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Home My WebLink AboutROBIN HILL #3 BLK 3 LT 1ARobin Hills #3 Block 3 Lot 1 A #017-443-05 ULIMITTAJ nrr a. 9nio Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: 05P k3 ( 22 I PID Number: O('1Z ~ 4('-f 3 — D 5 - Dwelling: Dwelling: [Z Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: NC New ❑ Upgrade Name: 9 t ABSORPTION FIELD ❑ Deep Trench [Shallow Trench ❑ Bed ❑ Mound Address ❑ Other Phone Number of Bedrooms Soil Rating / Total depth from original grade /n LV( GPD/SF 5, Q Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 2, V Ft. Gravel depth beneath pipe -3' C Ft. Subdivision 1r Block Lot ( 6 Wo l (14 Fill added above original grade /, P Gravel length G 5— -0 t Y1 Township Range Section Ft. Ft. Gravel width 5. 0 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 Linez S l0 2 Ft ( Ft. Well UD /� 5 0!t _ TANK [N -Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer r k k- Capacity Surface Water VDt ( uo' /lin e ' -N kj 100 D Gal. Material 5 �--e& C Number of compartments 2 -- Lot Line [ l¢- (� , �- NA Foundation Foundation 5 f �� LIFT STATION Manufacturer Capacity Gal. Curtain Drain JF Remarks 1 Pump on level at Pump off leve High water alarm at �� uK �, q C in. in. Pump make model Electrical Inspections performed by Installer PIPE MATERIAL House to tank Tank to `3' ��' � drainfield A, Drainfield 'j L9 3 L4 CO/MT Inspector �!h't �eYSU✓l nCJ941 BENCHMARK (Assumed elevation) (00 ft Inspection dates: ?i� — % Z2nd � g/ - 9 ZAvl3 Location and description //�� r - C7 u nQ4 G •S R h t 3`d 4'n COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL�/!�� o. s e...ovd Conditional Approval: Date;•' �� • •• �f �� MICHAEL N. ANDERSON ; "= �� f•. CE_ 4 9 0 ° �`�' .Its '•��•'' Approved Date 1If 6// q `R OFES aa01&_� inspection rteport_9-i-iz.aoc Permit No. OSP131229 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: ROBIN HILLS #3 BLK 3 LOT 1A PID No.: 017-443-05 60; BENCH, GARAGE S B THtl— 005 MT CO3 4 o CO2 0 02 CO ASBUILT SCALE, 1"=30' co,TCOI TCO2 CQ5 RIGWAL 102 101 MT t00 1 .........L 9 �y �� C FILL IV !NLATJON FILTER FABRIC 1,10 ORO , AV 2' INSULATION AF r5j AV 49 TH 0 ...... * ,.. 0 ................. 1.000 GALLON STEEL TANK Irm SM JAI MICHAEL N. ANDERSON.-,,- a 0No469 <- AF H2O MAY 2013, 90 *0 4 0 -14, 50H. ELEV, 85 <Z�AV 41` 411� SEPTIC SECTIO N.T.S. MAR A 8 CO --y- '1 3 02 34 18 TC01 34 2 TCO2 34 250 CO2_ 30 26 CO3 0 2 C04 2 36 C05 67 MT 60 8 Municipality of Anchorage Date Gross Time Development Services Department A, On -Site Water and Wastewater Section 4700 Elmore St. 00 0 T H . P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 . . . . . "H A L N, A N D�i .mj Cr Soils Log ® Percolation Test e, Performed For: 9C ev ju Date Performed Legal Description: 4 HV I 1C 1- 5 Township, Range, Section: fW Slope 1- 2- 3- 4- 6- 7- 8 - WAS -2- 3- 4- 6- 7- 8- WAS GROUND WATER 9- ENCOUNTERED? 61 10- IF YES, AT WHAT DEPTH? L Depth to Water After 0 Cy I P 11- Monitoring? E 12- Date: 13- 5 "ro 14 15 16- 17- 18- 19- 20 - COMMENTS Site Plan M Y% -e- — 4. & k., &4 L.—e- Reading Date Gross Time Net Time Depth to Water Net Drop T 3/A, PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND 957 FT PERFORMED BY: tv? I k" I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Alpine Drilling & Enterprises Well Log Permit Number: #SW 131229 Date of Issue: 8-8-13 Parcel Identification Number: 01744305000 Date Started: 8-12-13 Date Completed: 8-13-13 Is well located at approved permit location? x Yes ❑ No Legal Description: Robin Hill #3 Block 3 Lot 1A Property Owner Name & Address: Adolf Peter & Julie S 4900 Old Seward Highway Anchorage, Alaska 995037422 Borehole Data: Depth (ft) Method of Drilling x air rotary ❑ cable tool Soil Type, Thickness & Water Strata From To Casing type: steel Stick-up 0 2 Wall Thickness:.250 inches Gravel fill 2 5 Diameter: 6 inches Depth: 101 feet Liner Type: gravelly silt 5 51 Diameter: inches Depth: feet silt 51 56 Casing stickup above ground: 2 feet silty gravel 56 67 Static `eater level (from ground level): 46 feet gravelly silt 67 92 Pumping level: 100 feet after silt 92 96 2 hours pumping 8 gpm Recovery Rate: 8 gpm Method of Testing: air li t Well Intake Opening Type: silty water sand & gravel won't clear 20 96 99 bedrock 99 108 ❑ Open End x Open Hole ❑ Screened Start feet Stopped feet ❑ Perforations Start feet Stopped feet Grout Type: bentonite granules Volume: 2 bgs Depth: Start 0 feet Stopped ? feet Pump: Intake Depth feet WATER QUALITY TESTING Coliform Ne., CoV100mL Pump size hp Brand Name Nitrates NL mglL Well Disinfected Upon Completion? x Yes ❑ No ASIC Np `-/t Method of Disinfection: chlorine tablets 201 Comments: Well can be perforated from 98' to I00'easing level in future if higher quantity needed. Will be very silty. Well Driller: Alpine Drilling & Enterprises PO Box 110496 Anchorage, AK 99511 j % Jt1 Give a copy of the enclosed log to the MOA within 60 Keep a copy for your records. Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Matk Begich Anchorage, AK 99507 Mayor www.muni.org/onsit (907) 343-7904 Pump Installation Log Well Drilling Permit Number: SW 131229 Date of Issue: 8/8/13 Parcel Identification Number: 01744305000 Legal Description Property Owner Name & Address: Block 3, Lot 1A Robin Hills #3P eter & Julie Adolf 4900 Old Seward Hwy. Anchorage, AK 99503-7422 Pump Installation Date: 10/31/13 Pump Intake Depth Below Top of Well Casing: 93 Pump Manufacturer's Name: Goulds Pump Model: I0SBO5422C I Pump Size 1/2 hp I Pitless Adapter Burial Depth: NIA feet I Pitless Adapter Manufacturer's Name: N/A I Pitless Adapter Installer: N/A Well Disinfected Upon Completion?Fv-"I Yes M No Method of Disinfection: Comments: IPump Installer Name: Aarow Pump & Well Service, LLC P.O. Box 110496 Anchorage, AK 99511-0496 feet Please save for your engineer. This is needed for your COSA. Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. On -Site Water & Wastewater 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 Permit Number: OSP131229 Tax Code Number: 01744305000 Work Type: WellSeptic Permit Effective Dates: August 08, 2013 to August 08, 2014 Design Engineer: ANDERSON CONSTRUCTION & ENG'G Subdivision: ROBIN HILL #3 Site Legal Address: ROBIN HILL #3 BLK 3 LT 1A G:2838 Owner/Address: ADOLF PETER W & JULIE S 4900 OLD SEWARD HIGHWAY ANCHORAGE AK 995037422 Site Mailing Address: 6446 NENANA PL, Anchorage Lot Size in Sq Ft: 267233 Total Bedrooms: 3 This permit is for the construction of: Y Disposal Field N 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: PRIOR TO CONSTRUCTION: Soils and percolation testing shall be completed such that the proposed drainfield is no more than 30 feet from a soils classification testhole and the entire proposed drainfield is within 30 feet of completed percolation tests. An approved change order shall be acquired if a design change is required. Test results shall be submitted with the final inspection report. Received Issued By MUNICIPALITY OF ANCHORAGE 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. O(7 —4 q'5 —05— Property 0SProperty owner(s) G -r-4 T�/ Xktl�'(u� �J� L Day phone 4� Mailing address i� t+�2ptvA`h Site address Legal description (Sub'd., Block & Lot) &6;" g / r'.4/ *k,3 Legal description (Township, Range & Section) Lot Size 2(®? Z'0Sq. Ft. Number of Bedrooms ? APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field Initial Single Family (SF) [V Septic Tank Upgrade ❑ (w/wo ADU) (D) F-1 Holding Tank ❑ Renewal F1Duplex Multiple 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. nature of property owner or authorized agent) Permit/Rush Fees: Z(904 -S-30 Waiver Fees: _ �r a Date of Payment: Ck*" Date of Payment: Receipt Number: )(a % Receipt Number: Permit No. O SPI O) Ia0I Waiver No. Permit App_.:: ;:..,:c. Michael N. Anderson, P.E. Civil/Structural Engineering &z Construction 4661 Natrona Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 July 24, 2013 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: Robin Hills #3 SID, Blk 3, Lot I To Whom it may concern: This is a request for a new septic and well permit. A test hole was excavated to 14 feet revealing silty gravel for the entire test hole depth. The perc rate was 10 minutes per inch with no water observed during excavation but after the 7 day waiting period the water was measured at 9 feet. A simple rench has been designed with 4 feet of effective depth. The slopes in the septic area are less than 2%s c site plan. - v This new system will not impact any of the neighboring properties due to the large lot sizes and good soils. Please call me if you have any questions. Sincerely r Michael . Anderson, P.E. DESIGN CRITERIA:MOUND OVER o (TH#1) //-GRADE 3 BDRM X 150 = 450 GPD1 ° & ORc FILTER FABRIC SOILS = 450/0.8 = 562 GPD INSULATION 562 GA/5* 0.58 = 65' -2.0 4"0 PIPE (1) TRENCH SM/GM SEWER ROCK 5.0' DEEP 3.0' EFFECTIVE H2O09' —5.0 5.0' WIDE s.D' 65' LONG 14.0 SEPTIC FIELD SECTION I I ------1F--____- , I I I 5 II \ PROPOL NEW �! PROPERTY UNE ROBIN HILL 13 ` WELL 100' I `\ BLOCK 3, LOT 1A RADIUS \ EXISTING WELL \ 100' RADIUS---�- \ �-- I EXISTING HOUSE \ I II II I II JI 11 I Septic Design Prepared for PETER & JULIE ADOLF �.�p�..�F• q.... ROBIN HILL #3, BLOCK 3, LOT 1A % % Anchorage, Alaska ....49 TH ..... ....................... i... � ; ........................ Michael N. Anderson, P.E. DATE: 8/5/2013 Aj ;MICHAEL N. ANDERSON: 4661 NATRONA DRIVE DRAWN: DJR ANCHORAGE, ALASKA 99516 345-3377 / FAX: 345-1391 SCALE: 1"=300' ROBIN HILL #3 WELL BLOCK 3, LOT 1A EXISTING HOUSES fr EXISTING WELL 10V RADIUS SEPTIC ------- PROPOSED WELL X EXISTING SHED PROPOSED SHOP v A v zi. . . ..... 2' CONTOURS__/�'------.. TYP PROPERTY LINE --- -------- DOUBLE CO cA co PROPOSED 1000 GAN TANK - ----- LIMITS OF CLASS WET LANDS Septic Design Prepared for PETER & JULIE ADOLF ROBIN HILL #3, BLOCK 3, LOT 1A Anchorage, Alaska Michael N. Anderson, P.E. DATE: 8/5/2013 4661 NATRONA DRIVE DRAWN: DJR ANCHORAGE, ALASKA 99516 345-3377 / FAX: 345-1391 SCALE: 1"=50' 7 " Municipality of Anchorage Page —I —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 Permit Number: gJ� D a'L S .... PID Number: 017 4433 O–G Name: Lam' -.e Wastewater System: ❑ New Upgrade 13 �P,,,� Address: ABSORPTION FIELD D o I Phone: No. of Be rooms: Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: J• GPD/Sq. Ft. 0 Lot: Block: Subdivision: (� Depth to pipe bottom from original grade: Gravel depth beneath pipe 75 Re:, 6; ; t 3 J Ft. Ft. Township:Range: Section: Fill added above original grade: Gravel length: (� •3 J Ft.`.> O Ft. WELL: ❑ New 11 Upgrade Gravel depih:lA.4dPh Number of lines: Distancabe_tweenlines: Ft. Ft. Classificatiorr(Private, A,B,C): Total Depth: Cased To: Total absorption area: / Pipe material: , Ft. Ft. O.O SQ. Ft. 39)Sq 1=8 IV Driller: Date Drilled: Static Water Level: Installer: Date installed: 9?1q:& Ft. N �l �-, s Yield: Pump Set at: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES ,� & Septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer LinesT ,• Nt Et.l�1. (,� 12.5 WellMaterial: 14 b I60 s Number of Compartments: z Surfac e � �' LIFT STATION Wate Water Lot Size in gallons: Manufacturer: Line %/O-0/UU Foundation "Pump on" level at: "Pump off' level at: High water alarm at: O ; Curtain Pump Make & Model Electrical Inspections performed by: Drain Remarks: BENCH MARK e Location and Description: / Flow s G�' Ey, sy� V, Assumed Elevation: 00 ,no' ISN@TN h,6,$e"AI. NOY 10 1993w "rwt 4z 19 Az y t+ '•' ' " " ept• I, I of 1C h &Human Servic' /� _-S �� Inspections performed by: Dates: 1st Z 0. oo �c �p 9ro el3 ,e .y. �0 0 o•cnea oa oae 2nd �p oe CE -2.225 Department of Health and Human Services approval p FE Reviewed and approved by:� Date: Z-VlU (vs,) MUA 25 r � \ + \ + \ + t J TOBBEN SPURKLAND P.E. LOT IA BLOCK 3 ROBIN HILL #3 SEPTIC SYSTEM AS BUILT 203 W 15TH. AVENUE DATE Nov. 9, 1993 ANCH, AK. 99501 SECTION 26 MON R3W ,,,,,, — JIM BLASIN64ME SHEET, 213 GRID, 2838 + -�wPtt + + RECEIVED + + + NOV 10 1993 + +Dept.h` � PEihty of Anchorage Heafth & Human Services AC 44,5 + BC 32, 5 A B + + AD 52,5 + + + ++ BD 40.5 + + ++ , + * AE 61.5 + + + + C + + BE 50 + ++ QD + + r AF 98 ++ + + + E + + BF 85 ++ + + + + + + + + AG 111 + tB� 98 + + + + F + + ++++++++,++ *7w G ++ + + ++ + + + ++ ++ ++ + +4-++ ++ ' 4 1 + + + + + + RECEIVED NOV 10 1993 peptunrc'I'al� Y of health \r W i` icL & yumnchorage , ,; Gf�'n^ 25 0 25 sa 75 ma \1 IsoanServices SCALE. 1' = 50 FT, TOBBEN SPURKLAND P.E. LOT IA BLOCK 3 ROBIN HILL #3 SEPTIC SYSTEM AS BUILT 203 W 15TH. AVENUE DATE Nov. 9, 1993 ANCH, AK. 99501 SECTION 26 MON R3W ,,,,,, — JIM BLASIN64ME SHEET, 213 GRID, 2838 3 O 'N C 3 C O Qu C U m o V 50 m a 3 o � CMonitor Clean Out a —00— O Clean Out Standard Trenches- 1250 gal Septic tank 3' Wide 50' L ong 10' Deep 5' Sewer rock under pipe 5' Co ver DECEIVED NOV 10 1993 RECEIVED NOV 10 1993 Municipality of Anchorage Dept. Health & Human Services Mu.:c-pa!ity of Anchorage Dept. Health & Human Services Cleanouts Monitor ZZ/ 1>\ Mira Fi 140 5 Ft of Septic Rock UNDER PIPE Exist, Ground 1250 gal. septic tank NU SCALE �I�83 rs `/,Wen Bench Mark., Garage Floor Slab Elev, 100,00 TOBBEN SPURKLAND P.E.LOT lA BLACK 3 ROBIN HILL #3 SEPTIC SYSTEM AS BUILT AaO3nc wrath Ave JS BLASINGAME DATE Nov,9 1993 Anchor1�11age AI< 99501 RV,, BOX 101338 SHEET, 313 GRID, 2838 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:SW930258 DATE ISSUED: 7/27/93 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. EXPIRATION DATE: 7/27/94 OWNER NAME:BLASINGAME JAMES B OWNER ADDRESS:P.O. BOX 101338 ANCHORAGE, AK 99510 PARCEL ID:01744305 LEGAL DESCRIPTION: ROBIN HILL #3 BLK 3 LT lA LOT SIZE: 267233 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /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 (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS 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: e ) ✓J�-!�� DATE DATE: ISSUED BY Z 203 W 15th. Avenue, Suite 206 ANCHORAGE, ALASKA 99501 (907) 279-:916 SEPTIC SYSTEM DESIGN JIM B. BLASINGAME No Ground Mater or Impervious Laver- to 16 ft. Use Standard Trench Soil Ratincq_ From test June 1, 1993 5 amin: in = 1.2 gal train Required Area per Bedroom: 15011.E = 125 sq.-zt.. Test -hole Total Depth 16 f t. Less 6 feet 10 ft Less 5 it Cover _-__-�- - - Rock Depth 1 ft Plumber of Bedrooms 4 Leng't'h of Trench 4 x 125 I 1-0 = 50 ft.. STANDARD TRENCH TOTAL LENGTH 50 FT. TOTAL WIDTH 3 FT TOTAL DEPTH 10 FT. ROCK DEPTH 5 FT. COVER 5 FT. SEPTIC TANK 1250 GAL. AB'ANLIE€}N EXISTING SYSTEM PUMP AND CRUSH EXISTING TANK PUMP, CRUSH, AND BACKFILL EXISTING PIT 5t -O pc- < '079 The installation of this septic system will not prevent well from he installed on the adjacent lots. There are no developed or natural surface J sub Surface draai:Edge courses on this Or the adjacent _ots. The proposed septic system will not change the general slope of the area_ Fcfriding and,`or concentration of sur=ace runoff will riot r'cs1;.t from this installation. LOT I Well o / I r \ / LOT IB r Lar 2A LOT 3 r _ r — LOT 4 / �i / LOT 5 lY a ii:. � V��6 •� 0 p�• i� V• a, s`� � `K44�v ':9�a9 nc Qap6e aoanno e ®co�<a o®e oo aao oQao oa aoy , Tobben Spurkfand s �' ©s °ep CE -2225 r- F QAOp FOTO eSi�YJf // f 100 150 200 250 300 350 SCALE- I" = 2100 FT TUBBEN SPURKLAND P.E.LOT IA BLOCK 3 ROBIN HILL #3 I I SEPTIC SYSTEM DESIGN 0, ANCH, AK. 99501 1993 203 W 15TH, AVENUE SECTIT12N R3W DATE: JULY 2 JIMM BLASINGAME SHEET 1/3 GRID 2838 U 50 Ln 0 CUc 6 U Q, s q Monitor Clean Ju �♦ Clean Out Standard rrenchesl 5 3' Wide 50' L ong 10' Deep 5' Sewer rock under pipe 5' Co ver Mira fi 140 tic Rock NO SCALE 1250 gal Septic tank Exist. Ground 1250 gat, septic tank TOBBEN SPURKLAND RE, SEPTIC SYSTEM DESIGN LOT IA BLOCK 3 ROBIN HILL #3 Anc orage Ave J.B. BLASINGAME DATE- JULY '18, 1993 Anchorage Ak 99501 pn Rn)( u7v?.'3R SHEET, .4/9 GRID, 8838 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR:tJ" i d�—'�� t r 1'"' • DATE PERFORMED: LEGAL DESCRIPTION: Ina G 1A1-13 V, Township, Range, Section: i 1'9-m\ a% Vie. c- 9-" DrP�' SLOPE SITE PLAN 1 5 - H 1-1 1 �-i 6 Z i 7 8 9 10 11 — 1 12- 13 14- 15- 16 -- ?,,,, 415 16 14ovi-q 17 Ita�� 18- 19 co COMMENTS WAS GROUND WATER h ENCOUNTERED? I` S L IF YES, AT WHAT O DEPTH? P E Depth to Water Atte 7 Monitoring? `r ii _ Date: 1 N Reading Date Gross Time Net Time Depth to Water Net Drop 25ag, il 545 A, I PERCOLATION RATE } (minutes/inch) PERC HOLE DIAMETER C¢/, TEST RUN BETWEEN FT AND " FT 'I' l - CERTIFY T T THIS TEST WAS PERFORMED IN PERFORMED BY: LIV IACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG-- PERCOLATION TEST SOILS LOG [~"~PE RCO LATION TEST 10 WAS GROUND WATE ~ 11 _l ENCOUNTERED? ~ 0 O P 12 IF YES, AT WHAT DEPTH7 13- 14- 15- 16 17 18 19 ~ Net Depth to Net Reading Date Time Time Water Drop 20 PERCOLATION RATE .... %'~'---~,%~ (minutes/inch) . . TEST RUN I~ET~E/I~ ~ FT~AN~! -- FT, , - 72-008 (6/79) -'X4 ECL Municipality of Anchorage •Yt •Y. Development Services Department Building Safety Division On -Site Water and Wastewater Program . t + 4700 Bragaw Street P.O. Box 196650 SNS Anchorage, AK 99519-6650 R www.muni.org/onshe (907) 343-7904 G _ A� CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 017443-05 1. GENERAL INFORMATION COSA # Q9C161 0101 Expiration Date: S Complete legal description Lot 1A, Block 3, Robin Hills Subdivision No. 3 Location (site address) 6444 Nenana Place Anchorage. AK 99516 Current Property owner(s) James Blasingame Mailing address Lending agency Mailing address Real Estate Agent Mailing Address P.O. Box 101338 Anchorage, AK 99510 Unless otherwise requested. COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Four (4) Day phone Day phone Day phone 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ID Individual On-site El Individual Water Storage _ _ ❑ Individual Holding Tank____ ❑. Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of Onsite 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 engineers 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 Onsite 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 rtbmber of bedrooms and type of structure indicated herein. I further verify that based •bn the Information obtained from the Municipality of Anchorage files and from my investigation and Inspection, the an -site water Cpply'and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, -�ordifiances, and regulations in effect at the time of installation. ' • Name of Firm Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage. AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 514/2010 5. DSD SJGNATURE I0 c �wuc+Aa E uw / L # CE -4381 i .•. -I t7 V Approved for bedrooms. ��AFB••••••••• Disapproved. �1 1 i�`E;;� Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory of • pglrc`N = .•q\ X Arsenic �'�I Advisory •''••"�••CrYy= Maintenance Agreemeng',10.,,m 0• `` Supplemental Engineer's Report Nitrat Advisory Other tr �2 Original Certificate Date: d (RN IWS) Municipality of Anchorage • Development Services Department Building Safety Division On-Sfte Water & 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 CHECKLIST Legal Description: Lot 1A. 8bck 3. Robin Hills Subdivision No. 3 Parcel ID: 017143-05 A. WELL DATA Well type Private If A. B, or C provide PWSID # _ Well Log (Y/N) N Date completed 2inknown Sanitary seal (YM) v Wires properly protected (YM) Y Total depth UNK fL Cased to i4o ft. Casing height (above ground) >24 in. FROM WELL LOG AT INSPECTION Date of test unknown 412112010 Static water level unknown ft, - 101.4 ft, Well production unknown g_P,m, 9.2 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate 1.74 mg/L Other bacteria 0 colonies/100 mL Arsenic: '_ mgA Date of sample: 1/29/10 Collected by: A. Karats B. SEPTICIHOLDING TANK DATA Tank Type/Material Sepuctsteel Date installed 9/9193 Tank size 1.250 gal. Number of Compartments Two Cleanouts (YM) Y Foundation cleanout (Y/N) Y Depression over tank (YIN) N High water alarm (Y/N) N Date of pumping August 3. 2009 Pumper A Pius Home services C. ABSORPTION FIELD DATA Date installed 919193 Soil rating (g.p.d^2 or fts/bdrm)1.2 GPDISF System type Deep Trend, Length 50 ft. Width 2 ft. Gravel below pipe 5 ft. Total depth 10 ft. Eff, absorption area 500 fts Monitoring tube Y Depression over field N Date of adequacy test 4121/2010 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 2.210 gal. New depth 8 in. Elapsed Time: 25 min. Final fluid depth 0 in. Any rejuvenation treatment (past 12 mo.) (Y/N & type) Absorption rate >= 600 g.p.d. If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) •Pump on' level at _ In. 'Pump off level at _ In. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: %4 Septic tank/lift station on lot >100' On adjacent lots >1D0' Absorption field on lot >100, On adjacent lots >100• Public sewer main NIA Public sewer manhole/cleanout N/A Sewer/septic service line >25' Holding tank N/A Animal containment areas None Manure/animal excrete storage areas None SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >51 Property line>S Absorption field >5' Water main >10' Water service line >10 Surface water >100' Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >io' Water main >10 Water Service line >10' Surface water >700' Driveway, parking/vehicle storage >25' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS: G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems in 491H ./ i•••......N• N >1 / NN go N•••/ are �C`' conformance with MOA COSA guidelines in effect on this date. I p ; Mr r...••••,••••••. CHAEL E"ANDERSON = Engineer's Printed Name Michael E. Anderson, P.E. Date 514r2010�1;Orisssi %4 COSA Fee $ Waiver Fee $ Date of Payment Date of Payment Receipt Number Receipt Number (Rev. 11/05) � •626 2S2 V07 0 Y O i � M t P e CEO o e 8 «OCt o O� w w r a Enew c �MQ4ee c ao o i40 nt o c e e • ua�u•p €a .e v HO iMCCO T'C _ Qa 0 2,0 0 c�Q nOC eTZY sa w ou Qaco c-Gt � eL emri S � O �In G O c—C:E 06 Al E o v t f.m0a w a w C� • MnEco • a`o e:!gei 04! _« P .cf-odlex »e.co esr� =E e e '•' c _ < 3 cc a° e p° t