HomeMy WebLinkAboutGREENBROOK BLK 4 LT 1Greenbrook
Block 4
Lot 1
#017-431-16
Inspection Report_t-1=12.1V-1
Municipality of Anchorage
Community Development Department Page 1 of 3
On -Site Water and Wastewater Program
4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http:/Iwww.muni.org/onsite • (907) 343-7904
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP131030
PID Number: 017-431-16 ❑ New ✓❑ Upgrade
Name:
Charles & Teri Barclay
ABSORPTION FIELD
❑ Deep Trench ❑✓ Shallow Trench El Bed ❑Mound
Address
12731 VonScheben
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
3
0.8 GPD/SF
1.O Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
0.5 Ft.
Gravel depth beneath pipe
0.5Ft.
Subdivision
Block Lot
Greenbrook
4 1
Fill added above original grade
2.0 Ft
Gravel length
50/70 Ft
Township Range Section
Gravel width
5.OFt.
Beds: Number of Lines
N/A
Distance between lines
I N/A Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
600 Fts
2
10.0 Ft.
Well
N/A
N/A
N/A
NIA
N/A
TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Existing
Capacity
I Gal.
Surface Water
(E)
100+
(E)
N/A
Material
Number of compartments
Lot Line
(E)
10.4
(E)
N/A
NA
Foundation
(E)
10+
(E)
N/A
LIFT STATION
Manufacturer
Capacity
Curtain Drain
(E)
50+
N/A
Existing
Gal.
Remarks
Pump on level at
in.
Pump off level at
in.
High water alarm at
in.
Pump make and model
Electrical Inspections performed by
Installer
PIPE MATERIAL Housetotank (E) Tank to 3034
drainfeld
Beek's Excavating
Drainfield 3034 Co/MT 3034
Inspector Pannone Engineering Services, LLC.
BENCH MARK (Assumed elevation) 100ft
Inspection r
dates: 1� 4/13/13 2ntl 4/14/13
Location and description
3'"
4
Front Door Threshold
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
Engineer's Stamp
Conditional Approval:
DateInk-
r�OF
`• • �teven� •f�. �annorae��
/
CE 8149
Approved
R Date � ' /
`t �R?p��,Si�aP
.
�•+
r
Inspection Report_t-1=12.1V-1
I
o C2
TH-5-1994 M4
(MEA)
M2
NEW DRAIN FIELD 10.9
r�2
A)50LFx5'WxO.5'EDx1.O'TD '�
A)70LFx5'Wx0.5'EDxi.O'TD C1
i
5
TP -2-1996
j M3 (WHITE)
TP -1-1996 M1
(WHITE) -w 04
DRAIN FIELD (E)
IN FAILURE
003 �° RE -USE
1 S (RESERVE
TEE
b INSTALLED TEE AND
(2EA) 1Y" BALL VALVES
\1250G S.T.E.P. TANK (E)�(ONE ON EACH LINE AFTER TEE)
TO REMAIN
i
TH-1 A B
G
3 B
O�
w_w R
Np HOUSE ?7
w—
;. (E) =i
\ 2
OCG D/W %
F
C04 CO3
NOTES:
RECORD DRAWING
PANNONE ENG
P.O. BOX 100217 ANCHOR(
PHONE (907) 272-8218 FAX
SOUTH PARK DRIVE (R.O.W)
I
L951 LC
o
272-8211 /rlh�p
GREENBROOK, BLOCK 4, LOT 1
CHARLES & TERI BARCLAY
12731 VON SCHEBEN DRIVE
PLAN ANCHORAGE, AK 99516
*: 49 TH '
.....
Steven R. Pannone
Pte•. CE 8149 �1
4/29/13
Scale
1"=50'
'.I.D. NO
017-431-16
'ERMIT NO
2 OF
mi
32.00
32.00
M2
42.60
80.50
C1
41.20
80.10
M3
47.70
31.20
C2
60.00
94.40
M4
58.70
94.10
TEE
59.50
12.60
A
128
90.00
B
112.00
86
NOTES:
RECORD DRAWING
PANNONE ENG
P.O. BOX 100217 ANCHOR(
PHONE (907) 272-8218 FAX
SOUTH PARK DRIVE (R.O.W)
I
L951 LC
o
272-8211 /rlh�p
GREENBROOK, BLOCK 4, LOT 1
CHARLES & TERI BARCLAY
12731 VON SCHEBEN DRIVE
PLAN ANCHORAGE, AK 99516
*: 49 TH '
.....
Steven R. Pannone
Pte•. CE 8149 �1
4/29/13
Scale
1"=50'
'.I.D. NO
017-431-16
'ERMIT NO
2 OF
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION WAS 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.
2. SCOPE OF WORK: INSTALLED NEW SOIL ABSORPTION SYSTEM.
3. GROUNDWATER WAS NOT OBSERVED LESS THAN 5' BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. AN
APPARENT WATER TABLE WAS NOT OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 5.0 FEET BELOW EXISTING
GRADE,
5'0
1 = 105.6
2.0
DIP
RIGID INSULATION
FILTER FABRIC
4" 0 DRAIN PIPE
GRAIN ROCK 6" ABOVE PIPE INV
106.2 1
TH-5-1994
103.9
TH
03.1
FC
0.5
-0.5
-OR 1.0 103.7
C#
102.6
M#
MONITOR TUBE NO.
R. 1.
�I. 103.2
5•
DCO
DOUBLE CLEAN OUT
DV
DIVERTER VALVE
FS
SM GRAIN ROCK
1 �. D' ---"111
%-5.0 (5/1/19_'94)
-6.5
9� SECTION
ML
-14.0
89.9 m ULATION
m
FABRIC
,�-
o ROCK 6" ABOVE PIPE INV
o
a0
0
0
z
0
JDRA
0 GRAIN PIPE
oz
�z
z
z
IiU
U
U
106.2
1250 g S.T.E.P.
TANK (E)
DESIGN PARAMETERS
REPLACEMENT SEPTIC SYSTEM
NO. BEDROOM: 3 (450 gpd)
TANK SIZE: 1250g S.T.E.P.(E)
PERC RATE = 6-15 MPI
SOIL RATING: 0.8 GPD/SF
AREA ROD: 562.5 SF
SYS. TYPE: WIDE TRENCH 0.5' E.D
MIN LENGTH: 112.5 LF
USED:
(1 EA) 70 LF X 5' WIDE, 0.5' E.D.,
1.0' TO
(1 EA) 50 LF X 5' WIDE, 0.5' E.D.,
1.0' TD
TOTAL AREA: 600 SF
SEE SECTION & PARAMETERS
PROFILE
_::: : •►N
CU
COPPER
DIP
DUCTILE IRON PIPE
TH
TEST HOLE
FC
FOUNDATION CLEAN OUT
T#
TANK CLEAN OUT NO.
C#
CLEAN OUT NO.
M#
MONITOR TUBE NO.
R. 1.
RIGID INSULATION
DCO
DOUBLE CLEAN OUT
DV
DIVERTER VALVE
FS
FLOW SPLITTER
LEGEND
W WATER LINE/
WELL RADIUS
— SS — NEW SEPTIC
NOTES: Pt11`I1VON ENG SVC, LLA. .�' pF AC\��l Date
4/29/13
RECORD DRAWING q 1
P.O. BOX 100217 ANCHORAGE, AK 99510 � is S
i2"i6 i'FVImoA PHONE (907) 272-8218 FAX (907) 272-8211 /�g�•' -101 Scale
j *: 49 TH * (r Nrs
'.
%•••• P.I.D. NO
GREENBROOK, BLOCK 4, LOT 1 � .. .. .G .... 01I7-431-16
CHARLES & TERI BARCLAY an ore jFEO�,.149 .'�� 12731 VON SCHEBEN DRIVE fANCHORAGE, AK 99516'4DESIGN DETAILS �SSS
NOTE: 1) Bearings and distances are as per Prat No. 74-147_
L 13TW
R=260.00'
L1756'19"
B L 0 C
X
M.
Drivewayy oD
2 Story
Log Home
4
0 0
0
60.6'
L=367.75' i
L=4212' flR=127°6709."'21' South Park Drive
R=3Q00' � I
;
!
ABOn26'34" — (n ieveioped I
ffarr®int Land 5erviceeI, LLC LFOEND
SURVEYING, MAPPING, LAND PLANNING, C>iS 0 C{aart out
1 1 3 1 E. 76th Ave., Suite 10 t Anchorage, AK 95515 Lift Station
Farpomt:AK.corn + (907) 522-7770 • survey@farpotntak.com d Found property car.
ASBUILT SURVEY OF: SURVEY CERTIFICATION: PARPOINT has conduced a
Lot t,Block 4,GreenbrookSubdivision, PilywcalsunevofThe subjectpropetix,the unpievemenlssimnted —x X
Anchorage, Alaska thea on ase Whi n fire prapare+ lines and no encroachnsents exist Existing Fence
oS3srtHtan uotrxl.
EXCLUSION NOTES. itis Use awnets respunsibitfa� to detennure
WYNiK OR.ffiRM¢LDDATE SCALE: YFIP. CY15fEt1GG OI'nnp eti5etueNS. CALGSIantS_Oi iL'92tiCflpn5 WY11Ch Ci4
Nay 3.261i F°=46' tartappearantlrPiaussed for rhis sunv):. NO`IT;.€indexnn130))32 LM AHECKeca GRIDNo: E664CSKIPAorH ME SW2%39 106;12-I3 for the esrabHsf ng of pmperiy lines.
__1111 1111.. 1111.
On -Site Wastewater Disposal System Permit
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
Permit Number: OSP131030
Tax Code Number: 01743116000
Work Type: Septic Upgrade
Permit Effective Dates: March 21, 2013 to March 21, 2014
Design Engineer: PANNONE ENGINEERING SERVICE
Subdivision: GREENBROOK
Site Legal Address: GREENBROOK BLK 4 LT 1 G:2839
Owner/Address: BARCLAY CHARLES S & TERI M
12731 VON SCHEBEN DR ANCHORAGE AK 995163205
Site Mailing Address: 12731 VON SCHEBEN DR, Anchorage Lot Size in Sq Ft: 42824
Total Bedrooms: 3
This permit is for the construction of:
Y Disposal Field N Septic Tank 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.
Received
7—`r
Issued By: Date: I /-Z_
l
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On -Site Water & Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I. D. 017-431-16
Property owner(s) Charles & Teri Barclay Day phone
Mailing address 12731 Von Scheben Drive, Anchorage, AK 99516
Site address 12731 Von Scheben Drive
Legal description (Sub'd., Block & Lot) Greenbrook, Block 4, Lot 1
Legal description (Township, Range & Section)
Lot Size 42,824 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(® all that apply)
Absorption Field Initial ❑ Single Family (SF)
❑X
(w/wo ADU)
Septic Tank ❑ Upgrade
Duplex (D)
❑
Holding Tank ❑ Renewal ❑ Multiple Dwellings
❑
Privy ❑ (SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: 5 5o
Date of Payment: X51 11 125
Receipt Number: 05-1?-6G-1
Permit No. 0_50 NO'7J0
Permit App_.;
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
Pannone Engineering Services Lac
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: steve@paneneak.com
March 11, 2013
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
4700 S. Bragaw Street
P. O. Box 196650
Anchorage, Alaska 99519
Subject: Greenbrook, Block 4, Lot 1
Septic System Upgrade Permit Request
Ladies and Gentlemen:
I am writing to request a permit to upgrade the septic system be issued for this property. The proposed
systems will serve an existing three (3) bedroom house. Currently the lot is developed. The existing trench
is in failure and will be re -used as a reserve. This lot is served by a class W well (PWSID: 210346) that is
over 200 feet from the existing and proposed septic system. The surrounding lots to the north, south, and
west are also served by this system. The lots to the east are served by private wells that are located over
100 feet from this system.
1. Soils. Two test holes were excavated by J. Kevin White in May of 1996, and the ground water
monitored for seven days. Groundwater was observed in the hole monitor tubes after the seven day
monitoring period at a depth of 5 feet, and 10 feet. Bedrock was not encountered in the test hole. It is my
opinion, based on the results of the percolation tests and overall soils appearance; an application rate of
0.8 gallons/day/square feet should be used for a conventional wastewater system. A diverter valve will
be installed and the existing drain field will be re -used as a reserve.
2. Soil Absorption System Design.
a. See Sheet 2 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 topography slopes from southwest to northeast at approximately 5% in the
area of the proposed drain field. There are no steep slopes in the area.
S. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification
Mailing: P.O. Box 10021.7, Anchorage, AK 99510-0217
Physical: 332 East Manor, Anchorage, AK 99501.
Telephone: (907) 272-8218 FAX: (907) 272-8211
Page 2 of 2
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 the surrounding or existing lots. There
are no wells or septic systems within 100 feet of the proposed septic location.
If you have any questions or concerns, please contact me at 272-8218.
Sincerely,
Steven R. Pannone
Steven R. Pannone, P.E.
Owner/Civil Engineer
Attachments
-Soils Log
-Septic System Design
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 Fast Manor Ave, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
Pannone Engineering Services uc
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: steve@panengak.com
March 19, 2013
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
4700 S. Bragaw Street
P. O. Box 196650
Anchorage, Alaska 99519
Subject: Greenbrook, Block 4, Lot 1
Water Monitoring for Septic Design
Ladies and Gentlemen:
I am writing to request the use of existing water monitoring for the design of this drain field. Extensive water
monitoring has been performed in the area of this system. A total of 9 test holes have been excavated on the lot.
Water was monitored to a depth of 5.5' below the ground in MEA's TH-5 in 1994, and 10.0' below the ground after
the monitoring period in Kevin White's TP -1 and TP -2 in 1996. We designed the system to maintain groundwater
separation from the initial groundwater reading of 5.0' below the ground in Kevin White's TP -2.
The new system will be installed in the reserve area as was specified and permitted in the original system design.
There have been no changes made to the ground adjacent to the septic area since the installation of the original
drain field. It is not likely that the ground water in the area has been affected in any way. P.E.S. performed a test
hole on March 19, 2013 in the western portion of the lot and groundwater was found at a depth of 10.8' below the
existing grade, confirming that groundwater is still at approximately the same depth as it was at the time of the
original test holes.
If you have any questions or concerns, please contact me at 272-8218.
Sincerely,
Steven R. Pannone, P.E.
Owner/Civil Engineer
Attachments
-Soils Log
Mailing: P.O. Box 100227, Anchorage, AK 99510-0227
Physical: 332 East Manor, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
NOTE:
EXISTING AND PROPOSED SEPTIC SYSTEM MEETS
ALL REQUIRED SEPARATION DISTANCES TO
SURROUNDING WELLS.
MAINTAIN 200' MINIMUM SEPARATION FROM SEPTIC
SYSTEM TO CLASS 'A' WELLS, AND MAINTAIN 100'
MINIMUM SEPARATION FROM SEPTIC SYSTEM TO `
PRIVATE WELLS IN THE AREA.
DRAIN FIELD (P)
(1EA)50LFx5'WxO.5'EDx1.O'TD
(1EA)70LFx5'Wx0.5'EDx1.0'TD
j
TH-5-1994
(MEA)
TP -1-1996
j (WHITE)
PLAN
TH-1
i
W—
D/W
i
TP -2-1996 \.
(WHITE)
10.4
DRAIN FIELD (E)
_ -11IN FAILURE ,
555 RE -USE
AS RESERVE
I
I
INSTALL TEE AND
�y (2EA) 1Y4" BALL VALVES
(ONE ON EACH LINE AFTER TEE)
1250G S.T.E.P. TANK (E)
TO REMAIN
I;
'5
F
� H
W N
3 BR
HOUSE
(E)
0
0
i
i
i
SOUTH PARK DRIVE (R.O.W)
I
PANNONE ENG SVC, LLC
P.O. BOX 100217 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211
GREENBROOK, BLOCK 4, LOT 1
CHARLES & TERI BARCLAY
12731 VON SCHEBEN DRIVE
ANCHORAGE, AK 99516
*..49TH yR •.*�� 1.._50'
"'Q.. ...•' P.I.D. NO
017-431-16
Steven R. 'P 'no ne k PERMIT NO.
��'Fn •. r.CE 8149 ..j OSP131030
1 OF 2
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.
2. SCOPE OF WORK: INSTALL NEW SOIL ABSORPTION SYSTEM.
3. GROUNDWATER WAS NOT OBSERVED LESS THAN 5' BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF
AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 5.0 FEET BELOW EXISTING GRADE,
NOTIFY THE ENGINEER IMMEDIATLY.
3
1F-
-8.5
TH-5-1994
SM
6
ML
SECTION
ID INSULATION
ILTER FABRIC
14. 0 PERF PIPE W/
1/8" HOLES 18" O.C.
)RAIN ROCK 6" ABOVE PIPE INV
3
1 1
ROCK
1250 g S.T.E.P.
TANK (E)
111 we] ',G�u
REPLACEMENT SEPTIC SYSTEM
NO. BEDROOM: 3 (450 gpd)
TANK SIZE: 1250g S.T.E.P.(E)
PERC RATE = 6-15 MPI
SOIL RATING: 0.8 GPD/SF
AREA ROD: 562.5 SF
SYS. TYPE: WIDE TRENCH 0.5' E.D
MIN LENGTH: 112.5 LF
USE:
(1 EA) 70 LF X 5' WIDE, 0.5' E.D.,
1.0' TD
(1 EA) 50 LF X 5' WIDE, 0.5' E.D.,
1.0' TO
TOTAL AREA: 600 SF
SEE SECTION & PARAMETERS
PROFILE
CU
COPPER
DIP
-140LJ
m
RIGID INSUUTION m
FC
FOUNDATION CLEAN OUT
T#
TANK CLEAN OUT NO.
C#
FILTER FABRIC
z
MONITOR TUBE NO.
R.I.
RIGID INSULATION
o
DRAIN ROCK 6" ABOVE PIPE INV o
0
S
S
o
z1Ya"
0 PERF PIPE W/ z
Qo
0
0
0
1/8" HOLES 18" O.C. 0
z
o�
LLU
U
U
1250 g S.T.E.P.
TANK (E)
111 we] ',G�u
REPLACEMENT SEPTIC SYSTEM
NO. BEDROOM: 3 (450 gpd)
TANK SIZE: 1250g S.T.E.P.(E)
PERC RATE = 6-15 MPI
SOIL RATING: 0.8 GPD/SF
AREA ROD: 562.5 SF
SYS. TYPE: WIDE TRENCH 0.5' E.D
MIN LENGTH: 112.5 LF
USE:
(1 EA) 70 LF X 5' WIDE, 0.5' E.D.,
1.0' TD
(1 EA) 50 LF X 5' WIDE, 0.5' E.D.,
1.0' TO
TOTAL AREA: 600 SF
SEE SECTION & PARAMETERS
PROFILE
CU
COPPER
DIP
DUCTILE IRON PIPE
TH
TEST HOLE
FC
FOUNDATION CLEAN OUT
T#
TANK CLEAN OUT NO.
C#
CLEAN OUT NO.
M#
MONITOR TUBE NO.
R.I.
RIGID INSULATION
DCO
DOUBLE CLEAN OUT
DV
DIVERTER VALVE
FS
FLOW SPLITTER
NOTES: PAMONE ENG SVC, LLC
FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211
GREENBROOK, BLOCK 4, LOT 1
CHARLES & TERI BARCLAY
12731 VON SCHEBEN DRIVE
DESIGN DETAILS ANCHORAGE, AK 99516
LEGEND
W WATER LINE/
WELL RADIUS
SS — NEW SEPTIC
r!An��i 3/18/13
*749 TH
.... .... .. .......,�
Steven F2. Pannone w
PF61 CE 8149
OFE
NTS
P.I.D. NO
017-437-i6
PERMIT N0.
OSP131030
Sheet2 OF 2
SOILS LOG - PERCOLATION TEST
SLOPE
X
TH
WAS GROUND WATER
ENCOUNTERED? N
IF YES, AT WHAT
DEPTH?
DEPTH TO WATER AFTER
MONITORING? -10.8-
DATE: 3/19/13
PLAN
TP -1-1996
(WHITE)
3 BR
HOUSE
(E)
SLOPE
TH
X
READING DATE
TEST HOLE 1
NET TIME
WATER
LEVEL
READING
NET DROP
OR
ORGANICS/
1
7.49
--
FROZEN
2
30 MIN
9.40
1.91
3
3
--
7.49
--
4
4
30 MIN
8.02
0.53
6
4:55
SM
SILTY SAND/
---
6
5:25
SILT
5
0.52
6-
7-
789
8-
9
SILT/
ML
VERY LITTLE
10
SAND
17
11
/19113
12
13
14
BOH
15
16
17
18
DATE
PERFORMED: 3/5/13
SOILS LOG - PERCOLATION TEST
SLOPE
X
TH
WAS GROUND WATER
ENCOUNTERED? N
IF YES, AT WHAT
DEPTH?
DEPTH TO WATER AFTER
MONITORING? -10.8-
DATE: 3/19/13
PLAN
TP -1-1996
(WHITE)
3 BR
HOUSE
(E)
SLOPE
TH
X
READING DATE
CLOCK
TIME
NET TIME
WATER
LEVEL
READING
NET DROP
1 3/5/13
4:05
--
7.49
--
2
4:35
30 MIN
9.40
1.91
3
4:35
--
7.49
--
4
4:55
30 MIN
8.02
0.53
6
4:55
---
7.49
---
6
5:25
30 MIN
8.01
0.52
PEROLATION RATE 57.7 (min/inch) PERC HOLE DIAMETER 6 inches
TEST RUN BETWEEN 3 FT AND 4 FT
COMMENTS: Test hole excavated by BEEK'S CONTRACTING. Prec hole was presoaked.
Test run for one hour. Last 3 readings reported
PERFORMED BY: Steven R. Pannone. P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST.
NOTES:PANNONE ENG SVC, LLC \\ Date
SOILS LOG
P.O. BOX 102954 ANCHORAGE, AK 99510 �.
PHONE (907) 272-8218 FAX (907) 272-8211 /�g�p �9t� Scale
jW.4W *�� NTS
GREENBROOK, BLOCK 4, LOT 1
`••" ... ......� P.I.D.
NO
1-16
CHARLES & TERI BARCLAY S'teve'n 'R' Panno.Re'PERMITNO.
12731 VON SCHEBEN DRIVE l++Ps: �CE a149 r OSP131030
SOILS LOG ANCHORAGE, AK 99516 �It�RFD o L � Sheet 1
SUBMITTA L
SEP 181997
ROD DUNSTON
lO I 4TI LAJ ( M.505
as shown on this record drawing.
(as -built) corn lid wi Tia% M
gy; r
Date:
NOTE: TH1SWr 15 it:A+7vn � A COMt1S1N\'S� lh1/T90. SysT+;sM�
PLOT PLAN AS BUILT Y_ SCALE '- d -o' GRID I&= Project No. 7t.- m15
1731 George Bell CircleMeziasLk �o team& Lvvo
Anchorage, Alaska 99515 (907) 345-6476
1 Hereby certify that I have surveyed the following described property:
Lot I Block ¢ 0,1 OF A'��,►�,�
ANGio{i.p&L_ Recording District, Alaska, and that the improvements situated w �V,•..• .!�
thereon are within the property lines and do not encroach onto the property AV
that no improvements on the property lyg adjacent thereto a+
adjacent thereto, infrj; p i
encroach on the surveyed premises and that there are no roadways, transmission '"'t q' ` ` .'••• Yt
...i...
lines or other visible easements on said property except as indicated hereon. 0. �
Dated this the 1411` Day of ducps'&T 19"? -7 ,'at Anchorage, Alaska �I . , �•^^e�h G. to
• lS - 5202 s
It is the responsibility of the owner to determine the existence of any easements, f �I�.•'••.....••••p
covenants, or restrictions which do not appear on the recorded subdivision plat. 4*4
A
Fi
0
Municipality of Anchorage
• Development Services Department
iBuilding Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
www.muni.org/onsite
(907)343-7904
ON-SITE SEWER/WELL PERMIT APPLI
FOR A SINGLE FAMILY DWELLI G
Parcel I.D.
Property owner(s) Charles S & Teri Barclay
TION \ 1 52c
oeJ e� r
Mailing address12731 Von Scheben Drive Zip Code 99516
Site address 12731 Von Scheben Drive Zip Code 99516
Legal description (Sub'd., Block & Lot) Greenbrook SID, Block 4, Lot 1
Legal description (Township, Range & Section)
Lot Size 42824 Sq. Ft.
THIS APPLICATION IS FOR (® all that apply):
Absorption Field 19
Septic Tank 123
Holding Tank
❑
Privy
❑
Private Well
❑
Water Storage
❑
Number of Bedrooms 4
THIS APPLICATION IS AN:
Initial
❑
Upgrade
Renewal
❑
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.
Pannone Engineering Services,
(Signature of property owner or authorized agent)
Permit/Rush Fees: 1�z t'+ O Waiver Fees:
Date of Payment:
Receipt Number:
(Rev. 11105)
G fl % Date of Payment:
9 SS %Z "�eceiptNumber:
72-013 (Rev. 9/91) MOA 25
Municipality of Anchorage Page of
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: 5 L) g(p Do 9({ PID Number: — b Iq - y 3t _ I G
Name:
Wastewater System: Pq New ❑ Upgrade
Address:
�Zlo W 153cr t.ck.� ��
ABSORPTION FIELD
Phone:
2'{g- L11038
No. of Bedrooms:
1 3
❑ Deep Trench &ShallowTrench ❑ Bed ❑ Mound ❑ Other
LEGAL DESCRIPTION
Soil Rating:
O 8
Total Depth from original grade:
GPD/Sq. Ft.
Lot:l Block: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe
C—L,'e-P+'1 brcx k
0 Ft.
I Ft.
Township:
Range:
Section:
Fill added above original grade:
Gravel length:
50.s-
-X I Ft.
Ft.
WELL: [I New El Upgrade
Gravel width:
S
Number of lines:
Distance between lines:
/.S
Ft.
Z.
Ft.
Classification (Private, A,B,C):
Total Depth:
I Cased To:
Total absorption area:
5-75-
Pipe material:
Asrn 3o3`f
Ft.
Ft.
SO;. Ft.
Driller:
Date Drilled:
Static Water Level:
Installer:
andar•sw�, � •�- CAn •
Date installed:
co / 4 9 �o
Ft.
Yield:
Pump Set at:
I
Casing Height Above Ground:
TANK
GPM
Ft.
Ft.
SEPARATION
DISTANCES
❑ Septic ❑ Holding S.T. E. P.
To
Septic
Absorption
Lift
Holding
Public/PrivateManufacturer:
Capacity in gallons:
From
Tank
Field
Station
Tank
Sewer Lines
finch . TanK
12SO
Material:
Isie-C
Number of Compartments:
Well-
_
—
—
-
—
i
Surface
loof
_
/c��
LIFT STATION
WaterLot
foot
loop
,
!
r
Size in gallons:
Manufacturer:
Line
60
/8
IZSo
AnCh. l�K
"Pump on" level at:
"Pump off" level at:
High water alarm at:
Foundation
�5!
��
r,•r
.—
�—
aE2
'✓FZ
sEZ
Curtain
,—
Pump Make&Model
Electrical Inspections performed by:
Drain
_
Zoo5fo5HHF-
5-rcocJS Elec+, ZnC.
BENCH MARK
Remarks:
*(. F'nal grad n iv tx corvt Ply Ecd b� cW ne r.
Location and Description: 1
NW Co rner '6,:>h t. o C+�000L li .i
See a•!Weol !et'fe,-.
�E Z. Sed 'by Sporrew s E/ee f ctE . JCL I d ct•
" Dy rr
Assumed Elevation:
/oo
eI L- CLAS wsecL m i-kact e �
4 r .
ENGI.NFE #'S, gAL
CX( cwne- s eceSf fo arcG clean;
_ c
r.` �� r E#�
Wev;.o Dates: 1s
Inspections performedb
�9,r
2nd``
"T'
ftw • fl i.
¢�`�°t
Department of H It and Hu n Services approval
'GI. Iv ECJ • ��_�
Reviewed and approved by. Date:j&lel
72-013 (Rev. 9/91) MOA 25
Permit No. SW gGOO 9 ct
Page or — -
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: Lt 1 8l Lf green brool<
COMMUNITY WATER
K. & P. ENGINEERING
726 O Place #105
Anchorage, Alaska 99501
(907) 274-2493
72-013 A (2191) MOA 25
PID No.: to 1'7- y31- I
OT.P. f
T.H. 15
A TA. t2
SYSTEM AS -BUILT
W.O. # 96-04
Location: Lot 1 Block 1
Greenbrook Sub.
Nov. 1� X'o
Date:
S_PP4:.—, 1996
Scale: 1" = 50 FEET
A
B
FCO
15
33
STI
15
35
ST2
17
42
C01
77
70
CO2
120
101
CO3
90
86
C04
128
112
MTI
101
86
—WT -2
114
101
COMMUNITY WATER
K. & P. ENGINEERING
726 O Place #105
Anchorage, Alaska 99501
(907) 274-2493
72-013 A (2191) MOA 25
PID No.: to 1'7- y31- I
OT.P. f
T.H. 15
A TA. t2
SYSTEM AS -BUILT
W.O. # 96-04
Location: Lot 1 Block 1
Greenbrook Sub.
Nov. 1� X'o
Date:
S_PP4:.—, 1996
Scale: 1" = 50 FEET
A0 Tu
Permit No. w w 1� 1" ' 1
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 0 Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: L+ ( 731k Ll C_/ern 6,-oolt Sah • PID No.: 10'q- 431- 16
Note 1 — final grading and Seeding to
be completed by owner.
4" CLEANOUT
96.8' (Note 1)
4 MONITORING TUBE /
i4" PERF PIPE
INSULATION
SOIL LOG
94.4
C01,213,4=94.4'
SW MTI = 93.4'
91.4 MTz = 93.Z
GROUNDWATER AT 89.4
K. & P. ENGINEERING
726 0 Place #105
Anchorage, Alaska 99501
(907) 274-2493
72-013 A (2/91) MOA 25
1250 GAL
S.T.E.P. TANK 90.7
90.6'
SYSTEM AS—BUILT
W.0. # 95-04
Location: Lot 1 Block 1
Greenbrook Sub_
Date: Nov. 17, 1996 g,
Scale: As Shown
98.0 ft
97.0 ft
96.0 ft
95.0 ft
94.0 ft
o
w
93.o ft
w
92.0 ft
91.0 ft
9a0 ft
89.0 ft
0
"SPARROWS"
.. 9TA7'R LICEUBE fAd-20219 ELECTRIC INC. lNN =PAP, LICIMME 094-0282
7310 Bulen Drive . Anchorage, AK 99507
Office: (907) 344-5539 FAX: (907) 344-5538
PROPOSAL
June 25, 1997
TO: HIKE ANDERSON
RE: SEPTIC LIFT STATION AT MR. gg+gyg B
ARCLAY RESIDENCE_
TO WHOH THIS MAY CONCERN ! THE ELECTRICAL INSTALLATION OF THE
SEPTIC -LIFT STATION CONTROL WIRING AND UNDERGROUND ELECTRICAL
IS INSTALLED ACCORDING TO NATIONAL STANDARDS AND LOCAL STANDARDS.
THIS INSTALLATION WAS INSTALLED AND WIRED BY JOURNEyIi
ELHCTRICIMS AiY
LICENSED BY THE STATS OF ALASKA_
(IF THERE ARE Amy QUESTIONS CONCERNING THIS INSTALLATION PLEASE
DO NOT HESITATE TO CALL ABOVE NUHBER)
i6'd lfJ101
JAI
i
TO'd ho^Z2' 6VE L06 T+ fb1ifll.f liH 'J.IH u� n»
i
w
7>
1
i
JAI
i
TO'd ho^Z2' 6VE L06 T+ fb1ifll.f liH 'J.IH u� n»
i
\\\frr• JJJ���"`iiiFFF���jjj
.A il"
I
�
J-1
07-
mo
�
�
3
!2 4.
a
a
1
ol
6
-
m
r^
f
ID
JAI
i
TO'd ho^Z2' 6VE L06 T+ fb1ifll.f liH 'J.IH u� n»
i
. jl/iDft cv�'y
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW960094
DESIGN ENGINEER:K & P ENGINEERING
OWNER NAME:STEVE BARKLEY
OWNER ADDRESS:8026 WISTERIA ST.
ANCHORAGE, ALASKA 99502 4571
PARCEL ID:01743116
LEGAL DESCRIPTION:
GREENBROOK BLK 4 LT 1
LOT SIZE: 42824 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
PAIGE p 1 O` F 1
Lo
DATE ISSUED: 5/31/96
EXPIRATION DATE: 5/31/97
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 ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
�PECIAL PROVISIONS:
TOTAL DEPTH
RECEIVED BY:
ISSUED BY
DATE: ✓� `
DATE:-
NOTE: ALL LOTS SERVED BY
SUBDIVISION WATER SYSTEM.
SLOPE IS LESS THAN 2% (est).
T.H.#1 TO T.H.#5 BY OTHERS,
MAY 1994.
T.H. #4 LOCATION UNKNOWN.
LOT 2
10' UTILITY I
EASEMENT /�_
/> LOT 3
F1 I I I ADJACENT
SYSTEM
L J (typ)
WIDE
2
BACK—UP DRAIN
DRAIN FIE T.H. I FIELD
s
AREA I I� AREA
T. . 3041 v��
TP 3I
LOT 4
1250 gaL STEP tank
� Ill
BOX p
LOT 1 0� T.H.#i I I
I
BLOCK 4 ax FOUNDATION
P4 CLEAN—OUT
I � LOT 5
� I I
T.H.#2 I I
4
I I
` CL SOUTH PARKI
DR. (unconstructed�
a ----drainage direction
LOT 7
SITE PLAN "Engin ar, .•"°"'•. ��9 ,..
K. & P. ENGINEERING W. o.
726 0 Place #105 Location: Lot 1 Block 4 ' ° °' ° • •/' n to
Anchorage, Alaska 99501 Green brook 5ub. • • ... / . ,Z'�; , , ,-!e
(907) 274-2493
Date: May 28, 1996 e J. KEViN ��f; Ef�
Scale: As noted t1 CE �4i2® •.' v+'
h. . _.C�
to lift
statior
to lift
statior
2"
Ila
2" gravel 3
above pipe 1
to caped
station en d
1 1/4" perforated g
round
surface
lateral
12" gravel
depth of trench 1'-0"
below existing grade
pipe
General Notes:
This system design is based on a 3—bedroom home. The lot is served
by a community well and distribution system. The system will be a pressurized
wide drain field system with a lift station. Previous monitoring indicated
a minimum, depth to ground water of 5 ft, Previous logs are attached
for reference.
Impact on adjacent lots: There are no private wells within 100'
of this proposed system and no public wells within 200'. The proposed
system has no impacts upon any adjacent lots as shown on the
attached site diagram. No major drainage's were observed Pressurized distribution
within 100' of this proposed system. system
Pump= 20 05I 05HHF-5 stage
Absorption area calculations: (,,,30 GPI)
3 bedrooms X 150 gallons/bedrooms = 450 gal. 2 laterals 49' long -10 GAL/Lat
Soil rating = 0.$ gpd / sf 10 Holes r lat
(5'—O"o.c.= 30 holes total
Absorption area = 450 gpd = i GPM/HOLE
= 563 sf 1/4"dia. holes faced downwards
0.6 gpd/sf 1-1/4"dia, laterals
Use 12 inches of sewer rock. Therefore (reduction factor) ItR= 0.87
Trench length = 563 sf X 0.67 = 98 ft = 49 ft X 2 trenches
5 ft
Trench depth = 1'-0" below grade
K. & P. ENGINEERING I W. 0. #
726 0 Place #105
Anchorage, Alaska 995D1
(90) 274-2493
SYSTEM DESIGN
96-04
Location: Lot 1 Block 4
Greenbrook Sub
Date: May 28, 1996
Scale: N.T.S.
"En inee�'s
® �ia . 1 e• a s a s a a t a •il. ��
,J aK81TE
CIE 88 c �
Municipality of Anchorage .`
DEPARTMENT OF HEALTH & HUMAN SERVICESZIP
825 "L' Street, Anchorage, Alaska 99502-0650
SOILS- LOG — PERCOLATION TEST
PERFORMED FOR: .STF►/E ?SARK
LZ� DATE PERFORMED�li�,N� .!Z•'<P .t3
LEGAL DESCRIPTION: LUT/ vfA!K tI CTRt6V13Rt»K �/B,
Township, Range, Section:
SLOPE SITE PLAN _
DEPTH
2
3
4
5
6
7
8
9
10
Date
WAS GROUND WATER
Es
Net
Time
Depth to Net
Water Drop
ENCOUNTERED?
5 /z
2tou
S
11
/03/3/y"
IF YES, AT WHAT L
'f 6 '� P
DEPTH?
12
E
zo
3
After/O -f* HAY lz
Mo fa
13
z :30
topth 9ater
i ate
14
15
16
17
1s
19
Reading
Date
Gross
Time
Net
Time
Depth to Net
Water Drop
S"
5 /z
2tou
�-
/03/3/y"
z:to
zo
3
q 3.
z :30
30
4'1/"
S"
Y
2:3o
—
—
S/
z, n
ro
iV'g
pry '
Z '-S-0
z o
3 "y
20
PERCOLATION RATE 3 (minutesnnch) PERC HOLE DIAMETER
TEST RUN BETWEEN / FT AND FT
COMMENTS PRLJ< ON 464X l' •DO TM -
PERFORMED BY: kf—KIN !//i/TE I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE IV
72-008 (Rev. 4/85)
\• +.e Municipality of Anchorage p �• of t
DEPARTMENT OF HEALTH & HUMAN SERVICES z `+ '__
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG —PERCOLATION TEST
4.• til f3
PERFORMED FOR: '37"46'SARKLF"V DATE PERFORMS@ 'c%"•/'%IJ4Y• !Zzg
4ar-1
LEGAL DESCRIPTION: GREFNZWCO'< SU$, Township, Range, Section:
DEPTH_ SLOPE SITE PLAN _
pT Ir—rl —I��I +F -T --T-1 Ii
1
2
3
4
5
6
7
8
9
j
WAS GROUND WATER U
10 ENCOUNTERED? %SEs
S
11 L
IF YES, AT WHAT ��,�,,,,, O
DEPTH? MAY �� 0 P
12 E
Depth to Water Atter
13 Monitoring? /0 A4 Date: A ►Z
14
15
16
17
18
19
Reading Date
Gross
Time
Net Depth to
Time Water
Net
Drop
l5
— —
—
3"'
Z: ZS
I
Z r
4
2.35
Zo
3,s•r
1
Z% S
—
—
14 "14
7-: S
10
& 318
3'. is-
30
5 3/ '
3-. z s
o
—
20
IL—�I PERCOLATION RATE 6 (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND Z, S FT
COMMENTS P��SQ:iIt�D OrV /`•//4�/ // + "c/�o FR07EN
PERFORMED BY: A* ✓1/✓ •iii/7,F I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-M (Rev. 4/85)
Municipality of Anchorage 'S; •' _ '+
DEPARTMENT OF HEALTH & HUMAN SERVICES
I � • •4y � t 1 F
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST may:"•�'a)° `Z!`y�`'',
(( %t
PERFORMED FOR: S7CKE B'gw4LEt1 DATE PERFORMhi't2 & 1/ a.. •'S1 u
Gar / $COck q
LEGAL DESCRIPTION: CsRFNBQcoK Township, Range, Section:
SLOPE SITE PLAN
DEPTH
1 sr/ I -f -TT
SW/ML
2
SW
3
4
5
6
7
8-
91011 9-
10-
11
12-
13-
14-
15-
16-
213141516- 7
17-
is-
19-
WAS
71819
WAS GROUND WATER ,/
ENCOUNTERED? A
S
IF YES, AT WHATL
O
DEPTH? ��� P
E
Depth to Water After _
Monitoring? Dale:
Reading
Date Gross
Time
Net Depth to
Time Water
Net
Drop
—
yz"
2:7-0
Z
;2s"
931
Z'•3o
_-
—
'7 yu."
$ 3#14
2
-or 1
3 to
if—
20
PERCOLATION RATE S (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND 3 FT
COMMENTS �,�1`r5py{rtD O/Y MAY //,,'9(-
PERFORMED BY: Al"I"✓ C.�Nirr I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE MAS 2 9�0
72-008 (Rev. 4/85)
Prr Lod,s
Tv r. DA-r&s 4130, sf r 1,10F
J.
a.La,urm.r ME.7q `S f
mores
OL
2.9
/tAL3-'
'• 6 1� 1 ( Z -L -q
84 A�L
IC
to to Y/ , 10 / _ r 10 -j MllS�
it 11
12- 13 D.N. 12iliZ �._ / s % 12-
13 - • -. ..._ ..
13 t8 1 r 13 L-•
it r. 14 14
1
4 ;pl.r7-r 14 $.Q.}'�•
rT
is
16 i6 t6
T6
18 Is- lei
17
17 17 ,
t8 1S
to
19 1® 19
20 2020
_. 20 a.
NJ r►�.l1�Ged
Parcel I.D. 017-431-16
__::NIL
11161:4J71•
Certificate of On -Site Systems Approval
a
Phone: 907-343-7904
Fax: 907-343-7997
Expiration Date:
Complete legal description GREENBROOK BLK 4 LT 1
12731 Von Scheben Dr
LOCaLlon (slte address)
Current property owner(s) MANSFIELD
Mailing address
Real estate agent
2. TYPE OF DWELLING:
F-1 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
Day phone 907-376-7653
Day phone
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
Li
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 # 0 S ca 1 16 so Waiver #
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shovtri below, I verify that my investigation, based
on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the
on-site water Supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater
disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in
effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted.
Name of Firm NorthRim Eng. Phone 694-7028
Address PO Box 770724, Eagle River
Engineer's Printed Name Steve Eng Date $/3/21
jW
6. DSD SIGNATURE * 49Ili* `0`
System #1 Approved for .3 bedroomsf' "......
System #2 Approved for bedrooms CE
62 9 €?_`
Disapproved
Conditional approval for bedrooms, with the following stipulations:
`(O iii
ON-SvTE,�
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Ja W O�PM
PRO9ZIN
By: 16�i�n t**4ck�4W/0riginal Certificate Date:
The Municipality of Anchorage Development services Division (DSD) issues Certificates of Or}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
Legal Description: GREENBROOK BLK 4 LT 1
If more than 1 septic system on lot: COSA Checklist # of
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled
Total depth ft
Cased to ft
❑ Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ground) in.
Date of flow test for COSA
Static water level at beginning of test ft.
Comments Public Water
B. TANK DATA
Age of tank(s) 25 years
Tank type/material sptcstl
Measured operating fluid level in septic tank na
❑ Standpipes/foundation cleanout per record drawing
Date of pumping 5/11/21
D. ABSORPTION FIELD DATA 4/13/13
Which system tested (date installed) same
❑ ALL standpipes present per record drawing
Total measured depth from grade 3 ft (max)
Measured depth to pipe invert from grade 2.5 ft (min)
❑ N/A — pressurized field
❑ Monitor tubes go to bottom of effective. If not, state
depth into effective
❑ Code -required soil cover over field
❑ System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced gallons
Comments/Deficiencies:
COSA Checklist yellow sheet
Parcel ID: 017-431-16
Structure served by this system
Well production at time of test gpm
Water storage tank volume gallons
Well disinfected for coliform test? ❑ Yes ❑ Nc
❑ Coliform bacteria is Negative
Nitrate mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ❑ Arsenic less than MRL (ND)
Collected by
Date of Sample
C. LIFT STATION
❑ Required maintenance completed
Age of lift station 25 years
Lift station material Stl
Comments: Level not measured due to fluctuating STEP
Adequacy test date 8116/21
Results ❑✓ Pass For 3 bedrooms
Fluid depth prior to test 0 in
Water added 450 gal
New depth 0 in
Elapsed time 30 min
Final fluid depth 0 in
Absorption rate 450 gpd
Any rejuvenation treatment (past 12 months)
If yes, enter date
10%,
E SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if cornmunitywell
Septic TonkJLiftStation onLot >10I
Yes
Community Sewer Man >10/
E] Yes
JNoM
F-11YesifNoft
[7Yea
ifNVft,
Neighboring Tank >1OO' Fl Yes
ifNoft
Wells onAdjacent Lots:
Private Sewer/Septic Line > 25`F—lYes
ifNoh
Absorption Field onLot >�1O0' Fl Yes
|fNoD
Holding Tank >10O' F-1 Yes
|fNoft
Neighboring Absorption Fields >�1O0'
Yeo i[Noft
Water Main >1O'
Animal Containment > 50' 0Yes
ifNoft
F-1Yesi[NnM
F-11
Community Wells >�200'
Yes ifNnM
Water Service Line >10'
Yes
ifNnft
Manure/Animal Excreta Storage > 100'
|fseptic tank \ounder driveway
Community Sewer Main >75' FlYes
|[hlnD
FlYes
|[NoD
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations >10'
Yes
ifNoft
Surface VVa<nr>10O'
F-11YesifNoft
Property Line >5'
Yea
Yes
i[NoM
Wells onAdjacent Lots:
Wells mnAdjacent Lots -
F-}
Absorption Fie|d>5'
Fv1Yes
ifNoM
Water Service Line >1O`
Private Wells > 100'
Yeo i[Noft
Water Main >1O'
Yes
ifNnft
F-11
Community Wells >�200'
Yes ifNnM
Water Service Line >10'
Yes
ifNnft
|fseptic tank \ounder driveway
comment below
From Absorption Field onLot to: (Please enter distances hless than required)
Building Foundation > 10y
El
Yeo
ifNoft
If absorption field in under driveway comment below
Property L|no>�10'
21
Yea
ifNn_____M
Wells onAdjacent Lots:
VVaior Main > 10'
F-}
Yes
KNVft
Private Wells > 100' Yes i[NoD
Water Service Line >1O`
R11
Yes
ifNoft
Community Wells >ZOO' Yes ifNoM
Suff ace Water > 100'
F-11
Yes
if No
ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION
/oertXy that / have determined through field ineVo*o/kons and review
of Municipal records that the above systems are in conformance with
MOA COSA guidelinesineffect onthis date.
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT 4 907-343-7904
On -Site Water and WFax: 343astewater Section -7997
www.muni.org/onsite
Septic Tank Advisory
Certificate of On -Site Systems Approval #OSC 211530
Subdivision: Greenbrook Blk 4 Lot 1
Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for
this property is 25 years old. Typical replacement costs range from $8,000 to $11,000
This advisory must be attached to all copies of the subject Certificate of On -Site Systems
Approval.
This is an example of what the metal of a 20 -year-old steel tank MAY look like.
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Parcel I.D. 017-431-16
Municipality of Anchorage
On -Site Water and Wastewater Program
(907)343-7904 sxreR G
Certificate of On -Site Systems Approval
1. GENERAL INFORMATION
Complete legal description Greenbrook, B4, L1
Location (site address) 12731 Vonscheben Dr.
Expiration Date: `l / 3 - 13—
Current Property owner(s) Charles & Teri Barclay Day phone
Mailing address 12731 Vonscheben Dr.
Real Estate Agent
2. TYPE OF DWELLING:
E Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
Day phone
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well ❑
Individual (]
Individual Water Storage ❑
Holding Tank ❑
Community Class A Well 0
Community ❑
ruU1 vvarcI oyatcni U
ruulbli.�cvvci U
WaiverNariance request for:
Distance:
5 b (l 3
Received by:
Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ ;) 6 2Kf3f1%6 W>
Waiver Fee $
Date of Payment 510 It 3
Date of Payment
0INIG`
Receipt Number
Receipt Number
COSA# 06C43II( 2
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 Pannone Engineering Services LLC Phone (907) 272-8218
Address P.O. Box 100217, Anchorage Alk. 99510
Engineer's Printed Name Steven R Pannone Date 4/26/13
*7--49 TH .*
6. DSD SIGNATURE
VIGSystem #1 Approved for -3 bedrooms
j}
System #2 Approved for bedrooms + 4'•. CE -8149
Disapproved << Ri0fE .S.0.
1W\t1►0
Conditional approval for bedrooms, with the following stipulations:
By: C/. ` dOriginal Certificate Date: 5 - L ' Z -j
The nici li of Drage 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
Septic System Advisory
Well Flow Advisory
COSA blue sheet!'- L c
Nitrate Advisory
Arsenic Advisory
Other
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: Greenbrook, B4, L1
A. WELL DATA
Parcel ID: 017-431-16
Well type Class 'A' If A, B, or C provide PWSID # 210346 Well Log (Y/N)
Date completed Sanitary seal (Y/N) _ Wires properly protected (Y/N)
Total depth ft. Cased to ft. Casing height (above ground) in.
FROM WELL LOG AT INSPECTION
Date of test
Static water
ft.
Well production g.p.m.
WATER SAMPLE RESULTS:
Coliform colonies/100 mL Nitrate mg/L
Arsenic ug/L Date of sample:
B. SEPTIC/HOLDING TANK DATA
Collected by:
M,
g.p.m.
Tank Type/Material S.T.E.P./Steel Date installed 6/9/96
Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout (/YIN) Y Depression over tank (Y/N) N High water alarm (Y/N) Y
Date of pumping -// // i3 Pumper A -t- 140 Af tl:� -� ALV « i1S
C. ABSORPTION FIELD DATA
Date installed 4/13/13 Soil rating (g.p.d./ftz or ftz/bdrm) 0.8 GPD/SF System type Shallow Trench
Length 50/70 ft. Width 5.0 ft. Gravel below pipe 0.5 ft.
Total depth 3 ft. Eff. absorption area 600 ftz Monitoring tube Y Depression over field N
Date of adequacy test NEW Results (Pass/Fail) For _ bedrooms
Fluid depth in absorption field before test in. Water added gal. New depth in.
Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date
D. LIFT STATION
Date installed 6/9/96 Size in gallons 1250
"Pump on" level at 43 in. "Pump off" level at 40 in.
Datum Bottom of Tank Cycles tested -5
E. SEPARATION DISTANCES
WELL ON LOT TO
Manhole/Access (YIN) Y
High water alarm level at 45 in.
Meets alarm & circuit requirements?
Septic tank/lift station on lot 100+ On adjacent lots 100+
Absorption field on lot 100+ On adjacent lots 100+
Public sewer main 75+ Public sewer manhole/cleanout 100+
Sewer /septic service line 25+ Holding tank 100+
Animal containment areas 100+ Manure/animal excrete storage areas 100+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5+ Property line 5+
Water main 10+ Water service line 10+
Wells on adjacent lots 100+
ABSORPTION FIELD ON LOT TO:
Property line 10+ Building foundation 10+
Water Service line 10+ Surface water 100+
Curtain drain 50+ Wells on adjacent lots 100+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
t certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name Steven R. Pannone
Date 4/26/13
COSA brown sheet 10-10-12,doc
Absorption field 5+
Surface water 100+
Water main 10+
Driveway, parking/vehicle storage11 0+
MUNICIPALITY OF ANCHORAGE
• DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On -Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D.# 0 1 3 -K31 - I(a HAA#
1. GENERAL INFORMATION (�
Complete legal description Lo+ l Q�� L(
Location (site (site address or directions)
Property owner
Mailing address
Lending agency
Mailing address.
Agent
Address
S-� eve- VJao
Unless otherwise requested, NAA will be held for pickup.
--7
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
Day phone 2 2`? -- 5(-?- I
Day phone
Day phone
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system. ,
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA M21
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 of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is 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 in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm [AVc-L& AL Jvl d E"-41 7one
Address I LE 25o C'-7aC lcn r<<�k
Engineer's signature
6. DHHS IGNATURE
Approved for
Disapproved.
M
Conditional approval for
Additional Comments
bedrooms.
3 u Is- -313 .-)-- ?-
Y?,sr
Date 3c) 92
_rOF At
�h.• •-q 1l
ems• 49TH •',�!!
P y • MICHAEL N. ANU RSG11t;i-n-C
C 469
bedrooms, with the following stipulations:
111TIC1
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesyto purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-M(Rev.1/91) Back MOA#21
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SEF&'IECI IVC
Environmental Services Division L
825 L Street, Room 502 • Anchorage, Alaska 99501 • (@@ ) 3j3ijj44
Health Authority Approval Chef cipality of Anchorage
ealth & Human Services
Legal Description: o L4 C f-eeP 6tfy4-, Parcel I.D.: /b(�L – W 3 f ^ f 6
A. WELL DATA
Well type (:�(-) *1 N'>. 1013, or C, attach ADEC letter. ADEC water system number Z / 03 `{ (o
Log present(Y/N)
Total depth
Sanitary seal (Y/N)
Date of test
Static water level
Well production
Date completed
Cased to
FROM WELL LOG
WATER SAMPLE RESULTS:
Coliform
Date of sample:
B. SEPTIC/HOLDING TANK DATA
Nitrate
Casing height (above ground)
Wires properly protected (Y/N)
9.10 -m -
Collected by:
AT INSPECTION
Other bacteria
g.p.m. .
Date installed Supe- 96 Tank size I S Number of Compartments 'Z-- Cleanouts (Y/N)-_
Foundation cleanout (Y/N) Y Depression (Y/N) t4 o_ High water alarm (Y/N) Y
Date of Pumping Irk eye Pumper IK pw
C. ABSORPTION FIELD DATA
Date installed ?vnP +b Soil rating (g.p.d./W or ft2/bdrm) System type w, fey
r P rl i
Length Z Width Gravel thickness below pipe 1 Total depth S
Effective absorption area �F 7 < Monitoring Tube present (Y/N)_>�— Depression over field (Y/N)
Date of adequacy test 1� >`cA-.? Results (Pass/Fail) l4 ew For -,3 bedrooms
Fluid depth in absorption field before test (in.); Immedi _gal. water added (in.): _
Fluid depth (ins) Minu�lt Absorption rate = g.p.d.
Peroxide tr past 12 months) (Y/N) If yes, give date
72-026 (Rev. 3/96)' (\`` r w
D. LIFT STATION
Date installed 3
Manhole/Access (Y/N)
High water alarm level at*
Cycles tested I\( r<v
E. SEPARATION DISTANCES
Size in gallons 112 -
"Pump
2
"Pump on" level at* t�-k -R-0 "Pump off" level at* t4 �w
*Datum
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot /(2q -4 On adjacent lots /oo �
Absorption field on lot /CQ f On adjacent lots /od `-
Public sewer main 14o ne, Public sewer manhole/cleanout fro oe,
Sewer /septic service line /CV +
Lift station /00
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation /0 Property line 100 'f Absorption field k"
Water main/service line /CC�'l Surface water/drainage &10,f Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
Property line
Building foundation
I& ° Water main/service line to 0 Y"
Surface water /Oo 4 Driveway, parking/vehicle storage area /moi
Curtain drain Y 0 ke Wells on adjacent lots /(?CD �
F. ENGINEER'S CERTIFICATION
0 F A Vkj
I certify that I have determined thru field inspections and review of Municipal recordsAm e.aw •�re
in conformance with MOA AA guidelines in effect on this date.. 'd
4 9TH
✓I<•<< ♦o<p••r ••r•co�1
Signature /l/� J"'"r✓�'Glrt � ,yy�� ii
Engineer's Name Mt ria rl : rnrcNae.. N, ANDIRSCN;•{
CC �" 9469
Date j y '1
l
ZFRRjFSSY',,;,
HAA Fee $ �(a�� cC (� Waiver Fee $
Date of Payment �S I -�� Date of Payment
Receipt Number �� ' 1Sy Receipt Number
72-026 (Rev. 3/96)*