HomeMy WebLinkAboutT15N R1W SEC 4 LT 34BT15N R1W Sec. 4 Lot 34B #051 - 072 -63 Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page / of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: O S /[1/326 PID Number:O 510726 3000 Dwelling: ciirSingle Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New $ Upgrade Name: 3.14All i/4 kOz/,tis (1/ ABSORPTION FIELD Address Z/t/20/LLSi— C/i/X�/�¢fC ❑ Deep Trench ❑Shallow Trench gBed ❑Mound ❑ Other Phone Number of Bedrooms Z $Q - / O 38 3 Soil Rating /� ►�• C9 C. l GPD/SF Total depth from original grade / Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot a a � Ft. el Ft. Fill added above original grade Gravel length Township�ipRange Section 2 Ft 64 Ft. / /SN MW -SEC g _ . 34"B Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES /0 Ft. 2 y Ft. To From Septic Tank Absorption Field Lift Station 40 Holding Tank Sewer Line Total absorption area by 0 Ft2 Number of trenches — Dist between trenches Ft. Well SS /oo Cr2! -i TANK 0 Septic 0 S.T.E.P. • Holding • Other E'td.(fy-A•.'1(F •751 Manufacturer •: pacify Surface Water 00,5# to r- Gal. /Q 0 100'4- Material • . •• .er of compartments Lot Line ! / a f 41 NA Foundation qq Q ; p• _ LIFT ST •TION E}(I 7 //VG�V 0 Manufacturer Capacity Curtain Drain . / d /`� L NA Am 4 Gal. Remarks .,b �. s. a C,, i�/ 7Pe ./iNdS Pump on level at Pump off le -t High water alarm at /�% / revR) id („j 4IVI rS in. in. in. Pump make and model Electrical Inspections e - ormed by Installer PIPE MATERIAL House to tank al. Tankto/jr, drainfi@Id C4, /'I SCff(( dir4iSid4O /3Yeco/Mr /2ce,S Inspector /VG K. �r q Y BENCH MARK (Assumed elevation) ft /00 Inspection si G �yJ dates: 1 ! Z f 2, [ /174( Location and description /f D,.2s SLAB' C 6 SL B 3"' /O/ /y 4th N /3P LtInil. OJSe j Lind COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Conditional Approval: Date Engineer's Stamp yOF $ �,,n ,°°w°°wt° ° Stt MS em°se ee^.. feeee; Va�geaee[tw r's /� Approved Ait / Date 3.24'-/, -- Steven W. Eng•^./ 0 ; Is : •, PE 6256 Al 'r '<°31%5�(t3 , .. ` nspection Report_9-1-12.doc BLM L23 AS -BUILT MEASUREMENTS A B MT1 23 MT2 74 31 42 Well Radius 1% Slope 64 New Force Main Existing Lift Station No Conflicts Within 200' 0 MT2 T1 A New Leachfield w/ 1" Schedule 40 PVC Pressure Distribution 1% Slope 3 Bdrn y Existing Concrete ..9y Septic Tank 1% Slope • R=100' LOT 34A PROTECTIVE RADIUS WELL WOODEN FENCE 1% Slope 20' RDW & Utility Easement =�E.°Fi T15N y'�P NORTHRIM 1;;\::;,;,,*.:7;- *'4 ua. '* R1W G RECORD DR A W I N SECTION 4, LIT 34B Po Box 770724. :y Eagle RNsr, Alaska 995773 f S (.5 907. 694. 7028 WASTEWATER RECORD REPLACE LEACH FIELD 3/15/15 2 of 3 DNI/AVK aauo e1 ,L6 8 uoi}on813 Original Ground Elevation @ 98' n Elevation Final Ground @ 99.5' 03 IP' iU v l J z n m O x < h 3 (0 pag MaN Jo }uiod-p W N O Io i n 3 3 N Q Si 3 "5- c - c h -o (0< a 3P P3 0 P 10 QP N 3 0 h }nouoalg 6ui}six3 uoi! l_al_S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 � n /� S❑ILS LOG — PERC❑LATI❑N TEST STH `IIv' [ GINEERING Date Performed 9/20/14 Performed For: Janina Legal Description: T15N R1W SEC 4 Lot 34B DEPTH (FEET) Organic SP Sand w/ Gravel Low Silt T.H. Location: See Attached Design Groundwater? Yes Depth 7' Water Depth After Monitorino.5.5' Date: 9/28/14 # Date Gross Time Net Time Depth Net Drop 1 9/28 0 -- 7" -- 2 9/28 10 10 min. 10.5" 3.5" 3 9/28 12 -- 7" -- 4 9/28 22 10 Min, 10.5" 3.5" 5 9/28 25 -- 7" -- 6 9/28 35 10 min. 10.5" 3.5" 7 9/28 37 -- 7" -- 8 9/28 47 10 min. 10.5" 3.5" 9 9/28 50 -- 7" -- 10 9/28 60 10 min. 10.5" 3.5" Percolation Rate 4 min./inch Perc Hole Diameter 6" Test Run Between 1' and 2' Comments: Presoaked. Measured to nearest 1/16th inrh. Performed By NorthRim Fng I �� CERTIFY THAT THIS TEST WAS Performed in Accordance with All State/Municipal Guidelines in Effect ON THIS DATE. DATE: 9/28/14 — NOR THRI M ENGINEERING PO Box 770724 Eagle River, Alaska99577 907.694.7028 ycP.•• * 4 % ww t(5r TH1 TESTH❑LE LIG GEITECHNICAL tee: 9/28/14 'IEET: 1 On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP141326 Tax Code Number: 05107263000 Work Type: Septic Upgrade Permit Effective Dates: August 27, 2014 to August 27, 2015 Design Engineer: NORTH RIM ENGINEERING Subdivision: T15N R1W SEC 4 Site Legal Address: T15N R1 W SEC 4 LT 34B G:1458 Owner/Address: KOZINSKI JANINA PO BOX 672541 CHUGIAK AK 995672541 Site Mailing Address: 21420 JILL ST, Chugiak Lot Size in Sq Ft: 40718 Total Bedrooms: 3 This permit is for the construction of: Y Disposal Field N Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: PRIOR TO CONSTRUCTION: A new test hole shall be completed to verify the design drainfield application rate and separation to groundwater and impermeable soils or bedrock. If required, an approved change order shall be issued prior to construction. Test hole results shall be submitted with the final inspection report. Received By: Date: ell Issued By: Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http://www.mu n i.orq/Onsite Development Services Division On -Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: OSP141327 COSA#: PID#: 051-072-63 Legal Description: T15N R1 W Sec4 L34B Engineer: North Rim Engineering Applicant: Janina Kozinski Permit#: OSP141326 Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 1.0 foot. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ® The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of non -objection have been received from the owner(s) of the affected adjacent property. ❑ Adjacent properties are not affected by this waiver. Waiver is Granted: Waiver is not Granted: Date: /7 �( Approvedbj Name of Reviewer MUNICIPALITY OF ANCHORAGE r MIA Community Development Department Development Services Division On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION hone: 907-343-71904 Fax: 907-343=7997 Parcel LD. C)5I — 0 72 - (3 Property owner(s) k0 p/i/ Ski 3-4/V/» A Day phone Z//zo 3744 S Mailing address Site address 4451 Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) 7754( /''/k7 sec y 21925' Lot Size LI OW/Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: ( all that apply) Absorption Field IS Septic Tank Holding Tank Privy Private Well Water Storage 9 0 APPLICATION IS AN: Initial Upgrade Renewal TYPE OF DWELLING: ❑ Single Family (SF) (w/wo ADU) 0 Duplex (D) 0 Multiple Dwellings (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: 1C0 / h /A7E ® f 1 Distance: / I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or auth ed agent) Permit/Rush Fees: 51oq - Date of Payment: g j(? Receipt Number (05-7 Permit No. (3Sp/Ll13 Permit App_9-1-12.doc Waiver Fees: ays Date of Payment: 7/13/Id Receipt Number: Ql7-ti Waiver No. 4.s1p1411.32? \ORTI-••••••••..:II M ENGINEERING Date: 8/11/14 To: Jay Crewdson, PE MOA On -Site Services MEMO Steve Eng, PE, PH P.O. Box 770724, Eagle River AK 99577 (907) 694-7028 tel northrimeng@aol.com Subject: T15N R1W Section 4 Lot 34B New Bed Design Jay, Number of Pages: 5 I spoke with you concerning this system. An existing concrete septic tank and lift station are in place and working; they have past approved waivers. The owner wishes to place a new leach field on Lot 34B and abandon the old bed on Lot 34A. The design calls for an elevated bed to be constructed; connect the existing 1000 gallon concrete tank and lift station. The subdivision is served by private on -lot systems. Slopes are flat. We are requesting a 1 -foot lot line waiver due to the tight constraints. Please review the wastewater system design for the single family home. I have included design plans & specs, design guidelines, & soil tests. If there is need for additional information or clarification please give me a call. Thanks -Ste NERTF-I M ENGINEERING •rive., e• ac f tthi Is) I It 4° Tia @1••• iay.arr!•7e T15N R1W Section 4 Lot 34B SPECIFICATIONS '& DESIGN GUIDELINES Wastewater System Sizing: This is an existing 3 -bedroom, single family home. The owner requests a new leach field on Lot 34B and abandon the old bed on Lot 34A. The existing concrete tank and lift station will be utilized; existing waivers in place. Neighbor lots are served by septic systems and private wells; there are no conflicts. The topography is flat, no slope. A previous soil test indicated a GW soil at the bed site; additional soil test at construction can be completed if necessary. No bedrock was encountered. An application rate of 214 FT2/bdrm will be used for the bed. Bed length = 643 FT2/10' = 64.3'. A lot line waiver is requested to I' due to the limited area, Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • Existing Concrete Septic Tank and Lift Station to be used. • 5' minimum between the tank/lift station and bed. 1' minimum to property line from bed. 10' minimum between trench and existing cribs. • 2' of cover and insulation is required for bed; 2" Minimum thickness for insulation. • Tank & solid pipe must be set on well compacted, stable soil. • 4 inch diameter cleanouts with airtight caps are required 1' to 4' from foundation wall, prior to any 90 degree bend in 4 inch line. • All cleanouts must extend to at least ground level. • In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron. • Trench to be placed level, minimum of 4' to groundwater, 6' to bedrock from drain - rock. • Drain rock to be Yz' to 2 '/" screened. Drain rock to be distributed uniformly. • Force main to be 1" Schedule 40 PVC or equal. • Distribution pipe to be 1" Schedule 40 PVC w/ 1/8" orifice @ 18" on -center. Perforated pipe to be installed level with perforations down. • Silt barrier (filter fabric) to be installed above the drain rock. • Smeared bed must be raked or scarified before drain rock placement. • The finish grade must be mounded to promote drainage away from trench. • Insulation must be placed over any pipe installed under driveways or parking areas. • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, • Sewer Service Line is minimum 2% slope. • Septic Tank to be pumped every two years or when required. • Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI/equal) DESIGN NOTES: 1. New Bed Depth At 2'. 2. Sewer Service Line minimum 2 3. 2' Cover + Insulation Over Bed 4. Lots Served by Private Water V 5. No Conflicts Within 200'. 6. Connect To Existing Concrete (Sc Lift Station. Existing L34B Leachfield To Be Abandoned L34A Septic Area 1'/ Slope Lot 34A 1% Slope slope. ells. Tank. / No Conflicts Within 2 1% Slope New Leachfield w/ 1" Schedule 40 PVC 10 Pressure Distribution New Force Main onnect To Existing 64 Lift St. 'e- Existing Concrete Septic Tan 3 Bdrm cH o 1)/� 11, Q y . - Y Co Existing Lift Sta 8100 Existing Well 1'/ Slope 20' ROW & Utility Easement Yarnot Ave 44444 NOR TH RI M 44 4., ENG/NEER/NG' 4 m . *' x:47 PO Box 770724 Eagle River, Alaska 995774 907. 694. 7028 Ih T15N R1W SECTI❑N 4, LOT 34B PLAN WASTEWATER DESIGN LAYOUT REPLACE LEACH FIELD 8/26/14 rE of 3 1" = 40' Existing Lift Station Foundation Cleanout To End -Point of' Existing Cleanout 0 0) d r�J UJ - 5_ U o U1 c o -CO @.) 0 a, 1- o _ • ci- w 0 •ct- c U - 1_1 a -4-, .;--' a ,VI 0 0 D • cf) __.1 -,2 c a.) c -.- C CI "4) CD .CL) Om r do D - 0 U C 0 CD ai cuo0,1.60 -0-0000_4- 0 .E - d( -k _Ey L a Cpb_100 6.1 E: CU wL -a E ck0 G1__," VI W W > 2 0 C 03 .0 (1.) (1-) OU 0 so Ul Isl :: -0c + 75 (1) I- ck c 0 h- cu I a L L 0 CA o - 0) Z - - 01 L v 0-_-; 0 - -0 -, (_) -c -Qccu 3-)cxc z-fr>72c5,--i_p o-cb-10,_ I v) n v) ai _-• v) a 0 < 0 isi la --1 ni ri 4 flN: cd BED END VIEW LJ SEPTIC TANK ........... A. 41 24/ NEW BED DESIGN MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST OA- L a774 77= SLOPE PERFORMED FOR: i �Ag lin %172 rL-31.1 Sec_ 4 s/t rys.44io 6,em'ee LEGAL DESCRIPTION .16' T /a/ft AJoy tree ..)6T-4 cZ-J TJ.. 20 _M PtiO ESSS>> COMMENTS a/✓ , 4 �c ArCdU. PERFORMED BY:r 72-008 (6/79) :ffry ,4s r 1 3X PAR Al ARKA • P(157? . SOILS LOG ❑ PERCOLATION TEST DATE PERFORMED: ZS' J7) WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? /es 0 P 6 " E SITE PLAN fk S' _T_ 441:eaus 3/11 U T.Q I1•I _re 0r `1 D Reading Date Gross Time Net Time Depth to Water Net Drop 141: io PERCOLATION RATE (minutes/inch) TEST RUN pETWEEN -may-. T2� �� T! c+�Sodl i/e�T1 a 6124' ite pl(1 21 Aave C� 1-1 c30 4 -g070 CERTIFIED BY: et a//2s `d DATE: 4! •-•-,• . MUNICIPALITY OF ANCHORAGE (---, f (1 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME 73©igy S �AL .—V 7-,e9 7a PHONE ❑ NEW UPGRADE MAILING ADDRE S j 0, /ox ?:7 7 e-hbLf-ll-4 41{ c. j Z'7 LEGAL DESCRIPTN LOCATION NO. OF BEDROOMS SEPTIC TANK DISTANCE TO: Well Absorption area(J /r Dwelling PERMIT NO. Manutaet ., A7 .s 7/ iv c C mar e / No. of compartments t, Liq. I: in g�lons /TiA'Z� IF HOMEMADE: Inside length Width Liquid depth D0z OZF DISTANCE TO: Well q// j/) �`� `/'� Dwelling PERMIT NO. Manufacturer Material Liquid capacity in gallons TILE DRAINFIELD. TRENCH DISTANCE TO: Well ) Foundation Nearest lot line PERMIT NO. No. of lines � Length of eine Total length of lines Trench width inches Distance between lines Top of ti le to finish grade Material beneath tile inches Total effective absorption area SEEPAGE Lengthars /I. Width /2 / ,i. Dep, h -f / / /so/C PE(JS i1In»o/14 f/ a 7� Type of crib Crib diameter Crib depth Total effective aCbsorptiopargaj/L � DISTANCE TO: Well / /) j f Building foundati / -� Nearest lot line /I /0 ._ w Class "' X/5 7/ti Depth/ ( f� Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Llline Septic tank Absorption area(s) OTHER ss'%=�%�..r®'�®� iti % �/ _- -- , PIPE MATERIALS 0' % • c g_r ,ado .. /, . , . * ,-o- 0 .a f - AWN SOIL TEST RATING e ♦ �i t` /��% / /00 ,•. 1 t� �G14 0116_ fl ' fir. c 7 C /1-' INSTALLER r ° ,-r 9 v A/ E �® cP� o°o No. 1457 - ; It en/ LJ REMARKS 4Yti ®��AttMtiio ES$loN�\'®® / /at/IS 6- Seep /% S l jiC T3Ale�r 0. CO E r l //) ,e /a c - . , S' e -- //d %/t1S6c4A-7Xg Mu Flo M&7eJ 4 (pUp ea-, Ircziil- 1J Dtic , w 1th...: or Po AP . • A. DATE LEGALrs�- 111/i� y� '� % > �///tom f q�si..,�4�Ep )t zTh ALASKA oS5ih 4. : Ip R,6944_29t9 72- 13 (Rev. 3/78) t•1L It -J I C: I!-�HL i T r" or hlC-JC:H 1Fm:F1OE [:DEPARTMENT , 'HEALTH AND ENVIRONMENTAL :OTECTION 825 'L' STREET: ANCHORAGE, AK. 99501 264-4720 ON—SITE SW! L!F°OF:fE'E1 F-EF=Z'Iy I T PERMIT NO. < 321042 ) APPLICANT TODAY REAL ESTATES PO BOX 279 CHUGIAK 99567 LOCATION PART L34 S4 T15NRIW LEGAL PART L34 S4 T15NR1W LOT SIZE 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: DRRtNF}EL-D MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (CO FT BR)= 100 f( THE REQUIRED SIZE OF THE SOIL AE:SORPTION SYSTEM IS: !, CaEF°T1-1= = ILEr40 9-1= =° OF:G IVE:I_ E)EF'Tf-I= THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). TF -IE TFZEt-4C:1-1 t•J I C=aTI-1 I' 2C1_ CC° F=EET_ THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION SIN FEET). PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. --- TWO <2> I NSF' Ec:T I CJr-4S ~MAZE FlgaIDUIFa BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL E:Y THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE I_ 25 FEET AND TO R COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F°EF 1'•1 i TEr :F- I ES C1®_ FtlelaF_ I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED; APPLICANT TODAY REAL ESTATES ISSUED BY T----1NTE V4. 0 PERFORMED FOR: LEGAL DESCRIPTION MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST 0Di",g�� 4L s77477= /127 1 ( L ✓ `%'" 5'cac 4 77s- A-) te) IA) SITE PLAN X. SOILS LOG O PERCOLATION TEST DATE PERFORMED: Z(S' g7 <gf/C rrein/_c 571 -Tr.; 44-10 beadee /J0 5 #i ItJ O/ r g/L 10 12 13 14 15 16 17 18 ywi Ra 20 o2- "<• srr SLOPE WAS GROUND WATER /kJ' ENCOUNTERED? O P IF YES, ATWHAT 6 ( E DEPTH? s'i /J6 S 1 j 51 T Tie ;I e. ei Q • 1;1 0 Reading Date Gross Time Ne Time Depth o Water Net Drop /Al l PERCOLATION RATE (minutes/inch) yr.� TESTRUN/ ETWEEN/ T� Tr COMMENTS a / :C. ' G�-�-��Q4! _ � �J b1 - / �l C S) Vl C / _ ra 6L 4 AlColie �- sa aY> �`e�: %�C�!' (- ��id �V -%O? K. CMZ- ep/ col --/25`U fU 99WC PERFORMED BY:i1:1i . .rg7= ? ?J AS1(A nm77 _ CERTIFIED BY: 694-2973 72-008 (6/79) DATE: RIVER ,Q' - Mary Ann Koehler Dear Mary Ann, EXCAVATION ROBERT A. SHAFER WORK CIVIL ENGINEER 694-2979 September 28, 1982 Reference: Part Lot 34; Section 4; T15N; R1W A sewer system adequacy test was performed on the system located on the referenced property as you requested. The septic tank was pumped and verified to have a capacity of 500 gallons. The seepage pit was full of water. After the water was removed from the seepage pit, approximately 900 gallons was placed back into the system to fill the crib. After a period of 24 hours approximately 35 gallons had percolated out. It will be necessary to excavate and expose the septic tank to further verify its capacity (1000 gallon minimum requirement). I regret to inform you that the seepage pit seems to have completely filled and will require replacement with a new absorption system. If we may be of further service, please do not hesitate to call. cc: Munidipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA unlcipality ®f Anchorage October 3, 1985 (Th P.O. BOX 6650 ANCHORAGE, ALASKA 99502-0650 (907) 264-4111 TONY KNOWLES, MAYOR DEPARTMENT OF HEALTH 8 HUMAN SERVICES Robert A. Shafer, P.E. S & S Engineering SRB 196-X Eagle River, Alaska 99577 Subject: Waiver Request WR85-029, T15N R1W Section 4 Lot 34B Dear Mr. Shafer, This department hereby waives the required 100 foot minimum horizontal separation distance to 92 feet for a sewage lift station located on the subject property to the well on that same property. This waiver shall be considered valid only as long as the lift station housing and associated plumbing remains watertight. This waiver will be revoked in the event that the lift station is found to be leaking or suspected of being less than structurally sound. Sincerely, CV -ewe -x.1 Stephen S. Morris Civil Engineer On-site Services SSM/ljw HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION SYSTEM DESIGN WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN ERT A. SHAFER September 7, 1985 Municipality of Anchorage Department of Health and Environmental 825 L Street Anchorage, Alaska 99501 r1� IL ENGINEER 94-2979 r rse 4 e �(9�r FCO Protection REFERENCE: Lot 34B; Section 4; T15N; R1W Request you issue a waiver for the horizontal separation distance between the well and the lift station located on the referenced property. The septic tank located on this property is approximately 55 feet from the existing well. In accordance with the information available to us, this septic tank was installed prior to June 1973 and was in accordance with the code that existed at that time. As a result of an adequacy test in 1982 it was determined that the seepage pit was constructed in the water table and could not be considered adequate. The log crib was removed and a lift station was installed in its place. A new seepage bed was also installed. The lift station is a sealed unit manufactured from a 30 inch galvanized culvert with a welded steel bottom. The inlet and outlet of the lift station is adequately sealed to prevent intrusion of water or leakage from the lift station. It is our opinion that the lift station is a sealed unit and adequately protects the private well from contamination, therefore the horizontal separation distances prescribed by 18AAC72.021 are not required in this case. Since the existing seepage area is now located on Lot 34A a memorandum of agreement between the owners of Lot 34A and 34B is also attached. If we may be of further service, please contact us. 400 0 /•• A. SHAFER, P.E. S/ss SRB 196X EAGLE RIVER, ALASKA 99577 Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Expiration Date: 6/2-3/-5 Parcel 1.0. 051-072-63 1. GENERAL INFORMATION Complete legal description T15N R1W Section 4 Lot MB Location (site address) 21420 Jill Street, Chugiak, AK Current Property owner(s) Janina Kozinski Day phone 250-1038 Mailing address same Real Estate Agent Audey Mason Day phone 622-3344 2. TYPE OF DWELLING: ® 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 ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class C Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Received by COSA to be released to the engineer, unless otherwise requested by the engineer. Date: -1:2-34-5- COSA 1:a34 S COSAFee$ ata -.so Date of Payment 3I tYlbb 04, Receipt Number 019 k COSA # 05c. t6tcg Date: Date of Payment Receipt Number 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 NorthRim Engineering Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng 6. DSD SIGNATURE System #1 Approved for. 3 bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. Phone 694-7028 Date 3254 ' LOFag eF/F a� F iq9 s-1• '-S.Y Steve . Eng PE 6256 bedrooms, with the following stipulations: �a ON-SITE WATER AND WASTEWATER o= PROGRAM ss();: iftt " r SEt-( .. By: frAl Original Certificate Date: A-3 �.S The Municipality of Anchorage Devlopment Services Division (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory COSA blue sheet_9-1-12.doc X Nitrate Advisory Arsenic Advisory Other 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: T/Si,t2/6V' .SFS'. Parcel ID: 057 Q 72-€j 3 A. WELL DATA Well type P If A, B, or C provide PWSID # Well Log (Y/N) ✓t(' Date completed v/J`L- Sanitary seal (Y/N) Total depth gvA ft. Cased to 40 It ft. FROM WELL LOG Date of test Static water level - ft. Well production g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate / mg/L Arsenic /(`,d ug/L Date of sample: 3/(//8 B. SEPTIC/HOLDING TANK DATA Celt) e Rn Tank Type/Material 2 C/3 / �C7 « ET Tank size /Coo gal. Number of Compartments Foundation cleanout (Y/N) Depression over tank (Y/N) Al Date of pumping t( f�(c� Pumper C. ABSORPTION FIELD.ATA Date installed z7 /c/ Soil rating (g.p.d./ft2 or ft2/bdrm) /. 2 System type - 8. L) Length ' . ,'b ef ft. Width /0 ft. Gravel below pipe B. 9' ft. Total depth Z. 5 ft. Eff. absorption area 600 ft2 Monitoring tube y Depression over field/v Date of adequacy test A/( J Results (Pass/Fail) f For . bedrooms Fluid depth »a,absgrptjon field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenates' treatment (past 12 mo.) (Y/N & type) If yes, give date Wires properly protected (Y/N) /din. Casing height (above ground) AT -INSPECTION 44 el 7. (J ft. g.p.m. Collected by: Date installed .1rare� c/7,3' Cleanouts (Y/N) 1 High water alarm (Y/N) 4, D. LIFT STATION Date installed 196PZ Size in gallons ,SG C5 "Pump on" level at 30in. "Pump off' level at Z/5 Datum 1 c [nn. Cycles tested "y E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on to 3 -- Absorption Absorption field on lot /06 r7` Public sewer main /VA Sewer /septic service line Z 5 '-f• Animal containment areas 50 SEPTIC/HOLDING TANK ON LOT TO: Building foundation / 0 < Property line / 0 '? Absorption field /0 Cr Manhole/Access (YIN) y in. High water alarm level at NA in. Meets alarm & circuit requirements? 7 On adjacent lots On adjacent lots L a art Public sewer manhole/cleanout /Y!4 Holding tank N4 Manure/animal excrete storage areas Ai //00 Water main l O '� Water service line �� Surface water Wells on adjacent lots /0 67r ABSORPTION FIELD ON LOT TO: f Property line Life*. Building foundation (4 r Water main /U/. Water Service line /0 Cr Surface water Q 6 7" Curtain drain /V%} Wells on adjacent lots /00 '¢" F. COMMENTS 5CY s f �r� Driveway, parking/vehicle storage 2 O re -e" G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems am . in conformance with MOA COSA guidelines in effect on this date. Engineer's Pri ted Name =eve eve C Date 37!sfr5 COSA yellow sheet 2-6-15.doc *of OF Alt Art ® -'! ' inose "i p ges fit ii4SP • F* swam w. Eng ,r�s6 a tA�� ]), E. . BLM L23 S 89'52'30"E 135.36' SEPTIC/ PIPES LOT 34A 2 eI1.5' CANT 39.1' 1.0'x1,7' CANT fek z: 2.3'x5.0 LIFT STATION CANT ❑ SEPTIC PIPE I Ne LOT 34B 40,718 s.f. 71.4' 5.0'x4.0' DECK FRONT PROW CANT 5.3' HOT TU3 DECK R-100' PROTECTIVE RADIUS WELL W00DEN ��FENCE l 30.0' W LI -Nr& / 8.4'x10.2' SHED 20' ROW & UTILITY EASEMENTS --- WE ---- aT— PbWER POLE—�/ \‘‘N 89'59'00"W 134.89' YARNOTtL AVENUE J J NOTE: DRIVEWAY LOCATION APPROXIMATE DUE TO SNOW COVER PLOT PLANT AS BUILT X SCALE 1" - 40' GRID NW 1458 Project No. 15-053 Lang & Associates, Inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Registered Land Surveyors (907) s22-4625 fax kenOlangsurvey.com / jonathanOlangsurvey.aom (907) 522-6476 Phone I hereby certify that 1 have surveyed the following described property: LOT 348, Ti5N, R1 W. SEC 4, SEWARD MERIDIAN (PLAT 81-119) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property odjacent thereto. that no improvements on the property lying adjacent thereto encroach on the surveyed premises and that then are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated this the ......... ',c 49Id KENNETH G. LANG • 20 •.IS -520.••0 a ter Xs v N Day of , at Anchorage, Alaska It Ts the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. { MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 2644720 n Date _ �/� Application GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) 2 Location (address or directions) (b) Applicant Name /< 'Applicant Address 1 CH' (c) 4Applicant is (check onejf, Lending Institution :Telephone:Home Owner/builde, Address `. (e) Real Estate Company and Agent Address _-'-- Telephone (f) Mail the HAA to the following, address TYPE OF RESIDENCE Single -Family , Multi Family 0 Number of Bedrooms 3. WATER SUPPLY Individual Well. Community 0 Public 0 attesting to the legality and status. Note: If community well system, must have written confirmation from the State Department of Environmental Conservation 4. SEWAGE DISPOSAL Onsitei�f�Public Community Holding Tank 0 attesting to the legality and status. I Note: fcommunity well system, must have written confirmation from the State Department of Environmental Conservation 5. ENGINEERING FIRM PROVIC i INSPECTIONS, TESTS, FILE SEARCH, B. A AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm , Telephone Address ' SRB 196x Date ' F'"le 'flyer,4laska 99577 /6 8 6 43 DHEP APPROVAL' / Approvedfor' bedrooms by r-� Date Approved D(sapprov ondihon Terms of -Conditional Approval ' .r .-.. r ....- ,. ... <at vv .. .x � •r-. s._l, � ar nr.. 5,.. • ii Rl' _� ..-.. _. .. _ r. -qtr.. CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) A. WELL DATA Well Classification fl MUNICIPALITY OF ANCHORAGE (MOM; HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description•�r �Q.11lur`i� / t/t/ ns -n/1 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION FEB 1 41986 �R.CCEIVsem%D 3 � � %/ If A, B, C, D.E.C./Approved (Y/N) A1L/f— Well Log Present Date Datepompleted Total Depth t A / lased tog Yr' ---.-- Depth of Grouting Static Water Level ( Z -t-1 Yield r vicar./'u`'`7 Casing Height Above Ground Pump Set At LA1C LLA Sanitary Seal on Casing/041j Electrical Wiring in Conduit&Nye Depression Around Wellhead -era Separation Distances from"Well: To Septic/Holding Tank on Lot S On Adjoining Lots Ov'� To Nearest Edge of Absorption Field on Lot I ((9(9C)11-ia' On Adjoining Lots I To Nearest Public Sewer Line It's To Nearest Public Sewer Cleanout/Manhole N— To Nearest Sewer Service Line on Lot t. c Water Sample Collected by 5 S144Gf-P-16`'t ; Date "!L`6 Co Water Sample Test Results SA T! se..9C?v2� Comments B. SEPTIC/HOLDING TANK DATA Date InstalleaCtna_T I'f13 Standpipes,Ik) Depression over Tank.(1I�lj Size IOtJO No of Compartments Air -tight Caps 6/O' Foundation Cleanout c22wr Date Last Pumped 2.--E3.6 II /4 lam- ; for N+t3- Pumping/Maintenance Contract on File (Y/N) Holding Tank High -Water Alarm (Y/N) Separation Distances from To Water -Supply Well ire To Property Line To Water Main/Service Line Course �i Comments * lA:W Septic/Holding Tank S`-1` 3©'' - Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field 30' To Stream, Pond, Lake, or Major Drainage co De -3- T#fir a -(j -re 0 2,1 re ori 00C -date( Page 1 of 2 72-026(11/84) ,y/fcg C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed \U-\9rE 2 - Width of Field lel t Type of System Design 53' t Length of Field Square Feet of Absorption Area 0(0,4 3ED Depth of Field Z i1 Gravel Bed Thickness Standpipes Present (Y/N) Depression over Field („Y-6 Date of Last Adequacy Test z- f Z-8 Co Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well 100 1 +- To Building Foundation sO' f Lot Nl (51 p,�CTOZ\( To Property Line r lk- To Existing or Abandoned System on • On Adjoining Lots 30 1 } To WaterMaia/Service Line 3D14 - To Stream/Pond/Lake/or Major Drainage Course 3014 - To Driveway, $Parking Area, or Vehicle Storage Area Comments Armr C-1-4 b Esna—tier N k To Cutbank (if present) rt D. LIFT STATION Date Installed )n- l`d-62— Size in Gallons "Pump On" Level at 7,1 la ffrlhsc a6TrOi. High Water Alarm Level at 4/0 r /P p . 4r Rite svr-re e. co Tested for 6 Pumping Cycles duuring Ad quacy Test. Meets MOA Electrical Codes OGt 87' (.7.-;a / /fit' /nr4624" /�-'++ Comments fi✓40 4 GUQ/Uv / 5- see se ro 92 ?Q.e/ Dimensions 9 Id " X 5c " Manhole/Access &kr "Pump Off" Level at / '6// crew" /di1 rra lG Vent (Y/N) N '4 G✓P/u( A Gin rr , C/O T4/ UG /98s- ** 98'S ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. 5 & 5 Engineering Signed Date 2" /51— 8E SRL% 196x Company Receipt No. IS Y 3`7 51 isa MOA No kr—c-50 -S Date of Payment 2-144`t5iSa Amount $ t9o_-- Page 2 of 2 72-026 (11/84) .61 ' 03* sr es n R•obod A. Shofar u No, 1.457-E we t. Municipality ®f Anchorage October 3, 1985 P.O. BAA6650 ANCHORAGE, ALASKA 99502-0650 (907) 264-4111 TONY KNOWLES, MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES Robert A. Shafer, P.E. S & S Engineering SRB 196-X Eagle River, Alaska 99577 Subject: Waiver Request WR85-029, T15N R1W Section 4 Lot 34B Dear Mr. Shafer, This department hereby waives the required 100 foot minimum horizontal separation distance to 92 feet for a sewage lift station located on the subject property to the well on that same property. This waiver shall be considered valid only as long as the lift station housing and associated plumbing remains watertight. This waiver will be revoked in the event that the lift station is found to be leaking or suspected of being less than structurally sound. Sincerely, Stephen S. Morris Civil Engineer On-site Services SSM/ljw % �/(//j� � r T O -6,, i l.M1- -..x8 e�a�. � - \_ SUBJECT L 34 <ed. --4j 77c -A.1 /. / tilt/ MESSAGE /3 r- -Qi. 4- s -e• ,c..- eQ i„>e-[ ( i✓2 F R 0 M DATE / / Pot i Ado 22.--/ o 4 Z - SIGNED SIGNED DATE REO(FORM ® 45 472- - PART 3NWILL BESRETURNED WITH REPLY. - POLY PAK (50 SETS) 4P472 Times ^' Time. ^^.n-ee (n�l /�-� 1 0 �C2SL1. Q i_ Li \a4`tOY S l'\Cen X41 6_,LLts Date Date q -eq 1- OE. Date C\ -)L12, '') IS Inspector Inspector P��I II YQ `Pd Inspector MUNICIPA TY C, Comments Conditional Approval=`�� Cite ENVI,rio rAnPist SE RECEIVED T GJ— (V(a.C,, Q ". 9-C ViAlc _��ANCHORAGE '__ _ 1 \ ,i ` <- 1982 CA..,—A . , rsFI �� ' f' Date Sewer Installed .—? _ 2 ki Permit No. Septic Tank Size / a Sa) Holding Tank Size Soils Rating Well To Absorption Area Well to Tank Well Log Received APPLICANT FILLS OUTLOWERHALF ONLY - Property Owner "1"L- /G - S ef W1 IP L I i ni L lit MOO !+ f�I CJC..> L -C - 'a oMailing Address Phone Buyeri _- /C. r: = t = a 1 :Address; Lending Institution r i i' /" ... 7 ` 7 = `2 U , ' 1 Address ' G V i i / � it _ fs 1 -L ---'-i j l i� 1L_ I u /c f.. -pc. 96)3y7 Phone Realty Co.&Agent -/-1Dr-)s) 1r ,_ Ali L14LI Sr TS Al A-) le 1 74 fin A. Acer ii ''-ci Addres9 l..J6k2 9/.->CkiU1,y >� /t�,s�%r 7(7J �7 Pon .- -'/�// Legal Description /-) / t'1;- L' (-_ 1�0 7 41 cc Street Vocation )441/c)AJO ( D/ -&i /c cl— C%EZ: &,,,_-_-,/<„,. -�5 ,l/e'it),E Cei Type ,oj,Residence Single Family I. 0 Multiple Family No. O Other °; "` t, .. t.,..,. 1 _ of Bedrooms- ° r` _ . Water�Suggpiy /15'Tndividual t„.- - ATTACH WELL LOG. A well log is required for all wells drilled since June ❑ Community 1975. For wells drilled prior to that date, give well depth (attach log if / 0 Public Utility available.) Sew eaq 1�sdal la Individual , .:Year Individual-Installed:s' 0 Public Utility When Connected 0 Holding Tank --. .- to Public Utility' NOTE THE INSPECTION FE°EMUST-'ACJOMPANY EACH' 'RE6 IESjS'EFORE PROCESSING CAN BE INITIATED. Mary Ann Koehler WORK CIVIL ENGINEER 694-2979 September 28, 1982 MUNICIPALITY OF AN" CF'T r- ENVIE. -: R..:L:l..:.01 RECEIVED Dear Mary Ann, Reference: Part Lot 34; Section 4; T15N; R1W A sewer system adequacy test was performed on the system located on the referenced property as you requested. The septic tank was pumped and verified to have a capacity of 500 gallons. The seepage pit was full of water. After the water was removed from the seepage pit, approximately 900 gallons was placed back into the system to fill the crib. After a period of 24 hours approximately 35 gallons had percolated out. It will be necessary to excavate and expose the septic tank to further verify its capacity (1000 gallon minimum requirement). I regret to inform you that the seepage pit seems to have completely filled and will require replacement with a new absorption system. If we may be of further service, please do not hesitate to call. cc: Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA