HomeMy WebLinkAboutT15N R1W SEC 18 LT 103TI
N RIW
P.,C.
18
Lo'l' 103
051 - 172
-26
Permit Number:
Tax Code Number:
Work Type:
On-Site Wastewater Disposal System Permit
OSPl11344
05117226000
Septic
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Upgrade
Permit Effective Dates: December 05, 2011 to December 04, 2012
Design Engineer: SPURKLAND ENGINEERING
Subdivision: T15N R1W SEC 18
Site Legal Address: T15N R1W SEC 18 LT 103 G:1155
Owner/Address: ANDERSON REBECCA
18916 S BI RCHWOOD LOOP ROAD CH UGIAK AK 995676606
Site Mailing Address: 18916 S BIRCHWOOD LOOP RD, Chugiak
Lot Size in Sq Ft: 51836
Total Bedrooms: 3
This permit is for the construction of:
Y Disposal Field Y SepticTank N Holding Tank N Privy N Private Well N Water Storage
All construction must be in accordance with: 1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater
Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80).
3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
/
Issued By: ~ b~/'~l~.~ ,:
MUNICIPALITY OF ANCHORAGE
Community Development Department
Development Services Division
On-Site Water & Wastewater Program
Mayor Dan Sullivan
Phone: 907-343-7904
Fax: 907-343-7997
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. CSi- t-~%-
Property owner(s) 66c~)
Mailing address 500 D~LL~OO~; ~I~1~5' ~'
Site address IS~i~ 5, ~k ~
Legal description (Sub'd., Block & Lot)
Legal description (Township, Range & Section)
Lot Size sq. Ft. Number of Bedrooms
Day phone
THIS APPLICATION IS FOR:
([~ all that apply)
Absorption Field [~
Septic Tank ~.
Holding Tank []
Privy []
Private Well []
Water Storage []
THIS APPLICATION IS AN:
Initial []
Upgrade ~
Renewal []
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
I certify that the above information is correct. I further certify that this application is being made
for ,.a Single Family Dwelling and is in accordance with applicable Municipal Codes.
(S~iig~~o/~ p~ro~pert~y own~er o r authorized age~)
Permit/Rush Fees:
Date of Payment:
Receipt Number:
Permit No. O~
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
G:\Building\On Site\Forms\Client Forms\Permit App_010411 .doc (Rev. 1/11 )
Environmental Consulting and Design
SEPTIC SYSTEM DESIGN
Municipality of Anchorage
Development Services Department
On Site Water and Wastewater Program
4700 Elmore Rd.
Anchorage, Alaska 99519
November 28, 2011
Subject:
Septic System Installation Permit
T15N R1W SEC 18 LOT 103
Ladies and Gentlemen:
I am writing to request a permit to install a well and septic system for the above referenced property. The
proposed system will serve a 3-bedroom single-family residence. The existing system is in a state of
failure and must be upgraded. Soil logs, design calculations, a site plan, design drawings and construction
specifications are enclosed for your review.
Design Calcs:
No Groundwater observed to a depth of 16 feet below ground surface (11/14/2011)
Soil Rating. From Testhole Nov. 1,2011
8 min/in = 0.8 gal per sq.ft/day
No. of Bedrooms 3
Required Area per Bedroom: 150/0.8 =187.5 sq.ft.
Total area required: 187.5 x 3= 562.5 sqfi
System: We are proposing a 1000 gallon septic tank, and a deep trench absorption field. The absorption
field will be 65 feet long and 2 feet wide and contain 6 feet (780 sq.ft, effective) of sewer rock.
Soils: A test hole was excavated on Nov. 1st, 2011. See the attached soil logs. Ground water was
monitored for through Nov. 14th, 2011. Ground water was not observed.
Surface Water: No surface waters were observed within one hundred feet of the proposed septic
system.
Topography: The lot is generally level.
Waivers: None required.
The installation of this septic system will not prevent wells and septic systems from being installed on the
adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or
concentration of surface runoff will not result from this installation.
203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland~gci.net
Environmental Consulting and Design
I
If you have any questions or concerns, please contact me at 279-3916.
Sincerely,
Lars Spurkland, P.E.
Civil Engineer
203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland~gci.net
SEPTIC SYSTEM DESIGN
Municipality of Anchorage
Development Services Department
On Site Water and Wastewater Program
4700 Elmore Rd.
Anchorage, Alaska 99519
December 5,2011
Subject:
Percolation Test
T15N R1W SEC 18 LOT 103
Ladies and Gentlemen:
The percolation test at the above referenced lot was conducted on November 1, 2011 at a depth of 5 feet
in gravelly silt with some sand. The percolation hole was pre-soaked and then readings were conducted at
10 minute intervals over a 60 minute period. A percolation rate of 8 min./in, was recorded. I am
confident in the results obtained and do not feel an additional percolation test with 30 minute readings is
necessary. The design submitted is based upon visual classification of the soils and the observed
percolation rate. Percolation tests are notoriously variable. The absorption area specified in the design is
considerably above the minimum required for the observed percolation rate and 8 minutes per inch is on
the Iow side of the application rate range.
If you have any questions or concerns, please contact me at 279-3916.
Sincerely, .
Lars--Spurkland, P.E.
Civil Engineer
203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland~gci.net
,/,
I I
I I
I I I
I I I
,J ,
~ ~ ! I
- - N-7"- ...... ~ ~ ~ if ~ -
'
~ ; / x:'?" ,' ',
NO~: THIS IS NOT A SURV~EO P~ WELL ~ SEP~C
L~A~ONS TAKEN FROM ON-S/~ ~A~R ANO WASTE WATER
SPURK~ND EN~INEEBING ~15~ ~1~ ~ 1~ LO~ 10~ SEPTIC SYSTE~ DESIGN
20~ W 15TH. AVENUE
ANCH. AK. 9950~ BECKY ANDERSON DATE: NOV. 28, 201
(907) 279-$91~ 189~ S. B/RCHWOOD LP., CHUG/AK, AK SH~T: ~/S GRID: NWf f~6
PERMIT ~ OSP1110XX PID ~ 051-17~-~6 T15NRiWS18L103SC10~DWG
+ ~reH
LOT
I
I
I
I
I
I
<~ Well
YSTEM PER MOA REQUIREMENTS q: ',~,
N
If'eH
/
//
//
LOT lZ4 //
//
NOTE: THIS IS NOT A SURVEYED Phil'. WELL k SEPTIC ]
LOC4TIONS TAKEN FROM ON-SITE WATER AND WASTE WATER]
OEPARTt, tENT DOCUMENTATION. ALL LOCATIONS SHOIfN ARE
APPROXIt, tATE.
Ll]T 1~3
25 O 25 5~ 75 lOO 125
SCALE: 1' = 50 FT.
INSTALL 3-BEDROOM SEPTIC SYSTEM
1000 GALLON SEPTIC TANK
LENGTH 65 FEET
WIDTH 2.0 FEET
TOTAL DEPTH 10 FEET
IROCK DEPTH 6.0 FEET
COVER 4.0 FEET
SPURKL4ND ENGINEERING
203 tf 15TH. AVENUE
ARCH. AK. 99501
(907) 279-3916
T15N RIE SEC 18 LOT 103
BECKY ANDERSON
1891G S. BIRCHWOOD LP., CHUG/AK, AK
SEPTIC SYSTEI~I DESIGN
DATE: NOV. 28, 2011
SHEET: 2/3 GRID: NWl 155
PERMIT # [1SPIlIOXX PID # 051-172-£6 T15NRll,/S18LiOSSCiOO. DWG
/0 0 Oi 0
i
__ 1000 go! Septic
o
/ St~nd~rd Trench:
/ 6~ Long
10' ~eep
/ 6' Sewe~ ~ock
4' Cove~
Nfl ~ALE
Monior onou$s
6 Ft o~ Septic ~ock (Effective)
1000 9al, septic tank
B.O.N. ELEK= ND SCALE
BENCH
ASSUMED ELEVATION 100'
SPURKLAN9 ENGINEERING ~J5~ B~ S~C ~ ~0~ ~03 SEPTIC SYSTEM SCHEMATIC
203 V1Sth Ave BECKY ANDENSON DATE~
Amcho~e Ak 99501
279-3916 18~I~ & BINON~OOB L~P, ONU~IAK, AK SHEET~
PENWIT ~ OSP111XXX PANCEL ID ~ 051-172-26 FI5NN1~SISLIO~D~.D~G
Performed For:
Legal Description:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Road
P.O. Box 196650 Anchorage, AK 99507
www.ci.anchoraqe.ak.us
(907) 343-7904
Soils Log - Percolation Test
Becky Anderson
T15N R1W SEC 18 LOT 103
-' --4,--'"4'
~. ;49TH~'~ '~
I. ~ LAR'"'StE. SPURKLAND i~"
~1 *~"'" *'",k, ,.--'
Date Perform ed: N o;et ~'~'~,-"~1'''1~
Slope
Township, Range, Section:
Site Plan
2-
3-
4-
9-
10-
11-
12-
13-
14-
15-
16-
17-
18-
19-
20-
COMMENTS PRE SOAKED
WAS GROUND WATER
ENCOUNTERED? NO
S
L
IF YES, AT WHAT DEPTH? ---
O
Depth to Water After p
Monitoring? ~'¢ E
Date: il/'~l[~
Reading Date Gross Time Net Time Depth to Water Net Drop
11/1/11 10:56 AM 10.25"
8.25" 11/1/11 11:06 AM 10 MIN 10.25" 2"
9" 11/1/11 11:16 AM 10 MIN 10.5" 1.25"
9.125" 11/1/11 11:26 AM 10 MIN 10.5" 1.375"
9.125 11/1/11 11:36 AM 10MIN · 10.5" 1.375"
9.125 11/1/11 11:46 AM 10 MIN 10.25" 1.375"
9.125 11/1/11 11:56 AM 10 MIN 1.25"
PERCOLATION RATE 8 (minutes/inch) PERC HOLE DIAMETER 6
TEST RUN BETWEEN 5 FT AND 6 FT
i C~I ~
PERFORMED BY: Lars Spurkland I (~_~,l:w¥~ CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDe:LINES IN ~FFECT ON THIS DATE. DATE: 1 1/4/1 1
Subject Property:
Date:
General:
:1.
m
Environmental Consulting and Design
I
Single Family On-site Wastewater Disposal System
Construction and Material Specifications
T15N RlW SEC 18 LOT 103
November 15, 2011
The owner shall contract with a contractor to perform the work outlined in these
specifications and plans in accordance with the attached MOA permit. There is not
contractual arrangement between the contractor and the Engineer. The Engineer shall
be the owner's representative and will inspect the work to document the contractors
activities. Final acceptance of the contractors work rests with the owner and the MOA.
The scope of the project includes the procurement and installation of a 3-bedroom on-
site wastewater disposal system at the location depicted on the attached site plan
drawings. The scope of the work includes the installation of a 1000 gallon septic tank
and a drain field comprised of I trench, 2-feet wide x 65 feet long, with a maximum
depth of 11.0 feet, with 6 feet of septic rock below the distribution piping. All
components of the proposed septic system must be constructed a minimum of 100 feet
from any surface water or water wells in the area. A minimum of 4 feet of earthen cover
is required over the septic tank and a minimum of two feet of cover is required over the
drain field. Tn addition to the required earthen cover, 2-inch thick, 40 psi, direct bury
board foam shall be installed directly over ail installed piping.
Construction shall be in accordance with the approved site plan and design drawings and
any special provisions noted on the Municipal well and/or septic permit. All materials,
components, workmanship and construction practices shall comply with the Municipality
of Anchorage's latest ordinances regarding wells and septic systems, as well as MOA,
Development Services Department, On-site Water and Wastewater Program (DSD)
policies.
The contractor is responsible for obtaining all underground utility locates, layout of the
proposed system, and verifying and maintaining all required separation distances to lot
lines, surface water, wells, steep slopes, etc.
The property owner shall be responsible for final grading any depressions formed from
settlement of backfill material. The property owner is also responsible for vegetation of
all areas disturbed by septic system installation activities.
Contractors installing Wastewater disposal systems must be certified to do so by the MOA
DSD, On-site Water Wastewater Program. Property owners installing their own systems
must receive advanced approval from MOA DSD prior to system installation activities.
The contractor shall ensure that ALL materials being used are in compliance with the
most current guidelines established by the Municipality of Anchorage. Refer to
"Standards and Specifications for Component Parts and Materials Used in the
203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland~gci. net
Environmental Consulting and Design
I
Construction of On-site Wastewater Disposal Systems", Dated December 2000, as
provided by MOA DSD, On-site Water and Wastewater Program.
Septic Tank Znstallation:
3.
4.
5.
6.
9.
10.
11.
12.
13.
14.
15.
16.
A new septic tank, of the size specified in the design drawings, shall be procured from a
qualified manufacture/supplier if the existing septic tank is found to be defective.
Construction shall include two 4" diameter cleanouts for pumping access.
The burial rating of the tank shall be adequate for the actual burial depth encountered.
The tank shall be level and sufficiently bedded to prevent settling of shifting of the tank.
All standpipes on the tank shall extend a minimum of 12inches above the final grade.
Tanks installed with less than 4 feet of cover shall be insulated.
The sewer service line from the house to the tank shall have a minimum slope of 2%
unless prior approval is obtained from the engineer.
The inlet and outlet lines from the tank shall be bedded in drain rock or the soil shall be
sufficiently compacted to prevent future settlement of the soil.
Septic tank inlets, outlets and cleanouts shall be fitted with water tight couplings.
A cleanout shall be installed i to 4 feet from the foundation.
Post tank cleanouts shall be installed per MOA requirements. Does not apply to
pressurized lines.
Tn areas with high ground water, the septic tank shall be sufficiently anchored to resist
buoyancy forces when there is not adequate soil cover to resist uplift force. The
contractor shall refer to the engineer for direction regarding this matter.
The tank backfill shall be graded sufficiently to ensure positive drainage away from the
tank.
All holding tank and lift stations shall have an audible and visible alarm inside the
residence being served.
All lift stations shall be wired in compliance with all MOA guidelines and the Uniform
Electrical Code. A municipal electrical permit and inspections must be obtained where
required by the MOA.
The contractor shall verify that the septic tank/lift station is a minimum of 100 feet from
any residential water well, 150' from any class 'C' well and 200 feet from any community
water wells. Additional separation distances must also be maintained.
The contractor shall remove or abandon the existing tank in compliance with the Uniform
Plumbing Code.
Drain field Construction:
The drain field shall be excavated to the dimensions outlined in the design drawings. If
any discrepancies are noted, contact the engineer immediately for clarification.
The drain field shall be installed parallel to slope contours.
203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland~gci.net
m
w
9.
10.
Znspections:
1.
Environmental Consulting and Design
I
The bottom of the drain field shall be within 2" of level. ]~f the sidewalls or bottom of the
excavation become smeared, they must be raked or scarified prior to the placement of
filter sand or drain rock.
The drain field must be a minimum of 5 feet from the test hole excavation.
Distribution pipe is to be installed level with perforations facing downward, atop a level
bed of drain field rock. Septic rock shall then be placed atop the distribution piping to
provide a minimum of 2' of cover, level across the entire width and length of the trench,
above the piping.
A silt barrier must be insLalled at between the final drain rock and the naLive soil backfill.
The sill barrier shall cover the entire drain rock surface.
Monitor tubes must be 4" in diameter, installed in the locations depicted on Lhe design
drawings, and extend a minimum of 12' above final grade. The portion of the
monitoring tube below the septic rock must be perforated and the portion above the
drain rock shall be solid.
Backfill over the final gravel layer must not be less than 2 feet. ~[nsulation must be
installed when the backfill depth is less than 3 feeL.
Drain field back fill shall be mounded to prevent depressions from forming due to
subsequent settlement of backfill material.
The contractor shall veri~y that the drain field is a minimum of 100 feet from any
residential water well, 150' from any class 'C' well and 200 feet from any community
water wells. Additional separation distances must also be maintained.
A minimum of two inspections are required by the Municipality of Anchorage. These
inspections must be conducted under the supervision of a Professional Engineer licensed
to practice in the SLate of Alaska.
The first inspection must be conducted after the excavation of the drain field and before
the placement of any gravel. The septic tank may be set in place, but may not be
backfilled.
The second inspection must be conducted after the placement of the silt barrier, gravel,
distribution lines, stand pipes, cleanouts, and insulation, but before the placement of any
backfill.
The contractor shall provide a legible copy of all field notes relating to system layout and
construction to the engineer for the use in preparing the record drawings.
The contractor shall coordinate all inspections with the Engineer. A minimum of 24 hours
notice is required prior to the start of construction. If necessary, a preconstruction
meeting will be held on-site.
203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland~gci.net
Tom Fink,
Mayor
Municipality Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
January 9, 1989
Don Anderson
PO Box 772444
Eagle River, Alaska 99577
Subject: T15N R1W Section 18 Lot 103
Permit 9880225, PID 9051-172-26
A permit issued by this Department for an individual well
and/or on-site sewer ~ystem has expired as of December 31,
1988.
Permits are issued on a calendar year basis by authority of
Municipal Ordinance. A new permit must be obtained from
this Department for any well and/or on-site sewer system
not installed by the expiration date.
If you have drilled the well, a well log needs to be sent to
this Department for documentation of the installation and to
close the permit.
If a private engineer inspected the installation of the
on-site sewer system, the original as-built inspection report
(three-part form) must be sent to this office for review and
approval, and for documentation.
When applying for a new permit, the fees are: $90.00 for
an on-site sewer permit; $50.00 for a well permit; $140.00
for a combined sewer and well permit.
If there are any further questions, please call this office
at 343-4744.
Sincerel~, ~
Acting Program Manager
On-site Services Section
DJR/ljw
enc: Copy of Permit
F'ar' c e I I d ~f I:)~,:~ 1..... 172.-26
Lo'l:. I....l*:~l:;j~:¢,tJ.,", !]ii..d:)cl:i.v:L!~:i. or'l~" ..... I.; L..o'Lil ..... Eit(::)c:k~ .....
L:~l....l~l LC)I" 10:3
yflling
DOC Co. c~ba
SULLIVAN WATER WELLS
P.O, SOX 67027'2, CHUGIAK, ALASKA 99567 · TELEPHONE 688.2759
OWNER OF LAND
LEGAL DESCRI~ION Ll'rT' /0.~ ~'~ ~ /~'~xl < / t~) DRAW DOWN FT.
DATE- Started / ~//~/&%~" Ended /O~/,e~' GALS. PER HR
/ ~ ~ ~ ~ ,
PERMff NUMnER ~ ~ ;~ ~ K~ND O~ CaS~N~
DEPTH OF ~,'ELL Jo~O
SI'XTIC LEVEL OF WATER FI' ,'/
From
From
From
From
KIND OF FORMATION:
Ft. to '~ Ft. ~ ,~,3, ,-¢-~ ~ fi_ ~'~ O~ From.__
Ft. to ~ Ft. 0t)~ ~O~z~ From
~ ~ ~< ~ From
Ft. toc~/ Ft, ~0 6~4,~,fi~.~ From
From c-~, Ft. to ,~G Ft. ~74~ d'<o~ ~Y,,~ From
From __ Ft. to Ft._~ ~O ~:L. From
From /~ 7 Ft. to--Ft. ,~'~,OOS T',}~a~ From
From /O & Ft. to_/'~O:~
From Ft. to
From__Ft. to
From Ft. to_
From. Ft. to
From Ft. to
From Ft. to
Ft. ,~TO,~4 T"~a /O~G/~,~ From--
Ft. From
Ft; From
Ft. __ From
_Ft. From
Ft From
MUNICIPALITY OF AI',ICHOI~Nt~E
Ft. to I~T. OF HEALTH &
ENVIRON~c~,'~L
Ft.
F~EB ~ 1989
Ft. to Ft.
,.,o_ RECEIVED
Ft, 1o Ft.
~ Ft. to_ Ft..
Ft. to Ft.
Ft. to ..... Ft.
,, , Ft. to Ft.
Ft. to Ft
Ft, to Ft._
Ft. to Ft
Ft. to~ Ft
_Ft. to~
Ft, to.~ Ft,
Ft. to Ft.
_Ft, to
MISCL. INFORMATION:
DRILLER'S NAME ',:: c
Gr'~'ATER ANCHORAGE AREA BORO'
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
N? 547
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
/
SEPTIC TANK:
D~STANCE EROM WELL.
UQU~D CAPACITY ,)2
GALLONS.
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAL
NEAREST LOT LINE.
SEEPAGE PIT:
OUTSIDE DIAMETER
OR WIDTH '~ ~- , LENGTH '~ ~>~ , DEPTH
DISTANCE FROM WELL , BUILDING FOUNDATION
TILE DRAIN FIELD:
ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRADE
WELL: TYPE CIv,//("C[- DEPTH
NEAREST SEPTIC
LOT LINE , SEWER LINE . TANK
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE T~LE __
DISTANCE FROM ~(~) WATER
, BUILDING FOUNDATION. SAMPLE NEAREST
~ ~.~ SEEPAGE /~) ~. OTHER
, SYSTEM , CESSPOO~ , SOURCES
DISTANCES:
lOC}
DIAGRAM OF SYSTEM
z.b'dI., -_~ C
DATE
GAAB-HI
GREATEI
ANCHORAGE AREA
HEALTH DEPARTMENT
327 Eagle St. Anchorage, .Alaska 995~01 ~ ~
7
S~iAGE DISPOSAL SYSTEM - APPLICATION
OROUGH Case N:o.
279-2511
& PERMIT
NAME OF APPLICANT
RESIDENCE ADDRESS
LEGAL DESCRIPTION
APPLICATION TO INSTALL: SEPTIC TANK.
TO SERVE THE FOLLOWING FACILITY
FINANCED THROUGH
PERCOLATION TEST RESULTS
MAILING ADDRESS '~ /~'~'
LOCATION OF INSTALLATION
""'""~, SEEPAGE PIT ~J' , DRAIN FIELD
TO BE INSTALLED BY ~
ANTICIPATED DATE OF COMPLETION
, OTHER
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS FIR. ~t~l~-..,[~ , PERMIT TO INSTALL A
DISTANCES:
;~
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED
SEPTIC TANK SIZE. I~l '-~"~-~ TYPE ~--~' T~30~SEEPAGE AREA
DIAGRAM OF SYSTEM
TYPE
I certify that I am £am1]iar with the requkeme~ts o£ Greater Anchorage Area Borough Ordi~ance~_No. 28-68 and t~at t~
above described system is in accordance with said code.
) / -- . .
MUNICIPALITY OF ANCHORAGE
.
Development Services Department , j` Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 051-172-26
1. GENERAL INFORMATION
Expiration Date: Z '70
Complete legal description T15N R1 W SEC18 LT103
Location (site address) 18916 S. Birchwood LOOP
Current property owner(s) Rebecca Anderson Day phone
Mailing address 900 E Dellwood St
Real estate agent Day phone
2. TYPE OF DWELLING:
El Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
0
Private Septic
0
Water Storage
❑
Holding Tank
❑
Community Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Waiver request for:
Distance:
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $
Date. -of Payment
Receipt Number LIS&
COSA # 65 0_Iq 15
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
6. 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.
In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA
COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time
of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on
the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not
guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot
provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole
benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly
recommends buyers hire their own engineer to evaluate this report.
Name of Firm Pannone Engineering Services
Address P.O. Box 1807 Palmer, AK 99645
Engineer's Printed Name Steven R. Pannone P.E.
6. DSD S GNATURE
System #1 Approved for 3 bedrooms
System #2 Approved for bedrooms
Disapproved
Phone (907) 745-8200
Date /'?///
Aw ��
0. AL,,4
•Steven R: •Fcnnolse•
CE 8149
Conditional approval for bedrooms, with the following stipulations:
OF
TER AND �
o WASTEWATERo^
'NT SE?N�G',
By: �d G✓ Original Certificate Date: Z 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
Legal Description: T15N R1 W SEC18 LT103
Parcel ID: 051-172-26
If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1
A. WELL DATA
0 Well log is filed with Onsite (or attached)
Date drilled 10/13188
Total depth 120 ft
Cased to 59.5 ft
0 Sanitary seal is functioning correctly
0 Wires are properly protected
Casing height (above ground) 20 in.
Date of flow test for COSA 9117/19
Well production at time of test 3.1 gpm
Water storage tank volume n/a gallons
Well disinfected for coliform test? ❑ Yes F,/� N
0 Coliform bacteria is Negative
Nitrate mg/L 0 Nitrate less than MRL (ND)
Arsenic ug/L 0 Arsenic less than MRL (ND)
Collected by Pannone Engineering Services
Date of Sample
Static water level at beginning of test 48.6 ft.
Comments
B. TANK DATA
Age of tank(s) 8 years
Tank type/material 5ap'�"�wl
Measured operating fluid level in septic tank 48"
❑® Standpipes/foundation cleanout per record drawing
Date of pumping 11/4/19
D. ABSORPTION FIELD DATA Deep Trench
Which system tested (date installed) 72/7'2011
ALL standpipes present per record drawing
Total measured depth from grade 10 ft (max)
Measured depth to pipe invert from grade 4 ft (min)
❑ N/A — pressurized field
0 Monitor tubes go to bottom of effective. If not, state
depth into effective "
0 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: " +/ 1.0 sludge in monitor tube
COSA Checklist yellow sheet
9/17119
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments:
Adequacy test date 9/17/19
Results ED Pass For 3 bedrooms
Fluid depth prior to test 26 in
Water added 450 gal
New depth 31 in
Elapsed time 160 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'
2✓
Yes
Community Sewer Manhole/Cleanout > 100'
❑✓ Yes
if No
ft
❑✓ Yes
if No ft
Neighboring Tank > 100' 2✓ Yes
if No
ft
Private Sewer/Septic Line > 25' Q Yes
if No ft
Absorption Field on Lot > 100' M Yes
if No
ft
Holding Tank > 100' Q Yes
if No ft
Neighboring Absorption Fields > 100'
Q Yes if No ft
Water Main > 10'
Animal Containment > 50' Q Yes
if No ft
Q Yes
if No
ft
Q Yes if No ft
Water Service Line > 10'
Q
Yes
if No
Manure/Animal Excreta Storage > 100'
If septic tank is under driveway
Community Sewer Main > 75' Q Yes
if No
ft✓�
Yes
if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
2✓
Yes
if No
ft
Surface Water > 100'
Q Yes if No ft
Property Line > 5'
Q
Yes
if No
ft
Wells on Adjacent Lots:
0
Absorption Field > 5'
❑✓
Yes
if No
ft
Private Wells > 100'
Q Yes if No ft
Water Main > 10'
21
Yes
if No
ft
Community Wells > 200'
Q Yes if No ft
Water Service Line > 10'
Q
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'
Q
Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
Q
Yes
if No
ft
Wells on Adjacent Lots:
Water Main > 10'
0
Yes
if No
ft
Private Wells > 100' Q Yes if No ft
Water Service Line > 10'
Q
Yes
if No
ft
Community Wells > 200' Q Yes if No ft
Surface Water > 100'
Q
Yes
if No
ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION
1 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. /Qtt(l y
COSA Checklist yellow sheet
I) LOT 102 I � �
LOT t 02 I COMMUNICATION / �50. p
G' WIRE FENCE x 4' WOOD FENCE \ PEDESTAL / 4v
/ }` LOT I O I A
---------------------N90°00'00"E 329.91'(8 C)----------------- ( SO 0 / Q
----------------- - /
--- ------_;__-;--x-- ______ __ _ c ___ NATES:
---------------------255.43'(C)-- -------- --
! x - CURRENT ROAD wN 1. THIS MORTGAGE LOCATION (A5 -BUILT) SURVEY
_ (..,.. CENTERLINE PO WAS PREPARED IN
1 • • • • • • . 51,557 OT 103
a C) MORTGAGE LOCATION SOURVEY STANDARDS,
j 3G,573 5.F.(C I) COMPUTED ROAD �(-n / REPRESENTS FOUND CONDITIONS AT THE TIME
1 4' WIRE FENCE 26. n 1 . 1 9 AC (R) L CENTERLINE OF SURVEY, DOES NOT CONSTITUTE A
F I -STORY HOUSE 4 -,.'.' p o
(TYPICAL) (� �y - I . 18 AC (C) / rn / BOUNDARY SURVEY, AND 15 SUBJECT TO ANY
Gliv t. INACCURACIES THAT A 5UB5EQUENT
O' PAVED `'..'.'.',
— VU �• • .... BOUNDARY SURVEY MAY DISCLOSE.
is V 2.2,
x %� p �1 -. 2. INFORMATION CONTAINED HEREON SHALL NOT
OO° + r: _ ::::: / V
/ BE USED TO E5TABL15H ANY FENCE,:;: _4'5TEEL
„y y STRUCTURE, OR OTHER IMPROVEMENTS. IT 15
a CORRAL CRWAL5PACF / (�` THE RESPONSIBILITY OF THE LAND OWNER OR
p' FENCE N D ;�. (� p� /\ I BUILDING CONTRACTOR TO DETERMINE THE
m ACCESS BRICK PATIO / `� EXISTANCE OF ANY EASEMENTS OF RECORD,
-. _ �, /` v, :•�• m O / COVENANTS, OR OT RE5TRICTION5 WHICH ARE
12.2' 2 t .2' CAf� 11LEVER (30 NOT IDENTIFIED ON THE RECORD PLAT.
A.
/QJ �1-') ® /i°�v��nr / 3. UNLE55 GR05E NEGLIGENCE 15 DISCOVERED,
s THE LIABILITY EXTENT FOR TH15 SURVEY SHALL
\ �) SEE NOTE 4 / / n /O BE LIMITED TO THE FEE AMOUNT COLLECTED TO
ILI
T i I -� p� / PREPARE THI5 DRAWING. THI5 DRAWING WA5
vl z 1 100' WELL }Ik /'S' / O 21 PREPARED WITHOUT THE BENEFIT OF A TITLE
�`� REPORT.
RADIUS /h 4 / �� Q �v. ry
t �/ QIP' / 4. DEPARTMENT OF HIGHWAYS LETTER DATED
fqll / SEPTIC PIPE � p AUGUST r3, 1975, CALLS FORA 50'ROtA/I-STORY BARN / (TYPICAL) �v A BASED ON EY.1511NGROAD CENTERLINE.
O�1 LOT I O! B 5. (C I) REFERS TO THE REMAINING AREA WEST OF
�t0110Z500 ,�q�A4)°R�ti` / THE 50' ROf✓ FOR S. BIRCHWOOD LOOP ROAD.
65 17'
- �177.35'(C)------- / r
-r------r------- _--r�J=------ _------3 (RI)---_---_ 5E CORNER LOT 101 B
-'-- 590'0 0'00"W 271.75'(C) 271.90'(R) ----------
20' O' 40'
8'iNOOD FENCE ---------------- ----/-----------
LOT 12 4 -`- / 590°00'00"W G59.G2'(M) G59.9 P(R)--------- LOT 125
i / BASIS OF BEARING / GRAPHIC SCALE
"=40'
� LEGEND t
I HEREBY CERTIFY THAT AN ACCURATE SURVEY _-'` \
OF THE FOLLOWING DESCRIBED PROPERTY; i `� F A1q \l! FOUND 3" ALUMINUM (M) MEASURED~�-
I I5N R1 W SECTION 18 GOV. LOT 103
,f �P. ' I'll I�
'
CAP (880-5)
(C)
CALCULATED
OF THE ANCHORAGE RECORDING DISTRICT,
j
ALAS\A 11iA5 MADE ON 0-04-2019 AND
......... :,......... ..... j
FOUND 5/8" REBAR
Q
ELECTRIC METER
THAT THE IMPROVEMENTS SITUATED THEREON
DO NOT ENCROACH ON THE PROPERTY LYING
.
,`` v ,�J '`
�s
j ✓
O
FOUND f "IRON PIPE
A
GAS METER
. ' ' . ' . ' '
-0-,
UTILITY POLE
ADJACENT TO THE PREM15"E5 IN QUESTION
EXCEPT AS
�, "•RICHARD L. vrENTMATH•' �o /r
(R)
RECORD BLM PLAT
1z'GUY
V✓iRE
INDICATED HEREON. EASEMENTS
l� psi '. N0. +1004
OF RECORD OTHER THAN TH05E 51`10k4/N ON
THE
C<%
t Fp' • . ��'J�
DATED MAY 13, 1955
vv
WELL
RECORD PLAT MAY EXIST.
,\lP'�FFSSIOt;AL `p0
(RI)
RECORD PLAT 7G-48
;
WOOD DECtC
a
I-) &- k' I A K I F-)
G• 1
10
Rt K LAND SURVEYING
PO BOX GOG
WILLOW, ALASKA 99G88
(907) 495-0047
HJ-CJUIL
PREPARED FOR:
REBECCA ANDERSON
DRAWN BY: R.LV✓ FIELD BOOK:
CHECKED BY: KEW RKL5 2019-09
JOB NO.: MOA GRID MAP#:
2019-153 NW 1155
SCALE:
„_ n n•
DATE:
in i i 9nIC)
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received May 19, 1976
Time of Inspection ~,~'~)~i
Date of Inspection /l)~/- ~.~
1. Approval requested by:
Mailing Address:
2. Property Owner:
Mail'ing Address:
3. Legal Description:
4.
5.
6.
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Cony.
Amfao Mortgage Corporation
705 West 6th Avenue, Suite 201
John W. & Ella O'Bryant
Post Office Box 586A Chugiak
T15N R1W Section 18 Lot 103
Location:
' 3~/' /
Phone: 277-8588
Phone: 688-2358
99567
South Birehwood Loop Road, weside before phone company
Type of facility to be inspected
Well Data: Individual
A. Type
Single Family No. of bedrooms 4
Size
B. Depth 55'
D. Bacterial Analysis
On-site system
B. Installer
2. Manufacturer
2. Material
1. Absorption Area
Total length of lines
, Absorption area
, Other contamination
, Absorption area
SeWer Lines .. ,
C. Construction
7. Sewage Disposal System:
A. Installed 1971
C. Septic Tank: 1.
D. Seepage Pit:
E. Disposal Field:
8. Distances:
A. Well to: Septic tank
Nearest lot line
B. Foundation to septic tank
C. Absorption area to nearest lot line
EQ-034 (1/74) Page 1 of two pages
3330
,.REATER ANCHORAGE ARk;, BORuuGH
Departmeilt oF Environmental Qualii;~ '
"C" St., Anchorage, Alaska 99503 - 27~Ll~FANcN
. · ,~rAL PROT~CFiON
'REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES MAY
· l. Type of Inspection: CMRO VA
2, PFope'rty Ovlner: . Jolm~. w. aL~d Ella O'~Fant
FHA
Mailing Address': P.O. Box 586A, Chu~Liak, Ak. .Da,y_ Phone
Name of Buyer: Altert Sears, Jr.
.;ailing Address~ n~N 4n~ j. SRA~ Annh,._9--gJ.~l-Q Day Phone
Name of Lending Institution: Am~ae Mo~t~O~9o:ation
Mailin9 Address: 7n5 W._~ve.. suite 201 '
Name of Realtor or Agent: Direct Sale
Mailing Address:
Phone 277=-8.588
Phone
688-2358 ?.
6. Legal Description:' Go~t. Lot 103, Sec~ 18, TiSN, RiW, Sew-a_~d Meridia~
Location: S. Birct~ T_cx~p - W. side ~efore phone Co.
7. .Type of Facility to be inspected: si~gle family No. Bdrms. 4
8. Nater Supply
Type of Supply: .Public Utility ind~vidual ~
If
if
Sewage Disposal'System
. Type .of S~stem: Public
if ~ndividual,
Individual, number of dwellings
individual, depth of well ._55' _
presently .serxed ..1
Util i ty Individual
date of installation 1971
(on-site)
** Owner is leaving area on approx. 5/20/76. If inspection is to be made after
this date, please contact J~ck Billings (day phone 265-5371) for access.
Page 2 of two pages - Re it for Approval of Individual )r & Water Facilities
Legal Description T15N R1W Section 18 Lot 103
Comments /~ ~-~ ~k~
Approved ~__c_ y ~/ut~.~. Disapproved ~ ~2te/
/ ~proval,Valid for oneyear .om date signed
G~eate~ Anchomage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
ii /
certify that the information contained in this re~est for approval to be a true ~-nd
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED Date
EQ-034 (1/74)
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD
ANCHORAGE, ALASKA 99507
279-8686
DATE RECEIYED:~
INSPECT:
TIME: '~;~ ~.~,
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER AND WATER FACILITIES
FOR
e
APPROVAL REQUESTED BY:
PHONE: /~-~ -~7~-'~2
PROPERTY OWNER:.__-'~'~""'"~-'~,_F-~x~
LEGAL DESCRIPTION:~m~ /o~ ~e~/~
PHONE:
TYPE FACILITY TO BE
NUMBER OF BEDROOMS:
INSPECTED:
WELL DATA:
A. TYPE
DEPTH
Be
C. SIZE ~'~
D. CONSTRUCTION
E. BACTERIAL ANALYSIS-",~q
6. SEWAGE DISPOSAL SYSTEM:
A e
SEPTIC
1.
2.
3.
TANK (]iF HOMEMADE,
SIZE /
AGE
SHOW DIAGRAM ON BACK)
MANUFACTURER
INSTALLER ~'~-~l~
APPROVAL REQUES1 OR SEWER & WATER FACILITIL
PAGE TWO
B. SEEPAGE PIT
1. SIZE j.. ~ 2~
2. LINING ~<:~
/
C. DISPOSAL FIELD
1. NUMX~,~R OF LINES
2. TOTAL k"~NGTH
REQUIRED MEASUREMENTS
A. WELL TO SEPTIC TANK ~'~'~
B. WELL TO SEEPAGE PIT /~-~'~2
C. WELL TO SEWER LINE
o. WELL TO PROPERTY LINE
E, WELL TO OTHER POSSIBLE CONTAMINATION
F. FOUNDATION TO SEPTIC TANK ~Lyq-y~/
G. FOUNDATION TO SEEPAGE PIT
H. SEEPAGE PIT TO PROPERTY LINE
COMMENTS
c~. ~:~_,~, ~.L
APPROV~F~-...~..~.,,~.-~z~g~..-~-( DISAPPROVED:
DATE: ,_SZ~,~/'?~. DATE:
APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED.
GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY
J mm' ry 1 ]~ t,':~'?1
Box 684
Alask~ 995(,7
}iay 27, 1970 you obtainod a permit from t,~l,~ i)cpartmo]~t
fOr"
L,I(. '
I 1¢ ..... ;~dvJ. so thi:; l]cp:~?tlucl~t if you h:~vc Jnstr~]]o,,l, of
stJJ1 int~ml t~ i~sta]l, u sewer systma on thc subject
prol~crl:y and w:i.:;h y ur ]er Jt kept pendin.~: in our :giles.
.... Coad
5~te Rac3-:v'ac 5-28-75
3aza o7'
~EqUEST FOR /,?::20?AL OF
iNDiVIDUAL SEWER i WA'FSR FACILiTiES
C~nventional
.. ~,p;..~w, requested by:
Smiley's
2. Property Owne,% Joe Roseman
688-2511
~. .<:~.; uesc,-~,mN~on: % TiSN R1W Sec 18 Lot 103
6, Loca%(or~: Birchwood Loop W. side before phone co.
~. '-ypa ,of fac'i'iity ~o ~u :nspec'ced
' ",.,:. Drilled
System:
1971
D
]. Size 1250 gal
I Aoso, p .... : Area
Total length o':: :,
Single
2. };ai'i~','~act U rep
486 sq. ft.2. ,%:~..". ~:, ':.: __L.o_gs__ .............
A. !:eli to: Septic tank
Nearest lot 'line
3. Foundation :o septic tank
C. Absorption area to nearest lot :ine
Absorption area
60'
L~,~j=, Bascrlp'~.~on
CoaT, m4: n~s
Ap?o,/a~. :": {: ,.', .
, ; .. ~- /! ,. Disapproved
./' Approval Va~d 'For one year 'From date signed
Greater Anchorage Area Borough~ Department of -
.. Environ lan
DIAGRAM OF SYSTEM
' certify that the information contained in this reques't for approval to be a' "' ...... .~.~'-"
ccu~o,u~ representation of the subject sewer and water facilities ane Chase 'F~c~: '~:~,~
are operating satisfactorily.
SIGNED Date
(I/74)