HomeMy WebLinkAboutSKYWAY PARK ESTATES BLK 4 LT 7Onsite File
Skyway Park
Estates
Block 4
Lot 7
#019-151-03
suoml 1 1 AL
(Rev 05/02/18)
Municipality of Anchorage AUG 0 7 202
On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP201127
PID Number: 019-151-03
Dwelling: X Single Family (SF)
❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade
Name
Beverly & Clifford Ivey
ABSORPTION FIELD
❑ Deep Trench ❑e Wide Trench ❑ Bed ❑ Mound
Site Address
12001 Toy Dr. Anchorage, AK 99515
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
868-3159
4
5.0 GPD/SF
3.0 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
2.5 Ft.
Gravel depth beneath pipe
0.5 Ft.
Subdivision
Block Lot
Skyway Park Estates
4 7
Fill added above original grade
0.0 Ft.
Gravel length
30 Ft.
Township Range Section
Gravel width
5.0 Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Lift Station
Tank
Line
150 Ft2
1
Ft.
Well
>50'
>50'
>50'
N/A
>25'
TANK El septic EJS.T.E.P. E] Holding XOther
Manufacturer Capacity
Orenco/Advantex FAP 1,500 Gal.
Surface Water
>50'
>50'
>50'
N/A
Material
Fiberglass
Number of compartments
2
Lot Line
>5'
>10'
>5'
N/A
NA
Foundation
>1 0'
> 1 0'
>1 0'
N/A
LIFT STATION
Manufacturer
OrenCo/Asch. Tank
Capacity
100 Gal.
Remarks Line under driveway is insulated with 4" of insulation.
Alarm location
Electrical installed by
Laundry room.
Capstone Electric
PIPE MATERIAL House to tank D3034 Tank to D3034
drainfield
Installer
A+ Home Services
Drainfield D3034 Co/MTD3034
Inspector L. Tidwell / J. Millette
BENCH MARK (Assumed elevation) 100 ft
Inspection15` 7/15/20
nd 7/16/20
Location and description
dates:2
Threshold of front door.
3rd
4'h
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
OF 44
Conditional Approval:
Date
sa�P,.•••" ••:�S ®®
Aff
' 9th'_®�'
®
-4
....._. . -............. v�
1XCHAEL E. ANDERSON a
Septic Syste
Approved
Date 8
-;a,% No.
No. CE -4381 ffi
ZD
F •..,a/s/zo ,,,>-''��
�'°ROFESS����®'4j®®
��
Note: this approv;7oes
not include well permit requirements.
(Rev 05/02/18)
SKYWAY PARK ESTATES, BLOCK 4 LOT 7
=RMIT # OSP201127 PID # 019-151-03
EXISTING SEPTIC SYSTEM DECOMMISSIONED & /
\DRIVEWAY
INSULATION ABANDONEDJIN PLACE.
VER LINE UND R
\ 1-1 /LOT 66
1 00'WELL RA IUS
t4-BDRM
/ 5' UTILITY EASEMENT
1500 -GAL DVANTEX
TANK W/ 420 POD
M ( TH1
MT1 /
TFA cI LOT 7
/ T2
IGARA,E SHED THH2
C
s EXIS�fI G WELL
\ / 50' / ALTERNATE SITE
X
�
sHE1� \ _ NOTE: NY pTHER WELL RE
SHED OR FOUND N PROPERTY
30' LO x 5' WIDE x .5' EFFECTIV
DEPTH BSORPTION TRENCH.
I 5' FRO PROPERTY LINE)
LOT 8
EXISTIN� WELL
ENGI N EERI NGI I� \ � I
PLAN AS -BUILT
_0
Z
Lu
Lu
U)
0
,QR D
J-
0 50 100
FEET
1 "=50'
B / /C
2C0 1.5 16.8
MH1
3 .5
15.4
MH2
44.2
15.9
PV
47.
17.
MT1
5 .3 —4-8'0
MT2
76.5 /52.3
LEGEND
CONTOURS: 5' INTERVALS
CO - CLEANOUT
2CO - DOUBLE CLEANOUT
FCO - FOUNDATION CLEANOUT
PV - PUMP VAULT
MH - MANHOLE
MT - MONITORING TUBE
SV - SEPTIC VENT
TH - TEST HOLE
SKYWAY PARK ESTATES, BLOCK 4 LOT 7
PERMIT # OSP201127
95.1
GE
ENGINEERING
PID # 019-151-03
2" INSULATION
94.6
m
97.6 ORIGINAL/FINISH GRADE
DRAINFIELD ROCK
30'
GROUNDWATER @ 90.6 3/6/18
89.1 (TO IMPERMEABLES)
PROFILE AS -BUILT
(NO SCALE)
Eve
95.1
C
r►_
0-
=40' =40'
I
30
P-632
SKYWAY PARK ESTATES
LOT 7, BLOCK 4
67,108 S.F.
AS -BU
I LT
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
PROPERTY DEPICTED ABOVE AND THAT NO
GASTALDI LAND
ENCROACHMENTS EXIST EXCEPT AS INDICATED.
SURVEYING, LLC
IT IS THE RESPONSIBILITY OF THE OWNER TO
JEFF A. GASTALDI, R.L.S.
DETERMINE THE EXISTENCE OF ANY EASEMENTS,
?000 E. DOWLING RD., SUITE 8
COVENANTS OR RESTRICTIONS WHICH DO NOT
ANCHORAGE, ALASKA 99507
APPEAR ON THE RECORDED SUBDIVISION PLAT.
PHONE 248-5454
UNDER NO CIRCUMSTANCES SHOULD ANY DATA
GRID
DATE
HEREON BE USED FOR CONSTRUCTION OR FOR
ESTABLISHING BOUNDARY OR FENCE LINES.
SW2729
8/10/2020
ANCHORAGE RECORDING DISTRICT, ALASKA
F.B.
JOB NO.
NOTE: NO CORNERS SET THIS DATE
06-02 1 SPE74
0
N
W
0
0
0
0
0
0
0
OF 14#
i * :• 49TH
�.. .........9000........
/.. .. 9999 ...........�
:. Jeffery A. Gastaldi : o
LS -6091 : �
8/10/2020 : a�
•
• •
mPa�•......9'°�•a SJI.
p rOfessiona\ ••\-a� •1`�1 YA1••
1R'v .-
BUILDING DETAIL
SCALE: 1 "=20'
MUNICIPALITY OF ANCHORAGE
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
On -Site Wastewater Disposal System"Permit
Permit Number: OSP201127
Work Type: Septic Upgrade
Tax Code Number: 01915103000
Site Legal Address: SKYWAY PARK ESTATES BLK 4 LT 7 G:2729
Site Mailing Address: 12001 TOY DR, Anchorage
Owner: IVEY BEVERLY
Design Engineer: FORGE ENGINEERING
This permit is for the construction of:
Effective Date:
Expiration Date:
Lot Size in Sq; Ft:
Total Bedrooms:
5 `1r
Department
6/5/2020
6/5/2021
67594
0 Disposal Field P 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 Departmentl per AMC 1.5.65. 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
4pecial Provisions:
1. The Engineer is to do an additional test hole prior to the construction of the s e4d-C- enstniction-may-
t., proceed at your own risk before the 7 day water monitorin is e. lease submit stamped and signed
if"results with the As -built Inspection Report. If th require a design change, construction of the system will
stop pending On -Site review and 9p rev �2. The mound is t have it and be seeded right after construction in order to quickly establish vegetation.
716/Zo Chun ,-,erd6v • DeS,' ��+n f, -6eea
Oil nein -I0L ho)e_'
Received By: (11111;'21z4�4 !"�/ ��.�/ Date: 1
Issued By: Date:
4
l��l�UMUPAUTY OF QIMC HO R 2 OE
�l?Y
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. 019-151-03
Property owner(s) Beverly & Clifford Ivey
Mailing address 12001 Toy Dr. Anchorage, AK 99515
Site address Same
Day phone 868-3159
Legal description (Sub'd., Block & Lot) Skyway Park Estates, Block 4 lot 7
Legal description (Township, Range & Section)
Lot Size 67,594 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 ❑X Upgrade R
pg
Duplex
ElHolding
(D)
Tank ❑ Renewal ElMultiple
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 of property owner or authorized agent)
Permit/Rush Fees: JR5 1 il�t 6'ZS
Date of Payment:
Receipt Number:
Permit No.
Permit App__- : .:..mac
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
PO BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
July 16, 2020
MOA Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
Subject: Skyway Park Estates, Block 4, Lot 7 – 12001 Toy Drive
Septic System Design
Dear On-Site Services Engineer:
The owners of the above lot intend to sell their property and the existing septic system on the lot is
undocumented and within the 100’ well radius. We are submitting this design and permit application for
the construction of a new septic system. The attached site plan identifies the location of the home and the
existing well, existing septic location and the proposed system and alternate site. No conflicts exist between
this proposed system and any other well or septic system, whether on this lot or adjacent lots.
The new system is designed based on a test hole recently placed on the lot. This test hole indicated
groundwater at 7’ below the surface. The percolation rate of the underlying soils was determined to be less
than 1 minute per inch. A soils analysis indicated the accepting soil is classified as a sand.
The ground surface on the lot slopes gradually to the west at no more than 10%. There are no slopes greater
than 25% within 50 feet downslope of either the primary or alternate site. Ground surface contours are
shown on the site plan showing the grade and direction of flow. Storm water drainage will not impact this
septic system. The new trench will be constructed parallel to the slope as much as possible.
Wells on this and adjacent lots are shown. The new Category III system will be a minimum of 50’ from all
wells and surface water, and more than 5’ away from the property line.
Please refer to the attached test hole logs, plan and profile sheets for the septic design. If this design is
followed, there will be no adverse impacts to adjacent properties.
Sincerely,
Michael E. Anderson, PE
7/16/20
// // // // // // // // // // // // // // // // // // // // // // // // // // // // // // // // // // // // // // // // // // // // // // // // // // // // // 100500
FEET
1"=50'
30' LONG x 5' WIDE x .5' EFFECTIVE
DEPTH ABSORPTION TRENCH. (MIN.
5' FROM PROPERTY LINE)
1500-GAL ADVANTEX
TANK W/ AX20 POD
NOTE:
NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE
PROPOSED SEPTIC SYSTEM
ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS
PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC
SYSTEMS.
CONTOURS: 5' INTERVALS
CO - CLEANOUT
2CO - DOUBLE CLEANOUT
FCO - FOUNDATION CLEANOUT
FS - FLOW SPLITTER VALVE
MH - MANHOLE
MT - MONITORING TUBE
SV - SEPTIC VENT
TH - TEST HOLE
LEGEND
2CO
MT
TH1
SKYWAY PARK ESTATES, BLOCK 4 LOT 7
TOY DRIVE7/15/20
5' UTILITY EASEMENT
10' UTILITY EASEMENTSHED
SHED
SHED
4-BDRM HOME
GARAGE TH2
PUMP VAULT
MT
ALTERNATE SITE
EXISTING WELL
DECOMMISSION EXISTING SEPTIC SYSTEM PER MOA CODE.
(EXACT LOCATION & ORIENTATION OF TRENCH UNKNOWN)
50'
100'
EXISTING WELL
100' WELL RADIUS
9085 95NOTE: NO OTHER WELL RECORDED
OR FOUND ON PROPERTY.
2" INSULATION
OVER LINE UNDER
DRIVEWAY
TH3
SKYWAY PARK ESTATES, BLOCK 4, LOT 7
DESIGN FACTORS:SYSTEM REQUIREMENTS:
600 GPD PEAK FLOW
PERK RATE: <1 MIN/IN
APPLICATION RATE: 5.0 GPD/SF
5'-WIDE SHALLOW TRENCH SYSTEM
1500-GAL F.A.P. TANK w/AX- 20 POD
PUMP VAULT
TYPICAL TRENCH SECTION
(NO SCALE)
1" PERFORATED PVC
(HOLES DOWN)
30-3/16" DIAMETER HOLES
@ 1' SPACING
DRAINFIELD ROCK
5'
NOTES:
1.GRADE AREA OVER TRENCH TO DRAIN AWAY
2.PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2'
WITH 2" OF INSULATION
3.CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER
THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY
TOP OF TRENCH: 6" ABOVE GRADE
FLOW LINE ELEVATION:2.5' BELOW GRADE
BOTTOM OF TRENCH: 3.0' BELOW GRADE
600 GPD / 5.0 GPD/SF /5' WIDE = 30 LF TRENCH REQUIRED (30 LF SPECIFIED)
7/15/20
6"
6"
6"
2" INSULATION &
GEOTEXTILE FABRIC
ORIGINAL GROUND
2'
LEGAL DESCRIPTION:
PERFORMED FOR:
DATE:
PARCEL ID#:
SOILS LOG AND PERCOLATION TEST
TECHNICIAN:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
DEPTH
(feet)
PROJECT No.:
TEST HOLE 3
SLOPE
SLOPE
SITE PLAN
DATE READING GROSS TIME(minutes)NET TIME(minutes)
DEPTH toWATER NET DROP
PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH)
TEST RUN BETWEEN: FT. and FT.
COMMENTS:
(inches)(inches)
SKYWAY PARK ESTATES B4 L7
7/8/20
L. TIDWELL
DATE OF MONITORING:
WAS GROUND WATER ENCOUNTERED?
DEPTH TO WATER AFTER MONITORING:
IF YES @ WHAT DEPTH?9.5
0.2 6
3 4
019-151-03
BEVERLY & CLIFFORD IVEY
11:47
7/8
1
2
3
4
5
6
3 0
16 / 9 0
16
11:52
11:54
11:55
11:57
12:01
1' OB
Professional Engineers Stamp:
7/15/20
<1 min
yes
7.0
7/14/20
SP/SW GRAVELY SAND
CL SILTY CLAY
3 0
16 / 9 0
16
3 0
16 / 9 0
16
3 0
16 / 9 0
16
3 0
16 / 9 0
16
3 0
16 / 9 0
16
6 0
16
6 0
16
6 0
16
6 0
16
6 0
16
6 0
16
<1 min
<1 min
<1 min
<1 min
<1 min
PROJECT CLIENT:% GRAVEL 30.4 USCS SP
PROJECT NAME:% SAND 67.9 USACOE FC N/A
PROJECT NO.:% SILT/CLAY 1.7 % PASS. 0.02 mm N/A
SAMPLE LOC.:% MOIST. CONTENT 6.1 % PASS. 0.002 mm N/A
NUMBER/ DEPTH:UNIFORMITY COEFFICIENT (Cu)
DESCRIPTION:COEFFICIENT OF GRADATION (Cc)
DATE RECEIVED:ASTM D1557 (uncorrected)N/A
TESTED BY:ASTM D4718 (corrected)N/A
REVIEWED BY:OPTIMUM MOIST. CONTENT. (corrected)N/A
SIEVE SIEVE TOTAL %SPECIFICATION
SIZE (mm)SIZE (U.S.)PASSING (% PASSING)
152.40 6"
76.20 3"100
38.10 1.5"98
19.00 3/4"88
12.70 1/2"81
9.50 3/8"77
4.75 #4 70
2.00 #10 60
0.85 #20 35
0.43 #40 11
0.25 #60 3
0.15 #100 2
0.075 #200 1.7
ELAPSED DIAMETER
TIME (MIN) (mm)
0
0.5
1
2
4
8
15
30
60
250
1440
HYDRAULIC COND.
(ASTM D2434)
DEGRADATION
(ATM T-313)
PLASTICITY INDEX
ASTM 4318
PASSING
The testing services reported herein have been performed to recognized industry standards, unless otherwise noted. No other warranty is made. Should engineering
interpretation or opinion be required, NGE-TFT will provide upon written request.
11301 Olive Lane ∙ Anchorage, Alaska 99515 ∙ Phone: 907-344-5934 ∙ Fax: 907-344-5993 ∙ www.nge-tft.com
N/A
N/A
4.9
0.7
Forge Engineering
HYDROMETER RESULT
N/A
SIEVE ANALYSIS RESULT
Skyway
5665-20
Block 4/ Lot 7
20-S-1
Poorly-graded sand w/ gravel
7/10/2020
JA
RJPC
TOTAL %
115
120
125
130
135
140
145
0 2 4 6 8 10 12 14 16DRY DENSITY (pcf)MOISTURE CONTENT (%)
MOISTURE-DENSITY RELATIONSHIP ASTM D1557
SILT or CLAYCOBBLES
GRAVEL
Coarse Fine
SAND
Coarse Medium Fine
0
10
20
30
40
50
60
70
80
90
100
0.0010.010.1110100FINER BY MASS (%)GRAIN SIZE (mm)
PARTICLE SIZE ANALYSIS ASTM D422 / C136
#200#40#101.5 1/2363/4 #4 #20 #60 #1003/8
U.S.SIEVE OPENING IN INCHES U.S.SIEVE NUMBERS HYDROMETER
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201127, Deb Wockenfuss, 06/05/20
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201127, Deb Wockenfuss, 06/05/20
1 Y OFANCHORACE
A I N I i- i
L,
WN1 i civil: 1
N i C! n It 1v
Advantex Waste Water Treatment System
V': V,
1 1 1: 1
( )\1 N F'. R :
< ! \ i 1 1. 1 i \ i A � i"'. \
i ) J I 'I ) 1 (1 AL D! S I R
adb
We -
Notary Publir
ROMALD DAVID
&ate of Almlm
�� � Dii
F 0 R, A LAS KA My Comvnmlmn Expires 0--L i, 20?1
I 1"N' - !CI P:\LITY:
ilk -, 0 181
_i
0
=40'
I
30
P-632
SKYWAY PARK ESTATES
LOT 7, BLOCK 4
67,108 S.F.
NOTE: LIMITS OF A.C. PAVING SHOWN ARE APPROXIMATE DUE
TO SNOW COVER AT THE TIME OF THIS SERVICE.
AS -BU
I LT
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
F•P• CANT
0
PROPERTY DEPICTED ABOVE AND THAT NO
GASTALDI LAND
ENCROACHMENTS EXIST EXCEPT AS INDICATED.
SURVEYING, LLC
IT IS THE RESPONSIBILITY OF THE OWNER TO
JEFF A. GASTALDI, R.L.S.
DETERMINE THE EXISTENCE OF ANY EASEMENTS,
?000 E. DOWLING RD., SUITE 8
COVENANTS OR RESTRICTIONS WHICH DO NOT
ANCHORAGE, ALASKA 99507
APPEAR ON THE RECORDED SUBDIVISION PLAT.
PHONE 248-5454
UNDER NO CIRCUMSTANCES SHOULD ANY DATA
GRID
DATE
HEREON BE USED FOR CONSTRUCTION OR FOR
O
ESTABLISHING BOUNDARY OR FENCE LINES.
SW2729
4/16/2020
Z
COVERED5p•0.
PORCH
�n
d
ANCHORAGE RECORDING DISTRICT, ALASKA
F.B.
JOB NO.
DECK
NOTE: NO CORNERS SET THIS DATE
06-02 1 SPE74
4
AIF
CO49TH
0000 .........0.0..00....../
/... .. 0000 ..........�
c Jeffery A. Gastaldi : o
LS -6091 : AIF
m� '. 4/16/2020
•• NPap ��•... H.�°'•a SJI.40 rOfessiono\ \-o�
YA
BUILDING DETAIL
SCALE: 1 "=20'
1.8'X 4.5'
COVE RED PORCH
F•P• CANT
0
0
34.5'
0
d
U
Zow
11.0'
O N
O
O 6.5
N o
;o
W
N Q
U
_
O
Z
U
O
O
O N
O
12.0•
Z
COVERED5p•0.
PORCH
�n
d
COVERED
DECK
4
AIF
CO49TH
0000 .........0.0..00....../
/... .. 0000 ..........�
c Jeffery A. Gastaldi : o
LS -6091 : AIF
m� '. 4/16/2020
•• NPap ��•... H.�°'•a SJI.40 rOfessiono\ \-o�
YA
BUILDING DETAIL
SCALE: 1 "=20'
M -W DRILUNG, Inc. 85-226
P.O. Box 1IM78 9 10= O(d Saward Highway &-.
(907) 34M535
ANCHORAGE. ALASKA 99511
DRIIIING LOO
Wall Owner 4.or&ne Stuart- _UseofWtll DQUAtIC
Location (address of: Township, Range, Section, if known; or distance main road
V. B4 Skyway Park Estates
Size of caslng-�A�pth of Holp 262- eet feet
Static water level 40 fL ow) land surface. F inish of well (check one) open end X
Screen Perforated I 's
Describe screen or pe
Well pumping test at -gella�, 694 (minute) for.;-�hours wl
'of drawdown from sta
7/1
Datd of completion
WELL LOO
Npth in feet from
ground surface 4�jb'rmatlons penetrated, size of material, color and hardness
0 2
TO -
2
5 38
38 41 &V Idet
-To----:-
41_TO
64
_T0_21 V�
',.4'CW
71 To 9
99 t
TO_L50 7
150 3 utritacer'UtAi4it
.1�0_158
158 To. 165 Gra vely Hard Pan
165 T0_.L99 Gravely clay
Va
199 256 Gravely Hard Pan
—TO -
256 262 Water Gravel IF
-TQ—
NWWA Co c
-TO— cuuma-te No'M. FRTV�3
-TO-
2 -STATE
G*":'ATER ANCHORAGE AREA BORO~'~H
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
N? 437
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
MAILING .. . ->. :7 .~ · ~,~,-
.ADDRESS,~A~(P,,~' / :'/-~ PHONE
DISTANCE FROM WELT ~/'~'- ~
LIQUID CAPACITY ..-~.--~ d~-d)
__MATERIAl
GALLONS. INSIDE LENGTH.
NUMBER OF
_COMPARTMENTS
INSIDE WIDTH r~:
LIQUID
DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS
LINING MATERIAL
NEAREST LOT LINE
OUTSIDE DIAMETER
?
Z--" OR WIDTH //(~/~ , LENGTH_ //~"' DEPTH
DISTANCE FROM WELL .~.~*"
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
BUILDING FOUNDATION ~/2 ,/7~
"~' d? c~'2' SQ. ET.
TILE DRAIN FIELD:
DISTANCE FROM WELl ../ _, FOUNDATIONX~NEAREST LOT LINE
NUMBER OF LI~ SE~ DISTANCE BETWEEN LINES ~, TRENCH WIDTH
ABSo~TdAREA SQ. FT. LENGTH OF EACH LINE
DEdH: TOP OF TILE TO FINISH GRADE _DEPTH OF FILTER MAI'ERIAL BENEATH TILE
TOTAL LENGTH
, OF LINES
./~IN. TOTAL EFFECTIVE
IN. ABOVE TILE
WELL: .' . '-.~-~ -, ..~:..: DISTANCE FROM -'~.:~-:,'~'~'/': WATER
TYPE~/~-..~'//~z~'~- DEPTH , BUILDING FOUNDATION../_~Z~___SAMPLE_ /~/~? ., NEAREST
NEAREST ,,:/SEPTIC / SEEPAGE ./ /.~ OTHER
LOT LINE ~'/(~ / pz_. , SEWER LINE ,TANK. ~ ., SYSTEM ~ CESSPOOL , SOURCES
DISTANCES:
,9. ./~ ~ ~-
DIAGRAM O1= SYSTEM
H EALffl AUTHORIIY
GAAB-H D-2 "~OROUGH Cas~ N o..-~,C~~
GREATEr ANCHORAGE AREA
ItEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279-25111
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
NAME OF APPLICANT ~-~v,)
RESIDENCE ADDRESS,
LEGAL DESCRIPTION__
APPLICATION TO INSTALL: SEPTIC TANK
TO SERVE THE FOLLOWING FACILITY
MAILING ADORESS.~i~d),~ '<" '~
__ LOCATION OF INSTA_LATION.
SEEPAGE PIT.
PHONE NO..
,ORAIN FIELO , OTHE~
FINANCED THROUGH '~')¢? n ¢~ t TO BE INSTALLED BY .~.'!~ '~Z!~
PERCOLATION TEST R~SULTS I~)-¢"J~/ /~,^~ ANTICIPATED DATE OF COMPLETION.
f'l~-- ~-~ ,~.,/'--
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS ~ ~(. t' '-" /
. , ,:'~c 0~5 ,/:,~_, PERMI r ro INSTALL A __ ,,~-(~A,~'t-¢
ASDESCRIBEO BELOW. SIZE OF UNIT TO BE SERVEl:)__. ,~-'
· SEPTIC TANK SIZE /,.~"~h2/__:) TYPE ,0 ~/~C' Z. SEEPAGE AREA__~¢~ -
DIAORAM OF SYSTEM
DIS'rANCES:
/) ,, J
I certify tha~ I am familiar with the requkements of Greater Anchorage Area Borough Ordh~ance No. 28-68 and that the
above described system is in accordance with said code.
-/
GATE
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
t - Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 019-151-03
1. GENERAL INFORMATION
Expiration Date: �)_et L{ , Q C)2 6
Complete legal description Skyway Park Estates, Block 4, Lot 7
Location (site address) 12001 Toy Drive Anchorage, AK
Current property owner(s) Beverly Ivey Day phone (907) 360-0572
Mailing address
Real estate agent
12001 Toy Drive, Anchorage, AK 99515
2. TYPE OF DWELLING:
❑■ Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
4
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
❑■
Private Septic
❑K
Water Storage
❑
Holding Tank
❑
Community Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Waiver request for: Distance:
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 2.10 CO U j 1�2
Date of Payment " `� ��' z 0
Receipt Number' �''
COSA#
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the
on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater
disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in
effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted.
Name of Firm Forge Engineering Phone (907) 522-7773
Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503
Engineer's Printed Name Michael E. Anderson, P.E. Date 8/22/2020
6. DSDSIGNATURE
V// System #1 Approved for r bedrooms
System #2 Approved for bedrooms
Disapproved
Conditional approval for bedrooms, with the following stipulations:
��l�c�tttttirtr��r
A
G
F �
v
CO
1
CyIB : Original Certificate Date:
U
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 Checklist blue sheet
COSA Checklist
Legal Description: Skyway Park Estates, Block 4, Lot 7
If more than 1 septic system on lot: COSA Checklist # 1 of 1
A. WELL DATA
❑■ Well log is filed with Onsite (or attached)
Date drilled 7/30/85
Total depth 262 ft
Cased to 262 ft
X Sanitary seal is functioning correctly
FE -1 Wires are properly protected
Casing height (above ground) >18 in.
Date of flow test for COSA 7/28/20
Static water level at beginning of test 36 ft.
Comments
B. TANK DATA
Age of tank(s) 11 years
Tank type/material F.A.P./Fiberglass
Measured operating fluid level in septic tank New
9 Standpipes/foundation cleanout per record drawing
Date of pumping New Construction 7/15/20.
D. ABSORPTION FIELD DATA 5' Wide Trench
Which system tested (date installed) 7/16120
0 ALL standpipes present per record drawing
Total measured depth from grade 3.0 ft (max)
Measured depth to pipe invert from grade ft (min)
X N/A — pressurized field
Monitor tubes go to bottom of effective. If not, state
depth into effective
1 Code -required soil cover over field
System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced NA gallons
Comments/Deficiencies:
COSA Checklist yellow sheet
151-03
Parcel ID: 019 -
Structure served by this system 1
Well production at time of test 1.3 gpm
Water storage tank volume None gallons
Well disinfected for coliform test? ❑ Yes No
n Coliform bacteria is Negative
Nitrate mg/L FUI Nitrate less than MRL (ND)
Arsenic ug/L 0 Arsenic less than MRL (ND)
Collected by FORGE ENGINEERING
Date of Sample
8/13/20
C. LIFT STATION
Q Required maintenance completed
Age of lift station <1 years
Lift station material PVC
Comments:
New Construction 7/15/20
Adequacy test date New System
Results [J Pass For bedrooms
Fluid depth prior to test in
Water added gal
New depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
Any rejuvenation treatment (past 12 months) None
If yes, enter date
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100'Community
✓v Yes
if No
Sewer Manhole/Cleanout > 100'
Yes
if No>0
ft
E] Yes
if No ft
Neighboring Tank > 100' Yes
if No
ft
Private Sewer/Septic Line > 25' ✓� Yes
if No ft
Absorption Field on Lot > 100' ❑ Yes
if No >50
ft
Holding Tank > 100' ❑ Yes
if No NSA ft
Neighboring Absorption Fields > 100'
Surface Water > 100'
❑ Yes
Animal Containment > 50' ®✓ Yes
if No ft
P1 Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' F/ Yes
if No
ft
❑✓ Yes
if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10' E Yes if No ft Surface Water > 100' ❑ Yes if No >50 ft
Property Line > 5'
✓v Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5'
Yes
if No
ft
Private Wells > 100' 0 Yes if No ft
Water Main > 10'
❑✓ Yes
if No
ft
Community Wells > 200' 0✓ Yes if No ft
Water Service Line > 10'
Yes
if No
ft
If septic tank is under driveway comment below
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10'
C]✓ Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
Yes
if No
ft
Wells on Adjacent Lots:
Water Main > 10'
Yes
if No
ft
Private Wells > 100' Yes if No
Water Service Line > 10'
Yes
if No
ft
Community Wells > 200' Q✓ Yes if No
Surface Water > 100'
❑ Yes
if No
>50 ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I 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.
COSA Checklist yellow sheet
Ig
ft
. MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR. AGREEMENT, herein the "AGREEMENT" made and
entered into as of this Day of J,"V M R.r of 20_2O, by and between
hgrein the "OWNER," and the Municipality of
Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as Advantex Waste Water Treatment System
located at (legal description)
Skyway Park Estates Block 4 Lot 7
2. Maintenance, Repairs and Alterations.
(Owner is required to read, understand and initial each section)
rVg Throughout the term of this Agreement, the Owner shall enter into a service agreement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS shall be maintained in satisfactory
condition capable of performing as designed and producing.treated septic effluent in
accordance with the equipment's approval for operation in the Municipality.
jjL SL It shall be the responsibility of the Owner during the term of this Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $600).
L 55 Owner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
Uz?— Owner acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement.'
(rev. 05/18/2018) Pagel of3
Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
Owner acknowledges that the fine for failing to maintain and repair an AWVYTS may be
assessed in accordance with AMC 14.60.030.
Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
'per Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
Zzp Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AWWTS.
Owner agrees to maintain remote monitoring of the AWWTS as required by the
ANVWTS approval.
3. Term. The term of this Agreement -shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. 1Vonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. A__mendment. This Agreement shall only be amended.by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7. Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
4
(rev. 05/18/2018) Page 2 of 3
0'vVNTER:
By: ignature) Date: -11 14/7-0 7-0
�(print name)
STATE OF ALASKA
)ss.
cv5 J'"""" JUDICIAL DISTRICT
The foregoing instrument was acknowledged before me this'L#t day of Ak�
20 p, by IVN"A- 06--1)
OF ALASKA
NOTARY PUBLIC FOR ALASKA , PUBLIC IV
NOTARY
My Commission expires: Nine Wideman
My COMCAUon Ends September 23, 2024
MUNICIPALITY:
By: (�Mxl (signature)
Re -6e c C 6g C -9-f- cc) L( (print name)
Date: I /) n
13 I 1-,� 0
Title:
Page 3 of 3
~ATE
I~SPECT~_ ~
TIMI"'
Rr~IJEST FOR APPROVAL OF:
INDIVIDUAl~ SB'IER ,ql'~D !'lATER FACILITIES
~PE FACILI~ TO ~E IF]SPE~I
[tUF~ER OF B~ROOf, IS:__
!'/EI.J. ~ATA:
'//
C, szz~_~_ ~ .... ~.~_~.,/./,~ ......
D, CONSTRUCTION .z/_Z~.~r-~- .....
E, BACTERIAL ANALYSIS _~-"~.~--~?~-C~,?,,.~:.~5,¢~-
S~,tA~_ DZS~SAL SYSCO,
SEPTIC TAt;K (IF l'JOi'qEl"¥q~E.. S1'1091 DIAGR/VVj ON ]]ACK)
t4, I~-ISTAU. J:.~ .....
APPROVAL R.. U,,. :,T ' . o,: ..:u~ : ~'ATER FACILITIE2
,~-~,.~ /F; ¥_../_¢_..C~_
C,DIS~SAL FIEU)'
1, ;~U/,~ER OF
7, ~{EOUIR~ :EASUR~B~ITS
WELL TO ~,
WELL TO~*'
D, NELL TO PROPERTY t.I:IE.__J~
F, FOU~'~ATIOR TO SE~IC T~4K
FOUNDATIO .1 TO SEEPA6E PIT.
8EEPA6E PIT TO PROPE~ LINE_
t ,.../.. ,. .....
~'~ IA ~r~ ~ ) . .r f! 'A F, '
/W/,O\.£ t, LL, lob O,.E .YE.,., RI.:, .,!,TE 8I .E~,
I~rll~TI.t,R/~,,I~-IOI'tA( E AREA BOROUGtt DEPARTMEi'.IT OF' BPFIRONFEITFAL eUALII'Y J
m;71
1. Sewer line
2. Septic tank ~
6, Othe~ sources off possib&e co~tamJnation~ J.,e,~ cr,eeks~ L~kes~
houses~ ba~n~ d~aina~e 6itch~ etc,~~
Age of system
c.,
.....
~ame o~ septic tank manuYactu~e~,, J)' 3 '~ ~ ,
Z. Z~ "hom~ made" show .....
. ' .
Disposal field op seepaKe p~t size and type,
e. PercoJ~tlo~ Te~t Yesults
f. Percolation Test performed by_. ~ ~ .:~ ....,
~ Use the reverse .side of this form to shoW diagram, Diaf-ra~ should ~.nclude
.~ .~he .following information: ~operty lines; .well location, house location,
~ptic tank location, disposal area location, location of percolation test~
a~.~ dtreetion of ~round slope,
9. The ~forma~ion on this form is true and correct to the best of my knowledge,
Si~:nature o Applicant ' Date Szgned
TO BE FILLED. ou'r BY HEALTH DEPAET{.JENT PERSONNEL
./
~'he above descmtbed sanlta~,y faeil~ies are hereby approved, s~ubject to~
.......... ~f6~:.%gwin~ cgn~i~ons ~
The above described sanitary facilities are disspproved for the follo%~ing
reasons:
..~' CPJ:cw
?