HomeMy WebLinkAboutPETERS CREEK BLK 3 LT 2Pe e s C eek
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Lot 2
· 051-115
-O2
Municipality of Anchorage
Development Services Department
Building Safety Division ..
On-Site Water and Wastewater Program, 4700 Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650 Page 1 of 3
www.ci.anchorage.ak, us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: OSP111056 PID Number: 051-115-02
Name:
Keith Harley WastewaterSystem: [] New [] Upgrade
Address:
23337 Tundra Rose Avenue ABSORPTION FIELD
Phone: Number of Bedrooms:
[] Deep Trench [] Shallow Trench [] Bed [] Mound [] Other:
LEGAL DESCRIPTION so~, Rating: Total Depth from original grade:
0.8 GPD~Ft~ 8.5 Ft.
Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe:
3 2 Peters Creek 2,5 Ft. 6 Ft.
Township: Range: Section: Fill added above original grade: Gravel Length:
1 Ft. 65 Ft.
Well: [] New [] Upgrade Grava~ width: 3.0 Ft. Numberlof lines:~1 Distance between= lines:Ft.
Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material:
AWWU Ft. Ft. qt00 ~ Ft2 3034 PVC
Driller: Date Drilled: Static Water Level: Installer: Date Installed:
Ft. Flintstone Enterprises 8/212011
Yield: J Pump Set at: I Casing Height Abeve Greund:
cPM Ft. Ft. TANK
SEPARATION DISTANCES [] Septic [] Holding [] S.T.E.P. [] Other:
T~.To Septic Absorption Lift Holding ~ublic/Private Manufacturer: Capacity:
Frorn ~
Tank Field Station Tank Sewer Line Anchorage Tank 1250Ga,.
Material: Number of Compartments:
We, 150+ 150+ 150+ Steel 2
Su#aceWater 100+ 100+ ~ / LIFT STATION
Lot Line 10.8 2.9~ Size: Manufacturer:
Gal.
Foun~ion 38.5 38.7 "Pump on' level at: "Pump off' level at: I High water alarm at:
in. in.I in.
Curtain Drain N/A N/A Pump Make ~ Model E,ectric~,nspect~ons pe~ormed
Remarks:
BENCH MARK
Location and Description:
House FF
Assumed Elevation:
' 100.0 Ft.
Engineer's Stamp
Inspections performed by: PANNONE ENG. SVC, LLC Dates: 1st 8/1/2011
2"d 8/2/2011
Development Services Department Approval
Conditional Approval Date: ~ ..... ,,; ~,., -- , ..... [,,,,~.
..... ,,
Reviewed and approved by: ~ :
, NOTE: NO WELLS WITHIN 150' OF NEW SYSTEM. ,
~ Vl/__~ W__ __~ W~
EXPANDED EXISTING RELD NEW PRIUARY DRAIN RELD
5L~x 3'Wx 5'ED x g'TD-- ~- 85LEx ~'Wx 8'ED x 8.5'TD
(50SF) ~ EXISTING /
~ SEPTIC AREA ~ ~ Z / EXISTING
~, ~~ / ~ SEPTIC AREA
........... ~.6~~ ~~11./INSTALLEDDCO AND DV j
' 10 1 __ DCO
EXPANDED /~ ~'~ ~g ~
5.0 LFx 5'WA 5'ED x 9'TD ~ ~ l~_-~~
FOR A TOTAL OF ~/~ ~ x ~ O00g SEPTIC TANK
77LF x 3 W x 5'ED x 9' TD ~EC~ ~N~a~ ABANDONED PER CODE
AND REUSED AS A · ,, ~/ ~';~f / ·
~ ~ / LOT UNDEVELOPED
3
~ NEW 4ER HOUSE
A B C
C1 15.90 28.20
C2 16.90 27.30
T1 15.50 24.80
T2 17.90 19.00 D/W
DC 18.20 17.40
C3 2~.~0 15.30 ~
Ul 22.70 18.40
M2 32.90 31.40 TUNDRA ROSE AVENUE
c4 36.40 ~4.80 ~. LEGEND
M5 37.50 55.40 W'~ W~ ~ W
~ w~ w WATER LINE/
C5 58.30 54.60
C6 8.60 20.70 WELL RADIUS
C7 49.30 65.10 ~ ss ~ NEW SEPTIC
ECl 57.50 35.70
~~. Dot e
NOT~S: P~O~ ~O ~C, L~ - OFAL
~.. ..... ;~ ~, 10/27/11
PHOU[ (007) 272-8218 [~X (~07) 272-8211 ~."~m ~
~"=30'
P.I.D.
PETERS CREEK S/D, BLOCK 5, LOT 2 -o5~-~5-o2
KEITH HARLEY
25557 TUNDRA ROSE AVENUE ~.~.. .:~¢~ OSPlllO56
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE blUNICIPALITY OF ANCHORAGE
STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE
WASTEWATER DISPOSAL SYSTEMS.
2. ALL WORK WAS IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS.
.3. SCOPE OF WORK: INSTALLED NEW 1250 GALLON SEPTIC TANK AND NEW SOIL ABSORPTION SYSTEM. DECOMMISSIONED
EXISTING WELL PER CODE.
4. NO GROUNDWATER WAS OBSERVED AS EVIDENCED BY THE SOIL TEST HOLE. AN APPARENT WATER TABLE WAS NOT
OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 15.0 FEET BELOW EXISTING GRADE.
TH -1 11 ',~ .3
-97.,3 OR
,
-1.o -- ,3 5
SM/ -~--r~- ~;~i~- 94-.8
GM
-5.0 :-- 6.0' ~
- 88.8
6.0
-15.0 B'-O'~ m m
GROUNDWATER @ 14.5' ~- ca
CSZ
Z 5/8/2011 ~-- Z ,,,
~ ~o , 05°
z~z0 0 0
E z z m~ ~ .~- ~ ~ /- 6' TOPSOIL AND VEGETATION _ ~ z~
< < /,_
D ,,, ,,, bd D Ed ~ b.{, ~ U FILTER FABRIC
OJ -J J OJ:O r,D .~, / /
b_ o o o ca ~ o i / / /- DRAIN ROCK 6" ABOVE PIPE INV
· - ,, ;;1 94- 8
SE.T,C ; .
i:';.i; i"; ~: i: i 888
PROFILE TRENCH SEE SECTION, DESIGN
DRAIN ROCK BELOW PIPE I
DESIGN PARAMETERS
DESIGN PARAMETERS RESERVE SEPTIC SYSTEM
PRIMARY SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) ABBREVIATIONS
NO. BEDROOM: 4 (600 gpd) TANK SIZE: 1250g CU COPPER
TANK SIZE: 1250g PERC RATE = 7.7 MPI DiP DUCTILE IRON PIPE
PERC RATE = 7.7 MPI SOIL RATING: 0.8 GPD/SF TH TEST HOLE
SOIL RATING: 0.8 GPD/SF AREA RQD: 750 SF FC FOUNDATION CLEAN OUT
AREA RQD: 750 SF SYS. TYPE: DEEP TRENCH 5.0' E.D. TiC TANK CLEAN OUT NO.
SYS. TYPE: DEEP TRENCH 6.0' E.D. MIN LENGTH: 75 LF CiC CLEAN OUT NO.
MIN LENGTH: 62.5 LF
USED: MiC MONITOR TUBE NO.
USED: REUSE EXISTING R.I. RIGID INSULATION
65 LF X .3' WIDE, 6.0' E.D., 8.5' TD 72 LF X .3' WIDE, 5.0' E.D., 9.0' TD DCO DOUBLE CLEAN OUT
TOTAL AREA: 800 SF ADDED 5 LF x .3' WIDE, 5.0' E.D., 9.0' TD DV DIVERTER VALVE
TOTAL AREA: 770 SF FS FLOW SPLI'FI-ER
NOTES: PANNONE ENG SVC, LLC '-'
P.O. BOX 100217 ANCHORAGE, AK 99510
RECORD
DRAWING
10/27/11
PHONE (907) 272-8218 FAX (907) 272-8211 ~,~:.' ~;~;.q..~J¢~ Scale
.TS
..... P.I.D. NO
"- 051-115-02
PETERS CREEK S/D, BLOCK .5, LOT 2 'l--'~"'-'¢e'n"l~:'P;~'n'$&&'¢~, .~_~e ~
KEITH HARLEY
:ERMIT
NO.
25`5`57 TUNDRA ROSE AVENUE ~'~,'~-~/~.0~~
DESIGN DETAILS CHUGIAK, AK 99567 Sheet
Permit Number: OSPl11056
Tax Code Number: 05111502000
Work Type: Septic
Permit Effective Dates: May 24, 2011
Design Engineer:
Subdivision:
On-Site Wastewater Disposal System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Upgrade
to May 23, 2012
PANNONE ENGINEERING SERVICE
PETERS CREEK
Site LegalAddress: PETERS CREEK BLK 3 LT 2 G:1360
Owner/Address: HARLEY KEITH & GAlL
23337 TUNDRA ROSE AVENUE CHUGIAK AK 995670000
Site Mailing Address: 23337 TUNDRA ROSE AVE, Chugiak
Lot Size in Sq Ft: 10500
Total Bedrooms: 4
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage
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 (18AAC80).
3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Special Provisions: The permit includes waiver OSP111057 allowing the drainfield to be 0 feet from
the east property line and 9 feet from the north property line.
Received By: ~'~'~~'///'
Issued By- ~i~,: ;,¢//~,~..,,~,~,~,¢.~/~/~4~,j~
.x~/~ ,,,~ ~ I~,, ~- L~ ' ¢ ~,'~ ~ ~ ~' '
Date:
Date: ¢~':/~ //
Municipality o! Anchorage
P.O. Box 196650 4700 EImore Road
Anchoraqe, Alaska 99519-6650 · (907) 343-7904 · Fax (907) 343-7997
http:llwww.muni.or.qlOnsite
Development Services Department
On-Site Water and Wastewater Program
**** VARIANCE/WAIVER REVIEW ****
WR#: OSPl11057 HA#:__ Permit~: OSPl11056
PID#: 051-115-02
Legal Description: Peters Creek, Block 3, Lot 2
Engineer: PES
Applicant: Keith and Gail Harley
Your request for a waiver of the required 10 feet horizontal separation from the absorption field
to the property line has been approved. The approved separation distance is 0 feet to the east
property line and 9 feet to the north property line.
This waiver approval applies to the existing absorption field to property line separation 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:~.5/24/11 Approved
~'j' Name of Reviewer
Rec#: 015662 Amount: $200.00 Date Paid: 511012011
**** VARIANCE/WAIVER REVIEW ****
UNICIPALITY OF
Community Development Department \\~
Development Services Division
On-Site Water & Wastewater Program
Mayor Dan Sullivan
ANCHORAGE
Phone: 907-343-7904
Fax: 907-343-7997
Parcel I.D.-~
Property owner(s) /Z'._f.~7!.-T'./,/ /).,,¢',0
Mailing address ~'-%'~7 ".'~d.~..¢~4
Site address ~/--~3~ 7 '7"O.~j~,~,~t
Legal description (Sub'd., Block & Lot) ,~__1'-~'¢-~
Legal description (Township, Range & Section)
Lot Size !~:~-'~,~ Sq. Ft. Number of Bedrooms
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
.~..,R~L~'~ ¢ Day phone
THIS APPLICATION IS FOR: THIS APPLICATION IS AN:
([~ all that apply)
Absorption Field ~ Initial []
Septic Tank ~ Upgrade ~
Holding Tank [] Renewal []
Privy []
Private Well []
Water Storage []
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
I certify that the above information is correct. I further certify that this application is being made
for a Single Family Dwelling and is in accordance with applicable Municipal Codes.
,,
(Signatu~ of propers? owner or authorized agent)
~ P_~mit/Rush Fees:
"'-D~{e ~f Payment:
Receipt Number:
Permit No.
Waiver Fees: .~.~-LT-~('",
Date of Payment:
Receipt Number:
Waiver No.
G:\Building\On Site\Forms\Client Forms\Permit App_010411 .doc (Rev. 1/11 )
Pannone Engineering Services LLC
Steven R. Pannone, Principal
Registered Professional Engineer
E-maih steve@l~anenRak.com
May l3,2011
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
4700 S. Bragaw Street
P. O. Box 196650
Anchorage, Alaska 99519
Subject:
Peters Creek S/D, Block 3, Lot 2
Septic System Permit Upgrade Request
Ladies and Gentlemen:
I am writing to request a permit to construct an upgraded septic system be issued for this property. The
proposed systems will serve an existing three-bedroom trailer. The owner is looking to construct a four-
bedroom house in the near future. This upgrade is for a four-bedroom house. The existing drain field will
be re-used as a four-bedroom reserve with the addition of 50 SF making it adequate for four bedrooms.
Currently the lot is developed. The lot is served by a private water supply. The existing septic system is in
failure. A new drain field will be installed. The surrounding developed lots are served by private water
systems. The private wells are located over 100 feet from the proposed soil absorption system.
1. Soils. A single test hole was excavated by Pannone Engineering in April of2011. See the attached
soil log. Ground water was monitored for seven days. Ground water was monitored at a depth of 14.5 feet
below ground level after the monitoring period. Bedrock was not encountered in the test hole. It is my
opinion, based on the results of the percolation tests and overall soils appearance; an application rate of 0.8
gallons/day/square feet should be used, using a 1250 gallon septic tank that will discharge into a deep
trench.
Soil Absorption System Design.
See Design Drawings sheet 2 of 2 for design calculations.
3. Waiver Request: We request a lot line waiver to 0' be granted between the drain field and the
property line. Granting this waiver will not affect the future development of the surrounding lots.
4. Reserve Field: The original drain field is 72LF x 3'W x 5'ED x 9'TD for a total of 720SF. The
original inspection report states 675SF which is incorrect. The drain field will be expanded by 5LF x 3'W x
5'ED x 9'TD which will add 50SF of absorption area. The newly expanded reserve drain field will have a
total of 770SF which will be adequate for a four-bedroom house.
1"~? e:?"~o~e: (~O?') 2'72-..82:]~8 FAX: (90¥)
Page 2 of 2
5. Surface Water: There is no surface water within 100 feet of the proposed septic tank and the
existing drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water
and drainage ditches.
6. Topography: The average topography in the area of the proposed septic system is approximately flat
based on the survey information. The proposed installation will be greater than 50 feet from the shoulder of
the steep slopes.
7. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification
that the review is complete and that there are no further comments is received from MoA On-Site
Department, the note will be removed and "Issued for Construction" drawings will be issued.
The proposed installation will not affect the future development of the surrounding or existing lots. There
are no wells or septic systems within 100 feet of the proposed septic location.
If you have any questions or concerns, please contact me at 272-8218.
Sincerely,
.............
Steven R. Pa~one, P.E.
O~effCivil Engineer
Attachments:
Box i{i, 021'7,
~ / I / I I
NOTE: Contractor shall have well radii and property lines closer than
~10 feet from the proposed drain field staked by an Alaska licensed
surveyor before construction.
EXPAND EXISTING FIELD !P) ,-L PRIMARY DRAIN FIELD (P)
5LFx3'Wx5'EDrx~J~ -~
,, .... / ~ SEPTIC AREA~ ~Z /--1250g SEPTIC TANK (P)
~t ~ / x~ ; / / INSTALL DCO AND DV
EXISTING / -~- 1- ~~-WSS~~ I~-
5.0 CF x 3'W x 5'ED x 9' TD~ ! X . ~'""'""~'' ~7~ 'vi ~
FORATOTAL OF : ~. /~xb.' \ r'-------~ ~ ~ lO00g SEPTIC TANK (E)
,,.~x;.wx~.~x9.~o - ~----_~I,~o ,~A.~O,~,co~
AND REUSED AS A
4BR RESERVE '/~ (E) ~ ~''~
¢ ,-
LOT UNDEVELOPED
~ 00.6 Z NO WELLS OR SEPTIC
.~ ' WILL (~)
, ~/W ~ .
"~ I i I
>~ TUNDRA ROSE AVENUE
LEGEND
--w w WATER LINE/
WELU RADIUS
_~/ ~ ss ~ NEW SEPTIC
NOTES: P~O~ ~G ~C, L~
~ ~F Al ~ Date
~Y .... ¢~}h. s/24/11
~o~ ~o~,~,~,,o~ ~.0. ~ox ~002~ ,,c,o~[, ~ ~s~o ff~.. ~~,~ ~,~
~,0~[ (~0~) 272-s2~s ~,x (~07) 272-s2~ ~,...~ ~ .....~
1"=30'
~..~.,.~..o..
PETERS CREEK S/D, BLOCK 3, LOT 2 , 0s~-~s-02
HARLEY~~n~nn3~pERUlr NO.
PLAN CHUGIAK, AK 99567 'll~3~S{~-- Sheet
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF
ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF
ON-SITE WASTEWATER DISPOSAL SYSTEMS.
2, ALL WORK SHALL BE IN ACCORDANCE WITH THE A-FrACHED SPECIFICATIONS.
5. SCOPE OF WORK: INSTALL NEW 1250 GALLON SEPTIC TANK AND NEW SOIL ABSORPTION SYSTEM.
4.. NO GROUNDWATER WAS OBSERVED AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS
OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 15.0 FEET BELOW EXISTING GRADE, NOTIFY THE ENGINEER
IMMEDIATELY,
TH -1 ~0.5
-5.0 --
BOH
GROUNDWATER @ 14.5' La La
ED m
5/8/2011 D
F-db F-
rh
Z OZ OZ
0~ I~ I~ I.~ ZLd ZLd
0 0 L~ ~J
~<:z <z <:z ~ E E Pz: ~ F 6" TOPSOIL AND VEGETATION
o J -J -J o ~ ~ ~ ~o ~ FILTER FABRIC
b_ r.D C) (D dl_O0
0 "~- '~ //
PROFILE TRENCH SEE SECTION, DESIGN
DRAIN ROCK BELOW PIPE I
DESIGN PARAMETERS
DESIGN PARAMETERS RESERVE SEPTIC SYSTEM
PRIMARY SEPTIC SYSTEM NO. BEDROOM: 4- (600 gpd) ABBREVIATIONS
NO. BEDROOM: 4 (600 gpd) TANK SIZE: 1250g CU COPPER
TANK SIZE: 1250g PERC RATE = 7.7 MPI DIP DUCTILE IRON PIPE
PERC RATE = 7.7 MPI SOIL RATING: 0.8 GPD/SF TH TEST HOLE
SOIL RATING: 0.8 GPD/SF AREA RQD: 750 SF FC FOUNDATION CLEAN OUT
AREA RQD: 750 SF SYS. TYPE: DEEP TRENCH 5.0' E.D. T# TANK CLEAN OUT NO.
SYS. TYPE: DEEP TRENCH 6.0' E.D. MIN LENGTH: 75 LF CC/ CLEAN OUT NO.
MIN LENGTH: 62.5 LF
USE: M# MONITOR TUBE NO.
USE: REUSE EXISTING R.I. RIGID INSULATION
65 LF X 5' WIDE, 6.0' E.D., 8.5' TD 72 LF X 5' WIDE, 5.0' E.D., 9.0' TD DCO DOUBLE CLEAN OUT
TOTAL AREA: 800 SF ADD 5 LF x 5' WIDE, 5.0' E.D., 9.0' TD DV DIVERTER VALVE
TOTAL AREA: 770 SF FS FLOW SPLITTER
NOTE : PANNONE ENG SVC, LLC
5/24/~
FOR CONSTRUCTION P.O. BOX 1002'17 ANCHORAGE, AK 99510~.~'"~"t"'~""'
(90z) (90z)
NTS
.... .
PETERS CREEK S/D, BLOCK .5, LOT 2'- ,. ~ P.I.D. NO
KEITH HARLEY '~ PERMIT NO,
2,5557 TUNDRA ROSE AVENUE '.
DESIGN DETAILS CHUGIAK, AK 99567 ~,~'~,~/Jf~OFES5/O' ~.v~.~,.~Sheet
SOILS LOG - PERCOLATION TEST
TEST HOLE
OR
BRO~ SIL~ X TEST
SAND ' HOLE
3
GM W/SOME G~VEL
SIL~ SAND
WAS GROUND WATER SLOPE
~4 ~ ENCOUNTERED? N
IF YES, AT WHAT TH 1
BOH DEPTH? -0-'
X
DATE PERFORMED: DEPTH TO WATER AFTER
MONITORING? -14.5'-
DATE: 5/8/2011
WATER
CLOCK
READING DATE NET TIME LEVEL NET DROP
TIME
READING
2 11:20 10 MIN 3.35 1.45
3 11:20 1.90
4 11:30 10 MIN 3.27 1.37
5 11:30 1.90
6 ! 11:40 10 MIN 3.20 1.30
PERO~TION ~TE 7.7 (min/inch) PERC HOLE DIAMETER 6 inches
TEST RUN BE~EEN 5 FTAND 6 FT
COM~S: ~est ~o]e excavated by ~ntsto~e ~terptJse. ~est ~o]e ~as preso~ed before perc test.
......
FOR CONSTRUCTION P.0. BOX 100217 ANCHORAGE, AK 99510 ~.~'
PETERS CREEK S/D, BLOCK 5, LOT 2--~~~s~z..~..$:TT'~P'l'D' NO
KEITH HARLEY rl~,~-._ CE 8149 .'~ PERMIT NO.
23557 TUNDRA ROSE AVENUE ,ll~.' ..~ 0SPl11056
SOILS LOG CHUOIAK, AK 99567 I~' ~o~sg~ sheet
WATER
CLOCK
READING DATE NET TIME LEVEL NET DROP
TIME
READING
1 4-27-11 11:10 1.90
2 11:20 10 MIN 3.35 1.45
3 11:20 1.90
4 11:30 10 MIN 3.27 1.37
5 11:30 1.90
6 11:40 10 MIN 3.20 1.30
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
IP~ONE ! XNEW
~EGALDESCRIPTION ~
LOCATION
~ ~ Manufacturer~ ~ ~ Ma~. ~__ No. o~Rartments
~ Inside length Width Liquid depth
i Liq' c~® IF
~ ~ DISTANCE TO:
~ ¢ ~ Material ~iquid capacit~ in ~aHons
0 ~ ~ Manufacturer
Q Welt/~/ Foundation 7 ~ Nearest Iotlin?~ ,PERMITN~~
~. DISTANCE TO: Le~ '~ h~ Total a~l~enlines
ac ,eng~ Trenc~gh Dist
~ No. ofiines ~ ~ i inches
~ ~ ~ ~OP of tile to finish grade 'U' ' Material beneath tile ~ inches
Q ~ PERMIT NO.
Length Width Depth
~ Total effective absorption area
( ~ Type of crib Grib diameter Crib depth
~ 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
INSTAELE~ / ~ ~
Ml_Ir~Ig:] 'RL IT~" CIF Ar-IISI )R~GE
DEPARTMENT .~F HEALTH AND ENVIRONMENTAL rROTECTION
825 'L' STREET, ANCHORAGE, AK. 9950t
L-JELL R~4D
( 821021 )
PERMIT NO.
APPLICANT KOEHLER CONST
LOCATION
LEGAL L2B3 PETERS CREEK
TY~E OF SOIL ABSORPTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING <SQ FT?BR)=
264-4728
"3lt-.,I--S I TE SEL4EF~: PERI"-1 T "T'
PO BOX 279 CHUG IRK 99567 ~,,_,8
LOT SIZE 9999q. 9 SQUARE FEET
22s d/.
THE REQUIRED SIZE OF THE =,t. IL ABSORPTION_,~.;d,'~',c"c .... IS
E:,EPTH= 9 LE~-JGTH= 6:3 GRR%~EL [-~EPTH= 5
THE LENGTH DIMENSION IS THE LENGTH <IN FEET) OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF R 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).
REg2LI I E:E[) SEPT I C: TR[4~.' S I ZE= 1OEEC ~3RLLL-~[-JS
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.
TL4~9 (2> I [-JSPE~3TIC~NS ARE RE~]LIIRED
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 THE DEPARTMENT WITHIN 30 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
PERM I T E×F' I RES DECEr. IBEE' 31.. 1982
I CERTIFY THAT
t: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS.
~ .....,~/PLIC:AN~~ KOEHLER CONST /j ...--, ,' ..... ~ .......
SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
I oo ~/~
11
12
13
14
15
16
17
18
19
2O
Roi~ert A. Sharer
No. 1457~E
WAS GROUND WATER
ENCOUNTERED?
P
E
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
9/"
z ,, I/.'3~' .7o~;, /~ ~ //m
PERCOLATION RATE 2 ~-/~- (minutes/inch)
TEST RUN BETWEEN ~ - FTAND
PERFORMED BY: [~ ~IV~. ~,1¢~¢¢A nm:~ CERTIFIED BY: ~ DATE:
72-008 (6/79)
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
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. o5:~-3.z5-o2
GENERAL INFORMATION
Complete legal descriptiOn Peters Creek, Block 3, Lot
Location (site address) 23337 Tundra Rose Avenue
COSA#
Expiration Date:
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Keith & Gail Harley Day phone
23337 Tundra Rose Ave, Chugiak, AK 99567
Day phone
Real Estate Agent
Mailing Address
Day phone
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4,
m
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 I--I
[] Community On-site I--I
[] Public Sewer r'-'l
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent-professional civil
engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm Pannone Engineering Services, LLC
Phone 27:~-82~8
Address P.O. Box ~oo:z~_7, Anchorage, AK 995~-o
Engineer's Printed Name Steven R. Pannone, P.E.
Date zo/27/~o~
Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in
accordance with MOA DSD Guidelines & 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. PES can therefore not provide any warranty for future
performance nor give any estimate of how long the system will continue to meet the operational
requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed
above. Any reliance upon or use of this report by any other person or party is not authorized nor will it
confer any legal right whatsoever.
5. DSD SIGNATURE
'~'"'" Approved for ~ bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Attachments:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date:
Tetai~h ft..,'
~sea~
Cased to' ,ft.
.ff.
.
wea, Log ;0'~}
AT INSPECTION
,,g,p,m.
~Umper
Raid
.ft.
IN
¸in.
D. LIFT STATION
Date installed
"Pump on" level at~
Datum
in.
E. SEPARATION DISTANCES
Size in gallons
"Pump off' level at~
Cycles tested
in.
Manhole/Access (Y/N)
.High water alarm level at
Meets alarm & circuit requirements?
in.
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
Absorption field on lot
Public sewer main
Sewer/septic service line
Animal containment areas
On adjacent lots
On adjacent lots
Public sewer manhole/cleanout
Holding tank
Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation =}8.5
Water main 75+
Wells on adjacent lots =.oo+
Property line =.o.8
Water service line 50+
Absorption field..
Surface water
Fe
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 2.9
Water Service line 50+
Curtain drain NIA
COMMENTS
Building foundation =}8.7
Surface water ~oo+
Wells on adjacent lots =.oo+
Water main 75+
Driveway, parking/vehicle storage 3.o+
New Sy~em
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.
Engineers Printed Name. Steven R. Pannone~ P.E.
Date
COSA Fee $
Date of Payment
Receipt Number
(REV. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
~ :
~ HOUSE o
~ 8.0
N90* 00' 00"W 70.00'
TUNDRA ROSE AVENUE
UNDER NO ~R~M~ANC~$ SHOULD AN AS-BUILT BE U~ FOR CONS~UC~ON OR FOR ESTABUSHIN~ ~OUNOARY ~ ~CE
~E SUR~OR TAK~ R[~ON~I~LIW ~R ~ INI~AL ~ANSAC~ON ONL~ AND ASSUMES ~NAN~AL UABIU~ ONL~ F~ ~E COST OF ~E
USeD DISTANCES PR~AIL O~R SCAUN~, ~R~UC~ON MAY CAU~ ~RORS IN
~ SUR~ T~E s~BOLs '
~A~ ~B~T
~ RNAL ~U~ AS-~T · ~T R~AR ~ ~ ~RA[NAO~ ~ ASPHALT
PLOT PLANS ~ LOT SUR~YS NOTE:
IT IS ~E RESPONSIBILITY OF ~ ~UfLD~R OR O~, PRIOR TO ONLY ~OSE IMPRO~M~N~ ABO~ GROUND ANO ~SlaLg
CONS~UC~ON, TO ~RIFY PROPO~D BUILDINO GRADE RELA~ SHO~. F~N~S. ~L~, S~C CLEANOU~, SIDEWALKS, DRI~AYS
· 0 FINI~ ORAOE AND U~LI~ CONNEC~ONS AND TO DE~RMIN~ ETC., ARE SHO~ IN ~EI~ APPROXIMA~ LOCATION, ~LY. SNOW
~E ~NC~ OF AN~ E~MEN~, CO~NAN~ OR RE~IC~ON~ MAY PRE~T SOME IMPRO~MEN~ ~ROM B~INO SE~ AND
.~ICH DO NOT APPEAR ~ ~E RECORD~ ~B~I~SION PLAT.
ALL
DI~TANC~
SURLY C[R~RCA~ON **~[~. Prepared by
,,o,~ ~**~. o~ ~7 ,, Robert E. Johns, Jr. & Assoc.
~.~..~ --~' ~ Professionol. l,, = ~U Land Surveyors
Plo[
~ "" ~ Dote Su~e~d: ......... oreek bg CheWed b
FROM :Alpine Drilling
FAX NO. :907 345 0202
Now. O1 2011 10:44AM Pi
Aarow Pump & well Service,
P.O. BOX 11049.6
Anchorage, AK 99511
Office: (907) 346-9355 · Fax (907) 333-8976
'Eagle River: (907) 622-9335
/t
No. 91,73"
CUSTOMER JOB SITE ',
F .,',- '" ,,' -'1 F- i%-..../ ,,. .'...
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"7:. ~ - '~, ', '.
" . " . ..... ...... , ........ '{...,} .:'.",
:, . ~,. >,,
~BOR HouRs RATE AMOUNT TOTAL MATER.IAi
TOTAL ~aOR
WORK ORDERED ~YI DATE COMR TOTAL
Thank You ,.' '~""~ "'
· .. . ..:,,,,.,.:.,::.,~,,?;,.,,,.....~y,;~:,., .
. ' ' ', /" SIGNATURE . ,. . , .....
(I Hereby A~knowledge the Satisfactory Completion of'the Above Oe~dbed Work and agree that if above work is not paid for in 90,~a~/s" !' agree' tO allow:A~r~w
· Pump & Well Scw~ce., LLC. the. ~;19ht tO remove unpaid for equipmen! and charge for labor already performed & labor to remove unpaid'lor equipS'eat,). ·.
TERMS: ACCOUNTS PAYABLE AT lOTH OF MONTH FOLLOWING PURCHASE.
