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HomeMy WebLinkAboutPARKSIDE BLK 1 LT 3 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221310 PID Number: 050-591-03 Dwelling: X Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New N Upgrade Name NameABSORPTION KIKTA FIELD ❑ Deep -Trench ide Trench ❑ Bed ❑ Mound ❑ Other Site Address 23378 GLACIER VIEW DR, EAGLE RIVER Phone Number of Bedrooms Soil Rating depth from original grade 3 GPD/SF JTotal Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot PARKSIDE BLK 1, LOT 3 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft, Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ftz Ft. Well 100'+ 50'+ TANK N Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity GREER TANK 1000 Gal. Surface Water 100'+ Material PLASTIC Number of compartments 2 Lot Line 10'+ NA Foundation 0'+ LIFT STATION Manufacturer Capacity Gal. Remarks TANK DEMO PER UPC, Alarm location Electrical installed by PIPE MATERIAL House to tank 3034 drainfield Tank to 3034 Installer NORTHERN EXCAVATION Drainfield COIMT3034 Inspector MIKE N ANDERSON, P.E. BENCH MARK (Assumed elevation) 100 ft Inspection 1,' 7115122 Location and description ection 2nd TOP OF MANHOLE 3rd 4m ON-SITE WATER AND WASTEWATER SECTION APPROVAL En tamp ©� Conditional Approval: Date ,.�1�:•' •:�-!*? •49rN '•dip : MICHAEL N. ANDLRSCN ; I" 1'�• Septic Syste �. ,� Approve Date cl 9a �9� - �— tett R Note: this approval does not include well permit requirements. (Rev 05102118) Permit No. OSP221310 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: PARKSIDE BLK 1 LT 3 PID No.: 050-591-03 MARK I A B TC0162 TC00032 46 53 C04 43 48 f� GIAC GES, 6 � - OA BENCH, GARAGE SLA -, _._ CO -B' COt PUMP UNE NEW 1000 GALL L ii K 2' HDPE FORCED SE LINE FROM THE HOUSE WELL U ASBUILI SCALE: 1"=50' 5' LH,__,'Y ESMT ,.AAA GUN PLASM IMA( -------j o®®®E 0F, q 49 TH MICHAEL N. ANDEF o. CE 9469 ' •.8N-26-22 0 m �R 0cl, p F •C.L1 N x n 0 04 DO ro04 G Ir 1 -2 -- b� y m W co rD`Aa� w o _.tz n Ell GO r r y QD 64 AD 0 `m+. 3 ' m N ` �i 7. V I m n ti v' O R• v 47 7 y' O Ai ,pi 'CpS �'w e `" CC CD c N yt! �o N N �c < cc 4 o•p r C, c C is J.CD 5� n J W 81 Oj �. i 5 zz p yCD -' O 8 A O. m 2 5�Q5 W a 0CD � w C, o N F � � CD 0. a O O .-. CD , b r UY0r: !(j:• �R n t+: p F •C.L1 m O 0 2 ' ip 0 04 DO ro04 G Ir 1 -2 -- � ~ r CO > co rD`Aa� z O �k/Sn y�Usf c 18.8' QD 64 AD 0 `m+. 3 ' m N ` C<1 �AC/ER 00 d rte o H GO p/H X2'00„w a m m 153 7' r O RAS � n Q X110.72 R�5 n FJ SM O lAjf'�' 02o Z � m � z ti` A'1 CO r - r0 O 0 7\-w 15' UTILITY ESMT S89'52'15"E 450.00' 0 rn N74 22,00»W 64.06' i 3215' Csl C t M r -< r m { j z O �k/Sn y�Usf c 18.8' .mow o � �i 7. V I 00 3215' Csl MUNICIPALITY OF ANCHORAGE Onsite Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 httpJAvww.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number. OSP221310 Work Type: SepticTank Upgrade Tax Code Number: 05059103000 Site Legal Address: PARKSIDE BLK 1 LT 3 G:0060 Site Mailing Address: 23378 GLACIER VIEW DR, Eagle River Owner: KIKTA BERNARD J Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 8/8/2022 8/8/2023 E:BII m ❑ Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either. a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Issued By: Date: Date: S 2Z MUNICIPALITY OF ANCHORAGE- Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 050-591-03 Property owner(s) '� Seg7ctrA Day phone Mailing address 23378 GLACIER VIEW DR, EAGLE RIVER AK Site address-� �" _Gnme. Legal description (Sub'd., Block & Lot) PARKSIDE BLK 1 LT 3 Legal description (Township, Range & Section) Lot Size 83023 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank ❑ El Upgrade X Duplex (D) El Holding Tank F] Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A 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: �t 3 b O Date of Payment: 3/5 /a022 Receipt Number: � a 5 9 3 9 Permit No. O S P �'9 1 3 1 Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc August 8, 2022 Municipalities of Anchorage On-Site Water and Waste Water Section 4700 Elmore Rd Anchorage, Alaska Phone 343-7904 Re: New septic tank permit Legal: PARKSIDE BLK 1 LT 3 To whom it may concern: This is a request for a septic tank permit on the above referenced lot. This tank replacement will not impact any of the neighbors or encroach on any wells, septic or open water issues. The tank will be decommissioned per the Uniform Plumbing Code (UPC). Sincerely Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221310, Deb Wockenfuss, 08/08/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221310, Deb Wockenfuss, 08/08/22 Municipality of Anchorage Page '.~ of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 ' On-Site Wastewater Disposal System and/or Well Inspection Report Nam~,4*~,~/ ¢~£~ ¢.. ~ ~4,~ ~C~ Wastewater Syste~ CK~ B Upgrade Address: J ~2~ ~,.,/ ~'~ ~.~/~ ~,'~-~,A~ ABSORPTION FIELD No f Bedrooms: Phone: ~_~ ~ ~ Deep Trench ~ Shallow Trench ~Bed DMound ~Other L E G A L D E S C R I PT I O N sci, Rating: Total Depth from original grade; I~ ~ ~/Sq. Ft. / Subdivision: 0epth to pipe bottom from original grade: Gravel depth beneath pipe Township: Range: ] Section: Fill added above original grade: Gravel length: O Ft. ~ Ft. WELL: '~ New ~ Upgrade Gravel ~:~/~ I Number of lines: Oislance ~lw~n lines: ~ FI. / ~/4 Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: Driller: Date Drilled: Static Water Level: Installer: Date installed: Yield: Pump Set at: Casieg Height Above Ground: SEPARATION DISTANCES ~Septic ~ Holding ~ S.T.E.P. To Septic Absorplion Lilt Holding ~ubfic/Private 'Manufacturer: Capacity in gallons: Material: Number of Compartments: s,,,f~ i f~'~ LIFT STATION Manufacturer: Lot ~/ ZO~ i ( Z~ .... Line ¢ / i "Pump on" level at: "Pump off" level at: High water alarm at: J Pump Mak~-M~ Electrical Inspections performed by: Curtain ~ ~ y .... ~ Drain Remarks: ~ t'~T~//~ /~ ~,~/~ ~ BENCH MARK ~d ...... / / Location and Description: ENGINEER'S SEAL inspections performed by: ~ Dates: ~st h- e~ ~.~...~--~ ' Department of Health and Human Services approval ,~,~. c~47~ Reviewed and approved by: / 72-0!3 t!,'9t) MOA 25 Permit No. SW970021 Page 2 of Municipality o1: Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-¢744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: Parkside Lot 3 BIk 1 PID No.: 0505910:3 OPO~l POLE Existing t000 Gc~t 450.00 tS' UTILITY EASEMENT ump in Crowlspace Little Giant Submersiblel Sewage Ejector Pump ,~.. ~ I ~.- /~/~''~ , 3/27/98 ENGINEE, R°S SEAL ~,~.. ....... :..,.... ~ ~% ~-"' ~9 TH~ ".~( .... ,~". LOUIS A. BUTERA ."~ ~.~". CE-6756 ..'~ PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW970021 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES OWNER NANE:SIVERS LOIS J & VERN OWNER ADDRESS:57646 BRISBAINE WARRENS OAK, OREGON 97053 DATE ISSUED: 2/19/97 EXPIRATION DATE: 2/19/98 PARCEL ID:05059103 LEGAL DESCRIPTION: PARKSIDE BLK 1 LT 3 LOT SIZE: 83083 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18/LAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ~, --~-- DATE: Eagle River Engineering Services Louis Butera, P.E. P.O. Box 773294 (907) 694-5196 tel ]~agle l~iver, AK 99577-3294 (907) 694-3297 fax February 5, 1997 Jim Cross, P.E. Manager, On-Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re~ Parkside Lot 3, Block 1 Narrative & Permit Application Dear Mr. Cross: On behalf of our client, we are requesting a permit to construct a new sewer line which is necessitated by relocation of the house to another portion of the lot, while retaining the existing, approved, leachfield. The existing septic system successfully passed an adequacy test performed by us on January 13, 1997; a copy of the report is attached. The change in house location and elevation will require a sewage pump be installed in the crawlspace of the new home with pumped sewage to the existing tank location. This lift station would be considered part of the home plumbing. General specifications are attached. There is no well at this time, and a proposed well site is indicated on the site plan. The proposed septic sy6stem change and new well construction will have very limited impact on adjacent properties for the following reasons: 1. The surrounding lots are large, allowing sufficient room for septic sites. 2. Immediate neighboring septic systems are all +30' distance. 3. We are not modifying the existing septic system. 4. Drainage will not be affected and is not a major consideration in our design. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. \ 1997\96-045A-NAR.DOC Eagle River Engineering Services Louis Butera, P.E. P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax SEPTIC ADEQUACY TEST REPORT TEST DATE: January 13, 1997 LEGAL: Parkside Lot 3, Block 1 LOCATION: NHN Carol Drive, Eagle River RESIDENCE: Single Family, 3 Bedrooms SEPTIC SYSTEM: From Municipal Records Tank: 1,000 Gallons Absorption System: Trench Type INSTALLATION DATE: 09/22/83 INSTALLED ABSORPTION AREA: 462 Square Feet ORIGINAL SOIL RATING: 125 SF/BR From Septic Asbuilt TEST PROCEDURE SEPTIC: The leachfield was charged with water from a tank truck with a total of 1,250 gallons of water, in 250-350 gallon increments. The septic tank and leachfield liquid levels were monitored referencing a measurement below the top of the standpipes. During the test, water was added through the monitor tube and the leachfield and septic tank water level were monitored as water was added and then absorbed into the surrounding soil. The water level in the septic tank did not rise during the addition of 1,250 gallons of water showing that the trench had accepted the entire amount. A total rise in liquid level in the leachfield was recorded as 48". Measurements were taken of the leachfield level, at 10 minute intervals with a satisfactory reduction of 36" in liquid level over a 1.5 hour time period. The monitoring indicates the septic system will accept the required 150 gallons per day of effluent, per bedroom, which is the required absorption rate for Municipal approval. TEST RESULTS The septic system soil absorption rate meets the requirements of the Municipality of Anchorage for a 3 bedroom single family residence as of the day the system was tested. There is no guarantee that the well and septic system tested will meet the requirements for approval in the future. The test data and investigation of existing conditions is provided to our client for submittal to the Municipality of Anchorage for their review and approval. Any concerns with this test report should be discussed with the testing engineer. \1997\96-045A-P. PT.DO£ PAGE 1 of 2 i NB DEVELDPMENT rI~ ~ 74.~ x x ~ ~ BE RENBVED ~ / TRENCH / ~~eZ~ ~ ~ ~ PRfl[ ]SED L~CATE SEWAGE PU IN HOME CRAWL~PACE 1- 450.00 15, UTILITY EASEMENT I NO DEVELBPMENT ~ TEST HOLE · - MONITOR TUBE o - SEWER CLEANOUT ~ - WELL EASEMENT PROPOSED LEACHFIELD SURFACE WATER AS INDICATED ~- EXISTING LEACHFIELD ELEVATION NO KNOWN CURTAIN DRAINS LEGAL: PARKSIDE LOT 3, BLOCK 1 A EAGLE RIVER ENGINEER/NC SER VICES P.O. ~o~ 773294 EAGLE RIVER, AK. 99577 (907) 694-5195 FAX: (907) 694-3297 Eagle River Engineering Services Louis Butera, P.E. P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LEGAL: Parksid© Lot 3, Block 1 02/05/97 A. GENERAL 1. The well and septic plan are for a single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. 4. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 5. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi-family wells. 6. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. B. LEACHFIELD AND SEPTIC TANK 1. Existing septic tank and leachfield are to be retained and are to be undisturbed by construction activity. C. SEWAGE PUMP 1. The sewage pump is to be installed in the residence, above grade, in a location that is readily accessible for maintenance and inspection. 2. The pump shall be capable of supplying a minimum of 10 gpm flow rate at a total head of 40' through an 1-1/4" discharge pipe. C. SEWER LINE 1. The sewer line is to be ~" HDPE SDR-11 pipe, installed at a minimum of 8' burial depth with 2" of burial foam, 35 psi minimum, 2' wider centered over the pipe, with joints overlapping 6". 2. Pipe is to be insulated with 4" of board foam in locations of sePtic tank, and house foundation. 3. The attachment to the existing septic tank is to utilize an Orenco flex reducing coupling attached to the HDPE with a brass barb fitting with proper adapter. Twenty-four (24) hours notice required for all inspections. \1997~96-045b-spc.doc Drilling by DOC Co. dba SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 * TELEPHONE 688-2759 OWNER OF LAND _ .~ /,pc' ~'i ,:. " .?: ', ~,;'/. ,'~,: ,'4.!, ADDRESS '; ,' }'" /i'/ .-~_/ .- DATE - Started Ended PERMIT NUMBER --~ ~ ~ ~5 .... · KIND OF FORMATION: From_ From_ DEPTH OF WELL . / STATIC LEVEL OF WATER Fr. DRAW DOWN FT. GALS. PER HR - KIND OF CASING t.' , Ft. Ft. Ft From . Et to__ Ft. _Ft. to~' Ft.- ;}" *'[ ~ ' lit.,; ' '/'tC,' .,)¥"] From .... Ft. to___Ft._ ·: _ ~ .' ,:: :d t, :.;-.4-/~7: ~ ~ ' From -- Ft. to. Ft. _Ft. to~ ? ...Ft. Ft to~:) ': ' ' ' 'f -;'~"~ From~Ft. to_ Ft. Ft. ,' From'"' ) ~ / '" "; L: -,2, / ~"'/:~ 'T From Ft. to_ Ft~ t, ',, ,,,.,. ' . . . .,.~ I Ft From / :~ --:~Ft. to / ~ o Ft. /'?,.,~,,,q ~.. C fi,'-?."-.~ / "'"¥ ~2' t-Fr~m~ > Ft. io_ From_/ From_ Ft. to Ft.~"-:tzar'~ /~3 .'., .:.~-. Fz From Ft. to. ..... ~ "" : ' ~/7 7 From Ft. to Ft. From_ '~ From .' ,, ...... .' ~ ...... ~ [c 'T/7~ .x.. { /" From Ft. to From- _Ft. to.---Ft. From _Ft. to. FroTM-- zFt;'to-C MISCL. INFORMATION: , .......... d~'. ~ · From-- Ft. to_~Ft.- From Ft. to__-FL From- _Ft. to-- Ft. From_- Ft. to___ Ft. From_ Ft. to_~Ft. From_ Ft. to_ __Ft. From_ Ft. to_ Ft. From~Ft. to__Ft. From__-Ft. to Ft, From- FL to~Ft, ~~[~Tv E D ~AR ~ 0 1998 Municipality ol Anciqorago Dept. Health & Human 8ervioea DRILLER'S NAME PAGE 1 OF 1 MUNICIPALITY OF i~NCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM PERMIT PERMIT NUMBER:SW970045 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES OWNER NAME:SIVERS LOIS J & VERN OWNER ADDRESS:57646 BRISBANE WAY WARREN, OREGON 97053 DATE ISSUED: 4/02/97 EXPIRATION DATE: 4/02/98 PARCEL ID:05059103 LEGAL DESCRIPTION: PARKSIDE BLK 1 LT 3 LOT SIZE: 83083 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) A_ND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SALVE DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: , ~ - _r ISSUED BY: ~~. ~ DATE: DATE: EEK LOCATE ~E~AGE PU~ IN HO~E CRA~L~PACE ND DEVELOPMENT ~ -- TEST HOLE · - MONITOR TUBE o - SEWER CL~NOUT ~ - WELL ~SEMENT PROPOSED L~CHFIELO INDICATED ~- EXISTING L~CHFIELD SURFACE WATER AS - EL~ATION NO KNOWN CURTAIN DRAINS WELL/SEPTIC SITE PLAN LEGAL: PARKSIDE LOT 3, BLOCK 1 -~¢ ..... .~,~ EAGLE RIVER ENGINEERING SERVICES (907) 694-5195 FAX: (907) 694-3297 [ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL DESgRIPTION Material No, of compartments ~ ~ I nside length Width Liquid depth Liq. capacity in gallons IF HOME.DE: ~all ~allMg ~ER~IT ~0. ~ Well / ~ D]STANCETO: ~ ~O'~ iN Foundation Nearest lot line PERM]TNO, - Total length of lines 2 Trench width Dista~etween lines _~ ~ ~ ~o. o~ ~in., / 'U~.~t, o~ ~, ~i.%~.,. ~ ~ Z ~ ¢ i.~, ~ ~ ~ Top of tile to finish grade ~ / Material beneath tile ~ inches Total~effective a~sorption~ ~ area Length Width Depth PERMIT NO. ~ Type of crib Crib diameter Crib depth Total effective absorption area m Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO. ~ Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER PIPE MATEBIALS -~ SOIL TEST RAnG INSTALLER ~ REMARK8 ~'" A ."~, / ~...~ 60~:. ...:~:'-- ' ' 72-013 (Rev, 3/78) I'IUI'I.LL, II"'AL1 I 'l' Ul" Departmen%.~ f Health and Environmenta' Protection 825 ~.& Street, Anchorage, AK. '~9501 ' 264-4720 ,' . * * Permit ~ ~ ~O~ HANDWRITTEN PERMIT * * * ~LL AND/OR ON-SITE SEWER PERMIT Applicant: :~/~/L~~.7~ Mailing Address:~[~ ~g/~/~ ~_~..~ L~cation: ~ ~,, . ~D /~V/~~ ~/~. Phone Number: /t)~. Legal Description: ~Z ~/ ~,~ ~b~. LOt Size:/dQ?~ T~pe of Soil ~sorption System Is: Trench: Drainfield: Seepage Bed~: Holding Tank: Maximum N~ber of Bedrooms: ~ Soil Rating(sq.f~/br) /~)~ The Required Size of the Soil Absorption System Is: ' ! DEPTH /'O 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 = [©~ 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 departmen will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 fee f~r 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 come,unity sewer line is 75 feet. Well logs are required nad 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 8 3 * * * I certify that: (1) I am fa/niliar with the requirements for on-site sewers and wells as set forth by the Municipality of A~chorage. I will install the system in accordance with codes. ' I understand that the on-site sewer system may require enlargement if (2) (3) 3 bedrooms the residence is remodeled to include more t~ . Signe~: Issued '~/~.~~ Applicant Date: SWP/024 (1/81) · MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG- PERCOLATION TEST SOILS LOG [] PERCOLATION TEST PERFORMED FOR: LECAL DESOR,PT,ON: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16- 17 18 19 2O COMMENTS SLOPE SITE PLAN WAS GROUND WATER ) (ENCOUNTERED IF YES, AT WHAT DEPT.? S Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE TEST RUN BETWEEN FT AND --. FT PERFORMED BY: 72-008 (6/79) CERTIFIED BY: DATE: RUSH MUNICIPALITY OF ANCHORAGE Development Services Department `� �j, Phone: 907-343-7904 On -Site Water & Wastewater Section - Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel l.D.050-591-03 1 Expiration Date: 6 2 91 22 1. GENERAL INFORMATION Complete legal description PARKSIDE BLK 1 LT 3 Location (site address) 23378 GLACIER VIEW DR, EAGLE RIVER AK Current property owner(s) Mailing address EVANS SAME Day phone Real estate agent Day phone 2. TYPE OF DWELLING: El 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: Private Well El Private Septic El 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 $ 000 Waiver Fee $ Date of Payment Date of Payment Receipt Number Receipt Number COSA # D,'5G 2 2 19 t-1 Waiver # 6. 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-MIKE_N_ANDERS_O_N,_P__E_ -Phone 727 8864 Address 4661 NATRONA AVE ANCH AK Engineer's Printed Name MIKE N ANDERSON, P.E. Date 8-26-22 ... 0.011P��• � F r h. '•, T, 6. DSD SIGNATURE .�, ;. TH 49 • • • • • • ? � System #1 Approved for 3 bedroomsj• • • • . • ........... rte" MICHAEL N. ANDERSON ."k- /'0 System #2 Approved for bedrooms if Gi C - 94 Disapproved`•ic 1� P or[SS10 Conditional approval for bedrooms, with the following stipulation\���.� � m WASTL V ATER ? �X% rKUUKAM � J h. )))))))1111 Original Certificate Date: -2 1� - 2 Z 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 Chec dist blue sheet COSA Checklist Legal Description: PARKSIDE BLK 1, LOT 3 Parcel ID: 050-591-03 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Well production at time of ._ te� -t *B0.255 gpm s�soraz --------- Date drilled ,_ Water--stora e -tank volume -l - gallons Total depth 300 ft Well disinfected for coliform test? ❑ Yes ❑ No Cased to 21 ft All Coliform bacteria is Negative ❑ Sanitary seal is functioning correctly Nitrate mg/L ❑ Nitrate less than MRL (ND) ❑ Wires are properly protected Arsenic ug/L ❑ Arsenic less than MRL (ND) Casing height (above ground) 30 in. Collected by MNA Date of flow test for COSA 7/21/22 Date of Sample 7121122 Static water level at beginning of test 80 ft. Comments *STORAGE TANK IN CRAWL SPACE B. TANK DATA Age of tank(S) NEW years Tank type/material "Ppa OPE Measured operating fluid level in septic tank 48 ❑ Standpipes/foundation cleanout per record drawing Date of pumping NEW TANK D. ABSORPTION FIELD DATA Which system tested (date installed) 9/83 ❑ ALL standpipes present per record drawing Total measured depth from grade 10.1 ft (max) Measured depth to pipe invert from grade 3.1 ft (min) ❑ NIA – pressurized field ❑ Monitor tubes go to bottom of effective- If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced 0 gallons Comments/Deficiencies: COSA Checklist yellow sheet C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 7/21/22 Results Q Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 450+ gal New depth 1 in Elapsed time 1440 min Final fluid depth 0 in Absorption rate 450 gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Q✓ Yes Septic Tank/Lift Station on Lot > 100' ft Wells on Adjacent Lots: Community Sewer Manhole/Cleanout > 100' 0✓ Yes if No ft 21 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 ft Holding Tank > 100' Yes if No ft Neighboring=Absorption=Fields=>=100' if No ft Animal -Containment > 50' ❑✓ Yes F. ENGINEER'S COMMENTS if No ft ✓❑ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' [DYes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' Q Yes if No ft Surface Water > 100' El Yes if No ft Property Line > 5✓Q Q✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Yes if No ft Private Wells > 100' 21 Yes if No ft Water Main > 10' Q Yes if No ft Community Wells > 200' E✓ 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' Q✓ 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' Q Yes if No ft Private Wells > 100' Yes if No ft Water Service Line. > 10' Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' Q Yes if No 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 ti���de8a 0,4 • OW • • ern e •• • ,49TH , r MICHAEL N. ANDERSON `�. f•�• CE 9469 ••�~`°s 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.ci.anchorage.ak.us (907) 343-7904 Parcel I.D. O5'O 5'?/ O5 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING oqo (qq/' Expiration Date: ~ - ~. ,~- O 17/- GENERAL INFORMATION Complete legal description Location (site address or directions) Current Property owner(s) Mailing address Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well 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 Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Cedificates of Health Authority 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 wo!'k. 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 Health Authority Approval Guidelines for this application, shows that the or~- ~ite 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. Address./¢'./,,~-/ I/F"~ ,~'... ~,,-~.. ~,¢ / Engineer's Printed Name r-.~-,,-,~/~-~¢/~#~;,z. .,~-.-. ~JaoZ) DSD SIGNATURE Approved for ' Disapproved. Conditional approval for Phone ~//-f'- 5'/5',5' bedrooms. Date 5'- I/-,~ F- bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist Septic System AdVisory Well Flow Advisory X By:'~ Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: .'~L-'_ ~ ,.,~_.0/'~ (Rev. 01/02) Legal Description: A. WELL DATAi Well type i:~;v-~..~... Date compl6t(~d Total depth:i~O ft. Date of tesi '" Static water level Well production 'Municipality of Anchorage Development Services Department · Building safety Division On-Site Water & Wastewater Program ; 4700 South BragawSt. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us ~ (907) 343-7904 HEALTH AUTHORITY APPROVAL CHEOKEIST If A, B, (~r C prOvide PWSID # __ San)tary seal (~)N)~ Cased tO. ,,~,1 ft. FROM WELL'LOG ":: 5'.~-- ' ft. :g.p.m. Parcel ID: ~"~ ~"'~! Well L~)g ~N) ~ Wires pr0perly;p~o~ected ~N) Casing height (above ground)' AT INSPECTION ~ ~ :~ ~ ft. WATER SAMPLE RESULTS: Coliform !i ~ colonies/100 mi. B. SEPTICII'I~bi~N~ TANK DATA · ,' ~Tank Type/Material ,-~c.. ~---~,J_ . Tank size!' [~ · gal." ' Numl~er of compartments ~.- Foundabon ,cleanout (y(~)/V'O Depression over tank (Y/~ /JO Date"of' 'pur~pl"!: h'r'ing[:. ~ /;'~ '/Oq C.'ABSORPTi0N FIELD DATA Dateinst~lled' ~/)/'~..~ ': ':Length I~'!~'..~ -. ft, iWidth :~ ft. Nitrate O. I + mg./I. Date of sample: ~ pUmper ,7',~. ~' Soil rati.ng '(g.p.dJftt or/rft2/bdrrn,(,/=,2.5' Other bacte'ria ~ .~ colonies/100 mi. Collected b~y:, ~(./Y-~/X (,/O~.: Date installed Cleanouts ~Ni T0~l'd~pffi!. ~ 'ft. E". abso['pt!on area z--/~',~n-ft~ Monitoring tube Date of adequacy test ~"/~,~/~ V Results ~/Fail) Fluid dop[h ~n~absorption field before test ~. 5 m. Water added ~K~ gal. Elapsed Ti~e: ~& min.' Final fluid depth q~.5in. Absorption ,'1' ~ Any rejuv~?on treatment (past ~2 ~o':) (Y~& type) High Water ~l~rm (Y/~[~)'~ '/~ : · System !ype Gravei, "' r' below pipe 7 fl. 'D6pression over field ; ~ :- For ~ bedrooms -~ "~ , New depth /, rate ?= .qEO g.p.d.' If yes, give date D. LIFT STATION , ,. ,. : .,, . , ,. ,. . ~;,~ 'i Date installed Size in ~/~ss (Y/N) , Datum ' ~ EJ Cycles tested SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: SePtic tank/lift station on lot,' .2_$0 ' Absorption' field on lot o?.~ ~ Public sewer main '~ .'75' / High water alarm level at Meets alarm & circuit requirements? On adjacent lots ~ .i~ ibO:l-t-,,,::[~, On adjacent lots in. I certifY,that/..have'determined through'field inspections and review of Municipal records that the above systems are in conformanbe With MOA HAA 'guidelines in effect on this date. Engineer's~rinted Name Date -~:,',,i;:;id *' ~*~ II '~51--, HA~ Fe~; *; r: '~ '~':'"~''~ Waiver Fee $ · Public sewer Sewer/sephcservmeline" "/~ ~ Holding tank ' ! {~/./~',: SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: "'-' Property line ,~-~' ~ Absorption field Building foundation ,~-0 ~ ': Water main,' /~ I Water se~ice line ~5' ¢ SUdace wate~ , Wells cent lots' /d~' ~ SEPA~TION DISTANCE FROM ABSORPTION FIELD ON LOT TO: ~ ";:~; Propedyline~ ~ / Building foundation ~3 / Watermain ~ , water Se~ic'e,:, line ~ ~ ,~ . Su~acewater '~/o/. Driveway, ParkingNehicle storag Cudain'drai~ /~ Wells'On adjadent 10ts /~' ~ ': ~'~ ' G. ENGINEER'S CERTIFICATION,' .... : ,,,., ,; '-~ . Date of Payment. Receipt ~Number: (Rev. '12/01) Date of Payment Receipt Number