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HomeMy WebLinkAboutROSEBUD HILLS BLK 1 LT 6 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: .~'Z~ O/ ¢~ PlDNumber: 01~*.~/- ~ Na~: ~ O~O~ Wastewater System: ~ New ~ Upgrade Address: /~/o / ~-/~ s~ ABSORPTION FIELD A~cdo~A~: A/d Phone: ~ ? ~. ~ ? ~/ ~/ No. of Bedsores: ~ Deep Trench ~ Shallow Trench O Bed O Mound O Other LEGAL DESCRIPTION soi~ Rating: Total Depth fro~rlginal grade: Lot: ~ Blook: / ~°~cl~Subdiv~i°n: ~ ~ Deplh to pipe bo~o~,from odginal grade: Ft. Gravel depth ben~pipe Ft. Township: Range: ~ Seotion: Fill added ~bov~ original grade: Growl I~gth: WELL: D New D Upgrade Gravel width: ~ Ft. ~ /~ Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption are~ Pipe material: / Driller: - Date inst~lled: z ~ -- ~ ~1~[~ ~ Dat~ DriJled: StaticWaterLevel: installer: Yield:i~ GPM Pu~p Set at: Ft. Casing Height~ Above Ground:Ft. TANK SEPARATION DISTANCES ~ Septi~ ~ Ho~d~,~ ~ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: / Material: Number of Compadments: Surface ~ / [ LIFT STATION Lot /~ Size in gallons: Manufacturer: Foundation ~ / yO / ~ "Pump on" leve~~: .... level at: High water alarm at: CudainDrain /~/-/~- ~ ~ P~ode[ Electrical inspections pedormed by: Remarks: BENCH MARK Location and Description: Inspections pedormed bY:s &, ,N~i~,,~;N, Dates: 1st ~/~/¢ Z Oepartment of H~[Ith and Human Se~mes appruval Reviewed and approved by: ~, ~ate: ~- / 7- e ~ 72-013 (Rev, 9/91) MOA 25 PERMIT No. SW980146 PAG~. 2 OF 2 Municipg!,i ,¢y_o. F Anchor'o. oe DEPARTMENT OF HbAL/H AND HUM"AN SERVICES ENVIRONMENTAL SERVICES DIVISION P.D. Box 196650 I Anchorage, ALaska 99519-6650·TeLephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 6, BLOCK 1, ROSEBUD HILLS S/D P.LD. NO. 017--381--55 FCO 8.5' 20.5' ST1 25.0' 55.0' w EL ST2 25.5' 41.0' DBL1 27.0' 44.0' ~ , C01 26.5' .50.0' MT1 59.5' 66.5' C02 40.5' 51.0' MT2 61.0' 74.5' C05 81.0' 87.0' C04 45.0' 60.0' C05 83.0' 93.0' : FS 40.0' 54.5' ST1 ST2 /98'9' /FINAL GRADE C 9 . 1~50 GAL ~94 ' S.T. . tJ L~ C05 C03 FINAL GRADE C04 = 97.9' 98.4', C05 = 97.8> ~02 = 03 = 98.3 MT2 T1 C03 ~ ~ ~ ~CA~ ~" = ~o' [I ~11 , .,~ co~ = 93.~:~ . 93.5 ~/ U U ~T1 = 88.6TM .... WATER FOUND A B FCO 8.5' 20.5' ST1 25.0' 55.0' ST2 25.5' 41.0' DBL1 27.0' 44.0' DBL2 27.0' 44.5' C01 26.5' .50.0' MT1 59.5' 66.5' C02 40.5' 51.0' MT2 61.0' 74.5' C05 81.0' 87.0' C04 45.0' 60.0' C05 83.0' 93.0' FS 40.0' 54.5' 08/21/98 FRI 10:14 FAX 9073455549 OSBORNE M-pW DRILLING, INC O BOX 110378 ANCHORAGE, AK 99511-0378 345-4000 FAX 345-3287 NORONGH SUEDMSION LOT BLOCK SECTION QTHS SECTION ?O~D.~ ......." I DEPTHS I{EASURED PRO}{: [ ~ CASI~ TOP [ ] GROU~ SDRFAOE HA~ ~PE ~ CO,OR FROR TO NELL AH-BUIlT: DATE OF COHPCETION: DEPTH OF HOLE: ./d'd FEET DEPTH OF CASIUS: 2o'~ TO STATIC WATER LEVEL: DATE: Od/2d/~ .//2 Fl; BELOW{ [~ TOP OF CA~G [ ] GROUND SURFACE ~YPE: Sff~ LH{BR ~YPE: ~/~ D~R: ~. FROK ~JO PERFO~TIOH$: TO SCREEH TYPE: $LOT/gESH SIZE: LEHG~It: fc VOLURE USED:. DEPTH TO DEPTH:ERON fct~ ROT~Y SEP 5 1998 Municipaliiy ot Anchorage USE OF NELL: []0TNER PUIIP1HG LEVEL AllD 8: AFTER 1 UPON CORPLETIOI~ RERARKS: HOUR PHRP~{G YES []NO EUPPLY EISA Certified Contractor DATE ~I~OBERT C. COWAN, RE. ROBERTA. SHAFER, RE. CIVIL ENGINEERS HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS S EWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE pLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN (907) 694-2979 FAX (907) 694-1211 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 RECEIVED JUL 7.3 1998 Municipality ut Anct3o age Dept. Health & Human S;~Wces The septic inppgctions for t~etreferenced property were performed on~/q/9 ~ and ~ .[/~9~ · Prior to submitting the On-site Wastewater Disposal System and~o~Well Inspection Report we are waiting for the ~~~/~>~ £~v6~to be completed. If we may be of further service please contact us. Sincerely, Robert C. Cowan, P.E. 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P. 0. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Date Issued: Jun 03, 1998 Expiration Date: Jun 03, 1999 Permit Number: SW980146 Design Engineer: 0019 Flattop Technical Services Owner Name: Jeff Osborne Owner Address: 12101 Jerome St. Anchorage, AK 99516- Parcel ID: 017-381-35 Legal Description: ROSEBUD HILLS BLK 1 LT 6 Site Address: 005635 RIDGEVIEW DR Lot Size: 52500 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] SepticTank [] Privy [] Private Well [] Holding Tank [] 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 engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special ~rovisions. Date: Date: CIVIL & ENVIRONMENTAL ENGINEERING * ENERGY CON: ERVATION & ANALYSIS TttEODORE F. MOORE, P.E. 14530 ECHO ST. PH: (907) 345-1355 ANCHORAGE, ALASKA 99516 May 28, 1998 M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: The purpose of this letter is to provide the required design narrative in support of our application for a permit to construct wastewater disposal facilities on Lot 6, Block 1, Rosebud Hills S/D, located at 5635 Ridgeview Drive. Soils logs, perc test results, a site plan, design drawings and specifications are enclosed for your review. The initial construction will be temporary living quarters located in the garage, with the main house to be constructed at a later date. Ultimately, the main house will have 4 bedrooms and there will not be any bedrooms remaining in the garage structure, however there will still be a toilet in the garage. The proposed system will be constructed in the vicinity of test hole #1. As can be seen from the soil log, the native material between 2.5' and 12' below ground level is a silty sandy gravel with a measured perc rate of 4 minutes per inch. Using a slightly conservative soil application rate of 0.8 gpd/sq. It, this proposed 4 bedroom residence requires a total absorption area of(4 x 150)/0.8 = 750 square feet. The proposed design consisting of 2 parallel 38-foot long trenches with 5 feet of sewer gravel below the horizontal distribution pipe has a total absorption area of 760 square feet. The topography of the lot in the area of the proposed construction slopes down towards the west at approximately 2%. The designated replacement soil absorption system is planned for the vicinity of test hole #2 where the measured perc rate in the optimum receiving stratum is 19 minutes per inch. The design of this system will differ from the original system in that the trenches will be sized on the basis of 0.6 gpd/sq. ft. and the absorption stratum will be between 7 feet and 12 feet below ground level. The two 50' trenches with 5 feet of sewer gravel will result in an effective absorption area of 1000 square feet. The proposed project will have no significant impact on present or future water supply and wastewater disposal systems serving adjacent properties, nor will it have any significant impact on reserved space-surface and subsurface, or on drainage. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, Ted Moore, P.E. SEPTIC SYSTEM o SEPTIC SYSTEM 100'+ N OF PROP. LINE .'''-- ---_.. o THIS AREA o '' LOT 1, CONTOUR LOT 2, CONTOUR ACRES'~2 .- ACRES #2 .............................................. }; ~'-2-- ............ ---'-'~ r./ - LOT 6, BLOCK 1 PROPOSED~ ..'' , ROSEBUD HILLS WELLSlTE //....' ',, ; / ,' LOT 7, BLK 1 ~ ~ ........... ~ ,' ROSEBUD HILLS LOT 5, BLK, I ~ ', ROSEBUD HILLS , :DROP. ,~ (VACANT) ', I 3ARagE "~' ^ ,' ~J' : ~,,. , , WELL ';TEMP. % / r~ T.U. '. ....... .......... ~ ~:ii!~ii!~ '" ~ ~ · , :o,. ...... :!', '.~i USE FLOW SPLITTER ~ z - u ~o / ~ ~ PROPOSED i', ~ PROPOSED i;(( 8;,; '. ~ ~ ~--~' --- % 1250 GALLON !~''?'( ~'/'- 2x38'SOILABS. ~ , , oT.h' ,,~ / -... TRENCHES WITH I ~, ¢ #1 SEPTIC TANK 4b '-- - -' 5.0' SEWER GVL. I , ~ ~ '.; '.'. '; ~ ~XISTING F, :: '~ i!;': ?'. :i: ~ SEPTIC YSTEM SITE FOr,~,,, ' i REPLACEMENT--,, , ,O 2x50'SOILABS. < " ' ..... ' r 11 T, :.~ O.6 GPD/SQ. FT.) ,, ,, SEPTIC ,, ,, SYSTEM ~- ~-%.v........ ~. ~ RIDGEVIEW DRIVE · --~ ~z~w.. ~ -..~,~ ~. _ ~_~ LOT 6, BLK. 1, ROSEBUD HILLS S/D ~' :~.* ~.~ %'IS ,A PROP. WELL AND SEPTIC SYSTEM 49TM SITE PLAN -~, '~'[ ................ :*~.'~ FLATTOP TECHt~CAL SERVICES 1 INCH = 50 FEET ~' ·e THEODORE F. MOORE e· e -~'e~. %e CE - 3589 ..e ;~ee~ 14530 ECHO STREET DRAWN BY TFM ~'e~ .. ..... o'/.~_'ar LOT4, BLOCK2 ANCHOAAGE, AgASi~99516 MAY, 1998 w~,yo' p,,.. ~o o~'..~,~ ROSEBUD HILLS '~,.. ,0Tess ~..~' NOTE: THIS IS NOT A SURVEYED PLAT. '~,~,~'~" (VACANT) ALL LOCATIONS SHOWN ARE APPROXIMATE. I ~ 1250 GALLON SEPTIC TANK c.o.~l ~ /. U.T. ~ 4"DIA :~ ~ s: _,~_~, ................................. ~ NON-PERF H / k ,, ' o.o. . ,] ~ ~ OUTER LIMITS OF ~ ~ ~ -TRENCH EXCAVATION PLAN VIEW SCALE: 1" = 10' MONITOR "] CLEANOUT MOUND BACKFILL 1.0' 10 GINAL GR 4" DIA, F-810 PERF. DIST. PIPE 1/2" - 2 lf2' SEWER GVL. -- BOTTOM OF EXC: SECTION "A - A" SCALE: 1" = 5' - 0" LOT 6, BLOCK 1, ROSEBUD I-1TI.LS PROPOSED SEPTIC SYSTEM PLAN AND CROSS-SECTION FLATTOP TECHNICAL SERVICES SCALE: AS SHOWN 14530 ECHO STREET DRAWN BY: TFM ANCHORAGE, AK, 99516 MAY, 1998 Flattop Technical Services 14530 Echo Street, Anchorage, AK 99516 Phone (907) 345-1355 Lot 6, Block 1, Rosebud Hills 5635 Ridgeview Drive Wastewater disposal system installation Specifications 1.0 General: 1.1 The scope of the project consists of installation of a 1250 gallon septic tank followed by 2 parallel 38 foot long soil absorption trenches containing a total of 5.5 feet of sewer gravel. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform with Municipal and State requirements. All separation distances shall be in conformance with Municipal requirements, unless specifically waived. 1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. 1.4 The contractor shall provide adequate cover material and rough grading over all system components to ensure that proper drainage is achieved after settlement and that there are no residual depressions. Insofar as possible the contractor shall minimize .damage to trees and existing lawn areas. 1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the construction. 2.0 Septic Tank: 2.1 The new 1250 gallon, 2 compartment septic tank shall be Municipally approved and shall be set level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover and a 4" cleanout. If the tank is buried less than 4 feet, it shall be insulated with 2 inches of approved burial type, rigid insulation. 2.2 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The waste line from the residence to the septic tank shall have a minimum slope of 1/4'" per foot, and the waste line between the tank and the soil absorption system shall have a minimum slope of 1/8" per foot. A cleanout shall be installed within 5 feet of the building foundation as well immediately prior to the 900 bend preceding the septic tank. A double cleanout shall be installed within 5 feet downstream of the septic tank. 2.3 A "Zabel" hydraulic flow splitter shall be installed downstream of the double cleanout to evenly divide the Wastewater between the two soil absorption trenches. 3.0 Soil absorption system: 3.1 The soil absorption system shall be constructed by excavating two parallel trenches spaced 10 feet apart to a depth of 8 feet below ground level in the vicinity of test hole #1. 3.2 The bottom of the excavations shall be level and at the same elevation. Any compacted or smeared surfaces shall be raked to allow proper infiltration. Sand for leveling or serving as filter material shall comply with Municipal specifications. 3.3 A total of 5.5 feet of approved sewer gravel shall be placed in the bottom of the excavation with the perforated distribution pipes laid level such that the pipe inverts are no less than 5.0 feet above the bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing the #200 sieve. 3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on the design drawings. The portion of the monitor tube extending through the sewer gravel shall be perforated. 3.5 Approved filter fabric shall be placed over the entire top surface of the sewer gravel. A minimum of 2 feet of soil cover is to be placed ove~: the filter fabric. If the soil cover thickness is less than 3 feet, two inches of rigid, burial type insulation is to be placed over the entire top surface of the gravel, in addition to the filter fabric. 3.6 The top surface of the cover material shall be raised a minimum of 12 inches higher than the surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill slopes shall be no steeper than 3:1. 3.7 Unless specifically agreed otherwise the homeowner shall be responsible for arranging to have the site finish graded after the backfill material has stabilized, and for placement of adequate topsoil and seed to promote rapid revegetation of all areas disturbed by the construction. 4.0 Inspections: 4.1 A minimum of 4 engineering inspections will be required during the course of the project: (1) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the native material has been excavated to expose the infiltrative surface to ensure that it is level and at the right elevation, and conforms with the soil test information, (3) after the sewer gravel is in place and the distribution pipes have been laid and connected up to the septic tank, but prior to placement of insulation or filter fabric, and (4) after rough backfill and grading is complete. The septic tank requires one inspection after it is set level and the piping connected, but prior to backfill. This inspection may be incorporated with any of the above inspections. 4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. JTEST HOLE LEGAL DESCRIPTION: DATE PERFORMED: PERFORMED FOR: DEPTH (feet) 1 COMMENTS: _ FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 SOILS LOG -- PERCOLATION TEST Lot 6, Block 1, Rosebud Hills May 11, 1998 Jeff Osborne Pt. SM Reddish sandy loam SLOPE GP/GM Silty sandy gravel Dark gray, damp Water seeps Depth to Groundwater Date ~ ~ 12' B.G.L. 5/11/98 17'- 3" b'.G.L. 5/19/98 ML Gray silt B.H. LOT 6, BLOCK 1 ROSEBUD HILLS  T.H.#3 ¢¢ T.H. #1 3?., T.H. #2 Clock Net Time Percometer Net Drop Date Reading Time (minutes) Reading (inches) 5/11 12" Presoak 27 3/4 Add water & start 12:23:30 23 7/16 #1 12:28:30 5 21 3/4 1 11/16 add water 12:28:45 23 1/2 ~r2 12:33:45 5 21 3/4 1 3/4 Add w~ter 12:34 23 5/8 #3 12:39:45 5:45 71 314 1 7/8 add water 12:40:30 23 7/16 #4 12:45;30 5 21 11/16 I 3/4 PERCOLATION RATE 4 (minutes/inch) PERC HOLE DIAMETER 7" TEST RUN BETWEEN 5.5 _ FT AND_ 6 0 FT Des ,qn soil absorp~inity of this test hole on basis of 0.8 ,clpd/sq. ff. us n,cl soils between 2.5' and 8' b.g.I. PERFORMED BY F LA'I-['OP TECHNICAL SERVICES. I_ ~.~ ~¢~/~"~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~¢""/~ ~ ~ ~ TEST HOLE # 2 LEGAL DESCRIPTION: DATE PERFORMED: _ PERFORMED FOR: _ DEPTH -- (feet) FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 SOILS LOG -- PERCOLATION TEST Lot 6, Block 1, Rosebud Hills May 11, 1998 Jeff Osbcrne Pt. SM Reddish sandy loam ML Gray sandy silt GM/SM Gray sandy silty gravel Siltier than T.H. #1 Top of stratum is shallower on East SLOPE side of test hole than on West Depth to Groundwater Date ~at 18 feet 5/11/~ 17~B.G.L 5/19/98 LOT 6, BLOCK 1 ROSEBUD HILLS  T.H. #3 Clock Net Time Percometer Net Drop Date Reading Time (minutes) Reading (inches) Start ~00:30 23 5/16 2:15:~00 15__ 22 7/1~ 7/8 ~ 23 1/2 --~water__ 2:16 __ -- ~ 2:31 15 -- ~6 13/16 ~--~ ~- 23 1/2 #3 - 2:46:~15~ 15 22 11/1~6 13/16 __ PERCOLATION RATE 19 (minutes/inch) PERC HOLE DIAMETER _ 7" TEST RUN BETWEEN 7.0 FTAND~5 FT COMMENTS: Design soil absorption system on basis of 0.6 gpd/sq, ft. using soils between 7 and 12 feet b.g.I. PERFORMED BY FLA'I-I'OP TECHNICAL SERVICES. If,~'~ ~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: _ ,~' '~,~ ~'~' ITEST HOLE LEGAL DESCRIPTION: DATE PERFORMED: PERFORMED FOR: DEPTH (feet) 1 2 FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 SOILS LOG -- PERCOLATION TEST Lot 6, Block 1, Rosebud Hills May 11, 1998 Jeff Osborne Pt. SM reddish sandy loam GP Clean sandy gravel GP/GM Somewhat silty sandy gravel Water flowing into T.H. @ 6' (North end) ML Gray silt SLOPE SP/SM Silty sand ML gray silt B.H. LOT 6, BLOCK 1 ROSEBUD HILLS  T.H.#3 ~ T,H. #1 Depth to Groundwater Date Water ~, 6' 5/11/98 Clock Net Time Percometer Net Drop Date Reading Time (minutes) Reading (inches) PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS: No monitor tube set because shallow groundwater precludes trench in this area. PERFORMED BY FLA'I-rOPTECHNICALSERVICES. I ~_~ ~ CERTIFYTHATTHISTESTWAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: • QP.. s„ •y Municipality of Anchorage On-Site Water and Wastewater Program (907) 343-7904 s a E*r Certificate of On-Site Systems Approval Parcel I.D. 017-381-35 Expiration Date: _ 1 L1 12 1. GENERAL INFORMATION: Complete legal description ROSEBUD HILLS: BLOCK 1, LOT 6 Location (site address) 5635 Ridgeview Drive'Anchorage 99516 Current Property owner(s) Jeff Osborne Day phone 441-6600 Mailing address Real Estate Agent _ Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex (7 Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank LJ Community Class _Well ❑ Community ❑ Public Water System ❑ Public Sewer WaiverNariance request for: Distance: Received by: (/) Date: //PLO-7 COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5-2C, Waiver Fee $ Date of Payment lIl3 Date of Payment Receipt Number 6050/6 Receipt Number COSA# ocf9-15-240 Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101-Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: LI `3'7/7' �00000 -v%, In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system o OF Q, in accordance with the guidelines and regulations established by the Municipality of Anchorage and .��..• • ..�6. j industry practices. The reported results describe the.condition of the system/s on the date/s of the Q Q ' evaluation. Separation distances were measured to readily identifiable features. Hidden defects or DQE , • T -)� '.."...._77°(),, encroachments may exist that were not identified during the evaluation. The operational life of all wells * , ,7* V0� and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and Q workmanship), and the water usage of the family utilizing the system/s. These conditions can vary,and -..��.. ... Q are outside the control of GEG. Satisfactory test results do not guarantee future performance of the O -f : A. ,•rn-ss,.. 0 system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of (/ % C 79 3 ' �Q� the well or septic system. GEG makes no representation whether an alternative well or septic system 0 9 ��Q can be installed on the property in the event either of the current systems fail to perform adequately in �Q e fit! /.�• °o the future. The content of this report is for the sole benefit of the person/party that retained GEG to �DOq pro fess e�oo� perform the evaluation. Reliance upon the information provided in this report by any other person or ��Opoo�c party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE System #1 Approved for 3 bedrooms System #2 Approved for bedrooms ,_'-\\( OFt t�t Disapproved �`V `_ NTE �G) Conditional approval for bedrooms, with the follows stip SAND ' 7-3 C3 WASTEWATER o ' PROGRAM ,OA `G<G�O- .. NT SER\I By: lit-....._ mss.' Original Certificate Date: 1 / / tf—/ 7 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-10-12.doc If more than 1 septic system is on the lot: COSA Checklist# of_ Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: ROSEBUD HILLS; BLOCK 1, LOT 6 Parcel ID: 017-381-35 A. WELL DATA 160.2 Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 6/15/98 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 160 ft. Cased to 160.2 ft. Casing height(above ground) 18+ in. FROM WELL LOG AT INSPECTION Date of test 6/15/98 10/19/17 Static water level 111 ft. 112.3 ft. Well production 13 g.p.m. 6.7+ g.p.m. WATER SAMPLE RESULTS: Coliform s colonies/100 ml. Nitrate 1' 3 6mg./L. Collected by: GEG, Ltd. Arsenic: <S•Oug./L. Date of sample: 10/19/17 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 6/9-10/98 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 10/23/17 Pumper ISAAC'S PUMPING C. ABSORPTION FIELD DATA BELOW EXISTING GRADE AT MTS WEST/EAST Date installed 6/9-10/98 Soil rating •.p d./ 2or ft2/bdrm) 1.2 System type DUAL TRENCH Length 40/40 ft. Width 3/3 ft. Gravel below pipe 5/5 ft. Total depth •9.7+ ft. Eff. absorption area 800 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 10/19/17 Results (Pass/Fail) PASS For 3 bedrooms 313/306 Fluid depth in absorption field before test 20/0 in. Water added gal. New depth 22/2 in. Elapsed Time:120/111min. Final fluid depth 20/0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) NONE KNOWN If yes, give date - -1016 GALLON PRE-SOAK PERFORMED ON WEST TRENCH 10/18/17 -1008 GALLON PRE-SOAK PERFORMED ON EAST TRENCH 10/18/17 D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) "Pump on" level at in. "Pump off' level at '• wa er alarm level at in. - _- Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 75'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ _ Property line 5+ 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 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS ..*��%%a a, r G. ENGINEER'S CERTIFICATION ••••< ....•""" .ipv-.-./... ., I certify that 1 have determined through field inspections and - 49 �� •• review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this . • i date. co,) J f 0 y •. Garn-ss!I Engineer's Printed Name JEFFREY A. GARNESS �2, CE-79' .. ' Date LI ) (9' �4.•' ROFESSI�P••. LICENSE ��%aaaa**�� #AECC884 (Rev.10/12/12) FINAL STRUCTURE AS BUILT G 9138 G "Q+�� I, William D. Fleming, hereby certify that I have performed on 8221 DEL STREET "�i * ANCHORAGE, ALASKA 99502 as built survey of the structure on this lot and that oll the Pi+or+E 243-4090 dimensions and information as shown hereon are true and that no encroachments exist unless shown otherwise. I I/5/98 FINAL AS BUILT 44-15 6/22/98 AS BUILT FOUNDATION 42-43 7 5/8/98 PLOT PLAN 42-09 30 I DATE +�lowaaMr,, f'LD. BK. . * .� S 00.05.07-E 332.09 (R) '=:•49m O. S 00°06'30-E 332.27' (M) ., , Ile/fa,: .-...11.Z41.1.' • Will D. Fleming •. 4 - �� .: •. LS-5773 _.• �•m 1 LU se-..:-.. •Oy• o 2 O "� Rp,IE�Oaf J1_ Q ,,P�4r°a�lono����. N Of Mt m a� �l G „�,�N 62 ,1t►aaOo• �, _-- m 0 c; a _----— f—� NOTES: Easements not appearing on record subdivision Lu j ,- I N plat are not shown unless description of easement is w a w 3 L_U z provided by client. It is the responsibility of the owner 2 g'a> 6 a in > U or builder, prior to construction, to verify proposed in in m 65.8 - -- ' `-"'=t- • --- - t n❑ LU o building grc•ie relative to finish grade and utilities . i r s Volir)in C' r connections, and to determine the existence of any O I 66.6' a> m 0_ easements, covenants, or restrictions which do not ff` ' 'O ExiSTUN, `+OUSE 0 '.... Z z ' ,,_1 W x 0 z fA d' appear on the recorded subdivision plat. 666' ✓'''` o 66.6 �. _ o 0 0 o Elevatldns based on assumed datum unless otherwise ".�°tt " ltii. g 0 181.8 \ indicated, and bearings and distances are record data. to m o e o O NI ...------- a-PVC SEPTIC N N STD-PIPES mon CLIENT: S 00°05'07'E 331.16' (M) JEFF OSBORNE S 0(BASIS)•E 33;.24 (R) \ • LEGAL DESCRIPTION N. • 30 LOT 6, BLOCK I, ROSEBUD HILLS SUBDIVISION 5 PLAT NO. SCALE GRID 74-187 �• 0 2837 • ;• Municipality of Anchorage _, ,_ DC%clopment Services Department Building Safety Division `A'E,e On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On-Site Systems Approval # OSC 171526 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 1, Lot 6 of Rosebud Hills subdivision. This inspection revealed a nitrate concentration of 7.38 milligrams per liter (mg/L) was reported for the property's well water sample. 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. 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. 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.