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Home My WebLink AboutT15N R1W SEC 4 S2NW4SW4NW4T15N, R1W Section 4 S2, NW4, SW4, NW4 #051-042 O7 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: ospxxxxxx PID Number: 051-042-07 Dwelling: El Single Family(SF) ❑ with ADU [' Duplex (D) ❑ Two Single Family Project: ❑ New 1:] Upgrade NameORPTION FIELD Kingrea 50% & Marchlinski 50% Site Address ❑ 13'atp Trench ❑Wide Trench El Bed ound 22225 Knik Vista Street �] Other Phone Number of Bedrooms Soil Rating \ Total depth fr rt original grade V I�/�r,t S.9" GRQ/SF Ft. LEGAL DESCRIPTION r Depth to pipe invert from original g ode 'Gravel depth beneath pipe Subdivision Block Lot F. Ft. S2NW4SW4NW4 Fill added above original gr-=- Gr. •I length Township Range Section Ft. Ft. 15N 1W 4 Gravel width Beds:Number of Lines Dista ce between lines SEPARATION DISTANCES Ft. Ft. To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist.between t ches Tank Field Lift Station Tank Line Ftz From t Well 100'+ 4 25'+ TANK 0 Septic 0 S.T.E.P. 0 Holding 0 Other Manufacturer Capacity Anchorage Tank Material 2000 Gal. Surface Water 100'+ Number of compartments Lot Line 5+ NA Steel 2 Foundation 10'+ LIF�"3T�ION �� Manufacturer Capacity Gal. Remarks Alarm location Electrics ' lied by PIPE MATERIAL House to tank 3034Tank to 3034 drainfield Installer Previous Homeowner Drainfield CO/MT 3034 Inspector BENCH MARK (Assumed elevation) 164.5 ft Inspection 1„ Location and description dates: 2^d Gars e Slab 3N 4... 9 ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Date OF N.4 k\' Conditional Approval: ,.. � s t:.:en I . Panrior„ r Septic System �$+ <; t •• ;,. Approved /�!!,U" l� Date )'�/w/Iq xk <L, ,...s Note: this approva does not include well permit requirements. \��a��~ (Rev 05/02/18) 43 'cam olopya,c,A 04y. ,91/, — - - ' —..,:. — . — . —/./— . — . — . _ . — . — . rG . — . _ . — . — . _ rn o of X / ( co c4 o x / / A B ° Zo zX o r'4 *Yr**ir.' a�N4 / r _ - _ — Ti 140.6 140.5 \-, ou� au' W ;1..: *'� S Y" i / / T2 151.4 1 53.5 < vv 0- o- _In % is / Q ; -- TRUE NO5RNV .p SCALE : t•. 60' / O. / O 1 tel- ,YTT�� _ DRIVEWA� / - •DRAIN FIELDS E ' /'��p•.7. � ;c.K�,y tr La /c 1r�`.ms/// 1 GRINDER PUMP 1 ( /, •y moved locotion per � / / t � 1/0041.k...? ,�� homeowner.) / { i ..liky. S r /\-- -- A S55-6<---------S SS T2 /!.(:1-7 DUPLEX t.�3 / /iii O B / 000. SEPTIC TANK in / \ 1�/ J/ // INSTALLED BY PREVIOUS HOMEOWNER. - ro - Q 0 1_ 1 • WELL E 1 � r /� C.) � wLLUW 1- z1 /1 / / // / -/ / \\ J.vn .,1. --- r-- (..), / /! / / / / / 1 Vamal. _z Y �_ } I / / / / I Mr x Z Q I I �/ / / _ _/ { � � W = 1 / ( 185 i90j ,;\ki_z_i_..z._/ m •t' CC CD 1651 / /1 / 1 / Za�ov WS � YD \ - 17 11751 11801 I / O x^ (n l- z S W ( / / / 1 1 Z13-mo Y QY0 1 \nJ / / / / ` 4- cc `st - N N a Co CO I W > N OC: 170.0 1- 2 ].1 1c 1I I II. II,IILn - - --_.---' Q —w w — WATER LINE/ �r WELL RADIUS /-.0 NEW SEPTIC - t 1 ABBREVIATIONS \ _ CONNECTED TO O 0 Z TH TEST HOLE 165.6 2000 g SEPTIC \ 165.4 DRAIN FIELDS 0 U < (P) PROPOSED Q (E) EXISTING TANK �; D CLJ CO CLEAN OUT NO. L.L. OT FC FOUNDATION CLEANOUT z z L>J DCO DOUBLE CLEAN OUT - FS FLOW SPLITTER Cl)Z MT MONITOR TUBE NO. PROFILE 0 o NP TYPICAL SCALE:NTS MUNICIPALITY OF ANCHORAGE I. Development Services Department `� 21 Phone: 907-343-7904 On-Site Water & Wastewater Section -- Fax: 907-343-7997 89 �ON-SITE SEPTIC/WELL PERMIT APPLICATION ::: : 7 2019 z Parcel I.D. 051-042-07 45�' Property owner(s) James& Katherine Kingrea &Virginia Marchlinski Day phone B L Mailing address PO Box 672389, Chugiak, AK 99567 Site address 22225 Knik Vista St, Chugiak, AK 99567 Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) T15N R1 W Sec 4 S2NW4SW4NW4 Lot Size 217,800 Sq. Ft. Number of Bedrooms A 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑ (w/wo ADU) Septic Tank 0 Upgrade 0 Duplex (D) E Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A 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: a2►5 Waiver Fees: Date of Payment: IL I la'[(9 Date of Payment: Receipt Number: 611546 Receipt Number: Permit No. QSPtgt505 Waiver No. G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Pannone Engineering Services [lc Steven R. Pannone, Principal Registered Professional Engineer E-mail:steve@panengak.com 7 November 2019 Subject: T15N R1W SEC4 S2NW4SW4NW4 22225 Knik Vista Street Septic Tank Documentation To whom It may concern; I am writing this letter in order document a septic tank that was installed without a permit. In 1999 a permit was acquired for the subject property to install an on-site wastewater disposal system.This design noted the use of a steel 1000-gallon septic tank. In July of 2012 a steel 2000-gallon septic tank was installed on the subject property by the homeowner.Attached to the letter is a stamped and signed record drawing showing the location and depth of the undocumented septic tank as well as a stamped and signed as-built. If you have any questions or concerns, please contact me at 745.8200. Sincerely, 41\ TO Steven R. Pannone, P.E. Owner/Civil Engineer I• •o - Q z, moi c• R ' 9_ . Y , • ' , • L ss t 'Q 1 \\ a �\ \ ..1.... �..cg 1 C 00 \ \ \ ..7.,...,.. . \ \ \ ,\\\'_ ..Zi '; N \ •...„--\\ G l'• ( . \ • • . , , • \ 4 \ c 1 \,• t o • \ a . \ • o g J rrr \ L , L % A `O ed/ �h ; Sys ate/ SG/ A. \ Ix *c..• 1-• 7. / \ 1r • N. .•A. kk a' . � p r9A -92r \C1 , ' \ 11 • t ' . ,a ‘ 4 .\\:\\,\..- . i --Q....itt.... . e `. .off 7774/ d ;h.4 may'-t $ } O �a°IP se ( C \ �`` o o,, /ring:„f d -r ya'"W,7 �.t�1-e. ;- 4/41 ' 330,5/1-4 ASBUILT SEWARD & ASSOCIATES LAND SURVEYING 694-0829 I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE' ' . vie�, FOLLOWING DESCRIBED PROPERTY: OF 4� tt, .5- -�v,,s, w�i�/w/----.4z e7-icx. ,/ev - ..DATE. 0. .......4 n 1 INDICATED.AND THAT OACHMENTS OITNIS THE RESPONSIBILITY OIST FT E 9AS /�� / �'.' ''rte ^`�� • -5' 4. �-J Y `i - OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: `! EASEMENTS, COVENANTS., OR RESTRICTIONS ",/,=v/S->�' o, ,.tom,, ,�, i !;rG:.11:.LI° WHICH DO NOT APPEAR ON THE RECORDED SUBDI- '. Duan. Mer Seward : ,per a VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB' ,y,��g '., LS-691 8 .J�.44 - ANY DATA HEREON BE USED FOR CONSTRUCTION t�'t�, •..e/.2.,-;-%.X/4�4. OF FENCE LINES, OR FOR ESTABLISHING BOUND- ' ' ,,we-1-icrt:.L;�-� 4' ARY LINES. DRAWN:�� `� 1.-m..hs',"•� Municipality of Anchorage Page I o! 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: ~-~//0(~/~"~ ~,'~Z/ PID Number: 0~'/-~}~'~ Name: ~O ~/~O~ Wastewater System: ~New ~ Upgrade Address: P0 ~o~ ~ t~/~/ ~/~. ~ ~5~ / ABSORPTION FIELD Phone: ~ Nc. of Bedrooms:~ ~ Deep Trench ~Shallow Trench B Bed B Mound ~ Other LEGAL DESCRIPTION so,, ..t,..: 0.~GPD/Sq. FI. TotalDepthfromoriglnalg,ade:~' ~ / Block: Su div~ion: Lot: ~J~ ~ O~ ~ ~' ~-- ~ )epthtoplpe,ottomlro. odg/na, grade: Graveldepth beneath pipe Tow.ship: / ~ ~ tR..g.: ] ~ Fil, added above orig,.., grade: Gr.vel [e.¢h: WELL: ~ New ~ Upgrade Gravelwidth; ~-, Number of lines: l Oistance between lines: ~t. ~ I~~ ~t. Classification (Private,A,B,~: i Tot~eplh: Cased To: fotal absorption area: x Pipe material: ~ Driller: Date .rilled: Static Water Level: Installer: Yield: ~0 GPMIPumpSet;t~ ~ Ft. ICasingHeightAb~Gr°u;~: TANK SEPARATION DISTANCES ~'Se.tic U Ho~.~ B TO Septic ADsorption Lift Holding ~ubllc/Pdvate Manufacturer: . Capacity in gallons: From Tank Fle,d Station Tank Sewer Lines ~¢~¢¢~ ~ ~ /~ ¢ Well- I~'+ I0O'S .__ ~ Material;O- ~ / * ~ ' Number of Compa,ment,: ,, s.,.c. ~ LIFT STATION Foundalion 'Pump on" level at: ~e~waler alarm at: Remarks: ~,[*,¢,~ c~i~..c~..~ 'to ;~'/~' BENCH MARK [ Assumed Elevation: I00 17034 Eagle River Loop Roa~ ~r ' : v ~ ...~¢,,g~;~,~,~ ........ ~.,.,..~ · ~,... ....,~ Department of Health and Human ~erv,ces approva, ~ c,, ,,., Reviewed and approved by: ~ ~ ~Date: /- / ~' ~ "~: ";:':'::;~g'"'~*'<~.~--.-- 72-013 (Rev. 9/91) MOA 25 PgRiVI[? NO SW990274 PAGg 2 oF 3 Hunicip. cLit.. _y_..oF .A.n_c h.o? .e 9.e' DEPARTP1ENT OF HEALTH AND HUMAN SERVICES ENVlRONIvlENTAL $ERVlCE$ DIVI$10N PE]. Box 196650 eAnchorage, A/aske 99519-6650 e Telephone: 343 4744 ON-SITE WASTEWATER DISPOSAL SYSTEN AND/OR WELL INSPECTION REPORT LgGAL S1~, NWI~, SWI~, NWI~, T15N. RlW, SEC. 4 P.I.D. NO. 051-042-07 TRACT C 15' DRAINAG£ £ASEHENT I I I I i PERMIT NO SW990274 PAGE 3 OF 3 ivlunicip, oLi$¥ oF Anchocc~Qe DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 oanchorage, Alaska 99519-6650eTe[ephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL iNSPECTION REPORT LEGAL S~, NWI~, SWI/4, NW¼, T15N, RIW, SEC. 4 P.LI). NO. 051-042-07 105.7' ~FINAL GRADE ~ NEW ~ __, Yl lOOO GAL ~ 99'9'~ I SEPTIC ~997' ~ TANK ' A B ST1 96.0' 91.5' ST2 100.0' 94.0' DBL1 101.5' 94.5' DBL2 104.0' 96.5' C01 107.0' 98.5' MT1 146.5' 150.0' C02 162.0' 142.0' MT2 113.0' 96.5' C05 112.5' 96.0' CO1 CO1 104.4'J~, Ci2~ MT1 C~3HM~ C02 ~ 104.1' C03 = 101.8' I "~-~JrJ~C01 - 99.1' ~ [ IC02 = 99.3' ~C03 = 99.6' MT2 967'j ,, ,-.~ ¢,,J - ' MT2 = 96,9 ~. T. s. · WATER FOUND @ 91.7' 89.7' B,0.H. D~Oi-9~WED 01;15 PM SULLIVAN WATER WELLS 680 2?59444444444444 by COO ~. db~ SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 · TELEPHONE 688-2759 OWNER OF LAND ADDRESS pb LEGAL DESCRIPTION' PERMIT NUMBER ~ O~'"/~ Date of Issue ~ TAX INOENTIFICATION NUMBER.~).~"! - ~- Is well Ioo~ted ~t epproved permi~ Iocefion? ~s Method of Drilling: ~te~ ~ ceble tool Depth of well: ~._. Casing Type ~~11 Thickness m ~ inches Diameter ~ ~. inohes, depth ~ / feet Liner Type; Casing Stiokup Above Ground; C~ feet Static Water Level (from ground level): /c~l) ,,~h~<o fee[ Pumping lave., feet after hfs. pumping ~gpm Recover Rate: _~,~.~gpm Method of Testing: ~ . Well Intake Opening Type: ~ End ~ Open Hole ~ Screened; S~ feet Stopped ~eet O Pedoratione Sta~ ~fFe~Stopped feet Grout Type; ~r~ C ~[lume /~Z~ ~' Depth: from ~ feet, to ~ / ]eet Pump Intake Depth: ~feet Pump Size_ hp Brand Name ~ WelIDislnfe~ed Upon Completion? ~ ~ No Method of Disinfection: C~z~,~ ~ Comments; BORE HOLE DATA DEPTH ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Selvices and/or Department of Environmental Conservation. MatSu Borough: Department of Environmental Conservation. MUNICIPALITY OF ANCHORAGE Department of Hea#h and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Upgrade Date Issued: Aug 11, 1999 Expiration Date: Aug 10, 2000 Permit Number: SW990274 Legal Description: TI5N R1W SEC 4 S2NW4SW4NW4 Design Engineer: 0003 S & S Engineering Owner Name: Bobby Brown Owner Address: PO Box 210214 Anchorage, AK 99521- Parcel ID: 051-042-07 Site Address: 022228 MAYTAG ST Lot Size: 217800 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] SepticTank [] Holding Tank [] Privy [] Private Well [] 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 engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. The existing well shall be decommissioned according to provisions of AMC 15.55 Received By: "~/' ~'~"-'-' Date: Issued By: ~-'~"~--~'Z/ ~ ~,~ Date: C~'//'~ ROBERT C. COWAN, P.E. ROBERTA. SHAFER, RE. SEWER&WATER INSPECTION WELL INSPECTION &FLOWTEST ROADDESIGN 80iLTEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS CIVIL ENGINEERS (907) 694-2979 · FAX (907) 694-1211 August 5, 1999 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: S '/2 ofNW ¼ ofSW ¼ ofNW ¼, Section 4, T15N, RIW Request you issue a permit to install a well and septic system to serve the existing three bedroom dwelling on the referenced property. One test hole was excavated and a percolation test performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation, 7-19-99, water was found at 11 feet. After seven days of ground water monitoring, water was found at 11 feet. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. If you require additional information, please contact us. Sincerely, Rcc ojj Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 EAGLE RIVER, ALASKA 99577 1" = 100' DESIGN SITE-PLAN ~ ~ x x xxx.~x xx~ o~m~ ",KNIK VISTA DRIVE 0 x ~ X · . · Mur~lmpahty el Anchorage DEPARTMENT OF HEALTFI & HUMAN SERVICES 825 "L' Street, Aechorage Alaska 99502~0650 , ~[ ~ ',ownshil~gcr?e, Sect 1 2 4 5 6 7 8 9 10 . - ~"~--11 12 13 14 15 16- 17- 18- 20- N WAS GROUND WATER ENCOUNTERED? Reading Date Gross Time Net ~( Depth to Water Net Drop PERCOLATION RATe ['~ ,2~ Im,nules/inch) PERC HOLE DIAMETER TEST RUN BETWEEN '~,~'- FTAND ~'~'- FT COMMEN1S 17034 Eag p - /v , ACCORDANCE W~'a~[r'GLR~apI,~'~I~ItI~J~,~¢~AL GUIDELINES IN ~FFECT ON THIS DATE. DATE: 72-008 (Rev 4/85) ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: S ¥2 ofNW ¼ ofSW ¼ of NW %, Section 4, T15N, R1W August 5, 1999 GENERAL: The scope of this project includes the installation of a 1000 gallon wastewater S.T.E.P. system (septic tank) and leachfield trench to serve the existing three bedroom residence located on the referenced property. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Depm'tment. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. Page 2 S ½ ofNW ¼ ofSW ¼ of NW ¼, Section 4, T15N, RIW August 5, 1999 Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away ficom the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed-up) before gravel (sewer rock) placement. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page 3 S ½ ofNW ¼ ofSW ¼ of NW ¼, Section 4, T15N, R1W August 5, 1999 MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation mnst be constructed by a Municipal approved septic tank manufacturer. 2. The following pipe materials m'e approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. When sand is being used as a filter material, its gradation specifications must conform to em'rent M.O.A. or D.E.C. requirements, which ever requirement applies. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: Page 4 S ½ ofNW ¼ ofSW ¼ of NW ¼, Section 4, T15N, R1W August 5, 1999 The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for thc construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER RECEIVED SEP ::~0 1999 Municipality ot tkncl~orage Dept. Health & Human Servioes IUNIUPAUTY OF ANCHORAGE Development Services Department i Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-042-07 Expiration Date: V' S -;Zn 2 1. GENERAL INFORMATION gecq Complete legal description TI 5N R1 W �4 S2NW4SW4NW4 Location (site address) 22225 KNICK VISTA ST Current property owner(s) CATHY KINGREA Mailing address Real estate agent 2. TYPE OF DWELLING: Fx� Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Fx_1 Private Septic Ex -1 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 $ 412.50 COV I D-19 Waiver Fee $ Date of Payment �� '� �0�� Date of Payment Receipt Number. D 09 7y G Receipt Number COSA4 OSC201692 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MCA 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 Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. 6. DSD SIGNATURE Date 0. k qkS,�� H% v System #1 Approved for bedrooms CE 0145 System #2 Approved for bedrooms %r�•. Disapproved �_�� Conditional approval for bedrooms, with the following stipulations: "'"MM"! "! , By: V"' Original Certificate Date: 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 COSA Checklist Legal Description: T15N R1 W S4 S2NW4SW4NW4 Parcel ID: 051-042-07 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA Q Well log is filed with Onsite (or attached) Date drilled 1999 Total depth 61 ft Cased to 61 ft Q Sanitary seal is functioning correctly 01 Wires are properly protected Casing height (above ground)�IrSWI 18+ Date of flow test for COSA A . !�. I!{Static water level at beginning of testNA ft. Comments B. TANK DATA Age of tank(s) 7 years Tank type/material 5`11 VS,EE Measured operating fluid level in septic tank OF Standpipes/foundation cleanout per record drawing Date of pumping 11/25/20 D. ABSORPTION FIELD DATA Shallow Trench Which system tested (date installed) 1999 0 ALL standpipes present per record drawing Total measured depth from grade 5.5 ft (max) Measured depth to pipe invert from grade 4.5 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 Well production at time of test 6.5 gpm Water storage tank volume NA gallons WeH-dfsirifecfed-for coliform test? ❑ Yes ❑✓ No Coliform bacteria is e i �Itrate mg/L �j N e less than MRL (ND) Arsenic ug/L '® Ar nic less than MRL (ND) Collected by NGINEERING Date of Sample 1218/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 9/19/19 Results [DPass For 3 bedrooms Fluid depth prior to test 0 in Water added 600 gal New de th 0 in V Elapsed time 230 min Final fluid depth 0 in Absorption rate '600 gpd Any rejuvenation treatment (past 12 months) na 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' El Yes Community Sewer Manhole/Cleanout > 100' [✓ Yes if No ft M Yes if No ft Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line > 25' ED Yes if No ft Absorption Field on Lot > 100' dQ Yes if No ft Holding Tank > 100' Z✓ Yes if No ft Neighboring Absorption Fields > 100' F-11 Yes if No ft Water Main > 10' Animal Containment > 50' 0 Yes if No ft ❑✓ Yes if No ft (�✓ Yes if No ft Water Service Line > 10' F/� Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway comment below Community Sewer Main > 75' M,/Yes if No ft M✓ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' El Yes if No ft Surface Water > 100' Q Yes if No ft Property Line > 5' Q Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' [✓ Yes if No ft Private Wells > 100' F-11 Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' (�✓ Yes if No ft Water Service Line > 10' F/� 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' Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓Q Yes if No ft Private Wells > 100' ❑✓ Yes if No ft Water Service Line > 10' F✓ Yes if No ft Community Wells > 200' Q✓ Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that l 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. COSA Checklist yellow sheet Steven R� Pannone