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HomeMy WebLinkAboutROSEBUD HILLS BLK 2 TR A Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON -SITE WASTEWATER INSPECTION REPORT Permit Number: OSP241236 PID Number: 017-381-45 Dwelling: ❑Q Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New R Upgrade Name Gary & Cindy Keyes ABSORPTION FIELD ❑ Deep Trench RN Wide Trench ❑ Bed ❑ Mound Site Address 12900 Birch Road ❑ Other Phone Number of Bedrooms Soil Rating depth from original grade 4 0.8 GPD/SF JTotal 1.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 0.5 Ft. Gravel depth beneath pipe 0•5 Ft. Subdivision Block Lot Rosebud Hills Tract A 2 Fill added above original grade 2.6-3.9 Ft. Gravel length 2@75 Ft. Township Range Section Gravel width 2@5•0 Ft. Beds: Number of Lines n/a Distance between lines n/a Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank 1 Line 750 Ftz 2 9.0 Ft. Well 100'+ 100'+ NA NA 25'+ TANK ElSeptic 9 S.T.E.P. ❑ Holding ElOther Manufacturer GREER Capacity 1500 Gal. Surface water 100'+ 100'+ NA NA Material Number of compartments Lot Line 51+ 10'+ NA NA NA HDPE 2 Foundation 10'+ 10'+ NA NA LIFT STATION Manufacturer Capacity Remarks GREER 250 Gal. Alarm location Inside Garage Wall Electrical installed by Capstone Electric Installer PIPE MATERIAL House to tank 3034 Tank to ASTM D1785 drainfield BC Excavating Drainfield ASTM D1785 CO/MT 3034 Inspector PES BENCH MARK (Assumed elevation) 768.5 ft Inspdection 08/21/24 08/21/24 Location and description znd 3`d 08/22/24 41" 09/19/24 See Site Plan, Top of deck corner ON -SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp F. !� Conditional Approval: Date �� .4 TH Septic SystemL Approved Date z Steven 'R. Pannoma jr �� � , L 814-19 ���,•�' ,� Note: this approval does not include well permit requirements. (Kev ubiuzl9 u) NOTE THE HOUSE IS A 2 STORY RESIDENCE WITH A WALKOUT BASEMENT. ---------1—-------------- L------------- Lot 4 RIDGEVIEW DRIVE N 89'59'43"E 350.04' SEPTIC PIPES SEPTIC MANHOLES / 8.2' x 10.2' SHED /__,,� O 00 WOODEN 'DECK IK D' p TEC*T WE cn IGRAVELNJ Ln 14.2' x\20.2' SHED WITH D Tract A \ 2.309 Acres RADIUS 10.2' x 12.1' DECK GREENHOUSE �25.8' WITH OPEN \ o STORAGE \ 23.7' 141.5' N 49.5' j I�10' UTILITY EASEMENTS BLOCK RETAINING WALL L=47.08' R=30.00' W M n O Ln D 0 o O Cl O v M S 89'59'43"W 380.00' — I 30' Tract A-1 I PLOT PLAN AS BUILT _X_ SCALE _1__= 60__ GRID _ SW 2837 Project No J24-0941A2 Lang & Associates, inc. P.O. Box 210005 Anchorage, Alaska 99521-0005 c Professional Land Surveyors (907) 522-6476 kenOlangsurvey.com �g QJ p�o4 2 a jonathanOlangsurvey.com 1 hereby certify that I have surveyed the following described Tract BLOCK property: 9 A, 2, ROSEBUD HILLS SUBDIVISION (Plat No. P-3058) Anchorage Recording District, Alaska, and that the improvements situated thereon are""' ""' "' """ "' ""0 within the property lines and do not encroach onto the no improvements on the property lying adjacent thereto property adjacent thereto, that encroach the Q ' and that there are no transmission on surveyed lines o " �•ONATHAN LA NG premises roadways, easements on said property rty except as indicated hereon. or other visible VO r^c, o� 0 Dated this the lYprDay of _ �/ _ �Z 4—at Anchorage, Alaska F`,1v0 �Fo 9944.• Q �• • • • • • •'' o 0 ,o It is the responsibility of the owner to determine the existence of any easements, y�Opppood covenants, or restrictions which do not appear on the recorded subdivision plat. State of Alaska AECC963 1500 GAL GREER POLY STEP TANK PROFILE PA N N O N E E N G S V C , L L C ( C . I . 1 0 8 8 ) PA N N O N E E N G S V C , L L C ( C . I . 1 0 8 8 ) COMMENTS: Test hole excavated by B.C Excavating, LLC. PERFORMED BY: PANNONE ENGINEERING SERVICES, LLC. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. ·7.4 (min/inch) ·6" ·1.5 FT AND 2.5 FT SOILS LOG & PERCOLATIONTEST ·13.3 (min/inch) ·6" ·1.5 FT AND 2.5 FT MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP241236 Work Type: Septic Upgrade Tax Code Number: 01738145000 Site Legal Address: ROSEBUD HILLS BLK 2 TR A G:2837 Site Mailing Address: 12900 BIRCH RD, Anchorage Owner: KEYES GARY & CINDY Design Engineer: PANNONE ENGINEERING SERVICES This permit is for the construction of: Effective Date: Expiration Date Lot Size in Sq Ft: Total Bedrooms: 8/16/2024 8/16/2025 95868 2 Disposal Field Q 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 Special Provisions: 4 The Engineer is required to do an additional percolation test in the area of TH-1 prior to construction of the septic field. Please submit stamped and signed results with the As -built Inspection Report. If the results require a design change, construction of the system will stop pending On -Site review and approval. Received By: S 5 ; D Date: , Issued By: (Z11 IL Date: P ON -SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 017-381-45 Property owner(s) Gary & Cindy Keyes Mailing address Site address 12900 Birch Road Day phone Legal description (Sub'd., Block & Lot) Rosebud Hills Block 2 Tract A Legal description (Township, Range & Section) Lot Size 95,868 —Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field FXJ Initial n Single Family (SF) nX (w/wo AD U) Septic Tank Upgrade nX Duplex (D) ❑ Holding Tank ❑ Renewal 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. (Signature of property owner or authorized agent) Permit/Rush Fees: A!5q!5. Date of Payment: S Z f� 2o -L Receipt Number: Permit No. 0-Se2.912-36 Waiver Fees: Date of Payment: Receipt Number: Waiver No. Permit App_'-'- : - ; Munidpality d Arx horage On -site Water and Wastewater REVIEWED FOR CODE CONIPUANCE Pannone Engineering Se rvi ce S uc OSP241236, Cubs Townsend, 08/18% Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panenggk.com Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, Alaska 99519 Subject: Rosebud Hills Block 2 Tract A Septic System Upgrade Permit Request This is a design narrative for a permit to install a septic system upgrade on the subject property. The proposed system will serve an existing four -bedroom (4) house. Currently the lot is developed. This lot and surrounding lots are served by private wells. Currently there are no wells within 100 feet of the proposed system. 1. Soils: Two test holes were performed on this lot by Pannone Engineering Services, LLC on 07/18/2024. Groundwater was not observed during the excavation of these test holes, and bedrock was not encountered. Groundwater was not observed in the test hole monitor tube of TH-1 after 7-days. Based on the results of the percolation test conducted in (TH-2), overall soils appearance of TH-1 & TH-2, and the selection of the proposed drain field; an application rate of 0.8 gallons/day/square feet was used for a conventional wastewater system in the area of the test holes. An additional percolation test within the area of (TH-1) will occur by PES prior to construction to confirm system design parameters. 2. Soil Absorption System Design. a. See Sheet 1 of the design package. 3. Surface Water: There is no surface water within 100' of the proposed septic system. 4. Topography: See attached site plan for area topography. S. Drawing Markings: The Drawings are marked "For MOA Review Only". When written notification that the review is complete and no further comments are received from MoA On -Site Department, the note will be removed and "For Construction" drawings will be issued. The proposed installation will not affect the future development of this or the surrounding lots. If you have any questions or concerns, please contact me at (907) 745-8200. Sincerely, vc' T2 {7 Steven R. Pannone, P.E. F. ASCE Owner/Civil Engineer 311uly 2024 el phone: (907) 4S-8200 FAX: ( 10 7) 745-8201 XXXXXXdSO 'ON 11N13d 5b-l8F-Ll0 ON '0'1'd ,OS = "L 31VOS bZOZ/l2/LO 71NnI SNOISIA38 J � 1 2 �j Z2 \ ti0 T¢ 2q gink 3 � (Zi t- tie .,4 Z Lo63 O Q m0 40 zz W3 �O e4 0� I 2 w > J WQ Q In J O�n W`L 3 0� WU Ln� 0. z~ y64W OW O p �` \ 4N� 2 - T W lw W O 2 ¢O / W I \ Y2y 2Qo4 120� Y� N0.W�iZ� �2pO�40p WW �m0 Q J 0�ti ��O pjZ �� p�- t;. 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FA Lot 4 -----------L-------------- i RIDGEVIEW DRIVE N 89'59'43"E 350,04' _ SEPTIC PIPES f 8.2' x 10.2' SHED WOODEN 'DECK 00' p TEC1� WE I WELL GRAVEL 14.2' x\20.2' SHED WITH DECK 10.2' x 12.1' , GREENHOUSE DECK �25,8' " WITH OPEN o STORAGE `0 23.7'' ..... ..., 141.5' 10' UTILITY EASEMENTS Tract A 2.309 Acres RETAINING WALL L=47.08' R=30.00' n 0 L > o O O U i ^J rr N W CJ� N i S 89'59'43"W 380.00' 1 1 -430 Tract A-1 i i PLOT PLAN _ AS BUILT _ _ SCALE _1" = 60' GRID SW 2837 Project No ,l24-094/ 1 nc Alas Lang �C Associates, InC ABox 21odao� Anchorage, Alaska 99521-0005 (907) 522-6476 Qo�>� Professional Land Surveyors ken0langsurvey.com Jonathan®langsurvey.com ® X\ •. 95�� I hereby certify that I have surveyed the following described property: Tract A, BLOCK 2, ROSEBUD HILLS SUBDIVISION (Plat No. P-305B) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. D Dated this the � _ __---Day of J_`_'y_' 2 at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. LANG a .,LS-9944.•- SJd 4 AR 4_:7 OFeSSIONm- State of Alaska AECC963 · O ' 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 Permit Number: ~'6L) ~)~.~,~ PID Number: t'~"-~ u~: Wastewater System: D New ~grade Address: /~)¢~ ~/~ ~ ~ ABSORPTION FIELD Phone: Nc. of Bedsores: ~p Trench D Shallow Trench ~ Bed ~ Mound ~ Other Total Depth from original grade: LEGAL DESCRIPTION SoilRating~, ~ GPD/Sq.F,. Lot: T~'~ ~BI°ck: ~ ~Subdiv~i°n:/~ I ~ Depth to pip~ttom~ ~fr°m original grade: Ft. Gravel~epth beneath pipe Ft. Township: ~ Range: Section: :ill added above original grade: Gravel I~th: WELL: ~ New ~ Upgrade Grave~ width: Numberof lines: Distance be~een lines: ~ Ft. / ~ Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: Ft. Ft. I ~ -~ ~ SQ. Ft. Driller: Date Drilled: Static Water Level: Installer: / Date instated: ~ -- Yield: GPM I~ump Set at: Ft. Casing Height AboveGround:;Ft. ~ TAN K SEPARATION DISTANCES ~tic a Holding D S.T.E.P. To Septic Absorption Lift Holding Public/Private ~anufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~ ~ ~/~ Z Material: Number~ompadments: Su~ao. LIFT STATION Lot -- ( / ~ Size in gallons: Manufact~r: Line ~ ~ ' ~ ~/~ ~ "Pump o~el at: ~Pum. off" level at: High water alarm at: CudainDrain /~ '~ /~ ~ ~ ~/~ ~/ Pump Make &~Model Electrical Inspections performed by:~ / Remarks: ~ ~ ~¢~ BENCH MARK . Assumed Elevation: Inspections performed by: ~.~ ¢~P~/~/~Oates: 1st/ ¢¢~¢ of Health~Hum~ ~vices appro~l Department Reviewed and approved b 72-013 (Rev, 9/91) MOA 25 Municipality of Anchorage DEPABTMENT OI= HEALTH AND HUMAN 8ERVlO[8 ENVlROI~AL SERVICE8 DIVISION Box 196650 o Anchorage, Alaska 99519-6850 · Telephone: 54-5-474z~ ~, ~On-Site W,~etewater Diepoeal System and/or Well Inspection Report Description: l~ O.~!flf,)Z2 tPll--& g T/4,/~PID No, ¢21 7,~ ~ / ztL~- Municipality of Anchorage DEPARTMENT Ol= HEALTH AND HUMAN SERVICE8 ENVIROt, aVlENTAL SERVICES DMSION P.O. Box 196650-Anchorage, Alaska 99519-6650,Telephone: 343-4744 On-Site Waetewster Disposal System and/or Well Inepection Report Leg<~l Description:,~O~L~/2~2 /~/L-/_F 'T'~, /or' PID No. z Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 6 7 8. 9 I0 11 12 13 14 15 16 17. 18- 19- OF 20- ~ ~- . .~: ~, .%.~:~.~ . ~ /' ,, -~.... ., ,.: ,-~ DATE Township, Range, Section: SLOPE SITE PLAN WAS GROUND WA,E. ENCOUNTERED? ff ~) S L IF YES. AT WHAT O DEPTH? p E Depth to Wal~ After MAnit~ing? Date: Reading Date Gross Net Del~th to Net Time Time Water Drop PERCO'*TION R*TE lq ,m,.u,e.,,',c.I,'~C.O'EOIA'"'ETER ( ~ ~OMMENTS THIS TEST WAS PERFORMED IN ACCORDANCE WIT; ALL STATE AND MUNI;IPAL GUIDE~]N iF&CT ;N THIS BITE. DAT~ /~// ¢+ Rick Mystrom, Mayor Municipality of AnchOrage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 March 31, 1995 James Mark Wright, P.E. 2900 W. 33rd Avenue Anchorage, AK 99517 Subject: Waiver Request for: Tract A, Rosebud Hills Waiver Approval: # WR950012 Dear Mr. Wright: Your request for waiver(s) of the required 10 foot horizontal separation of an absorption field to a lot line has been approved. The approved separation distance(s) are: Absorption Field to Property Line 6 feet This waiver approval applies to the existing absorption field to lot line separation only. Any future upgrades to either will require all separation distances be met or another approval be obtained from this department. Robert W. Robinson Civil Engineer On-Site Services kb WR~ WR950012 PID# Date Received: Legal Description: Engineer: MUNICIPALITY OF ANCHORA~ Department of Health and Human Services On-site Services Section Waiver Review Worksheet 017-381-45 HA# March 28, 1995 Tract A, Rosebud Hills Permit # SW940364 James Mark Wriqht, P.E. 2900 W. 33rd Avenue Anchorage, AK 99517 Applicant: Gary Keys Waiver Requested: Absorption Field to Property Line - 6 feet Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: ~ Waiver is NOT Granted: List Conditions or Reasons for above: Date: By: ~ame of Revie/wer Rec ~: 00756 (1339) Amount: $ 115.00 Date Paid: Mar. 22, 1995 March 23, 1995 Department of Health and Human Services Anchorage Alaska James Mark Wright P.E. 2900 West 33rd Ave. Anchorage Alaska 99517 (907) 243-4361 RE: Request for a lot line wavier for Rosebud Hills, Tract A. Dear DHHS, This is a request for a lot line wavier. The lot line set back was violated due to the owners request to preserve some large trees. The set back distance requested is six feet. No impacts to the surrounding properties are foreseen. Sincerely, ,~Mark Wright ?.~. RECEIVED MAR 8 1995 Munio~pahty ot Anohorage Dept. Health & Human Services PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.0. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT ~ER:SW940364 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:KEYES GARY & CINDY OWNER ADDRESS:12900 BIRCH RD ANCHORAGE, AK 99516 (UPGRADE) PERMIT DATE ISSUED: 9/26/94 EXPIRATION DATE: 9/26/95 PARCEL ID:01738145 LEGAL DESCRIPTION: ROSEBUD HILLS TR A LOT SIZE: 95868 (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 343-4744 (24 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 Bo COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ISSUED BY: -- / DATE: September 14, 1994 Department of Health and Human Services Anchorage, Alaska ,I'~UNIC:IPALITY OF ANCHORAC~I~ ENVIRONMENTAL SERVICES DIVISION SEP l 4 1994 RECEIVED Re: Onsite sewer system design for Tract A, Rosebud Hills Subdivision. Dear DHHS, This is a request for an onsite sewer permit for an existing residence located at the above address. The existing system has been in place about 30 years and has failed. A test pit was excavated located as shown in attached plan view. The soil profile showed a sandy/silty gravel to a depth of 18 feet with a percolation rate of 24 min/inch. The existing tank will be replaced. No impacts to the surrounding properties are foreseen. All have onsite systems already and appear to be preforming adequately. Many of the surrounding lots are undeveloped. The required set- backs are easily obtained within the confines of the lot. The topography of the area is sloping at about 10% to the north. The lot footprint is about 250 feet fronting Birch Road by 380 feet deep. Sincerely s M. Wright P.E. W (_D Z Z ~ I'-- }-- 2 c~ 0 kO '~ 13_ n c~ O3 CL C3 C9 13_ mvou N0318 3 ,,£O,cJO. O0 N O <~ (D Z S 00'05'07" E 265.17' © 4" CLEAN OUT% 42' '"'-4" CLEAN OU~-~ PLAN VIEW ~-"~ / ~42 LIN. FT. S = 0.0%, 4" PERFORATE 4-" MIN. COVER ..ELEVATION 4"CLEAN OUT - _ FROM SEPTIC '-- TANK ~ 4"CLEAN OUT MONITORING TUBES FILTER FABRIC ~ FROM SEPTIC PIPE TANK 6' I SECTION -TRACT A, FILTER FABRIC 4-" PERFORATED PIPE DRAIN ROCK ROSEBUD HILLS SUB. 24' 23 22 20 4 3 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anct~orage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION:"T/F~'~"/-/3L. ~/~-~ ~(-)./~ ~//.J.~Township, Range, Section: / SLOPE 8 9, ENCOUNTERED? S L; IF YES. AT WHAT OI DEPTH? ~ Depth t° W~t~r Alter L/'7~ ~//~//¢f Monitaring? i-v c,,- Da~ SITE PLAN Gross Net Oel3th to Net Reading Date Time Time Water Orol3 ~," ,~/z~./¢,/.7; ~-¢;.~ ",. /~ ~;~; ~ ~o i,~ '~ ~/~/~ 7; ~; ~ t~,~ 3o I, I~ 7/o zz ~ ~ ~: ~z; o~ ~o 1~ I >" 4'~~/ ~ q;l~3 to ~ I, I~" PERCOLATION RATE ~" '~ (mlnuteslmcl3) PERC HOLE DIAMETER ~:~ 10- 11 12 13 14 15 16- 17- 18-- 19 20 $OMMENTS PERFORMEDRY: ./~/l~'/'~" ~..~/;{_./.,/7.-'~'7'" I .~ /~["~-" /~/'V/P~/'~3¢¥'/ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN E,FECT ON THIS DATE. DATE; ~/~--~/¢t" NOTE: THE HOUSE IS A 2 STORY RESIDENCE WITH A WALKOUT BASEMENT. FA Lot 4 -----------L-------------- i RIDGEVIEW DRIVE N 89'59'43"E 350,04' _ SEPTIC PIPES f 8.2' x 10.2' SHED WOODEN 'DECK 00' p TEC1� WE I WELL GRAVEL 14.2' x\20.2' SHED WITH DECK 10.2' x 12.1' , GREENHOUSE DECK �25,8' " WITH OPEN o STORAGE `0 23.7'' ..... ..., 141.5' 10' UTILITY EASEMENTS Tract A 2.309 Acres RETAINING WALL L=47.08' R=30.00' n 0 L > o O O U i ^J rr N W CJ� N i S 89'59'43"W 380.00' 1 1 -430 Tract A-1 i i PLOT PLAN _ AS BUILT _ _ SCALE _1" = 60' GRID SW 2837 Project No ,l24-094/ 1 nc Alas Lang �C Associates, InC ABox 21odao� Anchorage, Alaska 99521-0005 (907) 522-6476 Qo�>� Professional Land Surveyors ken0langsurvey.com Jonathan®langsurvey.com ® X\ •. 95�� I hereby certify that I have surveyed the following described property: Tract A, BLOCK 2, ROSEBUD HILLS SUBDIVISION (Plat No. P-305B) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. D Dated this the � _ __---Day of J_`_'y_' 2 at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. LANG a .,LS-9944.•- SJd 4 AR 4_:7 OFeSSIONm- State of Alaska AECC963 Date: 10/2/24 P.O. Box 670269 Chugiak, AK 99567 P: (907) 688-2759 F: (907) 688-2259. Pannone Engineering RE: 12900 Birch Rd, Anchorage WELL CAMERA INSPECTION We did a camera inspection of the well from the top of the casing down to the static water level at 136’ and found no issues that would contribute to elevated nitrate levels. There were no perforations, cracked welds or leaks from the pitless area. The entire well is steel cased and in good condition. Total depth of the well is 176’. Certificate of On -Site Systems Approval Parcel I.D. 017-381-45 Legal description ROSEBUD HILLS BLK 2 TR A Site address 12900 BIRCH RD Anchorage AK Current property owner(s) KEYES Expiration Date: X The On -site system(s) is/are approved for 4 bedrooms Conditional approval for Comments or advisories: c 5/29/2025 bedrooms, with the following stipulations: Original Certificate Date: 10/2/2024 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory _ Absorption Field Advisory Nitrate Advisory X Tank Age Advisory Arsenic Advisory _ Other COSA Approval_June 2022 MUNICIPALITY OF ANCHORAGE Development Services Department Phone. 907 -343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 t_J Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 017-381-45 Complete legal description COSA 2022 Rosebud Hills Block 2 Tract A Location (site address) 12900 Birch Road Current property owner(s) Keyes Gary & Cindy 2. ON -SITE SYSTEMS SIZED FOR 4 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: X Private Well F Private Well serving 2 dwelling units El Private Well serving 3+ dwelling units R Community Well or Public M Water Storage 4. TYPE OF WASTEWATER DISPOSAL: X Private Septic ❑ Private Septic serving 2 dwelling units 0 Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: F-1 Steel nN Plastic E] Concrete n Fiberglass Age <1 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: E] AWWTS E] Bed n Deep Trench nN Wide Trench 17 Seepage Pit Waiver request for: Expedited review requested: R Distance: By applying for this entitlement, this property is subject to inspection by municipal On -site staff to verify the accuracy of the information provided. C"l- COSA Fee $ 'y 1 6 Waiver Fee $ Date of Payment C1 A C) /2- Date of Payment S Waiver # COSA # , (—/ , C %3 0 Application June COSA Checklist_June 2022 COSA Checklist Legal Description: Parcel ID: If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank Date of pumping Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes go to bottom of effective. If not,state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Adequacy test date Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) in Effective depth used in Effective depth remaining in Comments/Deficiencies: COSA Checklist_June 2022 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F.ENGINEER’S COMMENTS G.CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC & MOA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail, and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore, we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Phone Engineer’s Printed Name Date MUNICIPALITY -OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907 343-79Ja• On -Site Water and Wastewater Section ) Fax: 343-7997 www.muni.org/onsite � - Nitrate Advisory Certificate of On -Site Systems Approval # OSC241397 Subdivision: ROSEBUD HILLS, Block: 2, 1 Tract A A water sample revealed a nitrate concentration of 5.83 milligrams per liter (mg/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. r , Mailing Address P O Box 19665Q, *Anchorage, Alaska 99519 6650 * uuww muri� org ' Nitrate Fact Sheet From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. Ma�llrg Address P ,O Bax 19665Q *Anchorage, Alaska 99519 6650 * www mun org