HomeMy WebLinkAboutGREEN FOREST BLK 3 LT 3Green Forest
Block 3
Lot 3
#018-011-19
Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site Water & Wastewater Program, 4700 Bragaw St. S ; - T .
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: OSP 1 11174 PID Number: 018-011-19
Nome:
CLAIRE WIPPERMAN
Wastewater System: ❑ New ■ Upgrade
Address:
12600 NORTHERN RAVEN DRIVE *ANCHORAGE, AK
ABSORPTION FIELD
Phone: No. of Bedrooms:
C/O AGENT 2
❑ Deep Trench ❑ Shollow Trench ■ Bed ❑ Mound ❑ Other
LEGAL DESCRIPTION
Soil Rating:
0.6
Total Depth from original grade:
GPD/Sq. Ft.
SEE DWG. Ft.
Block: Lot: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe:
3 3 GREEN FOREST
SEE DWG. Ft.
6.26 Ft.
Township: Range: Section:
Fill added above original grade:
Grovel length:
SEE DWG. Ft.
42 Ft.
WELL: ❑ New ❑ Upgrade
Grovel width:
2
Number of lines:
1
Distance between lines:
—
Ft.
Ft.
Classification (Private, A.B.C): Total Dep °
Cased To:(BEDROCK)
Total absorption area:
Pipe material:
^\^` ^ Ft.
Ft
525 So. Ft.
D 3034/ F-810
Driller. \\v V Date Drilled:
Xis
Static Water Level:
Ft
Installer.
WILCO CONTRACTORS
Date installed:
8/4/11
Yield:Pump
Set At:
Casing Height Above Ground:
TANK
GPM
Ft.
Ft
SEPARATION DISTANCES
0 Septic ❑ Holding ❑ S.T.E.P. ❑ Other*
To
Septic
Tank
Absorption
Field
Lift
Holding
Public/Private
Manufacturer.
GREER
Capacity in gallons:
1000
From
Station
Tank
Sewer Lines
Well
100'+
100'+
—
—
25'+
Material:
STEEL
Number of compartments:
2
Surface Water
100'+
100'+
-
-
-
LIFT STATION
Lot Line
5'+
10'+
—
—
—
Size in gallons:
Manufacturer.
Foundation
5'+
10'+
—
—
—
"Pump on" level at:
"Pump off" level at:
a or alarm at:
Curtain Drain
NONE KNOWN
Pump Make & Mo ectrical Inspections performed by:
Remarks: OLD TANK "DECOMMISSIONED" PER UPC.
BENCH MARK
Location and Description:
PORTION OF EXISTING WEST TRENCH HAD TO BE ABANDONED
TOP OF SONOTUBE @ CENTER OF DECK
TO MEET SEPARATION REQUIREMENTS TO NEW TANK.
Assumed Elevation:
96.98
Ft,
Inspections performed by: GEG, Ltd. Dates: 1st 8/4/1 1
ENGINEER'S SEAL
�o6ovO
0
0
()..... -9 Q�
3rd 8/5/11
Development Services Department Approval
9
Conditional approval: Date:
Q• ...... . .... ........ .... �
QO f e A. Ga
Q 9; E 79 3 00 0
'
Reviewed and approved by: ` Date:
�p� p o
�ofession c
PERMIT NUMBER: AS—BUILT DRAWING PARCEL ID NUMBER:
-
OSP111174 018-011-19
A B
ST1 48.40 65.65 DOUBLE C/O'S INSTALLED
PRIOR TO TANK BECAUSE NO
ST2 54.82 62.61 FCO EXISTS.
DBL1 1 45.13 53.58
I /
DBL2 46.29 54.67
DBL3 57.94 65.58 LITTLE DRAINROCK WAS FOUND
IN OLD DRAINFIELD AREAS.
DBL4 59.71 67.19 VIABILITY OF OLD TRENCHES IS I
FD 67.97 74.41 QUESTIONABLE./
C01 84.15 90.04
MT1 81.97 87.09 100' WELL RADIUS
CO2 75.78 69.90 I
MT2 76.37
10' UTILITY EASEMENT
\ 10' UTILITY EASEMENT
ST2 ST1
DBL3&4 DBL1&2
1 \ CO A \ MT1 F
C EA STI G 2 .4 .. ..'
\\
BEOR
TH# 1\\ \ HOUSE
\ DECK — — —
1 \ \\ \\ \ B -- ---
1 MT2
CO2 \\ \\
1
2 Si
1 APPX. 9' OF EXISTING
00
WEST OF
WAS ..
ABANDONED TO ENSURE
5'+ SEPARATION TO NEW
SEPTIC TANK. \
/ \ SCALE:
1'=30'
o§ -OF v p
0
lipol
GARNESS ENGINEERING GROUP, Ltd * : 9
--m, CONSULTANTS & GENERAL CONTRACTORS,,, w.--,,,,,,,_ .....,.,..... ......... ........... ... . ....
3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE. AK 99507 • PHONE (907)337-6179 • FAX (907)336-3246 • WEBSITE: w .gemmengjn ring.eom
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ............
....
CLAIRE WIPPERMAN C/O AGENT 2 OF 3 �O J r roes
LEGAL DESCRIPTION: DRAWN BY: Q09• 79 3 G
GREEN FOREST; BLOCK 3, LOT 3 PNB 4�rerea ���1�\•�o�O
TYPE OF WORK: DATE. 4p�-rofess*W' 0
ASBUILT DRAWING 8/8/11
PERMIT NUMBER: AS—BUILT DRAWING PARCEL ID NUMBER:
_
OSP111174 018-011-19
INSULATION
FINAL GRADE = 95.65-95.70
ST1 ST2
TOP OF TANK"
� TOP OF TANK
AT INLET = 93.10 //AT OUTLET = 93.01
NEW 1000 GALLON
INVERT OF BUNG SEPTIC TANK INVERT OF BUNG
AT INLET = 92.69 AT OUTLET = 92.21
FINAL GRADE = 94.26+
ORIGINAL GRADE T
94.05 ® HIGHEST POINT FILTER FABRIC
II o
o
o
00
IZRELATIVE ELEVATION TO BOTTOM OF TESTHOLE= 78.05 (DRY)
o —
0
GARNESS ENGINEERING
GROUP, Ltd.
*� 4 T
r— CONSULTANT'S & GENERAL CONTRACTORS A, s , .,� ,w . «,.3, ....
:....
...
3701 E. TUDOR ROAD. SUITE 101 • ANCNORAGE, AK 99607 • PHONE (907)337-6179 • FAX (907)336-3246 • WEBSITE: www.9omesmNin rings
PREPARED FOR: PHONE NUMBER:
CLAIRE WIPPERMAN C/O AGENT
PAGE NUMBER:
2 OF 3
• .. ...... .........
O� ff A. Gar ess•:
LEGAL DESCRIPTION:
GREEN FOREST; BLOCK 3, LOT 3
DRAWN BY:
PNB
Q 9, CE— 9
�404P e�°►
0�`A
TYPE OF WORK:
PROFILE
DATE:
aprofessio�000
DRAWING
8/8/11
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:
OSP111174
Tax Code Number:
01801119000
Work Type:
Septic Upgrade
Permit Effective Dates: July 26, 2011 to July 25, 2012
Design Engineer:
GARNESS ENGINEERING GROUP LTD
Subdivision:
GREEN FOREST
Site Legal Address: GREEN FOREST BLK 3 LT 3 G2833
Owner/Address: WIPPERMAN RAYMOND H & CLAIRE A
923 W 11TH AVE # 137 ANCHORAGE AK 995014393
9
Site Mailing Address: 12600 NORTHERN RAVEN DR, Anchorage Lot Size in Sq Ft: 19837
Total Bedrooms: 2
This permit is for the construction of:
Y Disposal Field Y 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.
0.1 >nt t~j,(_ts 4k1k ate.:IAP: t a - SAO
Received By:
I
Issued By:
Date:
Date -T
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Fax: 907- 343-7997
On -Site Water & Wastewater Program
Mayor Dan SullivanU S /►'
qn!-Site Sewer/Well Permit Application
; For ASin I Family Dwelling
g
Parcel I.D. 018-011-19
Property owner(s) CLAIRE WIPPERMAN Day phone C/O AGENT
Mailing address P.O. BOX 111207 * ANCHORAGE, AK * 99511
Site address 12600 NORTHERN RAVEN DRIVE * ANCHORAGE, AK * 99516
Legal description (Sub'd, Block & Lot ) GREEN FOREST S/D; BLOCK 3, LOT 3
Legal description (Township, Section & Range)
Lot Size
Sq. Ft. Number of Bedrooms 2
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:
N/t— 51GVr u='"i�.2W
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.
GARNESS ENGINEERING GROUP, Ltd.
(Signature of property owner or authorized agent)
Permit/Rush Fees: 53 =31, � L?cr� " %A aiver Fees: a CC
Date of Payment: -7 h) Date of Payment:
Receipt Number: 0, -)Sy % Receipt Number: q
Permit No. r'';� �� ������� Waiver No.
(Rev. 01/11)
4
Municipality of Anchorage
P.O. Box 196650 • 4700 Elmore Road
Anchorage Alaska 99519-6650 • (907) 343-7904 a Fax (907) 343-7997
http://www.muni.org/Onsite
Development Services Department
On -Site Water and Wastewater Program
relent S
¢N
� n
Department
**** VARIANCE/WAIVER REVIEW ****
WR#: OSP111175 HAM Permit#: OSP1 Ill 74
PID#: 018.011-19
Legal Description: Green Forest, Block 3. Lot 3
Engineer: GEG
Applicant: Raymond & Claire Wipperman
Your request for a waiver of the required 50 feet horizontal separation from the absorption field
to the slope greater than 25% has been approved. The approved separation distance is 15 feet.
This waiver approval applies to the existing absorption field only. Any future upgrade to the on-
site wastewater disposal system will require all separation distances be met or another approval
from this department.
...............................................................................
Waiver is Granted: X Waiver is not Granted:
Date: 8/5/11 Approved b��Name f Reviewer
...............................................................................
Rec#: 025401 Amount: $200.00 Date Paid: 7126/11
**** VARIANCEIWAIVER REVIEW ****
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
July 25, 2010
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, Ak 99519-6650
(907) 343-7904
Ref: Proposed Septic System for Green Forest Subdivision; Block 3, Lot 3,
To whom it may concern:
The existing 2 bedroom house is served by a private well and septic system. The drainfield is in a state of
failure and must be upgraded. We are proposing to install a new 1000 gallon septic tank and �611h
trench type drainfield. One test hole was excavated on the property. The drainfield will be designed
around the 30 foot radius of this test hole. Comments regarding the design are summarized as follows:
1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the
percolation test results.
2. TRENCH DESIGN: See attached design drawing for drainfield specifications
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system.
4. TOPOGRAPHY: The average topography in the area of the proposed drainfield is relatively flat,
however, the proposed trench will be approximately 15' from a slope exceeding 25%. Attached is a
profile drawing showing the slopes within 50' of the drainfield. We request you waive the distance to
excessive slopes to 15'. We are unaware of any adverse impacts this waiver would have on adjacent
wells, septic systems or surface water.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems.
;stions, please contact us at 337-6179. Thank you for your assistance.
P.E., M.S.
NOTE: Attached is a site plan drawing, a design drawing, one soil log, and a 7 page construction
specification letter which are all part of the design package for this septic system.
3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com
---------� ------ ------------
I I �
I I
GREEN FOREST S/D; I I GREEN FOREST S/D;
BLOCK 2, LOT 6 I I BLOCK 2, LOT 1 I HUFFMAN HILLS
I NORTH S/D #3;1
I I GREEN FOREST S/D; BLOCK 2, LOT 20
BLOCK 2, LOT 2 I I
I SERVED BY PUBLIC I
WATER AND SEWER 1
I
I I I
GREEN FOREST S/D;
BLOCK 2, LOT 5 I '�
I
I I Ld I
GREEN FOREST S/D; HUFFMAN HILLS
\ \ \ BLOCK 2, LOT 3A �� GREEN FOREST S/D; wl� NORTH S/D #3;
BLOCK 3, LOT 1 < V) BLOCK 2, LOT 21
�� I D SERVED BY PUBLICII
<� — —�I O WATER AND SEWER
LJ
GREEN FOREST S/D;H
\ \ \\ �� �I
BLOCK 2, LOT 4\ \ 0/O wr Q
_ Oma, i
\ GJ , ' `Z O \
— I \
GREEN FOREST S/D; // \ HUFFMAN HILLS
\ \ BLOCK 3, LOT 2 / I 10 'WELL RADIUS NORTH S/D #3;
I I / BLOCK 2, LOT 22
PROPOSED
SEI 0' WELL RADIUS \ I
PTIC SYSTEM — \ SERVED BY PUBLIC
— — — — — I WATER AND SEWER I
y —
f GREEN FOREST S/D; \ I
BLOCK 3, LOT 4 \ 00 WELL RADIU
(VACANT)'
HUFFMAN HILLS HUF N HILLS MUFFMAN / NORTH S/D #3;
I
NORTH S/D #3; NORTH �P #3; BLOCK 2, LOT 23
BLOCK 1, LOT 14 BLOCK 1, LOi` 4.5 _
FSERVED-B-Y—P—UB—L-IC-1 SERVED BY PUBLICSERVED BY PUBLIC I
WATER AND SEWER WATER AND SEWER WATER AND SEWER I
I N
HUFFMAN HILLS
— — NORTH S/D #3; CALI
�RCLE BLOCK 2, LOT 24
SERVED BY PUBLIC - 1
WATER AND SEWER I
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
7D7 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 • PHONE (907)337-6179 * FAX (907)338-3246 * WEBSRE: www.gam owngfn"ring.coi
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
CLAIRE WIPPERMAN C/O AGENT 1 OF 3
LEGAL DESCRIPTION: DRAWN BY:
GREEN FOREST S/D; BLOCK 3, LOT 3 1 A.J.G.
(TYPE OF WORK:
DESIGN OF PROPOSED SEPTIC SYSTEM
7/25/2011
�� of
... ...... ........
...........:........
A. Garndss:
•mac �
IWIfro f e s sio�1o5;�
ULJIUN C:KI I LNIA:
NUMBER OF BEDROOMS: 2
GALLONS PER DAY (GPD): 300
PERCOLATION RATE/S: 8 MIN/IN
ALLOWABLE APPLICATION RATE: 0.8
PROPOSED APPLICATION RATE: 0.6
MINIMUM DRAINFIELD SQ.FT.: 500
DRAINFIELD DESIGN:
MAXIMUM DEPTH: 10'
WIDTH: #$ Z
LENGTH: 42'
M.O.A. APPROVED SAND FILTER: N/A
EFFECTIVE: 6'
REDUCTION FACTOR: N/A
ACTUAL SQ.FT.: 504
NOTE: CONTRACTOR SHALL
HAVE 100' WELL RADIUS AND
EASEMENTS FLAGGED BY A
REGISTERED PROFESSIONAL
LAND SURVEYOR PRIOR TO
CONSTRUCTION.
f
PROPOSED DIVERTEI
co
LETTER THAT PERTAINS TO THIS DESIGN.
TO OBTAIN A COPY OF THE LETTER
CONTACT GEG. BY PROCEEDING FORWARD
WITH THIS INSTALLATION, THE ENGINEER,
WELL DRILLER, CONTRACTOR AND
PROPERTY OWNER AGREE THAT THEY
HAVE READ THESE SPECIFICATIONS AND
AGREE TO ACCEPT THE TERMS AND
i�
REVISED
100' WELL RADIUS
I I
100' WELL RADIUS
PROPOSED DOUBLE — -
-C E i OUTS \ 10' UTILITY EASEMENT
ZOPOSED 1000 GALLON \
—SEPTIC TANK
,1 PROPOSED DOUBLE
CLEANOUTS
I
\ EXISTING TANK TO BE
ABANDONED PER UPC
10' UTILITY EASEMENT
EXISTING 2\
BEDROOM
HOUSE
a:.
.4
SEE ATTACHED SLOPE EXISTING TRENCH TO
BE CONNECTED AS
WAIVER DRAWING RESERVE SITE
\
SCALE:
1" = 30'
��oF
N h
GARNESS ENGINEERING
GRfJUP, Ltd,
���: T —
p 4H
„ . .: CONSULTANTS & GEINERAL CdNTRACTORS w : _ .
*
p ........... . . ... ........ C
WT
3701 E. TUDOR ROAD, SE 101 • ANCHORAGE, AK 99507 • PHONE (907)337-6179 • FAX (907)338-3246 WEBSRE: gamessenglneerinq.com
C
PREPARED FOR: PHONE UMBER:
PAGE NUMBER:
. • • • • • • • • • • • • ..... • • • • •
O ff
CLAIRE WIPPERMAN C/O AGENT
2 OF 3
e A. G S'S.--
S.-LEGAL
LEGALDESCRIPTION:
DRAWN BY:o09s
—7953
GREEN FOREST S/D; BLOCK 3, LOT 3
A.J.G.
��D�e .
TYPE OF WORK:
DATE:
DO r ofesslo
�DO000��
DESIGN OF PROPOSED SEPTIC SYSTEM
8/5/11
(Rev. 01/05)
N.T.S.
64
c o I
SLOPES MEASURED BY GEG, LTD.
PROPOSEDI— 17'
TRENCH
FLAT
409,
�\���\ SCOpF ® FFp
� � T
� S
15209,
— (I SLOPE
0.,
GARNESS ENGINEERING GROUP Ltd. �`'�,. 49 � �*
CONSULTANTS & GENERAL CONTRACTORS
3701 E. TUDOR ROAD, SUITE 101 - ANCHORAGE, AK 99507 • PHONE (907)337-8179 • FAX (907)338-3246 WEBSITE: www.gamosamginmring.eom -�
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ••• .••••••••i
CLAIRE WIPPERMAN C/0 AGENT 3 OF 3 e1 a Garnss.
LEGAL DESCRIPTION: DRAWN BY: Q4 I E-79
ps 5 c�G
GREEN FOREST S/D; BLOCK 3, LOT 3 A.J.G.
TYPE OF WORK: DATE: �-40QaProfessi0(\6�o\��
PROFILE DRAWING OF PROPOSED SEPTIC SYSTEM 7/25/2011
GARNESS ENGINEERING GROUP, Ltd
CONSULTANTS & GENERAL CONTRACTORS
01 E. TUDOR ROAD. SURE 101 • ANCHORAGE. AK. 99507 • PHONE: (907)337-6179 • FAX: (907)338-3246 • WEBSITE: gameeeengineer
SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: GREEN FOREST S/D; BLOCK 3, LOT 3
PERFORMED FOR: CLAIRE WIPPERMAN _ DATE: 7/19/2011
DEPTH
(feet)
1 ORGANICS
AND FILL
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
ML W/ MIXED
LAYERS OF SAND
AND WELL
GRADED GRAVEL
DEPTH TO
GROUNDWATER
DATE
DRY
7/19/2011
` 1,.60' WELL RADIUS,
r
I 5
1�------------------ �P
•
6"
—
IIIIIIIII
2:48
I�111�1
rm ..
r
#1�`
/0i
—
N/E1.
G
MIN
HUFNAN HILLS
111111111
NORTH S/D #3;
Rm
BLOCK 1, LOT 15- -
i//iI
SERVED BY PUBLIC
`i` ` 11
WATER AND SEWER
6
SCALE:
�`i.;ME,
2 4/16"
3 12/16"
DEPTH TO
GROUNDWATER
DATE
DRY
7/19/2011
` 1,.60' WELL RADIUS,
r
I 5
1�------------------ �P
--------------
6"
—
..........
Yrr,,ey x-,.,L7-Qrness:
y�CE-7951
'Z
��
\��pro f ess�ooo
DATE READING
CLOCK
TIME
GREEN FOREST S/D;
` BLOCK 3, LOT 2 110 ---ELL RADIUS
WATER LEVEL
READING
` 1,.60' WELL RADIUS,
r
I 5
1�------------------ �P
--------------
6"
—
2
2:48
30
rm ..
r
#1�`
2:48
—
6"
1 `
4
HUFNAN HILLS
30
NORTH S/D #3;
i
BLOCK 1, LOT 15- -
3:18
SERVED BY PUBLIC
6"
WATER AND SEWER
6
SCALE:
DATE READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
7/23/2011 1
2:18
—
6"
—
2
2:48
30
2 1/6"
3 15/16"
3
2:48
—
6"
—
4
3:18
30
2 4/16"
3 12/16"
5
3:18
—
6"
—
6
3:48
1 30
2 4/16"
3 12/16"
19 PERCOLATION RATE 8 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 6.5 FT. AND 7.5 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: E YES ❑ NO
SOILS LOGGED BY: ROB CAMPBELL PERCOLATION TEST PERFORMED BY: ANDREW GRAY
COMMENTS: RECOMMEND USING A 0.6 GPD/FTZ APPLICATION RATE.
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WA PE FORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 2
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.orgionsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
0
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 018-011-19 COSA#
1. GENERAL INFORMATION Expiration Date:
Complete legal description GREEN FOREST; BLOCK 3, LOT 3
Location (site address) 12600 NORTHERN RAVEN DRIVE *ANCHORAGE, AK 99511
Current Property owner(s) CLAIRE WIPPERMAN Day phone C/O AGENT
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
12600 NORTHERN RAVEN DRIVE *ANCHORAGE, AK 99511
Day phone
CLAUDIA PEARSON W/ KELLER WILLIAMS Day phone 310-4000
501 W. BENSON BLVD SUITE 503 *ANCHORAGE, AK 99503
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 2
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF WSPECTION BY ENGINEER
As ceitified by nty" seal al", ixed hereto and as ofthle validation date shown belovi, I verify that my
investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines far 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 fair ,her verify that based on the
inform
atlC7 Cbfalned from the .M.G'n/Cipa!;ty of Anchorage filar and from my :nvestlgat'Cn andinspection, ctiFinn +he
r,.
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 GARNESS ENGINEERING GROUP, Ltd.
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name
Engineer's Comments:
JEFFREY A. GARNESS, P.E.
Phone 337-6179
Date A I
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
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conscientious engineering analysis of the system in accordance with ADEC and MOA
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DSD Guidelines & Regulations. The reported results described 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
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septic systems depend on the local soils condition, groundwater levels that may.
..... . .........
fluctuate during the year, and the water usage of the family being served by the system.
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These conditions are outside the control of the evaluator of the system. Satisfactory test
... ... .. ........ ...... .
results do not guarantee future performance of the system, nor do they guarantee that
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there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
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any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
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0
Professlo�oo�
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
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other person or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
COS'A C iecfiiist
Septic System Advisory
Well Flow Advisory
Nitrate Adv,sor,
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By:— Original Certificate Date:
(Rev. 11105)
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: GREEN FOREST; BLOCK 3, LOT 3 Parcel ID: 018-011-19
A. WELL DATA *PER BEAU AT AAROW PUMP
AND WELL SERVICE
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES
Date completed UNK Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth *60'+ ft. Cased to *60'+ ft. Casing height (above ground) 12+ in.
Date of test
Static water level
Well production
FROM WELL LOG
NO WELL LOG
WATER SAMPLE RESULTS:
ft.
AT INSPECTION
7/13/11
84 ft.
4.7
9.13 -m -
Coliform 0 colonies/100 ml. Nitrate 0.1 mg./L. Collected by: GEG, Ltd.
Arsenic: 9.22 ug./L. Date of sample: 7/13/11
B. SEPTIC/HOLDING TANK DATA *DOUBLE C/O'S INSTALLED PRIOR TO TANK.
Tank Type/Material SEPTIC/STEEL I Date installed 8/4/11
Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (Y/N) * Depression over tank (Y/N) NO High water alarm (Y/N) N/A
Date of pumping NEW Pumper —
C. ABSORPTION FIELD DATA I *BELOW FINAL GRADE
Date installed $/4-5/1 Soil rating (g.p.d./Wo 2/bdr 0.6 System type TRENCH
Length 42 ft. Width 2 ft. Gravel below pipe 6.26 ft.
Total depth 10.21 + ft. Eff. absorption area 525 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test NEW Results (Pass/Fail) PASS For 2 bedrooms
Fluid depth in absorption field before test — in. Water added — gal. New depth — in.
Elapsed Time: — min. Final fluid depth — in. Absorption rate >= 300+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N/A If yes, give date —
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N
"Pump on" level at in. "Pump off' level High water alarm level at
Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots
100'+
Absorption field on lot 100'+ On adjacent lots *91'+
Public sewer main N/A Public sewer manhole/cleanout N/A
Sewer /septic service line 25'+ Holding tank N/A
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water,
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
100'+
Property line
10'+
Building foundation
10'+
Water main N/A
Water service line
10'+
Surface water
100'+
Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION OF....
d
► certify that / have determined through field inspections and 0 * 4 ' �*
review of Municipal records that the above systems are in �' ' ' ' ' ' ' ' ' ' • .. ' ' ' ' ' ' ' ' ' ' • ' ' ' •
conformance with MOA COSA guidelines in effect on this
date. Jeff A. Garne s:
Engineer's Printed Name JEFFREY A. GARNESS 004 E— 0m�
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Date \D�h�r o f es sio —
COSA Fee
Date of Payment
Date of Payment
Receipt Number �� Receipt Number
(Rev. 11/05)
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N00009'00"W 110.00
NORTHERN RAVEN DRIVE
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SGS
SGS Ref.#
1113139001
Client Name
Garness Engineering Group, Ltd
Project Name/#
Green Forest
Client Sample ID
Green Forest B3, L3
Matrix
Drinking Water
Printed Date/Time
Collected Date/Time
Received Date/Time
Technical Director
07/19/2011 14:57
07/13/2011 15:00
07/13/2011 15:25
Stephen C. Ede
Sample Remarks:
450ONO3-F - Total Nitrate/Nitrite - MS recovery is outside of QC criteria. Refer to LCS for accuracy requirements.
Allowable Prep Analysis
Parameter Results LOQ Units Method Container ID Limits Date Date Init
Metals by ICP/MS
Hardness as CaCO3
20.7
5.00
mg/L
SM20 2340B
C
07/13/11 07/14/11
NRB
Waters Department
Total Nitrate/Nitrite-N
0.100 U
0.100
mg/L
SM20 450ONO3-F
B
07/18/11
AYC
Microbiology Laboratory
E. Coli
Negative
1
100mL
SM20 9223B
A
07/13/11
DLC
Total Coliform
Negative
1
100mL
SM20 9223B
A
07/13/11
DLC
Private Individual Analysis
Alkalinity
259
10.0
mg/L
SM20 2320B
D
07/14/11
NRR
Aluminum
52.2
20.0
ug/L
EP200.8
C
07/13/11 07/14/11
NRB
Antimony
1.00 U
1.00
ug/L
EP200.8
C
(<6)
07/13/11 07/14/11
NRB
Arsenic
9.22
5.00
ug/L
EP200.8
C
(<10)
07/13/11 07/14/11
NRB
Barium
17.2
3.00
ug/L
EP200.8
C
(<2000)
07/13/11 07/14/11
NRB
Cadmium
0.500 U
0.500
ug/L
EP200.8
C
(<5)
07/13/11 07/14/11
NRB
Calcium
5190
500
ug/L
EP200.8
C
07/13/11 07/14/11
NRB
Chloride
98.5
0.500
mg/L
EPA 300.0
D
(<250)
07/14/11 07/15/11
SDP
Chromium
2.00 U
2.00
ug/L
EP200.8
C
(<100)
07/13/11 07/14/11
NRB
CO3 Alkalinity
10.0 U
10.0
mg/L
SM20 2320B
D
07/14/11
NRR
Conductivity
805
1.00
umhos/cm
SM20 2510B
D
07/14/11
NRR
Copper
733
1.00
ug/L
EP200.8
C
(<1300)
07/13/11 07/14/11
NRB
Fluoride
0.100 U
0.100
mg/L
EPA 300.0
D
(<2)
07/14/11 07/15/11
SDP
HCO3 Alkalinity
259
10.0
mg/L
SM20 2320B
D
07/14/11
NRR
Iron
1720
* 250
ug/L
EP200.8
C
(<300)
07/13/11 07/14/11
NRB
Aarow Pump & well Service LLC
(907)346-9355
Inspection Report
I ran a camera 60' down the well at 12600 Northern Raven Drive and
did not find any holes/ cracks in the casing or leaking around the pitless.
Page 1 of 1
Sonja Blewett
From: Beau Maxim [aarowpump@gmail.com]
Sent: Friday, August 05, 2011 2:21 PM
To: Sonja Blewett
Subject: Re: 12600 Northern Raven
yes, I put a new well seal and conduit on.
On Fri, Aug 5, 2011 at 1:38 PM, Sonja Blewett <Sonja&garnessengineering.com> wrote:
Hello, was the wires in the conduit fixed on 12600 Northern Raven? Thanks so much!
Sonja Blewett
Corporate Secretary/Treasurer
Garness Engineering Group, Ltd.
3701 E. Tudor Road, Suite 101
Anchorage, AK 99507
Phone: (907) 337-6179
Fax: (907) 338-3246
8/5/2011
Municipality of Anchorage age .��A),
Department of Health and Human Services
Tom Fink. 825 "L" Street
Mayor. P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
March 6, 1989
Bruce Corwin, P.E.
Corwin & Associates, Inc,
1000 East Dimond Boulevard, Suite 205
Anchorage, Alaska 99515
Subject: Waiver Request for Lot 2 Block 3 Green Forest SID
Waiver Request #WR890007
Dear Mr. Corwin:
Your request for waiver of the required 100 foot separation of
a septic system to a private well has been approved. The
approved separation distance is 91 feet from sewer system (trench)
on Lot 2 Block 3 to the well on Lot 3 Block 3.
This waiver approval applies to the existing septic system to
well separation only. Any future upgrade to either will
require all separation distances be met or another approval
from this department.
Sincerely,
Robert W. Robinson
Civil Engineer
On-site Services
RWR/ljw#6
GRED "R ANCHORAGE AREA BOR' IGH
Department of Environmental Quality
" 3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME�<� �2- +L'. i`i �/%� MAILING ADDRESS PHONE =Z? 2 /���
LOCATION ���r� LEGAL DESCRIPTION
SEPTIC TANK:
DISTANCE ��`� X' JGi�✓�
FROM WELL /US' MANUFACTURER ��fa'%��j MATERIAL
NUMBER OF
COMPARTMENTS
INSIDE LENGTH ---INSIDE WIDTH _.- LIQUID DEPTH LIQUID CAPACITY/fir GALLONS.
TILE DRAIN FIELD: �+
TOTAL LENGTH
DISTANCE FROM WELL����'
FOUNDATION�ly1 _NEAREST LOT LINEaw �` _ OF LINES
i
NUMBER OF LINES -: DISTANCE BETWEEN LINES ZG' -s_ TRENCH WIDTH IN. TOTAL EFFECTIVE
ABSORPTION AREA �� z_ SQ. FT. LENGTH OF EACH LINE
i DEPTH OF FILTER
DEPTH: TOP OF TILE TO FINISH GRADE? MATERIAL BENEATH TILE36� / IN. ABOVE TILE IN.
WELL:
TYPEz/✓fl/(//G%/G CONSTRUCTION l �i I✓�/�G_-h�'�-��"DEPTH Z___ DISTANCE FROM:
BUILDING i NEAREST NEAREST SEPTIC ���-- �'' EEPAGE/`°���'
FOUNDATION/ LOT LINE�hf�� SEWER LINE, �7 TANK SCS SYSTEM �^'s
CESSPOOO I-IER SOURCES
APPROVED -__ DISAPPROVED REMARKS
DISTANCES:�!>_ _��✓lJ/G�
XV Tv ce '- ,� .,
INSTALLED BY: 102fiCl�G�iriT
SEWER LINE DEPTH:.VA�/�J
M
PIPE MATERIAL:.'l� �Gif// -
LOT SLOPE:
REMARKS:
Form EQ -032
DIAGRAM OF SYSTEM
1V
3
DATE'!`
APPROVED _
G.A.A.B.
:.• .
NAME OF APPLICANT
INSTALLATION LOCATION
LEGAL DESCRIPTION
/o A
GREATER ANCHORAGE AREA BOROUGH ,`e
DEPARTMENT OF ENVIRONMENTAL QUALITY 7 PVR M1T N0. —
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT
ING ADDRESS
.`
INSTALLATION OF: SEPTIC TANK _ yj—�— SEEPAGE PIT —. DRAIN FIELD
TYPE AND SIZE OF FACILITY TO BE SERVED
PHONE, Z ) 0 &v
OTHER
FINANCED THROUGH TO BE (INSTALLED BY
SOIL TEST RESULTS I " Q—Q `NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL, TEST
COMPLETION DATE ANTICIPATED
ry EI'm
v v V
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROsF_CUTION.
SEPTIC TANK SIZE TYPE SEEPAGE AREA SIZE
MINIMUM DISTANCES. REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT — -. DRAIN FIELD -
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC 'TANK - SEEPAGE PIT , DRAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK 10 J SEEPAGE PIT -
--•
DRAIN FIELD 10 (� ± , ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK — SEEPAGE PIT
DRAIN FI EL.D
/OU
SEPTIC TANK, 16 U SEEPAGE PIT DRAIN FIELD
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING CTAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND
SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
G®�
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGAFG INSTALLATION.
r
G.A. .B.
�I/�
OR
/ I�j/
LICENSED DESIGNER
ley
TYPE
d"
DIAGRAM OF SYSTE
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE �--A APPLICANT'S SIGNATURE _�-�
CASE d
327
ANCHORAGE,, AL/ -,-,KA 99501
Per. orr.:,_d ror�n\,�F'r...rorr,ed E
LOCO �. Dus4: �, C. Okl dwy_�j `1��. �.�..,� '�l...l. _'✓1:,1G� �_�_�� ��t,.... .i�!�at� r ...,....
Illi s F'cr l }i4rOT l' d: �O] Sm� 0 .•..�. - ««.. r c;e'CG1i1t4:.011
Location Sketch
Vas Ground Fluter I:ncounterea'r' (�
if Yes, At What PaplL),,
Reading I Date
G:^OSS Time Net 7irr,e Depth To H2O
;et Drop
...wa.w....._..a.•'s.__.___.__w.e..._..._.......rM...`...�._......�.-r_._�.....•n.....«_.._v,..w......_.I.^.++,.+_.o..��.w.._n.r.w.._.w}1 __......._.,...._____._._..
d�:.5' �. U _ [: • l (. � � � ..l . L' A �......s_1....,,.... ..I..._' i ... I_ d-,. ......i.�.._..>__....�_ n.................._�....w F._r 1+.L.�.w-_...-..wiz.+�...+.�.�.
�"•";'�G:,�:] In ,i:)).�at:c);i: ve is
Pit l i _ Drain i icid
Depth Of filet ---....-.,_ .�... n
_ ')c ;, ;o��ct�o;; 0 ,'it; Orp it^nch _
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Test Pertor rr.ed :>y;k-r-. kS
Data Certified By� to •__,-_r�
Upth.
%'eet
Soil Char' cter.:tic;
It
C
-•--
46
r --
Location Sketch
Vas Ground Fluter I:ncounterea'r' (�
if Yes, At What PaplL),,
Reading I Date
G:^OSS Time Net 7irr,e Depth To H2O
;et Drop
...wa.w....._..a.•'s.__.___.__w.e..._..._.......rM...`...�._......�.-r_._�.....•n.....«_.._v,..w......_.I.^.++,.+_.o..��.w.._n.r.w.._.w}1 __......._.,...._____._._..
d�:.5' �. U _ [: • l (. � � � ..l . L' A �......s_1....,,.... ..I..._' i ... I_ d-,. ......i.�.._..>__....�_ n.................._�....w F._r 1+.L.�.w-_...-..wiz.+�...+.�.�.
�"•";'�G:,�:] In ,i:)).�at:c);i: ve is
Pit l i _ Drain i icid
Depth Of filet ---....-.,_ .�... n
_ ')c ;, ;o��ct�o;; 0 ,'it; Orp it^nch _
C61
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Test Pertor rr.ed :>y;k-r-. kS
Data Certified By� to •__,-_r�