HomeMy WebLinkAboutT15N R1W SEC 30 LT 51T15N R1W
Sec. 30
Lot 51
#051 - 293 - 38
'T MUNICIPALITY OF ANCHORAGE r
DEFF..,4TMENT OF HEALTH AND HUMAN SERV...iS
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name
11
DISTANCES
��(a t yn1 Y l LAkin r tL co KATO
SEPTIC
ABSORPTION
Address
FROM
TANK
FIELD
WELL
-Pr O , I-ox32.---S
Phonels)
Permit No.
No. of Bedrooms
WELL
1 D o t a-
1 0 ot i-
Lba, g _q S (06
8(901 LI 1
3
LEGAL DESCRIPTION
LOT LINE
Z -o t }
\2 -0 t ~
1 (]' ~
Lot
Block
Subdivision
S I
—.
'—
FOUNDATION
I
1 r
Township, Range, Section
Tot
U o'
a
1-6---1-6---f �� )
AS -BUILT DIAGRAM (Show location of well,
driveway. water bodies etc.)
septic tem. prope ty lin s, loundation,
TANKS
�T
IV
SEPTIC ■ HOLDING
' ?
Ma�nulwac,turer
Capacity in gallons
0l
_y G -to ain
1 0 0 0
Material
Na of Compartments
J
�
Sv t�fL l.--
Cr-Zit,'
Z
O
/
TYPE OF
SYSTEM
'_
?Co
PGs of
I1 'TRENCH ■ BED
■ W. DRAIN • OTHER
¢
Jf
Depth to pipe bottom from ,
original grade L
Total depth from original grade
e
a.'
FT
FT�a0
Fill added above original grade
Gravel depth beneath pipe
a
_ �FT
LA -RT.
�!
sio:
spa
-ice.
ca
I
"'�"—�
%�
Gravel IonaGravel
3Z FT
widen'`
Z•S FT
°•-T»^_,,,_..-.+
(
tit
Total absorption area
S
Distance between lines
t/
�
�
2 6 SO FT
FT
�
,
Number 01 lines
Soil rting
Pipe material
d
I BS—so FT
?VL. A-Srp4 tSso-sL{
Installer
5I oe-r
Date Installed
le- `-/-3&
(17
V
___
WELLS
ki PRIVATE ■ OTHER (Identify)
\y(11A
Classification (A,B.C)
Total Depth AI
Cased to r�
`
I
L_ FT
itB FT
Installei / ,4
Get
Date Installed:
S -Z `/-86
a. `ado 010,(44r
REMARKS:
AS
Ip�
S
�ffLJ
ii
Scale:p
Inspections
Performed
by:'.
"•
11�
1r - _ r
s
_
et
Date:
ar fable "h14-
o• op -®_
S & S ENGINEERING
SR
JUN 5 1986
�• ! .'
• ;;.;ti eo .• .
B 196X
EAGLE RIVER, AK 99577 ceni(y Thal Ihis)nspeclion was performed according to all
so
Hurt A. %
Municipal and Slate guidelines in effect on this dale 6/-5 �
ar dtti es
c' •. It. 1487.4 . �a• •e
eec/'.. .• r9 °
Health Department Approval: t Data /H� G
�"
`9 •oe iJ .j. eY
Ra• HR\96onak iv -
E q
4
72-013 (3/85)
fre,.4p7;" /1141-41/4a A411 -I $S7on-elr*a
DE:F'ARTM
„_.:A:: ''re" ElP FE
i =u 1•,,E E 1-1 E B %2: rEI CS E:_
NT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L STREET, ANCHORAGE:, AK 99501
264-4720
G"GS:.:: Li 'r: PAF ::F :: ;< RAO P. R......_ F "�::6=.El I.
1"a:ftM1.T NO °, E360141.
DATE . St., E.D, 05/28/8
APPLICANT°
ADDRESS°
CONTACT PHONE°
LEGAL. DE.SCRIF °
LOT SIZE:°
MAX BEDROOMS
- EVELYN HUN f INGTON
P.O. BOX 323
EAGLE RIVER, AK: 99577
688-9566
SUBDIVISION::. NA
SECTION. 30 TOWNSHIP: 15N
2-5A (80. FT, OR ACRES)
Listed below are the options available to
system. Choose the option that best fits
11-1= .IEEg3..9C':::8--a
DEPTH TO PIPE BOTTOM (FT.) 4.0
GRAVEL,. DEPTH (FT.) 4.0
TOTAL. :DEPTH (ET.) 8.0
GRAVEL WIDTH (FT.) 2.5
GRAVEL LENGTH (FT.) 32.0
GRAVEL. VOLUME (CU.YDS.) 13.4
TANK SIZE: (GA!...8) i.,0Ca.).0 **.
-
,il']:[L... RATING {SG.1=:1'.:lktEi) 85
**. TANK MUST HAVE: AT LEAS
LOT: 51
RANGE: 1W
you in des Cl
your site.
:mssiE_LD
4.0
0.5
4.5
14.0
28.0
14.6
1,000.0
85
TWO IMPARTMENTS
*
BLOCK: NA-
ng
NA-
ng your septic
I: certify t.hat_:
1. 1: am familiar with the requirements for on s1t_f= sewers and
forth by the Municipality of Anchorage (MOA) and the State
2., I will install the system in accordance with all MOA codes
and in compliance with the design criteria of this permit.
3. I will adhere to all MOA and State of Alaska requirements for the set back
distances from any existing well, wastewater disposal. system or public
sewerage system on this or any adyacent or nearby lot.
I understand that this permit is valid for a. maximum of 3 bedrooms and
any enlargement_ will require an additional permit.
n n 1 rq
r1.,,0
3.5
7.5
5.0
28.0
20.13
85
wells as set
of Alaska.
and regulations,
IF A I....IFT STATION IS INSTALLED IN AN AREA COVERED BY MDA BUILDING CODES„
THEN (1) AN ELECTRICAL PERMIT AND INSPECTION.MUST BE OBTAINED; (2) AS -BLUETS
WILL NOT :BE:: APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE
I:!:L_ECTRICAL. WORK MUSS. BE DONE BY A LICENSED ELECTRICIAN.
81 GNE t) �/
APPLICANT: EVEL.Yh.1 IUP.IT' 1ItiIGT
ISSUED BY
DATE;. 7'i7/�
DATE:
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: T.V, 1 'TN•ser-1
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
,36PTH
(R&M -
COMMENTS
PERFORMED BY'
l�T
0 ogG, P47-11.
CA W -
es. Lltv
ciF
r YT �w7vaa. v.
Dont A. She* e 1
iP • N•. 14.51'-14 t
DATE PER FO Fg""' Sb
Township, Range, Section: T" GtJ \'3 Sc 3c
SLOPE SITE PLAN
.1 -
WAS
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
NO
S
L
O
P
E
Depth to Water Alter
Monitoring? I4 \tJPf Date
v
r ' 1 V >
4{
Reading
Date
Gross
Time
Ne
Time
Depth o
Water
Net
Drop
kVA
/
PERCOLATION RATE
A
(minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND
S & S CNCINEERING
SR B 196X
EAGI E RIVER, AK 99577
FT
sw s rel -t- =0'
CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINE IN EFFECT ON THIS DATE. DATE'
72-008 (Rev. 4/85) - -
MAY 1 91986
fl
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: V rra- -iJ1,d
LEGAL DESCRIPTION: Lo'( SI
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
P PTH
(FEET{
N
8 012/6"4101L
Co`.0
••• , b
o
a O
0 -o
es °tan-
8orrota 11DI.-.S
d
O
r
DATE PERFORMEE*..
Township, Range, Section: 'r151.4I (L\� tse. ,z,
SLOPE SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
kb,
S
L
0
P
E
Oepth to Water Atter
Monitoring? la WIKT21-nate
t
N
s
.1
Reading
Date
Gross
Time
Ne
Time
Depth o
Water
Net
Drop
SIA
COMMENTS Z74/C, %-/X
S & S ENGINEERING
PERCOLATION RATE
TEST RUN BETWEEN
NIA (minutes/inch) PERC HOLE DIAMETER
FT AND
7Ze-C f C f
FT
.,r
PERFORMED BY'SR B 196X
E%��I,E �/¢{} e�(Q .Gy^� CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL glA'F RFAA•UNI�1P`AC GUIDELIN IN EFFECT ON THIS DATE. DATE: MAY 1 9 1986
72-008 (Rev. 4/85)
it
(-6
3301
"yr
SP -1.--4-1\ R1/.< -.t, a. -,JD
tinV-i\/ C.;;"6"-`:eir
Ct
3v,v
33',
Ora-P�fa(1> d
rJ
A/Y
PRELIMINARY
I hereby certify that I have surveyed the following
l
described property 7 9!
/J E= » ' S_v c I lc>,^- 30
1-15-hJ+f (`.ti4_'%/-•-�
Anchorage Recording Precinct, Alaska, and that the pro-
posed improvements, as planned thereon by the builder,
will be within the property lines and will not overlap
or encroach on the property lying adjacent thereto, that
no improvements on property lying adjacent thereto
encroach on the premises in question and that there are
no roadways, transmission lines or other visible ease-
ments on said property except as indicated hereon.
Dated at Eagle River, Alaska
this • — day of
SCALE:
1" = i_4
/4-174Z 19gie;
ROBERT C. JOHNSON o? ' �4 ,
Registered band Surveyor No. SFO -LS
Box 456. Eagle River, Alaska
Phone 694-2543'
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STATIC LEVEL OF WAT
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P.O.Box 770
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GALS. PER HR. 60%al per hour est
KIND OF CASING 28 ft. sch # 40
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DATE — STARTED
DATE — ENDED
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tes implied
MISCL. INFORMATION:
O
A
Joe Gielarowski
DRILLER'S NAME
Municipality of Anchorage
On -Site Water and Wastewater Program
(907) 343-7904
Certificate of On -Site Systems Approval
Parcel I.D. 051-293-38
1. GENERAL INFORMATION
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Real Estate Agent
Expiration Date:
3 6/13
T15N, R1 W, Section 30, Lot 51
15731 Mooseberry Drive, Chugiak, Alaska
Larry and Vera Bennett Day phone 696-28-43
P.O. Box 670377, Chugiak, Alaska
Audrey Mason of Eagle River Day phone 622-3344
2. TYPE OF DWELLING:
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 0 Individual 0
Individual Water Storage ❑ Holding Tank ❑
Community Class Well 0 Community ❑
Public Water System ❑ Public Sewer 0
WaiverNariance request for: Distance:
Received by: + /i �1� ,z e� = Date: /-2"/'
11'i 2
COSA to be released to the engineer, unless othe 'e requested by the engineer.
COSA Fee $ LI 9 0
Date of Payment I i/27/ 2 --
Receipt
Receipt Number 0251 0 I4
cosA# OSc 12/51-(5
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm Douglas T. Kenley P.E. Phone (907) 746-1073
Address 9806 E. Northstar circle, Palmer, Alasaka 99645
Engineer's Printed Name Douglas T. Kenley Date t_Jtb/fZ
6. DSD SIGNATURE
V System #1 Approved for 3 bedrooms
System #2 Approved for bedrooms
Disapproved
S Cc `-
Conditional approval for bedrooms, with the following stipulations:
�tttr(rrrrr/r
aipti
�St1OFgN��?
Iff
S5 ON SFF
WATER AND
°ry WASTEWAI E N 6;
PROGRAM
il0,o ��0;�
By: Gl�i w
Original Certificate Date: /Z�S�Z
The Municipality of Anchora 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 jG Other
COSA blue sheet r t c
If more than 1 septic system is on the lot:
COSA Checklist # of _
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description: T15N, R1 W, Section 30, Lot 51
A. WELL DATA
Well type Private
Date completed 5/27/86
Total depth 405
If A, B, or C provide PWSID #
Sanitary seal (YN)
Cased to 28 ft.
FROM WELL LOG
Date of test 5/27/86
Static water level 300 ft
Well production 1.0 g.p.m:
WATER SAMPLE RESULTS:
Coliform Negative colonies/100 mL
Arsenic ND ug/L Date of sample:
Nitrate ND mg/L
10/22/12
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel
1000
Parcel ID: 051-293-38
Well Log (Y/N)
Wires properly protected (Y/N)
Casing height (above ground)
AT INSPECTION
12/15/12
14.0 ft
0.51
g.p.m.
Collected by: F. Kenley
Date installed
Tank size gal Number of Compartments 2 Cieanouts (YIN) Y
Foundation cleanout (Y/N) Depression over tank (Y/N) N High water alarm (WN) N/A
Date of pumping 11/16/12 Pumper JRs Pumpers
Y
Y
24
in.
6/4/86
C. ABSORPTION FIELD DATA
Date installed 6/4/86 Soil rating (g.p.d./ft2 or ft2/bdrm) $5 System type Trench
Length 32 ft. Wide, 2.5 Gravel below pipe 4
Total depth 8 ft. Eff. absorption area 256 ft2 Monitoring tube Y Depression over field
Date of adequacy test 6/26/2012 Results (Pass/Fail) Pass For Y bedrooms
Fluid depth in absorption field before test 0 in. Water added 547 gal. New depth 21 in.
Elapsed Time: 55 min. Final fluid depth 5 in. Absorption rate >= 450 g p d
Any rejuvenation treatment (past 12 mo.) (WN & type) N If yes, give date --
ft.
N
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off' level at -. a water alarm level at
Cycles tested Meets alarm & circuit requirements?
in.
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100+ ft. On adjacent bts 100+ ft.
Absorption field on lot 100+ ft. On adjacent lots 100+ ft.
Public sewer main N/A Public sewer manhole/cleanout N/A
Sewer /septic service line 25+ ft. Holding tank N/A
Animal containment areas 50+ ft. Manure/animal excrete storage areas 100+ ft.
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5+ ft. Property line 10+ ft• Absorption field 5+ ft.
Water main N/A Water service line 10+ if Surface water 100+ ft.
Wells on adjacent lots 100+ ft.
ABSORPTION FIELD ON LOT TO:
Property line 10+ ft. Building foundation 10+ ft. Water main N/A
Water Service line 10+ ft• Surface water 100+ it. parking/vehicle storage Driveway, 5+ ft.
Curtain drain None Known Wells on adjacent lots 100+ ft.
F. COMMENTS
There is a 400 gallon water storage tank in the garage.
An additional 445 gallons of water is stored in the well casing. Total = 845
G. ENGINEER'S CERTIFICATION
! certify that ! have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name Douglas T. Kenley, P.E.
Date IL/ 1002
CASA brown sheet_10-1O-12.doc
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Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
Water Well Advisory
Certificate of On -Site Systems Approval (COSA) # OSC121545
During a recent COSA on-site inspection and test of the potable water
supply well on Lot 51 of T15N R1W Sec 30 subdivision, the well's
productivity was determined to be .51 gallons per minute. The minimum
well productivity required by this Department (AMC 15.55) for a 3 -bedroom
residence is .31 gallons per minute. Although the subject well currently
exceeds this minimum requirement, all parties concerned are advised that the
production capacity of the well may fluctuate. Restriction of non-critical
water uses such as washing cars and watering lawns and gardens may be
required.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
NOTE: BEARINGS &
■ISTANCES FROM
O.A. GRID NW0755
o °
(710
N
W D
MOOSEBERRY BEND
330.99' S00° 01' 00"E
PATENT R.O.W. RESERVE BK. 223 PG. 32
01 GRAVEL DRIVE
O
m
N
c,%,
GFt
AN• ch
o F o
C. 0 , yoG
.2 SF
LOT 57
329.67'
LOT 58
UNDER NO CIRCUMSTANCES SHOULD AN AS–BUILT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES.
THE SURVEYOR TAKES RESPONSIBIUTY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL LIABILITY ONLY FOR THE COST OF THE SURVEY.
LISTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCALE.
U LOT SURVEY SURVEY TYPE
SYMBOLS
sttla PROP
SET REBAR DRAINAGE
❑ FOUNDATION AS–BUILT
❑ FINAL STRUCTURE AS–BUILT
• PLOT PLAN ... AS–BUILT ... LOT SURVEY ... TOPOGRAPHY
Al AS–BUILT ... NO CORNERS SET rl RECERTIFICATION AS–BUILT ... NO CORNERS SET
0 FOUND REBAR IA.,...A{ CONCRETE
-0-19-0- WOOD FENCE
DO II ASSUMED ELEV. /I
//i
X X X METAL FENCE WOOD DECK
PLOT PLANS & LOT SURVEYS
NOTE:
ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE
SHOWN. FENCES, WELLS, SEPTIC CLEANOUTS, SIDEWALKS, DRIVEWAYS,
ETC., ARE SHOWN IN THEIR APPROXIMATE LOCATION, ONLY. SNOW
MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED.
ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED.
IT IS THE RESPONSIBILITY OF THE BUILDER OR OWNER, PRIOR TO
CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE
TO FINISHED GRADE AND UTLITY CONNECTIONS AND TO DETERMINE
THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS
WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT.
SURVEY CERTIFICATION
Prepared by
Robert E. Johns, Jr. & Assoc.
Professional Land Surveyors
1700 Brink Drive.
ANCHORAGE, ALASKA 99504
PLOT PLAN
1 hs'tY certify hal 1 haw phySoSIy Wrested
ha lot dw, me describedal hereon.the lot that 1
f comers
haw found or a plan as m of Me best
pe shorn an Me plan and men hest army
« dimensions have ash
knot«9° ace abilities. correct
m«.,r.e we and aawet.
FOUNDATION AS–BUILT
..,�r"��,1,
�..•.s , OF /14%
♦KP.••"" "''• •S
••• •
r f •: • ••
N 4`• , a, / \ ' • 0
�•• '••'•A y... Mir
Scale: 11
1 = 60'_
Rec. Lot S.F.
Rec. Plat File No.
I. Robed c John., Jr., hereby certify that 1
have performed el Ane .t an wy of M.
(oxidation m this lot and that a1 the L
dhnennr,. and Inra nallen as show, hereon
M we and no encroachments mist unless
abysm oMxn1«.
FINAL STRUCTURE AS–BUILT
1. Robert a Johns. r., hereby certify that 1
haw urfpmW m, Mdult survey1of the
structure on MIs lot and that J1 M.
dimensions and information ow sham hereon
encroachments tett unless
areetrueeMmld otherwise
t-
r11
ROBE rrrrS, JR. '
, /
••�,• `4121—S ,d��
I. r' •''•.,•• • ,: 'yot �1
,•i, /� fes siono twee."
y'o L e
1111 •
\1.\\.
Date Surveyed:
/23/12
Drawn b >: REJ
Checked by. WL
S
Date Drawn:
11/23/12
Grid:
NW0755
W.O.
12-517
Legal Description:
T15N R1 W SEC 30 LOT 51