-W50 Page of
www.cLanchorage.ak.us (907) 3417904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. SW 060237 PID Number. 015-201-15
David & Charlotte Eberle
Wastewater System: ❑ New ® Upgrade
Am...
11955 Wildemess Dr., Anchorage, AK 995162240
ABSORPTION FIELD
P 348-0620 K"°` a a'6o"" 3
P Dow Tmxh 17 sero. T aci a a.a o rr.la ❑Oar.
LEGAL DESCRIPTION
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Dean Construction (Bob Dean) I
Sept. 26, 27 8 28, 2006
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TANK
SEPARATION DISTANCES
0 Septic ❑ Holding ❑ S.T.E.P. ❑ Oar:
To
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r
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MOA Building Safety (attached)
Ft ti
BENCH MARK
Lamb, rr D.Wgb.
Large Rock (311 Dia+) In yard that is the headstone for a pet
Rock Is shown on site plan 100 FL
Inspections performedby:ST6t'fft ��O //L Dates: 1"9.17f�P G
Engineer's Stamp
2^° v mT sat acc6
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Development Services Department Approval
Conditional Approval Date:
* : 9TH
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STEVEN FLODIN, PE
PO BOX 671269
CI IUGIAK. AK 99567
Phone/Fax 688-7111
October 26, 2006
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street, PO Box 196650
Anchorage, AK 99519-6650
Subject: Lot 5, Block 2, Talus West
Septic System AS -BUILT
To Whom It May Concern:
The existing 3 bedroom home is served by a private well and a private septic system. The owner
originally said the existing system was working and he wished to upgrade since the original system
was installed in 1974. We originally planned to keep the existing seepage pit by the use of a diverting
valve.
Originally I estimated the outlet elevation of the septic tank by measuring the water level in the septic
tank pump -out tube. Upon excavation of the tank, we discovered the tank was actually 2.5 to 3 feet
deeper than originally anticipated, installed backwards and the septic system was under pressure. We
then excavated the original pit and found the leach water was about 3 foot above the leach rock.
I contacted Dan Roth with the Anchorage On -Site Water and Wastewater Program and explained the
situation and told him that due to the elevation changes, the existing design would not work and a new
lift station system would need to be installed. We were in the middle of construction so Dan said he
would note our conversation on the permit and to proceed with construction and provide information
about the new system on the AS -BUILT documents.
The original leach pit tank had basically disintegrated and the pit had collapsed upon itself. The
contractor finished collapsing the tank and filled the pit.
A new 1250 gal. septic / lift station tank from Anchorage Tank was installed. Pressure pipe installed
was 1 '/4 inch sch40 PVC pipe (ASTM D1785) with 3/16 inch distribution holes. The two trench
system in the original design was utilized with the exception that we elevated the trench bottom depth
and added about 6 inches of additional drain rock (additional effective area). The pipe header and
distribution pipe were insulated with 2 inch of insulation even though not technically required.
Attached are the AS -BUILT documents and back up information you may require.
If you have any questions, please feel free to contact me at 688-2230.
Sincerely,
�
Steven Flodin, P.E.
POST IN A CONSPICUOUS PLACE
ALL WORK MUST BE INSPECTED
A 24-HOUR NOTICE IS REQUIRED FOR INSPECTION SERVICE -
�' INSPECTION REQUEST LINE (907) 343-8300 OR FAX REQUEST (907)
\ — 249-7777
MUNICIPALITY OF ANCHORAGE
BUILDING SAFETY DIVISION
4700 BRAGAW STREET
TELEPHONE (907) 343-8211
ELECTRICAL PERMIT
RETROFIT
SITE ADDRESS: 11935 WILDERNESS DR
PERMITEE/OWNER: EBERLE DAVID R & CHARLOTTE A
CONTRACTOR: BRICKWELL INC
LOT: 5 BLOCK/TRACT: 2 SUBD: TALUS WEST
TYPE: RETROFIT
PROPOSED WORK R-3 RESIDENTIAL, SINGLE FAMILY
WORK DESC. Adding circuit for septic system
REMARKS: gjs
TOTAL CONSTRUCTION VALUATION: $.00
Total fees for $112.00
this issuance:
Total payments for $112.00
this issuance:
0
Men .r
4 n
N
apartment
NO: 06--9193
Date: 10/02/06
Permit Issued By: STULLER, GRETCHEN J.
Approvals:
ALL WORK IN STRICT CONFORMANCE WITH PLAN INSPECTION REQUIRED OF
CHECK REQUIREMENTS AS PER JOB PRINTS. FOUNDATION EXCAVATION PRIOR
FIELD INSPECTION REQUIRED TO PLACING ANY CLASSIFIED FILL
CONTACT THE UTILITY FOR APPROVAL OF SERVICE EQUIPMENT AND LOCATION PRIOR TO INSTAL-
LATION. SERVICE CHANGES MUST BE SCHEDULED IN ADVANCE WITH THE UTILITY COMPANY
AND THE BUILDING SAFETY INSPECTION SECTION.
I HAVE READ THE ABOVE APPLICATION AND KNOW THE CONTENTS
1 FURTHER AGREE THE ABOVE WORK WILL BE DONE IN ACCORDAN
ORDINANCES. ..
Signature of pennitee or Agent:
Printed Name:
THE SAME IS TRUE AND CORRECT.
.L STATE. MUNICIPAL LAWS, AND
IF WORK IS NOT COMMENCED
From ApplledMicrosystems Mon 02 Oct 2_006 0_3:44:2_1 PM AKDT Page 1 of 1
MUNICIPALITY OF ANCHORAGE, BUILDING SAFETY DIVISION
4700 SOUTH BRAGAW
INSPECTION INFORMATION & HELP: 343-7962
INSPECTION: VOICE 343-8300 INSPECTION: FAX (907)249-7777 www.muni.org/BSD/Inspections.cfm
NAME: Bill PERMIT*. 06-9193
COMPANY: Brickwell; Inc. INSPECT DATE: 10/3!2006 PM
PHONE •: 440-9351 PHONE M 34 PHONE r
ADDRESS: 11935 WILDERNESS DR
LOT 5 BLOCK 2 SUBDIVISION: TALUS WEST GRID 6: SW2736
COMMENTS or DIRECTIONS
Septic System... New Circuit S Underground Please Call- Thanks
TYPE OF INSPECTION: Retro Electrical
COMMENTS: (FOR INSPECTOR USE ONLY)
ti
PRINTED NAME
DATE' �'L='
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MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519.6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Permit Number: SW060237
Legal Description: TALUS WEST BLK 2 LT 5
Design Engineer: 0841 FLODIN ENTERPRIES
Owner Name: DAVID & CHARLOTTE EBERLE
9/2G/DG � sr
PH r4A.k I*v
FLA -C E
(sv9 GewA, F -,,C•
914
/3�6
Date Issued: Aug 02, 2006
Expiration Date: Aug 02, 2007
oil
Parcel ID: 015201-15 qla& 9ia� ���o t
Site Address: 011935 WILDERNESS DR 1l�tr
Lot Size: 21258 SQ. FT. la�
Owner Address: 11955 WILDERNESS DR Total Bedrooms: 3 Permit Bedrooms: 3
ANCHORAGE, AK 99516-2240
This permit is for the construction of:
❑✓ Disposal Field ❑? Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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 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.
F. 9.•1 L L PF Rµ19NENTL)' DECOAW137S ION rKE SF PT/G TAO(*
THC 1x0;r1A'& SEbPaIfE p/T• Au 4N(N0046E r)9IPk /2SO GAL.
$.1.E.� T)4NK k.l&.L OK COA/ST�PtttTliD TD DEI-7�Ele 6FfLllEA1T To
PRAlol FIFc.D.
Received By:
Date: Leh 6
Date: Z. d.
Municipality of Anchorage
-� Development Services Department ,ea
Building Safety Division
Onsite Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
ON-SITE SEPTICMELL PERMIT APPLICATION i
FOR A SINGLE FAMILY DWELLING
Parcell.D. O1 5-20/—/,S— I
Property owners) J/, y j o 4 Gl4A2 t_o f'r'4 E04<1-£ Day phone 2 C+ G -2596
I
Mailing address / / 93 W 11_,P6icA1,5 's' PKjyE Zip Code
f
Site address (�i?"mE i Zip Code
Legal description (Sub'd, Block & Lot)I R is yr Wes r a i- K 2 . Lo 7 -
Legal
Legal description (Township, Section & Range)
Lot Size 21, �2� 6 Sq. FL
THIS APPLICATION IS FOR (®all that apply):
Absorption Feld
a
Septic Tank
❑
Holding Tank
❑
Privy
❑
Private Well
❑
Water Storage
❑
Number of Bedrooms .3
i
THIS APPLICATION IS AN:
Initial
❑
Upgrade
I
Renewal
❑
I certify that the above information is correct. I further certify that this application is being made for a
Single it Dwelling and is In accordance with applicable Municipal Codes.
T7)
(Signature of properowner or authorized agent)
I
i
Permit/Rush Fees: LI&O Waiver Fees: I�
Date of Payment:�3 f/�F'_r Date of Payment:
Receipt Number. $� Receipt Number.
(Rev. 11105) ;
STEVEN FLODIN, PE
PO BOX 671269
CHUGIAK. AK 99567
Phone/Fax 688-7111
July 28, 2006
Municipality of Anchorage I
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street, PO Box 196650
Anchorage, AK 99519-6650
Subject: Lot 5, Block 2, Talus West I
Septic System Design and Permit Application
i
To Whom It May Concern:
i
The existing 3 bedroom home is served by a private well and a private septic system. The owner says
to existing system is working however he wishes to upgrade since the original system was installed in
1974. We will keep the existing seepage pit by the use of a diverting valve.
A test hole was excavated, monitor tube installed and a perc test performed. The attached Site Plan and
backup documentation identify the location and configuration of the new septic system. The lot is
fairly level with a little slope from east to west.
The test hole was placed as indicated on the site plan. No groundwater or bedrock was encountered in
the test hole. The test hole was silty sands with gravel and sand lenses. A water monitor tube was
placed to a depth of 16.0 feet and observed for 2 months. No water was observed.
I
Trench System Data: i
a. Percolation Rate: 20 minutes/inch
b. Allowable application Rate: 0.6gallons/day/sq.R.
c. Number of Bedrooms: 3 I
d. Design Flow: 450 gallons per day i
e. Minimum Absorption Area: 750 sq. fl.
f. Total Depth: 10.0 ft.
g. Effective Depth: 4.5 ft.
h. Width: 3 ft.
i. Minimum Length: 84 lineal feet (2 @ 42 feet long each)
j. Effective Absorption Area: 756 sq. ft.
We are proposing to install a new 1,000 gallon septic tank and two deep trenches at 42 feet long each.
The trenches will be constructed parallel to the property contours. Grading will be accomplished to
assure a positive surface drainage away from the new trenches. There are no known surface waters
within 100 feet of the proposed septic system.
If you have any questions, please feel free to contact me at 688-2230.
Sincerel +,
Steven Flodin, P.E.
a Municipality of Anchorage
DEPARTMENT OF HEALTH d HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: 9AVb0 "g<'z6 DATE
LEGAL DESCRIPTION: LT is
t F'7 /^t LL
2
3
4
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ROU D WATER
tv 17V G�L
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DEPTH?
COMMENTS
PERFORMED
Section:
N/A
Depth to Water AIIeI 0 NhY
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COMMENTS
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Section:
N/A
Depth to Water AIIeI 0 NhY
Nmitarinp7 .�ytat%E pe[9106
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PERCOLATION RATE 90 (minutes/inch) PERC HOLE DIAMETER 1419
TEST RUN BETWEEN -7 --FT AND go FT
s+. I �rP dBR t 0elf"t CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE:
72 -MB (Rev. 4/851
Dave Eberle Home, 11935 Wilderness Drive, Anchorage
Lot 5, Block 2, Talus West, Anchorage, AK
Septic System Notes;
1. All materials and workmanship shall meet the Anchorage Development Services
Department and the Alaska State Department of Environmental Conservation
requirements and standards.
2. All deviations from the plans and notes must be approved by the engineer.
3. Replace existing 1000 Gal. Septic tank. Tank is to be set level with a minimum of 5
foot of separation to the home foundation. (Discuss Tank outlet Invert elevation
with Engineer prior to proceeding past this point)
4. All cleanouts are to be 4" approved materials and extend above grade per MOA
standards.
5. Pipe from septic tank to leach area is to be approved material and sloped at 2%+/-.!
6. All piping under any driveway and parking area is to be insulated with approved 2
inch rigid insulation. ;
7. The trench bottom must be level within plus or minus 1.5" throughout the trench I
length.
8. Trench drain rock must be 1/2" to 2 %s" screened material. j
9. Perforated pipe must be installed level with perforations down.
10. Gravel depth over the perforated pipe must be a minimum of 2". i
11. A filter fabric (silt barrier) must be installed between the gravel layer and the soil
backfill.
12. Finish grade over the trench must be mounded.
13. The new septic tank and trench system must not be closer then 100' to any private
well or 150' to any class "C" well.
14. Perforated drain pipe to be 4" PVC ASTM D3034 or approved equal.
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UKtA -K ANLHUKAUt ARLA BOR( -`,GH
t /
Department of Environmental Quality L
3330 C Street
Anchorage, Alaska 99503
�r
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME LK/ IMNC'-lt`1��7ST MAILING ADDRESS - 0-(' % [yt�t �z PHONE-
LOCATION LEGAL DESCRIPTION I L: PZ,(. 2,
SEPTIC TANK:
DISTANCE
OF
FROM WELL �-�`� MANUFACTURER Milk `�� 1 - NUMBER M
/�MATERIAL�J Li �.L COMPARTMENTS I
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY /-I'h GALLONS.
SEEPAGE PIT:
NUMBER OF PITS DIAMETER OR WIDTH 6/, LENGTH23,/ DEPTH Ij '
LINING MATERIAL'�''�_ Itl,'rl_ CRIB SIZE: DIAMETER �t DEPTH / DISTANCE FROM: WELL ff�'C'
10 / TOTAL EFFECTIVE
BUILDING FOUNDATIONNEAREST LOT LINE I ABSORPTION AREA (WALL AREA) W'r=`. SQ. FT.
ADDITIONAL ABSORPTION
WELL: _%,N
TYPE 11U%l V/LY/Ai_ CONSTRUCTION
DEPTH `�
DISTANCE FROM:
BUILDING i NEAREST /
- FOUNDATION .30 �- LOT LINE ID '1'
NEAREST I
/(1
SEWER LINE
SEPTIC
/- �U S- SEEPAGE
TANK SYSTEM
CESSPOOL Alc�rLc_ , OTHER SOURCES
APPROVED 4--� DISAPPROVED
REMARKS
DISTANCES:_ X15 .5'f-/Ol/ld
DIAGRAM
OF SYSTEM
INSTALLED BY: bnT t
2 •Y
PIPE MATERIAL: G�� (°20'I N)CiYi
LOT SLOPE:
REMARKS: LY -L G(itz.I( 9
'-7T1
h<cck U,,tc
N !II
DATE _E{'f
APPROVED �tgbAA_C
/)f''✓i- /I,fhq;
G.A.A.B.
Farm No. EQ -031
f' v GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO.
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT
NAME OF APPLICANT _r /-y!V X�;Xf41 L /�-�' MAILING ADDRESS ^� "'' � ✓��� PHONE
INSTALLATION LOCATION/��✓'/�iC//'_� .,12/�/'I L+%•j s`—
LEGAL DESCRIPTIONGf/
INSTALLATION OF: SEPTIC TANK
(% SEEPAGE PIT
DRAIN
FIELyD/
, OTHER ,
iJ�-%'✓sG/ /�/j"'
��%/�✓-1
✓' 1i %_.
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
TO BE INSTALLED BY
SOIL TEST RESULTS _�/-s��% zz NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE/��L� y7 //. TYPE ` SEEPAGE AREA SIZE /-''��
TYPE
MINIMUM DISTANCES, REQUIREMENTS DIAGRAM OF SYSTEM
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT -%Z =� DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK =� SEEPAGE PIT �}i1 DRAIN FIELD T
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK �r/� SEEPAGE PIT
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK -��/ / SEEPAGE PIT
DRAIN FIELD
SEPTIC TANK, �� SEEPAGE PIT //�iJ , DRAIN FIELD
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
G.A.A.B.
OR
LICENSED DESIGNER
1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE /� APPLICANT'S SIGNATURE
ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
U.
Performed For'JIF:>Q,j at 'Rp S e h �o t�v Date Performed �e�e to e^r l Q, V-4-7-
Legal Description: Lot Block Sub vision q L'—'
This Fcrm Reports a: Soils Leg,j ercolation Test�_�
GREATER ANCHORAGE AREA BOROUGH"
J',_.,HEALTH DEPARTMENT
/ 327 EAGLE STREET
ANCHORAGE, ALASKA 99501
CASE 4
Depth
Feet Soil. Characteristics
o 1SCati $S^
6 °� S;t�y ��5c• C �j Qr(Lvc>�
a^cz�� l� •+� �Y'c�veLl�
:v
Pods e c�rcwo 1
t n �G VO)
�v g
Was Ground Water Encountered?--�
If Yes, At. What Depth
Reading
Proposed
Depth Of
N<rs: c
Date ( Gross Time
Installation `—Seepage Pit
Net Time Depth ToH2O Net Drop
®_ Drain Field
fo Bottom Of Pit Or Trench
Test Performed B).;vn
Data Certified By:
Date:
(�
�S^o�saonct��US�
q�
y
o Ol.
a� Illi►
hill ;
loo .s
A�VCj_ I "-P7-1C 1A
T?fU< Pp2G
P,2ppc)ScD ELE✓��% S
�LT�G, G,2fi0�
�,p2AGC SLRB — /03.8
It h thr re6 .:p ihrl t,y n[ the m7rnre crr
bul)ger -prim bi err lr� uh, I. ir[y
pptofu c,t hull) n[ �r r r rr i 1 i to tirr-
ishPd grade and of lrt,y innn—tuns nod
io deter rrrnre thr t r r o[ ar y ea•e'
Cnents, covenant,, or rr..,V-010.r, which
do not appear.on t; c.wordrd subdivi-
sion plat.
P,e(>POSF7�
k3 /
✓n9
--- ---------- -- LEGEND:
IV Brass Cap Monument
LOT SURVEY CERTIFICATION 0 Iron pipe
e Steel Pin
o Survey Hub 9 Tack
Lot Block
Anchorage Recording Precinct, Alaska REVISIONS DATE I BY
Prepared By: DICOMUN-aWN D-WALCH-LCC Residence of; -
® ENGINEEV ANCHORAGE. ALRSHA -
Do/e: BY: z� Sco/e: — W. FB. A' —� Grid:
5. LEGAL DESCRIPTION
DATE RECEIVED
' INSPECTION APPOINTMENTS -
7 u
STREET LO/CAPTION
TIME
TIME
TIME
6. TYPE OF RESIDENCE
(��
-2c7
El One E:1 Four ❑ Other
SINGLE FAMILY
DATE
DATE
DATE
7. WATER SUPPLY
a�za
I�4 INDIVIDUAL* *ATTACH
WELL LOG. A well log is required for all wells drilled
❑ COMMUNITY
INSPECTOR i,7
�/oll
INSPECT R
INSPECTOR
B. SEWAGE DISPOSAL SYSTEM
MUNICIPALITY OF ANCHORAGE
DEPT. Gr :-::. L:.i S,
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIOrfNVIRON)J;Lie L-.,. ,.. 1 _CTION
825 L Street - Anchorage, Alaska 99501
NOTE: THE INSPECTION FEE MUST. ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
I L.dil.�
ENVIRONMENTAL SANITATION DIVISION
Telephone 264-4720
R E C I � / E.D
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DI RECTI ONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10)
days for processing.
1. PROPERTYOWNER
PHONE
MAILING ADDRESS
PROPERTY RESIDENT (If different from above) -
PHONE
g7ael
a'TE✓E 3QAVa
.34zt
2. BUYER
PHONE
MAILING ADDRESS
3. LENDING INSTITUTION
PHONE
MAILING ADDRESS
4. REALTOR/AGENT
PHONE
©n)
MAILING ADDRESS -
91?3 2 "C`
5. LEGAL DESCRIPTION
poi- Ldc!L�JS
7 u
STREET LO/CAPTION
^�
/VesS
7ipr✓ep -
6. TYPE OF RESIDENCE
NUMBER OF,BEDROOMS
El One E:1 Four ❑ Other
SINGLE FAMILY
❑ Two ❑ Five
❑ MULTIPLE FAMILY
Xr Three ❑ Six
7. WATER SUPPLY
I�4 INDIVIDUAL* *ATTACH
WELL LOG. A well log is required for all wells drilled
❑ COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.)
B. SEWAGE DISPOSAL SYSTEM
5I INDIVIDUAL/ON-SITE**
YEAR ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST. ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
L
f x -
72-070 (Rev. 6/79) � 1 � - GN �' -
'!
/)
72-010 ( Rev. 6/79)
THIS SIDE FOR OFFICIAL USE ONLY
-
1. TYPE OF RESIDENCE
'91 SINGLE FAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
O ONE THREE ❑ FIVE
❑ TWO FOUR ❑ SIX
❑ OTHER
2. WATER SUPPLY
-® INDIVIDUAL
❑ COMMUNITY
❑ PUBLIC UTILITY
Connection Verified
PERMITNUMBER
DEPTH OF WELL
DATE DRI LLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
91INDIVIDUAL/ON -SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATE INSTALLED
INSTALLER
PLA1
-0Septic Tank or ❑Holding Tank
Size: Ic�il �]i� If Tank is homemade
give dimensions:
SOILS RATING
G4
TYPE OF TALKII
_]_Q2 Y
MANUFA URER
F
TOTAL ABSORPTION AREA
MATE L
4. DISTANCES
WELLTO:
Septic/Holding Tank
I��
Absorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
[� APPROVED FOR BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE
BY
72-010 ( Rev. 6/79)
ALASKA MUIR011O1011TAL COIITROL
13npeering & 6nuironmental Studies
First National Bank
Southcenter Branch
Box 4 2090
Anchorage AK 99509
""i
RRUICOS, Inc.
MUNICIPALITY OF ANCHORAGE
oEPT. cF
CTION
ENVIRon;�rwT,,� __" I e
r"2 3 Iwo
December 26, 1980 RECElV
SELLER IRAAHHNRNRY
SCIE,D:XV:I:S:LON--TALUS WEST DL.(:1CK-2 LOT -5
TFIIE: TYPE OF AB�SORF'TICIN SYSTEM IS A PIT WITH AN AREA OF" 756 Si:1F"To
Tru:: SYSTEM IS CAPABLE: CIF" ACCEPTING 4.`S0 GALLONS OF WATER F,ER DAY>
THI SOII...S RATING CIF" THS:'. SYSTEM AT CONSTRUCTION WAS 22,15 AND NOW
IS 252 SC1F"Ti BE-:DFtiOOM
BASED UPON THE: TEST DATA THE SYSTEM IS ACCI_PTABLE. FOR A
3 BEDROOM HOME::
THE SEF'U(�,.XANK WAS PUMPED ON OCTOBER 21 1979
1220 West 25th Auenue • Anchorage, Alaska 99503 9 (907) 276-1361
_ R&M ENG EERING & GEOLOGIC ' CONSULTANTS
229 EAST 51st. AVE. — P.O. BOX 6087 —ANCHORAGE, ALASKA 99503
TELEPHONE 9o7-279-0483 TELEX 090-35419
Civil Engineers Geologists Land Surveyors
JAMES W. ROONEY, P. E. RALPH R. MIGLIACCIO
MALCOLM A. MENZIES, P.E., L.S. Engineering Geologist
JAMES H. WELLMAN, P.E.
June 8, 1972 R & M No. 26521
Mr. Howard Nugent
Star Route A 1591-N
Anchorage, Alaska 99507
RE: Test Hole and Soil Log Report for Sanitary System
Lot 7, Block 2, Talus West Subdivision
i
Dear Mr. Nugent:
We are submitting herewith the test boring results and our comments
regarding soil conditions encountered at the subject site. This investi-
gation was performed in accordance with your request of June 8, 1972,
and those procedures outlined in a letter dated September 13, 1971 by
Mr. Rolf Strickland of the Greater Anchorage Area Borough Department
of Environmental Quality.
A single test hole was put down within the Lot 7 area for the purpose
of defining general subsurface soil conditions for the proposed sanitary
system. Excavation was accomplished with a tractor -mounted backhoe
and the test hole was extended to a total depth of 12 feet below ground
surface. One sample was recovered from the bottom of the test hole
and retained for grain size analysis. The sample will be held in storage,
up to approximately one month, for possible testing before it is discard-
ed. The final log prepared for the test hole has been included in Drawing
A-01.
Ground water was not encountered in the test hole.
We appreciate being given this opportunity to be of service to you. Should
you have any questions with regard to the above, please do not hesitate to
contact us.
Very truly yours,
R & M ENGINEERING & GEOLOGICAL COVSULTANTS
James W. Rooney
JW R: wb
Enclosure
cc: Greater Anchorage Area Borough
ANCHORAGE FAIRBANKS !U':'EAU
Municipality of Anchorage
•
Development Services Department t
Building Safety Division
On -Site Water & Wastewater Program
4700 Elmore Road. i
PD, Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904 ,
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 015-201-15 COSA# Q5C_ J,,1b6�
1. GENERAL INFORMATION Expiration Date:
Complete legal description TALUS WEST S/D; BLOCK 2, LOT 5
Location (site address) 11935 WILDERNESS DRIVE * ANCHORAGE, AK * 99516
Current Property owner(s) DAVE EBERLE Day phone 242-4961
Mailing address P.O. BOX 15379 * FRITZ CREEK. AK * 99603
Lending agency Day phone
Mailing address
Real Estate Agent SHAWN BABBIT W/ COLDWELL BANKER Day phone 562-7653
Mailing address 3000 C STREET, SUITE 101 * ANCHORAGE, AK * 99503
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
0
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 samples. (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, 1 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 structur a indicated herein. /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 GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date �, Z
Engineer's Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described 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 soils condition, groundwater 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 the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operationsl requirements of the ADEC or 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
otherperson 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:
Attachments:
COSA Checklist Arsenic Advisory
Septic System Advisory Maintenance Agreements
Well Flow Advisory Supplemental Engineer's Report
Nitrate Advisory / Other
By: Original Certificate Date:
(Rev. ii
Municipality of Anchorage
• -� Development Services Department
Building Safely Division
On -Site Water 8 Wastewater Program
4700 Elmore Road
P.O. Box 196650 Anchorage, AK 99519-6650
www.d.anchorage.ak.us
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: TALUS WEST S/D; BLOCK 2, LOT 5 Parcel ID: 015-201-15
A. WELL DATA *PER GEG INSPECTION. **PER AAROW PUMP AND WELL INSPECTION. SEE ATTACHED REPORT.
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (YIN) NO
Date completed -1975 Sanitary seal (YIN) YES Wires properly protected (YIN) YES
Total depth *134+ ft. Cased to **40+ ft. Casing height (above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test 8/11/2011
Static water level ft.
86 ft.
Well production g.p.m. 4.58+ g,p,m,
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 ml. Nitrate AdiO_mg./L. Collected by: GEG, Ltd.
Arsenic: NO ug./L. Date of sample: I l � >• �
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material
Tank size 1250 gal.
011111M:11111%
Number of Compartments E
Date installed 9/27-28/2006
Cleanouts (YIN)
YES
Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) N/A
Date of pumping 131 1.2-011 Pumper ISAACS PUMPING
C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE
Date installed 9/27-28/2006 Soil rating .p.d./ orft2/bdrm) 0_6 System type DUAL TRENCH
Length 84.3 TOTAL ft. Width 2/2 ft. Gravel below pipe 5 ft.
Total depth *8.3 8.5ft. Eff. absorption area 843 ft' Monitoring tube YES Depression over field NO
Date of adequacy test **8/11/2011 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test 110 in. Water added 450 gal. New depth 29 in.
Elapsed Time: 125 min. Final fluid depth 21 in. Absorption rate >= 450+ g,p,d,
Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date
**TESTED SOUTH TRENCH ONLY. EAST TRENCH HAD 12" OF LIQUID AT INSPECTION.
D. LIFT STATION *PER ORIGINAL INSPECTION REPORT.
Date installed 9/27-28/06 Size in gallons 1250 Manhole/Access (Y/N) YES
"Pump on" level at *6 in. "Pump off' level at *2 in. High water alarm level at *18 in.
Datum BOTTOM OF PUMP BASKET Cycles tested 3 Meets alarm & circuit requirements? YES
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM 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
N/A
Public sewer manhole/cleanout N/A
Sewer /septic service line
25'+
Holding tank N/A
Animal containment areas
50'+
Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION o "' ^ U�
per.•'• •.. �i
i certify that f have determined through field inspections and
review of Municipal records that the above systems are in �" ' "' " ' "' ......
conformance with MOA COSA guidelines in effect on this Q
date. r7 ffr A. am ss. -
Engineers Printed Name JEFFREY A. GARNESS �O 9, 1CfEf-79x53
��afm^ tlZ�r'2•' �a�oG
Date 'ITZ p10 fessio��oc
COSA Fee $ Ll ` b
Date of Payment i a
Receipt Number Gla�It^,
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
SGS
SGS Re£#
1120180001
Client Name
Garness Engineering Group, Ltd
Project Name/#
Talus West L5 B2
Client Sample ID
Talus West L5 B2
Matrix
Drinking Water
Sample Remarks:
Printed Date/Time
Collected Date/Time
Received Date/Time
Technical Director
01/24/2012 15:54
01/16/2012 13:23
01/16/2012 13:50
Stephen C. Ede
Allowable Prep Analysis
Parameter Results LOQ Units Method Container ID Limits Date Date lilt
Metals by ICP/MS
Arsenic ND 5.00 ug/L EP200.8 C (<10) 01/17/12 01/23/12 NRB
Waters Department
Total Nitrate/Nitrite-N ND 0.100
mg/L SM20 4500NO3-F B (<10)
Microbiology Laboratory
Colony Count 0 col/100mL, SM20 9222B
Fecal Coliform 0 col/100mL SM20 9222B
Total Coliform 0 col/100tnL SM209222B
A (<200)
A (<I)
A (<1)
01/18/12 CMA
01/16/12 MEM
01/16/12 MEM
01/16/12 MEM
Aarow Pump & Well Service LLC
{907}346-9355
Inspection Report
I ran a camera 55' down the well at 11935 Wilderness Drive and did
not find any holes/ cracks in the casing or leaking around the pitless.
Beau Maxim