HomeMy WebLinkAboutKASILOF HILLS BLK 9 LT 6Kas i* I of Hills
Block 9
Lot 6
#015-131-07
Municipality of Anchorage
Development Services Department*0 ;�?
Building Safety y-
Division
On-Site Water and Wastewater Program. 1700 Bragaw St.
P.O. Box 196650 Anchorage, AK 995196650 Page of
,aww.cl anchorage.ak.us (907) 313-7901
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION
REPORT
Permit Number. SWo:1009SPID Number: IS- 131-0
wa.
RO b B,9c R MArly
Wastewater System: ❑ New ❑ Upgrade
Aao.sF
.'D 110-49-3
Pao'
ABSORPTION FIELD £Xif in
hln of aed $
3
Tata,swb
O Do" 13 a Tlam ,O sea O uam O Oear
LEGAL DESCRIPTION
Sal Rawg
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cFaFr'
Dram bpw eonan rtan u,�W v.a
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TOwnaW Rrge Semon
il.
Fa aoMOe onFaa Watt,GreM
Lagm Fl
Well: f XfS }in ❑ New ❑ Upgrade
Fl.
a'Vi1Y
n.
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aMr
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vw Fa,o SMa D+u,F Mey+/now C�vu,a
l
GPM Fl. n
TANK
SEPARATION DISTANCES
121Septic ❑ Holding ❑ S.T.E.P. ❑ Other.
To Sank ADsorpuon Field Llh Holding udiWnvale
Flom Tank Station Tank Sear Dna
ague' r
Anc Ttir11C
W.F loo + � 5
ora Da oop
unaw I wnw a canpaanan,
�
t a
Q I
s mwMe loo a
LIFT STATION
LM U"
r 1
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T
�
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T
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b
a
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F,.aF Ma46 feKarr byeOpq Falan,aa aY
RemaAF
BENCH MARK
LPULun aq a.uye,,,
Pitio Date
" 1O0 FL
`
1,rj
_ ters.
Inspections performed by: J_Por An h fN Dates: 10 6 ZI 0 ".;
pm
fp Ap.q �� 1
2nd
Development Services Department Approval
�. Y
`'
49TH,*
Conditional Approval Date:
0
� 1..:..�� ..
Reviewed and approved by:D-/$-t7
OFLjS���P-
lae.w.,,n, ate:
1 I
\1
1 �
LOT 4 I I LOT 7 a
C:) 1 N
S
1 �
` 1 ABANDONED EXISTING
`� I SEPTIC TANK PER MOA
1 I CODE REOU/REMNETS
LOT 5
1 e
1 LOT 6 HOUSE
1 \c A
A D INSTALLED NEW
CD c 515' 50.0 1000 GAUON _ _
Q D 56.5'U5 SEPTIC TANK VAT a 0T I
C 40.5' J9.5
F 4.L0' 42.0 /
I 1
1
--—— — — — — —— L————— — — — — —— — -----
1 �l /
POND
I-¢ Well /
� NO1E5• /
1) NO WEL1S OR SURFACE WA MR WHIN 100'���
I 0r PROPOSED SEP17C TANK LOCAION LOT 9 ��E OF•44*�
I 21 ALL WORK SNALL K PREFORMED DJ
••• • ••••••. ♦.
ACCORDANCE WAN AMC 1165. G'�;.•....• • ,♦
J) 1611ERULS USED SNAU Or N ACCOROANCE � ,a. •
*71H HOSE SP anrD N AMC 15.61 49th
•
•••LAR SPURKLAND•• t11�.;J1111111111 11111111111�
�=
�
f% No. CE-usoo (� i
25 0 25 50 75 107 125 150 / .� •. �" 2O•'•••i
SCALE, 1' = 50 FT. ... •••• o
SPURKLAND ENGINEER/NG KASILOF HILLS BLK 9 LT 6 SEPTIC SYSTEM ASBUILT
203 W 15TH. AVENUE
ANCH. AK. 99501 ROBE BAERMAN DATE.• JULY 2, 2007
907 279-3916 10710 VAS/KOF PLACE SKEET. 21J GRID: 2541
PERMIT r/ SV07O095 PID # 015-131-07 Ka silo fHillsB9L6BI.dwg
SEPTIC TANK REPLACEMENT DETAIL
DOUBLE
CL£ANO"'"
CONNECT
£X1ST BRAB1
4+ FEET COVER
1000 901, septic tank
' 49th
SPURKLAND
BENCH MARK BOTTOM PATIO DOOR JAM
ASSUMED ELEVATION 100'
t GwNIIVLLKIIVU I I KASILOF HILLS BLOCK 9 LOT 6 I
203 W15th Ave SEPTIC SYSTEM DESIGN
Anchorage Ak 99501 ROBB BARMAN DATE, �aJ[ 6, 2007
10740 vAMlKor putt
SHEET 2/2 GRID 2511
PARCEL ID / 015-131-07
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water 8 Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Permit Number: SW070095
Legal Description: KASILOF HILLS BILK 9 LT 6
Design Engineer: 0007 SPURKLAND ENGINEERING
Owner Name: ROBB BAERMAN
Owner Address: PO BOX 110743
ANCHORAGE. AK 99511-0743
Date Issued: Jun 07, 2007
Expiration Date: Jun 06, 2008
Parcel ID: 015-131-07
Site Address: 010740 VOSIKOF PL
Lot Size: 42249 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
This permit is for the construction of:
❑ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction must be In accordance with:
1. The attached approved design.
2. All requirements specked 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 DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 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 provisions.
- (EMERGENCY TANK REPLACEMENT) - SEPTIC TANK INSTALLATION MAYBE LOCATED NO LESS THAN
FIVE FEET FROM ANY PROPERTY LINE OR BUILDING FOUNDATION; TEN FEET FROM ANY WATER
SERVICE LINE; ONE HUNDRED FEET FROM ANY SURFACE WATER; AND ONE HUNDRED FEET FROM ANY
PRIVATE WELL; AND THE SEPARATION DISTANCES REQUIRED BY 18AAC72 FROM WATER SUPPLY
WELLS.
Received By: "`' Date: 6 7
Issued By: ��. _ Date: i7 1
Municipality of Anchorage
(• -� Development Services Department
Building Safety Division
Onsite Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, Alaska 99519.6650
www.muni.org/onsite
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. nI Vi - (3l- 0__J-
Property owner(s) Rob SAOr11'1an Day phone 3Y6- 1303
Mailing address PC), QoX IIDT43 , Ancllomq,,_ Ak 99511 Zip Code
Siteaddress ID340 VzsiI`o( Place. Zip Code
Legal description (Sub'd., Block & Lot) bsilof Iiil'S Bpi, 9 Lo{ G
Legal description (Township, Range & Section)
Lot Size t19 -I'm Sq. Ft. Number of Bedrooms 3
j!�7't 0720 9Jc77-)/-J
THIS APPLICATION IS FOR (® all that apply): THIS APPLICATION IS AN:
Absorption Field
❑ Initial ❑
Septic Tank
19 Upgrade 0
Holding Tank
❑ Renewal ❑
Privy
❑
Private Well
❑
Water Storage
❑
certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees:Waiver Fees:
Date of Payment: Date of Payment:
Receipt Number. 9 7033 Receipt Number.
(Rev. 11105)
0 :` Environmental Consulting and Design
June 6, 2007
Municipality of Anchorage
Development Services Department
Building Services Division
On-site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
Subject: EMERGENCY SEPTIC TANK PERMIT APPLICATION
KASILOF HILLS BLOCK 9 LOT 6
We are submitting an application for the replacement of the septic tank for this lot. The existing
septic tank has collapsed and the house is with out sewer service. The submittal consists of two
(2) drawings showing the present improvements on the lot and the proposed improvements of the
lot, of which only the septic tank is subject to this permit application.
There are no wells within one hundred feet of the proposed replacement site. The installation of
this septic tank will not prevent wells and septic systems from being installed on the adjacent
lots. There are no developed or natural surface / sub surface drainage courses within 100 feet of
the proposed septic tank location. The proposed septic tank will not change the general slope of
the area. Ponding and/or concentration of surface runoff will not result from this installation.
If you have any questions or are in need of additional information please contact me at 279-3916.
Lnc.ercly,
s Spurkland, P.E.
203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (907) 276-6013, SpurklandEng@gci.net
1 I 1
LOT 4 ► LOT 7
1
ABANDON EXISTING
`�` ► SEPTIC TANK PER MOA
1 1 CODE RfOUIREMNETS
LOT 5 �C O 1 ► :,
O I
� � I LOT 6 LTJ HOUSE
1 ► INSTALL NEW #ell
S ► 1000 GALLON _
Q ' I S£PAC TANK I NA ttr1' I
� Liar s�
�C � ► 1
� ► 1
lY
I
I
Well
NOTES
1) NO WE115 OR SORFACE WATER WAHI11 100•
I 0< PROPOSED &TW LANK LOCATION
2) ALL WORK SNAIL K PREFORMED AN
ACCORDANCE WAN AMC 15.65.
5) MATERIALS IUD S/14U BE W ACCORDANCE
w9TN moor SPEano IN AMC 15.65.
25 0 I 25 W 75 100 125 150
SCALE, I' = 50 FT.
LOT 9 "pi
c: 4
' 49th
�...L ......... =...
i. �„ 7
'�R y LARS RRn;IK f C
/ ♦ o No. r usao ti
2 V.�W 15 . AVE [Ruvtr KASILOF HILLS BIX 9 LT 6 SEPTIC SYSTEM DESIGN
103 W 15TH. AVENUE
ANCN. AK. 99501 ROBB BARMAN DATE: JUNE 6, 1007
907 279-3916 10740 VASIKOF PLACE SNfET 2/3 GRID: 2541
PERMIT 9 0., _ __
SEPTIC TANK REPLACEMENT DETAIL
DOUBLE
CLEANO"'^
CONNECT
EXIST DRAlh..__
/— 4+ FEET COVER
! uuu yu I, septic -conm
FOUNDATION
CLEANOUT
20 URIC 5th Aveuirvccrcirvv KASILOF HILLS BLOCK 9 LOT 6 SEPTIC SYSTEM DESIGN
203 orage AR098 RAERMAN DATE, JM 6 2007
Anchorage Ak 99501
a79-99lA 10740 VASIKOI PUC£ SHEET, 2/2 GRID, 25+1
PERMIT / PARCEL ID / Kasila/NillsBA6.dwo 1
Environmental Consulting and Design
Single Family On-site Wastewater Disposal System
Construction and Material Specifications
Subject Property: Kasilof Hills Block 9 Lot 6
Date: June 6, 2007
General:
1. The owner shall contract with a contractor to perform the work outlined in these
specifications and plans in accordance with the attached MOA permit. There is not
contractual arrangement between the contractor and the Engineer. The Engineer shall
be the owner's representative and will Inspect the work to document the contractors
activities. Final acceptance of the contractors work rests with the owner and the MOA.
2. The scope of the work includes the installation of a new 1000 gallon septic tank. The
location of the drainfield is shown on the attached site plan drawings. All components of
the proposed septic system must be constructed a minimum of 1D0 feet from any surface
water or water wells in the area. A minimum of 4 feet of earthen cover is required over
the septic tank. If less than 4 feet of cover is available, 2 -inch thick, 40 psi, direct bury
board foam shall be installed directly over the septic tank and all Installed piping.
3. Construction shall be in accordance with the approved site plan and design drawings and
any special provisions noted on the Municipal well and/or septic permit. All materials,
components, workmanship and construction practices shall comply with the Municipality
of Anchorage's latest ordinances regarding wells and septic systems, as well as MOA,
Development Services Department, On-site Water and Wastewater Program (DSD)
policies.
4. The contractor is responsible for obtaining all underground utility locates, layout of the
proposed system, and verifying and maintaining all required separation distances to lot
lines, surface water, wells, steep slopes, etc.
5. The property owner shall be responsible for final grading any depressions formed from
settlement of backfill material. The property owner is also responsible for vegetation of
all areas disturbed by septic system installation activities.
6. Contractors installing wastewater disposal systems must be certified to do so by the MOA
DSD, On-site Water Wastewater Program. Property owners installing their own systems
must receive advanced approval from MOA DSD prior to system installation activities.
7. The contractor shall ensure that ALL materials being used are in compliance with the
most current guidelines established by the Municipality of Anchorage. Refer to
"Standards and Specifications for Component Parts and Materials Used In the
Construction of On-site Wastewater Disposal Systems", Dated December 2000, as
provided by MOA DSD, On-site Water and Wastewater Program.
203 West 15'" Avenue Suite 203, Anchorage, AK 99501, phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland(_agci.nct
'= 11R,pa��U�a�d
Environmental Consulting and Design
Septic Tank Installation:
1. A new septic tank, of the size specified in the design drawings, shall be procured from a
qualified manufacture/supplier If the existing septic tank is found to be defective.
Construction shall include two 4" diameter cleanouts; for pumping access.
2. The burial rating of the tank shall be adequate for the actual burial depth encountered.
3. The tank shall be level and sufficiently bedded to prevent settling of shifting of the tank.
4. All standpipes on the tank shall extend a minimum of 12inches above the final grade.
S. Tanks installed with less than 4 feet of cover shall be insulated.
6. The sewer service line from the house to the tank shall have a minimum slope of 2%
unless prior approval is obtained from the engineer.
7. The inlet and outlet lines from the tank shall be bedded In drainrock or the soil shall be
sufficiently compacted to prevent future settlement of the soil.
S. Septic tank inlets, outlets and cleanouts shall be fitted with water tight couplings.
9. A deanout shall be Installed 1 to 4 feet from the foundation.
10. Post tank cleanouts shall be installed per MOA requirements. Does not apply to
pressurized lines.
11. In areas with high ground water, the septic tank shall be sufficiently anchored to resist
buoyancy forces when there is not adequate soil cover to resist uplift force. The
contractor shall refer to the engineer for direction regarding this matter.
12. The tank backfill shall be graded sufficiently to ensure positive drainage away from the
tank.
13. All holding tank and lift stations shall have an audible and visible alarm Inside the
residence being served.
14. All lift stations shall be wired in compliance with all MOA guidelines and the Uniform
Electrical Code. A municipal electrical permit and Inspections must be obtained where
required by the MOA.
15. The contractor shall verify that the septictank/lift station is a minimum of 100 feet from
any residential water well, 150' from any dass'C' well and 200 feet from any community
water wells. Additional separation distances must also be maintained.
16. The contractor shall remove or abandon the existing tank in compliance with the Unform
Plumbing Code.
Inspections:
1. A minimum of one Inspections are required by the Municipality of Anchorage. These
Inspections must be conducted under the supervision of a Professional Engineer licensed
to practice in the State of Alaska.
2. The septic tank may be set in place, but may not be backfilled.
3. The contractor shall provide a legible copy of all field notes relating to system layout and
construction to the engineer for the use in preparing the record drawings.
4. The contractor shall coordinate all inspections with the Engineer. A minimum of 24 hours
notice is required prior to the start of construction. If necessary, a preconstruction
meeting will be held on-site.
203 West 15'" Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland@gci.net
c
. GREA- R ANCHORAGE AREA BORT 'GH
Department of Environmental Quality
�m y% 3330 C Street
Anchorage, Alaska 99503
_
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL. SYSTEM ,�
NAME "�''/(J %YJy�t /MAILING ADDRESS �i% ��i 47' lelaMl "!/ PHONNEE 71? '/S'
LOCATION U C/ �C t/*//, � C� LEGAL DESCRIPTION /K % /`�S�` 0-r
SEPTIC TANK: , ✓
DISTANCE C) � �_� NUMBER OF
FROM WELL MANUFACTURERS MATERIALS i �tr'� COMPARTMENTS /
�Z X16 7///
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY 000 GALLONS.
SEEPAGE PIT:
t
NUMBER OF PITS / DIAMETER OR WIDTH, LENGTH!! DEPTH
LINING MATERIAL (�2r1C62LZ_ CRIB SIZE: DIAMETER DEPTH DISTANCE FROM: WELL
Z/ �OTAL EFFECTIVE %!///
BUILDING FOUNDATIOI\Itw�, NEAREST LOT LINE Z5 Tb� ABSORPTION AREA (WALL AREA) `7 7 SQ. FT.
ADDITIONAL ABSORPTION
WELL:
TYPE CONSTRUCTION DEPTH DISTANCE FROM:
BUILDING NEAREST t NEAREST SEPTIC SEEPAGE
FOUNDATION w��LOT LINE 10 4oIF, SEWER LINE—_TANK/t&_, SYSTEM
CESSPOOL -- OTHER SOURCES
APPROVED DISAPPROVED REMARKS
DISTANCES: DIAGRAM OF SYSTEM
INSTALLED BY:
PIPE MATERIAL: °
5r�IL
LOT SLOPE: / ['i�/r�
REMARKS: ��C"
Fnrm Nn Fo-n91
GREATER ANCHORAGE ARCA BOROUGH
DEPARTMENT OF ENVIRONMENTAL OUALITY PERMIT NO.
�. 3500 111UOR ROAD E'OUCH r, 550
A::CTHORAGE. ALASKA 99502
TEi.1:PHONE 2.79-C60P
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
NAME OF APPLICANTLl�'I v ✓'+--1-+-------1,1 6 --- MAILING A/UUF F55 �_1.'_. �'�}.---� J PHONE
INSTALLATION LOCATION J`--1Zf= 1 ("� }• `-�.V�j ��"d'�7
1 f
LEGAL DESCRIPTION
INSTALLATION OF: SEPTIC TANK
I ---
SEEPAGE PIT
ORAIN FIELD OTHER
TYPE AND SIZE OF FACILITY TO RE SERVED {- '
TO BE INSTALLED BY f �
1 I (
SOIL TEST RESULTS'-� J l` 17('/��7C�1/l'Z NOTE, THIS PERMIT IS NOT VALID WITHOUT SOIL TF57
COMPLETION DATE ANTICIPATED —'
_ PFRMTT VAl.IL1�lI�F YEAR - -
FINAL INSPECTIONI 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HKALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
% `//1 1 PS X (, (,'%<- TYPE
SEPTIC 'TANK SIZE _ TYPELit-G'. °i1_Drconn 'P.t PSEEPAGE AREA SIZE
MINIMUM DI$TAREQUIREMENTS DIAGRAM OF SYSTEM
5 ft,
FOUNDATION TO SEPTIC TANK �s MJf•E
FOUNDATION TO SEEPAGE PIT GO ft, DRAIN FIELD 1.0 ft,
SEPTIC TANK TO SEEPAGE PIT WALL 15 ft
SEPTIC TANK _—ftt SEEPAGE PIT 20 ft, . DRAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
DRAIN FIELD
SEEPAGE PI'I —.— '
ALSO CONSIDER AREA WELLS,
WATER MAIN TO SEPTIC TANK 10 ft• SEEPAGE PIT 10 ft
DRAIN FIELD --- 0ft• -_.
SEPTIC TANK, 25 ft*, SEEPAGE PIT _100 C,r� ft0 , DRAIN FIELD � ft,
4" CAST IRON SIPHON
SUPT IC PIPE WITH AIRTIGHT CRIB
I AN 1; CAPS
EAS, IRf:� .
4 5'..a
MOND:
CAST IRON _ — INTO
UNDISTCCDED SOIL:'��s
III II I MUI1
C I required vhenever line crosses
under Jrivea y.
TO RIVER. LAKE, STREAM.
I❑H,I":III I!1I,
rn rA.rr- zoo'
AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
r oo'
CAST IR014 INTO
II':'P")DAL
EXCAVATION S FEET INTO UNDISTUR13ED SOIL.
10 PI1- 100'
I,0 %il1:R LIN[- 10'
CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
A INCH DIAMETER
„Li- POULIC
FITTED WITH AIRTIGHT REMOVABLE CAPS.
111 TAP;!:- PC"
T^ If T- 170'
I;0 •.!; Ip IIS(- 40'
40' M,' O1!1.'r
GRAVEL BACKFILL
EA',: )ION SE:IER
I. Fur
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
P11H IC
rn rA.rr- zoo'
r oo'
'
105'-;I �.O' n-tls.
.P.` r I:'ca SEUEI:
Iris-. ry9 S111!rCC NP
HEALTH AUTHORITY
OR
LICENSED DESIGNER
RAVEL FA44KFILL
AROUNDCk1o.
a,DIfINII;UN A.BOs'E WATER
TABLE)
4 11101 SEVER LHic.
CONSINIZ ARE!. RELIS.
SLEPAGE I'll EXCMATIOH BASED ON
5011. HEST.
y£LL'ao
Grade: i.Por 'GO'
or 1/4' P r foo:
except 10' precredinq
tank d tha. shoold I
not exceed 21. j
6' per 100 on flat
terrains.
CAST Ir011, .7 SEPTIC
T1111 /
IGICI
nl IT PGEn/—) CAST IRON SIPHON PIPE
SOIL ;
.� —CRIB
PIT
F - / CAIB
_ I
GRAVEL BACKFILL
�r
i '
20' HINIMUM
IIf AP E ST t 0 T LIIIF___�r
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE: AREA BOROUGH ORDINANCE NO. 28-66 AND THAT THE AE3OVE
DESCRIBED SYSTEM 15 IN ACCORDANCE WITH SAID CODE. //,J/
P pNOlonncC�
rr x
W V1E L� � I e96o`
o >I
4H/ZEO JPN//\'
GREATER ANCHORAGE AREA BOROUGH
3500 TUDOR ROAD
ANCHORAGE, ALASKA 99507
December 4, 1972
DEPARTMENT OF ENVIRONMENTAL QUALITY
Glenn Smith
P.O. Box 4-1444
Anchorage, Alaska 99509
Subject: Permit to install sewer system
Dear Sir:
C���
�REATEDF gryY AONM I'ITA6 G1U �11Y11
BKPT•
A permit was issued to you by this Department for the
installation of an on-site sewer system and at this time
we have no record of this system having been installed.
Please complete this form and return it to this Department
at your earliest convenience.
yes no
F] 1. The system has been installed.
2. The system will be installed later this year.
3. Void my permit; the system will not be installed.
�I 4. The system will be constructed during the next
construction season.
Your cooperation is requested as we have a great number of
outstanding permits for 1972 and we would like to clear our
permit files out as much as possible.
TN nk you,
oe
ohn R. Lee, R.S.
Environmental Services Supervisor
Coniftaetion gest Ya.
"One test is worth a thousand opinions"
8829 TUDOR ROAD, ANCHORAGE, ALASKA 98807 9 TELEPHONE 333-8472
Performed For e /;/ry —`Date Performed
� H�iB�e
Legal Descrintion: Lot", Block`Subdivision__
This Form Renorts Soils Loo-- Percolation Test_
nenth
Feet Soil Characteristics
Si 5 A- 6,roruetis ckj
C & to
5 — ,
F — SA�Vct`j 6esgWe
8—
(,�
ln yy
Was Ground Water Encountered? V&
If Yes, At what Depth?
Read inq Date
Gross Time Net Time
Depth to H2O
Net Dron1'
Percolation Rate _Minute
Proposed Installation: Seenaae Pit VeX Drain Field
Death of Inlet Depth o Bottom Of Pit Or Trench�_BB
C r) M M E N T S : / % :? '9^a_ 01 .O .r..® .ea. 094- n 9C �s. A6 iw . 11,r a Al PP%® e
Test Performed By tz"? ®` oo C -/� Data Certified
r .
o MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date _
1. GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or direc�tioo s
1--e _27 6� p.a l i -`a
(b) Applicant Name4241W 5.�°1i4V Te/le/phone: Business
Applicant Address _ 4R'a"
(c) Applicant is (check one): Lending Institution ❑ ; Owner/builderT; Buyer ❑ ; Other ❑ (explain);
[a
(e)
(f)
LendingInstitutip •fit �t'c:d �i'r f �� /l� �d d2fhone .3`� `�4
Address
Real Estate Company and Agent
Address
Telephone
Mail the HAA the following address:
2. TYPE OF RESIDENCE
Single -Family Multi -Family ❑ Other
Number of Bedrooms Z.
3. WATER SUPPLY
Individual Well Pr 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 ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 (11/04)
5. ENGINEERING FIRM PROVIDING, INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and requlations in effect on
the date (
Name of
Address
Date, P_�
Ju • 1. Corviin +� �> Engineer's Seal
' a
CE -5283 0 �VErJ
G
6. DHEP APPROVAL IC00
Approved fors_ bedrooms by J~t Cate
Approved __.._ Disapprov Conditional
'Terms of Conditional Approval
CAUTION .
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
72-025 (11/84)
MUNICIPA`t O OHEA HliORAGE MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
DEPT' pROiEcTtON CHECKLIST - FEBRUARY 1984
�NIRONMENTAI
2sa-a72o
SO ba *85Legal Description, ��� � A A04�
A. WELL DAJ(ECE•� ,-
Well Classification d If A, B, C, D.E.C. Approved (Y/N)
Well Log Present (Y�V��Date Completed — Yield er/ �� % A/
Total Depth-��Ss _ Cased to ` 7` Depth of Grouting '-
Static Water Level - - Pump Set At -]!� y0
Casing Height Above Ground 9W Sanitary Seal on CasingY/ )
Electrical Wiring in Conduit J) Depression Around Wellhead (Y0155d —
Separation Distances from Well:
To Septic/Holding Tank on Lot G� ; On Adjoining Lots
To Nearest Edge of Absorption Field on Lot �` ; On Adjoining Lots 4 _
To Nearest Public Sewer Line To Nearest Public Sewer
Cleanout/Manhole To Nearest Sewer Service Line on Lot
�
Water Sample Collected by t '- W%4�i' ; Date
Water Sample Test Results
Comments
B. SEPTIC/MetOtt+G TANK DATA
Date Installed —Size Xe:�WD No. of Compartments
StandpipesY/ ) Air tigh e
Depression over Tank (_ O
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High -Water Alarm (Y/N)
FouTidation Cleanout ( —
Date Last Pumped�s
i
for
Temporary Holding Tank Permit (Y/N) —
Separation Distances from Septic/Holding Tank:
To Water -Supply Well — l®s To Building Foundation
To Property Line To Disposal Field --
To Water Main/Service
Course i
Comments _
Page 1 of 2
rA
� '�
To Stream, Pond, Lake, or Major Drainage
if
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata ��/� Type of System Design
Date Installed %— `% — ?:�S Length of Field
� f
Width of Field Depth of Field
Gravel Bed Thickness
Square Feet of Absorption Area �� Standpipes Prese q) lzesS
Depression over Field ( /N) a nate of Last Adequacy Test
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water -Supply Well '7,"To Property Line
To Building Foundation 3d _. To Existinggr Abandoned System on
Lot d /res« ; On Adjoining Lots DO �—
To Water Main/Service Line To Cutbank (if present)
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments —
D. LIFT STATION
Date Installed -
Size in Gallons
N/f
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Comments
Iq
** Check P r itted ddW
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Rating Against HAA Request **
Vent(Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
I certify t e eked,v rifie� , or conformed to all MOA and HAA guidelines in effect on the date of this inspection
Signed / / Date 9 —��� 65;P
Comp a MOA No.
_
Receipt No. -4601
Date of Payment _ 7l2
Amount: $ �� S r c� Engineer's Seal
9
f '
C�
.'� � a ;r co J. Corciin
Page 2 of 2 �
= Q,7
; o o. CF -5283°
�V
c�
72-026 (11/84)
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
A%Xxn\L
TELEPHONE (907) 562-2343 5633 B Street
Anchorage, Alaska 99518
v
^•�^"° Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIERI TO BE COMPLETED BY LABORATORY
El PUBLIC WATER SYSTEM I.D.#
❑ PRIVATE WATER SYSTEM
'Name Phone No.
Mailing Adyress
City State Zip Code
SAMPLE DATE: 1% �
Mo. Day Year
SAMPLE TYPE:
�f Routine
Check Sample (for routine sample
with lab ref. no. ) ❑ Treated Water
❑ Special Purpose ❑ Untreated Water
SAMPLE Time Collected
NO. O ATI Collected By
1 rRsi/ OFic �s-�S �-
2
3
4
5
Analysis shows this Water SAMPLE to be.
01 Satisfactory
❑ Unsatisfactory
❑ Sample too long in transit; sample should
not be over 30 hours old at examination
to indicate reliable results. Please send
new sample via special delivery mail.
Date Received
Time Received
Analytical Method: Membrane Filter
* No. of colonies/100 ml.
Lab Ref. No.
yo.5-7- )q3
BACTERIOLOGICAL WATER ANALYSIS RECORD
READ INSTRUCTIONS Membrane Filter: Direct Count
RLCGI�pC ~ Verification: LTB
COLLECTING SAMPLE Final Membrane
Reported By
TNTC = Too Numberous To Count
OB = Other Bacteria
BGB
Analyst
-:15CL
Coilform1100ml
s Cpilfgrml100m1
Date V / �( / v v
Time: �> L� a. M.
��I�j p.m.
678910 77 0
• � Municipality of Anchor..
MAY 0 9 2018
On-Site Water and Wastewater Progra '
\ (907) 343-7904 SAM',iF T.
c
Certificate of On-Site Systems Appro -' 6 8 L 9
Parcel I.D. 015-131-07 Expiration Date: Cm 10 , ,�0 I g
1. GENERAL INFORMATION:
Complete legal description Kasilof Hills; Block 9, Lot 6
Location (site address) 10740 Vosikof Place*Anchorage,AK 99507
Current Property owner(s) Sharon Baerman Day phone
Mailing address
Real Estate Agent Bob Baer Day phone 261-7505
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ 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 El
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: _ Distance:
Received by: A Date: —O/8
COSA to be released to the engineer,unless otherwise requested by the engineer.
COSA Fee $ ,c2IO Waiver Fee $
Date of Payment 5 f/Q I ts Date of Payment
Receipt Number OO ?2 Receipt Number
COSA# .SP•19` 1� 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:
.„,-:::5:,..s .....\‘,
In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system , 01- 0�
in accordance with the guidelines and regulations established by the Municipality of Anchorage and O ,.•••..• *.- S-A
industry practices. The reported results describe the condition of the system/s on the date/s of the ' • 0
evaluation. Separation distances were measured to readily identifiable features. Hidden defects or D "' c Q
encroachments may exist that were not identified during the evaluation. The operational life of all wells �•. 4 !'I'. I . v0
and septic systems depend upon a variety of variables, including but not limited to, soil conditions, 0)
groundwater levels (that may fluctuate during the year), quality of construction (materials and I VA
workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and
�,.. . ..�
are outside the control of GEG. Satisfactory test results do not guarantee future performance of the 00:30,
�� A. or ,ess:
system/s; therefore, GEG makes no warranty(express or implied) regarding the future performance of UQ�� . CE aS�G
the well or septic system. GEG makes no representation whether an alternative well or septic system (,)1 s q.5
ce0can be installed on the property in the event either of the current systems fail to perform adequately in u4� �, .• .f& �Ao
the future. The content of this report is for the sole benefit of the person/party that retained GEG to %Zed prp;ess��n0\��
perform the evaluation. Reliance upon the information provided in this report by any other person or ��00000��6
party (including subsequent property purchasers) is not authorized, nor will it confer any legal rigtt,. 01=
whatsoever.
C./ ? #AECC884
6. DSD SIGNATURE J ON-SITE `76,
J System #1 Approved for 3 bedrooms Z• WATER AND '11
aril :
System #2 Approved for bedrooms WASTEWATER o
-kPROGRAM ,�
Disapproved 'moo �`
Conditional approval for bedrooms, with the following�slipul tons:
e.p.- oI--i c \-ct A k tz Ciresl.,l,tc;k .t 5 t-LC cL --\-0r - I�Q 1 cc:a l',"\-' .
t I U
ra-20\1:.-t_.e C rl' JVD s,ze -Fv P 2 5 be c1c�1, (.e ctL w a l e"`1- \-0
.5 Pzv,_,le>- Sc e en c - v
`�ck� S Ie-I�e1 Sor JuS'��'{-� Cc;� 1 �t�
-\""[Nc`npcove ns bc8iz.,Cm Swhle.titi
I . d
By: 2L t.c ) �s�•itCO ��t Tr►, ��ltlu,� Original Certificate Date: 5 /1 /18
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 Y
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other &i ci l''leer's I C I-fie r
C)
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: Kasilof Hills; Block 9, Lot 6 Parcel ID: 015-131-07
A. WELL DATA *Per MOA HAA Checklist approved on 9/26/1986
Well type Private If A, B, or C provide PWSID# N/A Well Log (Y/N) No
Date completed 1973(?) Sanitary seal (Y/N) Yes Wires properly protected (Y/N) Yes
Total depth *345 ft. Cased to Unknown ft. Casing height(above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test 4/17/2018
Static water level ft. 18.7 ft.
Well production g.p.m. 6.6+ g.p.m.
WATER SAMPLE RESULTS:
Coliform Kee) colonies/100 ml. Nitrate 41•08 mg./L. Collected by: GEG. Ltd.
Arsenic: <5 J ug./L. Date of sample: 4/18/2018
B. SEPTIC/HOLDING TANK DATA **Pre—tank double cleanouts
Tank Type/Material Septic/Steel Date installed 6/21/2007
Tank size *1000 gal. Number of Compartments 2 Cleanouts (Y/N) Yes
Foundation cleanout(Y/N)**No Depression over tank (Y/N) No High water alarm (Y/N) N/A
Date of pumping 4/17/2018 Pumper ARM Services
C. ABSORPTION FIELD DATA
Date installed 7/9/1973 Soil rating (g.p.d./ft2o /bdr 173 System type Seepage Pit
Length 16 ft. Width 15 ft. Gravel below pipe 7 • ft.
Total depth *11.5+ ft. Eff. absorption area**434 ft2 Monitoring tube Yes Depression over field No
Date of adequacy test 4/18/2018 Results (Pass/Fail) Pass For ** bedrooms
Fluid depth in absorption field before test 16.5 in. Water added 761 gal. New depth 43 in.
Elapsed Time: 120 min. Final fluid depth 34 in. Absorption rate >= ** g.p.d.
Any rejuvenation treatment(past 12 mo.) (Y/N &type) Unknown If yes, give date —
A 2,066 gallon pre—soak was performed on 4/17/2018
*Below existing grade at seepage pit.
A+ Home Services added approximately 24" of soil cover over the east half of the septic tank
(4.41' total cover) and approximatley 21" of soil cover over the seepage pit (3.46' total cover)
on 5/7/2018
**See attached letter
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off' level at .• wa er alarm level at in.
1- - •• 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 10'+ 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
G. ENGINEER'S CERTIFICATIONoo ,` OF AL... !`kph
o Q• -. 4 00
I certify that I have determined through field inspections and Ai* 4 9 , •.9*O
review of Municipal records that the above systems are in VA
conformance with MOA COSA guidelines in effect on this 0
date. '0O % f r: A. orne- ;•
Engineer's Printed Name JEFFREY A. GARNESS gh4,.;.. CE 779 3�p .. .\c�Qo
Date r! D/(5 4OQaprofessloa`=
°40000
#AECC884
(Rev. 11/05)
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT I • }!c.'uw 907-343-7904
On-Site Water and Wastewater Section Fax: 343-7997
www.muni.org/onsite
Nitrate Advisory'
Certificate of On-Site Systems Approval # 0SC181199
Subdivision: Kasilof Hills, Block: 9, Lot: 6
A water sample revealed a nitrate concentration of 9.08 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.
Mailing Address: P.0. Box 196650 *Anchorage,Alaska 99519-6650 *www.muni.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.
__ Quanics
GARNESS ENGINEERING GROUP, Ltd A°'' °T '"7=t 's"""
CIVIL&ENVIRONMENTAL ENGINEERS Dea/er
May 9, 2018
Municipality of Anchorage
Development Service Department
On-Site Water& Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
Ref: COSA for Kasilof Hills; Block 9, Lot 6
To whom it may concern:
As discussed previously and overviewed in the attached email, the existing lot has a 2 bedroom
drainfield (technically sized for 2.5 bedrooms) and a 1,000 gallon steel septic tank that was
installed in 2007. On the 2007 inspection report and design, it states that the home is 3 bedrooms
and was approved by the MOA. Based upon our conversations/emails, the MOA would approve
a COSA stating the bedrooms the tank is rated for and the number of people the drainfield was
approved for if it met the specified criteria (listed in the email). Our justification for proposing the
COSA be approved for 3 bedrooms and 5 people is listed as follows:
• The design for seepage pits is conservative in that it only accounts for sidewall area. In
this case, there is also 240 square feet of bottom area that is also available for absorption.
• The majority of the seepage pit sidewall area (434 sq.ft) and bottom area is in a soil rated
at 150 sq.ft/bedroom.
• As can be seen on the attached COSA paperwork, the drainfield was pre-soaked on
4/17/2018 with 2,066 gallons and an adequacy test was performed with 761 gallons
(enough for 5 bedrooms) on 4/18/2018.
• On 4/18/2018 the liquid level started at 16.5 inches, rose to 43 and dropped down to 34
after being allowed to recover over a 120 minute period.
If you have any questions, please contact us at 337-6179. Thank you for your assistance.
:Incerely,
e r:y 'I. carn=ss, P. ., M.S.
Pre •e t
3701 East Tudor Road, Suite 101 *Anchorage,Alaska 99507-1259
Phone: (907)337-6179*Fax: (907)338-3246*Website: www.garnessengineering.com
Jeff Garness
From: David Harper <dlharper2@gmail.com>
Sent: Monday, April 23, 2018 11:35 AM
To: Jeff Garness
Subject: 10740 Vosikof Place
Jeff,the well located on the above addressed property, has been brought up to the MOA requirements as needed as of
this date. 4-23-18.
Sent from my iPhone
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