HomeMy WebLinkAboutBRUIN PARK BLK 4 LT 2Bruin Park
Block 4
Lot 2
#016-102-07
Municipality of Anchorage
Development Services Department i~.~ I~'
~uilding Safely D~$io~ ~.
OmSde Water and Wastewater Program, 4700 Bragaw SL
P.O. Box 196650 Andx~age. AK 99§19-6650 Page of
www d.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM ANDIOR WELL INSPECTION REPORT
Permit Number: ,.S'I.~O~O ~1.~.5 PID Number:.,
"'"" C~¢n [,t]G~,/I'~ WastewaterSystem: DNew I~Upgmde
~ ~lO01 ~c~ff pr;~P. ABSORPTION FIELD
LEGAL DESCRIPTION s~,.~ I, 0 c~,~ II ,,.
.6
~-;~ ,. ~// ,,.
Well: I~ New I-} Upgrade c..,~ .,,~ ~-'3
SEPARATION DISTANCES I~ Septic n Holding I-I S.T,E.P. D Other:
Tank Fiekl $lal~o~ Tank ~ Line C. ~ PI
~w~ [00 t- '- ~ ~ LIFT STATION
Development Services Department ApprOval '"
Co..o.a, o..ova, .ate: .;'.. !,
Reviewed and approved by:~r''~ Date: ~Z. I,?~ !Oq
LDT 6A
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W~TAUI'D FO~#OABON
I000 GALLON ~PTIC TANK
~-3 FELT
DEPTH !1 ~
~, P ~ ~ / ... [~"
"1"~ ~ ~ 4 ..
No.
~o ~a~ ~ BRUIN PARK BLOCK 4 ~
~~ uoo~ m~esr omvr
SEPTIC SYSTEI~ ASSUI£T
fl4TE: OCTOBER ~, 2007
SHEEr: 2/$ GRID: 2G33
bRUINpARKb4IZd2.BVG
PERMIT # SV070225 PID # 016-I0£-07
-o o1
I000 gnl Sepf#¢ tonk
..0
Stondard Trench:
P-3' Vide
41' Long
II' Beep
5,5' Sewer rocA
5' Cover
NO SCALE
TEST HOLE
E.G. tier.=97.2"
Monitor
~ Oe~nouts
I ~ 4' COver'
E/ev.=98.§'
Elev.=91.8" ~
Slit Barrier'
Elev. =8$.3'
5.5 £t o£ Septic Rock
Effective
B.O.H. tier.=80.3' NO SCALE
No ~und Wofer Obse~ed
Elev.=gi '
1000 gal septic t~nk
Bench I~ork Ooffom Siding SE House Corne~
Assumed Elevation I00'
SPURKLAND ENGINEERING 'rr BRUIN PARK BLOCK 4 SEPTI,~ SYSTEM
~03 Wl5th Ave H CAEOEN · ANN WEIGHT j j DATE OC[. 4, 2007
, Anchorage Ak 99501 tl~t ~ ~ SHEET, ~ 3 GRID, P633
PERt, tiT f~ SP/070225 PARCEL Iff /016-102-07 OruinPorkB4Z2O$.dwg
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program \ ~r~ ~
4700 South Bragaw Street ~ ~ ~, ~ ~ ~ ~v
P.O. Box 196650, Anchorage, AK 99519-6650 (~ \ ~v \~.)
(907) 343-7904 ' \ \ ,,\~
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT ~¥'
Upgrade
Date Issued: Aug 31, 2007
Expiration Date: Aug 30, 2008
Permit Number: SW070225
Legal Description: BRUIN PARK BLK 4 LT 2
Design Engineer: 0007 SPURKLAND ENGINEERING
Owner Name: CAMDEN & ANN WRIGHT
Owner Address: 11001 FOREST DRIVE
ANCHORAGE, AK 99516-1380
Parcel ID: 016-102-07
Site Address: 011001 FOREST DR
Lot Size: 20000 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
Ail construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify 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.
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site 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.
Property owner(s). Camden & Ann Wright
Mailing address 110Ol Forest Drive, Anchorage, AK
Site address 11001 Forest Drive
.Day phone 561-0137
Zip Code 99516
,Zip Code ~951s
Legal description (Sub'd., Block & Lot) .Bruin Park Bk~k 4 Lot 2
Legal description (Township, Range & Section).
Lot Size r~O ~ 0 0'O Sq. Ft. Number of Bedrooms 3
THIS APPLICATION IS FOR ([~;;~ all that apply): THIS APPLICATION IS AN.'
Absorption Field [] Initial []
Septic Tank [] Upgrade []
Holding Tank [] Renewal []
Priw []
Private Well []
Water Storage []
I certify that the above Information is correct. I further certify that this application Is being made for ~
Single Family Dwelling and Is in accordance with applicable Municipal Codes.
(Signature of'property owner or authorized agent)
Permit/Rush Fees:
Date of Payment:
Receipt Number.
(Rev. 11/05)
Waiver Fees:
Date of Paymew.
~('~ Receipt Number:.
Environmental Consulting and Design
I
SEPTIC SYSTEM DESIGN
Bruin Park Block 4 Lot 2
Munkipallty of Anchorage
Development Services Department
On Site Water and Wastewater Program
4700 Seuth Bragaw Sa, eet
Anchorage, Alaska 99519
August 10, 2007
Subject: Septic Permit
11001 Forest Drive
Ladies and Gentlemen:
I am writing to request a permit for the construction of a new septic system for this property. The proposed system will
serve a 3-bedroom single-family residence. The current septic system was installed in 1963 and is no longer functioning
adequately. An existing well serves the residence.
System: The proposed septic system will consist ofa 1000 gallon septic tank followed by a minimum 375 square feet of
drain field. A deep txench with 6 feet of rock below the distrlbutinn pipe will provide the required absorption area
Soils: A test hole was excavated on July 27, 2007. See the attached soil logs. Ground water was monitored for through
August 8, 2007. Ground water was not obsen~ed. A percolation test was conducted at a depth of 4 feel The percolation
rate is faster than I minute per inch, however, we do not feel that there is a significant potential for ground water
contamination because of the high sand content in the soil. Vertical flow through the soil should cause suspended solids,
bacteria and viruses to be txapped.
Surface Water:. There are no surface waters within I00 feet of either the proposed septic system area.
Topography: Thc topography in the area of the septic system is generally level. To the east ofthe drain field the
ground surface slopes upward at approximately 15 % grade.
The installation of this septic system will not prevent wells and septic systems from being installed on the adjacent
lots. The proposed septic system will not change the general slope of the area. Ponding and/or concena'ation of
surface runoffwill not result from this installation.
I f you have any questions or concerns, please contact me at 279-3916.
Sincerely,
Civil Engineer
203 West 15tl~ Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurldand~gcLnet
Environmental Consulting and Design
I
SEPTIC SYSTEM DESIGN
Bruin Park Block 4 Lot 2
Municipality of Anchorage
Development Services Department
On Site Water and Wastawater Program
4700 South Bragaw Stxeet
Anchorage, Alaska 99519
August 28, 2007
We are submitting an application for the upgrade of.septic system for this lot. The submittal consists oft/wee (3)
drawings showing the present improvements on the lot and the adjoining properties, (sheet I/3), the proposed
improvements ofthe lot, of which only the septic system is subject to this permit application, (sheet 2/3), and a
schematic of the septic system, (sheet 3/3). A Soils log and percolation test of applicable test hole is also anclosed.
The septic system design is based on the following:
No Ground Water to a depth of 17 feet
Use Standard deep trench
Soil Rating: From Test hole 7/27/07.
<1 rain/in = 1.0 gal per sq.fl/day
No. of Bedrooms 3
Required Area per Bedroom: 150/1.0 miS0 sq.fi.
Total area required: 150 x 3 ~450 sqfi
Bottom Rock At { I feet
Top Rock At 5 feet
Rock Depth 6 feet
Total Length 450112 - 37.5 feet
USE 40 FEET
SYSTEM CONFIGURATION
1000 GALLON SEPTIC TANK WI DEEP TRENCH
TOTAL LENGTII 40 FT
TOTAL WIDTtl 2 FT
TOTAL DEPTll I I FT
ROCK DEPTll 6 FT
COVER 5 FT
203 West 15tb Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland~gci.net
LOT
LOT 4
LOT 5
X\
LOT7
50 0 5~ loft 1,~ E~O E~ 200
SCALD 1' = 188 FT.
~PURKIANO ENGINEERING
~o,~ ., ~5TM. AVEmE
~MCN. AK. 99S0~
PERMIT # SVO70XXX
BRUIN PARK B£OCK 4 £OT 2
CAMDEN d ANN IV~IGHT
11001 FOREST DRIVE
PID #
SEPTIC 5¥STEJl DESIGN
DATE: AUGUST 8, 2007
SHEET: I/$ GRID: 2633
TI5NRIV$18LI72D1.DVG
+ ]fell
LDT 6/I
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1~oo C. AII~N ~L'PllC TANg
DL'PDt 11 fl'L7
BRUIN PARK BLOCK 4 LOT 2
C~MOEN & ANN ~gRIGHT
I1001 FOREST DRII~
SPURKLANO ENGINEERING
205 W 15TH. AVENUE
ANCH. AK. g9501
49~h
] SEPTIC SYSTEM DESIGN
DATE: AUGUST 8, 2007
SHEET: 2/5 GRID: 2633
PERMIT # PID #
0
-o oI
Septic tank
Standard Trench,
2' Vide
40' Long
II'Deep
60'Sewer rock
5' Cover
NO SCALE
Silt Borrier
6.0 £t of Septic Rock
EffecfNe
Monitor
f Cleanouf~
/~ 4' Cover
/
NO SCALE
1000 gat septic ~onk
ISPURKLAND ENGINEERING I I
~03 ~/15th Ave
Anchorage Ak 99501
P££~r ~r SWOTOOXX
BRUIN PARK BLOCK 4 LOT
C4t~DEN ~ ANN WRIGHT
tlOOl FORD5? ~
SEPTIC SYSTEH DESIGN
DATE, AUG. I~ 2007
PARCEL I~ ] BrdnPorkB4t2OJ. dwg
Pedormed Foc.
Lega; Oescri~o.:
Municipality of Anchorage
Development Services Department
O~-Site Water and WaMewater Program
47OO South Bragaw SL
P.O. Box 196650 AncO, AK 99519-6650
www ~ a~chora~e ak us
(~07) 343-~04
Soils Log - Percolation Test
,.. M.
T~ip, Ra~, ~:
~e ~n
11-
12-
13-
6,0.~
18-
19-
Reading Date Gnma Time Net T~rne Depth to Water Net Drop
PERCOLATION RATE ~ (m,~a,~e~ce) PERC HOLE D~MEIER ~
COMMENTS
PERFORMED BY: L ~t J'~ .J~'~ ' [~ 6J~-,~"~'" CERTI FY 1'HAT '~IIS TEST, WA~;
PERFORMED IN ACCORDANCE VV1TH ~ STATE AND MUNICIPAL GUIDE'~II~ES IN EFFECT ON THIS DATE. DATE: '"~/2. "~/C~
Environmenfal Consulting and Design
i
Single Family On-site Wastewater Disposal System
Construction and Material Specifications
Subject Prope~'~: Bruin Park Block a, Lot 2
Date: August 10, 2007
General:
2. The owner shall contract with a contractor to perform the work outlined in these
spedficaflons and plans In accordance with the attached HOA permit. Them 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 HOA.
2. The scope of the project Includes the procurement and Installation of a 3-bedroom on*
site wastewater disposal system at the location depicted on the attached site plan
drawings. The scope of the work also includes the Installation of a new 1000 gallon
septic tank, a drainfield compdsod of ! trenches,2-feet wide x 35-feet long, !! feet deep,
with 6 feet of septic rock below the distribution piping. The location of the drain field is
shown on the attached site plan drawings. The total depth of the field will be 1.! feet
below the existing ground surface. All components of the proposed septic system must
be constructed a minimum of 100 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 and a minimum of
two feet of cover is required over the dratn field. [n addition to the required earthen
cover, 2-inch thick, 40 psi, direct bury board foam shall be Installed directly over all
installed piping.
3. Construction shall be In accordance with the approved site plan and design drawings and
any spedal provisions noted on the Hunidpal well and/or septic permit. All materials,
components, workmanship and construction practices shall comply with the Hunidpality
of Anchorage's latest ordinances regarding wells and septic systems, as well as HOA,
Development Services Department, On-site Water and Wastewater Program (DSD)
polides.
4. The contractor is respensible 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 HOA
DSD, On-site Water Wastewater Program. Property owners installing their own systems
must receive advanced approval from HOA 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 Munidpality of Anchorage. Refer to
'Standards and Spedfications for Component Parts and Materials Used In the
203 West 15t~ Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 27%3916
Fax: (866) 354-1597, Lspurkland~gci.net
Environmental Consulting and Design
I
Construction of On-site Wastewater Disposal Systems", Dated December 2000, as
provided by f4OA DSD, On-site Water and Wastewater Program.
Sel~c Tank Znstallation:
:1. A new septic tank, of the size spedfied 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. 'fhe 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 shiffJng of the tank.
4. All standpipes on the tank shall extend a minimum of 12inches above the final grade.
5. 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 drain rock or the soil shall be
suffidentJy compacted to prevent future settlement of the soil.
8. SepUc 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 deanouts shall be Installed per I~IOA 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 them Is not adequate soil cover to resist uplift force. The
contractor shall refer to the engineer for direction regarding this matter.
12. The tank bacld~ll shall be graded suffidently to ensure positive drainage away from the
tank.
13. All homing 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 I~IOA guidelines and the Uniform
Electrical Code. A munidpal electrical permit and Inspections must be obtained where
required by the f.lOA.
:15. The contractor shall verify that the septic tank/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 Uniform
Plumbing Code.
Drainfield Construction:
The drain field shall be excavated to the dimensions outlined in the design drawings. If
any dis~:~epandes are noted, contact the engineer Immediately for clarification.
The drain field shall be Installed parallel to slope contours.
The bottom of the drain field shall be within 2" of level. If the sidewalls or bottom of the
excavation become smeared, they must be raked or scarified prior to the placement of
filter sand or drain rock.
203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland~gci.net
9.
10.
Xnspections:
1.
2,
3.
4,
5.
Environmental Consulting and Design
The drain field must be a minimum of 5 feet from the test hole excavation.
DistdbutJon pipe is to be Installed level with perforations fadng downward, atop a level
bed of drain field rock. Septic rock shall then be placed atop the distribution piping to
provide a minimum of 2' of cover, level across the entire w~th and length of the trench,
above the piping.
A silt barrier must be Installed at between the final drain rock and the naUve soil backfill
The silt barfler shall cover the enUre drain roc~ surface.
Monitor tubes must be 4' In diameter, Installed in the IocatJons depicted on the design
drawings, and extend a minimum of 12' above final grade. ~ portion of the rnenitodng
tube below the septic roc~ must be perforated and the portion above the drain rock shall
Backfill over the final gravel layer must not be less than 2 feet. insulation must be
Installed when the backfill depth is less that 3 feet.
Drain fie~d back fill shall be mounded to ixevent der~Jons from forming due to
subsequent settlernent of backfill material.
The contractor shall verify that the drain field is a minimum of 100 feet from any
residential water well, 150' from any class 'C' well and 200 feet from any community
water we~is. Additional separation distances must also be maintained.
A minimum of two Inspections are required by the Hunidpelity of Anchorage. 'rbese
Inspections must be conducted under the supervision of a Professional Engineer licensed
to practice In the State of Alaska.
3he first inspectJon must be conducted after the excavation of the drain field and before
the placement of any gravel. The septic tank rnay be set In place, but may not be
bac~fil~d.
distribution lines, stand pipes, deanouts, and Insulation, but before the placement of any
backfill.
The c=fl~ shall ixovide a legible copy of all field notes retaUng to system layout and
construc~n to the engineer for the use In preparing the record drawings.
3q~e contractor shell coordinate all Inspections with the Engineer. A minimum of 24 hours
notice IS requlred prlor to the start of construction. [f n~-~=~.ary, a preconstructJon
203 West 15t~ Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurldand~gcLnet
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWEPJWELL SUBMITTAL COMMENT SHEET
To: Spurkland Enqineerin.q
Legal description: Bruin Park, B4 L2
I~;~]Permit I-]C.O.S.A. [-Ilnspectlon Report
The attached paperwork has been reviewed and is being returned for the following reasons:
~'~1. A subsurface disposal field may not be installed in an a~:cepfing soil stratum having a percolation
rate faster than one minute per inch without installing a filtration layer. If the insitu soil has 51%
or greater passing the g4.sieve, then an additional filtration layer is not necessary. Please state
if the soil meets this condition.
~2. The proposed tank is less than 5' from the existing crib. How will the crib be abandoned?
or: 3. The site plan shall have a description of the topography, areas of excessive slope, and extent of
slopes and surface drainage patterns within 100 feet of any part of the system or portion of the
lot intended for use for on-site wastewater disposal. AMC 15.65.030 D. Please provide this
information on the site plan.
o~ 4. The proposed trench location is not parallel to the contours of the slope.
tK 5. Was the original well on lot 1 abandoned per code.
6. When the per.c rate is <1, a filter material is used and the application rate is 1 GPD/SF.
0~7. Is there a class A well within 200' of the septic system? (Well radiuses are not shown on all lots
that could have a possible Class A.)
~ 8. Show the location of the test hole on the site plan.
Name of reviewer: Deb
Date: .8/t5107
Please supply the necessary information and re-submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK
Municipality of Anchorage
Department of Health and Human Services
825 ~L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
Rick Mystrom htr p:/~/nvw.ci.anchorage.ak.us
Mayor
Permit Number:. #SW n/a Date of Issue: n/a
Date Started: 1-11-02 Date Completed: 1-14-02
Legal Description: Bruin Park BIk 4 Lt 2
Property Owner Name & Address: Camdon Wright
11001 Forewst Drive
Anchorage, Alaska 99516
Borehole Data: Depth (ft)
Soil Type, Thickness & Water Strata From To
stick-up 0 2
Original well depth-35' 35
silt 35 43
gravelly silt 43 67
silty gravel 67 88
water sand & gravel 88 95
silt g7 103
Parcel Identification Number:.
Is well located at approved permit location? [] Yes [] No
Method of Drilling [] air rotary [] cable tool
Casing type: steel
Wall Thickness: .025 inches
Diameter: _6 inches Depth: 103 feet
Liner Type: ~
Diameter: ~ inches Depth: ~ feet
Casing stickup above ground: _2 feet
Static water level (~om ground level): 74 feet
Pumping level: 103 feet a~ter
_2 hours pumping 1__~0 gpm
Recovery Rate: I_Q_0 gpm
Method of Testing: air lift
Well Intake Opening Type:
[] Open End [-] Open Hole
[] Screened Start ~ feet Stopped ~ feet
[] Perforations Start ? feet Stopped ? feet
Grout Type: Bentonite # 8 Volume: 1 bgs
Depth: Start 0 feet Stopped + feet
Pump: Intake Depth ~ feet
Pump size hp Brand Name
Well Disinfected Upon Completion? ~] Yes [] No
MethodofDisinfection: clorine tablets
Comments: fi'e//depth was $5' to start. Found we//to
be perforated approximately 2 to 5 feet from the shoe.
Well Driller: Alpine Drilling & Enterprises
P 0 Box 110496
Anchorage AK 99511
Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property
CERTIFICATE
FOR A
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
~70Q B~aga~ S~re~t
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
OF ON-SITE SYSTEHS APPROVAL
SINGLE FAMILY DWELLING
Parcel I.D. 016-102-07
1. GENERAL INFORMATION
Expiration Date: ~'-/-- //
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
BRUIN PARK S/D;
1001 FOREST DRIVE
ANN WRIGHT
11001 FOREST
BLOCK 4, LOT 2
* ANCHORAGE, AK * 99516
Day phone
DRIVE * ANCHORAGE~ AK * 99516
Day phone
748-4384
ALLEN JONES W/ THE REAL ESTATE'STORE Day phone
825 W 55RDAVE * ANCHORAGE, AK * 99518
561-4944
Unless otherwise requested, COSA will be held by DSD for pickup.
2, NUMBER OF BEDROOMS: ,3
3. TYpE'OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well · Individual On-site ·
Individual Water Storage [] Individual Holding tank []
Community Class Well [] Community On-site []
Public Water System [] Public Sewer []
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On-Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hel'eto and as of the 'v~lidation dste shown belov4 I verify thst m,y
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.
Phone 557-6179
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK'99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Date
Engineer's Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the tesf, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater 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 the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
DSD SIGNATURE
.V'/ Approved for __~
bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Attachments: COSA Checklist
Septic System Advisory
Well Flow Advisory
{Roy. 1 ~/05)
Arsenic Advisow
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Legal Description:
A. WELL DATA
CHECKLIST
BRUIN PARK S/D; BLOCK 4, LOT 2 Parcel lD:~/~z~- / 0~---07
*UNDOCUMENTED WELL WAS DEEPENED AND DOCUMENTED 1/11/2002.
Well tyl~e PRIVATE
,,,1964
Date completed '1/1:1/2002
Total depth 103 .ft.
Well Log (Y/N)
Wires properly protected (Y/N)
Casing height (above ground)
AT INSPECTION
10/15/2010
33 ff.
4.41 g.p.m.
YES
IfA, B, or C provide PWSID# N/A
Sanitary seal (Y/N) YES
Cased to 103 ft.
FROM WELL LOG
1 / 11/2002
74 ff.
g.p.m.
Date of test
Static water level
Well production 10
WATER SAMPLE RESULTS:
Coliform {~ colonies/lO0 mi.
Arsenic: N/"~ ug./k.
SEPTIC/HOLDING TANK DATA
Nitrate ~Jt'~ mB.IL. Other bacteria 0
Date of sample:10/1'5/2010 Collected by:
Tank Type/Material SEPTIC/STEEL
Tanksize 1000 gal. Number of Compartments 2
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO
Date of pumping Pumper.
ABSORPTION FIELD DATA I'BELOW EXISTING GRADEJ
Date installed 9/'26-28~2007 Soil rating ~or ft2/bdrm) 1.0
Length 41 ff. Width 2-5 .fi,
Total depth '11.9 ft. Eft. absorption area 4-51 ft2 Monitoring tube YES
Date of adequacy test 10/15/2010 Results (Pass/Fail) PASS
Fluid depth in absorption field before test '0 in. Water added 1105gal.
Elapsed Time: 25 min. Final fluid depth DRY in.
Any rejuvenation treatment (past 12 mo.) (Y/N & type)
YES
12+ ,in:
colonies/lO0 mi.
GEG Ltd,
Date installed
9/26-28/2007
Cleanouts (Y/N)
High water alarm (Y/N)
NORTHLAND PUMPING
YES
N/A
System type TRENCH
Gravel below pipe 5.5 ft.
Depression over field NO
For 3 bedrooms
New depth 2 in.
Absorption rate >= 450+ g.p.d.
NONE KNOWN If yes, give date -
D. LIFT STATION
Date installed
"Pump on" level at
in.
Size in gallons
"Pump off" level
Manhole/Access (Y_..~ ~
High water alarm level at
De__tM m f
E. SEPARATION DISTANCES
Cycles tested.
Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
Absorption field on lot
Public sewer main N/A
Sewer/septic service line 25'+
Animal containment areas 50'+
100'+
100'+
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout
Holding tank N/A
Manure/animal excrete storage areas
N/A
100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Buildin9 foundation 5'+ Property line 5'+
Water main N/A Water service line 10'+
Wells on adjacent lots 100'+
Absorption field,
Surface water
5'+
100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation. 10'+
Water service line 10'+ Surface water 100'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
Water main N/A
Driveway, parking/vehicle storage 10'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
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 JEFFREY A. GARNESS
Date
COSA Fee $ .L//
Date of Payment
Receipt Number
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
0 WELL
Lot I
5003
%,.",(%
fence
Lot 3
Lot 2
SCALE: 1"= 30'
EASEMENTS OF RECORD, OTHER THAN
THOSE SHOWN ON THE RECORDED
PLAT ARE NOT SHOWN HEREON.
Recert
7'Z~/Z ¢'7o BE
° O°o'~tievent~
Septic vents
link fence
AS-BUIL¢
/
/
NO CORNERS SET THIS DATE
/
/
I hereby certify that I have performed a Mortgagee's inspection
of the following described property: LOT 2, BL,OCK 4,
BRUIN BARK SUBDIVISION .....
Anchorage Recording Precinct, Alaska, and that the
improvements situated thereon are within the property lines
and do not overlap or encroach on the property lying
adjacent thereto, that no improvements on the property lying
adjacent thereto encroach on the premises in question and
that there are no roadways, transmission lines or other
visible easements on said property except as indicated
hereon.
Dated at Anchorage, Alaska
this 4th .____.__day of October, ,2010
FRED WALATKA & ASSOCIATES
Engineers and Surveyors
(907-248-1666)
SGS ReL# 1105582001
Client Name Garness Engineering Group, Ltd Printed Date/Time 10/22/2010 14:04
Project Name/# Bruin Parks B4,L2 Collected Date/Time 10/15/2010 11:00
Client Sample ID Bruin Parks B4,L2 Received Date/Time 10/15/2010 11:25
Matrix Drinking Water Technical Director Stephen C. Ede
Sample Remarks:
Allowable Prep Analysis
Parameter Results LOQ Units Method Container ID Limits Date Date Init
Metals by ICP/MS
Arsenic ND 5.00 ug/L EP200.8 C (<I0) 10/18/10 10/21/10 NRB
Waters Department
TotalNitrate/Nitrite-N ND 0.100 mg/L SM20 4500NO3-F B (<10) 10/15/10 AYC
Microbioloc~y Laboratory
E~ Coli
Total Coliform
Nezative 1 100mL SM20 9223B A I0/15/10 DLC
Negative 1 100mL SM20 9223B A 10/15/10 DLC
MUNICIPALITY OF ANCHORAGE
DEPARTME,., OF HEALTH AND ENVIRONMENTAL PR~., ECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date
;ENERAL INFORMATION
Description (i ncl udev.~J;,, block,z~/~41~subdivisio/~.,)oj~Section,~ toj~i~hi p, range)
Location (add~ess bi: directions)
one,,):'L~'n~ti~g' institution []; Owner/builde Buyer []; Other [] (ex lain)i
Real Estate Company and Agent
elephone
(f) Mail the HAA to the following address:
· TYPE OF RESIDENCE
:,,.singi'e-Family~!~ Multi-Family []
:>Number of Bedrooms
Other
, WATER SUPPLY
...Individual Well~ Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status. ' -
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 I of 2 72-025 (11/84)
5o
ENGINEERING FIRM PROVIDIN JSPECTIONS, TESTS, FILE SEARCH, DA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigatio.n 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-~ite water supply and/or
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection.
Name of Firm /~ Telephone
Address /~"'~ /-~ ,,~'J /'/i/~ _p~I/7'"~r' ,~
Date ,/"'~- ~
DHEp APPROV'~:L ~"
Approved for ~'~'" bedrooms by
Approved ~ Disa~oved
Terms of Conditional ApProval
Conc~nal
Date
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)
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST- FEBRUARY 1984
264-4720
Legal Description:
M'JNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
WELL DATA
Well Classification ~/~/l/'/~f'~''~ IfA, B, C, D.E.C. Approved (Y/N)
Well Log Present (Y('~ Date Completed ~/V/~/~Jw/ Yield
Total Depth ~(~ ~,~-.,-t¢... Cased to _~ .~ z¢. Depth of Grouting
Static Water Level O ,~..Oo ~' / Pump Set At
Casing Height Above Ground
Electrical Wiring in Conduit(Y~4)
Separation Distances from Well:
To Septic/Holding Tank on Lot
Sanitary Seal on Casing(~l)
Depression Around Wellhead (Ye
; On Adjoining Lots
To Nearest Edge of Absorption Field on Lott~ /~--~'" / ; On Adjoining Lots
/
TO Nearest Public Sewer Line ~/~'/~ To Nearest Public Sewer
Cleanout/Manhole /,/'//~ To Nearest Sewer Service Line on
Water Sample Collected by /~/4 ,~' ~')/~/' ; Date
Water Sample Test Results ~'~/~"f~'~
Comments(~/,d~-..~ ,,~¢~-~J '7-~-~7~ /-ZJ//-~,.
B. SEPTIC/HOLDING TANK DATA
Date Installed/~-Z-
Standpipes~N)
Depression over Tank (YN~
Pumping/Maintenance Contract on File (Y/N)
./
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well ~"'-.~ /
Size ,/~'~'~ ~'/¢~' No. of Compartments / (~"-~"'/¢r.
Air-tight Caps.) Foundation Cleanout (Y~
Date Last Pumped
~/* 'for ~/~
Temporary Holding Tank Permit (Y/N)
To Property Line
To Water Main/Service Line
Course
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Comments
P~ge 1 of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata ~/,~',~.~d',~
Date Installed
Width of Field
Square Feet of Absorption Area
Depression over Field (Y(N'~
Results of Last Adequacy Test
Type of System Design
Length of Field ,~'~3r'
Depth of Field
Gravel Bed Thickness
Standpipes Presen~N)
Date of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation
Lot
/J
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments ¢--~I~ ~,d'~/57~
To Property Line
To Existing or Abandoned System on
' On Adjoining Lots -~
To C ut,~/~;(if present)
LIFT STATION
D~ Dimensions
Size in Gallons ~ Manhole/Access (Y/N)
"Pump On" Level at ~'~,..~Pump Off" Level at
High Water Alarm Level at ~.~Y/N)
Tested for Pumpin~'~~st Meets MOA
Electrical Codes (Y/N)
Comments ~---.
** Check Permitted Bedroom Rating Against HAA Request **
I certify that l ~,~~d~er~f~ed, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed ~ ~-'~//-"'-"'"- Date //-~-'z~- ~
Company /'~'~,~ MOA No. ~0 ~'
Receipt No. ~ 0 ~ ~ ~
Date of Payment ) ~ ~ ~
Amount: $ '~.. ~~
Page 2 of 2
72-026 (11/84)
ALASKA ENVIRON"'C. NTAL
CONTROL SERVIC. ., INC.
1200 West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
SHEET NO.
OF
CHECKED BY
SCALE / '* ,,~0
DATE
'1
ALASKA I FlUlROFIITIE [1TAL COiqTROL $1 RUICI $, IIIC.
I~nclinee~inq ~. I~nui~onmcntal Studies
January 27, 1986
Municipality of Anchorage
Department of Health & Human Service
825 "L" Street
Anchorage, Alaska 99502-0650
Attn: Steve Morris
Subject: Septic Tank Verification
Lot 2, Block 4, Bruin Park Subdivision
Dear Steve:
At your suggestion, I made a site visit to the subject lot to
inspect the existing septic tank. According to a 1973 MOA
Health Authority Approval, the tank was installed in 1963 and
was constructed of concrete rings. You raised a question as
to if the tank has a bottom. I used a steel pipe to bang on
the bottom of the tank; it appears to be solid and is most
likely made of concrete.
The tank has a standpipe with an airtight cap. A water sample
from the well was taken 1/24/86 and was free from coliform
bacteria contamination.
I hope this letter answers your questions.
Sincerely,
Approved by:
Dennis Roe
Soil Scientist
oo
1200 LUest 33rd Auenu¢, Suite [~ · Anchora§e, Alaska 99503 ,[907) 561-5040
ALASKA I FIUIROFlmI FITAL COFITROL $1 RUICI $, IFIC.
LIZ ANDERSON
11001FORREST DRIVE
ANCHORAGE ALAS I(A
99516
SELLER-SAME
JAN 28 1986
WILL PICK UP FROM OUR OFFICE
60035
LEGAL:BRUIN SUBD/BLOC K 4/LOT 2
ADEQUACY TEST FOR SEWER SYSTEM
ADEQUACY TEST DATE-JAN 24 1986
THE TYPE OF ABSORPTION SYSTEM IS A CRIB WITH AN UNI<NOWN AREA.
THE SYSTEM IS CAPABLE OF ACCEPTING 335 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 150 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
1 BEDROOM HOME.
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF 1200 IS ADEQUATE FOR
THIS 1 BEDROOM HOUSE.
THE SEPTIC TANF,/PACI(AGE PLANT WAS PUMPED ON JAN 22 1986 .
THIS REPORT DOES NOT VERIFY THE INTEGRITY OF THE PIPING FOR THE WATER
SUPPLY OR WASTEWATER SYSTEM.
FLOW TEST ON WELL
WELL FLOW DATE-JAN 24 1986
A FLOW TEST WAS PERFORMED ON THE WELL. 335
PUMPED AT A RATE OF 5.6 GPM OVER A DURATION OF
THE DRAWDOWN WAS 1.8 ' WITH A RECOVERY TIME OF
AND THE STATIC WATER LEVEL WAS 20.8 FEET.
THE WELL IS ADEQUATE FOR THIS 1 BEDROOM HOME.
GALLONS OF WATER WAS
1 HOURS.
2 MINUTES
1200 LUest 33rd Auenue, SuJle ~. Anchoraqe, Alaska 99503 .,(907) 561-5040
6tatic wonted, i!Level !L~e,st
]Lc) t 2, !:Cl.oe.~x 4
tic wate~. ]eve! ~0 f~eet below la:nd
LOt 2, 81ock 4, B~d. Pork SubdfFIslo.
Thle office has approved the simer system' on the subject lot for a
tab.bad, oma, sfngle famtly d~e111ng.
Sheuld the.bedrea~s madar tncrel#, additional &bsorptton must be added
to the systa.
TI~ n1! his ~ tnSlaCtid iai ts mad by thts d~lartaut.
1. A~proval Requested !3/:
Address, _IV V/
2. p~o~.erty O. ner: ,T%i,~?_0 ,,,
3. Leg.1 Description: ~07 ~ gig 4
5. Type of Facility to be Inspected:
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3500 Tudor Road, Anchorage, Alaska 99507 279-8686
Date Received
Time of Inspection
Depth__ ...... -
Number of"Bedrooms: _~.' ~
^. Type B.
7. Sewage Disposal System:
A. Znstan.dF~X t¢~o3 _ ~.
C. Septic Tank: 1. Size /~00~2.~ 2.
D. Seepage Pit: 1. Size/~.ZrWq~ 2.
Phone. 3"/~/- / 7~$
Bacterial Analysis
Disposal Field: Total Length of Lines
Distances:
A. Well To:
Septic Tank
, Nearest Lot Line
Foundation to Septic Tank
, Absorption Area //~
Sewer Lines
Absorption Area to Nearest Lot Line
· Other Contamination
Ab~orotton Area ~ ~
Requ~s,t for Approval of Individual Sewer & Water Facilities
,~age Two
Approval Valid for One Year F~om Date Signed
Greater Anchorage Area BorouQh, DeF~rtment of Environmental Quality
DIAGRAM OF SYSTEM.
I certify that the ~nformation contained in this request for approval to be a true
and accurate representation of t. he sub~ect sewer and water facilltles located at.'
x,:,~x~,--,~/,~,z, <, ,:~ 0, ,)~ ~ F 4~-4.. ,:4J .
.j
DORIS TIMPERLEY
RE PRESENTATIVE
2909 ARCTIC BOULEVARD
ANCHORAGE. ALASKA 99503
PH. 907 - 274-4505
HOME: 272-8927
February 14, 1~?~
~obert G. ~rinkle$
1771 Forrest i~rtve
A~chorage. Alaska
:;ubj ec'~:
~ewer and water f~cllitles o~) Lot ~', ~lbck 4,
~rui~) ~-r~ JUL-divi$io)~
~e~r ~r. ~rtnkley:
i~ecent tns'pe~tton fur dppr~v~l of the sewer
facilities un LoL g, ~lock 4 of ()rqi~) P,~rk ~ubdtvisto~
has been cm~pleted.
elb~itted by Hr. Hyron Ashcraft who lns:a)led Lng systu~',~
has been appproveu by this
Tt)e well servin~ :his lot Is located Ina piL. ~efure
depart~)ent ca~ ~ive approva! for the water Sys:e~,.
cunscructt'o~ of the well wtll need tu be upgraded. The
castn~ ,)us: be~exten~eu )d t,c~es above :he ground. :he
Pressure tank re-locaCeU an~ tJqe p(: ltl)au &r). ~ecauSe
weather conditions at t~iS tt~e of year, tnls dep'er:~ent will
give you a te~porary approval of the sewer and water facilities
pruvtdtnf~ :hat funds are excroweo :i)ruuih ~ b~nk or loan
co~pany for tne purpose uf upgradln~ the well by duly l, l~TJ
an~ that a copy of Che emcrow a<;ree~ent ls received by Chis
If you have any questions,co,lcernt~ this ~.,,atter, p&ease do
no: hesitate to con:act this office aC g74-4bb).
Sincerely,
~entse C. ~ashaw
&~)vtrom~e,tal Cant'roi Officer
~Cate 'VA
cc: 429 "D. Street
Uorts Ttr~perly
Real Lstate Corner