HomeMy WebLinkAboutBRUIN PARK BLK 5 LT 143
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Municipality of Anchorage
Community Development Department Page 1 of 2
On-Site Water and Wastewater Program
4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP171258 PID Number: 016-111-32 ❑ New ❑✓ Upgrade
Name:
June Goard Revocable Trust ABSORPTION FIELD
Address ❑✓ Deep Trench ❑ Shallow Trench
❑ Bed El Mound
11331 Polar Drive ❑ Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
3 1 GPD/SF 12.0 Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot 5.0 Ft. 7•0Ft.
Bruin Park 5 14 Fill added above original grade Gravel length
Township Range Section
0 Ft. 35.0 Ft.
Gravel width Beds:Number of Lines Distance between lines
SEPARATION DISTANCES 2.5Ft. N/A N/A Ft.
MI Septic Absorption Holding Sewer Total absorption area Number of trenches Dist.between trenches
From
Tank Field Lift Station Tank Line 490 Ft2 1 N/AFt.
Well 105.9 120.9 N/A N/A 25+ TANK p Septic ❑S.T.E.P. ❑Holding ❑Other
Manufacturer Capacity
Surface Water 100+ 100+ N/A N/A Anchorage Tank 1000Gal.
Material Number of compartments
Lot Line 41.9 16.7 N/A N/A Steel 2
NA
Foundation 33.6 48.6 N/A N/A LIFT STATION
Manufacturer Capacity
Curtain Drain 50+ 50+ N/A N/A Gal.
Remarks Pump on level at Pump off level at High water alarm at
in. in. in.
Pump make and model Electrical Inspections performed by
Installer PIPE MATERIAL House to tank 3034 Tank to 3034
drainfield
A+ Home Services Drainfield 3034 CO/MT 3034
Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 100ft
Inspection Location and description
dates: 1st9/27/17 25d 9/27/17 p
3`d 9/27/17 a"' 3/13/18 Bottom of Trim Nearest House Corner
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp
Conditional Approval: Date , .�OF A� 4k
' Dteven k. t"Oflnor
CE 8149 •
Appro .� v - F/ /
Date 3 '2 0 'IV �ill�`Dp�, �p� ...
Inspection Report_1-1-12.doc
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s OR71'F • \<\ PER DECOMMISSIONED
I STONED EXISTING CRIB
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/ ��r N� •1NEW UPGRADE DRAIN FIELD
35LF x 2.5'W x 7.0'ED x 12.0'TD i
B INSTALLED MT AND CO AT EACH ENDz
WELL (E) 3BR SHEDS R
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DECOMMISSIONED SEPTIC TANK ' A _ )- ,.
PER CODE AND INSTALLED TH 1/J\�• �P 16
NEW 1000g SEPTIC TANK J 0
WITH DOUBLE CLEAN OUT BEFORE AND AFTER 3, aO '`p �p �<<,,
iy v GAZEEBO • ��2-
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PROFILE
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DESIGN PARAMETERS
UPGRADE SEPTIC SYSTEM LEGEND 80.9 (DRY) -18.0
NO. BEDROOM: 3 (450 gpd) W WATER LINE/
TANK SIZE: 1,000g WELL RADIUS
PERC RATE: <1MPI
ABBREVIATIONS
SOIL RATING: 1 GPD/SF SS NEW SEPTIC TH TEST HOLE
AREA ROD: 450 SF (P) PROPOSED
SYS. TYPE: DEEP TRENCH: 7.0'ED
MIN LENGTH: 32.1 LF — – -GB- - — GRADE BREAK (E) EXISTING
DCO DOUBLE CLEAN OUT
USED: 0 0 RETAINING WALL CO CLEAN OUT NO.
35LFx2.5'Wx7.0' E.D., 12.0' TO MT MONITOR TUBE NO.
TOTAL AREA: 490 SF TYP TYPICAL
NOTES: —\\�\ Date
RECORD DRAWING PANNONE ENG SVC, LLC J` of A/ `kl 3/13/2018
P.O. BOX 100217 ANCHORAGE, AK 99510 -.1-%T....••••• 4a k1
PHONE (907) 272-8218 FAX (907) 272-8211 %g�P '�y�+ Scale
DRAWN BY: *; ...k? 1"=50'
DRM _ BRUIN PARK, BLOCK 5, LOT 14 % P.I.D. NO
JUNE GOARD REVOCABLE TRUST / 016-111-32
Steven Pannone
PERMIT NO.
KATHRYN FLANAGAN �+�� . CE 8149 .•c�// OSP171258
PLAN ANCHOIRAGOE,AR AKD91VE 9516 +0il� �oF-ES•s10NP`'�` �. Sheet
AN.\\X. " 2OF2
0A`_'.r.�0, MUNICIPALITY OF ANCHORAGE ,„„ „r
On-Site Water&Wastewater Program '1;
PO Box 196650 4700 Elmore Road
Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997
http://www.muni.org/onsite
Dupdititiritt
9'oCI onr,
On-Site Wastewater Disposal System Permit
Permit Number: OSP171258 Effective Date: 9/14/2017
Work Type: Septic Upgrade Expiration Date: 9/14/2018
Tax Code Number: 01611132000
Site Legal Address: BRUIN PARK BLK 5 LT 14 G:2633
Site Mailing Address: 11331 POLAR DR, Anchorage
Owner: GOARD JUNE K REVOCABLE TRUST Lot Size in Sq Ft: 20000
Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 3
This permit is for the construction of:
El Disposal Field El Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well El 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: lS �4. �'+ , i u Date: 1 I 1 I
®Issued By: te/' �4' Date: 0/
MUNICIPALITY OF ANCHORAGE
Community Development Department Pho e: -343-
Development Services Division - - . •-
On-Site Water & Wastewater Program
SEP 01 2017 1'
ON-SITE SEWER/WELL PERMIT APPLICATION a of
Parcel I D 016-111-32 << 01 6 8
Property owner(s) June Goard Revocable Trust, CO Kathryn Flannagan Day phone
Mailing address 11331 Polar Drive, Anchorage, AK 99516
Site address 11331 Polar Drive
Legal description (Sub'd., Block & Lot) Bruin Park, Block 5, Lot 14
Legal description (Township, Range & Section)
Lot Size 20.000 Sq. Ft Number of Bedrooms 3
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(M all that apply)
Absorption Field Ll Initial I I Single Family (SF) L]
(w/wo ADU)
Septic Tank Q Upgrade LX Duplex (D) ❑
Holding Tank ❑ Renewal (—]
Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE I 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: '4,67A Waiver Fees:
Date of Payment: Irr `AI
/ I �//�17 Date of Payment:
Receipt Number: W Y6-) Receipt Number:
Permit No. eLS� la. Waiver No.
Permit App_ - c
Pannone Engineering Services ac
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail:steve@panenaak.com
August 31, 2017
Subject: Bruin Park, Block 5, Lot 14
Upgrade 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 system will serve an existing three (3) bedroom house. The existing drain field is in failure
and will be decommissioned. The system will utilize a replacement 1000g septic tank and conventional
drain field. This lot and the surrounding lots are served by private wells, and the lots to the southwest are
served by AWWU. There are no wells within 100' of the proposed septic system.
1. Soils. One test hole was performed in the vicinity of this system by PES in August 2017, and
groundwater was monitored for at least seven days. Ground water was not observed to a depth of 18'
below the surface in the test hole monitor tube in August of 2017. Bedrock was not encountered in
the test hole to 18'. Based on the results of the percolation tests and overall soils appearance; an
application rate of 1.0 gallons/day/square was used for a conventional wastewater system in the area
of the test hole.
2. Soil Absorption System Design.
a. See Sheet 1 of the design package.
3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field.
The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage
ditches.
4. Topography: The existing topography on the lot generally slopes from northeast to southwest,
with a slope of approximately 3% in the area of the drain field, steepening to approximately 20% downhill
of the field. There are no steep slopes in the vicinity of this system. The proposed drain field will maintain
50' separation all steep slopes.
5. 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.
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
/
/M �M ` 7/// I
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At- a
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/ O • DECOMMISSION EXISTING CRIB
F � , 61//1/4)7/41.-
�/��.�q� `? PER CODE � ,�
• 1 UPGRADE DRAIN FIELD (P) _ W
<1" ---.
�•
35LFx2.5'WxI7.O'EDx 12.O'TD
INSTALL MT AND CO AT EACH END
WELL (E)—\/� O3BRUS SHEDS
HODS • (NO FOUNDATION)
A' 100.3 (E)
3 1 / 04�
�, I / 1
TO `. t , X0 0� 1
rwa
at. - ss • •(;)
SEPTIC TANK (E) ' y1 y>
DECOMMISSION PER CODE AND INSTALL TH 1�/J�� `\▪ `- � P
1 6
10008 SEPTIC TANK (P) \c-?S
y�J QWIIH DOUBLE CLEAN OUT BEFORE AND AFTER,•iI ,�/ J<vGAZEEBO . / ��`
w�— W--(NO FOUNDATION) / `c�
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I
DESIGN PARAMETERS
UPGRADE SEPTIC SYSTEM
NO. BEDROOM: 3 (450 gpd) LEGEND
TANK SIZE: 1,000g w WATER LINE/
PERC RATE: <1MPI WELL RADIUS ABBREVIATIONS
SOIL RATING: 1 GPD/SF
AREA ROD: 450 SF TH TEST HOLE
SS NEW SEPTIC
SYS. TYPE: DEEP TRENCH: 7.O'ED (P) PROPOSED
MIN LENGTH: 32.1 LF — — _Ge— — — GRADE BREAK (E) EXISTING
CO CLEAN OUT NO.
USE: MT MONITOR TUBE NO.
35LFx2.5'Wx7.0' E.D., 12.0' TD 0 ;> RETAINING WALL TYP TYPICAL
TOTAL AREA: 490 SF
NOTES: PATNI O LLC ,>��~�c\, Dote
FOR CONSTRUCTION PANN�NE ENG SVC, ..-.."-s.pF 14C h 9/13/2017
P.O. BOX 100217 ANCHORAGE, AK 99510 � ' .:46,14
:74- ••'F $ Scale
e
DRAWN BY: PHONE (907) 272-8218 FAX (907) 272-8211 *•
•`a ; *fj� 1"=50'
DRM BRUIN PARK, BLOCK 5, LOT 14 % "" % P.I.D. NO
� e16-111-32
JUNE GOARD REVOCABLE TRUST 0" teveri'•"15a'n'rior;e'� PERMIT NO.
KATHRYN FLANAGAN 'ht. CE 8149 .g.1OSP171258
11331 POLAR DRIVE th`% p•EP. Sheet
PLAN ANCHORAGE, AK 99516 A. `�\\\�t�� 1 OF 3
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF
ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF
ON—SITE WASTEWATER DISPOSAL SYSTEMS AND AND IN ACCORDANCE WITH AMC 15,65 AND 15.55.
2. SCOPE OF WORK: REPLACE SEPTIC TANK. INSTALL NEW DRAIN FIELD.
3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 18 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 18 FEET
BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY.
4. THE CONTRACTOR (BOTH WELL AND SEPTIC SYSTEM CONTRACTORS) SHALL HAVE ANY WELL LOCATION AND SEPTIC
LOCATION STAKED AND ANY LOT LINE AND WELL RADIUS SHOWN ON THE PLAN WITHIN 30 FEET OF THE PROPOSED
SYSTEM STAKED BY A REGISTERED LAND SURVEYOR BEFORE STARTING THE WORK.
5. THE CONTRACTOR IS RESPONSIBLE FOR ALL R.O.W. AND OTHER REQUIRED PERMITS, OTHER THAN THE ATTACHED.
6. THE CONTRACTOR SHALL CALL FOR LOCATING OF ALL BURIED UTILITIES.
7. THE CONTRACTOR SHALL PROVIDE 24 HOUR NOTICE TO THE ENGINEER PRIOR TO START OF WORK. ALL SURVEYING
AND LOCATES SHALL BE IN PLACE PRIOR TO NOTIFYING THE ENGINEER.
8. THE CONTRACTOR SHALL NOTIFY THE ENGINEER OF ANY DISCREPANCY BETWEEN THE APPROVED DRAWINGS AND SITS
CONDITIONS/LIMITATIONS POTENTIALLY CAUSING THE NEED TO MODIFY THE DESIGN.
9. AT THE COMPLETION OF THE WORK, THE CONTRACTOR SHALL SUBMIT RED—LINE AS—BUILT DRAWINGS TO THE
ENGINEER. THE RED—LINES SHALL INCLUDE PIPE LENGTHS, ORIGINAL GROUND ELEVATIONS, PIPE ELEVATIONS, AND
TANK ELEVATIONS.
10. THE CONTRACTOR SHALL PROVIDE PHOTOGRAPHS OF THE SYSTEM INSTALLATION TO INCLUDE BOTTOM OF
EXCAVATION, TOP OF PIPE WITH CLEAN—OUTS AND MONITOR TUBES INSTALLED. INSTALLED TANK AND FINAL GRADING.
11. THE CONTRACTOR PROVIDED DATA (UPON WHICH THIS RECORD DRAWING IS BASED) APPEARS TO REPRESENT THE
PROJECT AS CONSTRUCTED. THIS DATA IN CONJUNCTION WITH THE PERIODIC FIELD OBSERVATIONS BY THE
ENGINEER (OR HIS DESIGNEE) AS REQUIRED BY AMC 15.65 DOES NOT GUARANTEE THAT THERE ARE NO HIDDEN
DEFECTS BY THE CONTRACTOR.
12. THE CONTRACTOR SHALL SIGN THE FOLLOWING:
I CERTIFY THAT ALL WORK WAS PERFORMED IN ACCORDANCE WITH THE APPEND PERMIT, AND ANY AND ALL CHANGE
ORDERS, AND THAT THE AS—BUILT REDLINES ARE TRUE AND ACCURATE REPRESENTATION OF THE PROJECT AS
CONSTRUCTED.
CONTRACTOR:
BY: . TITLE:
DATE:
NOTES: ��� \ Dote
PANN�NE ENG SVC, LLC pF AL`�l 9/13/2017
FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 i'` ' qS �,
PHONE (907) 272-8218 FAX (907) 272-82114,.1.;,1 Scale
DRAWN BY: v*: �� *l0 NTS
DRM BRUIN PARK, BLOCK 5, LOT 14 %••• '' P.I.D. NO
JUNE GOARD REVOCABLE TRUST • • .. .. / QtR IT 32
�teven '� �onnor�e�� PERMIT NO
KATHRYN FLANAGAN �r -V.• CE 8149 . �� OSP171258
11331 POLAR DRIVE 9/%1„..'• • ``4
DESIGN DETAILS ANCHORAGE, AK 99516 kk;; SSI*- ` Sheet 3
\\\�"` OF
SOILS LOG - PERCOLATION TEST
TEST HOLE 1 C
OR ORGANICS SLOPE -- \ SITE PLAN I ii,\
2 GM FILL 1/ LL
E
3
OR/OL ORGANICS AND �f p
4 • ORGANIC SILTS 4BR '/
GM SILTY GRAVEL HOUSE 715
iL I
6
\ TH
(E) STH-1
6 LU
GARAGE
8 3 w,
9 :0'1
1
11SP SAND / I
12 2 � n
13
WAS GROUND WATER SLOPE
14 ENCOUNTERED? N
15 IF YES,AT WHAT TH
DEPTH? -DRY x
16
17 DEPTH TO WATER AFTER
MONITORING? -DRY
18 DATE: 8/31/17
BOH
WATER
19 READING DATE CLOCK
NET TIME LEVEL NET DROP
READING
20 1 8/24/17
2 PERCOLATION RATE TOO FAST
DATE PERFORMED:8/24/17 3 TO ACCURATELY READ
4
5
6
PEROLATION RATE <1 (min/inch)PERC HOLE DIAMETER 6 inches
TEST RUN BETWEEN 5 FT AND 6 FT
SEE SIEVE ANALYSIS SAMPLE(a),8'
COMMENTS:Test hole excavated by A+ HOME SERVICES
PERFORMED BY: Dan Moran. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE
AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST.
NOTES: D���T �I LLC l��xt�‘ Dote
7R CONSTRUCTION PANNONE ENG SYL1 L,L,CF A�q�, Date 017
• P.O. BOX 102954 ANCHORAGE, AK 99510 ....1-4..':-:-. S
�'tQ-•. '- Scale
PHONE (907) 272-8218 FAX (907) 272-8211 Avco.• �) 9
DRAWN BY: ;*.• ..! /\ f/ NTS
DRM "� •'•• , P.I.D. NO
BRUIN PARK, BLOCK 5, LOT 14 /_ + 016-111-32
JUNE GOARD REVOCABLE TRUST 0#..'s'e'ven R. =annone
KATHRYN FLANAGAN 0 PERMIT NO.
�Fc. CE 8149 .'��� 05P1 71 258
11331 POLAR DRIVE f1 �'' • •• . Sheet
SOILS LOG ANCHORAGE, AK 99516 <% a?orESS\ 2 OF 3
040.002 Crowther Associates
Client: Pannone Engineering Services
Projects: 211 r.,icA-Brivc $A01N p41 :_ , 13 at S, LT l y a 1 33i pot-AR I -i✓c
Date: August 30, 2017 l
Particle Size Distribution Table
Sample Source
Sieve Size
3 inch
1-1/2 inch
'/4 inch 100
#4 98
#10 95
#40 36
#100 5
#200 2
0.02 mm
Classification Sand(SP)
1632 Bellevue Circle/Anchorage.Alaska 99515
Telephone(907)349-2198/E mail:crowther@alaska.net
GAAB-HD-I
~,,iN'~'AII:I( ANk, I'IUKAkJ, I:: AKI:A I~UKUI"~I'I
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 27'/-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
ADDRESS f--,
LEGAL DESCRIPTION
SEPTIC TANK:
DIST'ANCE FROM WELL
LIQUID CAPACITY
GALLONS.
MATERIAL ~ ~'~"' NUMBER OF
COMPARTMENTS /
INSIDE LENGTH ~ I LIQUID
INSIDE WIDTH /~.1 DEPTH
SEEPAGE SYSTEM:
SEEPAGE PIT:
NUMBER OF PITS
LINING MATERIAL
NEAREST LOT LINE
OUTSIDE DIAMETER
OR WIDTH ~ ,LENGTH ~' ,DEPTH ~
DISTANCE FROM WELL BUILDING FOUNDATION ~"~',
TOTAL EFFECTIVE ABSORPTION AREA IWALL AREA)
SQ FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL
NUMBER OF LINES
ABSORPTION AREA.
DEPTH: TOP OF TILE TO FINISH GRADE
NEAREST LOT LINE
TRENCH WIDTH
FOUNDATION
DISTANCE BETWEEN LINES
SQ. FT. LENGTH OF EACH LINE
DEPTH OF FILTER MATERIAL BENEATH TILE'
TOTAL LENGTH
, OF LINES
IN. TOTAL EFFECTIVE
N. ABOVE TILE
WELL:
LOT LINE
TYPE
~ , DEPTH
NEAREST
SEWER LINE
DISTANCE FROM
, BUILDING FOUNDATION
SEPTIC SEEPAGE
, TANK SYSTEM
WATER
· SAMPLE__, NEAREST
OTHER
, CESSPOOL , SOURCES
DISTANCES:
C- 0 =
DIAGRAM OF SYSTEM
HEALTH AUTHORITY
DATE APPROVED
~-~-~./~ GREATE,, .aNCHORAGE AREA , .)ROUGH
. 7 Eagle St. Anchorage, Alaska 99501 279-2511
k, // S WAO. SPOS^ SVS; a - ^PPUCA O &
Case N o. ~ ~ ~
APPLI6ATIONTO I~STAkL: SEPTI6TANK )~ ,SEEPA6EPiT ~ ,BRAI~ FIELD ,0THER
TO SERVE THE FOLLOWING ,I:ACJ~Y
PER60LATION TEST RESULTS.
TO BE INSTALLED BY .~7~. _F.J
ANTICIPATED DATE OF COMPLETION
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS . (~~ t'~) ,~' , PERMIT TO INSTALL A
AS DESCRIBED BELQ~;'"SIZE OF UNIT TO BE SERVED ,..,g ,-, D~,,r, U)
· SEPTIC TANK SIZE TYPE '~.~A.~, ....... sEEI~AGE AREA DIA OF
DISTANCES:
Health Authority
I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
above described system is in accordance with said code.
DATE / 5 '~ APPLICANTSSlGNATURE.....-.."':E/~
~REATER ANCHORAGE AREA BOROUGH
HEALTH DEPARTMENT
327 EAGLE STREET
ANCHORAGE, ALASKA 99501
CASE #
This Form Reports a: Soz-r~-Log ~ ~ i/?ercolation resti_~i~i~/: :',,'i~,,,'
Depth
Feet Soil Characteristics Location Sketch
wa, ~rou w ¢~r~ ........ .- . . ,
nd ater Encountered? ~o ' ~ /I ! -I i l'-:- " ....
. ' I__ i._ ~ ,,l, fF_J.. [ ..... Zi i
' ~ t ,a~e I G~oss T/me 'j Net Time J Depth To H O Net g~o
~__~. ~ ~ ~ ....... ~ .......... :~ ..... .... ~ . ==,,,~
,,, ......... , ....... ..... ,
~~~~~ ...... , ............. ;, . ~ _;.%~.~_ ~
P~o~'~ed ~nstal~Seepa~e Pi~ ~~ ~aln Field
De~th.~ Inlet_ _ ,, Dep~ To' Bo~tOm'Of Pit OP TPenc~- - ''/
c0~: 1~ ~ ~ , '~ ,. -
Test Performed By: ~c~ '~ ~ ~
~'-' ~". .... ~' ~ '- _---._ ~ - y- . . . ,UCrh q~ HEALTH &
;~~~ ~VIRONMENTAL ENGINEERING DIVISION
R EQU ~T FO R A~ROVALO F IN DJ V I DUAL WAT E R AND SEWER FACI LI TIES
DiR~ON8: ~mplete a I parts on page 1. In~l~e req~= will n~ ~ proo~d, Please SHow ~en (q0~ days ~or proces;ing.
' ' ' ~W ER ' " - .... ~ ~ ~PHONE
1. PROPERTYO . . J .
BA1LI~6 ADDRESS _ - '- ..... ' ' -'
~R0~RTY RESIDENT (l~differ~t-from ahoy) ~-- - . ~PHONE
. (:~:n 2ar:, ::oc~. ~,'.~: ~4.. ~t=:eS3 ~ ~oZar ~=t~e. )
-3, LENDING INSTITUTION~/- . ' I PHO
MAt LING ADDR ESS ~
- /Pauch 7-02~, Anchorage. Alaska 99510 , -
4."REALTOa/AG~T Attention: LarrY, CampbellJ PHONE .....
'Mit LInG idbRESS ....... -
TI ME'/
DATE
THIS SIDE FOR OFFICIAL USE ON LY
DATE
INSPECTION APPOINTMENTS x-
'TIME
DATE
iNSPECTOR '
'I'NSPECTOR' '. ' ' '
D,.EcT ONS: '
: [] ONE
TWO '
PERMIT NUMBER
DEPTH OF'WELL
DATE
R C VEb
IC, TYPE'OF RESiD"-; C '
~':-[] 'SIN~LE'FAMILY
:' [] MULTIPLE FAMI'LY
2; WATER SUPPLY ~
~ F-I~ INDIVIDUAL
· ~'~ PUBUCUTiLiTY
_'~" ' Connection Verified , ,
3, ;SEWAGE DISPOSAL SYSTEM
~ INDIVIDUAL/ON -SITE
~ ~UBLIC UTI LITY
Connection Verified
TIME
DATE
INSPECTOR
NUMBER F ' -' ~' ~ ' ' ;~'~ - '
O BEDROOMS .. '--?--:: I
THREE ' ~1--1 FIVE . ' - [--I~ ~OTHER ' I
FOUR" , [] SiX~' -~' ~ -- ~.'.: ~.
PERMIT NUMBER
DATE INSTALLED
-~Septi_c Tank or [] HoldingTank
S'ize:~ If Tank is homemade
give dimens OhS:
TYPE OF TANK
TOTAL ABSORPTION AREA
4. DISTANCES
WELL TO:
Absorption Ar~a tO nearest Lot Line
5. COMMENTS
DATE
LEGAL DESCRIPTION
72-010 (Rev, 3/78)
.[~//'APPROVED FOR ~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
I BY (Title) ~
I'NSTALLER
iSOILS RATING
~NUFACTURER
July 4, 1979
Municipality of Anch.
Dept. o£ Health and ~nvironmenta! Protection
Anchorage, Alaska
Enclosed is a check in the amount of
~25.00 to cover the cost of approving
the water supply and sewage facilities
for Gerald T. Goard residence--BRUIN PARX
Lot 14, t~lock 5, Anchorage.
Also enclosed is a check in the amount of
~t5.00 for the anaylysis o£ our water.
I really do not understand all the things
you want, and hope this will su££ice and
that you get the things 'that you want.
Please send original copy of these
inspections to:
National Bank ~'£ Alaska
~ortgage Loan Dept.
Pouch ~-025
Anchorage, Alaska 99510
Attn: Larry Campbell...
also, send a copy to us .
/G. erald T. Goard
SRA, Box ]-785
t~nchorage, Alaska 99507
.Also is enclosed is a receipt for the septic
tank and cesspool pumped.
The test of our sewage system will be sent.
MUNICIPALITY OF ANCHORAGE
DEPT. OF }',~ALTM &
ENVIRONMENTAL pF<O'i'ECTION
JUk t 9 1979
RECEIVED
3uly 5, 1979 ASI No. 02579
Mr. Jerry Goard
SRA Box 1785
Anchorage, Alaska 99507
Re: Adequacy Test For Existing Septic System on Lot 14, Block 5,
Bruin Park Subdivision.
Dear Mr. Goard:
At your request our office conducted a percolation adequacy test
on your existing septic system at the above-reFerenced location
during the period July 2 to 4, 1979. You reported that your
septic system consists oF a septic tank and log er£b.
The septic tank and seepage pit had been pumped approximately 10
days prior to the percolation adequacy test. Since the 2-bedroom
house had been occupied up to the time oF the test, a normal degree
oF saturation within the leach field is assumed.
In accordance with the Anchorage Municipal Code, Chapter 15.65,
Waste Water Disposal Regulations, any on-site sewage disposal
system "shall have adequate capacity to properly dispose of the
maximum daily sewage flow." The maximum daily Flow is oomputed
at 75 gallons per capita-day (gcpd). Since "the population oF
dwellings shall be estimated at two persons per sleeping room,"
the maximum daily sewage Flow For your 2-bedroom house is 300
gallons per day (gpd).
To test the soil absorption capability as well as the surge
capacity oF your system, 110 percent of the maximum daily
Flow or 350 gallons of clear water was added in 50-gallon
increments to the seepage pit. The water was obtained From
your on-site private well at its maximum sustained rate of
about 4 gallons per minute. The liquid levels were monitored
closely to detect any backup in the septic system.
Mr. Jerry Goard
July 5, 1979
Page -2-
The attached Table of Test Data represents the depths of
liquid in the septic tank and seepage pit, and the quantities
of water added. The septic tank was determined, to be 7.4 feet
deep (bottom of tank to ground surface) with an initial depth
of 3.7 feet in the tank. The seepage pit was measured to be
10.6 feet deep with an initial depth of 1.2 feet. Ground
elevation at the septic tank standpipe is approximately
1 e v e 1 w i t h the seepage pit standpipe.
The attached Summary of Test Results indicates that the
liquid level in the seepage pit at the beginning of testing
on Day 2 fell to 0.1 feet aboveits initial static level on
Day 1, during a recovery period of 24 hours. On Day 3, the
level had fallen to 0.1 feet below its static level on Day 2,
during a recovery period of 24 hours.
The level in the seepage pit at its highest level during the
test ( 1.9 feet) was approximately 5.6 feet below the liquid
level in the septic tank.
Based on two days of testing, a minimum percolation rate for your
existing septic system of approximately 300 gpd is indicated.
Since an on-site sewage disposal system for a 2-bedroom
dwelling must be capable of disposing of 300 gallons of sewage
per day, your septic system appears to be functioning satis-
factorily at this time.
Hany factors affect the operation of a soil absorption type
of sewage disposal system. Soil type, groundwater depth, age
and history of maintenance of the system, and types of waste
are a few. This test has been performed in an attempt to
determine actual soil absorption capabilities of your septic
system under normal useage by considering the degree of saturation
of the leach field and surge loads that might be imposed on the
system. This test can only evaluate apparent performance at a
given point in time, and cannot deter'mine either the condition
of the leach field, seepage pit or other components of the septic
system, or the depth of the water table.
We appreciate the opportunity given to perform this adequacy
test. If you have any questions regarding this test, please
contact this office.
Very truly yours,
ALASKA SOILS INVESTIGATIONS
~ Shrader, P.E.
Project Hanager
Mr. Jerry Goard
July 5 , 1979
Page -3'-
ASI No. 02579
Wtr Added, Seepage Pit
Rise in Seepage Pit
Rise in Septic Tank
Gallons Wtr Added per
Ft of Rise (gal/ft)
SUMMARY OF TEST RESULTS
350 gal gal
0.65' 0.66'
0.00' 0.00'
538 530
Recovery Time between Test (Hours)
Drop in Rit during Recovery
Average Rate of Fall (ft/hr)
Average Absorption Rate
(gal/day)
24
0.55'
0.02'
296
24
0.76'
0.03'
403
Adequacy Test for E~isting Septic System
Ouner: Hr. Jerry Goard Project No.
Address: · 'SRA" Box. 1 785 Anchorage, Alaska 99507
02579
Legal Desc.ription: Lot 14, Block 5, Bruin Park Subdivision"
Components of Septic. SY~'{em:.. Septic tank; log-crib, seepage pit.
Number of Bedrooms: 2 Occupied prior to test: Yes XX No
How long vacant:.., na . Last pumped: o/a June 22, 19.79
Test performed by: S. Shrader/D. Shell§n-Water meter/S.N. #22812186
oerger
Initial Static Levels:- Septic Tank 3.70' ; Seepage Pit 1.20' '~ .
TEST DATA
Time Septic Tank Seepage Pit Added, gal Reading, gal Remarks
Ck levels.
8:30 4.7' 11.1' -0- 12,049 7/2/79
8~45 " 11.0' 50 12,099
8:58 " 10.9' 50 12,149
9:25 , " 10.7' 50 12,249
9:38 " t0.6' 50 12,299
9:50 " 10.55' 50 12,349
10:03 " 10.45' 50 12,399 End Test
Day 1.
350 gal. 350 gal.
8:50 4.8' 11.0' -0- 12,409 7/3/79
Ck levels.
9:02 " 10.89' 50 12,459
9:08 " 10.79' 50 12,509
9:18 " 10.71' 50 12,559
'9:26 " 10.64' 50 12,609
9:36 " 10.53' 50 12,659
9:44 " 10.44' 50 12,709
9:55 ," 10.34' 50 12,759 End Test
Day 2.
350 gal. 350 gal.
** Top of Standpipe to liquid level.
Owner: Mr. Jerry Goard Project No. 02579
Legal Description: Lot 14', Block 5, Bruin Park Subdivision.
TEST DATA (Cont'd)
· Liquid De~th,' ft' Water Meter
Time Septic Tank Seepage Pit Added, gal Reading, gal Remarks
9': 00 5.0 ' 11 . I ' -0- _ 7/4/79
Dnv 3.
Form Approved
~HA Form 2573 u.s. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Budget Bureau No. 63-R296.8
Rev. July 1958 FEDERAL HOUSING ADMINISTRATION
~' HEALTH AUTHORITY APPROVAL
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM
PART I.--TO BE COMPLETED BY FHA
INSURING OFFICE MORTGAGEE SERIAL NO.
MORTGAGOR OR SPONSOR PROPERTY ADDRESS
SU,D,V,S,ON NAME th, Ri, Rutr [ ~6cK NO.
TOTAL
NUMBERz
Con attic er other area be mede into
BASEMENT
~ New installation additional bedrooms?
LIVING UNITS BEDROOMS BATHS
{If Yes, how man)f)
WATER SUPPLY BY, SYSTEM DESIGNED FOR
O Public system J'--J Community system [-~ Individual ,o. o, ,o,,s. GA,,^O,'O,S,OS^L
SEWAGE DISPOSAL BY,
~ Public system D Community system Iii Individual ~ D Yes [] No
PART fl.--TO BE COMPLETED BY HEALTH DEPARTMENT
HEALTH DEPARTMENT INSPECTOR'S SKETCH
,
...... ,--4 ....
~. --. [..__ -.-~ .
......
. ' _.~ .... ~--- _~ ~ -
..... ~ ~-~ ........ ~- L---
t ,
...... ~- . ~--~ .... ~_~- .....
,.,,. - -- .,.~ ~- ..... ..., ~.,_~ .... ~ .---..-
~ ..........., ~ .--~ .... ...~_._ -q ~---_~-
' -4 I
..... .' ~ '-Z .......... '~ ' .... '
~- -~ ~- ....................... -~ ..... -q ~- J
~ -~ ~ ~ -~.- .... .~_~
~- -4 ~- -1 ..... - .........
~ ~ Z~ -' ........ '
.....
~_ ...... ~ .~ .... -~-~ .
. [.. ...... ~ -4 L.. ......
It is the opinion of the D State [--1 County [~ Local Department of Health that this individual
water-supply
[-~ is D is not satisfactory as a domestic water supply for the subject property.
It is the opinion of the ~ State [--] County ~] Local Department of Health that this individual
sewage-disposal
sys-
tem with proper maintenance:
~ Can be expected to function satisfactorily, and N Cannot be expected to function satisfactorily
is no~ likely to create an insanitary condition
D---ATE SIGNATURE /, ,.' J TITLE
NOTE, Tho hoelth ea~rl~y/h~"jd:~, - -.,. *-_ __,,ropiere'~ ~""~'--- -- --:--thoePPrOPrIOtoOPieIoa stoteme.t ,.bore and affix dote, signet,re ..d title In the
spaces provided.
t:s® Dj tho above grid ~or Health Department InspeCtor's Sketch as well es use of tho back of this form is at the option of the
health authority.
PART III.~FOR USE OF FHA OFFICE
TO THE CHIEF UNDERWRITER~
I have reviewed the foregoing and the pertinent FHA Compliance Inspection Report, and recommend that the
Individual water-supply system be considered J'--J Acceptable J-'] Not Acceptable
Sewage disposal be considered J--J Acceptable J~l Not Acceptable.
DATE
SIGNATURE
D CHIEF ARCHITECT
I--I OEPUn' FOR CHIEF ARC,ITECT
HEALTH AUTHORITY APPROVAL
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM
FHA Form 2573
Rev. July 1958
REPORT OF INSPECTION--INDIVIDUAL SEWAGE-DISPOSAL SYSTEM
PRIMARY TREATMENT consists of [] Septic tank.
Septic Tank:
Distance from well .... feet. Material
Total liquid capacity,
Inside length, feet. Inside width,·
Celspool:
Distance from: Well, feet; foundation,
Inside diameter, feet. Depth,
SECONDARY TREATMENT consists of [] Tile disposal field.
'TiM Disposal Field:
Distance from: Well,
Total length of tile lines,.
Trench width
Length of each line
gallons. Capacity inlet compartment,
feet. Liquid depth,
[] Cesspool.
Number of compartments
feet.
gallons.
feet; nearest lot line at [] front, [] side, [] rear,.
feet. Liquid'capacity, gallons. Lining material
[] Seepage pits. Other.
,.. feet; foundation, feet; nearest lot line at [] front, [] side, [] rear,
feet. Number of lines, Distance between lines
inches. Total effective absorption area in bottom of trenches feet. Depth, top of tile to finish grade,
Type of filter material: [] Gravel. [] Broken stone. Other.
Depth of filter material beneath tile,~ inches. Depth of filter material over tile.
Seepage Pits:
Number of pits ..... Outside diameter, feet. Depth,.
Distance from: Well, feet; building foundation,__
Inspedlon made by: [] State.
Date of inspection
feet.
square feet.
inches.
feet. Lining material
feet; nearest lot line at [] front, [] side, [] rear,
[] County. [] Local Health Authority.
Inspected by
19__
(TITLE)
inches.
feet.
REPORT OF INSPECTION--INDIVIDUAL WATER-SUPPLY SYSTEM
Distance to nearest public water main,__ __feet. Size of main, inches.
Individual wells [] are [] are not custotnary in neighborhood.
Give most recent record of failure of wells in immediate vicinity to furnish adequate supply of water
Properties in neighborhood [] are [] are not being deveh)ped with both individual water-supply and sewage-disposal systems.
Lot size: feet wide ____feet deep. Dwelling set back from front property line, feet.
Individual water supply from: [] Drilled well. [] Driven well. [] Dug well. [] Bored well.
Distance of well from:
Building foundation
cast iron sewer,
seepage pit,
Well construction:
Diameter,
feet; tile sewer,
.feet; cesspool,
feet; nearest lot line at [] front, [] side, [] rear,
__ feet; septic tank, feet; disposal field,
feet; other sources o£ possible pollution, ~'eet.
inches. Total depth,
Approximate depth to pumping level of water in well,.
Sealed watertight to depth of feet.
Exterior space around casing sealed with: [] Cement grout. [] Puddled clay. [] Ordinary backfill.
Well cover: [] Concrete. [] Wood. [] Metal. Openings in well cover watertight: [] Yes. [] No.
Pump: [] Shallow well. [] Deep well. Length of drop pipe,, feet. Pump capacity,
Ix)cated in: [] Basement. [] Pumproom off basement. [] Pumphouse above ground. [] Pump pit.
Pumproom properly drained: [] Yes. [] No. Pump mounting watertight: [] Yes. [] No.
Type of storage: [] Pressure. [] Gravity. Capacity, gallons.
Has bacteriological examination of water been made? [] Yes. [] No. If answer is "yes," give date
Quality of water [] is [] is not satisfactory for human consumption.
Installation [] does [] does not comply with approved exhibits, if any.
Inspection made by: [] State. [] County. [] ITT'al Health Authority.
Inspected by
Date of inspection 19__
feet. Type of casing,. Depth of casing,
feet. Approximate yield, gallons per minute.
.gallons per minute.
(TITLE)
feet;
.feet.
HUE~.WaBh., D. C.
REQUEST.FOR APPROVAL OF
i: INu~VIDUAL SEWAGE AND WATER FACILITIES
(Fill out in Triplicate)
~. Name of person requesting approval .........
2.
,~. o~ ~o~:ow~ :~,~~ ~_~ ...... ~ er: ~,,z .~ "~ , ,
Numb~z of.bedrooms in house
~ater~.nal~slS:'
.~.~ .. ~,,-,¢~,( ....... .
Casing
Distance from well to closest existing or proposed:
8ewer line
3. Seepage Area__
Cesspool' ..
5. Property Line
6. Other sources of Possible contamination, i.e., creeks, lakes,
houses~ barn, drainage ditch, e%c.
Sewage disposal system.
a. Age of syste~n ~ ~? ~ '
b. Septic tank capacity in galions ~ /~'~)O ,
....
c. Name of septic tank manufactu,~ _, ~ ~ .
'~' i~ ....... ~z ....... ' .....
1. If "home made" show diagram on ~everse ~ide of this foPm.
d.' Disposal field om seepage pit size and type
Perco,Latio~ Test '~es~Lt.s
f. Percolation Test performed by
Use the reverse .side of this form to show diagram. Diagram should include
~--,he foilowlng information: p?operty llnes,.well location, house location,
~utic tank location, disposal area location, location of percolation test,
an~ direction of ground slope.
9. The~m-~,~.~t~ ~'on .on this form is' true and correct to the best of my knowledge.
'~'ig~ature of Applicant'
TO BE FILLED OU'f BY HEALTH DEPAET~.~ENT PERSONNEL
above described sanitary facilities are hereby approved, subjec~ to the
~'l!owing con~l,~ions: ~ - .....
Conditions:
The above described sanitary facilities are disapproved for the followin~
Approval is valid for one year following the date of approval.
CPJ:cw
• Municipality of Anchorage 14 -••
On-Site Water and Wastewater Program • M� {
u�yQ!rl
(907) 343-7904 t
J•
Certificate of On-Site Systems Approval /0668 •
Parcel I.D. 016-111-32 Expiration Date: o —1
1. GENERAL INFORMATION
Complete legal description Bruin Park Block 5 Lot 14
Location (site address) 11331 Polar Drive
Current Property owner(s) June Goard Revocable Trust Day phone
Mailing address 11331 Polar Drive Anchorage, AK 99516
Real Estate Agent Day phone
2. TYPE OF DWELLING:
El Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
Received by. l41 S ego kW' Date: )1a.010
COSA to be released to the engineer,unless otherwise requesteld by the engineer.
COSA Fee $ oZ.cASWaiver Fee $
Date of Payment (1(b )1S Date of Payment
Receipt Number (A03i1 G Receipt Number
COSA# �C�0 n 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 It safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that
based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply
and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances,and regulations in effect at
the time of installation.
In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA
guidelines and regulations.The reported results describe the performance of the system under the conditions encountered at the time of the test,
and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil
condition,ground water levels that may fluctuate during the year,and the water usage of the family being served by the system.These conditions
are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future
performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty
for future performance, nor can we estimate remaining life of the system.The content of this report is for the sole benefit of the owner listed
above.
Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218
Address P.O. Box 100217, Anchorage Ak. 99510
Engineer's Printed Name Steven R Pannone Date 3/15/2018
OF Ak
Ale 4,9_11-1 �\ 9 �I
6. DSD SIGNATURE 0""'. ' '!�
System #1 Approved for bedroomse enR.'�anrione,
r��� �. CE-8149.• s
System#2 Approved for bedrooms s•. •� ,r
Disapproved kl �\```�
Conditional approval for bedrooms, with the following stipulations:
\G\���`�v OF/41v
'0
F/Ilv 'Ci
ON-SITE '
WATER AND '`rk
s�� WASTEWATER
PROGRAM o
liAdr Srfl'CFS
Original Certificate Date: 20-C
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet S • c
If more than 1 septic system is on the lot:
COSA Checklist# 1 of 1
Structure served by this system 1
Certificate of On-Site Systems Approval Checklist
Legal Description: Bruin Park Block 5 Lot 14 Parcel ID:016-111-32
A. WELL DATA
Well type Private If A, B, or C provide PWSID# Well Log (Y/N) N
Date completed 1969 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y
Total depth 103 ft. Cased to UNK ft. Casing height(above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test UNK 3/15/18
Static water level UNK ft 60.7 ft
Well production UNK gpm 5.7 g p m
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 mL Nitrate ND mg/L
Arsenic 5.67 ug/L Date of sample: 3/12/18 Collected by: PES
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel Date installed 9/27/2017
Tank size 1000 gal. Number of Compartments 2 Cleanouts(Y/N) Y
Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N/A
Date of pumping NEW Pumper N/A
C. ABSORPTION FIELD DATA
Date installed 9/27/2017 Soil rating (g.p.d./ft2 or ft2/bdrm) 1 GPD/SF System type Deep Trench
Length 35.0 ft. Width 2.5 ft. Gravel below pipe 7.0 ft.
Total depth 12.0 ft. Eff. absorption area 490 ft2 Monitoring tube Y Depression over field NJ
Date of adequacy test NEW Results(Pass/Fail) For 3 bedrooms
Fluid depth in absorption field before test in. Water added gal. New depth in.
Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d.
N
Any rejuvenation treatment(past 12 mo.) (Y/N &type) If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off' level at in. High water alarm level at in.
Datum Cycles tested Meets alarm&circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100+ On adjacent lots 100+
Absorption field on lot 100+ On adjacent lots 100+
Public sewer main 75+ Public sewer manhole/cleanout 100+
Sewer/septic service line 25+ Holding tank 100+
Animal containment areas 50+ Manure/animal excrete storage areas 100+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundations ' IO" Property line 5+ Absorption field 5+
Water main 10+ Water service line 10+ Surface water 100+
Wells on adjacent lots 100+
ABSORPTION FIELD ON LOT TO:
Property line 10+ Building foundation 10+ Water main 10+
Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+
Curtain drain 50+ Wells on adjacent lots 100+
F. COMMENTS
G. ENGINEER'S CERTIFICATION �kpF ALikkk
/ certify that ! have determined through field inspections and Al ti
eb.- • �)�•�:9' vA
review of Municipal records that the above systems are in *; .. /\ -.*To
conformance with MOA COSA guidelines in effect on this date. 0 :l!
Steven Pannone
Engineer's Printed Name . r•• S1everi 12.•�annore• 04
Date 3/15/2018 61:.. CE-8149 il
‘Wi‘,,*.%Z: :ESS113tio.-
COSA canary sheet_2-6-15.doc
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PLOT PLAN _ AS BUILT _ SCALE 1" = 40' GRID SW 2833 Project No. 18-080/A1
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & Associates, inc . (907) 522-6476 'Phone �o�
(907) 522-4625 Fax Q�
Professional Land SurveyorskenOlangsurvey.com 8 OF q �pp(��,,
jonathanOlangsurvey.com '�. .. '. ..''gs"h_
I hereby certify that I have surveyed the following described property:
LOT 14, BLOCK 5, BRUIN PARK SUBDIVISION (PLAT No. P-2229) 41-9Th y
Anchorage Recording District, Alaska, and that the improvements situated thereon ore
within the property lines and do not encroach onto the property adjacent thereto, that
no improvements on the properly lying adjacent thereto encroach on the surveyed •• ••
premises and that there are no roadways, transmission lines or other visible '• KENN G
easements on said properly except as indicated hereon. �j► 2l1 �e ,.'
{{� �� � . S-5202.
Doted this the > Day of MI6/[,14 , 2.0 lB , at Anchorage, Alaska ,off •••• O
ION
It is the responsibility of the owner to determine the existence of any easements, CSA
covenants, or restrictions which do not appear on therecorded subdivision plat. AECC963