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HomeMy WebLinkAboutKNIK HEIGHTS BLK F LT 16Knl*k Heights
Block F
Lot 16
#017-361-16
•
Municipality of Anchorage
Community Development Department Page 1 of 2
On-Site Water and Wastewater Program
4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650•http://www.muni.org/onsite•(907)343-7904
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP181081 PID Number: 017-371-16 ❑ New ❑✓ Upgrade
Name:
JIMMIE &JO-ANN WALLCE ABSORPTION FIELD
Address ❑✓ Deep Trench ❑Shallow Trench ❑ Bed ❑ Mound
12901 ATHERTON ROAD ❑ Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
4 1.2 GPD/SF 11.0 Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot 5.0 Ft. 6.0 Ft.
KNIK HEIGHTS F 16 Fill added above original grade Gravel length
Township Range Section Ft. 50 Ft.
Gravel width Beds:Number of Lines Distance between lines
SEPARATION DISTANCES 2.5Ft. Ft.
To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist.between trenches
From Tank Field Tank Line 600 Ft' 1 Ft.
Well 141.2 90.4 92.1 TANK l Septic 0 S.T.E.P. 0 Holding 0 Other
Manufacturer Capacity
Surface Water 100+ 100+ ANCHROAGE TANK 1250Ga1.
Material Number of compartments
I
Lot Line 34.0 52.1 STEEL 2
NA
Foundation 10 70.7 LIFT STATION
Manufacturer Capacity
Curtain Drain 50+ I 50+ I Gal.
1
Pump on level at Pump off level at High water alarm at
Remarks
in. in. in.
Pump make and model Electrical Inspections performed by
PIPE MATERIAL House to tank 3034 Tank to 3034
Installer drainfield
A+ HOME SERVICE Drainfield 3034 CO/MT 3034
Inspector PANNONE ENGINEERING SERVICES BENCH MARK (Assumed elevation) 100ft
Inspection 1" 6/29/2018 Location and description
dates: 2 7/3/2018
3id 7/3/2018 4th 7/25/2018 SW BOTTOM TRIM
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
Engineer's Stamp
���\\\\
OF A><gtlA
Conditional Approval: Date Q'�• - ,s
Ai cam' X40-.V#
ice:t:,' * * !
\ ,
tteven ". 'onnorae
��� 4 • CE 814.2)00!"
ApprovedDate 9/740/4 16 4e ' a +•r
PP I'�����ii &)V /Z �\ >3?OF�SS1
Inspection Report_1-1-12.doc
DESIGN PARAMETERS
— N \ \ I — \ y 1
\PRIMARY SEPTIC SYSTEM N � [
NO. BEDROOM: 4 (600 gpd) �— \
TANK SIZE: 1,250g N N
PERC RATE: 1 MPI 10' UTILITY EASEMENT
SOIL RATING: 1.2 GPD/SF 16 N w / \
-. I-
AREA RQD: 500 SF N -------- N----
SYS.
SYS. TYPE: DEEP TRENCH - 6.0'ED N 0 O� ��
MIN LENGTH: 41.7 LF \ N
\ o
C2RESERVE DRAIN FIELD IN FAILURE \ N I I
•
USED:
150 LFx2.5'Wx6.0' E.D., 11.0' TD RE-USE AS RESERVE od)
TOTAL AREA: 600 SF � N. \ 0
\ '...,
TH-1
•
\ \
I sz vi\
V 1 <
\ \ W
Q M1 \\ T2 T1 / 4BR 1
o / DCO HOUSE I 1 j
O 90.4 \ C 1 N, DV .mac_1 /
1
,\ / \ \B \
= WELL \\
\ Q I ) \ V� DECOMMISSIONED EXISTING 1500g SEPTIC TANK L
I PER CODE INSTALLED 1250g SEPTIC TANK
A B — • —71- ' ' CONNECTED TO FCO, INSTALLED
T1 12.2 19.3 /
DCO AFTER, INSTALLED DIVERTER VALVE \
I [
T2 18.8 26.3 / / INSTALLED DRAIN N FIELD
DCO 21.0 28.5 \ / 5OLF x 2.5'W x 6.0'ED x 11.0'TD 1
DV 23.3 30.0 INSTALLED CLEAN OUT AND MONITOR TUBE
Cl 73.0 85.2 \ / AT EACH END
i
M1 74.0 85.9 LOT VACANT
C2 111.1 127.1 \ NO WELL OR SEPTICS / 1
M2 111.6 127.5 �`1 1 / I / L\I
W
J
Q W W
7 7 ~~ > CO m
77
0 0
00 w I- i_ I- ~
Z ZZ ix 0 7
0 Ir O
_7 W W > Z O Z Z
° OG./FG. 0 0 0 0 W Z W
100.0 U M 4"DRAIN PIPF 0 0
DRAIN ROCK 6"ABOVE PIPE INV - - OG./FG.
88.0
TEST HOLE 1 (PES)
FILTER FABRIC, 1—, pR
3 GM/
/ 1250g SEPTIC 4— SIA
TANK 95.2 0 5
95.a 6-
-\
--
63.0 7—
83.0 8-
6.0'DRAIN ROCK 9_
PROFILE10-_
SCALE:NTS 11_ SW
12 DRY:
1i= 5/4/2018
71,0 15
16— CM
17
DATE PERFORMED:
4/26/18
NOTES: ��T�� �T� ETG _�_�����\ Dote
RECORD DRAWING P P.O.rBOX 100217 0217 ANCHORAGE,SVC, 99510I ��OF A.flo.kt, kl 8/1/2018
PHONE (907) 272-8218 FAX (907) 272-8211 j co.. • • Scale
REV 1: 9/13/2018 4 '���•' ••• """ 0 P.I.D. NO
KNIK HEIGHTS, BLOCK F, LOT 16 - . , —!11 \ /- 017-371-16
DRAWN: ACP Steven R. Pannone PERMIT NO.
JIMMIE & JO-ANN WALLACE C 814 'e
r F. OSP181081
12901 ATHERTON ROAD �, s ,•l%;W. .!
PLAN ANCHORAGE, AK 99516 til`\\\\"10,- Sh1eOF 1
(NI
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th
op
I LOT 17
LOT 2
N89°58'00"E 300.00
30 1 I I — —
0
" O1 10' UTILITY EASEMENT
18.2shed N i• 7
q,
�` 108.•
1 of 1—
z
H I Septic Vents w
2 O
Ill w 00 ibi O
I- v LOT 3
to — 2.1 •H =
OZ 155. 42.3 -`r1 \, H
s
cc N / ''i 3 Story Frame �, j, - N
W O Septic Vents �j House o 0. �� ' o O
z LOT 16 L—�I�i�;Ii 8.0 Z
Septic Vents
34.3
Septic Vent. 1.7 0 .0 OH .7 OH
Welt
" J
I I 10' UTILITY EASEMENT
—
30 N89°58'00"E 300.00
LOT 4
LOT 15
I
RECERTIFIED 9-14-1:41.44r-OZ,...()
AS-BUILT
AS-BUILT NO CORNERS SET THIS DATE
♦ OF •A � ' I I hereby certify that I have performed a Mortgagee's inspection
P, c • • . • �'9 , of the following described property. LOT 16, BLOCK F,
••• •S� I, KNIK HEIGHTS SUBDIVISION
INF`?' 49th is •7 r
.*/ Anchorage Recording District,Alaska,and that the
0' • •
r ••• •� •/ improvements situated thereon are within the property lines
•0�/ ," •/..• and do not overlap or encroach on the property lying
p: ••• adjacent thereto,that no improvements on the property lying
f" Ilzabeth L. alotka:ff
C adjacent thereto encroach on the premises in question and
i sr,• 8036 - LS •••fes that there are no roadways,transmission lines or other
SCALE: 1"= 40' S, o •o. , • • • •Jxo visible on said property except as indicated
'SSION).
�♦ Dated at Anchorage,Alaska
EASEMENTS OF RECORD,OTHER THAN 41.
1 �X�% this 8th day of APRIL 2007.
THOSE SHOWN ON THE RECORDED 9 --I e,-1 b FRED WALATKA&ASSOCIATES,L.L.C.
PLAT ARE NOT SHOWN HEREON. Lantech Engineers and Surveyors
UNLESS OTHERWISE NOTED FB 18-5, pg 60
BE 907-248-1666
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MUNICIPALITY OF ANCHORAGE ,� 0
d
'— enc
On-Site Water&Wastewater Program No Ste„
�.� PO Box 196650 4700 Elmore Road
Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997
httpa/www.muni.org/onsite geolliiir•
.
I)) 1).11 t nt,•n t
4"' HQ11P64
On-Site Wastewater Disposal System Permit
Permit Number: OSP181081 Effective Date: 6/18/2018
Work Type: Septic Upgrade Expiration Date: 6/18/2019
Tax Code Number: 01737116000
Site Legal Address: KNIK HEIGHTS BLK F LT 16 G:2836
Site Mailing Address: 12901 ATHERTON RD, Anchorage
Owner: WALLACE JIMMIE L & JO-ANN M Lot Size in Sq Ft: 43500
Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 4
This permit is for the construction of:
0 Disposal Field El Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
(0
Received By: Date: )ald
Issued By: 41(A 0714 Date: ./0.6'
111 I I
Municipality of Anchorage S^
P.O. Box 196650 • 4700 Elmore Road
Anchorage, Alaska 99519-6650 ® (907) 343-7904 e Fax (907) 343-7997
http://www.muni.orq/Onsite
Development Services Division
On-Site Water and Wastewater Program
**** VARIANCE/WAIVER REVIEW ****
Waiver#: OSV181026 COSA#: Permit#: OSP181081
PID#: 017-371-16
Legal Description: Knik Heights BF L16
Engineer: Pannone Engineering Services
Applicant: Jimmie and JoAnn Wallace
Your request for a waiver of the required 100 feet horizontal separation from the absorption field
to the private well has been approved. The approved separation distance is 85.0 feet.
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.
Waiver is Granted: X Waiver is not Granted:
Date: 6 Zi�/ 0. Approved by: L ��`
// Name of Reviewer
**** VARIANCE/WAIVER REVIEW ****
E pupirm
MUNICIPALITY OF ANCHORAGE
Awe
Community Development Department Phone: 907-343-7904
Development Services Division '-� Fax: 907-343-7997
On-Site Water& Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 017-371-16
Property owner(s) Jimmie & Jo Ann Wallace Day phone
Mailing address 12901 Atherton Road, Anchorage, AK 99516
Site address 12901 Atherton Road
Legal description (Sub'd., Block& Lot) Knik Heights, Block F, Lot 16
Legal description (Township, Range & Section)
Lot Size 43,500 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(®all that apply)
Absorption Field ❑X Initial ❑ Single Family (SF) [X
(w/wo ADU)
Septic Tank Upgrade ❑X
Duplex (D) ❑
Holding Tank ❑ Renewal ❑
Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR:
Well to Drian Field Distance: 85
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 authorized agent)
Permit/Rush Fees: Soul Waiver Fees: l, 12,3
Date of Payment: Date of Payment: 501
Receipt Number: 0(15Receipt Number: 0276%
Permit No. 6,5P 1 ?!dR/ Waiver No. C6V 1 Rt02 0
Permit App__•:• :...,.c
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP181081, Deb Wockenfuss, 06/18/18
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP181081, Deb Wockenfuss, 06/18/18
Page 2 of 2
above criteria for approval and does not constitute risk tohealth. | hope the above information will
assist you in determining that the waiver should be granted.
The proposed installation will not affect the future development ofthis orthe surrounding lots.
If you have any questions or concerns, please contact me at 272-8218.
Sincerely,
Steven R.Pannone, P.E
Mail |n1a: P,O. Box 100217,AnchonaIoe,AK89510-02l7
Physical: 332EastK4anorAve, Anchorage, AK9S501
Te|ephone:'8O7)27Z-82lO FAX: (9O7\272'8ZIl
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP181081, Deb Wockenfuss, 06/18/18
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP181081, Deb Wockenfuss, 06/18/18
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP181081, Deb Wockenfuss, 06/18/18
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP181081, Deb Wockenfuss, 06/18/18
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
I1 ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
.�
NAME
PHONE
NEW
nc
C
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❑ UPGRADE
MAI LIN RES
LEGAL DESCRIPTION
t 1 It Y� _ o_ l k !"' r
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LOCATION
ON A � �n a. ©T°� E�v�'�'mQ .
NO. OF BEDROOMS ..
v Wel f Absorption areDwelling �'I
DISTANCE TO:
.8 30?,?
y 'i
I— z Manufacturer Material�CGC'I
LL �1 I
No, of compartments
f
Inside length Width
Lic. qg( y in gallons IF H(EMADE:
�T" �'—
Liquid depth
DISTANCE TO: Well Dwelling
PERMIT NO.
_j0z
SQ
Manufacturer
Material
Liquid capacity in gallons
��
DISTANCE TO:
Wellht
/VQ-
Foundation
y��«,�I
t
Nearest lot line
I
PERMIT NO.
0T 17_
J u. z
k- R cc
No. of lines )
1
Length of each line
Total length of lines
i
Trench ' Trench width
,/inches
Distance between lines
p.
Top of tile to finish grade
��
Material beneath rile
Total effective a�rysoCnti on area
M
®
inches
t0 1
Length
Width
Depth
PERMIT NO.
w
C7
4 f-
w°
Type of crib
Crib diameter
Crib depth
Total effective absorption area
DISTANCE TO:
Well
e
Building foundation
Nearest lot line
Class
Depth
Driller
Distance to lot line
PERMIT NO.
J
W
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area (s)
OTHER
PIPE MATERIALS
SOIL TEST RATING
Zb
INSTALLE
a�-
REMARKS
t
a
-
fCt, YNA,.„
,) .Nr-
APPROVED DATE LEGAL
/2-U13 (Hev. 3/78)
li DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTFr,TION �—
a /1RONMENTAL ENGINEERING DIVISION
\\ 825 L SL..et • Anchorage, Alaska 99501 Telephone 264•x/20
�J N SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
---
NAME
I/►I
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PHONENEW
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i
- UPGRADE
MAI LIN 4 RES 1 �—yf
LEGAL DESCRIPTION
LOCATION O
0/1JA e on��. o�' Fina . _
NO. OF BEDROOMS
�
U Y
DISTANCE
well
W
Absorption area
Dwelling
PERMIT N0,8 30 ^ _? ;�_
Z
~
Manufacturer
C
Materiald+�wQ Cl`
_
No, of compartments
Z
rn
Lij.c I© ily in gallons
O
IF H �E1�AAD E:
Inside length
Width
Liquid depth
0 y'
J t7Z
L
DISTANCE TO:
Well
Dwelling
PERMIT NO.
2
Manufacturer
Material
Liquid capacity in gallons
[a
-�=
V
DISTANCE TO:
Well
_
Foundation
/_QI
Nearest lot line I
PERMIT NO.�y �t O n�
of `I
W u
J _ 2
No. of lines '
Len th of each line
g
Total length of lines
Trench Trench width
inches
_
Distance between lines
©
'Top of rile to finish grade 9
Material beneath rile
Z y inches
Total effectiveso area
w
Length
Width
Depth
PERMIT NO.
n d
w
Type of crib
Crib diameter
Crib depth
Total effective absorption area
m
DISTANCE TO:
Well
Building foundation
Nearest lot line
_d
J
YJ
Class
Depth
Driller
Distance to lot line
PERMIT NO.
DISTANCE TO:
Building toundation
Sewer line
Septic tank
Absorption ares(s)
OTHER
PIPE MATERIALS
-I-M
SOIL TEST RATING
INSTALLE �} �/An
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.v ,Ww X SOILS LOG
-_ MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION EJ PERCOLATION
TEST
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST
PERFORMED FOR:�•IIY 'B DATE PERFORMED: L T, P'1 5
mom III OWN I IN
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)
15?, Ia5 El /aedvoom
7M"N
MM11M
MM iM
MORN
MrNM
NFAEN
NIMNN
NINON
■IMM■
NINON
WAS GROUND WATER No L
ENCOUNTERED.
O�-
P
IF YES, AT WHAT E
DEPTH?
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
PERCOLATION RATE ,'.�?s,.,;,,.:.'1'tttiau�es/inch)
1 �,', '
TEST RUN BETWEEN .•PT ANZ y'ar_ +.FT,
,,. ! ,:^f' _•4• it
N \. �i f i � • 'f
�3 aaW CERTIFIED BY: DATE:
.,f Aw
MUNICIPALITY OF ANCHORAGE
Department Health and Environmenta.' Irotection
87.5 L Street, Anchorage, AK. _9501
264-4720���
Permit # 8 3 0?08 HANDWRITTEN PERMIT # # #
WEL_ AND. ON-SITE SEWER PERMIT
Applicant: Address: 0P-&-��f
Location: _ Phone Number:
Legal Description: ,- k)1 kC L[J�Lot Size: -
Type of. Soil Absorption System Is: __
Trench: Drainfield: (L Seepage Bed: Holding Tank:
Maximum Number of Bedrooms: Soil Rating(sq.ft/br)
The Required Size of the Soil Absorption System Is:
DEPTH LENGTH - GRAVEL DEPTH _ WIDTH
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE _ `�c�d GALLONS
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) INSPECTIONS ARE REQUIRED # #
Backfilling of any system without final inspection and approval by 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 a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is.25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
# PERMIT EXPIRES DECEMBER 31., 1 9 u 3 #
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 th sys t -em -in accordance with codes.
(3) I under. an a _lh�-site sewer system may r uire enlargement if
the resi e aideled to include more that 3 bedrooms.
Signed: Issued by: e -A1
Applic t r
Date:
SWP/024(1/81)
WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geological a Geophysical Surveys
Drilling Permit No.
LOCATION OF WELL (Please complete either la, Ib or lc,) A.D.L. No.
E-1Borough Subdivision Lot Block Ib. V4gtrs. Section No. Township NE] Range EMeridian
—Of— Of—Of SWE]
Ic. DISTANCE,AND DIRECTION FROM ROAD INTERSECTIONS 3. OWNER OF WELL:
Address:
Street Address and Area of Well Location
2. WELL LOG
Material Type Top
Feet Below
Surface
Bottom
4. WELL DEPTH: (final)
ft.
5. DATE OF COMPLETION
— —
6. Q Cable tool Rotary ❑ Driven Dug
Auger Jetted 0 Bored Other:
7. USE:,E] Domestic Public Supply E] Industry
❑ irrigation Recharge Commerical
❑ Test Well Other:
8, CASING: E] Threaded ❑ Welded
diam. in. to ft. Depth Weight Ibs./ft.
diam. in. to ft. Depth Stickup ft.
9. FINISH OF WELL:
Type: Diameter*•
Slot/Mesh Size: Length:
Set between ft. and ft.
Backfilling Gravel pack
10. STATIC WATER LEVEL: ft.
Above or E] Below land surface Date
Equipment used:
I I . PUMPING LEVEL below land surface and YIELD
ft, after hrs. pumping g.p,m.
ft. after hrs. pumping g.p.m.
12.GROUTING Well Grouted: Ej Yes Ej No
Material: ❑ Neat Cement E] Other:
13, PUMP: (if available) HP
Length of Drop Pipe ft. capacity g.p.m.
Q Subm. ❑ Jet E] Centrifical Other
14. REMARKS;:
16. WATER WELL CONTRACTORS CERTIFICATION:
15. Water Temperature ° El F 0 C
This well was drilled under my jurisdiction and this report is true to the best of my knowledge and belief;
Registered Business - Name Contract License Number
Address:
Signed: Date:
Authorized Representative
Form 02-WWR (11/81) Copy Distribution: WHITE -State DGGS, PINK -Driller, CANARY -Customer
Time
APPLIC',' 1T FILLS OUT UPPER HALF- ONLY
Property Ow„e�
- _'%/J 7 Phone
Mailing Addressl0/c/
Zip Code
Date
Date
Buyer
Dale
Address
Zip Code
Lending Institution
j
Phone
Address
_ Zip Code
Inspector
Realty Co. & Agent
1. -
Phone
Address
Zip Code
Legal Description
rOUNICIPALITY Ui i i�C11Gk=='„c
Street Location'
Type of Residence
10,,'S—ingle Family
/J
11 Multiple Family
No. of Bedrooms --K
❑ Other
E ES+ °4
Water Sypply
< ndividual
( ) APPROVED BEDROOMS
JAI -TACH WELL LOG. A well log is required for all wells drilled since June 1975.
Community
OF APPROVAL
or wells drilled prior to that date, give well depth (attach log if available).
Cl Public Utility
DATE
Sewer DDi posal
4!"Ihdividual
a
Year Individual Installed:
Public Utility
When Connected to Public Utility:
❑ Holding "rank
NOTE: THE INSPECTION PEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time
Time
Time
Time
Date
Date
Dale
Date
Inspector
Inspector
Inspector
Inspector
Field Notes:
rOUNICIPALITY Ui i i�C11Gk=='„c
EN\is , v,. ry P ON
E ES+ °4
►`yf 1
L C d �
( ) APPROVED BEDROOMS
'CONDITIONS
OF APPROVAL
( ) DISAPPROVED
( 7j) CONDITIONAL APPROVAL'
DATE
BY: Rr
Soils Rating
:jDate
Sewer Installed
Well To Absorption Area
Well Log Received
_ _
Well to Tank _
_
Septic, Tank Size
ALASKA CnUIROnMenTAL COnTROL RRUIUS, InC.
Engineerinq & 6nuironmental Studies
February 16, 1.984
Department of Health &
Environmental Protection
825 L. Street
Anchorage, Alaska 99501
Attn: Robbie Robinson
Dear Robbie:
On February 15, 1984, 1 inspected the sewer system and well located
on Lot 16, Block F Knik Subdivision. At that time a water sample
was taken and the results are attached.
All the standpipes were above ground and capped.
The well is located 104' from the sewer system. The well has a
sanitary seal and the wires were not encased in conduit. The
casing stands 1' above the ground surface. The ground is graded
away from the well.
We recommend a conditional approval be issued until the ground is
thawed for repairs of the conduit.
Sincerely,
l�
Jim Green
Geotechnical Engineer
JG/cad
Approved by:
1200 West 33rd Auenue, Suile 3 • Anchorage, Alaska 99503 • (907) 561-5040
EPLMJS
,,„•
Municipality of Anchorage
\\� On-Site Water and Wastewater Program
\\— (907)343-7904 >,
Certificate of On-Site Systems Approval
Parcel I.D. 017-372-16 Expiration Date: Jan 0 5) of 0 9
1
1. GENERAL INFORMATION
Complete legal description Knik Heights BH L16
Location (site address) 12901 Ridgewood Rd. Anchorage, AK 99516
Current Property owner(s) Julie Rabeau Day phone
Mailing address 12901 Ridgewood Rd. Anchorage, AK 99516
Real Estate Agent Day phone
2. TYPE OF DWELLING:
0 Single Family(w/wo ADU)
❑ Duplex
❑ Multiple Dwellings(Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well Q Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
Received b . V-V Date: /0?-0 ((i)
COSA to be released to the engineer,unless otherwise requested by the engineer.
COSA Fee $ 524 Waiver Fee $
Date of Payment tolabY Date of Payment
Receipt N umber 6.35-1-/U6 JU6 Receipt Number
COSA# 05c117,6X? 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.
In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA
guidelines and regulations.The reported results describe the performance of the system under the conditions encountered at the time of the test,
and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil
condition,ground water levels that may fluctuate during the year,and the water usage of the family being served by the system.These conditions
are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future
performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty
for future performance, nor can we estimate remaining life of the system.The content of this report is for the sole benefit of the owner listed
above.
Name of Firm Pannone Engineering Services LLC Phone (907) 745-8200
Address P.O. Box 1807 Palmer, AK 99645
Engineer's Printed Name Steven R Pannone Date 10/1/2018
p'i••° ...
6. DSD SIGNATURE p* •• s .I `��
System#1 Approved for 3 bedrooms • Steven �2.•'oririorie
System#2 Approved for bedrooms +}c�'•• CE-8149 ��
Disapproved k1 P4ESS 1fi"
Conditional approval for bedrooms, with the following stipulations:
ON-SITE kx'
=Z WATER AND
09 WASTEV4- o
PROGRAM ' _
C.Z,046vr sEo '
•
a
By: ' Original Certificate Date: 10 5 o Ip
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 TO..n12-. OppU- 0,..\,),„w) X
COSA blue sheet f
Municipality of Anchorage
On-site Water and wastewater
REVIEWED FOR CODE CONPLJANCE
OSC181527,Rebecca Carroll, 10105/1,
If more than 1 septic system is on the lot:
COSA Checklist# 1 of 1
Structure served by this system 1
Certificate of On-Site Systems Approval Checklist
Legal Description: Knik Heights BH L16 Parcel ID:017-372-16
A. WELL DATA
Well type Private If A, B, or C provide PWS�IID# Well Log (Y/N) Y
Date completed 10/14/77 Sanitary seal (Y/N) ( Wires properly protected (Y/N) Y
Total depth 250 ft. Cased to 185.5 ft. Casing height(above ground) 14 in.
FROM WELL LOG AT INSPECTION
Date of test 10/14/77 9/25/2018
Static water level 130 ft124.0 ft
Well production 2 g.p.m. 4 3 g.p.m.
WATER SAMPLE RESULTS:
Coliform Neg colonies/100 mL Nitrate ND mg/L
Arsenic
ND D ug/L Date of sample: 9/21/2018 Collected by: PES
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel* Date installed 6/24/1994
Tank size 1250 gal. Number of Compartments 2 Cleanouts(Y/N) Y
Foundation cleanout(Y/N) Y Depression over tank(YYIN) N High water alarm(Y/N) N/A
Date of pumping rot(41 2C)R. Pumper Ak `C-1O' Q 1(Q-5 i INC•
C. ABSORPTION FIELD DATA
Date installed 6/24/1994 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.8 g.p.d/sf System type Dual Trench
Length 40/24 ft. Width 2/2 ft. Gravel below pipe 5.5+ ft.
Total depth 12219.6-
2.219.6 ft. Eff. absorption area 768 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 9/25/18 Results(Pass/Fail) Pass For 3 bedrooms
Fluid depth in absorption field before test 0/0 in. Water added 450 gal. New depth 17/0 in.
Elapsed Time: 150 min. Final fluid depth 0/0 in. Absorption rate >= 450+ g.p.d.
None Known
Any rejuvenation treatment(past 12 mo.)(Y/N &type) If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access(YIN)
"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 1001+ On adjacent lots 1001+
Absorption field on lot 1 1 .16'**** On adjacent lots 100I+
Public sewer main 751+ Public sewer manhole/cleanout 100 +
Sewer/septic service line 251+ Holding tank 1001+
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPTIC/HOLDING TANK ON LOT TO:
'
Building foundation Property line 5 + Absorption field 5 +
'+
Water main 25+ Water service line 104. Surface water 100 +
Wells on adjacent lots 1001+
ABSORPTION FIELD ON LOT TO:
***81
Property line Building foundation 101+ Water main 101+
Water Service line 1 0'+ Surface water 1 001+ Driveway, parking/vehicle storage 10'+
Curtain drain None Known Wells on adjacent lots 1001+
F. COMMENTS
****Per 2008 COSA, *Measured from edge of well casing to edge of closest stand
pipe. ***Per existing waiver#WR940034***3'of cover over septic tank, see attached home owner letter.
MTa onlui Gk4.ends ' n\-o lx(0' E.
G. ENGINEER'S CERTIFICATION �4OF
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in 7*; • : '- /\ •* 7
conformance with MOA COSA guidelines in effect on this date. *Oat •• f
Engineer's Printed Name Steven Pannone ':Steven •. •onnorie -
10/1/2018 � �• CE-8149
Date
Ik t OFES.S10 -+.4
COSA canary sheet_2-6-15.doc
MUNICIPALITY O_.F ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT • F-)t.
i' 907-343-7904
On-Site Water and Wastewater Section Fax: 343-7997
www.muni.org/onsite
Septic Tank Advisory
Certificate of On-Site Systems Approval # OSC181527
Subdivision: Knik Heights Block:H, Lot: 16
The septic tank for this property is 24 years old. The average life for a steel septic
tank is 20 years. Typical replacement costs range from $6,000 to $9,000.
This advisory must be attached to all copies of the subject Certificate of On-Site
Systems Approval.
This is an example of what the metal of a 30 year old steel tank MAY look like.
J
r ,
r � ..,�a .i'. v �t2 K �:may, .3. ?•j�y.,�+'i`b
iR`
6'7 ( t .-
_ "�c., :� Imo '' li '0":""-
. ?..
K
x
--
�
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-a• . -'_ : may: *t.
•
djr. As
a � t `yi Fy. . 4
't. ;;s ir:A' r *, t
Th er 14 ' ,, \ ► ,, ° k' 2018r� L
Mailing Address: P.0. Box 196650 * Anchorage,Alaska 99519-6650 *www.muni.org
September 28, 2018
Municipality of Anchorage, Development Services Department
On-Site Water&Wastewater Section
P.O. Box 196650
Anchorage,AK 99519-6650
To whom it may concern,
I have continually lived and am the owner of 12901 Ridgewood Rd. since 2008. I attest that
since I have owned the home,the existing septic tank with its current amount of ground cover
has had absolutely no issues or problems with freezing. When I purchased the home,no prior
tank freezing issues,or any other problems,were disclosed to me by the previous owner with
provided documentation on the tank.
I am asking that the 3 feet of groundcover remain sufficient coverage to maintain my septic tanks
at their fully functional status.
Please feel free to contact me with any questions by phone(907-301-3750) or email
(julierabeau(aiaol.com)
Thank you for your prompt decision to this matter.
Respectfully,
Julie Rabeau
12901 Ridgewood Rd
Anchorage, AK 99516
Municipality of Anchorage
Development Services Department
Building Safety Division
Onsite Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onshe
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 017-371-16
1. GENERAL INFORMATION
-Fac LeN
COSA # 05 n 103
Expiration Date: 7 -19 -07 -
Complete
-19-07
Complete legal description Lot 16, 61o& F. Krik Heights suhdMsion
Location (site address) 12901 A0wrton Rwd a'd,o' , Arc 99516
Current Property owner(s) Allain Wayne Kora Day phone 345-1197
Mailing address 12901 anertm Drt" Anchorage, AK 99516
Lending agency Day phone
Mailing address
Real Estate Agent Day phone
Mailing Address
Unloss otherwise requested, COSA wX be held by DSD forpickup.
2. NUMBER OF BEDROOMS: Fl1B (s)
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
0
Individual On-site
El
Individual Water Storage
❑
Individual Holding Tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered In the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-ske wastewater disposal and/or water
-----supplyrsystem.-OSD-aIso7ssues-COSAs-Upon-request to-htxneownars-Cen ficaterof-On::Sitd-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 OnSke 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 Finn Anderson Engineering Phone 522-7773
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson. P.E.
5. DSD SIGNATURE
Approved for _,'� bedrooms.
Disapproved.
Date 4/13=7
Conditional approval for bedrooms, with the following stipulations:
0
(Rw. I,)
COSA Checklist X Arsenic Advisory
Septic System Advisory Maintenance Agreements
Well Flow Advisory Supplemental Engineers Report
Nitrate Advisory_ Other
Original Certificate Date: © 7
Municipality of Anchorage
Development Services Department
Bulging Safety Division
On Ske Water 6 Wastewater Program
4700 Bregaw Street
P.O. Box 198650
Anchorage, AK 99519-6650
www.muniarg/onstte
(907) 343.7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: Let 16. Bbdc F, KM HWft Subdivi" Parcel ID: 017.371-16
A. WELL DATA
Well type Pr t If A, B, or C provide PWSID ax _
Date completed 10131183 San" seal (YIN) Y
Total depth too R Cased to fro ti.
FROM WELL LOG
Date of test 1ore1119e3
Static water level 74 ft
Well production 4 9 -13 -m -
WATER SAMPLE RESULTS:
Coliform o colonies/100 mL Nitrate SA9 mglL
Arsenic: NO mgA Date of sample: 3=7
B. SEPTICINOLDING TANK DATA
Tank TypdMateriel 511161
Tank size 1.500 gat. Number of Cornpartments Two
Foundation cleanout (Y" Y
Date of puffing 91182096
C. ABSORPTION FIELD DATA
Date Installed 1111983
Well Log MINI) Y
Wires property protected (YIN) Y
Casing height (above ground) >?4 in.
AT INSPECTION
32W7
611.7 tL
3.6 g.p.m.
Other bacteria 0 colonies/1 W mL
Collected by: F. LeO=
Date installed 11/1983
Cleanouts (YIN)
Depression over tank (Y/N) N High waW alarm (Y/N) N
Pumper A Pis Hans SwAcm
Sall rating (g.p.d.Je or tefodr n)125 SFBDRM Systerm typo S wide Tmrch
Length 94 ft Width
tt. Gravel below pipe 2 fL
Total depth11--ft. Effabsorption area�? tlY Monitoring tube Y Depreaaion over field N
Date of adequacy but 31MW Results (PasWell) Pao For 5 bedrooms
Fluid depth in absorption field beforo teat - e - in. Water eidded aW gal. _New depth -n. -
Elapsed Time: 0 min. Final fluid depth _Lin,
Any nOuvenation treatment (past 12 mo.) (YIN 6 type) N
Absorption rate >= 750 g.p.d.
N yea, give data
D. UFT STATION
Data lnataned Size in gallons
'Pump on, level at _ in. 'Pump air level at _ in.
DaMn Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tw*Mft station on lot >tatr
Absorption field on lot >1W
Public sewer main WA
ManhoWAeoess (YIN) _
High water alarm level at
Mesta alarm b d=* rewwmwW
On aMacent lots
On adjacent lots
>Iw
>ton
Public sewer manhole/cleanout WA
Sewer hteptic service Ina >2F Holding tank WA
Animal containment areas None Manure/animal wwrete storage areas Nana
SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO:
Building foundation >s Property line >S Absorptiond >s
Water main WA Water service line >to Surface water >1W
Wells on adjacent Iota »oP
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
property line »v Building foundation »Q Water main »a
Water Service Ina >10 Surface water >10' Driveway. pwW g&Wvde storage >2S
Curtain drain Nene NOW Wells on adjacent kns >Iw
F. COMMENTS:
G. ENGINEER'S CERTIFICATION
I car* that I have detem*wd hrough field inspecm a and
review of Mw**)al records that the above systems SM in
oaAormance wlh MOA COSA guide0nes in effect on 0* data
Engineers Printed Name Michael E. Andersen. P.E.
Data Ut9r2W
COSA Fee S
Dote or payment cq
Receipt Number 1710-- SX
tftev. ttael
Wahrer Fee S
Date of Payment
Receipt Number
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.org/onsite
(907) 343-7904
Nitrate Advisory
Certificate of On -Site Systems Approval # 070103
A Certificate of On -Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block F, Lot 16 of
Knik Heights subdivision. This inspection revealed a nitrate concentration of
8.19 milligrams per liter (mg/L) was reported for the property's well water
sample. The Environmental Protection Agency (EPA) has established a
maximum contaminant level (MCL) of 10.0 mg/L for public drinking water
systems. While private wells are not subject to this regulation, EPA
standards are based on existing health information and can therefore be used
to gauge the relative quality of water from private wells. Please see the
attached "Nitrate Fact Sheet" for important information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
8312F
LOT 17
LOT 2
N8905900"E 300.00
30
o n
IV UTILITY EASEMENT
— — — --
----------------,
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all
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LOT 3
2. OH
55.3 42.3
yy
. ..... a (6 3 StoryFrameW
CD
House
o
LOT 16
Z
8.0
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Z
V=39
tic verSCALE:
0 34.3
---------- 46
00.
,peptc TO OH 7 OH
owel
30
N8905900"E 300.00
LOT 4
LOT 15
AS-BUILT NO CORNERS SET THIS DATE
I hereby certify that I have performed a Mortgagee's Inspection
of the following described property: LOT 16, BLOCK F.
KNIK HEIGHTS SUBDIVISION
OF A4 X�J
Anchorage Recording Precinct, Alaska, and that the
Improvements situated thereon are within the property Ines
rte^.. ... .
and do not overlap or encroach on the property lying
adjacent thereto, that no Improvements on the property lying
Fred VValatka
adjacent thereto encroach on the premises In question and
No. 3255-S oo
Fob
that there are no roadways, transmission lines or other
Indicated
visible easements on said property except as
0,
hereon.
Dated at Anchorage, Alaska
EASEMENTS OF RECORD, OTHER THAN
this 8th day of April 2007
THOSE SHOWN ON THE RECORDED
Lantech
FRED WALATKA & ASSOCIATES
PLAT ARE NOT SHOWN HEREON.
BE
Engineers and Surveyors
(907-248-1666)