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HomeMy WebLinkAboutTHIBAULT LT 2Thibault Lot 2 #051-232-73 tNev uotuzri u/ Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211283 PID Number: 051-232-73 Dwelling: K Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name Jacques and Jean Thibault A,SORPTION FIELD ❑ p Trench ❑Wide Trench El Bed El Mound Site Address 18036 S Birchwood Lp ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 D/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from origina ade Gravel depth beneath pipe Ft. Subdivision Block Lot Thibault 2 Fill added above original grade Ft. vel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Di s ce between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between enches From Tank Field Tank Line Ftz t. Well >1 ��� NA NA NA NA TANK 9Septic ❑ S.T.E.P. ❑ Holding E] Other Manufacturer Greer Capacity 1000 Gal. Surface Water >1 00 NA NA NA Material Number of compartments Lot Line >10' NA NA NA NA plastic 2 Foundation >10' NA NA NA LI1T�STATION Manufacturer Capacity Remarks Gal. Alarm location Elec r . stalled by PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield Installer JRs Septic Drainfield 3034 CO/MT3034 Inspector Curtis Townsend BENCH MARK (Assumed elevation) 100 ft Inspection1�t 7/22/2021 8/7/2021 Location and description ection 2�a door threshhold near point A 3'd 4"' ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp OF Conditional Approval: Date ®COTH . `.. ... .. ...... .. •.•a Curtis L T wns • • jo ��• Date 7 til "t�y�� Septic System Appro �.." Date ��Fcs•.•f�o.c�i�soa .• F S Note: this approval does not include well permit requirements. tNev uotuzri u/ W N�C7 0 c�D�DD ms D(A-D�OM SzmC)r;umrm >00Or"NK OmDKO TJ=CO -ID <�nOT, M�moOO-E mnom� �D�DZODo--{ 00 0rn z D m rn rrnzn -D Cn�cmCD0x �TU) C7 m S z 4 p K m D= 00 Z DC)�-r7=zZc m00 OD�7zTn�D��Z>C)M F <�zrM n 0 2 C 77 r- ---I rn0- z O <�OC� CnpZ z M SONCA D M z I W O W D zy O m O (n ;0 CD r Z a C- M 0 > cn N z m = m D C cn Q0 LTI I ®,®®Lu,ja® IV '•� D • o -;�0 `! n F�= 00 0 :o® 0C) ;10mx z : •\ All � n Z ' O _ r D m rn � m D C C ;=1z O mrO D —m =cn M o z N W N v W m O m co C/) � N O II - n O N rI n W W W O � j I W O W D zy O m O (n ;0 CD r Z a C- M 0 > cn N z m = m D C cn Q0 LTI I ®,®®Lu,ja® IV '•� D • o -;�0 `! n F�= 00 0 :o® 0C) ;10mx z : •\ All n Z ' O O Easement D O ;10mx Z zmU) n n Z ' O _ D rn 0 O D C C ;=1z O mrO D —m =cn M o x 20' Utility Easement ;10mx zmU) n n Z ' O _ < L7 rn 0 O D C C ;=1z M -D x mrO D —m =cn M o x S (A O CO Mm M 0 X 0 O K 0 n z 0 rr m zz� �On �C-D rn�i D N C7 Kc 0 D> D � Z > m D D Z D Z K O D 0 z0 0 C r m 0 o� \ l �Ole� Zo \\ O 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:lfwww.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP211283 Work Type: SepticTank Upgrade Tax Code Number: 05123273000 Site Legal Address: THIBAULT LT 2 G:1054 Site Mailing Address: 18036 S BIRCHWOOD LOOP RD, Chugiak Owner: THIBAULT JACQUES & JEAN ELLEN Design Engineer: EKLUTNA ENGINEERING, LLC" This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date: Expiration Date me9t G cV M1 n i Departnient Lot Size in Sq Ft: Total Bedrooms. 7/15/2021 7/15/2022 45110 ❑ Private Well ❑ 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 (2417), 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 B Issued By: Y'. Date: 2-1 Date: 3 MUNICIPALITY OF ANCHORAGE e'"tsar Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTICIWELL PERMIT APPLICATION Parcel I.D. 051-232-73 Property owner(s) THIBAULT JACQUES & JEAN ELLEN Day phone Mailing address 18036 S Birchwood Loop Chugiak AK 99567 Site address 18036 S Birchwood Loop Chugiak AK 99567 Legal description (Sub'd., Block & Lot) THIBAULT LT 2 Legal description (Township, Range & Section) Lot Size 45,110 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) El Septic Tank El Upgrade (w/wo ADU) ❑ Holding Tank F-1Renewal ElDuplex (D) Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A 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 okAuthorized agent) Permit/Rush Fees:5 Waiver Fees: Date of Payment: 7/2321 Date of Payment: 11 1 Receipt Number: 60 2-75 D Receipt Number: Permit No. ()Sp,111 2 & S Waiver No. GADevelopment Services\Building Safety\On Site Water and WastewaterTorms\Client Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211283, Deb Wockenfuss, 07/15/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211283, Deb Wockenfuss, 07/15/21 Municipality of Anchorage Community Development Department Page 1 of 4 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: PID Number: 051-232-73 ❑ New ❑ Upgrade Name: Jacques & Jean Thibault ABSORPTION FIELD Address 18036 South Birchwood Loop Road, Chugaik, 99567 ❑ Deep Trench 1 ❑ Other Shallow Trench ❑ Bed ❑ Mound Phone Number of Bedrooms 3 Soil Rating 1.2 GPD/SF Total depth from original grade 8 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 4 Ft. 4Ft. Thibault 2 Fill added above original grade Gravel length Township Range Section 0 Ft. 40 R. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES 5Ft. n/a n/aFt. To From Septic Tank Absorption Field Lift Station Holding Tank Sewer Line Total absorption area 400 Ft' Number of trenches 1 Dist. between trenches n/a Ft. Well 107.9 148.2 N/A N/A 84 TANK ❑+ Septic • S.T.E.P. • Holding ■ Other Manufacturer Capacity Surface Water 100+ 100+ N/A N/A Existing 1000GaI. NA Material Steel Number of compartments 2 . Lot Line 25.9 8.0 N/A N/A Foundation 19.0 63.4 N/A N/A LIFT STATION Manufacturer Capacity Gal. Curtain Drain N/A N/A N/A N/A Remarks This system was installed by the owner. Pump on level at Pump off level at High water alarm at P.E.S. exposed and documented this system on 8/7/13. in. in. in. Pump make and model Electrical Inspections performed by Installer to PIPE MATERIAL House to tank 3034 Tank drainfieId 3034 Unknown Drainfield 3034 CO/MT 3034 Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 100ft Inspection rt g!7/2013 m dates: 2 Location and description 3" 4"' Corner of house COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Conditional Approval: Date Engineer's Stamp �'r1\ age ,� 4 :Q`�� AC-2-e-' ed� n sr-e yr Re�Gv?` estate/ 9 � /- % p en i.#annt%ae' • �©Cr r �+. Inspection Report_1-1-12.doc LSEPTIC AREA (E) DRAIN FIELD (E) 4OLF x 5'W x 4.0'ED x 8.01T WELL (E) 1* 7148.2 0009 SEPTIC TANK (E) 10.7.9 (E) w NOTES: RECORD DRAWING PLAN WELL(E) PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 THIBAULT, LOT 2 JACQUES & JEAN THIBAULT 18036 SOUTH BIRCHWOOD LOOP ROAD ANCHORAGE, AK 99567 .„,..-•4.1%.%.1kt,,, --4Z 9. :41(44 ,:..---c .. • • . ,9 1 ...,4:. i Ao .Jr A Al*: 49 TH A.\ ..*y , az 100, Nir Al ed 4 Steven R. Pannone fri 6 v... CE 8149 ..:* \ Arr •U bP0FESSIa\kl....e Date ‘•ANNA.".*1.07— 0 kJ 10/9/2013 Scale 1"=50' P.I.D. NO 051-232-73 PERMIT NO. OSPXXXXXX Sheet 2 OF 4 A B C T1 20.8 35,7 0.0 T2 26.7 42.5 0.0 01 29.3 45.4 0.0 C2 45.5 62.3 0.0 C3 96.9 113.2 0.0 M1 66.4 78.6 0.0 WELL 73.3 54.6 THIBAULT, LOT 2 JACQUES & JEAN THIBAULT 18036 SOUTH BIRCHWOOD LOOP ROAD ANCHORAGE, AK 99567 .„,..-•4.1%.%.1kt,,, --4Z 9. :41(44 ,:..---c .. • • . ,9 1 ...,4:. i Ao .Jr A Al*: 49 TH A.\ ..*y , az 100, Nir Al ed 4 Steven R. Pannone fri 6 v... CE 8149 ..:* \ Arr •U bP0FESSIa\kl....e Date ‘•ANNA.".*1.07— 0 kJ 10/9/2013 Scale 1"=50' P.I.D. NO 051-232-73 PERMIT NO. OSPXXXXXX Sheet 2 OF 4 FILTER FABRIC 4" 0 DRAIN PIPE DRAIN ROCK 6" ABOVE PIPE INV w z o —= Qo z o -J t_ 0 0 0 97.8 0 0 0 1000 g SEPTIC TANK (P) LEGEND W WATER LINE/ WELL RADIUS SS NEW SEPTIC 0 0 0 CLEAN OUT FILTER FABRIC 4" 0 DRAIN PIPE DRAIN ROCK 6" ABOVE PIPE INV = 00 90.4 DRAIN ROCK DESIGN PARAMETERS RESERVE SEPTIC SYSTEM NO. BEDROOM: 3 (450 gpd) TANK SIZE: 1000g PERC RATE = 1 MPI SOIL RATING: 1.2 GPD/SF AREA RQD: 375 SF SYS. TYPE: WIDE TRENCH 4'ED RF: 0.50 MIN LENGTH: 37.5 LF USED: 40 LF X 5' WIDE, 4.0' E.D., 8.0' TD TOTAL AREA: 400 SF ABBREVIATIONS cu DIP TH FC T# C# M# R.I. DCO DV FS BFG OG FG TS&V COPPER DUCTILE IRON PIPE TEST HOLE FOUNDATION CLEAN OUT TANK CLEAN OUT NO. CLEAN OUT NO. MONITOR TUBE NO. RIGID INSULATION DOUBLE CLEAN OUT DIVERTER VALVE FLOW SPLITTER BELOW FINISH GRADE ORIGINAL GRADE FINISH GRADE TOPSOIL & VEGETATE NOTES: RECORD DRAWING PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 DESIGN DETAILS THIBAULT, LOT 2 JACQUES & JEAN THIBAULT 18036 SOUTH BIRCHWOOD LOOP ROAD ANCHORAGE, AK 99567 cK of a/.4 `kkl ts %1*:TH t*// • Steven R. Pannone CE 8149 Date 8/20/2013 Scale NTS P.I.D. NO 051-232-73 PERMIT NO. OSPXXXXXX Sheet 3 OF 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 TEST HOLE 1 OR GPI GM ORGANICS SILTY - POORLY GRADED GRAVEL GM SILTY GRAVEL BOH DATE PERFORMED: 8/7113 SOILS LOG - PERCOLATION TEST SLOPE X TH SITE PLAN i WAS GROUND WATER ENCOUNTERED? N IF YES, AT WHAT DEPTH? DEPTH TO WATER AFTER MONITORING? --. DATE: 8/16/2013 SLOPE TH X READING DATE CLOCK TIME NET TIME WATER LEVEL READING NET DROP 1 8/7/13 9:35 - 1.94 - 2 9:40:20 5.33 MIN 7.94 6 (DRY) 3 9:41 - 1.94 - 4 9:46:45 5.75 MIN 7.94 6 (DRY) 5 9:47 - 1.94 - e 9:53:05 6.1 MIN 7.94 6 (DRY) PEROLATION RATE 1.01 (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 4 FT AND 5 FT COMMENTS: Test hole excavated by JR's SEPTIC PUMPING. Prec hole was presoaked. PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: RECORD DRAWING PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 SOILS LOG THIBAULT, LOT 2 JACQUES & JEAN THIBAULT 18036 SOUTH BIRCHWOOD LOOP ROAD ANCHORAGE, AK 99567 `icOF A���4 * 49 4' .*r+l teven R. Pannone rOa . CE 8149 .if r Date 8/20/2013 Scale NTS P.I.D. NO 051-232-73 PERMIT NO. OSPXXXXXX Sheet 4 OF 4 -' • MUNICIPALITY OF ANCHORAGE r'r 1 .±..,{ 1 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 254.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME 5""'".—"^ Aar Ar T PHONE IIEW [ UPGRADE MAI LINGrES e / ZZOd 7/1 LEGAL DESCRIPTION 2 e L 7 in Lo2-07 gec /2 77,)--A(/ �/� SW LOCATION NO. OF BEDROOMS S LSEPTIC TANK DISTANCE TO: I �'7�/l.%i I Absor rra � DwelllryB- (L JS 7__ PERMJT�.N¢, . �f/(/%1/` , „are., Manufac er ee— / Y Met / No. of compartmentu -e Liq.ca ci n ggltons IF HOMEMADE: Inside length Width Liquid depth O2 0 Z 4 DISTANCE T0: Wel Dwelling PERMIT NO. Manufacturer Material Liquid capacity in gallons TILE DRAINFtPtD TRENCH DISTANCE TO: We> g, { /� % Foundatj y° „- /" Nearestlpi.liner_.. Jidth Z. P Ij'f�0�,��neee ywee No. of lines / 1 Leogtlh/yVf7ea�lind c..7 V Total leen f eye: Trenc U inches Distance n m in t ei h grade f . / KLA"7E4 �M�tenaa bssn_ t tie �/'j,N 2 2,'S/ e inches Total effect'v bsorpti on area SEEPAGE NT Length Width epth PERMIT NO. Type of crib Crib diameter %Drib 1MA Total effective absorption area DISTANCE TO: Well Bui in foundation Nearest lot line J -1 iC Di Class / ` w g� Depth 4.4...) Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorption [reads) OTHER PIPE MATERIALS ,V/ _ 6 SOIL TEST R NG dry 00 r 2 INSTALLED et a /A ` 9V' ee Pr° R EMARKS (t/Poo as n-••- L C3 � f)e`m/I fec4&Ip.� ,/ eV/ eine gib/% C I `f 5'k- uta `61 • r k.' l(n\ \ WV S a isPA ,N,.�.a•� 5011b_ p. 0 Robert 4,_ ,f t-0,,,,No. 1457-E tirraE. N,` p `•ton ..... •`FSSlur3 • ''�•".k RO DATE LEGA �,� 108X mama i , �/ (,PPIVER ALAASKA • 99677 �!/ /�i rid, 0$4-2979 MUNICIPALITY OF ANCHORAGE .Department. . Health and Environmental `rotection 825 . Street, Anchorage, AK. .J501 264-4720 * * HANDWRITTEN PERMIT * * * " , /OR ON-SITE .SEWER PERMIT Applicant: \j/..171/61-6/6.-7- Mailing Address: $/Fe j- 4?4 off' 07({9/ f Location: s• 6//PC/5GJ65o4)1r 'Phone Number: 3n c — Permit # 5al-A as * Legal Description: e_ 2 t .00( 7/ j /V k',W S.I2 Lot Size: Type of. Sail.Absorption System Is: .. -- Trench: Drainfieldx Seepage Bed: \C Holding Maximum Number of Bedrooms: 1 .Soil Rating(sq.ft%br), Tank: The Required Size of the Soil Absorption System Is: :DEPTH. LENGTH /0 )C'&8 -GRAVEL DEPTH / •WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth. of a trench or pi- is. the distance between the surface of the ground and the bottom of the excavation(in feet). 'There is ho set width for trenches. . The gravel depth is the minimum depth of gravel between the outfall pipe and. :the:bottom of the excavation(in feet). * *"REQUIRED S:EPTIC(HOLD.ING) TANK SIZE = £Z!/ -GALLONS * * Permit applicant has the responsibility to inform this department during<the installation :inspections.ofany wells adjacent -to this•.property and the number off residences that the well will serve.. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of..any system without_f.inal.inspection.and approval by this departmer will be subject -to prosecution. Minimum..distance between ,a well and any on-site sewage disposal system is 100 fee far 'a private.well or 150 -to 200 -feet from a _public weli.depending-upon the type of :public well. Minimum distance from a private well.to..a private sewer line is'25.:feet and to a .community sewer.line is75 feet.. Well logs are required and.must be returned.to this department within .30 .days Of the well completion. Other•.requirements may apply.-Sp-ecifications.and.coastruction diagrams are available to .insure proper installation. • * * * PERMIT -EXPIRES DECEMBER 31,.1 9 82 * * * I. certify that: I-an.familiar with the requirements for on-site sewers and wells as set .forth by the Municipality of Anchorage. I.wi 'nstall �< e system in accordance with. codes. I..0 der- nd fir, the on -site -sewer system may require -enlargement if i,-.remode.led to include more that .3 bedrooms. 'SigneE 1icant SWP./0.24(.1/81) Issued by: UUU Date:/)/( . Ba IC 2.2o7 5gi3 hat PERFORMED FOR: LEGAL DESCRIPTION: 10 11 12 13 14 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 80501 264-4720 1 SOILS LOG - PERCOLATION TEST 4 2 54,41 ZoT2 c? �( or/lie SiLry--571,6/J CH /Said 15 !►_ sap n.sa.. AL 16 S `aii A, 17 18 19 20 COMMENTS tomove 4 .c' 1:: nZ 2WOV1.lnilRG !M 11A; sX9577 PERFORMEDINIL9IY^: .'rl.! �.�.1e 72-008 (6/791 SLOPE DATE PERFORMED: gSOILS LOG ❑ PERCOLATION TEST SP Cs /f r /Sn/ if'/ lea .S� SITE PLAN WAS GROUND WATER ENCOUNTERED? IF VES, AT WHAT DEPTH? S L 0 P E icctt4\\i,t rTh pr ■uuu1111 gas moommmus Reading Date Gross Time Net Time Depth o Water Net Drop 1 /4 ir I PERCOLATION RATE (minutes/inch) TEST RUN BE WEEN FT AND FT an 1 c Co/if -7 ino nth 7 gi✓'!' iti • CERTIFIED BV DATE: PERFORMED FOR: SOILS LOG MUNICIPALITY OF ANCHORAGE MUNICIPALITLuOF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION)FPT Cr I : PEAC QLATION 825 L. Street, Anchorage, Alaska 99501 2644720 ENVIL )i1 .hi A. T9f7F-_.)I_.I J � tit SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: 1— Ci 13 L ivl L 0 7 10 11 12 13 14 2.o 5L organ! c // c-kuu av 'yak 64 111 C e27 44c� 15 n0. L - .oa • 16 17 IlrTZrl A. •, / rr. 18 �1 A_ .k°a„ Nn. 1457.E ` .?",4,46,H ..II h•+� 1901'F'F"Ik" k JT'. 20 COMMENTS SLOPE AUG 1 9 1982 DATE PERFOF IIEE ,� E `V E D SP C�c /s7/l�✓ 5'G /3 SIT PLAN Co WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? 1/4e..S\ 0 O P /0 E U 3 Reading Date Gross Time Net Time Depth o Water Net Drop ? 9 te Alha— '1) PERCOLATION RATE TEST RUN BETWEEN ,tea 8 s;NOI86X RING• PERFORMED BY - ALASKA @911%x. ' *3H. 94zxr9 72-008 (6/79) CERTIFIED B FT AND (minutes/Inch) FT DATE: L.. :E `8-' " r° CH IF m R V. -41C3: II IFr ° IES DEPARTMENT OF HEALTH FINN.: ENVIRONMENTAL v'ROTECTICINI 825 'L STREET. ANCHORAGE.. FIK. 99501 ;264-47 20 F a.° a I -T PERMIT NO. 3 :06 G ) APPLICANT JAQUES THIEBFII,IL..F LOCATION LOT 2 TFIIEFII_II_.I SBDV. LEGAL :.E1: :I-, ;-- T±5Nd—R::I.H ST. RT. BOX 2208 E;E8-2898 LOT SIZE: 4900 SQUARE FEET I.IINI.MI—IM DISTANCE EIETL.IEEFI Fi I:.IELL.. FIND ANY ON—SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 1501 TO 20001 FEET FROM A PL.IEILIC: WELL. DEPENDING UPON THE TYPE: OF PUBLIC .TELL. MINIMUM DISTANCE FROM FI PRIVATE WELL TO A PRIVATE SEL+IEE: LINE I5 25 FE:L:T AND TO Fi COMMUNITY SEWER L.1NE IS 75 FEET. WELL. LOGS ARE: REQUIRED AND MUST E:E RETURNED TO THE DEPARTMENT WITHIN 313 DAYS OF THE FIF.IJ_ C:OMF'I,,.E:TION. OTHER REQUIREMENTS MAY APPLY. SPEC:IFIC:ATIONS AND CONSTRUCTION DIAGRAMS FIRE AVAILABLE TO INSURE PROPER INSTALLATION. F" F F1 a 1. —IF a � a F 1 F: EES EE x__ N B E-. I CERTIFY THFiT • 1: 1: ANI FAMILIAR WITH THE R:E:rU_IIREMENd-f5 FOR ON --SITE SEWER::. AND WELLS Fr.'_; SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTFII...L.. THE SYSTEM IN ACCORDANCE WITH THE CODES. _;IGNdED: APPLICANT JAQUE'S THIBFIUL.T V4. 41 OEP AR CHEM F ri, HEAL TH HUD ENV I ROHI'IEIJ TI L PROTECT is -SA `I STREET, ANCHORAGE, s -E, AX. 9951?1 R=if ! IN f t°E8 ^F°t : 'r PERI.; 7ts')_ i ?11387 i ) 813tL I CAN I .41GIU£•s' FR I T LOCI; L,)F 2 THIGRIJLF 58Q9. i8—TWN---114 T. F.T. 1 SOY atria Lip 5EZ1 gee -Zan 1 49200 'SQUAW. FEE ` i'1ltd [NUN (', I';-; i AFDC€ 13E THEEN it lat. AND F37HY s)73 -5I TE SEHOW. O LSE's?,A1„ SYS TEN { -ir-_e) i'EsiT FUR A Yf2[4NTF hE1.1, WITs)-20g`"Y.'EET__FRr11.Ifi`P17OL[sb [K'}l DE1=Ei4OItAi 1JF.071 1.7 K' r'ssF'F OF PlJeL Il. WELL 11 rap; alum DISTII7ICE FPOI7 N tRfyin-E 14E1_1_ FO N PRIVATE LINE [5 * FEET MCP Ti) n s:QMHIJN[TY 5�R L Iii€ IS ?5 r €r. WLLL L'JCiS AST:: REQUIRED F4N0 1 H!'.a f OE RE: TURNED TO T}4C DEPFIR T7'1_ N f 11 [ rn [ 7i7.3s3 DRY ,'q' THE HELL CaJIIPLEFtON. siHER R€OUIP NEHT5 HA? APPLY. ' "ELIF[CAT{s51,1 ,rINO Gi77t-trail; TION 0MOTtt'IP7`_`+ ARE . i tiVAillicA.E T4 I it S')RE PROPER WS' TALUi T [ C.E TIPi THAT I :11'1 r F17 IL CAR 1.11 TH THE. REGO { REPICN Ta FOR ON -5 111 SEWER.; AND HEI..L' ti's SET 1)R111 5s' THE- I'IlIMIso {pRL[7"r 131= j*82IiiRF3s)E. : [ H ILL INSTALL THE '='r; r€t r aea'ORDAN w [ ru TIS CODES. - 1591E0 $',° 4.4{<4.4er - On TE ALL ALASKA P.O. SOX 670042 — CHUG!AK, ALASKA 99557 N H O .1; d ii1 4▪ i 4-4 N 0 1 0 0 ) 4-1 0 14 F6 L• L•n 1 n 4-f 0) N 0 0 0 F 0 0 0 0 0 0 0 0 0 0 0 o 0 2) 0 0 0 0 0 © 0 C44 (4 a W W wILI 444' C• CO N G" CO ri s) CLEy ✓ 0 0 lI N 0 0 ?1 N rn r - N ry r-1 u 0. w rt N 0 0 1-4 0© 0 0 0 0 0 0 0 0 OWNER OF LAND • 0 Q DATE — ENDED 0 cwt 8 N rn r -I N O r I- r N C H N 3-11 • rk • - 0c G c .tel Cl of 4" Plastic 0 Cv m �I N • ry N 9) -H F: • r{ E n aJ 4-3r.. o rU a1 rH RS 4a 0 00) Q w O o • In -) • 4-1 p, F; • us• } R.41 a 01 r la o 7s 0 0 0 0 0 0 0 0 • 0 © 0 v: Atl ▪ �w94w MISCL. INFO DRILLERS NAME MUNICIPALITY OF ANCHORAGE 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. 051-232-73 1. GENERAL INFORMATION Expiration Date: / / - //- z Complete legal description TH I BAU LT LT 2 Location (site address) 18036 S Birchwood Loop Chugiak AK 99567 Current property owner(s) THIBAULT JACQUES & JEAN Day phone Mailing address 18036 S Birchwood Loop Chugiak Real estate agent 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone AK 99567 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well El Private Septic E Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distan Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ 55 0 Waiver Fee $ Date of Payment %OA I Date of Payment Receipt Number 01371.0 Receipt Number COSA # 0 5 C Z i l H (o 5 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Eklutna Engineering, LLC Phone 907.406.1058 Address 19162 Mountain Rd, Chugiak AK 99567 Engineer's Printed Name Curtis Townsend, PE Date ! -2-0 L/ fn's'�Z% 6. DSD SIGNATURE System #1 Approved for -3 bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms s eseo ogee • � •• • • •• [)Ste Nwo CE 11904 . 0� 1� • b rte' al�a�s� pR0 FESS10yP�'�� bedrooms, with the following stipulations: Original Certificate Date: Z 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 Checklist blue sheet COSA Checklist Legal Description: THIBAULT LT 2 Parcel ID: 051-232-73 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA ON Well log is filed with Onsite (or attached) Date drilled 1984 Total depth 102 ft Cased to 32 ft ❑ Sanitary seal is functioning correctly F Wires are properly protected Casing height (above ground) -'> 24 in. Date of flow test for COSA 711012021 Static water level at beginning of test 16 ft. Comments B. TANK DATA Age of tank(s) years Tank type/material septic plastic Measured operating fluid level in septic tank OR Standpipes/foundation cleanout per record drawing Date of pumping installed new July 2021 D. ABSORPTION FIELD DATA Which system tested (date installed) unk ❑ ALL standpipes present per record drawing Total measured depth from grade 7.5 ft (max) Measured depth to pipe invert from grade 3.5 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective OR Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Well production at time of test 4.4 gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic 9.3 ug/L ❑ Arsenic less than MRL (ND) Collected by Curtis Townsend Date of Sample 7/11/2021 C. LIFT STATION ❑ Required maintenance comp] Age of lift station y ar§ Lift station material Comment Adequacy test date 7/1012021 Results ❑✓ Pass For 3 bedrooms Fluid depth prior to test 26 in Water added 505 gal New depth 30 in Elapsed time 1440 min Final fluid depth 26 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' 0 Yes Community Sewer Manhole/Cleanout > 100' 0 Yes if No ft ❑✓ Yes if No ft Neighboring Tank > 100' Q Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' FV� Yes if No ft Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' P'l Yes if No ft 0 Yes if No ft if No ft F. ENGINEER'S COMMENTS Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' Q Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' Q Yes if No Water Main > 10' 7/1 Yes if No ft Community Wells > 200' 21 Yes if No. Water Service Line > 10' 0 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' ❑✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No 8 ft Wells on Adjacent Lots: Water Main > 10' ❑✓ Yes if No ft Private Wells > 100' Yes if No Water Service Line > 10' 0 Yes if No ft Community Wells > 200' Yes if No Surface Water > 100' ❑✓ Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that l 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 .> .. ........: �urlia l A 10 Date _ S No. GE 11904 , ,h - ENGINEER'S 81 riv ft ft ft ft „LL X JL :3ZIS 133HS 2 LL. U, 10 C, 1 —Z.- C', < CD M t2 U-) 0 'i 0 F- *11 0 F- 0 1 < M 00 .: 0' LLJ M U) L,J L.1i N w :D c) cn <C'ic; cl� Or. a- :3 Ld C) 0 o <EL U- Z '-In 19 E C14 102 3. L -V,69.625 ,9z 41 > 0 .61E c x :P 'C%4 CL 0 0 C 2 > C: E 0 (D 0 0 0 C-4 -o O V 2 C N c CL 0 0 41 041 -0 E 0 0 0.6 V) 0 0 > 0 .0v O /O — c o o r- wo L- a CLO,�.6 =3 0 Q) 4) �� 4, = C 0 -F- 0 0 U) 0 0 0 '(nD 04 m 0 0) :3 0 ov)) *W- -C C: 0, < to E 0 CD o (D L- -0 r- 0p C 0 C C 0 U- 0 0its 4, 6 (D E L Z I O*oz 0 C 0 0) -� 4- 0 C) 0- 0 co 0.-0) 0 -C C,4 3t: 0 113 01 0) 41 o 00 3: V) C) C,4 J-- a > E VoC,4 a- Q- -i 0 to o to ioz F lb c N 0 CL 0 -10, z CN . �< , % 00 > C tK* c �- 0 D o L- A) 4) c < 0 -C 0 (D.+, �140 (D.T -2 -4SL 0 Q) 1-1 4f w -j Luo') IV Z) N > 0 (D E 0 0 c E < :3 -0 c ,00'26L 0 -0 aM,,00,20./-8N co C: a) 0 c 0 GJ L , -A�,v- 0 0 A 0 0 0 a) 0 z F- j- wo ell ,gz I LO -4 :d L CMI) < -30. C) el 0,Podeee Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 051-232-73 Expiration Date: r✓ — J - 1. 3 1. GENERAL INFORMATION Complete legal description Thibault, Lot 2 Location (site address) 18036 S. Birchwood Loop Current Property owner(s) Jaques &Jean Thibault Day phone 18036 S. Birchwood Loop Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) D Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water SysteiTi ❑ P4blic Sewer ❑ WaiverNariance request for \ , Distance: Received by: COSA to be released to the e er, unless ot`iierwise requested by the engineer. J Date: r ti/rj Gu 13 COSA Fee $ Date of Payment Receipt Number COSA# �l Q4& Waiver Fee $ Date of Payment q(013 Receipt Number Waiver# OSP/3/39g 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. 1 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 f3L'g2CC% Date igj• �1r .'f,17 j O * 49TH ;,t+/ 6. DSD SIGNATURE "' System #1 Approved for 2 bedrooms t` S even. one:'# �+ ,-. CE -8149 .•'� System #2 Approved for bedrooms Disapproved +!!k '`= Conditional approval for bedrooms, with the following stipulations: S' ON SITE �fi WR 1t WASTATEEWoAND R AIM�-- F` irr«,..,,...... /�J By: erage G�'71A Original Certificate Date: /U ' 9 —13 The unic alvelopment 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 E '- 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: Thibault, Lot 2 Parcel ID: 051-232-73 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 11/10/84 Sanitary seal (Y/N) Total depth 102 ft. Date of test Static water level Well production Cased to 102 ft. FROM WELL LOG 11/10/84 60 5.0 ft. g.p.m. WATER SAMPLEIRESULTS: Coliform/Ved colonies/100 mL Nitrate i I) mg/L Arsenic e '3 5 ug/L Date of sample: $/a),(1 3 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1,000 gal. Number of Compartments 2 Foundation cleanout (Y/N) Date of pumping 7 /),171.; Well Log (Y/N) Y Wires properly protected (YIN) Y Casing height (above ground) 36 in. AT INSPECTION 7/30/13 36 5.2 g.p.m. ft. Collected by: FSS Date installed Unknown Cleanouts (YIN) Depression over tank (Y/N) N High water alarm (Y/N) N C. ABSORPTION FIELD DATA Date installed Unknown Length 40 ft. Total depth 8 Pumper Sr s SE,,--, c Soil rating (g.p.d./ft2 or ft2/bdrm) 1.2 GPD/SF Width 5 ft. ft. Eff. absorption area 400 ft2 Date of adequacy test 7/30/13 System type Shallow Trench Gravel below pipe 4 ft. Monitoring tube Y Depression over field N Results (Pass/Fail) Pass Fluid depth in absorption field before test 25 in. Water added 460 gal. Elapsed Time: 130 min. Final fluid depth 25 in. Any rejuvenation treatment (past 12 mo.) (WN & type) No Absorption rate For 3 bedrooms New depth 29 in. >= 450+ If yes, give date g.p.d. D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons in. "Pump off" level at Cycles tested E. SEPARATIpN DISTANCES WELL. ON LCT TO: Septc tank/lift station on lot 101,'+ A'rorption field n lot 100+ ?ublic sewer main 75+ Sewer /septic service line 254 Animal containmer areas 100+ SEPTIC/HOLDING TANK ON LCA r TO: Building foundation 5+ Water main 10+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Manhole/Access (Y/N) in. High water alarm level at Meets alarm & circuit requirements? in. On adjacent lots 100+ On adjacent lots 100+ Public sewer manhole/cleanout 100+ Holding tank 100+ Manure/animal excrete storage areas 100+ Property line 5+ Absorption field 5+ Water service line 10+ Surface water 100+ Property line WitBur ling foundation 1C + Water main 10+ Water Service line 10+ Surf.cce water 100+ Driveway, parking/vehicle storage 10+ Curtain drain 50+ Wells 7n adjacent lots 100+ F. COMMENTS 'P- 'vast' Lo i Luv� us Acv art i o �-117 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 Steven R. Pannone Date 8/20/13 COSA brown sheet 10-10-12.doc 4,73 9t teg.:41kki *149TH J\� e rr 1 1,01 gS • CnE —1 849 ne ��� Page 1 of 1 Poet, Jeff W. From: Steve Pannone [steve@panengak.com] Sent: Monday, October 07, 2013 3:59 PM To: Poet, Jeff W. Subject: Thibault, Lot 2 Good afternoon Jeff, I am writing to request a lot line waive for the existing drainfield. A recent as -built survey by Karabelnikof Surveys shows that the drain field is located eight feet (8') from the east property line. I request a lot line waiver to five feet be issued for this property. Granting this waiver will not affect the future development of the surrounding lots, not endanger the public health. Please call if you have any questions. Steven R. Pannone, P.E. Pannone Engineering Services, LLC 332 East Manor Ave P.O. Box 100217 Anchorage, AK 99510-0217 Ph: (907) 272-8218 Fax:(907) 272-8211 E-mail. stevepanengak.com 10/7/2013 Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http://www.muni.orq/Onsite Development Services Division On -Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: 131378 COSA#: 131489 Permit#: PID#: 051-232-73 Legal Description: Thibault L-2 Engineer: PES Applicant: Jaques & Jean Thibault Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 5.0 feet. This waiver approval applies to the existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. N 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. Waiver is Granted: X Date: / 0 (` / 3 Rec#: Amount: Date Paid: Waiver is not Granted: Approved by: **** VARIANCE/WAIVER REVIEW **** LOT 1 Found 5/8" Rebar Wood Shed No Foundation .1, DENSON LANE 0 0.H. Elec. & Tele. Lines Found Iron Pipe 71 - 0 N) O zoo z 76. v � /' N\ ' 3;N el, 0 PCC vi / •. Landing N00°03'00"W 116.00' 0 0 N Power Line 20' Utility Easement Wood Frame 2—Car Garage w/Concrete Slab 0.‘7 d'\ Sheltered Storage Area \// Clean Out (Typ.) Wood Stairs - N.64,0 o d SCALE : 1" = 30' o' 15' 30' _ooa�lnnt 4 P7',: :*::491:11 ./\ .* Iof .:..�..:99,,e�� - ® �:F, Lee F, �.Karabe In ikoFF: �S Ro IPA Wis No. 3143-S .• :lb. atiS.S.IONAL � A 60' CD � 5 . Split Level Wood Frame`', �14 esidence% � O r): c 9; 0 ,,./ X34.2' 2Cantilever 23.9 Well LOT 2 THIBAULT SUBDIVISION (83-191) 0- 70 <cxy 0 7e< • o I hereby certify that an accurate survey of the following described property: THIBAULT SUBDIVISION (83-191) LOT 2 was made on August 26, 2013 and that the improvements situated thereon are within the property fines and do not overlap or encroach on the property Tying 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. Easements other than those shown on the record plat may not appear on this drawing. Anchorage Alaska, this 27th day of August 2013. Found 2" Iron Pipe No Cap 1.2" B.G.L. LOT 2 10 m LOT 195 PREPARED FOR: JACQUES THIBAULT AS -BUILT DWN. JSP DATE 8/27/2013 GRID NW 1054 FILE NO. 1339 F.B. 2013 PG. 63 JOB NO. 1379 KARA/BELNI KOFF Sly R ✓ E / /I N (909) 337-3434