HomeMy WebLinkAboutTERI #2 LT 5Onsite File
MUNICIPALITY OF ANCHORAGE
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Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 050-751-19
Legal description TERI #2 LT 5
Site address 3901 DELORES DR
Expiration Date: 9/11 / zoz` �9",u
Current property owner(s) KARNS CURTIS E & CYNTHIA J
X The On-site system(s) is/are approved for 3 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
By: Original Certificate Date: J 2 V_
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of
Anchorage, Development Services Department (DSD) issues COSAs based upon
representations provided by an independent professional engineer. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
COSA Approval_June 2022
_\;1
Development SeRtices Department
D� 0 0
On -Site Water & Wastewater Secfion �
Phone: 907-343-7997
07-343-7997
a>.. �G7 343 7,,,,7
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 050-751-19
Complete legal description TERI #2; LOT 5
Location (site address) 3901 Delores Drive *Eagle River
Current property owner(s) Cynthia Karns
2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS
Day phone 350-9262
3. TYPE OF WATER SUPPLY: N Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ❑ Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: JU Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: Q Steel ❑ Plastic ❑ Concrete ❑ Fiberglass
Age 6 - See advisory if steel older than 20 years
6. ABSORPTION FIELD: FE� AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: ❑
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee $. 550 Waiver Fee $
Date of Payment lZ11'i12.3 Date of Payment
COSA # O ) U 7 Z Waiver #
COSA Applicaftn—June 2022
COSA Checklist
Legal Description: TERI #2; LOT 5
Parcel ID: 050-751-19
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system
A. WELL DATA
0 Well log is filed with Onsite (or attached)
Date drilled 9/21/17 Total depth 165 ft
Cased to 164 ft
0 Sanitary seal is functioning correctly
X Wires are properly protected
Casing height (above ground) 18+ in.
Date of flow test for COSA 9/11/23
Static water level at beginning of test 124.4 ft.
Comments
B. TANK DATA
Measured operating fluid level in septic tank =
Date of pumping
Required maintenance completed, if AWWTS
Comments: -
D. ABSORPTION FIELD DATA
Which system tested (date installed) 8/25/17
X ALL standpipes present per record drawing
Total measured depth from grade 5.08 ft (max)
Measured depth to pipe invert from grade 3.91 ft (min)
❑ N/A — pressurized field.
❑ Per record drawings, field is insulated.
F Monitor tubes go to bottom of effective.
If not, state depth into effective 7" & 8"
❑ Presoaked required if
(Required if house vacant or field not us r more
than 30 days prior to date of test
Gallons introduced allons date
Any rejuvena ' reatment (past 12 months)
s, enter date
Well production at time of test 5.0+ gpm
Water storage tank volume N/A gallons
Well disinfected for coliform test? ❑ Yes M No
Coliform bacteria is Negative
Nitrate M14 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L PArsenic less than MRL (ND)
Collected by GEG, Ltd.
Date 9/11/23
C. LIFT STATION
❑ Required maintenance completed
Age of lift station ye
Lift station mated
Adequacy test date 9/11/23
Results Q Pass
Fluid depth prior to test 0 in
Water added 609 gal
New fluid depth 0 in
Elapsed time 0 min
Final fluid depth 0 in
Absorption rate 450+ gpd
FIELD STATUS — POST RECOVERY
Effective depth (per record drawings) 6 in
Effective depth used 0 in
Effective depth remaining 6 in
Comments/Deficiencies: !PWZAi4F->✓L-D PP -y 6�-f 6 2.�1/JZ3
COSA Checklist June 2022
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100'
Yes if No *50'+ ft FE Yes if No ft
Neighboring Tank > 100' ❑N Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No ft
Absorption Field on Lot > 100' ❑ Yes if No *50'+ ft Holding Tank > 100' 0 Yes if No ft
Neighboring Absorption Fields > 100' ** Animal Containment > 50' Yes if No ft
no Yes if No ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' M Yes if No ft Q Yes if No ft
❑ N/A – Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10' n Yes if No ft Surface Water > 100' ❑ Yes if No *50'+ ft
Tank to Property Line > 5'
Field to Property Line > 10'
Water Main > 10'
Water Service Line > 10'
F■ Yes if No ft
Q Yes if No ft
no Yes if No ft
R Yes if No X'-` *ft
F. ENGINEER'S COMMENTS
*AWWTS **50'+ TO NEIGHBORING LOTS
Wells on Adjacent Lots:
Private Wells > 100'
Community Wells > 200'
❑ Yes if No *50'+ ft
❑� Yes if No ft
If tank or field is under driveway comment below
* 7litc� D 7 l N SQ�G 11 D� ��._P a -tt— 1, \/
G. CERTIFICATION & 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, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm Gamess Engineefing Group, LTD. (GEG) Phone 907-337-6179
Engineer's Printed Name Jeffrey A. Gayness Date (-Z 112- Z _
In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in
accordance with the guidelines and regulations established by the Municipality of Anchorage and industry
practices. The reported results describe the condition of the system/s on the date/s of the evaluation.
Separation distances were measured to readily identifiable features. Hidden defects or encroachments may
exist that were not identified during the evaluation. The operational life of all wells and septic systems depend
upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate
during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing
the systems. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not
guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding
the future performance of the well or septic system. GEG makes no representation whether an alternative well
or septic system can be installed on the property in the event either of the current systems fail to perform
adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG
to perform the evaluation. Reliance upon the information provided in this report by any other person or party
(including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever.
COSA Checklist June 2022
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ovanTexO Field_ M.aintenance Report AnchorageTank..
•
Annual Inspection 907-272-3543.
Al)
Curtis & Cynthia Karns + Home Services Tee
Sit& Ad
3,901 Delores Drive, Eagle River AK 99577 (907) 555-5555
ULI 0.1t9k at LAM hispoetion
_ZX _aii; County ID 0 %
1427271 RTU141237 09123/2022
f0S�'P1711161
AX -142993
Retrieve O&M Info
Daily flow_—
Rocirc ratio
'5rner setting$,
Perform Field Sampling/Observation3
NTU (16 t NTU,)
L
pH (6-5)
00(2-6)
Odor of Slarnplo
Typt" I-
%(Yu4ty sartity DJ MOW
Non -typical J_]Wndo Cj Cabb go F_ -'Decay
oily farm inl0vu 0yes No
!room In tank 0 Ycr* 4, NV
Check Control Panel
Aectro Amps Nsoharge Ampu
laud d* ood v1suai alarm
DW t5irio (teldmetry only) Vag, 10 No
Inspect/Clean Pump System
ffispect clean
Fliser/Lid ......................
Guqvn�
Prevl6u4
Splice Box . - , " , .............
Priwioug
2nd Compartniont
Float Cords ............ ......
previous
Floats .......................
Prfovigus
Pump .......................
Inspect Ih!Sp1)tt
Cgotiibo* Filter .................
Risor/ud Floats 3
Biotube ftrrip Vault ............
Float cords
Rocirculefing Splitter VaJv* ........
InspactlSam" Other Systern Components
&
commerits
Measure Sludoo/Soum
scum
i ux Zo7n'Pa ment
Guqvn�
Prevl6u4
Curmn�
Priwioug
2nd Compartniont
current
previous
Ourront.
Prfovigus
Inspect/Clean AdvanTOX Fitter
flnplaoeUlik�caiothorltcan?
Pads Used. W Warranty, 9 = eatable V .4pr6pdate 6alectiori)
.............
Final/Safety Inspection
RSV mineuilled
Manifold reconriectod; f1mb usiv" closeo
*Ystem performing; no furttw action needed
i,_ GaH tar aervlce
tads bolted oh
ocorltr*4 pa" reactivated
Tank needs pumping
L_j Other?
-- I -
Dato —9 —
Pax c*mpleted form to 1-866-384-7404
Odor AFormal Pungent
Biamat: l!xCessive,
Pod Bottom
OridginVPonding, M.None/Minor i Exoessiva
intake Vent
Inspewelean 131schame Pump $Ystem
Inspect Ih!Sp1)tt
Clew
Risor/ud Floats 3
arAice sox,
Float cords
InspactlSam" Other Systern Components
Inspect
Ditinfootion S t)" -j Dispersal LateraWOr1fices
Additional SerAces Rendered
6,01WOd 10XV0 Reptacoo UV iterria?
flnplaoeUlik�caiothorltcan?
Pads Used. W Warranty, 9 = eatable V .4pr6pdate 6alectiori)
.............
Final/Safety Inspection
RSV mineuilled
Manifold reconriectod; f1mb usiv" closeo
*Ystem performing; no furttw action needed
i,_ GaH tar aervlce
tads bolted oh
ocorltr*4 pa" reactivated
Tank needs pumping
L_j Other?
-- I -
Dato —9 —
Pax c*mpleted form to 1-866-384-7404
Ml NIC'1PAI,ITY OF," NC HOItAGEI
ADVANCED
MAIN'T1,',NANCI," AND I2.ETA114 A( J? I"J"M ENT
TI IIS MAINTI NANO AN 1) RHPAIR AGR J!"I'M1:
r Owncracknowlc.dvcs that the ilIunicipality may rcxlucst records of,rnsaintcnancc and
repairs from the manufacturer's representative or maintenance provider,
v Owner <ackxrowlcdt cs that the tine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC; 14,60.030.
Owner agrees to grant the ,Municipality reasonable access to test and inspect the
AWW'TS. The Municipality will give at least 24-hour notice.
rt' - 't i Owner agrees that any sale or transfer of title of the property will not occur without a new
tr
Certificate of On -Site Systems Approval.
Owner agrees that the AWWTS installation and maintenance requirements as provided
by tine AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of tic Owner's AWWTS.
�VD Owner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The tern of this Agrcernent shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
d. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of tine provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the Third Judicial District of tine State of Alaska at
Anchora0c. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7, Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement,
(rev. 05/18/2018)
Pagc 2 o1'3
OWNER:
By: �t ��ignaturc)
V)n in 1 ry (print name)
STATE OF ALASKA )
ss.
THIRD JUDICIAL DISTRICT )
Date: _� - P3
'N111111111/j/1"
The foregoing instrument was acknowledged before me this,7A day of
2od3by -u -r, Co b
NOTARY PUBLIC FO t i7t� -re-)cctS
My Commission expires: Dpeg1ri�_3to;0--Z
MUNICIPALITY:
By: ✓ !� (signature)
(print name)
OF
1
1281 a
peo B 1/111111%W0
12
\
LUCIACOBB
.. My Notary ID # 128116099
Expires December 3, 2025
Date: %7z-/--Z-----ZZ-72
Title:
Page 3 of 3
711�
I-ftw
V
(PtAT, 75- 150),
WM'S OF BEAW"''
LOCATED IN A PORTION OF
2WW SEMWD��� "DMON NO. 2
RE T #1 (PLAT 73-177)
SITLWW WITHIN
DWG: 23-219 AB FB NO: NA
GRID: SE0704 DWN: 13WS," DATE: 10/30/23, DISK: H-DRW I SHEET: 1 OF 1
LLGEND
F M%WSS CAP MIMWDIU,
ELECTRIC METER
FOUNID., REBW
GAS MM
X)O(
MEARM, BkTA
UTILM- POLE
(XX,X)
RECORD DATA PER PIAT
GUY MOM
(73-177)
DECK/-P*Mi
LOCATED IN A PORTION OF
2WW SEMWD��� "DMON NO. 2
RE T #1 (PLAT 73-177)
SITLWW WITHIN
DWG: 23-219 AB FB NO: NA
GRID: SE0704 DWN: 13WS," DATE: 10/30/23, DISK: H-DRW I SHEET: 1 OF 1
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: OSP171161 PID Number: 050-751-19 ❑ 0 New El Upgrade
Name:
CURTIS & CYNTHIA KARNS
ABSORPTION FIELD
F-1DeepTrench ❑✓ Shallow Trench E] Bed E] Mound
Address
3901 DELORES DRIVE
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
3
5.0 GPD/SF
1.8 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
1.3 Ft.
Gravel depth beneath pipe
0.5 Ft.
Subdivision Block Lot
TERI #2 5
Fill added above original grade
3.0+ Ft.
Gravel length
20 Ft.
Township Range Section
Gravel width
5.0 Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
I Tank
Line
100 Ftz
1
Ft.
Well
131.2
132.3
N/A
N/A
25+
TANK ❑ Septic ❑ S.T.E.P. ❑ Holding El Other
Manufacturer
Anchorage Tank/ORENCO
Capacity
I 1500Gal.
Surface Water
100+
100+
N/A
N/A
Material
Number of compartments
Lot Line
50.4
59.9
N/A
I N/A
STEEL
2
NA
Foundation
21.8
15.8
N/A
N/A
LIFT STATION
Manufacturer
Capacity
Curtain Drain
50+
I 50+
N/A
N/A
ORENCO
250 Gal.
Remarks
Pump on level at
43 in.
Pump off level at
40 in.
High water alarm at
45 in.
Pump make and model
P2005
Electrical Inspections. performed by
(-14491 't-cc t
p(,r al-ae 4z, C__
Installer
PIPE MATERIAL House to tank 3034 Tank to 3034
drainfield
NORTHERN EXCAVATING
Drainfield 3034 CO/MT 3034
Inspector Pannone Engineering Services
BENCH MARK (Assumed elevation) 1120f
Inspections,
dates: 24AUG17 21,d 25AUG17
Location and description
3°' 4`h
House Trim near foundation cleanout
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
Engineer's Stamp
OF at����
Conditional Approval: Date
-� �G, 8
iteven F�. ponriorae
.E
814Aw
Approved i�`xJl/`A �� Date
_
11ISPJ UIIUI I RCFIUI l_ 1- 1- 1 C.UU(.
14
MH1 32.3 23.3
cl 21.3 19.5
EXTENT OF RESERVE FILL(NIC) (P
25
F FILL TRUE NORTH SCALE I'= 60'
RESERV� TR—EA 'N-177 EXTENT 0
vi
al
-6:§ 3 INSTALLED ABSORPTION FIELD (N)
VER ADDED, MTs and COS AT END
NSTALLED WELL. N 131. 1 2', 38R & SAND ADDED UNDER FIELD TO REACH
SFD ABSORPTIVE SOIL LAYER AS NEEDED
INSTALLED 1500q ADV NTEX
WATER LINE
0 WELL RADIUS
SS, SS NEW SEPTIC
--DESIGN -PARAMETERS
PROPOSED
\.TA K SIZE: 1500g ADVANTEX (E) EXISTING
PERC RATE: 7.1 MPI
co CLEAN OUT NO.
SOIL RATING: 5.0 GPD/SF
YM AREA ROD: 90 SF MT MONITOR TUBE NO.
TYP TYPICAL
\SYS. TYPE: WIDE TRENCH 0.5'ED
MIN LENGTH: 18 LF
SCALE 1"=10'
TER| #2 L5
DRAWN JRL CURT|S & CYNTHIA KARNS
3901 OELORES DRIVE
SITE PLAN EAGLE RIVER, AK 99577
_
DRAIN ROCK 6" ABOVE PIPE INV
even
CE 81 9
PERMIT NO.
FILTER FABRIC
m
Sheet
z
4"o PVC
26
SM
H20 1105.3
ADVANTEX TANK (N)
r
PROFILE
BON 1104.1
SCALE I"=10'
NOTES:
PANNONE
P.O. BOX 102954
PHONE (907) 272-8218
ENG SVC, LLC
ANCHORAGE, AK 99510
FAX (907) 272-8211
Date
12/17/2018
Scale
RECORD DRAWING
TER| #2 L5
DRAWN JRL CURT|S & CYNTHIA KARNS
3901 OELORES DRIVE
SITE PLAN EAGLE RIVER, AK 99577
_
even
CE 81 9
PERMIT NO.
Sheet
+1 9Uf.r 9x * •; 9 ,•-
�. A;
mat • � i ��. �� �.. � � � � x,.,-.�,� -�.� �...�. �.. .. -� a ,� "..� ,... a,
OWNER OF LAND: Cynthia & Curtis Karns
ADDRESS: 3901 Delores Dr. Eagle River, AK 99577
Bore Hole
Data
Depth
From
To
LEGAL DESCRIPTION Teri #2 Lot 5
DATE: 9-21-17
0
2
Casing Stickup
PERMIT NUMBER: OSP171161 DATE OF ISSUE: 6-28-17
TAX IDENTIFICATION NUMBER 05075119000
Is well located at approved permit location: ®Yes �No
Method of Drilling: ®air rotary cable tool
Depth of Well: 165'
Casing Type: Steel wall thickness,250 inches
Diameter: 6 inches, depth 164 feet
Liner type
Static Water Level: 131 feet
Recovery Rate 6 ® gpm F] gph
Method of Testing Air
Well Intake Opening Type: ® open end open hole
Screened Start feet Stopped
Perforations Start feet Stopped
Grout Type: Bentonite Volume: 50 lbs
Depth: from 2 feet, to 42 feet
Well Disinfected Upon Completion: ®yes Ono
Method of Disinfection: Chlorine 50 PPM
Comments:
2
4
Overburden
4
39
Hardpan & Boulders
39
79
Hardpan w/ Clay & Boulders
79
88
Hardpan & Boulders
88
97
Silty Sand & Gravel
97
160
Hardpan & Boulders
160
165
Tight Sand & Gravel Water
Drillers
Name:
Cole Sullivan
ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority.
Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation.
Matsu Borough: Department of Environmental Conservation.
Legal Description
Teri #2 Lot 5
11 Pump Installation Date: 10-9-17
11 Pump Intake Depth Below Top of Well Casing: 150
11 Pump manufacturer's Name: F & W
11 Pump Model: 4F07P073015
11 Pump Size: 3/4
11 Pitless Adapter Burial Depth: 10
Pitless Adapter Installer: Northern Excavating
Disinfected Upon Completion? ® yes ❑ no
Method of Disinfection: Chlorine 50 PPM
I) Comments: Pitless Manufacturer: Martinson
11 Pump Installers Name: Sullivan Water Wells
Property Owner Name & Address
Cynthia & Curtis Karns
3901 Delores Drive Eagle River, AK 99577
feet
hp
feet
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
N`""""'' MUNICIPALITY OF ANCHORAGE
On-Site Water&Wastewater Program
PO Box 196650 4700 Elmore Road
O�E Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax: (907)343-7997
" http:llwww muni.org/onsite ,•
DL__ �l,,irtntnt
4 4 C NON PGF'
On-Site Water & Wastewater System Permit
Permit Number: OSP171161 Effective Date:
Work Type: WellSeptic Initial Expiration Date: 6/29/2018
Tax Code Number: 05075119000
Site Legal Address: TERI #2 LT 5 G:0704
Site Mailing Address: 3901 DELORES DR, Eagle River
Owner: KARNS CURTIS E & CYNTHIA J Lot Size in Sq Ft: 83156
Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 3
This permit is for the construction of:
0 Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 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 Date: 1 �� ` T
Issued By: le,G(1ai (Lite,/le7 Leh Date: Aigt 4017
i ) Municipality of Anchorage =i ►r
rl .
\+_� DepartmctU
P.O. Box 196650 • 4700 Elmore Road
Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997
http:llwww.muni.orglOnsite
Development Services Division
On-Site Water and Wastewater Program
**** VARIANCE/WAIVER REVIEW ** **
Waiver#: OSV171063 COSA#: Permit#: OSP171161
PIO#: 050-751-19
Legal Description: Teri#2 Lot 5
Engineer: Pannone Engineering Services
Applicant: Curtis & Cynthia Karns
Your request for a waiver of the required 50 feet horizontal separation from the absorption field
to the excessive slope has been approved. The approved separation distance is 23.0 feet. See
engineer's letter and profile drawin for justifications.
This waiver approval applies to the proposed 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.
❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this
wai ver.
n 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.
t
Waiver is Granted: X Waiver is not Granted:
Date: f 1 z/'<><`�: I ( Approved by: Rt&A! A
ai.,...x
ttt Name of Reviewer
**** VARIANCE/WAIVER REVIEW ****
MUNICIPALITY OF ANCHORAGE
Community Development Department -
, P-• . • r Je
Development Services Division ry" - •17%
On-Site Water& Wastewater Program
JUIN z 7 20 t
ON-SITE SEWER/WELL PERMIT APPLICATIO At •
a-w
Parcel I.D. 050-751, T' O[ 6 :��
Property owner(s) CURTIS & CYNTHIA KARNS Day phone
Mailing address 3901 DELORES DRIVE, EAGLE RIVER AK 99577
Site address 3901 DELORES DRIVE
Legal description (Sub'd., Block & Lot) TERI #2 L5
Legal description (Township, Range & Section)
Lot Size 83,156 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(®all that apply)
Absorption Field ❑X Initial Single Family (SF) 0
(w/wo ADU)
Septic Tank ❑x Upgrade ❑ Duplex (D) ❑
Holding Tank ❑ Renewal ❑
Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well 0
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE I WAIVER REQUEST FOR:
SLOPE SEPARATION Distance: 23'
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
V. e)
ignature of property owner or authorized agent)
Permit/Rush Fees: l5(00) V/ Waiver Fees: d/3
Date of Payment: (p ]�ll Date of Payment: (o' Ii
t � 1
Receipt Number: OdlloWA Receipt Number: c-L4 2-�✓261
Permit No. 051211 it t,I Waiver No. (6V11 I O L 3
Permit App_ :: .c
Pannone Engineering Services 'lc
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: sieve@panengak.com
July 10, 2017
Subject: TERI #2 L5
Septic System Permit Request
Design Narrative
This is a design narrative for a permit to install an initial septic system and well to be issued for this
property. The proposed system will serve an existing three (3) bedroom house. Currently the lot is
developed. The system will utilize a new 1500g ADVANTEX tank system. This lot and the surrounding lots
are developed and served by private wells. There are no wells or surface water within 100' of the
proposed septic system.
1. Soils. One test hole was performed in the vicinity of this system by PES in June of 2017, and some
seepage of groundwater was encountered at 6.0'. Following water monitoring in June 2017 water
level was found to be at 6.75'. Bedrock was not encountered in the test hole.
Based on the results of the percolation tests and overall soils appearance; an application rate of 5.0
gallons/day/square was used for an advanced wastewater system in the area of the system.
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 slopes from northeast to southwest, with a slope of
approximately 17% in the area of the drain field. There are steep slopes within 50' of the proposed drain
field.
5. Waivers:
a. Steep Slope Separation: We are requesting a waiver for the subject property for a separation
distance to a steep slope and slope of the assumed infiltration line from the system. The
system will consist of a shallow bury wide trench with 3.0 feet of cover added. Due to the soil
make up and percolation rate the soils is of HSG-A which has an infiltration line of a 46% slope.
The area of the drain field has a slope of 17% with a grade break and changes to a slope of 37%
at 23.7 feet away and a further grade break to 71% at 50±feet away. At 57.1' from the leading
edge of the system the grade changes yet again to 0-10%to accommodate the cut in the
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
Page 2 of 2
hillside for the road. Despite the successive grade breaks, the system will not daylight within 50
feet based using the HSG-A infiltration line nor will it daylight prior to the toe of the slope at the
road. We request a waiver for the separation to a steep slope to a distance of 23.0' and to use
the appropriate infiltration line for the existent soil type (HSG-A).
6. 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. If you have
any questions or concerns, please contact me at 272-8218.
Sincerely,
OF
F ,,�♦♦
•
•M
. •
•`♦ Steven R Pannone 0
Steven R. Pannone, P.E.
Owner/Civil Engineer
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor Ave, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
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i INSTALL ABSORPTION FIELD (P)
2OLFx5.OWx0.5'E.D.,1.8'T.D. s .. to
WI 3.0' COVER ADDED, MTs and COs AT TRUE NORTH SCALE : 1'= 60'
END & SAND ADDED UNDER FIELD TO WY
REACH ABSORPTIVE SOIL LAYER IF NEEDED . EXTENT OF RESERVE FILL (P)
` . ` ` ` 7,.. DESIGN PARAMETERS
\10991 [10951111001111051 11,1.1 111151 kiln f® , ` . — . — PRIMARY SEPTIC SYSTEM -
RESERVE AREA (NIC)7`•`\ \:-.......„ \\1 EXTENT OF FILL (P)- NO. BEDROOM: 3(450 gpd)
` 1e —L. 11/ \W w \ •N w TANK SIZE: 1500g ADVANTEX
INSTALL 1500 ADVANTEX TANK
\ \ •�. . N PERC RATE: 7.1 MPI
\ \ \ W AX20 POD (P)
\ . N. '. \ \ £ SOIL RATING: 5.0 GPD/SF
\ �� \ �\ \, 73.0 1 \\ 0 AREA RQD: 90 SF
\\ \128.1 \ p•,. 3BR SYS. TYPE: WIDE TRENCH 0.5'ED
IL . ., - •\,\ \ \ ' �� \ . %\ SFD MIN LENGTH: 18 LF
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1 \\\ ,\ l \\�.�%� �I/j USE:
cJii:iiir 20.OLFx5.0'Wx0.5' E.Q., 1.8' TD
`\\ ..\ '• ••'yl% ,\\ TOTAL AREA: 100 5F
� \ . \ � `� . `\ —w — w — WATER LINE /
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N 4 \ \ 42.1 \\ 1\ `� 5\ \\ WELL RADIUS
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PROFILE (A-A) —3.0 EC
SCALE 1"=10' _ ---- —1.8
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NOTES: PANNONE ENG SVC, LLC Date
FOR CONSTRUCTION P.O. BOX 102954 ANCHORAGE, A99510 06/27/2017
_ PHONE (907) 272-8218 FAX (907) 272-8211 Scale
1" = 60'
• •• 4:0, P,I,D, NO
TERI #2 L5& -050-751-19
CURTIS CYNTHIA KARNS . PERMIT NO.
DRAWN JRL 3901 DELORES DRIVE `+ � � OSP1 71161
SITE PLAN EAGLE RIVER, AK 99577Street
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I
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: INSTALL NEW 1500g ADVANTEX SEPTIC TANK, AND SOIL ABSORPTION SYSTEM. INSTALL WELL
3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 6.75 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 6.75 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 SITE
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: Date
PANNONE ENG SVC, LLC of,� I
FOR CONSTRUCTION P.O. BOX 102954 ANCHORAGE, A 99510 ;.••• 06/27/2017
PHONE (907) 272-8218 FAX (907) 272-8211'•• �'•. / Scale
• *� . ••I; i2 NTS
• �7P.I.D. NO
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TERI #2 L5 050-751-19
DRAWN JRL CURTIS & CYNTHIA KARNS *AN: a PERMIT NO.
3901 DELORES DRIVE ?, •.RFV:::o7//CE o5/1 OSP171161
DESIGN NOTES EAGLE RIVER, AK 99577 -o� , Sheet
3 OF 3
TEST HOLE 1 SOILS LOG — PERCOLATION TEST
SLOPE - ATE P • •
OR TOPSOIL
1 0
2
n
3 ot Brown Silty 'f3BR
4 SM/GM SAND & t GRAVEL W/ SFD
COBBLES6TEST
HOLE7
BOH
DATE PERFORMED: 01JUN17NS11111411\41DRIVEwA'
O
WAS GROUND WATER SLOPE
ENCOUNTERED? Y
TH 1
IF YES, AT WHAT
DEPTH? —6.0' (SEEPAGE)—
DEPTH TO WATER AFTER
MONITORING? — 6.75 —
DATE: 19JUN2017
CLOCK WATER RATE SOIL TEST RESULTS/ANALYSIS
READING DATE TIME NET TIME LEVEL NET DROP (MPI) • PERCOLATION RATE 7.1 (min/Inch)
READING
(Hydrologic Soils Group: HSG A)
1 01JUN17 1105 5.900" • PERC HOLE DIAMETER 6"
2 1135 30 MIN 10.523" 4.623" 6.5" • TEST RUN BETWEEN_2 FT AND 3 FT.
3 1136 5.900" • TEST RUN FOR OVER AN HOUR, LAST
THREE READINGS PROVIDED.
4 1206 30 MIN 10.106" 4.206" 7.1"
5 1207 5.900"
6 1237 30 MIN 10.096" 4.196" 7.1"
COMMENTS:Test hole excavated by JR5 SEPTIC.
PERFORMED BY:Joseph Lawendowski. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL 51 A I F
AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST.
NOTES: PANNONE ENG SVC LLC Date
FOR CONSTRUCTION P.O. BOX 102954 ANCHORAGE, AK 99510 p�G.••••••., 06/27/2017
PHONE (907) 272-8218 FAX (907) 272-8211 c"•_• Scale
*;� • 11 ."* NTS
7,147, 4140p, •• ••••' P.I.D. NO751-19
TERI #2 L5 //CURTIS Sc CYNTHIA KARNS POT1^0111°• PERMIT NO.
DRAWN JRL 3901 DELORES DRIVE �•'•, 8 48 OSP171161
SOILS LOGS
EAGLE RIVER, AK 99577 °-oi�, Sheet
2 OF 3
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
BETWEEN MUNICIPALITY OF ANCHORAGE_
AND Oty*1AA a i r V15
THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this
Day of J uLj of 20.11;by and between d v L(6L .1 Kart--1 S
herein the"OWNER," and the Municipality of Anchorage, herein the
"MUNICIPALITY." In consideration of the mutual covenants contained herein,the
parties to this Maintenance and Repair Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. Municipality grants permission to
Owner to utilize and operate an Advanced Wastewater Treatment System
(AWWTS), described as
AAVOJAAVL
located at(legal description).
1
_so.L
2. Definitions.
Alteration. Any change to the design or function of an AWWTS that
includes the installation or removal of any parts,components or pieces not
included in the original construction permit and design.
Certificate of On-Site Systems Approval (COSA). An approval by the
Municipality of existing water and wastewater disposal systems given at
the time of property sale and title transfer in accordance with Anchorage
Municipal Code (hereinafter, "AMC") 15.65. These approvals certify that
the systems are adequate for the homes that they support and meet the
codes that were in place at the time of system construction.
Damage. Any man-made or natural change in a system that would inhibit
the system from performing as designed.
Maintenance and Repair. The scheduled and as needed replacement of
existing parts, components and pieces of an AWWTS that were included
in the original design which would allow the AWWTS to continue to
perform as designed.
Permit. An On-Site Wastewater Disposal Permit as required by AMC
15.65 to construct and operate an AWWTS.
3. Term. The term of this Maintenance and Repair Agreement shall begin on the
date of approval by the Municipality to operate the installed system or issuance of a
COSA, and shall continue while the AWWTS is in use or is operational or until the
property is sold or title is transferred by the owner and a new COSA is issued to the
new owner or transferee of the property.
4. Alterations, Installation and Removal of Additional Equipment. Prior to
performing any alterations to an AWWTS, the owner agrees to obtain an On-site
Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65.
5. Maintenance and Repairs.
A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall
maintain their AWWTS in a satisfactory condition capable of producing treated
septic effluent in accordance with the equipment's approval for operation in the
Municipality. The owner shall enter into a service agreement with an AWWTS
H. Owner agrees that the AWWTS installation and maintenance requirements as
provided by the AWWTS vendor/installer and approved by the Municipality are
the governing guidelines for the construction, maintenance and repair of the
Owner's AWWTS.
6. Nonwaiver. The failure of either party at any time to enforce a provision of this
Maintenance and Repair Agreement shall in no way constitute a waiver of the
provisions, nor in any way affect the validity of the Maintenance and Repair
Agreement or any part hereof,or the right of such party thereafter to enforce each and
every provision hereof.
7. Amendment.
A. This Maintenance and Repair Agreement shall only be amended, modified or
changed by a writing, executed by authorized representatives of the parties, with
the same formality that this Maintenance and Repair Agreement was executed
with, and such writing shall be attached to this Maintenance and Repair
Agreement as an amendment.
B. For the purposes of any amendment modification or change to the terms and
conditions of this agreement, the only authorized representatives of the parties
are:
a. Owner: el V t 6k 3 1 (V-S CAC eLl_ A\S E 1-6 it Yl
(5
b. Municipality: Director, Community Development or designated authority
C. Any attempt to amend, modify, or change this contract by either an unauthorized
representative or unauthorized means shall be void.
service and maintenance provider approved by the municipality and the
manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it
shall be the responsibility of the Owner during the term of this Maintenance and
Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay
for any and all: (1) repair(s), (2)maintenance, (3)adjustment(s), (4)replacement
costs, and(5) inspection costs.
B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules
and orders for the AWWTS.
C. Upon request by the Municipality,the owner agrees to provide the Municipality a
written schedule of routine maintenance and repairs which have been performed
on the system. When a record of maintenance is documented and maintained by
the system vendor, the owner agrees to allow the Municipality access to this
information.
D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS
may be assessed in accordance with AMC 14.60 for improper discharge.
E. Owner agrees that only maintenance and repair personnel approved by the
Municipality will inspect and make any necessary maintenance, repairs or
permitted alterations to the system.
F. Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS upon 24 hours written notice.
G. Owner agrees that any sale or transfer of title of the property will not occur
without a new Certificate of On-Site Systems Approval.
Municipality
of
Anchorage
POUCH 6-650
ANCHORAGE, ALASKA 99502-0650
(9O7) 264-4111
TONY KNOWLES,
MA YOR
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
~unicipality
of
Anchorage
POUCH 6-650
ANCHORAGE, ALASKA 99502-0650
(907) 264-4111
TONY KNOWLES,
MA YOR
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION