HomeMy WebLinkAboutILIAMNA ACRES LT 2Ci01
—
Municipality of Anchorage
On-Site Water and Wastewater Program • (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP171099 PID Number: 017-101-42
Dwelling: ® Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ® Upgrade
Name:
JAMES & BARBARA BERNER ABSORPTION FIELD
Address ® Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound
14350 Golden View Drive, Anch., AK 99516 ❑ Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
4 0.8 GPD/SF 10 Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot 3 Ft. 7 Ft.
ILIAMNA ACRES 2C Fill added above original grade Gravel length
Township Range Section Varies -.6 - .7 Ft. 54 Ft.
Gravel width Beds: Number of Lines Distance between lines
SEPARATION DISTANCES 2 Ft. Ft.
ToSeptic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist.between trenches
From Tank Field Tank Line 756 Ft2 1 Ft.
Well 100+ 100'+ 100'+ NA NA TANK co Septic ❑ S.T.E.P. 0 Holding ❑ Other
Manufacturer Capacity
Surface Water 100'+ 100'+ 100'+ NA ANCHORAGE TANK 1250 Gal.
Material Number of compartments
Lot Line 5'+ 10'+ 5'+ NA STEEL 2
NA LIFT STATION
Foundation 5'+ 10'+ 5'+ NA
Manufacturer Capacity
Gal.
Curtain Drain NA *50'+ NA NA
Pump on level at Pump off level at High water alarm at
Remarks *None known. Existing tank
decommissioned in place per code. Diverter in. in. in.
installed to new field and original field. Pump make and model Electrical Inspections performed by
PIPE MATERIAL House to tank 3034Tank to 3034
Installer Mike Anderson
draintield
Drainfield 3034 CO/MT 3034
Inspector ARCTERRA BENCH MARK (Assumed elevation) 100 ft
Inspdat sn 15'6/6/17 2"d 6/6/17 Location and description
3'°6/7/17 4th Garage Slab
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engin
., 01,' AI
Conditional Approval: Date `SX) 4.6.
* 4• TI--{ /C -s #
/
I �, KENNETH M. 60/L F'
A
l— — r If 4) lig/7116
e;.
Approved w-- Date ftin(.�;,¢ I'."
eer's Stamp
Inspection Report_9-1-12.doc
AS—BUILT SYSTEM DETAILS/SITE PLAN Permit ❑SP171099
ILIAMNA ACRES SUBDIVISI❑N LOT 2C PID# 017-101-42
INSTALLED NEW 54' L W/ 7'ED TRENCH z
COCASp�A�G
AS?�1F
,4, F INSTALLED NEW
►�•■�• MT M 128450-GAL S.T. 4A•R �
GM _
_.«�. ��' ADD.1 FCO .m"...-..--
.
TH 17-1 1 A 33,5' p'0 ,n
Jiii, ' DIV. • C I cv 10,11, t��,
COs 1 OD CO . `ray `A 3.0'
CSCO COo <,1a� .
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CrAl F l' = la'
C S89-45'06"E 279.20'
N A-C=31.5' 86.60 85.5
1 B-C=65.0'
il A-D=38.0'
B-D=68.5' i FINAL GRADE
o 80.05 80.15 - 79.41"
E A-E=68.0` 0 . . _.. i s
B-E=84.5' 4 FILTER FARRIC........ VARIES
A-F=95.5' o --1250 GAL
H SEPTIC 76.4C-7-C.745).--;' T
B-F=132,0' z, TANK SEWER ROCK T A-G=95.5'
`; B-G=133.5' 79.2 79.0 (69,4 I
Po
(_3.4V KV+
W 411.1:11116:41,0k I 54' I M GROUNDVATER
�' OF , r�+ SCALE' NTS
/��� �� PREPARED FOR: gcTER
,rr.� I ` JAMES BERNER ti `� r
,`o / 1 14350 GOLDEN VIEW DRIVE Z,
* 4• I T. * d* V ANCHORAGE, AK 99516 ;1'1(611
( \
06 E
N / • KENNETH . I y''S . FIELD BOOKS COMPUTED: <
' CE-• . w'� ` eQI ARY:N/A DRAW BMW =
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t j /7 tit STAXINC N/A °Emu): K M D • % . ...1'k''
1 I ,
p "A. ASBUILT: HOLT DATE 6/8/17
11 EESS101114' sis
:k7 ~� ACAD FilL FILE 4243 Pig.: 17-150 LFR K, 9IN0 ..�3s
MUNICIPALITY OF ANCHORAGE CR f
,\ On-Site Water &Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax: (907)343-7997
http://www.muni.org/onsite
ArECUlillif
4NCR ORPGE
On-Site Wastewater Disposal System Permit ;4o
6- -17 6'rr
Permit Number: OSP171099 Effective Date: 5/26/2017
Work Type: Septic Upgrade Expiration Date: 5/26/2018
Tax Code Number: 01710142000
Site Legal Address: ILIAMNA ACRES LT 2C G:3037
Site Mailing Address: 14350 GOLDEN VIEW DR, Anchorage
Owner: BERNER JAMES E & BARBARA J Lot Size in Sq Ft: 37727
Design Engineer: ARC TERRA CONSULTING INC Total Bedrooms: 4
This permit is for the construction of:
Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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
C I 6/64/7 C1& ngc -h-eitch 10 54A Ianj et cQ 7 ' At,"
Received By: Date: s
Issued By: / / Date: 5 2 6 17
MUNICIPALITY OF ANCHORAGE
�„ i
Community Development Department Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On-Site Water & Wastewater Program
ON-SITE SEWERNVELL PERMIT APPLICATION
Parcel I.D.
017-101-42
Property owner(s) JAMES & BARBARA BERNER Day phone 865-6406
Mailing address 14350 GOLDEN VIEW DRIVE, ANCHORAGE, AK 99516
Site address 14350 GOLDEN VIEW DRIVE, ANCHORAGE, AK 99516
Legal description (Sub'd., Block & Lot)
ILIAMNA ACRES LOT 2C
Legal description (Township, Range & Section)
Lot Size 37727 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
tZ all that apply)
Absorption Field Initial ❑ Single Family (SF)
(w/wo ADU)
Septic Tank [I Upgrade Duplex (D) ❑
Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature • •r•• -rty owner or authorized agent)
Permit/Rush Fees: S(e01 Waiver Fees:
Date of Payment: G1aLi 1-1 Date of Payment:
Receipt Number: 09 1 Receipt Number:
Permit No. (i 111099 Waiver No.
Permit App_9-1-12.doc
o �RCTERR,qe
4
ARC
¢ CONSULTING, INC
°*21su.TMG.'.4''s"' 212 E. 51st Ave,Anchorage, AK. 99503
Ak""' Office(907)868-3791, Fax(907)868-3793
May 24, 2017
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Upgrade Sewer Permit - ILIAMNA ACRES LOT 2C
It has been determined that the absorption field of the subject property is
saturated. Subsequently, the owner has requested we proceed forward to obtain
a septic permit to upgrade the septic system.
The general slope of this lot is from east to west at a grade of approximately 7-
12% over the septic area. On May 17, 2017 a testhole was performed to
investigate soils and groundwater. The results of this test are attached for your
review. The proposed upgrade will serve the existing 4-bedroom single-family
residence. We propose to install a deep trench. Groundwater was not
encountered at excavation or at monitoring.
The property and adjacent lots are served by private water. There is no surface
water within 100' of the proposed system and there are no known curtain drains
within 50'. We do not expect there to be any adverse effect on adjacent lots by the
development of this system. If you have any questions, please contact me at 868-
3791 / FAX 868-3793.
Respectfully submitted,
ArcTerra Consulting, Inc.
Fdld,
Kenneth M. Duf
Attachments: On-Site Sewer Application
Wastewater Absorption System Details/Site Plan
Soils Log/Percolation Test
20441 PTARMIGAN BLVD • EAGLE RIVER,AK 99577-8736 • PH(907)868-3791 - FAX(907)868-3793
WELL & WASTEWATER DISP❑SAL SYSTEM DETAILS/SITE PLAN
ILIAMNA ACRES LOT 2C
I I
LOT 2B
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FLAG PROPERTY LIN
a
WELL RADII & EASEMENTS
N PRIOR T❑ CONSTRUCTION scale; 1•= 100'
DESIGN DETAILS PAGE 1 OF 2
4 BDRM X 150 GPD = 600 GPD
600 GPD/.8 GPD PER SQ. FT. <9 MIN/IN.)= 750 SQ. FT
(750 / 2 x <6' GRAVEL) = 62,5 FT, TRENCH
USE 1 TRENCH - 63' (L) X 2' <W) X 6' <D)
ETotal depth of system Is 10' max from original grade.
.2 Total depth of gravel below distribution pipe Is 6' .
S. NO PUBLIC YELLS VITNIN 200' IF
a. IIVVATEPROPOSED YVELLS VITNIN 200' OF NOTES
PROPOSED SYSTEM EXCEPT AS NOTED. 1, VERIFY OR INSTALL 1250-GAL & INSULATE TANK IF <4' COVER.
di PROPOSED YELL EXC PT AS NOTED. 2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM IF < 3' OF FILL.
MIN. 2' FILL WITH INSULATI❑N, >3' COVER NO INSUL REQ.
IR 3. CONTRACTOR WILL ENSURE MINIMUM 2% SLOPE INT❑ SEPTIC TANK,
I 4. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT
2WELLS, SEPTICS EASEMENTS, PROPERTY LINES, ETC,.,
W / c� OF AZ 1Q, PREPARED FOR: gCTER D
or r JAMES BERNER ti
6 -, �� �`� 14350 GOLDEN VIEW DRIVE ,° iirmikr.o..\o * A 9 TH * ANCH❑RAGE, AK 99516
•°° KE D . 9 / F ELD BOOKS COYPUTOkce
CE 71 -/ 4' / BDUNDAxr N/A DRAYNI: BMWlip � �� �� �7/,r
$'� srApNa NSA cNErxEn: KMD ` �j ,_
1 ' �s / ASBUILT' HOLT DATE: 5/22 17 "APrmac' ` ��Dwa FILE: GRID: ! Ch. C .i1
r - i a°
`_ ACAD FELE .toe No.: FR rem OLT I TINGNG ,�.y6 L
FILE 17-150 AK, 99577
WASTEWATER DISPOSAL SYSTEM DETAILS
ILIAMNA ACRES LOT 2C
V.
ia��a
'''�' ON—SITE SYSTEMS TO BE DECOMMISSIONED — VACANT
INr..rM.■
IN.:111r
♦. ,I1
INSTALL NEW 63' L W/ 6'ED TRENCH
CO 1. VERIFY OR INSTALL NEW
:/....1./ ♦ : �12 1250—GAL S.T.
MT IN SAME LOC.
MT AS EXIST. S.T.
c• & ADD FCO
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& ADDL. O
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2 FLAG PROPERTY LINES
WELL RADII & EASEMENTS Scale: 1'= 20'
N 41110.• f��` PRI❑R TO CONSTRUCTION PAGE 2 OF 2
•V s
LI 41..*� 1 PREPARED FOR: CTE D
� 1 JAMES BERNER �R `���
F7' / c.1 fr
1 3.1 GOLDEN VIEW DRIVE X, '
ANCHORAGE, AK 99516
tI IN l �� g ' FIELD BOOKS ccuwreD
o c. 7 wfY / eQUNDAR"'N/A DRAWN: 8MW x, 4N/A a1ECKED' KMD� re amu: HOLT DAlE: 5/22/17 ��F1 ‘, `DW.FILE GM _
Z `_�� ACRD FILE: doe Na: F''k 4'SULTING •�y6'°P
FILE 17-150 AK. 99577'
o �RcTERR� ^ ARCTERRA !��, OF ALAS k
CONSULTING, INC
4 212 E. 515'Ave,Anchorage,AK.99503 / � • Thi ` Y #
Office(907)868-3791,Fax(907)868-3793 '" ,
..,'.' k 99G.'H.,° , k NNE7'H Id18. Al
SOILS PERCOLATION TEST � P
4 4��[C71 ''''i
Performed for: TAMES BERNER Date Performed: 5/17/2017 lik.`\L'Ill'f
Project: ILIAMNA ACRES LOT 2C TEST HOLE# TH 17-1
Depth
(Feet) SEE ATTACHED SITE PLAN
.. a:�� FOR HOLE LOCATION
1_14,41-terOrg/OL
``ft, t• Was Ground water encountered? NO What depth? NA
2-� ,
Y" x, Depth to water after monitoring? Ute( Date? 5/24/17
3- ..
4-
' SM/GM Reading Date Gross Net Depth of Net
5- .d T ' Time Time Water Drop
6- 1 5/23/17 1:00 - 6" -
7- 2 1:30 30 min 2 12/16" 3 4'16"
x- 3 * 1:31 - 6"
9 4 4 2:01 30 min 2 13/16" 33116"
10 5 * 2:02 - 6"
11 6 2:32 30 min 2 12/16" 3 4/16"
12- ' 7
•
I. 8
I1 9
I� 10
16- 1301-1 11
17- 12
18- * Water Added
19-
HOLE PRESOAKED Percolation Rate 9 (min/in) Perc Hole Diameter 6"
20- PRIOR TO TEST
Test Run Between 5 feet and 6 feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State
and Municipal guidelines in effect on this date.
MUNICIPALITY OF ANCHORAGE
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
'~AME
PNONE 66 ~NEW
w!, / (
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION
Well ~o~.~'*~bsorption area , Dwelling ~, ~ o~ PERMIT "~'¢0~" ' 0
~ DISTANCE TO: ¢/~ I~''W ~ ,%- Z~'
~ ~ Manufacturer
~ ¢ ~ ~,~. Material~ ~ ~4~0, ~o. of compartments
Liq. capacity in gallons Inside length Width Liquid depth
I /~-~ IF HOMEMADE:
~ ~ DISTANCE TO: Well Dwelling PERMIT NO.
0 ~ ~ Manufacturer
% -- ~ Material Liquid capacity in gallons
~ Well ~e~.~4c~6~ Foundation ~ ~ ~ Nearest lot line PERMIT NO.
:~ ~ ~ No. of lines Length of each line Total length of lines Trench width Distance between lines
~ ~ Top of tile to finish grade ·
~ ~ / Material beneath tile . Total effective absorptign area
Lengtb Width Depth
~ ~ . Type of crib Crib diameter Crib depth Total effective absorption area
m DISTANCE TO: Well Building foundation Nearest lot line
M Class ~ Depth Driller Distance to lot line PERMIT NO.
~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
OTHER
SOIL TEST RATING
I NST~LER I ....... ~
~s~,.~s -I ~'"¢' I
..WELL LOG
Date Drilledl
Static Water Level x:o feet
Gallons Per Minute
Draw Down ~? / ;' feet
Total Feet of Casing,,. 63
Type Material Drilled~
0 feet
to
Hefty Drilling
S.R.A. Box 1553 H
Anchorage ,Alaska
99507
MUNICIPALITY OF ANCHOP, AG~
DEPT. OF HEALTH &
ENVIRONMENTAL pROTECTION
RECE[VED
PJi!!RMIT !
1.,A I t~:: ..... I ..............
CONTAi:T'F PI'"iONI~!: ::
I.:.. O T !3 1 Z E:
MAX BE?!}I:~OOME;::
[.. LE .,I .... N iA
I. .......... i s'l: ~=-q"l I::)e 1 c),'...,t ar' c.., thc) c:)p'L :i. on s aw~ :i. ]. ,':':~1::) 1 (a 'L (:) you :i. n ,., ,..... =:, .t c]'~ ", '"" ....... ] ,. .] vc,..tr' septic
sys'!:.em, (:;hc:~c:)se 'Lhe c:q::rL :i. on tha't:, bi::~st f :i.'k.':'~ y(:)~ - site.
Il I ,. l_ Ii .il [ .., I, ]I It,,.,,11.,, '~'~]' I=::: t~!:-~ ..,,.. ~'' I1'",t[
DEF:"T'H TO F:' ]: I:::'IZ BCFI""I"OM (F:'T.)
GFIf~VI!EI.. DEF::'TI~ (F:]".)
'T'ETFAI.... DE]:::'TIq (l::'1".)
GRAVIi!]_..' N]:DTH (I:::'T,)
GRAVI!!!L.. LE:NE')TH (F:"F,,
(:':~l::d:%,"E].... VOL. UMIili: (CU., YDS, )
'T'ANK [31' ZE (GAL..S)
SO I I.... RAJ" I NG (,E;Q ,, F:'T. /BF;'. )
GRAVEL I........[ {::~ I, I > , ,.. F:]",, l.~[:: ..J.I I,,,., [I., L I .. r' '... [i... I ''''1~ (NOT I ......... I .......... II''IG F:''T ~::'C'''''' ~
TANK MUST HAVE A] ..... ' ........ ~' .......... ''''':
''...l''..fi':.'l 'T'WO [ .... II PI~IHI::''I .....
]: Cel"L:i.f'y that::
:[.,, :!: am fam:i.t:i, ar' ~,..!:i. th the r'equ:i. Pemen'L.::; for' C)l"V'-.i:;:i.'L,':'.] ::E;e~;~a:r's ar'id Wa::l.:l.:::;
fc):'Lh I:)y 'l'.l]a, Mun:i. cil::)al:Lty (::)F Ancl'-~oP-.':~.~:l(a (]"IOA) and 'l:.h,~:~ EH:ate of :::::::::::::::::::::::
::':~,, :1: w:i. ll :i. nsta:l.:t, tl"le system :i.n =============================== v~:i.'l:.h a:l.:l. N(]A cc:K:h:.~::; and
air'Id J.r'l cc:imp]. :i. ance ~z,~:i.'l:.l'i 'LI]e d:Ls:i, gr] c::P :J. tE.)P :i.a of 'Lb is I:::er'm:;~t,,
3,, :1: w:i.l:l, adh(.':)r.e 'Li::) all MCIA and State! of A:l. aska r'aqu:i.r'c~mc:~n'ks .ri:Jr' 'k.l':(.:: ::lie'S.. l::)acl.::
(::1 :i..'.ii;'{:.,~:lr}E:i.:as {' pt]fl'i ,::w]')/ (::~;.,' :i. st :i. FI,L.':J !,',~[~:1, :L s ~,'.~ E: :: 'i: (.::q*,~ a'l:, c], l" i:J :i.'::,l::lc)':::a]. sys'i:.e:,)m c:)r' pub ]. :i.c
i::e.,wl::.H"age sy:::;t..em on 'l:..h:i.s ch' ,'::',ny <":q::ljac(::ent't::H'. r'}(::.)ar'by :l. (:)'i:. ,,
4,, ]: L~r'll::le:.,r'i:yi:.<':~.FlcJ tl'lat 'k. h J.!i:: ]::)(:::,pm:i<t :i.s v&].:i.d {-'l::m .::). mi:':u.::i, mL:fi-'~ o{' ,z[. l:)E)i::ir'E)(::)im:i~
any (.:::,r::t. ar'g,:.ement {.,-~J.t]. r'a)(::lL.lJ.i'a.:, ,':':u~ a(::Idit:i.c)r~al pa)Pm:i.'l:.,,
IF' A L.IF]" S'I"ATION IS IN.C_'iFI"ALI...E:D :i:1~.1 AN AF~'.E:A r~r'~; ........
......... ' ,::.,", :: ,., BY ME)A BUII._DINE~ "p¥'~:::'c)
I',,:::.1,1 (LI). AN I::~ I::: .,II~.IL, AL Fq!'~RMIT aND ].,.ICA L~J.,I I(]N MUE;T l':')li!i: ,..,kc'~=:V~"~" ', ,-~.1.[,.[...I.),:" C:?) ~..~' :'.'. .... I.,.t.I, ........ "r'c:~
,,t I ,....1.... I',![::)'l" t':!:[!~ AF:'I::'RC)VF:" .............................. ) H I 'THOUT AN E]..E:CT!::;'. ]: [' Al "~' <~ :'~ ........... r',,,' ,,,~r,:::. ......... ::'F r:',~ ......,, AND ¢:':!;~. .... THE:
EL.I!!!)::7,'I"R]:CAL bl~ .... ....... '~ ... MUST BE: DONE~ FY A L.I." c.[:.~.:.l.,,:d:::.l.~, '"' ''~ L..L.,.X., 1 ,~:[CT::' ~:::' """~:"' , A,',.,,
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
SOILS LOG
PERCOLATION
TEST
PERFORMED FOR:
DATE PERFORMED: 5/ tq~ //~:~--~
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16-
17-
18-
19
20
COMMENTS
PERFORMED BY:
72-008 (6/79)
SLOPE
SITE PLAN
WAS GROUND WATER S
ENCOUNTERED? ~ o OL
P
E
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
5/~ ~°~5 ~ , ~.5
I~qfl IM , o5 .~o
io5o ~ , -z g
,1'~
1~o5 '- '2';l -
PERCOLATION RATE I '~ '/~- (minutes/inch)
TEST RUN~ETWEEN q . PT AND ~'/Z. FT
CERTIFIED
•
• GE BL
• .'� Municipality of Anchorage
On-Site Water and Wastewater Program
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 017-101-42 Expiration Date: [ r— 17
1. GENERAL INFORMATION
Complete legal description ILIAMNA ACRES LOT 2C
Location (site address) 14350 GOLDEN VIEW DRIVE,ANCHORAGE, AK 99516
Current Property owner(s) JAMES & BARBARA BERNER Day phone
Mailing address 14350 GOLDEN VIEW DRIVE,ANCHORAGE,AK 99516
Real Estate Agent Day phone
2. TYPE OF DWELLING:
Z Single Family (wlwo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
TYPE OF WASTEWATER DISPOSAL:
4. TYPE OF WATER SUPPLY: Individual
Individual Well ® Holding Tank ❑
Individual Water Storage ❑ Community ❑
Community Class Well ❑ Public Sewer ❑
Public Water System ❑
WaiverNariance request for: Distance:
Received by: i �i/moi /�,�_ Date: /
COSA to be released to the engineer, unless w- ,,;t•-,requested by the engineer,
COSA Fee $ U$.5b Waiver Fee $
Date of Payment (P/q`i Date of Payment
Receipt Number 0,36 La) Receipt Number
COSA# Oaer ig3fo 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 ARCTERRA CONSULTING, INC. Phone 868-3791
Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577
Engineer's Printed Name KENNETH M. DUFFUS Date /i812017
THIS COSA DOCUMENT CANNOT BE USED TO TRANSFER TITLE UNLESS ALL VENDORS(ENGINEERING,SURVEYING,CONTRACTORS,ETC...ASSOCIATED
WITH THIS COSA ARE PAID IN FULL AT OR BEFORE CLOSING. Engineer's Comments. This investigation was completed in compliance with
ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested.
The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use,
local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the
system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the
control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function
satisfactory for current or future occupants or can ArcTerra guarantee that no unseen +�\Ntk
encroachments,deficiencies or discrepancies exist. Air OF Q1
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6. DSD SIGNATURE / -4161114—Wr
System #1 Approved for bedrooms. �' •"7
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System #2 Approved for bedrooms. + 1ra �i 0 ,T;
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Disapproved. \ ' ,tbE:,r•.:;`''' .•
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Conditional approval for - bedrooms, with the following stipulations:
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--;C\A„, Original Certificate Date: C---/-- 7 _
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_10-10-12.doc
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: ILIAMNA ACRES LOT 2C Parcel ID: 017.101.42
A. WELL DATA
Well type PRVT If A, B. or C provide PWSID# _ Well Log (YIN) Y
Date completed 11/24/1984 Sanitary seal (Y/N)Y Wires properly protected (Y/N) Y
Total depth 63_ft. Cased to 63 ft. Casing height(above ground) 24+ in.
FROM WELL LOG AT INSPECTION
Date of test 11/24/1984 5-17-2017
Static water level 40 ft. 47 ft.
Well production 16 _ g.p.m. 4.7+ g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 mL Nitrate 4.24 mg/L
Arsenic: ND ug/L Date of sample: 511712017 Collected by: ARCTERRA
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL Date installed 6/6/2017
Tank size 1250 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 NA-NEW TANK Pumper
C. ABSORPTION FIELD DATA
Date installed 6/612017 Soil rating (g p.d./ft2 or ft2/bdrm) 0.8 System type DEEP TRENCH
Length 54 ft. Width 2 ft. Gravel below pipe 7 ft.
10-5 Ss a
Total depth/t. Eff.�u'absorptions area 756 ft2 Monitoring tube Y Depression over field N
Date of adequacy test NA-NEW FIELD Results (Pass/Fail) For bedrooms
Fluid depth in absorption field before test in. Water added gal. New depth _ in.
Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & 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 100'+
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main 10'+
Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain 50'+(NONE KNOWN) Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that 1 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 date. r OF A
Engineer's Printed Name KENNETH M.DUFFUS /<Si (4 t
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`00A SHANE 4, NO CORNERS SET THIS DATE
VO4%ov••. LS-6914 .-•ay�0 HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY
".�Pro/eesion>•l�ao SURVEY ORDERED BY fff OF THE FOLLOWING DESCRIBED PROPERTY
DAR�O�poo� '4 KE ERWL�A�MS LOTS 2B AND 2C, ILIAMNA ACRES SUB.( PLAT 84-396)
+ ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE
VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN
THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS
CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS:AND IS EXIST OTHER THAN NOTED.
NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES,IMPROVEMENTS,OR FENCELINES. DATED AT ANCHORAGE,ALASKA THIS 7TH DAY OF
EASEMENTS OF RECORD.OTHER THAN THOSE APPEARING ON THE RECORD PLAT.ARE NOT SHOWN
HEREON(UNLESS INDICATED) _JUNE , 2017.
NOTE, FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DE TERMNE
PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. HOLT LAND SURVEYING
ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. 9309 GROVER DRIVE
ANCHORAGE,AK 99507
13571, FE 1E2-51,183-3 345-5513
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIROh%iENTAL HEALTH
DEPARTMENT OF HEAl,TH AND E~IRO~ENTAL PROTECTION
APPLICATION FOR I-DEALTH AUTHORITY APPROVAL CERTIFICATE
General informat, ion Application Date
(:~.) Legal Description (include lot, block, subdivision, section, township, range)
Iliamna Acres Lot 2C Sec 33 TllN R3W
Location (address or directions)
Goldenview Drive north of Rabb_~ Creek Road.
(b) Applicants Name DANMAR Const. Telep!~one ~' Home Business 344-8042
Applicants Address DANMAR Const. c/o GEOI,AB 1131 E. 76hh Ave. Anchorage,AK
(c) Applicant is (check one) ]Lending Institution nl; Owner/builder ~ ;
Buyer -~--1 ; Other ~ (explain);
Telephone
Colonial Mort~at2d~%
701E. Tudor Rd.
(d) Lending Institution
Address
(e) Real Estate Coo & Agent
Attn: Nancy. Green
Heritage__Homes Attn: Dale Riordon
Address
(f)
Telephone
Mail the HAA to the following address:
DANMAR Consto c__q~o GEOLAB
1131Eo 76~h Ave. ~10___~1_
Anchoraq~ Alaska
2~ T~e of Residence
Single-Family~
Number of Bedrooms
3. Water Supply
Individual Well~
Other (describe)
Community ~--~ Public
Note: If community well systam~ must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
S__ewag e~
Onsite ~ Public ~ Community ~-i[ Holding Tank
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
[Page 1 of 2]
Engineering Firm Providing Ins__.__~ction.s, ~es.t.s~ File Search; Data and Informat!.~o~ ~:
As certified by my seal affixed hereto and as of the validation date shown below,
verify that my investigation of this Health Authority Approval shows that the
water supply and/or wastewater disposal system is safe, functional and adequate
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
investigation and inspection, the on-site water supply and/or wastewater disposal
system is in compliance with all Municipal and State codes~ ordinances, and regula-
tions in effect on the date of this inspection.
Name of Firm GEOLAB
Address
1131E. 76th Ave. ~101, Anchorage,_ Alaska
Date 5/17/85
Reco~nend Condi%ional Approval, pending inspection
of final grading. (ENGINEER SEAL)
DHEP Approval
Approved for
Approved
bedrooms
Disapproved
Conditional
CAUTION
THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND E~IRO~NTAL PROTECTION
(DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT~
ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED
IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PL~CHASERS OF HOMES z~qD
THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE-
MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A
CERTIFICATE IS ISSUED. THE MO~ICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS
OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK.
(DHEP SEAL)
RR4/ej/D18
[Page 2 of 2]
7-19-34
ae
MUNICIPALITY OF ANCHOP, ADE
DEPT. OF HEALTH &
MUNICIPALITY OF ANCHORAGE (MOA)~'NVIRONMENTAL-
PROTECI1ON
HEALTH ADTHORITY APPROVAL (HAA) ~A7 ~ 2 1985
CHECKLIST - FEBRUARY 1984 R E C E IV ED:'
Legal Description: Iiiamna Acres Lot 2C
Sec. 33 T11N R3W
If A, B, c~ C, D.E.C. Approved(Y/N)
Date Cc~pleted 11/24/84 Yield 16gpm
63' Depth of Grouting. none
Pump Set At
Well Classification Individual
Well Lcg PResent (Y/N) Yes
Total D~pth 63 ' Cased to
Static Water Level 40'
Casing Height Above Ground 2'
Electrical Wiring in Conduit (Y/N) Yes
Separation Distances frcm Well:
To Septic/Holding Tank on Lot 100'
Sanitary Seal on Casing (Y/N)Yes
Depression Around Wellhead (Y/N) No
To Nearest Edge of Absorption Field on Lotlt5'
To Nearest Public Sewer Line NA
Cleanout/Manhole NA To Nearest Sewgr Service Line on Lot
Water Sample Collected By D.Stanley ; Date 5/15/85
%
Water Sample Test P~sults Satisfactory-
CO~JiL~nts
~ On Adjoining Lots 100' +
; On Adjoining Lotsl00'+
To Nearest Public Sewer
NA
B. SEPTIC/HOLDING TANK ~ATA
Date Installed 11/26/84 Size 1250 No. of C~,%~artments 2
Standpipes (Y/N) Yes Air-tight Caps' (Y/N) Yes Foundation Cleanout (Y/N)Yes**
Depression over Tank (Y/N)Yes** Date Last Pumped NA new
Pumping/Maintenance Contract on File .(Y/N) NA ; for
Holding Tank High-Water Alarm (Y/N) NA Temporan!; holding Tank Peri,dr (Y/N)NA
Separation Distances f~om Septic/Holding Tank:
To Water-Supply Well 100' To Building Foundation 23'
To Property Line 60' To Disposal Field 5'
To Water Main/Service Line NA To Stream, Pond, Lake, c~ Major Drainage
Course NA
Comments ** Foundation Cleanout is buried until final grading is completed.
Sliqht Depression over tank ~ill be filled when final grading is done.
Receipt 9
Date Paid:
Amount: ~
[Page 1 of 2] 2-15-84
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata 177 sq.ft./BR
Date .Installed 11/26/84
Width of Field 30"
Square Feet of Absorption A=ea
Depression over Field (Y/N) Yes** Date of Last Adequacy Test
Results of Last Adequacy Test NA
Separation Distano9 f~om A~sc~ption Field:
To Water-Supply Wall 115'
To Building Foundation
Lot NA
To Water Main/Service Line
Type of System Design Trench
Length of Field 77 '
Depth of Field 4'**
Gravel Bed Thickness 5'
770 sq. ft ~ Standpipes Present (Y/N) Yes
NA new
To Property Line 39'
To Existing or Abandoned System cn
; On Adjoining Lots 100'+
NA To Cutbank(if present) NA
To Stream/Pond/Lake/ct Major Drainage Course NA
To ETiveway, Parki~lg Area, or Vehicle Storage Area
Cor~rents * *
45'
Depth of field will increase to 5'-6' after final grading.
Slight depression over field will be filled when final
grading is completed.
D. LIFT STATION
Date Installed NA
Size in Gallons
"P~ On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles c~,~_ing Adequacy Test.
Meets MOA
Comnents
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or confo~T~d to all MOA HAA Guidelines in effect
on the dat~ of ~.his inspection.
Signed ~ .~. ~c~-~-7 Date
Company GEOLAB / MOA No. ST85-007
KB1/d5/s
[Page 2 of 2]
2-15-84