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HomeMy WebLinkAboutHERITAGE PARK BLK 1 LT 2H eritage Park Block 1 Lot 2 #050-211-30 Permit Number: OSP211006 Municipality of Anchorage On -Site Water and Wastewater Section o (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT PID Number: 050-211-30 Page I of 2 Dwelling: N-1 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New K Upgrade Name Lowell and Danela Head ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 10687 Tradition Avenue ❑ Other Phone Number of Bedrooms Soil RatingTotal depth from original grade 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot Heritage Park 1 2 Ft. Ft. Fill added above original grade Gravel length Township Range Section Ft. Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES Ft. Ft. To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well 100'+ 25'+ TANK 0 Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1000 Gal. Surface Water 100'+ Material Number of compartments Lot Line 5'+ NA HDPE 2 Foundation 5.7 LIFT STATION Manufacturer Capacity Remarks Tank outside the soil bearing prism of Gal. the foundation Alarm location Electrical installed by Installer PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield JR'S Septic Drainfield Co/MT3034 Inspector Pannone Engineering BENCH MARK (Assumed elevation) 100 ft Inspection im 2/23/2021 Location and description es: 2nd 3 d 41„ Bottom of Trim -Nearest Corner of House ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date �,�� OF A / % � o- 9 -. 4 H Steven F Pannone CE Septic Syste AID Date 814-9 Note: this approval does not include well permit requirements. (Rav ns/m/i R\ I I II —BM: 100 I I p 6.2 1000g7INLET SEPTIC TAN OUTLET INV: 91.57 INV: 91.7 SECTION DECK PILE EXTENDS SCALE: 1 „=1 0' / BELOW BOTTOM OF TANK I 1 DRAIN FIELD (E) 7 3BR A HOUSE T1 (E) DCO NOTES: RECORD DRAWING DRAWN DRM SITE PLAN W WATER LINE / WELL RADIUS SS NEW SEPTIC ABBREVIATIONS TH TEST HOLE (P) 0 Now (E) ®I NOTES: RECORD DRAWING DRAWN DRM SITE PLAN T2---' 15.7 � FCO • �r,�7Ty o� e�SFM JE FNr \� 1000g SEPTIC TANK DECOMMISSIONED PER CODE AND INSTALLED NEW 1000g SEPTIC TANK --- -\ WITH DOUBLE CLEAN OUT PANNONE ENG SVC LLC(C.1. 1088) P.O. BOX 1807 PAUJER, AK 9645 PHONE (907) 745-8200 FAX (907) 745-8201 HERITAGE PARK, BLOCK 1, LOT 2 LOWELL AND DANELA HEAD 10687 TRADITION AVENUE EAGLE RIVER, AK ,`P,��"OF• A�ys���� Steven R. Pannone CE -8149 3 REVISIONS 03/02/2021 CALE 1' = 50' I.D. NO 050-211-30 ERMIT NO. OSP211006 HEFT 2 OF 2 W WATER LINE / WELL RADIUS SS NEW SEPTIC ABBREVIATIONS TH TEST HOLE (P) PROPOSED (E) EXISTING CO CLEAN OUT NO. FC FOUNDATION CLEANOUT FS FLOW SPLITTER MT MONITOR TUBE NO. TYP TYPICAL R.I. RIGID INSULATION T2---' 15.7 � FCO • �r,�7Ty o� e�SFM JE FNr \� 1000g SEPTIC TANK DECOMMISSIONED PER CODE AND INSTALLED NEW 1000g SEPTIC TANK --- -\ WITH DOUBLE CLEAN OUT PANNONE ENG SVC LLC(C.1. 1088) P.O. BOX 1807 PAUJER, AK 9645 PHONE (907) 745-8200 FAX (907) 745-8201 HERITAGE PARK, BLOCK 1, LOT 2 LOWELL AND DANELA HEAD 10687 TRADITION AVENUE EAGLE RIVER, AK ,`P,��"OF• A�ys���� Steven R. Pannone CE -8149 3 REVISIONS 03/02/2021 CALE 1' = 50' I.D. NO 050-211-30 ERMIT NO. OSP211006 HEFT 2 OF 2 Pannone Engineering ServiceS LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panenaak.com 2 March 2021 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road P 0 Box 196650 Anchorage, Alaska 99519-6650 Subject: Heritage Park, Block 1, Lot 2 Lot Line Waiver Request Ladies and Gentlemen: We request a separation distance waiver for an existing absorption field to the lot line to five feet (5.0'), as measured in the most recent as -built. This is an existing drain field which was installed in 1984. The field has been in operation since 1983. 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 907.745.8200. Sincerely, o0®®ceo9®p0 ® �0P-\E OF ql ,eao 0 a °• 4 b. .s Steven R. Pannone ?C ,41 g Steven R. Pannone, P.E. Owner/Civil Engineer iViailing: P.J. Box 1807, Palmer, AIC 90,645 Telephone: (907) 745-8200 FAX: (907) 745-8201 ttClt( Municipality ®f Anchorage P.O. Box 196650 ® 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 © Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program x x x x VARIANCE/WAIVER REVIEW x x x x Waiver#: OSV211013 PID#: 050-211-30 COSA OSC211079 Permit#:OSP211006 Legal Description: Heritage Park B 1 Lot 2 Engineer: PES Applicant: Your request for a waiver of the required 10'feet horizontal separation from the Absorption Field to the lot line has been approved. The approved separation distance is 5' This waiver approval applies to the Existing Error! Reference source not found. only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department ❑The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. ❑ Adjacent properties are not affected by this waiver. ............................................... ■ ............................. ■ 1 Waiver is Granted: X Waiver is not Granted: Date: App �) - Name of Reviewer **** VARIAN C E/WAIVER REVIEW **** 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: OSP211006 Work Type: SepticTank Upgrade Tax Code Number: 05021130000 Site Legal Address: HERITAGE PARK BLK 1 LT 2 G:0055 Site Mailing Address: 10687 TRADITION AVE, Eagle River Owner: HEAD LOWELL J & DANELA V Design Engineer: PANNONE ENGINEERING SERVICES This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: �1„cnr 0 a DeI)artment 1 /2 512 02 1 1/25/2022 20000 ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well O 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 Received By: Date: / h `� Issued By: r Date: I Q L202 3 11 UNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 050-211-30 Property owner(s) Lowell & Danela Head Day phone Mailing address 10687 Tradition Avenue, Eagle River, AK 99517 Site address same Legal description (Sub'd., Block & Lot) Heritage Park, Block 1, Lot 2 Legal description (Township, Range & Section) Lot Size 20,000 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑X (w/wo AD U) Septic Tank [AUpgrade ❑X (D) ❑ Holding Tank ❑ Renewal EJDuplex Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I.further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: $225 Date of Payment: _ f M o` Receipt Number: 09 Permit No. OSP211006 Permit App_ :-'.,:c Waiver Fees: Date of Payment: Receipt Number: Waiver No. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211006, Rebecca Carroll, 01/25/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211006, Rebecca Carroll, 01/25/21 MUNICIPALITY OF 4NCHORAGE 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 NAMEYY -> ' -on OF �-Ur-' PHONE 7W --I0 EW ❑UPGRADE e. .1 12r 08` MAILINGAtDDDRESS LEGAL DESCRIPTION ` (� .cad' Y� I < { V V^ i�{L' Pack LOCATION r Wt Ave- "��.ce Evei­ NO. OF BEDROOMS I� Well Ab orption�rea Dwelling y PERMIT 0. - Uy DISTANCE TO: C _®- 76 PZ Manufacturer Material S � No. of compartments L wF rn Liq.,ca acity in gallons I IF HOMEMADE: Inside length Width Liquid depth 6 Y DISTANCE TO: Well Dwelling PERMIT NO. jUZ SZ F Manufacturer Material Liquid capacity in gallons DISTANCE TO:N Well Foundation. Nearest otline PERMI NO. 7 Cs!_ �7 .J of lines Length of ea h line Total I n th of lines Trench width Distan e b tween lines inchesPcc 4Z"No. finish Material beneath the effective bsor ti op of ti to grade —y/�Total n area LI.ength ( `. inches Width Depth PERMIT NO. aF- Type of crib Crib diameter Crib depth Total effective absorption area wa LU rn Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO. J w � DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER I r PIPE MATERIALS per . 6) SOIL TEST RATING INSTALLER C Excay. 'n( REMARKS t� OO eCO�Vi � II �Y 9o9e 99o4f Oc9_o s°.;+� 1006 e90000 96009 OC 44449 ie 44 e e0Y0 JAY eROWNFIELD ° F t!.5-EMUNICIPALITY O �Q��r °°°e tew GE •o°° 'O� `3 DEPT. OF ` ,LTH ROT c: torofe ENVIRON)ALNTA TOR WIN915. APPROVED DATM RZ Pee C M I V ED \72-013 (Rev. 3/78) T' o,n����_Lr" ff _L»__rl k_9 I— " r-4 1, 9-3 L—_ DEPARTMENT HEALTH AND ENYI THL` 1]TECTION . 825 'L' STREET/ ANCHORAGE, HK. 99501 264-4720 PERMIT NO. ( 8]0278 ) APPLICANT DEYCON ENT. INC. 5411 QLD SEWHRD HWY. 561-1082 LOCATION LEGAL LOT 2 BLK 1 HERITAGE PARK LOT SIZE 99999 SQUARE FEET / TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS SOIL RATING (SQ FT,,'BR)= 105� THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: �C:51 1 ;2-7 ��F::u-T"� tF. THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF H 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 PIPE AND THE BOTTOM OF THE EXCAVATION (IW FEET). ��Q U I F-.� E= C-- ����I I::-- —F F:� " K =—. I = F= �� �0 C -i RD 0 F=� I L_ 10 P-4� PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE ' INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. —r &4 CH -2- 1 t-4:E..F=E= AZ� —r I CH "!H���� �������� BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY ON—SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET AND TO H COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. ���rl :1 —F F—� I FZ F=":E; ����I el FE. F—_ FR �j , ��EEO :E� I CERTIFY THAT ' 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]: I UNDERSTAND THAT THE ON—SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE 6 REMODELED TO INCLUDE MORE THAN ] BEDROOMS. SI ISSUED BT —�_ V4.0 yI I PA SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (-I PERCOLATION iI. •� TFST \\ •, /, 825 L. Street, Anchorage, Alaska 99501 264-4720 j SOILS LOG — PERCOLATION TEST PERFORMED FOR: -*' eU`--�Y1 DATE PERFORMED: I ' L F51- —) LEGAL DESCRIPTION: Lot- 2 -BI k I H e r; f( e- Firk SLOPE SITE PLAN DEPTH (FEET) ave yr bvrej e rl z G V1 G -p G W WAS GROUND WATER ^ S ENCOUNTERED? ` 0 L O P E IF YES, AT WHAT DEPTH? FKADITION AVE Reading Date Gross Time Net Time Depth to Water Net Drop I PERCOLATION RATE TEST RUN BETWEEN PERFORMEDBY: �ROb rowsF(�I� CERTIFIED 72-008 (6/79) (minutes/inch) FT AND FT Time APPLI`' fNT FILLS OUT UPPER HA" " ONLY Property owner Devcon Enterprises, Inc. Phone 5411 Old Seward Highway Mailing Address Zip Code 99509 561-1082 Anebarage, Alaska Date Buyer James C. & A. Joy Bardsley Inspector NHN Tradition Avenue Address Zip Code 99577 Lending Institution First National Bank of Anchorage Phone 5305 Fast Northern Lights Boulevard Address -" Zip Code QQr04 Anclhorage, Alaska 276-6300 Realty Co. & AgentPhone Century 21 Heritage Homes &Investments/Tom &Carolyn Szymanski L 11 4 207 E. Northern Lights Bourevard" 6- L��c t � J AddressAnctiorage, Zip Code 1333 Legal Description Lot 2 Block. 1 Heritage Park Street Location WIN Tradition Avenue Eagle River, Alaska Type of Residence e o Single Family ❑ Multiple Family No. of Bedrooms ❑ Other ( ) CONDITIONAL AaPPRO�L' Water Supply ❑ Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. EX Community For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility BY: —C'0�rj Sewer Disposal Individual Year Individual Installed: 19$3 Public Utility When Connected to Public Utility: ❑ Holding Tank .— � 3 Well to Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Insp'ectorr MUNICIPALITY OF ANCHORAGE Field Notes: DEPT. 6- L��c t � J �� ��i /f �J ��� ENVIROi ;,(_iVT.4L Pk3--C ;ON RECEIVED ( ) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL AaPPRO�L' 1 Z Z V DATE BY: —C'0�rj Soils Rating Date Sewer Installed Well To Absorption Area O G Nil I Vl Well Log Received Septic Tank Size � .— � 3 Well to Tank 72023 (3182) �9 N. N0006I32°888.021 V 6n Rec. - N 0006'09" W 887.801 ,.; ( See Note I ) 00' 210.00 m 129.47' 195.00' 160.00 / 3 ') / S o m ti io ti p Q4-0 0 Ln p� 0) Nrn 00, N y pf�i A N �^ V N2/° 01 ' 18 Z 3 c"v1 0()" w.� 1N 0 3 0 0 2 Cl) ° o° N0000 s'F o o 00 00 3g �4 F Cb 00 0 / �� o 'a N O O ° N gQ� c co O /0 LO to N O 20 38 0S O®p 20p 8 OS 00 m O COQ F , 00 0 00 •p� °0 , e o p S o 25 p o /V 0) O oo,�° p/ N 2/°38'0 O 0$ NOp°OS"F'ap00S O co HN2/°N2/0 3 � I 0 2Q0 0 0 S,F o ��o NQp p0, O t t O oN O to g Nj o N oo / N 2/ ° oo ti s� yv 2/°3 0 S 0_ 38 O � " C `� 0 2°00pS'F R o o 20°OOS"F o a �' O m N 3 Cil fZc /`D ° N/ tio\/ 2 0 F ti� A') P n Q O o D o +o �� N Q' �� V �.0; 'It • �ubza au -4 uo oT auk �Zw CO '� o- uoz-4zp-2as caoTTo3 N2/° 00 02 oTgTPPa,y 04 gsaJDTTTH ?a w 22085 ° o dJ N 070 ao 31 X59"r- 0`b. cn n� 246.7p' E 291.70' Oo Qi rn m r 'JS Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section - Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 050-211-30 1. GENERAL INFORMATION Complete legal description Heritage Park 131 L2 Location (site address) 10687 Tradition Ave Current property owner(s) Hagmeier Homes Mailing address Real estate agent 2. TYPE OF DWELLING: F-1 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: Private Well Private Septic Water Storage ❑ Community Well ❑ Public Water System ❑ Expiration Date: _j ZZ- -2-023 Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Private Septic F-71 Holding Tank ❑ Community ❑ Public Sewer ❑ Waiver request for: S� �t'i-, �� n &S M rr c �; ��� cel- �( V\ _G� Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ $880 Waiver Fee $ $360 Date of Payment Receipt Number Date of Payment Receipt Number COSA # OSC211079 Waiver # OSV211013 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 theMunicipality of Anchorage files and from my investigation and i inspection, the on-site water supply and/or wastewater disposal system s (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. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. 6. DSD SIGNATURE System #1 Approved for J bedrooms System #2 Approved for bedrooms Disapproved Date 0..TH s'tevenT P. Pannone L �, . CE 8149 Conditional approval for bedrooms, with the following stipulations: P4- 1TY OF'' 6- 'fl, o 'A ATER AND m �mr FROG ATER Original Certificate Date: 3" > t 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 Septic System Advisory Well Flow Advisory COSA Checklist blue sheet X Nitrate Advisory Arsenic Advisory Other 6 t511001111T.12014"! � 4 . ; ' to i I . `� [�, Legal Description: Heritage Park 131 L2 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Comments AWWU water B. TANK DATA Age of tank(s) new years Tank type/material 5l­'.HD'E Measured operating fluid level in septic tank new X Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA Deep Trench Which system tested (date installed) f"� 2" L f$�cJ3 ❑® ALL standpipes present per record drawing Total measured depth from grade 11 ft (max) Measured depth to pipe invert from grade 5 ft (min) ❑ N/A — pressurized field ❑-M Monitor tubes go to bottom of effective. If not, state depth into effective FM Code -required soil cover over field OR System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced 2000 gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 050-211-30 Structure served by this system 1 Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ Nc ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Date of Sample C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 1/22/21 Results ❑✓ Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 450 gal New depth 0 in Elapsed time 150 min Final fluid depth 0 in Absorption rate '450 gpd Any rejuvenation treatment (past 12 months) no If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' [J Yes if No 5.7 Community Sewer Manhole/Cleanout > 100' Yes if No ft 7 Yes if No fi Neighboring Tank > 100' ❑ Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No fi Absorption Field on Lot > 100' ❑ Yes if No ft Holding Tank > 100' ❑ Yes if No ft Neighboring Absorption Fields > 100' Water Main > 10' Animal Containment > 50' ❑ Yes if No ft ❑ Yes if No ft Water Service Line > 10' Yes if No ft Manure/Animal Excreta Storage > 100' comment below Community Sewer Main > 75' ❑ Yes if No ft ❑ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' [J Yes if No 5.7 ft Surface Water > 100' Q✓ Yes if No ft Property Line > 5'✓1 if No Yes if No ft Wells on Adjacent Lots: if No Absorption Field > 5' 0 Yes if No ft Private Wells > 100' Yes' if No ft Water Main > 10' Yes if No ft Community Wells > 200' Q Yes if No ft Water Service Line > 10' Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ✓Z Yes if No ft If absorption field is under driveway comment below Property Line > 10' %Yes if No;5 ft Wells on Adjacent Lots: Water Main > 10' Q Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' F/ Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' ✓Q Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION / certify that / 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. COSA Checklist yellow sheet OF AL "A :. 4o TH Steven P. Pannone 8149 , ty� N°of ti/ \\Q G'- �S'�-_rrCi C ASBUILT SEt•IARD & ASSOCIATES LAND SURVEYING 694-082 1 HEREBY CERTIFY THAT 1 HAVE SURVEYED THE SCALE-� ,. ,Q"a%� FOLLOWING DESCRIBED PROPERTY DATE.. AND THAT NO I+NCROdCHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THEGLH �r � OWNER TO DETERMINE THE E'XiSTENCE OF ANY GRID � f,••" � f ;�'�: * � EASEMENT$, COVENANTS, OR RESTRICTIONS-�'i�'Sr �•y �� �,, ,;�,� ��!' WHICH DO NOT APPEAR ON THE RECORDED SUBDI- Klerk Duan. Seward � VISION PLAT. UNDER NO CIRCUMSTANCE'S SHOULD FB' ��j ANY DATA HEREON BE USED FOR CONSTRUCTION #'° ��� %f c; OF FENCE LINES, OR FOR ESTABLISHING BOUND- FDr?ASIN• ARY LINES. N. � �,. 0 Parcel I.D. 050-211-30 #GE 8G Municipality of Anchorage a On -Site Water and Wastewater Program (907)343-7904 < ea ctr Certificate of On -Site Systems Approval 1. GENERAL INFORMATION ��11 1 Expiration Date: (cif Complete legal description Heritage Park, Block 1, Lot 2 Location (site address) 10687 Tradition Ave. Current Property owner(s) Robert Gardner & Kathleen O'Docharty Day phone Mailing address Real Estate Agent 10687 Tradition Ave. Eagle River, AK 99577 2. TYPE OF DWELLING:. Fx� Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System Fx I Public Sewer ❑ WaiverNariance request COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 52-62-0 Date of Payment 4�1= 5/15 Receipt Number 0433-7G COSA# GSC 15 (N ::)G Waiver Fee $ Date of Payment Receipt Number 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 Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE System #1 Approved for 3 bedrooms 0 System #2 Approved for bedrooms Disapproved Date 10/23/2014 Conditional approval for bedrooms, with the following stipulations: Original Certificate Date: J/d 2- / The M t5olity of Anchorage Development Services Division (DSO) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in uara ra ho 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 engineers work. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet If more than 1 septic system is on the lot: COSA Checklist # I of I Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: Heritage Park, Block 1, Lot 2 A. WELL DATA Parcel ID: 050-211-30 Well type Public If A, B, or C provide PWSID # AWWU Well Log (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 ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic ug/L Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 6/30/1983 Tank size 1,000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (YIN) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 6/24/2014 Pumper JR's Pumping C. ABSORPTION FIELD DATA Date installed 6/30/1983 Soil rating (g.p.d./ft2 or ftZ/bdrm) 105 SF/BR System type Deep Trench Length 28 ft. Width 5 ft. Gravel below pipe 6 ft. 33' Total depth 10 ft. Eff. absorption a ea ftz Monitoring tube Y Depression over field N Date of adequacy test 7/%/2014 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 457 gal. New depth 2 in. Elapsed Time: 75 min. Final fluid depth 2 in. Absorption rate >= 450+ g,p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. LIFT STATION Date installed _ "Pump on" level at Datum Size in gallons _ in. "Pump off' level at Cycles tested _ E. SEPARATION DISTANCES WELL ON LOT TO: Manhole/Access (Y/N) in. High water alarm level at Meets alarm & circuit requirements? Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer /septic service line Holding tank Animal containment areas Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Water main 10+ Water service line 10+ Wells on adjacent lots 200+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water Service line 10+ Surface water 100+ Curtain drain 50+ Wells on adjacent lots 200+ F. COMMENTS Absorption field 5+ Surface water 100+ Water main 10+ Driveway, parking/vehicle storage 110+ ��11 II I I, )) [� /� /hl S+rci\�S Iq� ���.-z. fie,,,,.-. `t�•e //�S-l�l�,�.� ��/ CP/i/V��/fl etc. ( 6 w to int,) cT) 4-e S o�y Ls -e /O C e, f Gw % r� $ -,Lc i Gee / �w p G. ENGINEER'S CERTIFICATION r+. OF A t certify that t have determined through field inspections and ,W��p. :Q review of Municipal records that the above systems are in * . '49 . conformance with MOA COSA guidelines in effect on this date. . • • • • • • • • . • 's Printed N Engineerame t�� Pa�Or Seven onnan . CE -8149 Date 10/23/2014Ql'%' .....• COSA brown sheet 10-10-12.doc in. N ASBUILT a^eP o c v P 'r•S`s� ra '�.Cli ad 9L� I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE - FOLLOWING DESCRIBED PROPERTY: to-_,' i DATE AND THAT NO ENCROACHMENTS EXIST EXCEPT AS /y INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY GRID- iASEMENTS, COVENANTS, OR RESTRICTIONS 1-'w-ror rVHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD F$ ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES,"OR FOR ESTABLISHING BOUND- DRAWN: ARY LINES. d�1 Duane Med Seward d w a 7&�