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HomeMy WebLinkAboutKLEMETSEN LT 1Klernetsen Lot 1 #015-521-14 Inspection Report_1-1-12.doc Municipality of Anchorage - Community Development Department Page 1 of 3 Orr -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-5650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPLDRT Permit Number: OSP151312 PID Number: 015-521-14 ❑ New ❑✓ Upgrade Name. -- ABSORPTION;FJELD David Browne - El Deep Trench ❑� Shallow Trench ❑ Bed ❑ Mound Address " - - PO Box 210981 ❑ Other Phone Number of Bedrooms Soil Rating - _ Total depth from original grade 4 0.8 GPD/SF 8.9 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade X4.9 Ft. Gravel depth beneath pipe 4Ft Subdivision Block Lot Klemetsen 1 Fill added above original grade w - 0 Ft Gravel length 38 (X2) Ft. Township Range Section Gravel width " 5Ft: Beds: Number of Lines N/A Distance between.lirrLPs N/A Ft. SEPARATION DISTANCES TO Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line - 760 Fe 2- 12.1 Ft. Well 107.5* 121.0* N/A N/A 80.0 TANK 71 Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank ,Capacity 1,250Gal. - Surface Water 100+ 100+ N/A N/A Material Steel Number.of compartments 2 Lot Line 31 7.7** N/A N/A NA Foundation 10.6 19.1 N/A NIA LIFT STATION Manufacturer - Capacity Gal. Curtain Drain 50+ 50+ N/A N/A Pump on level at Pump off level at High water alarm at Remarks *See ADEC Waiver in. in. in. **See Waiver OSV151120 . Pump make and model Electrical Inspections performed by RIAL Housetotank 3034 kto PIPE MATEdrTaaninfield 3034 Installer A+ Home Services Drainfleld 3034 CO/MT 3034 - Inspector Pannone Engineering Services, LLC. BENCH MARK (Assumed elevation) 100ft Inspection- 1s 10/14/15 a 10/14/15 Location and description dates: 2" Top of First Step V 10/14/15 4'" COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's�ySta\my�p� Conditional Approval: Date � r . -i �O� '•~ ^i .�i4}� seven f# ISannoRe C 8149 f, Approved Date Inspection Report_1-1-12.doc 00 ! A B C ` I _ - T1 21.9 17.5 1 T2 28.7 18.4 DC1 32.0 20.2 I / C i 39.4 21.6 M1 38.8 18.9 C2 56.4 40.6 - I % M2 55.9 39.5 1 - C3 85.7 60.2 L, M3 84.3. - 58.3 C4 72.0 44.7 -_ M4 70.9 43.6 " I ; DC2 15.3 - 21.1 CS 16.0 22.8 - (El �i'CRIB TO BE RE—USED AS RESERVE- " (400SF AVAILABLE.— 150SF / i REQUIRED), CAT III SYSTEM j VERIFY DURING CONSTRUCTION I ` � CRIB ABANDONED - PER MOA CODE -� - DRIVEWAY r_ "CLASS { ABANDONED SEPTIC TANK PER MOA BODE y "C" WELL E 1N TA L D 1 50 S PTIC TANK NEW W '. DC2 -------- DCO AFTER TANK AND FLOW SPLITTER " X07? o 30' Rowit r Dci 2BR T1 SFD (E) C1 " WATER LINEW : M2 C2 M1T2 7� C ;' APPROX. LOCATION F- I i 0 I F— I INSTALLED DRAIN FIELD NEW / (2EA)38LFx5.0 Wx4.0 ED, 8.9 TD TH W/ COs AND MTs AT ENDS 12.1 CT M3 M4 4BR n HOUSE (E) 112 SEPTIC NOTES: 7�t�]L�`7171�`1� N-:" rP.O. s��� \\ Dote RECORD DRAWING BOX 1j01022117 ANCHHOORA�CK 99 10 '(�AC'�Stii �y�) 1/25/2015 PHONE (907) 272-8218 FAX (907) 272-8211 %g�P Scale - �..... ... ........ PI NO KLEMETSEN LOT 1 015-521-14 DAVID BROWNE S'teve'n CE . Pennone'j 8149 %�� ._ PERMIT NO. DRAWN NJC PO BOX 210981 OSPI51312 PLAN ANCHORAGE, AK ZIP 99521 `llh�FRpESS10NPSheet �� 2OF3 "�-m SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION WAS 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. 2. SCOPE OF WORK: INSTALLED NEW 1,250g SEPTIC TANK AND SOIL ABSORPTION SYSTEM. 3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 15.0 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. NO APPARENT WATER TABLE WAS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 15.0 FEET BELOW EXISTING GRADE. - FILTER FABRIC - 4" 0 DRAIN PIPE - TH-1 DRAIN ROCK 6" ABOVE PIPE INV -0S 97.2 97.2 1 F _ - 92.3 92.3 - SM/ DRAIN ROCK GM 88.3 88.3 h-5.0-5 12.1-----+— 5.0 SECTION -15.0 Li -82.2 NO GROUNDWATER OBSERVED 0 o J Z O w Z U J J 0 Q .w O O U ti r r r m w w o o FILTER FABRIC o o - m a v v a z 4" m DRAIN PIPE z w a - DRAIN ROCK 6" O -97,3 ABOVE PIPE INV _ -FLOW SPLITTER 92.9 1,250 GAL 92.7 TANK NEW DRAIN R K PROFILE DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) TANK SIZE: 12509 - - PERC RATE: 12.2 MPI SOIL RATING: 0.8 GPD/SF _ AREA ROD: 750 SF ABBREVIATIONS = "' SYS. TYPE: 5' WIDE TRENCH 4.0'ED TH - TEST HOLE REDUCTION FACTOR: 0.5 w y MIN LENGTH: 75 LF - (P)_ PROPOSED (E) EXISTING USED: - CO CLEAN OUT NO. (2 EA) 38LFx5.0'Wx4.0' E.D., 8.9' TD _ MT MONITOR TUBE N0. TOTAL AREA: 760 SF TYR TYPICAL NOTES:�7��� 7�7� �+7�� _- \\ Date RECORD DRAWING - �,p VgpXOj 0107 ANCHORAGE, CK 98JSL10 �c��F'...... �1 11/5/2015 r �P' ale PHONE (907) 272-8218 FAX (907) 272-8211 + Scale , Tli *� RILD NO KLEMETSEN LOT 1 .. ........ .. .. -521-14 DAVID BROWNE Steven Pne annoj PERMIT No. DRAWN NJC CE 8149 .•� j OSP 151312 PO BOX 210981 f+� PLAN ANCHORAGE, AK ZIP 99521 11l`9``DR7.....0NP�` Sheet \\ "�� 30F3 Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer - E-mail: steve(paneneak.com November 5, 2015 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P O Box 196650 Anchorage, Alaska 99519-6650 Subject: Klemetsen., Lot 1 Lot Line Waiver Request Ladies and Gentlemen: We request a waiver to seven feet (7') to the lot -line. The new field was installed 7.7' off the lot line on 10/14/2015. Granting this waiver is not likely to affect the health and safety of this lot or the surrounding lots now or in the future. If you have any questions or concerns, please contact me at 907.272.8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Municipality ofAnchorage No went sr P.O. Box 196650 � 4700 Elmore Road Q N Anchorage Alaska 99519-6650 (907J 343-7904 • Fax (907) 343-7997 epartment h ://www r)uni.oro/Onsite' Develonmeet Services Division On-Site Water and Wastewater Program . *** VARIANCE/WAIVER REVIEW **** Waiver#: OSV151120 COSA#:OSC151618 Permit#:OSPIS1312 PID#: 015-521-14' "> Legal,,,[5escription: KlemeLot 1 Engineer: PES - Applicant: Robert.$ Pamela Renkert Your request fora waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. -The approved separation distance is 7.0 feet. This waiver approval appfios to,the existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. ® Tlie affected adjacent property owner(S) have `been given a 7 day notice regarding this waiver. ❑ Notarized`letter(s) of non-objection have been received .from the owner(s) of the affected adjacent property..' Q' Adjacent properties are not affected by this waiver. .......................:............................,,............� Waiver is Granted: X Waiver is not Granted: Date: t Approved by: ' arae of Reviewer ■...... ■:■..r:'..... rr.. ■,... ..ru.......O..:...,.,.............. i1*.■Rr.........., On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP151312 Tax Code Number: 01552114000 Work Type: Septic Upgrade Permit Effective Dates: October 12, 2015 to October 11, 2016 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: KLEMETSEN Site Legal Address: KLEMETSEN LT 1 G:2637 Owner/Address: RENKERT ROBERT A & PAMELA M 4620 MARS DRIVE ANCHORAGE AK 995073723 Site Mailing Address: 10901 TOTEM RD, Anchorage This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy WlylllS //I roc) 1011✓115 10.30 Lot Size in Sq Ft: 46963 Total Bedrooms: "P"� ac N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: The southern -most crib is to be documented at time of construction and paperwork submitted to Onsite for review and approval. Received By: M61 MUNICIPALITY OF Community Development Department Development Services Division On -Site Water & Wastewater Program ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 015-521-14 Property owner(s) David Browne Mailing address PO BOX 210981, Anchorage, AK 99521 Site address 10901 Totem Road Day phone Legal description (Sub'd., Block & Lot) Klemetsen, Lot 1 Legal description (Township, Range & Section) Lot Size 46963 Sq. Ft. Number of Bedrooms _�_'� APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (M all that apply) Absorption Field ❑X Initial EJ Single Family (SF) IK ADU) Septic Tank NUpgrade ❑X Duplex lea (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR: Separation Distance from Septic Tank and Absorption Field to Well (E) Distance:'° I certify that the above information is correct. I further applicable Municipal Codes. property owner or Permit/Rush Fees: 56q Date of Payment: �I �a 11 s CC% Receipt Number: 0 1"12-11 Permit No. 0'5191'61312, Permit App_-'-:- ,rhe '13' . is in accordance with Waiver Fees: I %fid Date of Payment: Receipt Number: 6b l55 Waiver No. 0Sy 151120 Pannone Engineering Services Lac Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve(a)panengak.com September 21, 2015 Subject: KLEMETSEN L1 Septic System Permit Request Design Narrative This is a design narrative for a permit to install an upgrade septic system to be issued for this property. The proposed systems will serve an existing two (2) bedroom house. The owner wishes to have a four (4) bedroom system to allow for future development. Currently the lot is developed. The proposed system will install a new 1250g septic tank and add a 5' wide absorption field. This lot and surrounding lots are served by private wells. The well on this lot is a Class "C" well that serves this lot and Lot 2. The well on the lot is within 150' of the proposed septic system (see Waivers). 1. Soils. One test hole was performed in the vicinity of this system by Pannone Engineering Services in August of 2015, and groundwater was monitored for at least seven days. Ground water was not observed to a depth of 15.0 below the surface in the test hole monitor tube in September of 2015. Based on the results of the percolation tests an application rate of 0.8 gallons/day/square feet was used for a conventional waste water system in the area of these test hole. 2. Soil Absorption System Design. a. See Sheet 1 of the design package. 3. Surface Water: There is no surface water located within 100' of the proposed system. 4. Topography: The existing overall topography slopes up from the northwest to the southeast at approximately 5%-7% on the lot. There are no steep slopes within 50' of the proposed drain field. S. Waivers: a. Septic Tank (E) to Well (E): We are requesting a separation distance waivers between existing Class "C" well on the lot to the proposed septic system. The distance between the proposed tank and well is 104.0'± and the distance between the proposed absorption field and the well is 115.4'±. We are requesting a waiver for both the septic tank and drain field to the existing well for a distance of 100'. DEC Criteria: The well on KLEMETSEN L1 is a Class "C" well and was drilled in approximately 1966 at the time of construction of the house. Well logs were located for several of the surrounding lots and the data is summarized as follows: LOT # WELL DEPTH STATIC WATER LEVEL YIELD Well Data Date H2O Test Date Soil Characteristics Well Log Data Nitrate Level KLEMETSEN Ll 110' 55' 15 gpm 1966 Unk Y Y Unk GROH TRA 270' 210' 5.3 gpm 1/17/07 Unk N Y Unk GROH B1 Ll 118' 60'- 4.4 gpm 6/23/81 Unk N Y Unk T12N R3W S22 L29 N132 110' 59' 5.1 gpm Unk 3/6/89 N N, Sat Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 - T12N R3W 522 144' 53' 5.1 gpm 9/16/01 4/2/13 I Y Y Sat L25 N125 The ground water in this area typically flows from the east to the west in a deep seam of silty -sandy gravel. 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 18 AAC 80.020 and 18 AAC 72.021(a), I have calculated the following points: Lot 1 Sentic Svstem to Well Distance from sewer system bottom to groundwater 5.29" Soil sorption below sewage system 2.94 Soil permeability below the system 1.24 Water table gradient 6.00 Horizontal separation 3.16 Total Points 18.63 "The sum of the above values could equate to the following conditions: 16-24 Almost sure to be free from any form of contamination from household sewage." In my opinion, this waiver request meets the above criteria for approval and does not constitute risk to health. I hope the above information will assist you in determining that the waiver should be granted.' A waiver request had been submitted to ADEC for consideration. 6. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On -Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of this or the surrounding lots. 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 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 CONSTRUCTIONOF ON—SITE WASTEWATER DISPOSAL SYSTEMS. 2. SCOPE OF WORK: INSTALL NEW 12508 SEPTIC TANK- AND SOIL ABSORPTION SYSTEM.. 3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 15.0 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL, TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 15.0 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. I`, I CO LLAPBANDOSED CRIB E / / TO.E ANED PER MOA CODE DRIVEWAY CRIB E i ''21 (4 0S RE -USED AS RESERVE (400SRED), CABLE - STEM /,� �j REQUIRED), CAT III SYSTEM ABANDON SEPTIC TANK E VERIFY DURING CONSTRUCTION PER MOA CODE - INSTALL 12508 SEPTIC TANK (P W/ FC AT FOUNDATION, DCO AFTER TANK AND FLOW SPLITTER 3 I 92 CLASS •C" WELL E 104.0 0 — 115.4 C6 I I 2BR Ijj fi_ f SFD (E) % 10. - / "WATER INE r,�.• "--'-"' �,` __ / APPROX. LOCATION __. io INSTALL DRAIN FIELD P 2EA)38LFx5.0 Wx4.0 ED, 7.0 TD ' \ i W/ COs AND MTs AT ENDS DESIGN PARAMETERS \ % PRIMARY SEPTIC SYSTEM iJ0 NO_. BEDROOM: 4 (600 gpd) \ TANK SIZE: 1250g /�7 \ DHS IPERC RATE: 12.2 MPI \ ''6 •IceSOIL RATING: C.8 GPD/SF \AREA ROD: 750 SF .% BBREVIATIONS " SYS. TYPE: 5'. 'WIDE 'TRENCH 4.0'ED V ! \ o REDUCTION FACTOR: 0.5 �pTlc "� � TH TEST HOLE MIN LENGTH: 75 LF A / — _(P) PROPOSED \'\ (E) EXISTING USE: / CO CLEAN OUT N0. (2 EA) 38LFx5.0'Wx4.0' E.D., 7.0' TD \\ /f MT - MONITOR TUBE NO. TOTAL AREA: 760 SF TYP TYPICAL NOTES:�T�� PANNONE ENG SVC, LLC _ of a ��>, Date FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 r ��•.•...Cgsl�l 09/21/15 PHONE (907) 272-8218 FAX (907) 272-8211 �rc,�P F9t� Scale j,t 49TH *l� .... ... .. . ...... P.I.D. NO KLEMETSEN LOT 1015-521-1 DAVID BROWNE • Stevenf2. •Pannone / PERMIT NO. DRAWN JRL 8149 OSP151312 PO BOX 210981 PLAN ANCHORAGE, AK ZIP 99521 �+lli�fOq�S510NP Sheet 1 OF 2 TEST HOLE OR TOPSOIL SOILS LOG - PERCOLATION TEST SLOPEf OLOCK TIME NET TIME 2 NET DROP (MPI) 3 F 4 I 5 1029 92-,__ 6 X TEST' 9.33 7 1029 HOLE 6.271" SM/ Brown Silty . 8 GM SAND & 8.851" 2.580" GRAVEL 9 1100 10 11 1130 30MIN 12 2.466" 12.17 13 (E) 14 (T,H 15 1205 30 MIN 1 8.725" BOH 12.22 DATE PERFORMED: 26AUG15 SOILS LOG - PERCOLATION TEST SLOPEf OLOCK TIME NET TIME SITE PLAN NET DROP (MPI) 1 26AUG15 F 6.271" I 2 1029 92-,__ 9.488" X TEST' 9.33 3 1029 HOLE 6.271" 4 1059 30 MIN 8.851" 2.580" 11.63 O 1100 6.271" 6 1130 30MIN 28R 2.466" 12.17 wSFD (E) 6.271" (T,H 8 1205 30 MIN 1 8.725" 1 2454" 12.22 O; 96% � j I too \ j WAS GROUND WATER - SLOPE ENCOUNTERED? N IF YES, AT WHAT - TH1 DEPTH? -0-' x - DEPTH TO WATER AFTER MONITORING? - DRY - DATE: 03SEP15 READING DATE OLOCK TIME NET TIME WATER LEVEL READING NET DROP (MPI) 1 26AUG15 0959 6.271" 2 1029 WMIN 9.488" 3.217" 9.33 3 1029 6.271" 4 1059 30 MIN 8.851" 2.580" 11.63 5 1100 6.271" 6 1130 30MIN 8.736" 2.466" 12.17 7 1135 6.271" 8 1205 30 MIN 1 8.725" 1 2454" 12.22 PERCOLATION RATE 12.2 (miniinch) PERC HOLE DIAMETER 6" TEST RUN BETWEEN 2 FTAND 3 FT HSDG: CLASS"A" COMMENTS: Test hole excavated by A+ HOME SERVICES. Test Hole was presoaked before Perc test. PERFORMED BY: Joseph Lawendowski, I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: 7��7�T7�� �T� �� ������Xxl Date FOR CONSTRUCTION rP•� �BC)XO1012 S4 ANCHORAGE, CK 99510T/1r '��0F'ACgslti 09//15 PHONE (907) 272-8218 FAX (907) 272-8211 - /%*� TH �y*00 Scale NTs / — NO KLEMETSEN LOT 1 P.I.D./ 1s—s21z1-1a DAVID BROWNE /1 Steven . Pannone PERMIT NO. DRAWN JRL PO BOX 210951 r�PF�i'•, CE 8149 •'o- OSP1 51312 ANCHORAGE, AK ZIP 99521 �� s� 'sheet SOILS LOG ,liFYO� 2 OF 2 THE S'T'ATE "ALASKA tsevERNtttz Bra WAi-KEP Steven R. Pannone, P.E. Pannone Engineering Services LLC P.O. Box 100217 Anchorage, Alaska 99510-0217 Department of Environmental Conservation Division of Water Wastewater Discharge Authorization Program 555 Cordova Street Anchorage, AK 99501 Main: (907)269-7519 Fax: (907)334-2415 October 9, 2015 Re: Anchorage-Klemetsen, L 1, 10901 Totem Road- Waiver of Separation Distances from a Class C Well Source -Classification of Class C Public Water System with Arsenic Concern-ADEC Plan Tracking Number 29Zef Dear Mr. Pannone, On October 9, 2015 the Department received an engineering plan submittal requesting waivers of the separation distances to the new septic tank and the new onlot soil absorption system that is to be installed to replace most of the existing wastewater systems. An alternative identified as "Crib E" is to be placed in reserve status and is listed as existing, but meeting the herein waivers requested for the planned onlot soil absorption system. Please properly decommission these older utilities. Waivers were identified and per the engineers requested design are found to be protective of public health. The 1,250 gallon new two compartment septic tank per design will be set no closer than 104 feet from the well head, thus a reduction from the 150 foot requirement. The soil absorption systems both new and existing "Crib E" are located a scaled distance 115.4 feet from the well head, thus a reduction from the 150 feet was reviewed and per the engineers recommendation found to be protective of public health at this distance. A comment on the waivers as they were requested by the engineer, This is an older site with activities not expected to increase in use and with only replacements expected as site changes in conditions. Should it be found that the site conditions endanger public health or are a public health concern, the waivers will be rescinded. The testing for nitrates as nitrogen were accomplished the value of none detected was determined. This approval does not imply the granting of any additional authorizations nor obligate any state, federal or local regulatory body to grant required authorizations. Any person who disagrees with this decision may request an adjudicatory hearing in accordance with 18 AAC 15.195- 18 AAC 15.340 or an informal review by the Division Director in accordance with 18 AAC 15.185. Informal review requests must be delivered to the Division Director, 410 Willoughby Avenue, Suite 303, P.O. Box 111800, Juneau, Alaska 99801, within 15 days of receiving the decision. Guidance information on the informal review process may be found at hilP://www.dee,state,ak.us/commisb/Review- Quidance.htm. Adjudicatory hearings requests must be delivered to the Commissioner of the Department of Environmental Conservation, 410 Willoughby Avenue, Suite 303, P.O. Box 111800, Juneau, Alaska 99801, within 30 days of the decision. If a hearing is not requested within 30 days, the right to appeal is waived. Thank you for your cooperation. if you have any questions please do not hesitate to contact me at 269- 7519. Respectfully, William R. Rieth, P.E. Environmental Engineer Enclosures: As stated MUNICIPALITY OF ANCHORAGE if 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 PHONE LINEW Klement Klenesen 344-2911 1 ❑UPGRADE MAILING ADDRESS 3126. 72nd. Ave. Anchorage, AK. LEGAL DESCRIPTION S1 Gov't. Lot 4 Sec.22 R3d T1271 LOCATION NO. OF BEDROOMS O'Malley/Birch Area _ 3 DISTANCE TO: Well 100, t AbsorpLtion area Dwelling 36 PERMIT NO. ,790600 um H ZQ WF Manufacturer Anchorage Tank Material Steel No. of compartments 2 rn Liq. capacity gallons Inside length Width Liquid depth 1 OOO Gial. IF HOMEMADE: Y DISTANCE TO: Well Dwelling PERMIT NO. 02 F Manufacturer Manufacturer_ Material Liquid capacity in gallons O Well ,/ Foundation r t Nearest lot line r PERMIT NO. w = DISTANCE TO: J LL z No. of lines Length of each line Totallength ;lines ' Trench wwjlith Distance between lines F? W ' 3b inches 4X Top of tile to finish grade Material beneath tile Total effective bso ption area A1� c4 Feet 96 inches S.F. Length Width Depth PERMIT NO. W aF Type of crib Crib diameter Crib depth Total effective absorption area W 6 w Well Building foundation Nearest lot line DISTANCE TO: J Class Depth Driller Distance to lot line PERMIT NO. J W 9 DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER ' PIPE MATERIALS T, Ductile Iron & P.V.C. SOIL TEST RATING - 190 Sq. Ft./BR F i L INSTALLER Schachle Excavating REMARKS q �� •ti OF v xrn . •... s,'f �1 ig�P''�.. 07 I 0 -%) 1 4932! 4 * I .N :.. •' 9 4 NDav aY' J. Harman J W drJ,% NO. 1798E % . ®®®�FESMlO „z APPROVED DATE LEGAL /I `(� s 11/13/79 52 Gov't Lot 4 Sec22 T12'I Raid 72-013 (Rev. 3/78) v PEt'MIT NO. ['•y L.1 " I A_: I & 1.-., 1 T 0-0 F-1 F- A'-$ P-4 c- I- ' t --t F i F DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 'L.' STREET, G.4—ANCHORAGE.- AK '. .aSi=t17:40f -OC APPLICANT CLINT KLNESEN 712r'. E. 72ND LOCATION TOTEM RD LEGAL GOVT LOT 4 S,EC:22 LOT ;IEE 21-000 SQUARE FEET TYPE OF SOIL_ ABSOR.BTION SYSTEM IS: TRENCH MAXIMUM NUMBER: OF BEDRCiOMS, = - SOIL. RATING ('Sl-'! FT/BR)=- THE REC!UIRED SIZE OF' THE SOIL ABS'ORP'TION SYSTEM IS: >,_ . � !_�° T i—I = � -�- L_ E t -J A_� T 1—i == �� �_? t—� �^ e=e °•°= E== d_ b=-. E- �° �- t --t =__ � w_ A THE LENGTH DIMENSION I=; THE LEN13TH (IN FEET) OF THE TRENCH OR DRAINFIEL...D. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION IN FEET:_. THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL F'IF'E AND THE BOTTOM OF THE E`.CAVATION IN FEET). Fm' E A.A kJ I F<' E. C} "= E F° T I 1_'. T""F--. I ` E = ::L A -,'A 4_'A A:_'A !__ L.- Co 1°44 —, PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING T'HE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE. NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. -- TWi A I. F t=•F'EA= T I Co) t =- i=p 'E F -"E A"ra__e I- t*' = . — IC-- - -- -- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPAR'T'MENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN Fi WELL AtD ANY AN—;SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL: � �R 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL.. OTHER: REQUIREMENTS MAY APPLY. S'P'ECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE: AVAILABLE TO INSURE PROPER INSTALLATION. F"EF'M I T E: -:F" I F-' E: E-aE:C:= FEE r-1E:EF' :2�:I_ I CERTIFY THAT 1: I HM FAMILIAR: WITH THE REQUIREMENTS FOR ON—SITE =EWERS FORTH BY THE MUNICIPALITY OF ANCHORAGE. : I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODE=. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE RESIDENCE IS ..ENOC+ELE'D TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED: --- ------------------ APPLICK C:LIt-dT KLNES•Etd -- ----'---- ISSUED E'v ------ `—----------' -- —._DA.TE—��Of—��--- f- °—Z=N "_=ff AND WELLS HS SET ENLARGEMENT IF THE Il44101VITA ] • 0 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6.650, Anchorage, Alaska 99502 276-2221 SOILS LOG — PERCOLATION TEST lint Ylnesen ❑ SOILS LOG m PERCOLATION TEST DATE PERFORMED: 9/26/79 LEGAL DESCRIPTION:- S; Govt. Lot 4 Sec.22 T12"1 R34 DEPTH SLOPE SITE PLAN (FEET) Organic Overburden 1 WAS Date Gross USCS "Pt" 2 ---- ------------------------ Time Time Water Inorganic Silt 3 92 0 USCS "ML" 4 -------------------------------- ---- 8:30A -------------------------- 5- 56 30 min 62 in 22 in. 6- r. Silty Sand 7 2 z in. 9:30A 12 hr. 30 112 in. USCS "SM" 8- 2 r. 9- 910 — 1n. 0:30A 10 - 30 9 in. 2 in. WAS GROUND WATER 11 ENCOUNTERED? 110 12 IF YES, AT WHAT 13 DEPTH? 14 15 16 Refilled Hole --- 17 (After Reading) 18 --------------------- BOH 19 S- r-- ---I-- L' Oi P I—i -._. --#-----+T E 1� t Reading Date Gross Net Depth to Net Time Time Water Drop 8:OOA 92 0 0 4 in. 0 8:30A 30 min. 30 min 62 in 22 in. 9;p r. in. 2 z in. 9:30A 12 hr. 30 112 in. 22 in. 0:00 2 r. 2-- = — 1n. 0:30A 22 hr. 30 9 in. 2 in. 1:OOA " 3 hr. 30 1 in. 2 in. 1:30A 32 hr. 30 13 in. 2 in. 12OUIT 44 hr. 30 15 in. 2 in. 20 PERCOLATION RATE TEST RUN BETWEEN "Table 1" page 6 "Manual of Se tic% 9 ce'*-* PERFORMED BY: B. Schachle CERTIFIED BY �`�j..n.:� 61%No. 119&E � •��� 72-008(7/76) !Fa'•a__ B. Lor t KLSMi: NTSeN 5/a SEWraL SY$TF?-1 ASBott.i- Vi/ELL NouSa 0 1 I � CS,Ai" C. C> I y d C.R. r r s II J� N -'49TH*;4tq`s��t '� 1d E f *.. 4o. 2225-E ..p NNE 25, 1971 NOV iHjlge3 TSPveXtAND F G Tfine APPLIC&T FILLS OUT UPPER HA ONLY Pr� ntt Owner Klement N.`and :noille S. Kleastsen Phone 16tai flog Address .. a rss . SRA Box 1708-B Anchorage, AK Zip code 99507 349-8442 Buyer Date Address -. - Zip Code ---, Lending Institution - _ - Phone Address Zip Code Inspect'rI'iL\\)J Realty Co. & Agent Phone Address Zip Cotle. - Legal Description:- Klemetsen Subdivision, Lot #1 Streali on mailbox. House Color, y CCPT. OF HEALTH P� Road (off O`Malley) beige, white trim and shatters - 10901 Totem Street Location. - _ Type of Residence IX Single Family one _ ❑ Multiple Family No. of Bedrooms ❑ Other - Water Supply - - - B Individual - ATTACH WELL LOG. A well log is required for all wells drilled since June 1875. ❑ Community For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility ( ) DISAPPROVED 115 feet dee it drilled 1966. Sewer Disposal- AF Individual '. 797071 - Year Individual Installed: ❑ Public Utility _ When Connected to Public Utility: ❑ Holding Tank - - - - NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.' Tfine Time - .Time Time Date - Date Date Date Inspector Inspector Inspector Inspect'rI'iL\\)J -- \\__�_ Field Notes: y CCPT. OF HEALTH P� l�(/ - {ryVIRON"r1-NIAL PROTECTIQj_�, /(/-�'�2,'-'r - _ -2 v 119- - OCT C RECEIVED; (�) .APPROVED BEDROOMS - - - 'CONDITIONS OF APPROVAL ( ) DISAPPROVED - ( ) CONDITIONAL APPROVAL - DATE — — BY: Soils: Rating Date Sewer Installed Well To Absorption Area 1641 Well Log Received Septic Tank Size ij ID a.. Well to Tank - / 04) r -�- 724M rNs ) .. 1 A I , :A .> 203 40 ° ° EM 80"M iIAM Po o AN HORAGE,VALASKA1T99501 CONSULTING ENGINEER TELEPHONE: (907) 279-3916 Klement N. Klementsen SRA Box 1708-B Anchorage, Alaska 99507 LEGAL: T.00ATTON OWNER: WATER SYSTEM SEPTIC SYSTEM DATE OF TEST TEST PROCEDURE TEST RESULT: OF At w o. 2225-E JUNE 25, 1971 SEPTIC SYSTEM ADEQUACY TEST Lot 1, Klementsen Subdivision 10901 Totem Drive K.N.Klementsen On Site Well NO MUNICIPAL RECORDS From Owners Statement. November 14, 1983 p/°UNICIPAl1YY OF-gN1CHORAGE ENVIRO ?,�; �T FL FROSECTIODI lb\�� 1 ;aU:S. RECE�v �D Tank Espinosa Concrete 1000 gal + Verified by pumping. Absorption System. Trench 45 feet long Absorption Area Unknown Soil Rating Unknown Installation Date 1977 November 10,1983 System was inspected on November 9, 1983. Tank was 7 feet deep with 45 inches of liquid. Stand pipe no. 1 was 8 feet deep with 16 inches of liquid. Stand pipe no. 2 was 6 feet deep, with 5 inches of liquid. Tank was pumped with approximately 1000 gal. removed. On November 10, water was added to the system via stand pipe no. 1 at a steady rate of 5 gal per min. 350 gallons was added to the system causing the liquid level in standpipe no. 1 to raise to 20g inches. in the next 4' hour the system absorbed 115 gallons extended to more than 600 gal for a 24 hour period. This system meets the Municipal Requirements ASE 8V • Municipality of Anchorage 1;kNi On -Site Water and Wastewater Program ZM (907) 343-7904 Certificate of'On-Site ,Systems Approval / Parcel I.D. 015-521-14 Expiration Date: 1. GENERAL INFORMATION Complete legal description KlemetSen, Lot 1'. Location (site address) .10901 Totem Rd. Current Property owner(s) Robert & Pamela Renkert Day phone Mailing address 4620 Mars Dr. Anchorage, AK 99507 Real Estate Agent; Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. "TYPE OF WATER SUPPLY: Individual Well Individual Water Storage CommunityClass 'C' Well Public Water System WaiverNariance r 4 TYPE OF WASTEWATER DISPOSAL: ❑ Individual ID ❑ Holding Tank ❑ Q Community ❑ ❑ - Public Sewer ❑ Received by: Date: COSA to be released to the engineer, unlessotherwiserequested by the. engineer. COSA Fee $ A (or � Waiver Fee .$ Date of Payment / Date of Payment Receipt Number U� ��l Receipt Number COSA # ©SC i51 b tk Waiver # 5. STATEMENT OF INSPF,.CWN.SN. ENGINEER As certified by my sea] 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 numberof bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the .Municipality of Anchoragefiles 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 waterpsage of the family being served by the system. These conditions are outside the control of the evaluator of this system. Allsystemseventually 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 weestimateremaininglife of thesystem. The content. of this report is for the sole benefit ofthe 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 11/6/2015 6. DSD SIGNATURE / System #1 Approved for bedrooms 51 $even it. Pbnnone c� CE -8149 System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: By: b _i� 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 Septic System Advisory Well Flow Advisory COSAbluesheet S-..., Nitrate Advisory Arsenic Advisory. Other 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.Oblecklist Legal Description: Klemetsen, Lot 1 Parcel ID: 015-521 -14 A. WELL DATTA, eJ Well types""�' If A�/B, or C provide PWSID # Class 4C, Well tog (Y/N) Date completed Sanitary seal (Y/N) _ Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level Well production ft. .. WATER SAMPLE RESULTS: Coliform ,2 -colonies/100 mL Nitrate IUD mg/L Arsenic ///. 4 ug/L Date of sample: 7 O LOf 5 r!/z� l aolS B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1,250 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Depression over tank(Y/N) Date of pumping NeW Pumper 'N/A Collected by: PSS Date installed 10/14/201-5 Cleanouts (YIN) Y N High water alarm (Y/N) N C. ABSORPTION FIELD DATA 10/14/20150.8 z GPD/SF Shallow Trench Date installed :, Soil rating (g.p.d./ft or ft?/bdrm)System type 4ngth 38 (X'S2) ft` Width 5 ft. Gravel below pipe 4 ft. Total depth 8.9 (t. Eff. absorption area 760 t Monitoring tube Y Depression over field- N' Date of adequacy test N/eW Results (Pass/Fail) PASS For4 bedrooms Fluid depth in absorption field before test New in. ;Water added New gal. New depth New in. Elapsed Time: New . min. Final fluid depth New in. _ Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) No 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 111 .8On adjacent lots 100+ Absorption field on lot 123.9 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 5+ 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: Pr4l,rty line 7 Building foundation 10+ Water main 0+ Water Service line 10+ Surface water 100+ Driveway, parkingNehicle.storage 10+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS *ADEC waiver on file: **See attached waivers USy Is f t� G. ENGINEER'S CERTIFICATION a,`ff Atm. I certify that I have determined through field inspections and review ,of Municipal records that the above- systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone Date 11/5/2015 COSA canary sheet_2-6-15.doc rJ N .q. 00 ti co m d N O J W Z z � co 00 w co Cl) M obZtr8 v o m el c 3 Q J � O dLO� N f¢(7 >, ❑ m O _ II U F rn `�mm,Lm,ca`i w 'Y� L II cn �� m g� 99'66 EL 69M£O.06 w mo m = » ° o -OycEn%m U 3 W o m Q m 000.= O ❑ c to ocLi 2�2a `o WW O as Ht (mp' � � P HV LLW O m'a Da acico3umi m z mmm -v IIEcc2m rn N �000c wo 2`cZ �.m.i Municipality of Anchorage ws Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Arsenic Advisory Certificate of On -Site Systems Approval # OSC 151618 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 1 of Klemetsen Subdivision. This inspection revealed an arsenic concentration of 11.9 micrograms per liter (ug/L) for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/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. Information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.or /g onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval.