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KASILOF HILLS BLK 8 LT 14
1 t m t � '�.z�r.� r"`�� '�„5��+, • �.' "� auk., .�.;�� Municipality of Anchorage Community Development Department Page 1 of 2 On-Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage,AK 99519-6650•http://www.muni.org/onsite•(907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181183 PID Number: 015-161-21 ❑ New ❑Q Upgrade Name: ROBERT SWANSON ABSORPTION FIELD Address El Deep Trench NShallow Trench ❑ Bed ❑ Mound 10801 GLAZANOFF DRIVE fig Other Phone Number of Bedrooms Soil Rating Total depth from original grade 5 0.8 GPD/SF 6.5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 2.5 Ft. 4.0 Ft. KASILOF HILLS 8 14 Fill added above original grade Gravel length Township Range Section 2.0 Ft. 94.0 Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES 5.OFt. Ft. To' Septic Absorption I Holding Sewer Total absorption area Number of trenches Dist.between trenches From Tank Field Lift Station i Tank Line 470 Ft2 Ft. Well 82.7 88.9 82.9 TANK IJ Septic 0 S.T.E.P. 0 Holding 0 Other I Manufacturer Capacity Surface Water 100+ 100+ F ANCHORAGE TANK 1500Gal. Material Number of compartments Lot Line 43.9 23.7 STEEL 2 NA Foundation 15.4 24.6 LIFT STATION Manufacturer Capacity Curtain Drain 50+ 50+ al. Pump on level at Pump off level at - • water alarm at Remarks in. in. in. Pump make a . - •.el Electrical Inspections performed by PIPE MATERIAL House to tank 3034 Tank to 3034 Installer drainfield A+ HOME SERVICES Drainrield 3034 CO/MT 3034 Inspector PANNONE ENGINEERING SERVICES BENCH MARK (Assumed elevation) 1432ft Inspection ., Location and description dates: 1 9/14/2018 2d 9/14/2018 3•' 9/15/2018 4"' 9/21/2018 AT HOUSE POINT B COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp OF At.��l Conditional Approval: Date ��Q'C�• rQS���� jGj •.+r •:9T 0 .•tteven F .. 'annorae Approved 9CvuU i _fl_o Date...�Q/.l Z//8._ >l\ tJ CtwE o pike fklu�td Inspection Report_1-1-12.doc PR,MARY DES GN TE PARAMERS 1 I 1 I, I 11 I II Il i- _ ! 1• I ,NO. BEDROOM: 4(600 gpd) I I I I I I I 1 I 1 I / I . TANK SIZE: 15009(E) I PERC RATE:8 MPI l I l I I I 1 I I I I 17" . . I CSOIL RATING: 0.8 GPO/SF I I I I I I I I I I I * -- ‘1 -REDUC AREA RON FACTOR:0.7: 750 SF I 1 I I I 1 I f I 4rTt , **** ' I ADJUSTED ABSORPTION AREA:525 SF I SYS.TYPE:WIDE TRENCH 2.0'ED I -I -. .�. -. .. I- ..- r --.. ..� i� - L. - ..I � L MIN LENGTH: 105 LF I I I I i 1 \ ` t I e J� y - /". USED: I I ( i •/ 1432 g \`.ti i''i_S,\ ,_. .;..,� � i., .., 94LFx5.0'Wx4.0' E.D.. 6.5'TD / y- 1428 - -\\ 1 TOTAL AREA: 470.0 SF I i I 1 v y /N 'RUE t��RTHI KALE ; 1'=I50' I 11 I .11 A � \ \ \ I I I 1 I , i ABANDON 48' EXISTING ABSORPTION FIELD I LflVT1 B \PER MOA CODE (P) I I �, M Cl f SFD \ / \ \1v` --` iMI I I 1 I M \ \I liI REMOVED 139' EXISTING ABSORPTION FIELD & I I 1 DV 1 \ ! \INSTALLED NEW ABSORPTION FIELD 1 - I i 94.OLF 5.0'Wx4.0'EDx6.5'TD IId' \\ f It \4/,\• \ \ \ W/ DCO BETWEEN FIELD AND TANK I I 1 4I S DCO AFTER SEPTIC TANK \ 1 \ W/ COs & MTs AT ENDS. ADDED FILL TO I DCO 41 -W/ 1 ENSURE EQUIVALENT OF MIN 3.0' COVER • / I , O. .011E N / ' 1 1 -I I t \ \ ` (APPROX. 8.5' T.D. AT FINAL GRADING) f / 1REMOVED 1500. E 1 \ \ • I III ` T2 I 1 / 1 r \ I / p D I ! z�1 A r 11 IC2 / M2 I\88.9.._ 0(//2.7 /WELL (E) / I. 1\ B • Ti 70.6 16. 1 1 -i, I ; 1 I X23.7 / // / .• Ir T2 79.9 26.4 1 ^\ \ \\1 ! 95.7 1 \ T-I 1 • I 1 DCO 81 .4 28.4 I\ \ \i \\ 1 ^\ \� \\ 11 Il I I C 1 24.0 53.6 l I1 '� \I ill _ _ \ \ I / \ \\ \ 1 ` M1 26. 1 54.5 I I 111 / I I / \ \ c / 1 a I I 1 WELL E 1 • I C2 104.9 52.7 IIIA I f �, 1 I I 1 \ 1 \ \ M2 104.0 51 .6 1 1 I I I 1 I \ 1 \ I i I I1 I, I I� I f 1 \ A \ / :\ w w CO03 D D DRAIN ROCK 6" D 0 ow o 0 of: ABOVE PIPE INV o 0 Zz -1 z z I- r z w o_, - 0 4" 0 DRAIN PIPE 0 0.G.F.F. - o o - - • FILTER FABRIC - - 1432.0 F.G.EL. 1430.0 0 G.EL. 1428.0 TEST r- 1500 g SEPTIC 1425.5 / 2 1427.4 TANK 4.0' SEWER ROCK I\ 1425.5 ° 1427.2 lug? DRY: PROFILE 13APR86 SCALE:NTS 1414.0 ° -1-------- 0010 PEPSMEtt.,J0vnee MS,.0001e'0 020 o5AP1e NOTES: PANNONE ENG SVC, LLCDate RECORD DRAWING P.O. BOX 102954 ANCHORAGE, AK 99510 '(' 9/22/2018 PHONE (907) 272-8218 FAX (907) 272-8211 �P•••• Scole - -WANO •• P.I.D. NO - KASILOF HILLS 88 L14 - -4111. ‘ ROBERT SWANSON ••��even R: •annoRe PERMIT NO. DRAWN ACP 10801 GLAZANOFF DRIVE %.•. Ev , �4g, � B � 1a� OSP181183 ANCHORAGE, AK •:,T, ,,:f):4100•-: Street I.1'N° 2 OF 2 30 1 Lot 13 EAST 190.00 t Lot 6 8478G co 10'Utility Easement � co deck 'i 2.0 OH 1�;. • '�.�:..:.. Lot 14 36.0 2.0 OH I O 1.5 OH o of :r • c O u, � 10. 1`• m O O Lr) 40 3 Story •, as LO I Frame • w House - H Lot 5 O I ] .'asphalt`.` rx I Z 0 7 64.• 12.0 w. ,:::..:4.....:;.•: : o 0 Q z , .,,. z Q o OH :e: pdeck septic .0 .4.1 • vents ��� C3I (tYP) m 0 we/ \retaining N wall } 30 Lot 4 � Lot 15 EAST 190.00 AS-BUILT I NO CORNERS SET THIS DATE I I hereby certify that I have performed a Mortgagee's inspection of the following described property:Lot 14,Block 8 .%:•%;\\\\IL Kasilof Hills Subdivision �ts..: OF• •AL�Sc. � Anchorage Recording District,Alaska,and that the improvements situated thereon are within the property lines j 49th )1c ' % and do not overlap or encroach on the property lying •* , adjacent thereto,that no improvements on the property lying adjacent thereto encroach on the premises In question and that there are no roadways,transmission lines or other r�• izobet L. olotko., s visible easements on said property except as indicated SCALE: 1"= 30' 'P •. 8036 _ LS hereon. •' °. iDated at Anchorage,Alaska EASEMENTS OF RECORD,OTHER THAN � o •• . . . • '•ao this 25th day of September,2018. THOSE SHOWN ON THE RECORDED I ?o ssloru- J` FRED WALATKA&ASSOCIATES,L.L.C. PLAT ARE NOT SHOWN HEREON `1\\\\%' Engineers and Surveyors UNLESS OTHERWISE NOTED. FB 18-7,pg 48-50 1 ,50—1 F MB 907-248-1666 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: OSP181183 Work Type: Septic Upgrade Tax Code Number: 01516121000 Site Legal Address: KASILOF HILLS BLK 8 LT 14 G:2641 Site Mailing Address: 10801 GLAZANOF DR, Anchorage Owner: SWANSON ROBERT B & DANA M Design Engineer: PANNONE ENGINEERING SERVICES This permit is for the construction of: Effective Date Expiration Date Lot Size in Sq Ft: Total Bedrooms: 7/19/2018 7/19/2019 28500 Q Disposal Field ;. 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: 1. A percolation test shall be conducted towards the center or northern half of the proposed drainfield prior to construction to confirm application rate. If results of the percolation test require a design change, construction shall stop pending On-site review and approval of a change order. Please submit stamped and signed soils log with inspection report. L! 2. The equivalent of 3 feet of cover shall be provided over the top of drainrock, with a minimum of 2 feet of cover being provided by soil. ,d If it is determined that the tank needs to be replaced, a change order will be required to confirm current code requirements are being met. 7/25/18 Co # Z►eAne d�- 5 bedrn s�� ad d.e.o( . Received B� I Date: 1 �v Issued By: aZ Date: 7 19 1 Municipality of Anchorage P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 995*11,9-66.50. *.(907) 343-7904 0 Fax (907) 343-7997 http://www.muni.org/Onsite Develp rt m �en t, pment Service§,�� On- �fte Wafer and Wastewater Section Waiver#: OSV181049 & OSVI81068 COSA#: Permit#: OSPI81183 PID#: 015-161-21 Legal Description: Kasilof Hills Block 8 Lot 14 Engineer: Pannone Engineering Services Applicant: Robert Swanson T MR -1 PM Your request for a waiver of the required 50 feet horizontal separation from the absorption field to the excessive slope has been approved. The approved separation distance is 20.0 feet. In addition, your request for a waiver of the required 100 feet horizontal separation from the absorption field and tank to the private wells on this lot and Kasilof Hills Block 8 Lot 15 has been approved. The approved separation distances are as follows: Kasilof Hills B8 L14 well to proposed tank: 90.0 feet. Kasilof Hills B8 L14 well to proposed drainfield: 82.0 feet. Kasilof Hills B8 L15 well to proposed drainfield: 88.0 feet. See engineer's profile drawing and waiver request letter for justifications. This waiver approval applies to the proposed absorption field and tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. a a 0 8 N a a a a a X a a a a a a M 8 M Z M a a a N a a a a a a M 8 a a 0 a a a a 0 a a a Z Z M M a 0 a a V N M 2 a M a a a 0 a a U 2 a a a a a a M M a a a I Waiver is Granted: X Waiver is not Granted: 1 (1/1 Date: Approved by: f&" avw# Name of Reviewer 0a 2 a a a K a K N a a a 0 a a 0 a M a a a a a a a a M ff a a a a M 2 U 0 Z13 2 a a 0 a a 8 a In M M 8 a V a a a 11 2 M M N R 0 a 0 M a 0 0 8 a a 8 a U a Is a a i 11 z4� WIT X -1t 1711111, It 111ii iiiit ';,7% U ICIPAU Y OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/VVELL PERMIT APPLICATION Parcel I.D. 015-161-21 Property owner(s) ROBERT SWANSON Mailing address 1503 W 33RD AVE, ANCHORAGE, AK Day phone Site address 10801 GLAZANOF DR Legal description (Sub'd., Block & Lot) KASILOF HILLS B8 L14 Legal description (Township, Range & Section) Lot Size 28,500 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION 1S AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑x Septic Tank ❑ Upgrade FR(w/wo ADU) Duplex (D) El Holding Tank ❑ Renewal ❑ Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: r cj��I �� 5� y 5 %� ��K S � c Distance: t 3 Z 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: �q/0. zq-,T, Waiver Fees: 0 115 + % 9 13 Date of Payment: 7l tg Date of Payment: i (� 9108 Receipt Number: Q� �rlj� Receipt Number: �� �I 3 Obi 386 Permit No. _DS�(81�g3 Waiver No. �S� �$ C� �{� + OSVi81 DSS' Permit App_ Steven R.Pannone, Principal Registered Professional Engineer August Z7,2O18 Subject: KAS|b]FHILLS 88L14 Request for Well Waiver Design Narrative This barequest for a separation distance waiver for a proposed septic system upgrade for the subject property. Due to existing conditions and available space on the property, the plan needed to be modified to enable it to confirm with amajority nfthe required separation distances. 1. Waivers: VVewould like torequest awaiver for separation distance for the proposed septic tank/absorption field to the well located on the lot with the details specified below. a. Septic Tank (P)/Absorption Held toWell (E):Aseparation distance waiver between existing well on Lot 14 & 15 and the proposed replacement septic tank and field on the same lot. The distance between the existing septic tank and well isQO.O±. VVeare requesting awaiver for the proposed tank/absorption field to the existing well for a distance of 82' on Lot 14/15. DEC Criteria: The well on Lot 14and the well on Lot 15 are both private wells and were drilled inI9O7. The well log for Lot 14isunreadable todata from Lot 15will beused asthey are inclose proximity. The data issummarized asfollows: LOT # WELL STATIC YIELD Well Data H20 Test soil Well Nitrate 2.28 DEPTH WATER Date Date Characteristics Log Level LEVEL Data Lot 15 260' 29' 5.0 gpm 09/25/1983 06/26/1986 y y Unknown The ground water in this area typically flows from the east tothe west. The soil cross-sections are similar across the area and a homogenous cross-section was used to calculate the DEC criteria for all components. As outlined under 18A4C80.02Oand 18AAC72.O2l/a\,|have calculated the following points: Lot 3SeuticTank toWell: Distance from sewer system bottom togroundwater 7}0 Soil sorption below sewage system 459 Soil permeability below the system 1.91 Water table gradient 6.00 Horizontal separation 2.28 Total Points 22.57 "The sum of the above values could equate to the following conditions: 16-24 Almost sure to be free from any form ofcontamination from household semmge." |nrnyopinion, this waiver request meets the above criteria for approval and does not constitute risk tnhealth. | hope the above information will assist you indetermining that the waiver should begranted. Ml@iiin�PO ��,Box1��2l�,An5 c�onB�2,A�9�1D-O2l7 Physica[_-K32E@st�,/ianorl/\nChOr��e,AK��5O� CO - Page 2 of 2 The proposed installation will not affect the future development of the surrounding or existing lots. If you have any questions or concerns, please contact me at 754-8200. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181183, Rebecca Carroll, 07/19/18 NOTES & SPECIAL PROVISIONS: ggig: 1. SCOPE AND SPECIFICATIONS: Imiffiggig; MOTEs__ 'OR CONSTRUCTION 113 1.1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS AND AND IN ACCORDANCE WITH AMC 15.65 AND 15.55. 1.2- SCOPE OF WORK! INSTALL UPGRADE SOIL ABSORPTION SYSTEM. 1.3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 14 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOL - TEST HOLE, IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS TP;_�N 1-4 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. 1.4. STRUCTURES DEPICTED ON THE SITE PLAN ARE BASED UPON ONE OFF -THE FOLLOWING: CONCEPTUAL PLOT PLAN DEVELOPED BY OWNER: A PLOT PLANAll, DEVELOPED BY RLS; OR A SURVEY AS -BUILT. 2. CONSTRUCTION SPECIFICATIONS: 2.1. ALL EXCAVATION DEPTHS ARE ADVISORY, THEY ARE TO BE VERIFIED AND MAY BE MODIFIED BY THE ENGINEER IF ACTUAL FIELD CONDITIONS VARY FROMTRUE1 NOOH' I --SCA E THOSE USED TO PREPARE THE DESIGN i— I I 2.2. EXCAVATE THE DRAIN FIELD. BOTTOM OF EXCAVATION SHALL BE LEVEL AND SCARIFIED. RECORD ELEVATIONS AT BEGINNING, MIDDLE AND END OF TRENCH BOTTOM, CONSTRUCTION EQUIPMENT SH -ALL NOT OPERATE ON THE FLOOR OF THE EXCAVATION, ANY MATERIAL COMPACTED BY THE OPERATION OF THE 1412 , LT"q REMOVED AND REPLACED WITH UNCOMPACTED MATERIAL. CONSTRUCTION EQUIPMENT SHALL BE r �1�4211 2.3, PLACE THE SEWER ROCK TO THE SPECIFIED DEPTHS. DO NOT CONTAMINATE SEWER ROCK WITH NATIVE MATERIAL OR SPOILS FROM EXCAVATION. LEVEL ABANDON EXISTING ABSORPTION 7;2 z ROCK SURFACE TO t.1" PRIOR TO INSTALLING THE PERFORATED PIPE, FIELD PER MOA CODE z 2.4. ALL PIPE SHALL BE PVC CONFORMING TO ASTM 03034 OR ENGINEER APPROVED EQUAL. MINIMUM SOIL COVER SHALL BE 3 FEET OVER THE PIPE AND 4If FEET OVER THE SEPTIC TANK. ONE INCH OF INSULATION MAY BE SUBSTITUTED FOR I FOOT OF SOIL COVER. 2.5. ALL INSULATION SHALL BE 2" THICK DOW HI -40 INSULBOARD OR ENGINEER APPROVED EQUAL. CENTER INSULBOARD WIDTH OVER SEPTIC TANK OR LINES. i I i i I >IL4�24/ 2.6. CEOTEXTILE SHALL BE MIRAFI 1405 OR ENGINEER APPROVED EQUAL. LAP ALL JOINTS 2 FEET MINIMUM. z 5BR I < 2.7. COVER THE DISTRIBUTION PIPE WITH A MINIMUM OF 2" OF SEWER ROCK AND COVER WITH GEOTEXTILE BEFORE PLACING INSULATION AND BACKFILL. 0 2.8. MATERIAL USED AS FILL SHALL BE CLEAN AND FREE OF ORGANICS, TRASH AND CONSTRUCTION DEBRIS q I I I I JFD 2,9. SLOPE ALL FILL MATERIAL TO DRAIN AT 2% MINIMUM SLOPE AND 3:1 MAXIMUM SLOPE AND IN SUCH A MANNER THAT PONDING AT OR NEAR THE DRAIN FIELD I I I INSTALL 1500C TANK o\ DOES NOT OCCUR. THE FILL SHALL BE LEFT AT 6" HIGHER THAN SHOWN TO ALLOW FOR SETTLEMENT. SEED SURFACE AFTER COMPLETING INSTALLATION AS R&R 3 J_ D*v 0 9 Z PER MOA CODE- 9' EXISTING ABSORPTION D & 1420 A < 2.10, RECORD THE FINISH GROUND ELEVATION OVER THE BEGINNING, MIDDLE AND END OF SYSTEM. 2.11, MAINTAIN 5' SEPARATION BETWEEN PERCOLATION HOLE AND THE DRAIN FIELD TRENCH. INSTALL NEW ABSORPTION FIELD (P) 2, 12. EXPOSE, PUMP AND FILL LOG DISPOSAL CRIB OR CONCRETE TANK WITH SOIL TO ABANDON LAW WITH MOA CODE IF NEEDED, 94.0LFx5.0'Wx4.O'E.D.T.D. W/ DCO BETWEEN FIELD AND TANK 3. CONTRACTOR RESPONSIBILITIES: W1 COS & MTs AT ENDS. ADD FILL TO N 3.1. THE CONTRACTOR (BOTH WELL AND SEPTIC SYSTEM CONTRACTORS) SHALL HAVE ANY WELL LOCATION AND SEPTIC LOCATION STAKED AND ANY I._OT LINE E I NSURE EQUIVALENT OF 3.0' COVER AND WELL RADIUS SHOWN ON THE PLAN WITHIN 30 FEET OF THE PROPOSED SYSTEM STAKED BY A REGISTERED LAND SURVEYOR BEFORE STARTING THE WORK. SECTION A ABANDON 1500G TANK(E) 3.2. THE CONTRACTOR IS RESPONSIBLE FOR ALL R.O.W. AND OTHER REQUIRED PERMITS, OTHER THAN THE ATTACHED, 90.6 11 THE CONTRACTOR SHALL CALL FOR LOCATING OF ALL BURIED UTILITIES. 0 3.4. THE CONTRACTOR SHALL PROVIDE 24 HOUR NOTICE TO THE ENGINEER PRIOR TO START OF WORK, ALL SURVEYING AND LOCATES SHALL BE IN PLACE 102.8 WELL z < PRIOR TO NOTIFYING THE ENGINEER._ -_j 3.5. THE CONTRACTOR SHALL. NOTIFY THE ENGINEER OF ANY DISCREPANCY BETWEEN THE APPROVED DRAWINGS AND SITE CONDITIONS/LIMITATIONS 21,4 83.7 0 <4 Ch POTENTIALLY CAUSING THE NEED TO MODIFY THE DESIGN. Ck" I 3.6. AT THE COMPLETION OF THE WORK, THE CONTRACTOR SHALL SUBMIT RED -LINE AS -BUILT DRAWINGS TO THE ENGINEER. THE RED -LINES SHALL INCLUDE 89'.8 . 7— 0 A .4 PIPE L N V LENGTHS, ORIGINAL GROUND ELEVATIONS, PIPE ELEVATIONS, AND TANK ELEVATIONS. WELL (E)U 3.7. THE CONTRACTOR SHALL PROVIDE PHOTOGRAPHS OF THE SYSTEM INSTALLATION TO INCLUDE BOTTOM OF EXCAVATION, TOP OF PIPE WITH -OUTS CLEAN 2: C) AND MONITOR TUBES INSTALLED, INSTALLED TANK AND FINAL GRADING. L6 4. THE CONTRACTOR SHALL SIGN THE FOLLOWING: I CERTIFY THAT ALL WORK WAS PERFORMED IN ACCORDANCE WITH THE APPEND PERMIT, AND ANY AND ALL0 2 L -Li CHANGE ORDERS, AND THAT THE AS -BUILT REDLINES ARE TRUE AND ACCURATE REPRESENTATION OF THE PROJECT AS CONSTRUCTED. U) W CONTRACTOR: BY: TITLE: DATE:_ 5. THE CONTRACTOR PROVIDED DATA (UPON WHICH THIS RECORD DRAWING IS BASED) APPEARS TO REPRESENT THE PROJECT AS CONSTRUCTED. THIS DATA IN CONJUNCTION WITH THE PERIODIC FIELD OBSERVATIONS BY THE ENGINEER (OR HIS DESIGNEE) AS REQUIRED BY AMC 15.65 DOES NOT GUARANTEE THAT THERE ARE NO HIDDEN DEFECTS BY THE CONTRACTOR. LS LOG L; ` PRIMARY DESIGN PARAMETERS 2 ML LATER Z FW NET DROP \N READING DATE NET 0 READING Z LU I z NO, BEDROOM: 5(750 gpd) TANK SIZE: ISDOg(E) --f (P) PROPOSED (E) EXISTING — W��FR\LjNLE—/ WELL RADIUS CO CLEAN OUT NO, MT MONITOR TUBE NO.TYR TYPICAL Ic 2 LAYE IXP % 'VISION$ REVI: IDJUL2018 EV2.12JUL2018 EE RECORD PERC RATE: 8 MPI 3— 2 z IU 3 1 SOILS LOG 2" SOIL. RATING: 0.8 GPD/SF 1 Lu on -i AREA ROD: 937.5 SF 4— 4 13APRa6 67 .50' 2" — FIMIN — AB�REVIATICIN'S REDUCTION FACTOR: 0.5 5 /4' I3APR86F_15m1N_T -75" 1 -, 1 11, T—T U I t ADJUSTED ABSORPTION AREA: 468.75 SF Y . TYPE: SYS.WIDE TRENCH 4.0'ED MIN LENGTH: 94 LF USE: 94.OLFx5.0'Wx4.0* E.D., 6.5' TO TOTAL AREA: 470.0 SF9 6 7 8 10 SP/Sm WAS GROUND WATER SOIL TEST RF ANA1151a ENCOUNTERED? N PERCOLATION RATE 8.0 (minlinch) HSG A) (Hydrologic Soils Group:Ic IF YES, AT WHAT TEST RUN BETWEEN 5 FT AND 6 FT. DEPTH" ___=N_A DEPTH TO WATER --AET R _E 14��— 2 W --f (P) PROPOSED (E) EXISTING — W��FR\LjNLE—/ WELL RADIUS CO CLEAN OUT NO, MT MONITOR TUBE NO.TYR TYPICAL Ic 2 LAYE IXP % 'VISION$ REVI: IDJUL2018 EV2.12JUL2018 804-1986 11 - t��RINGL? - DRY 12 — DATE__ RES THIO SS REV3'16JUL2018 _GOREW 215 �UGIO CO REV527AUG2013 �428 13 — tf CO REM OSSEP2018 COMMENTS: Test hole excavated by QUADRA ENGINEERING INC. 6.5 14 4�O 60H-2018 PERFORMED BY: W. MCFADDER (1986), Fl �4?2 N COMMENTS: Additional Test hole excavated by A+ HOME SERVICIES confirm soil profile and provide deeper profile for test hole. 0 PERFORMED BY: JRLAWENDOWSKIcc V�w SECTION A SCALE: 1"=10' SHEET DATE PERFORMED: t3APR86 E1416 C3.0 PES 24AUG18 (NO TER 05SEP18) I OFT MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME MAI LING ADDRESS LEGAL DESCRIPTION LOCATION ....... ~W~I~ ' . ~ Absorption area I o I DISTANCE TO: ~ /~¢' / /Cz I-.~ Ma ~( facturer ~ ILiq. capacity in gallons IF HOMEMADE: Inside length Dwelling DISTANCE TO: Well Foundation DISTANCE TO: ~" /(~) ! No. of lines of each !ine ~ of lines Top of tile to fi Material beneath tile Length Width Depth Fype of crib Crib depth Building foundation DISTANCE TO: Depth ~ ~ Driller 2O0 Sewer line ,/¢,?~; Building foundation DISTANCE TO: OTHER PIPE MATERIALS . _ SOIL TEST RATING iS"Z. ~. REMARKS .... i '; /Z ' ' ~ '~ ~lc~o~ E, Anderson ~,. ~ ,. E~O~Y ~~'~ DATE ' LEGAL IPFIONE ~.NEW [] UPGRADE Material Nearest lot line ] 30' / Trench width inches NO. OFBEDROOMS PERMIT NO. Licluid del}th PERMIT NO. Liquid capacity in gallons PERMIT NO. Distance between lines Total effective a~bsorption area h Septic tank/~, 7~ area P E R M/J.T NO. Absorption area(s) lg Z/ WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NA'FURAL RESOURES Division of Geological & Geophysical Surveys Drilling Permll No. LOCATION OF WELL (Please complete either Ia, lb or lc,) A.D.L. No, ,a.llBorou,h Subdi¥isio. Le, ,lee, I/4qtrl~' Ssctio~ NO, Tow~ohip N[~Re.ge Ic.J~OISTANCE AND DIRECTION FROM ROAD INTERSECTIONS 5. OWNER OF WELL: ,~L~ Address: Street Address end Arco of Well Location 2, WELL LOG Feet Below Surface 4. WELL DEPTH: (final) 5. DATE OF COMPLETION Material Type Top Bottom -- ~ ..?t::,? :~ ;:;'::; 7. USE: ~ Oome~tlc ~ Public Supply ~ Indusfr~ ,L.:~ ~ ;~e~.~ '::~ ~ Irrigation ~ Recharge ~ Commerical ~ Tes~ Well ~ Other: 8. CASING: ~ Threaded ~ Welded diam. ;', in. to ,:; ft. Depth We~ghl lbs./ft. ~ diam. in. to__ff. Depth Stickup ft. ~U~l~:~.:~.;'r',' O~ ~:HO~A~E 9. FINISH OF WELL', ~7! OF HEALT' & ENVIRONMEN~AL pgC [~CII~ Type: ~ ~ Dlamefor: ~E,~LI ~ ~ Ia, STATIC WATER LEVEl.: ~ Above or ~ Below lend surface Dote II, PUMPING LEVEL below lend surface end YIELD ~ff. (iffer _~hrs. pumping ~.p.m. 12,GROUTING Well Grouted: ~ Yes ~ No Material: ~ Neet Cemenl ~ Other: 13. PUMP: (If available) HP Length of Orop Pipe ff. capacity g.p.m. 16. WATER WELL CONTRACTOR'S CERTIFICATION: 15. Wafer Temperature ~o ~ F ~ C This wail was drilled under my jurisdiction end this report Is true to the ~est of my know~edge and belief; /V unicipa ,i:y Anchorage P.O. g ; 196650 ANCHORAGE, ALASKA 99519-6650 (907) 264-4111 TONY I(NOWLES. MA YO R DEPARTMENT OF HEALTH & HUMAN SERVICES June 23, 1986 Bob Swanson 338 East 12th Avenue Anchorage, Alaska 99502 Subject: Lot 14 Block 8 Kasilof Hills Subdivision On-site Sewer & Well Permit #860100 - Issued April 24, 1986 On May 20, 1986, The Anchorage Assembly approved a new ordinance regulating on-site wastewater disposal systems (septic systems). All septic systems c.onstructed after the effective date of this ordinance are subject to the provisions of this ordinance. Our records show that you currently hold a permit for the installation of a septic system. We strongly urge that you contact this office prior to constructing your system. Any changes in the code that could impact the construction requirements of your septic system will be identified and brought to your attention. Please contact the Enviromnental Services Division at 264-4720. Thank you for your cooperation. Sincerely, ? Susan E. Oswalt Program Manager On-site Services SEO/SSM/ljw MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 82.5 L, Street, Anchorage, Alaska 99501 264-47;20 SOILS LOG - PERCOLATION TEST [] SOILS LOG PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: GOLDER CONSTRUCTION Lot M Block 8 Kasilof Hills DATE PERFORMED: Subdivision 4/13/86 SP/SM SLOPE SITE PLAN 10 11 12 13 14 15 16 17 18 19 2O WAS GROUND WATER S ENCOUNTERED? No L O P E IF YES, AT WHAT DEPTH7 Gross Net Depth to Net , {.:,,, Reading Date Time Time Water Drop ¢1{ _ ~. 25" 4/13 0 0 61o5" 0 7.25" 4/13 15 15 63.5" 2" 5.75" 4/13 30 15 65.5" 2" 3.25" 4/13 45 15 67.5" 2" 1.5 " 4/13 60 15 66.75" 1 3/4 PERCOLATION RATE 8 (minutes/inch) TEST RUN BETWEEN ~-~,~ FT AND ----~ FT COMMENTS Top 2' frozen - hole was charged 24 hours before test. Recommended absorption rating of.150 Ft2/bedroom. No groundwater observed after mbe6~erinq testhole zor seven oays. PERFORMED BY: W McFadden CERTIFIED BY: . &~DATE: 4/22/86 72-008 (6/79) ,'4 / ~1 E. Fh'oweIcI Llnl . ~ (W~T) ~ a~ so' oo~,- - ~/~ (/~o. oo~ ' "F~D ~"xS"Hg8 ~TA~K __.: ......... ~ ~' ~/~-/ ~, ~-~:zz~ ~ ,'".~,~.. ,. 401 E, Fireweed Lane "~'~"''*"0""~""'*'~"'*""" ~'~'~"°~"*"~°*~"~'t~,~ Anchorage, Alaska ~ ...... , .................. ~,. ,~, .. .. ~ ~ W ~ '~~ KA ElL OF HIt, MUNICIPALITY OF ANCH©RAQE DEPT.,-'~'r' HEALTH & F~NVt ?,ONtv'~Elql'AL PROTECFION P, ECEIVED · FI, ID 2"~ ~" ,~tLIB ~¢ TACK AS-BUI~T CERTtFICATION 401 E. Fireweed Lane Anchorage, Alaska 99503-2197 sc~/#= ~O ~ 'Legal De~,crlpt,on: /_~O7. K'A ~/~ oF: ~-~IL. 401 E. FIREWEED LANE ANCHORAGE, ALASKA 99503-2197 (907) 276-3770 SHEET NO. OF CHECKED BY DATE SCALE //'~ .~' ol ? O1�-1A1�71 Pance|iD. "'~ '~' ~-' i Municipality of Anchorage On -Site Water and Wastewater Program Certificate «fOn-Site Systems Approval Expiration Date: _11�ov 11 GENERAL INFORMATION Complete legal description KaS'|nfH'US Block Q Lot 1/1 Location (site address) 10801 Glazanof Dr. Curren Property Rnb6�rf/t Fl8DB �mm�3OD ^ owner(s) �� —''— Day phone __ Mailing address 1503VV'33nd Ave. Anchorage, AKUQ5O3 Real Estate Agent 2. TYPE OFDWELLING: El Single Family kw/wnADU> L1 Duplex El Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OFBEDROOMS: 4. TYPE OFWATER SUPPLY: TYPE OFWASTEWATER DISPOSAL: Individual Well �� �� Individual �� Individual Water Storage F� Holding Tank 1771 Community Class Well El Community R Public Water System F1 Public Sewer 1771 Waiver/Variance request for: Distance: Received by: Date: CnnAmuereleased tothe engineer, unless otherwise requested urthe engineer. Date of Payment Receipt Number Waiver Fee $__ Date ofPayment Receipt Number Waiver# 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 fifes 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA 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 Pannone Engineering Set -vices LLC Phone (907) 272.8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 9/24/2018 7, All 6. DSD SIGNATURE System #1 Approved for bedrooms ` ` : Slev+rri f2. •NAG System #2 Approved for bedrooms �i••. CE -8149 ape Disapproved Conditional approval for bedrooms, with the following stipulations: WATER A kin m m WASTEWATER AM RVAC, Original Certificate Date:_ The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSH blue sheet ! c Legal Description: K�~~i|nfHi'lS ~(}Ck A Lot 14 A. WELL DATA Kmore than 1septic system isonthe lot: CO3ACheo |iut#�of1__ Structure served bythis system 1___ O1�_1�1��1 Parcel '~' ^-' Well typeP[[V8IprovideVV pe A. B. or C prove PS|D # Well Log (Y/N) Y Date completed 8/8/1986 Sanitary aoa| (Y/N) Y VVinas properly protected (Y/N) Y Total depth 200 ^ Cased to 25+ - Casing height (above ground) 12f in, FROM WELL LOG AT INSPECTION Date of test 8/8/1986 6/13/2018 Static water level 33 ft. Well production 10on '~ 9 -P.M. WATER SAMPLE RESULTS: Coliform NEG |onios/100mL Nitrate 4.11 mg/L kj[] F�/11y7D1A Arsenic ug/L Da�enfeomp|e�~''''^-~'~ B.SEPTIC/HOLDING TANK DATA TenkType/k8abaha| Septic/Steel Tank size 1500 ga|. Number ofCompartments 2 Foundation cleanout (Y/N)Y Depression over tank (Y7N) N Date ofpumping pumper New Collected by: PES ft. � Date installed CV1�y^-D1A d ~' ^~'~ Cleonnuts(Y/N) ' High water alarm (Y/N) N/AYN) C.ABSORPTION FIELD DATA Date installed 9/14/2018 Soil rating (g.pd./Mzorftz8bdnn) Ofkg.p/d/sf System type Shallow Trench Length ~ ' �� 11 ft. Width 5 ft. Gravel below pipe 4.0 ft. Total depth 8.5 ft. Eff. absorption area 470 -» Monitoring tube Y Depression over field Kj � �VV -- Date ofadequacy test '` Reou|ta(Paou/Fai|)For bedrooms Fluid depth in absorption field before test in. Water added_ gal. New depth_____in. Elapsed Time: min. Final fluid depth in. Absorption rate x=g.pA. Any rejuvenation treatment (past 12 mo.) (0N & type) If yes, give date_ D. LIFT STATION Date installed "Pump on" level at Datum __ Size in gallons Manhu|eA\ucens(YYN)______ in. "Pump off' level atin- High water alarm level m\_____ _ Cycles tested Meets alarm &circuit requirements? E SEPARATION DISTANCES WELL [)NLOT TO: Septic tank/lift ata*A� station ~^-'7. Onadjacent |ot10Of � '~~ � Absorption field °A� e|don|ot ~~'~' 10O + Onadjacent lots '~` Public sewer main 75f Public sewer monho|elc|oanout 100f Sewer /septic service line 25f Holding tank 100f Animal containment areas 50+ Manure/animal excrete storage areas 100f SEPTIC/HOLDING TANK ONLOT TO: Building foundation 15'/1' Property line 43.9 Water main 10+ Water service fine 10+ Wells onadjacent lots 100+ ABSORPTION FIELD ONLOT TO: Property line 23'7 Building foundation 24.6' f VVaherSemiceline 10f Surface water '~~ 10O Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS *S8e Waiver Requesting unconditional Cosa. G. ENGINEER'S CERTIFICATION / certify that /havo de&enninodthrough field inspections and review of Municipal nsoo/os that /he above systems are /n conformance with MOA COS4guidelines /heffect onthis date. Engineer's Printed Name Sf8VBO p@ODODe Date 9y24/2018 co8acanary sxeeL2-s1o.wuc Absorption field 5+Surface water 1DOf Water main'~ 10f Driveway, parking/vehicle storage 10+ in. c � kt 5 6 7 ;.f , is • �.�.rt'ere ,�v ,c,f 8, /i •I c.:" Municipality of Anchorage ti y,, ..i ;7 `° ','\ r On-Site Water and Wastewater Program .-011.i 'V\ (907) 343-7904 Q- ,J .^ 'E : '' ' A. t' Certificate of On-Site Systems Approval << �k,5�\ �( �r J 44 8 L ° Parcel I.D. 015-161-21 Expiration Date: t -` • 1. GENERAL INFORMATION Complete legal description Kasilof Hills Block 8 Lot 14 Location (site address) 10801 Glazanof Dr. Current Property owner(s) Robert & Dana Swanson Day phone Mailing address 1503 W. 33rd Ave. Anchorage, AK 99503 Real Estate Agent Day phone 2. TYPE OF DWELLING: O Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well E Individual E Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received • �' �� I A Date: i/ 7i 91 COSA to be released to the engineer,unless ot�e reit ested by the engineer. COSA Fee $C24.06++AEI cf•as =ire()S 00 Waiver Fee $ Date of Payment .1111 / 10 / . /b Date of Payment Receipt Number C8 3061 GX ! / • In `Receipt Number COSA# ()EC( e iY\ \� aiver# / 'i- 0 a 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. In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA 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 Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 7/11/2018 6. DSD SIGNATURE Ail*:••49 • /` •••i�` � • `� �/� l! System #1 Approved for bedrooms 4 •••Steven•R.•I�onnone System #2 Approved for bedrooms �9i°(149). �•, CE-8149 •• " Disapproved ��1 `�R?O`FESSIONP� 4 Conditional approval for bedrooms, with,the following stipulations:\ ` .\,•-14.5.sCskae 4-L.-en* ,e4„2 rt-L c 3 y -(-e ii,1 1-YNi-ve dr,c .c S,-S t S (NA.s--e. e \-LA-0 14(- '‘--0, 1(ZR_ C-4-1--,A.)/-kei°,d ID/y a_efri . ( cico „..", efri.,,,, ,:e- .L./ 70 .... . z ON-SITE i). - WATER AND m --.F-ti WASTEWATER - PROGRAM o. tc..---------\--<:./ Original Certificate Date: 7 2, [ 'J The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet f '• ., If more than 1 septic system is on the lot: COSA Checklist# 1 of 1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: Kasilof Hills Block 8 Lot 14 Parcel ID:015-161-21 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 8/8/1986 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 200 ft. Cased to 25* ft. Casing height(above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 8/8/1986 6/13/2018 Static water level 33 ft. 85 ft. Well production 10 g.p.m2.4+ g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 4.1 1 mg/L Arsenic ND ug/L Date of sample: 6/11/2018 Collected by: PES B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 7/1986 Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N/A Date of pumping 6/8/2018 Pumper Isaac's Pumping Service C. ABSORPTION FIELD DATA Date installed 7/1986 Soil rating (g.p.d./ft2 or ft2/bdrm) 152 SF/BDRM System type Wide Trench Length 48/39 ft. Width 5 ft. Gravel below pipe 2 ft. Total depth 6.25 ft. Eff. absorption area 621.4 ft2 Monitoring tube Y Depression over field N Date of adequacy test 6/13/2018 Results (Pass/Fail) PASS* For 2 bedrooms Fluid depth in absorption field before test 23 in. Water added 600 gal. New depth 30 in. Elapsed Time: 1440 min. Final fluid depth 25 in. Absorption rate >= 300+ g.p.d. N Any rejuvenation treatment(past 12 mo.) (Y/N &type) 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 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 100+ Animal containment areas 50+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10+ Property line 5+ Absorption field 5+ Water main 10+ Water service line 10+ Surface water 100+ Wells on adjacent lots 100+ 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 50+ Wells on adjacent lots 100+ F. COMMENTS *Passed for 2 bedrooms, `but failed for 4. ,0VQk (y) t.CL• G. ENGINEER'S CERTIFICATION Aal+� pF• ,1Q�11 I certify that I have determined through field inspections and j 61.- review �• )` :y���l review of Municipal records that the above systems are in 0*; / .-.*,9 conformance with MOA COSA guidelines in effect on this date. % 440 ',.. Engineer's Printed Name Steven Pannone 0"• levee•W,'Nnriorie:'', Date 7/11/2018 ��4� , CE-8149 / r COSA canary sheet_2-6-15.doc Pannone Engineering Services iic Steven R. Pannone, Principal Registered Professional Engineer E-mail:steve@panengak.com July 11, 2018 Municipality of Anchorage Development Services Department On-Site Water&Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage,Alaska 99519 Subject: Kasilof Hills S/D,Block 8,Lot 14 Conditional COSA Request Ladies and Gentlemen: I am writing to request a conditional COSA be issued for this property to accommodate its sale in the near future. A permit was issued to construct an upgraded septic system, however due to time constraints the system cannot be installed before the sale. 1. COSA.The Owner is in the process of selling this property. The existing system was located and inspected. The system was tested for operation and was found that it could not accept the required 150 gallons per bedroom per day(450 gpd). The system is able to absorb approximately 300 gallons per day. The intent is to install an upgraded septic system by August 31,2018. This system will not affect the health or welfare of anyone on this lot or the surrounding lots. The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells or septic systems within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, OF /1/,,44. lo Steven R.Pannone • 14 Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 1/2 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION D,v,s oN OF ENV,RONMENTAL .EA.T. CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVALs:1 ~"~ ¢ COq / OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date Z-//~ - ,:¢ 7 GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name _,Z~_~___.~_Telephone: Home 227/¢ - ~/~'[.. Business 3~/?'.,; Applicant Address .~..%~--.~. I&¢~ ~MC,q<DI~A,~'/, ,4~, (c) Applicant is (check one): Lending Institution []; Owner/builder ~; Buyer []; Other [] (explain); (d) Lending institution _~L~-~'~'~ (e) Real Estale Company and Agent _//Y/ Address Telephone (f) Mail the HAA to the following address: 'TYPE OF RESIDENCE Single-Family [Z~ Multi-Family Number of Bedrooms Other WATER SUPPLY Individual Well I~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite'~ Public [] Community [] FIolding Tank [] Note: If com munity well system, must have written confirmation from the State Department of Fnvironmental Conservation attesting to the legality and status. Paqe 1 ol 2 ~ ,to ~ a6ed NoIzn~o leas s,Jeau!6u3 sseJppv 'uo!loadsu! s!~l ~o ejep eLi1 uo lo@~e u! suo!t`elnl~aJ pub 'seaueu!pJo 'sepoo at`elS pue i~d!o!un~ lie LIj!~ aoue!lduuoa u! s! LUelSXS lesods!p Jet`~MejSeM Jo/pue ,qddns JeleM ej!s-uo aqt` 'uoit`oadsu! pue ua!lab!isa^u! ~uJ uuoJl pue saiff abeJoqouv 1o Xt`iled!a!un!~ aqt` tuoJj paulet`qo uo!t`euJJoju! alit, ua paseq t`eqt`/,j!Ja^ JaqlJnJ I 'u!a~aLi paleo!pu! aJnlanJls jo ed,q pue SLUOOJpaq JO JaqLunu aql Jot alenbape pue leUO!t`ounj 'ajes s! uJalSXS lesodsip Jat`eMalse~ Jo/pue Xiddns JaleM al!s-ua 8qt` teqi SMOqS leAoJddv ,~t`!Joqlnv LilleeH s!q~ jo ua!lab!Isa^u!/(uJ t`eLil/~lpa^ I 'MOlaq UMOqS alep ua!lap!leA alii JO Se pue ot`aJaq pax!j~e leas ,~uJ Xq pa!jipa3 sV NOI.L¥1MIJO:JNI C]N~' 'VJ.¥O 'HOJJ¥3S 3-114 'SJ.S--I.L 'SNOIJ. O3dSNI 9NIOIAOkld ~MIJ 9NHJ;~aNION3 .g ir EB 9 19B7 A. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: -/07' /~/ Well Classification Well Log Present (Y/N) )/ Total Depth ~¢O Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot If A, B, C, D.E.C. Approved (Y/N) Date Completed ,~:'-,'~" ~' Yield Z 5" --Kc Depth of Grouting Y Pump Set At Sanitary Sear on Casing (Y/N) Depression Around Wellhead (Y/N) ,aZ ; On Adjoining Lots /~, ~ ~ To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line ~ ~o' '/- Cleanout/Manhole Water Sample Collected by /V~c F~AZ~¢~-/,./ ___. ; Date Water Sample Test Results /~ g' ' ; On Adjoining Lots ~ ~ ' To Nearest Public Sewer To Nearest Sewer Service Line on Lot ~ ~ SEPTIC/HOLDING TANK DATA Date Installed 7/g'~, Size /-,~ ~- No. of Compartments Standpipes (Y/N) _ y Air-tight Caps (Y/N) __~ Foundation Cleanout (Y/N) Depression over Tank (Y/N) ~ Date Last Pumped Pumping/Maintenance Contract on File (Y/N) ; for Holding Tank High-Water Alarm (Y/N) ~ Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well /O2 . To Building Foundation To Property Line ~ ~ ~ To Disposal Field To Water Main/Service Line ~ To Stream, Pond, Lake, or Major Drainage Course ___.~OT /x/ Comments ~ ¢-~/~ 7~ ~/~ /S Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ?/~ Width of Field ~O ' Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well ]Z'-2' To Building Foundation /O¢ Lot ~V6,~E ~N COT /.,.~'~ Type of System Design Length of Field ~' 7'~¢_.¢~ Depth of Field --~1~' /4~/~,Gravel Bed Thickness ~ ~" · ~ ~0'~/';'/~ · Standpipes Present (Y/N) To Water Main/Service Line ..5'~. ' To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments /~.~,.~OI~pTI~)AI .~ISTgFr. A Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots /~ .~' To Cutbank (if present) D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test, Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify th.~ave checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~')//,~¢--.~£~-~C~~,¢."'"¢Date '?"//~/<~ ~ Company (~/.,//¢~//.4/;) ~'~6//,/.~, MOA No. Receipt No. /4¢~'~' / f_~O "~ ~ Date of Payment ~///7/,¢0'~ Amount: $ ~/' (.~O~ Engineer's Seal Page 2 of 2 72-026 (11/84)