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Home My WebLink AboutKNIK HEIGHTS BLK C LT 3Knik Height Block ¢ Lot 3 #017-034-03 Municipality of Anchorage ..3'.'- ". Development Servlces Department :** ~". Building Safely ~vislon '~ O~Site Waler and Wastewater Program. 4700 S. Bvagaw St.~.. P.O. Box 196650 Anchorage. AK 995196850 Page / of~) www.d.anchomge.ak.us (907) 343-7904 ON-SITE WASTE'WATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number, SW050106 PID Number, 017-034-03 Name: Ray & Dianne Cunningham Wastewater System: [] New [] Upgrade 12500 Shelbume Road ABSORPTION FIELD LEGAL DESCRIPTION s~..w 0.8 Gi~:~Fi~ I N.8.5'/S.8.5' ~,. ~"~ C ~ 3 a~,,,~: Knik Heights N.4.5'/S.4.6' ~,. N.4.0'/S.3.9' ~,. N.1.0'/S,0.5' R, 40+38=78 FI, Well: r-INew I-I Upgrade c.,,~,,~. 5.0' ,. """~"'~":2 F~. Ft 773 ~, F810/ASTM D3034 ~t Arctic Mtn Development 10/11/05 TANK SEPARATION DISTANCES E] Sep,¢ [] H~dlng E3 S.T.£.P. [] (~h~ ~ Septic A~.~,loli~, Lift Holding 'ubac/P~ate ~a~,~ Tank Field SlatJon Tank Se~er ~ Greer (1995) 1250 w,, 115' 145' N/A NIA 106' '"'~'Steep ~2 ~ ~.~w.. 100'+ 100'+ N/A NIA ~ /I LIFT STATION L~Un. 51' 12' NIA N/A/~ '~" N/A ~, ~'~ 5.5' 30' N/A N/A '~" "'~"~'~ '~'~ ~ ~"~'~ I Tank inspected and found in good condition. . ,;5 ~ BENCH MARK Moved to new location. Old seepage pit · -, '::" ~, Garage Floor decommissioned in place. Old trench~s ',' 102.63 excavated & backfilled with sand. Contaminated" .,~Cy ;" ' material buried on site. . ,' q "" ' Engineer's Stamp Inspec'tion$ I:~dormed by: Cindy W. Ellis. P.E. Dates: 1'~ 10/t0/2005 Department Approval~,~ ~.-~.~'~~,~ Development Services Reviewed and Lot 2 o WELl. 10' UTILITY EASEMENT FRAME BUILDING ^ EXISTING ~ 4 BR HOUSE . -- .-~ Lot 2 well radius ~, \-, ~:,-,.'~- ... ,~FCO ~ ----_. _J_ 1250 gal Steel Septic Tank Flow Splitter CO.~,., / Lot 4 we'~rl-- radius 10' UTILITY EASEMENT WELL A B FCO S4.5 8.2 STI 49.8 8.6 s'r2 45.8 14.4 DCO 44.3 17A FS 51.6 40.3 COl $0.2 40.8 C02 33.7 64.5 CO3 61.2 55.2 CO4 51.5 75.6 MTI 48.0 43.2 M'r2 60.0 57.3 Based apon a survey by Shane A. Holt LS-6914 South Property line was flagged prior to construction AS-BUILT Knlk Heights, BIk Q Lot 3 Record Drawing of SepUc Upgrade ~:'" ~ '"~'0 Ray & Dianne Cunnlngham Watkins Engineering, ~ ~."'49 TH~~ '~ Parcel ID: 017~34~3 ~.~.[ ...... ~f ["'~i[~'~.'[[u~ 'i"'~, Ondy W. Jills, P.E RO. Box 11044~ ~ -. .. ,.~ December 8, 2005 Anchorag~ Alas~ 99511~443 ~ale I inch - 40 ~ ~one (907) 349-1851, Fa~ (907) 349-1934 Splitter Final Grade100.97 Top of Tank , , ~ 97.29 I~FUIATION I I 1250 Gallon ~ 96.85 Steel Septic Tank 96.53 C02 tlTI COl North Trench ~ Final C;rade = 93.07 - 95.14 ~ ~ U I X of P, e 89.94 I ~ Sand oD.~ I N II Note: Test Role BOtto~~ono ,Bottom of ~ITI Relative Depth: 79.59 "'me~s~ti~' · 85.59 ~o Water. 80.66 Original 6rade = 93.02 - 91.09 Top of Sand Note: Test Ilole Relative Depth: 79.79 No tater. South Trench CO.I 1,172 C03 FILTER FABRIC + INSUL'~TION - I I I ~ Top of~?e 90.04 IH Sewer Rock t"0 PIPE ~ LFSBUNG SAND ~ Invert of Pipe ~'~ N 89.69 I" 380' Note: 0Id trench was excavated and contam,natcd mater,a, AS-BUILT removed. N.T.S. Original Grade = 93.60 - 91.29 Bottom of 1,IT2 86.01 82.89 Knlk Hetghb Block C Lot 3 ~-¢-~-'~'~'%'~"%%%,,.~,-~.~ Record Drawtng ofSepUc U~dc~ ~ Ray & Oianne Cunnlngham Watkins Engineering, Inc 9 z~ Parcel i~ 017~34~3 ~"7~'::)'"i~2/:~::"":'" Pe~it No. ~050106 ~: : ~oYw ELLa Cindy W. Ellis, RE RO. Box 110443 ~tt; ". tt cE - ~oszz .. b~., ... .. ,.~ December 15, 2005 Anchorag~ Alaska 99511~443 ~.. ............. Not to ~ale ~one (907) 349-1851, Fa: (907} 349-1934 ~(~: ........ MUNICIPALITY OF ANCHORAGE Development Services Deparlment 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 Date Issued: May 03, 2005 Expiration Date: May 03, 2006 Permit Number: SW050106 Legal Description: JKNIK HEIGHTS BLK ~: C LT2 3' Design Engineer: 0844 Watkins Engineering, Inc Owner Name: RAY & DIANNE CUNNINGHAM Owner Address: 12500 SHELBURNE ROAD ANCHORAGE, AK 99516-2919 Parcel ID: 017-034-O3 Site Address: 012500 SHELBURNE RD Lot Size: 43500 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage 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. Received By: Issued By:. Date: Date: ~'/?/o ~ Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/VVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 017-034-03 Permit Number SW Property owner(s). Ray & Dianne Cunningham Mailing address (1)12500 Shelbume Rd Day phone Mailing address (2) Anchorage, AK Legal description (Lot, Block & Sub'd.) Knik Heights, Block C, Lot 3 Legal description (Section, Township & Range) Lot Size 43,500 Acres/Sq. Ft. .Zip Code 99516 Number of Bedrooms 4 THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool [] Well Only [] [] Water Storage [] [] Jacuzzi [] [] Water Softening Unit [] [] I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. {Signature of properly o~ner or authored agent) Permit Fees: Date of Payment: Receipt Number. (Rev. 12~O) Waiver Fees: Date of Payment: Receipt Number: Watkins Engineering, Inc. P.O Box ~10443, Ancho[age, AK 995~! (907)349-1851 cwellis@g¢i.net April 29, 2005 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RE: Knik Heights, Block C, Lot 3 Septic System Upgrade To Whom It May Concern: Attached please find the application and supporting documentation to upgrade the septic system for the referenced 4 bedroom house. The existing septic system was installed in 1972 and upgraded without a permit in approximately 1995. The added drainfield was recently exposed to document the construction, and it was found to be unacceptable. A new 1250 gallon steel septic tank was installed in 1995, which was exposed and confirmed to be in good condition, although it is not level. It is proposed to move and reuse the septic tank and to rebuild the drainfield in the same vicinity as the old one. Two test holes were dug on April 14, 2005. Test hole #1 was dug downhill from the existing drainfield, as shown on the attached site plan. This hole was found to be unsuitable for a soil absorption system, with no permeable soil layer of at least 2 ft thickness occurring 6 ft above an impermeable layer encountered at 12 ft. Test hole #2 was dug in the vicinity of the existing drainfield, and it encountered the old trench between 2.5 ft and 4.5 ft. The percolation bench, to the west side of TH#2, encountered fill and silty gravel in the area where the trench was located in the test hole. A percolation test between 5 and 5.5 ft resulted in a rate of 5.3 minutes per inch. An application rate of 0.8 gpd/ft' is used in the design. The bottom of the test hole was at 14.5 ft with no water while digging or after 7 days of monitoring. It is proposed to excavate the existing shallow trenches and any contaminated material and backfill (if necessary) with clean sand to a maximum depth of 8.5 ft. Sewer Upgrade Permit Application for Knik Hts BIk C Lot 3 Watkins EnglneeHng, Inc.; April 29, 2005; page 2 Proposed Soil Absorption System: 4 Bedrooms x 150 GPD/BR = Drainfield Type: Application rate: 600 GPD / 0.8 gpd/ft~ = Maximum Depth: Effective Depth: Reduction Factor: Length Required: Design Length: 600 GPD 5-wide 0.8 gpd/ft= 750 ft= required 8.5ft 4.0ft 0.50 75 ft 2x38ff There are no surface waters or private wells within 100 ft of the proposed septic system. I am not aware of any adverse effect that this upgrade would have on any adjacent properties' water and wastewater treatment needs. Thank you for consideration of this permit application. If you have any questions or need further information, please call me at 349-1851. Yours truly, Cindy .Ilis, P.E. President " i I ' / k~ I ~ ./ J~ I / I' ,' rebuilt in same are~ ' i I Knik Hts., BIocL C -t , Knik Heigh~ Block Q Lot 3 =-~ ~'~ Proposed Septic Upgrade - Site PlanWatkins Engineering, Inc. e~..'" /,"qeh; ~.~ _/,.,'V' -< ~,'~ "."'/" ';:. Ray & Dianne Cunningham ,ts ,~.." 49 TH ,/ .~ '"'~" Parcel ID: 017-034-03 i....: ....... :.: ........ :.. , CindyW. Ellis, P.E. P.O. Box 110443 y~,: : C,n~¥ W. ELLIS .: (b'°~ ". dE - 10577 .' April 29, 2005 Anchorage, AK 99511-0443 ~.,~..,, ......, .....' ,..¥,- Scale 1' - 100' Phone: (907) 349-1851 Fax: (907) 349-1934 ~'~,,........... Lot '14 well radius Sept~Tank unsuitabl ~ S 89°58'00"W 300.00' Proposed: J (2) 5x38 trenches, 4 ft effective. DESIGN DETAILS 4 BR, 600 GPD 0.8 gpd/ft2 Requires 750 ft2 5-Wide Trench 4 ft effective, RF = 0.50 2 x 38 ff long= 760 ft2 Max 8.5 ft deep N 89°58'0 TH#2 300.00' Existing ~ 1250 gal Septic Tan~-- to be moved ~'Seepage Pit - to be Lot 2 well radius Lot 4 · ~,~' well radius shallow trenches to be excavated. Any contaminated soils to be removed and backfilled with clean sand. TH#2 Fill ' Old trench from 2.5 - 4.5' Silly gravel 14,5 BOH No water Proposed 5' w~de Tmnch 4.5 ~J4# perfpipe . °wet NTS Knik Heights, BIk C, Lot 3 ~_~: ~'~"" OF_A/." ~c~:~-. ~..,,~ Proposed Septic Upgrade Watkins Engineering, Inc ...... Ray & Dianne Cunningham ~" 49 ~"?"~ ~' w. Cindy W. Ellis, P.E P.O. Box 110443 ~.~ '*. April 29, 2005 Anchorage, Alaska 99511-0443 Scale I inch ~ 40 ff Phon~ (907) 349-1851, Fax: (907) 349-1934 -~:~,~;_~-2~ Pertormed For:. Lngal Description: Municipality of Anchorage Development Services Department Building Safety Division On-Site V~ater end Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 v,,ww.munLoeg/onsile (9O7) 343-7904 Soils Log - Percolation Test Ray Cunningham Knik Heights, Block C, Lot 3 1- Silt' 4- 11- 12- IZ.,D 13- 14- 15- 16- 17- 18- 19- 20- Date Performed: 4/14/05 Township, Range, Section: Site Plan WAS GROUND WATER ENCOUNTERED? NO S L IF YES. AT V~dAT DEPTH? -- O Depth to Water After p Monitoring? E ~le:. 4-21-05 Reading Date Gross Time Net Time Depth to Water Net Drop --........ PERCOLA~O61 RA~E ninuleshnch) PERC HOCE DIAMET~ R TEST RUN BETWEEN irt AND FT COMMENTS No percolalion lesl conducted, due to lack of 2 It of nath~e accepfin~ soits. PERFORMED BY: Cindy W. Ellis I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE W1TH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Municipality of Anchorage Development Services Department Building Safety Divl~Jon On-Site Water end Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.munl.oq~./onsite ·(907) 343-7904 So,Is Log - Percolation Test 2- 3- 4- 5- 6- 7- 8- 9- 10- Performed For: Legal Description: Ray Cunningham Date Performed: 4/14/05 Knik Heights, Block C, Lot 3 Township, Range, Section: , S~pe Site Plan WAS GROUND WATER ENCOUNTERED? NO IF YES. AT WHAT DEPTH? -- L Monitoring? , E ~e: 4-21-05 14- 15- 16- 17- 18- 19- 20- COMMENTS 4 hr presoak p~,or to test. Reading Date Gross Time Net Time Depth to Water Net Drop 4/14/05 2:28-2:38 10 6-4,125 1.875 2:39 -2:49 10 6 - 4.25 1.75 2:50- 3:00 10 6- 4.1875 1.8125 3:01 -3:11 10 6-4.125 1.875 3:12-3:22 10 6-4.125 1.875 3:23- 3:33 10 6 - 4.125 1.875 3:34 - 3:44 10 6 - 4.125 1.875 PERCO~.ATION RATE 6.3 (n~ulee~ch) PERC HOLE DIAMETER e 'I~$TRUNBETW'EEN 5 Fl' AND 5.5 FT PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELIN~S IN EFFECT ON THIS DATE. DATE: oG ATER ANCHORAGE AREA [ .,OUGH Department of Environmental Quality 3500 Tudor Road Anchorage, Alaska 99507 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM PHONE .~71' ~1 K,,;Ir Iit¢, $.t,, SEPTIC TANK: DISTANCE FROM WELL /~'~'# MANUFACTURER INSIDE WIDTH INSIDE LENGTH MATERIAL NUMBER OF COMPARTMENTS t . LIQUID DEPTH "~ , LIQUID CAPACITY /~,l~'i~ GALLONS, SEEPAGE PIT: NUMBER OF PITS I DIAMETER¢~1_ OR WIDTH /~', LINING MATERIAl- ~'~/~"'~ CRIB SIZE: DIAMETER BUILDING FOUNDATION /'~I't NEAREST LOT LINE ADDITIONAL ABSORPTION } I DEPTH LENGTH ~-, DEPTH DISTANCE FROM: TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) WELL l~t¢' ~ ~/~.' SQ. FT. WELL: BUILDING FO. ND^T,ON CONSTRUCTION ~l~i~l~ ~~'~Iu~ NEAREST NEAREST LOT LINE SEWER LINE DEPTH SEPTIC Iz,~.,.I , TANK _ DISTANCE FROM: SEEPAGE Iq~"' SYSTEM CESSPOOL OTHER SOURCES DISAPPROVED DISTANCES: INSTALLED BY: ~tv~v~iAcI~A~ PIPE MATERIAL: /~11 t~'¢f I¥¢~,-, 6Xc~pt DATE DIAGRAM OF SYSTEM (~RK/\7 !:-i< /\N%HORAC~E AREA SEWAGE D~SPOSAL SYSTEM -- APPLiCATiON AND PERMit / , 2 ~ / -... ........ ,...: :, R&M Civil Engineers ENGh EERING & GEOLOGIC, , CONSULTANTS 229 EAST 51st. AVE. - P.O. BOX 6087 - ANCHORAGE, ALASKA 99503 TELEPHONE 907--279--0483 TELEX 090--35419 Geologists Land Surveyors JAMES W. ROONEY, P. E. MALCOLM A. MENZIES, P.E,, L.S. JAMES H. WELLMAN, P.E. September 27, 1972 R & M No. 26540-34 RALPH R. MIGLIACCIO Engineering Geologist Mr. Ray Cunningham 3701 Eureka, Apt 53.~B Anchorage, Alaska Re: Test Hole and Soll Log Report for Sanitary System Lot 3, Block C, I<nik Heights S/d Dear Mr. Cunningham: We are submitting herewith the test boring results and our comments regarding soil conditions encountered at the subject site. This investigation was performed in accordance with your request of September 25, 1972 and those procedures out- lined in a letter dated September 13, 1971 by Mr. Roll Strickland of the Greater Anchorage Area Borough Department of EnvSronmental Quality. A single test hole was put down within the Lot 3 area for the purpose of defining general subsurface soil conditions for the proposed sanitary system. E×cavation was accomplished with a tractor-mounted backhoe and the test hole was extended to a total depth of 12 ~eet below ground surface. The final log prepared ~or -the test hole has been included in Drawing A-01. Ground water was not encountered in the 'test hole. YVe 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, ENGINEERING & GEOLOGICAL CONSULTANTS JW R: wb Enclosure xc: Greater Anchorage Area Borough ^~,Pwn. ^~.~ FAIRRANKS JUNEAU T.H.-I 9-25-72 6.0~ SILTY GRAVEL , · oose(GM) ~_~ SANDY G.AVEL (GW-SWl Med. Dense SILTY SAND Fine, Dense (ML) 5,0'../ , //:' ? .~/" / SILTY SANDY GRAVEL Dense (GM) Roy Cunninghom Property I ¢!~- Engineering ~ Geological Consultont~ LOG OF T FST BORING ~i~,/']. ~C.O.AO~ .^l~aA~(~ ALA,~KA ou~^u Anchorage Alask~ Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 017-034-03 Expiration Date:, GENERAL INFORMATION Complete legal description Lot 3, Block C, Knik Heights Subdivision Location (site address) 12500 Shelbume Road Anchorage, AK 99516 Current Property owner(s) Estate of Yancy L. Flair · Mailing address P.O. Box 671633 Chugiak, AK 99567 Day phone Lending agency Mailing address Day phone Real Estate Agent Mailing Address Day phone Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: ~ '~- TYPE OF WATER SUPPLY: Individual Well [] Individual Water Storage [] Community Class ~ Well [] Public Water System [] TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding Tank [] Community On-site [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) issues Certificates of 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 w~stewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Cediflcates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the og-site water supp!y an~o.r wastewater d sposal system is(are) in compliance with all applicable Municipal and State. codes ,ordi~'an~eS~ and regulations in effect at the time of installation. ; ./' ' -:~ Name of Firm Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. DSD SIGNATURE ~J Approved for ~ Disapproved. Conditional approval for bedrooms. 814//2 01 Date.. bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory (Rev. 11/05) X Arsenic Advisory Maintenance Agreements · Supplemental Engineer's Report Other Original Certificate Date: Municipality of Anchorage Development Services Department Building Safety Division .On-Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: 'Lot 3, Block C, Knik Heights Subdivision A. WELL DATA . Welt type ,P. dvate Date completed 1972 -~ Total depth lo2- ff.' ;. Dat® of test Static water level IfA, B~ or Cprovide PWSID # .. Sanitary seal (Y/N) Y Cased to. 102+ f. .FROM VVELL LOG Unknown Unknown fl:. parCel ID: 017,034-03 Well Log (Y/N). N Wires propedy protected (Y/N) Casing height (above ground) ~ AT INSPECTION 8/3/2010 Y >18 in. 77.4 ft. Well production Unknown WATER SAMPLE RESULTS: g.p.m. e.8 g.p.m. Coliform 0 colonies/100 mL ' Nitrate .802 mg/L Arsenic: NID Ug/I Date ofsample: 7/26/10 B, SEPTIC/HOLDiNG TANK DATA Otherbacteda o ' colonies/100mL Collected by: M. Anderson Tank Type/Material Sepac/Stea Date installed 1995 - Reset 2005 Tank size -~,250 g~l~..~... Number of Compartments 2 Foundation Cleanout~(Y/N)' Y Depression over tank (Y/N) Date.,efpum~irig DenaliSewer&Brain Pumper 8/4/2010 C. ABSoRPTIoN FIELD DATA Cleanouts (Y/N) Y N High water alarm (Y/N) N Date instaile¢l 10/11/95 Soil rating (g.p.d./ft2 or ft2/bdrm) .8 GPD/SFSystem type 5' Wide Trench Length ' 78. ft. ~. Width 5 ft. Gravel below pipe 4' N/3.9' S ft. Total dePth'r. J8;5 -- ~' ft.; Eft. absorption area 773 ft2 Monitoring tube, Y Depression over field. N Date of adequacy test 8/3/10 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field beforetest 0 in. Water added 1,009 gal. New depth <l" in. Elapsed Time: 60 min. Final fluid depth 0 in'. Absorption rate >= 6o0 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type).. N If yes, give date D. LIFT STATION 'Date installed ~Pump on' level at ~ in. Datum E. SEPARATION DISTANCES Size in gallons "Pump off" level at~ Cycles tested in. SEPARATION DISTANCES FROM VVELL ON LOT TO: Septic tank/lift station on lot >100' Absorption field on lot >lOO' Public sewer main N/A Sewer/septic service line >25' Animal containment areas >50' Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots >100' On adjacent lots >100' Public sewer manhole/cleanout Holding tank N/A Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5; Water main N/A Water service line >10' Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' . Building foundation >10' Water Service line >10' Surface water >100' Curtain drain None Noted Wells on adjacent lots >1oo' N/A Absorption field >5' Surface water >1oo' F. COMMENTS: Septic Tank was Initially Installed in 1995 and Reset in 2005. Water main N/A Driveway, parking/vehicle storage > 100' '5' in. G. ENGINEER'S CERTIFICATION ,,. · 49.111 rewew of Municipal records that the above systems are in ~'_~ff~ conformance with MOA COSA guidelines in effect on this date. ~~~~ Engineer's' ' Name ' ' ' ~= Pnnted Michael E. Anderson, P.E. ~d~,,: ~ ~'~ _~_.. ~[ Date 8/4/2010 ~k ,e~ .o~.,~, COSA Fee $ Z_/q (~ ~ ~ q C~ V~t~.~3 Waiver Fee $ I1 Date of Payment ~/~'[ //~.~ Date of Payment Receipt Number (~ ~//~'~ Receipt Number (Rev. 11/05) m N00°02'00"W 145.00 -- -- ~Z--~~ ~ 10' UTILITY EASEMENT 50.3 50.3 o'zg N00"02'00"W 145.00 SHELBURNE ROAD J1,,. C~ C:~ C~ SGS Ref.# 1103637002 Client Name Anderson Engineering Printed Date/Time 07/29/2010 8:55 Project Name/# Water Samples Collected Date/Time 07/26/2010 12:45 Client Sample lD L3,BC Knik Hts Received Date/Time 07/26/2010 13:48 Matrix Drinking Water Technical Director Stephen C. Ede Sample Remarks: 4500NO3 - Nitrite & Nitrate - MS recovery is outside QC criteria. Refer to the LCS fbr accuracy. Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 07/27/10 07/28/10 KDC Waters Department Total Nitrate/Nitrite-N 0.802 0.100 mg/L SM20 4500NO3-F B (<10) 07/27/10 LCE Microbiolog~ Laboratory E. Coil Negative I 100mL SM20 9223B A 07/26/10 DLC Total Coliform Negative I 100mL SM20 9223B A 07/26/10 DLC Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.orglonslte (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 017-034-03 1. GENERAL INFORMATION Complete legal description Knik Heights Block C Lot 3 Location (site address) 12500 Shelburne Rd COSA# 05 Expiration Date: · Current Property owner(s) Ray & Dianne Cunningham Mailing address Day phone Lending agency Mailing address Day phone Real Estate Agent Mailing Address Unless othen/vise requested, COSA will be held by DSD for pickup. 2. NUMBEROF BEDROOMS: 4 Day phone 3. TYPE OF WATER SUPPLY: Individual Well [] Individual Water Storage [] Community Class Well [] Public Water System [] TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding Tank [] Community On-site [] Public Sewer [] The Municipality of Anchorage Development Senrlces Department (DSD) Issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given In paragraph 4 by an Independent professional civil engtneer registered In the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properlJes 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 preperties sen/ed by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. 'rhe 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 th~ 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-sita water supply and/or wastewater disposal system Is(ara) in compliance with all applicable Municipal and State codes. ordinances, and regulations in effect at the time of installation. Name of Firm Waft(ins Engineering, Inc, Address PO Box 110443. Anchorage, AK 99511-0443 Phone34~1851 Engineer's Printed Name Cindy W. Ellis, P,E. DSD SIGNATURE ~ Approved for L-/, Disapproved. Conditional approval for bedrooms. Date 12/15/05 bedrooms, with the following stipulations: ' Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report ,Other Original Certificate Date:.. Municipality of Anchorage Development Services Department Bu~ing Safety DMslon On.SEe Water & Wastewafer Program 4700 Br~w P.O. BOx lg6650 Anchorage, AK 99519-6650 (~07) :~,3.7e04 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST ifA, B, otC IXovtde PWSlD #- SanitaP/esal (Y/N) Yes Cased~ 102+ ft. FROM WELL LOG N/A N/A ft. N/A g.p.m. Nitrate 0.910 mg/L Date of ~ampfe: 4/4& 12J~05 WEII DATA Wall type Pd Date c~npleted 1972 Totaldepth 102+ ft. wall pmducaon WATER SAMPLE RESULTS: Coliform 0 colonies/lO0 mi. Arsenic: NA mg/I B. SEPTIC/NOI.fllNG TANK DATA Tank Type/Material Steel Sept~ Tank Tank size 1250 gal. Foundation deanout (Y/N) Yes Date of pumping 4~13/2005 C. AB~ORFTION FIELD DATA Number of Compallments 2 Depression over tank (Y/N) No Pumper A+ Home Sewlces Soll rating (g.p d Jrt2 or ~Frx:lrm)0.8 Width 5 ff. Well Lng (Y/N) No wres pmbe~y protected (Y/N) Yes ~ height (above ground) 25 AT INSPECTION g.p.m. TO ~ 8.5 ft. Eft. absorption area 773 ~ In. Olher bacteria 0 colonies/100 mL Collected by: C.Ellis, Rock/Trainor Date installed 1995 (re~e12005) Cteanouts (y/N) Yes High wat~' alarm (Y/N) NA System type Shallow Trench Oraval below pipe 4 N 13.9 S Mo~tiorlng lutm Yes Depression over field No Date of a~K~uacy test New Field Results (Pass/Fall) N/A F~' 4 bedrooms Fluid depttt in al3~on field befo~ test N/A in. Water adcledN/A gal. New depth N/A Elapsed Time: N/A min. Final fiuld dep~ N/A in. Absorl~lo~ rate >= N/A Any rejuvenaUon Ireatment (past 12 mo.) (y/N & type) No If yes, give date IN. g.p.d. O. UFT ~TATION Date installed NA Size in gallons 'Pump on' level at in. 'Pump off' level at Datum Cycles tested E. SEPARATION DISTANCES SEPARATION OISTANCES FROM WEll ON LOT TO: Sel~c lank/lift station on lot ,115' Absoq~on field on lot 145' Public sewer main 100'+ Sewer/septic sewtce I~ne 106' Animal containment areas 100'+ Manho~W _.,~c~_ _ss (Y/N) High water alarm level at Meet~ almm & circuit mq~? In. On adjacent Io~ 100'+ On ao'jacent lots 100'+ Public sewer manhole/cJeanout 100% Holding lank N/A Manum/anlmal excrete ~torage areas 100'. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5.5' Water main 100'+ Wells on adjacent lots .1.00'+ Property line ,,Sp' Water eswlce line 2,5'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Prol~ line 12' Water Service line 25'+ Cu~ain drain N/A Absor~on field 22' Sur~ce water 100'+ Building foundation 30 Surface water 100'+ Wells on adjacent lots 100'+ Water main I Off+ F. COMMENT8: Seplic tank was inl0ell~ installed in 1995 and was ~,~_ rr,~!__,,~l and moved in Oct. __~005. O. ENGINEER'S CERTIFICATION I certify that I have deterntined through field in~ and review of Municipal reco~s that the above systems em in conformance with MOA COSA guideflnes in effect on this date. Enginesr's I:~nted Name Ci.'nd~ W. ~ P.E. Date 12/t5/2005 Waiver Fee $ Date of Payment Receipt Number Ellis CE. toss? SGS Ref.# Client Name Project Name/# Client Sample ID Matrix 1051736001 Watkins Engineering Knik Hu BIk C Lot 3 Knik His BIk C Lot 3 Drinking Water All Dates/Times are Alaska S~ndard Time Printed Date/Time 04/08/2005 14:07 Collected Date/Time 04/04/2005 15:00 Received DatedTime 04/04/2005 17:06 Technical Director Stephen C. Erie Samt~]c Remarks: Allowable Prep Analysis Parameter Results PQL Units Mc~hod Container ID L/mits Date Date Init Waters Debar tment Nitrate-N 0.910 { 0.100 ~crobiolo~ Laborator~ mg/L EPA 300.0 B (<=10) 04/04/05 CAM TotalColiform 12OB, NoColi col/100mL SM209222B A (<=1) 04/04/05 TLF SHEL_BUI~NE_ ROAD _. ,00'SH. :1,,00,~0o0 S Z ,O0'SH, AA,,00,~000 N