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HomeMy WebLinkAboutCRESTWOOD LT 10A-1Onsite File Cr stwood Lot I OA 1 #'015�361�53 ot 11 #015-361-03 Cr¢$twood Lot 11 #015-361-03 Municipality of Anchorage Page I of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater D,~sposal System and/or Well Inspection Report Permit Number: _.~ L,~' 9 ~ O / ?.. / PID Number: Name: V,~ ~; V~II~ /~r~/ ~em 1~ Wastewater System: ~ New ~ Upgrade Address: ' ~oo ~r~ ~ ABSORPTION FIELD Phone: ~ 7~ -- ~ ~No, of~drooms: ~ Deep Trench D Shallow Trench ~ Bed ~ Mound ~ Other LEGAL DESCRIPTION so, Rating: Total Depth from original grade: I* ~ GPD/Sq. Ft. I Lot: Block: Subdivision: Depth to pipe b01lom from original g~ade: Gravel depth beneath pipe Ft. Township: ~ Range: ~ Section: Fill added above original grade; Gravel length: J Ft. Ft, WELL: ~ New ~ Upgrade Grave~width: Numberoflines: JDist8ncebetweeMines; Classification (Pr rate, A.B.C): Total Depth: Cased To: Total absorption area: Pipe material: ~ Driller:~l~ / ~/ FL / ~/ Ft. ;5--~ SQ, FL D- ~¢- Date Drilled' Stagc Water Level: Installer: ~ GPM Ft. - /.~ ~,. TANK SEPARATION DISTANCES ~ Septic ~ Holding D S.T.E.P. TO Sepllc Absorption Lifl Holding Public/Privale Manulacturer: Capacity in gallons: From Tan~ F~eld Slalion Tank Sewer Li .... ~ ~ ~ ~ Material: ~ Number of Compartments: We~ I ~ ' l~q~ - - ~5-/ ~1 Surface w~t.~ > ~oo' > I~* .... LIFT STATION Lot Line ~ ~ ~- ~ -- Size in gallons: ~ Manufacturer: Curtain Drain -- _ ~ Pump Make & Model [ Electrical Inspections performed by: Remarks: ~y~ ~([~ F~ BENCH MARK ~ ~ ~ ~ ~ , ~-- ~/~ Locagon and Description: J Assumed Elevation: ENGINEER'S SEAL Inspections performed by: ~{~h~ ~4 ~c, Dates: lst~/~/P¢ .~, .... Department of Health and Human Services approval ~,~r~, C~ , 3~8 Reviewed and approved by:' ~ ~ Date: ~-~¢-Oo ,~e~¢ ...... PERMIT NO: SW990i21 , PA.GE 20~/~ PID NO: 015-361-03 ,~ ,~'~ "~ · ,'~ ~ ~ ~:* T.H. 40' LONG SOIL BELO~J~ FROM: COR. "A" COR. ,,B,, TO; ~a ."F ~ ~TBM S.T.C.O. "D" 10' 34' -"~ DBL. C.O. "F" 35' 8' 38' TR. C.O. "G" 38' 33.5' 68' TR. M.T. "H" 45' 24' 45.5' TR. C.O. "1" 55' 28.5' 31' PLAN VIEW SCALE: ~" = 30' ~ 4., S01L " FROM " 3'+ SOIL COVER ,,,, ,, ,," INV. - ~93~ ' ,, aoq, 40 LONGSOLABS IR r · ,, ~ ,, BOTTOM TR. EXC. ELEV. 85.2' LOT 11, CRES~OOD SlD ;', SEPTIC SYSTEM INSTAL~TION AS-BUILT INSPECTION REPORT :: BOT. T.H. ~1 ELEV. 79.2' VIEW ,~ PROFILE ~o~ Tgc~[cAg sgEv[cgs SCALE: AS NOTED M.T. DRY NOT TO SCALE ~0 ~cuo s~ DRAW. BY T~B AHCHO~Gg, AgAS~ 995 ]6 NOVEMBER, 1999 1~1/23/1999 13:52 9872789155 ANDERSON ELECTRIC PAGE 81 Municipality of Anchor. age Department of Health and Human Serv,ces 82,5 "L' Street P.O. Box 196650 Anchorage. Alaska 99519-6650 Rick Mystrom I~p:/N~ww.ci.armhorage.ak.us Mayor Permit Number: #SW 990121 Date of Issue: 6-3-99 Date Started: 6-5-9D Date Completed: 6-5-99 Legal I~scriptiop; Property Owner Name & Addr~s: 'i]orehole Data:" $o[1 Type, '[hickness & Wate~ Sa'ara Stick-up S,It Silty gravel gravelly silt graval sandy silty gravel gravelly silt water sand and gravel Parcel Identification Number: 015-361-03 Is well located at approved permit location? ~ Yes [] No RECEIVED FEB 10 2000 Municipa ty of Anchorage Dept. Health & Human Serv cas Crestwood Lt 11 Vicki Verrnilfion-Barq/ Steinkruger 1341 Birchwood St Anchora, ge, Ak 99508 Depth (ft) From To 0 2 2 4 4 15 18 37 37 52 52 81 81 115 115 121 Method of Drilling [] air rotary [] cable tool Casing type: ste. el Wall Thick,ess: 025 inches Diametm-: _6 inches Depth: 121 Liner Type: Dimncter: __ inches Depth: feet Casing stickup above ground: _2 feet Static water level (fi:om ground levcO: ~_.~_9 feet Pumping level: 120 feet after _2 hours pulnping 20 glm~ Recovery Rate: 20 gpm Method of T~ting: airiift Well Intake Opening Type: [] Open End [] Open Hole [] Screened Start __ feel Stopped __ [] Perforations Start __ feet Stopped feet Grout Type: _bentonite g8 Volume: 1 Depth: Start_0 fe~t Stopped Pump: Intake Depth _x fe~t Pump size __ hp Brand Name Well Disinfected Upon Completion? [~ Yes [] No Method of Disinfection: chloro~ Conlmentsl Well Driller: Alpine Drilling & Enterprises P.O. Box 110496 Anchorage, Ak 995~ 1 AK 0 log to the property owns' wi~i~s of completion and the property MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: _______________ Date of Issue: ____-____-____ Parcel Identification Number: ____-____-____ Legal Description Block Lot Property Owner Name & Address: Pump Installation Date: _____-_____-_____ Pump Intake Depth Below Top of Well Casing: __________ feet Pump Manufacturer’s Name: ___________________________ Pump Model: _____________________________________ Pump Size: ____________hp Pitless Adapter Burial Depth: _________ feet Pitless Adapter Manufacturer’s Name: _________________________ Pitless Adapter Installer: ____________________________ Well Disinfected Upon Completion?;;<HV No Method of Disinfection: _____________________________ Comments: Pump Installer Name: __________________________________ Company: ___________________________________________ Mailing Address: ______________________________________ City: ___________________ State: __________Zip: _________ Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. 015 361 53 CRESTWOOD 10A-1 STEINKRUGER BARRY J & VERMILLION VICKI L 5900 BARRY AVE ANCHORAGE, AK 99507-6672 06 21 2023 100 A.Y. MCDONALD 23075K3LB .75 15 MARTINSON PELLETS ANCHORAGE WELL & PUMP SERVICE 7640 KING STREET ANCHORAGE AK 99518 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Sfte Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (9O7) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Date Issued: Jun 03, 1999 Expiration Date: Jun 02, 2000 Permit Number: SW99012'1 Legal Description: CRESTWOOD LT 11 Design Engineer: 0019 Flattop Technical Services Owner Name: Vicki Vermillion/Barry Steinkruger Owner Address: 1341 Bimhwood Street Anchorage, AK 99508- ParcellD: 015-361-03 Site Address: 005900 BARRY AVE Lot Size: 45600 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 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. C~& EN~ON~NT~ENG~EER~G , ENERGYCONSERVA~ON.& ~YS~ ~ODORE F. MOORE, P.E. PH: (907) 345-1355 14S30 ECHO ST. ~CHORAGE, ~KA 99516 May 20, 1999 M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: The purpose of this letter is to provide the required design narrative in support of our application for a permit to construct wastewater disposal facilities on Lot 11 of Crestwood S/D, located at 5950 Barry, Avenue. Soils logs, perc test results, a site plan, design drawings and specifications are enclosed for your review. The proposed system will be constructed in the vicinity of test hole # 1. As can be seen from the soil log, the native material between 4.5 and 18 feet below ground level is a sandy gravel to a gravelly sand with a measured perc rate of 1 minute per inch. Using the soil application rate of 1.2 gpd/sq, ft. specified in the wastewater ordinance, this proposed 4-bedroom residence requires a total absorption area of(4 x 150)/1.2 = 500 square feet. The proposed 36-foot long trench design with an effective gravel depth of 7 feet has a total absorption area of 504 square feet. ' ' The topography of the lot in the area of the proposed construction slopes down towards the NNW at. approximately 5 - 10%. A site for a replacement trench is designated on the site plan between test holes #1 and #2. The proposed project will have no significant impact on present or future water supply and wastewater disposal systems serving adjacent properties, nor will it have any significant impact on reserved space-surface and subsurface, or on drainage. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, Ted Moore, P.E. LOT 7 LOT 6 (VACAN]-) __ ~2 ~BA~RRYA' ENUE KND ~T.H. #98-3 KND T.H. #98-4 PROPOSED 36' LONG LOT 10A SOIL ABS. TRENCH ', T.H (VACANT) W. 7' SEWER GRAVEL BELOW DIST. PIPE SITE FOR SIMI~R ~ _ ~ REP~CEMENT TR. LOT ~', ~VE~LL PROPOSED . . . __ C- WELL SITE LOT 12 PROPOSED 1250 GAL. SEPTIC TANK KND PROP. WELL LOT 11 CRESI'WOOD S/D ~¢ SEPTIC SYSTEM EXISTING SEPTIC SYSTEM ' ~700 EXISTING WELLS LOT 4, LODGEPOLE LOT 11, CRESTWOOD SUBDIVISION PROPOSED WELL AND SEPTIC SYSTEM SITE PLAN FLATTOP TECHNICAL SERVICES 1 14530 ECHO STREET ANCHORAGE, ALASKA 99516 NOTE: THIS IS NOTASURVEYED PLAT, ALL LOCATIONS SHOWN ARE APPROXIMATE. 1 iNCH =50 FEET DRAWN BY TFM MAY, 1999 ~ "A" 4" DIA. F-810 MT-- ~ ] / PERF. PIPE " CONSTRUCT 30' LONG SOIL ABSORPTION TRENCH / WITH 7.5' GRAVEL BE~EEN ,' D~A. ~-303~ / NON-PERF.~,PE I~ I ~ ~NSTALL~2S0~AL. WASTE LINE FROM HOUSE PLAN VIEW SCALE: J" = 10' CLEANOUT MONITOR TUBE LL 1 FOOT FABRIC 4" DIA. F-810 PERF. PIPE 1/2"- 2 1/2" SEWER GRAVEL BOTTOM OF EXCAVATION SECTION "A - A" SCALE: 1" = 5' LOT 11, CRESTWOOD SEPTIC SYSTEM DESIGN PLAN AND CROSS-SECTION FLATTOP TECHNICAL SERVICES I SCALE: AS SHOWN 14530 ECHO STREET I DRAWN BY: TFM ANCHORAGE, AK, 99516 MAY, 1999 Flattop Technical Services 14530 Echo Street, Anchorage, AK 99516 Phone (907) 345-1355 Lot 11, Crestwood S/D 5950 Barry Avenue Wastewater disposal system installation Specifications 1.0 General: 1.1 The scope of the project consists of installing a 1250 gallon septic tank and constructing a 36- foot long soil absorption trench containing a total of 7.5 feet of sewer gravel. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform to Municipal and State requirements. All separation distances shall be in conformance with Municipal requirements, unless specifically waived. 1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. 1.4 The contractor shall provide adequate cover material and rough grading over all system components to ensure that proper drainage is achieved after settlement and that there are no residual depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas. 1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the constmction. 2.0 Septic Tank: 2.1 The new 1250 gallon, 2 compartment septic tank shall be Municipally approved and shall be set level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover and a 4" cleanout. If the tank is buried less than 4 feet, it shall be insulated with 2 inches of approved burial type, rigid insulation. 2.2 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The waste line from the residence to the septic tank shall have a minimum slope of 1/4"' per foot, and the waste line between the tank and the soil absorption system shall have a minimum slope of 1/8" per foot. A cleanout shall be installed between 1 and 4 feet from the building foundation, and a double cleanout shall be installed within 5 feet downstream of the septic tank. 3.0 Soil absorption system: 3.1 The soil absorption system shall be constructed by excavating a 36-foot long trench to a depth of 12 feet below the original ground surface. The long axis of the trench shall be parallel with a natural contour of the land. 3.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked to allow proper infiltration. 3.3 A total of 7.5 feet of approved sewer gravel shall be placed in the bottom of the excavation with the perforated distribution pipes laid level such that the pipe inverts are no less than 7 feet above the bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing the #200 sieve. 3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on the design drawings. The portion of the monitor tube extending through the sewer gravel shall be perforated. 3.5 Approved filter fabric shall be placed over the entire top surface of the sewer gravel. A minimum of 2 feet of soil cover is to be placed over the filter fabric. If the soil cover thickness is less than 3 feet, two inches of rigid, burial type insulation is to be placed over the entire top surface of the gravel, in addition to the filter fabric. 3.6 The top surface of the cover material shall be raised a minimum of 12 inches higher than the surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill slopes shall be no steeper than 3:1. 3.7 Unless specifically agreed otherwise the homeowner shall be responsible for arranging to have the site finish graded after the backfill material has stabilized, and for placement of adequate topsoil and seed to promote rapid revegetation of all areas disturbed by the construction. 4.0 Inspections: 4.1 A minimum of 4 engineering inspections will be required during the course of the project: (1) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the native material has been excavated to expose the infiltrative surface to ensure that it is level and at the right elevation, and conforms with the soil test information, (3) after the sewer gravel is in place and the distribution pipes have been laid and connected up to the septic tank, but prior to placement of insulation or filter fabric, and (4) after rough backfill and grading is complete. The septic tank requires one inspection after it is set level and the piping connected, but prior to backfill. This inspection may be incorporated with any of the above inspections. 4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. iTEST HOLE LEGAL DESCRIPTION: DATEPERFORMED: PERFORMED FOR: DEPTH (fed) 1 3 FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 SOILS LOG -- PERCOLATION TEST Lot 11, Crestwood S/D June 8, 1998 VickJe Vermillion Pt. SM Reddishsandyloam SM Gray, very silb/ sand GP/SP Slightly silty sandy gravel Rounded pebbles Lenses of ML & SP extend to 6' Material sandier between 8' & 12' with more stable sidewalls Sidewalls unstable below 11' with much sloughing SLOPE Depth to Groundwater Date No Groundwater 6/8/98 Monitor tube dry 6/18/98 SITE PLAN BARRY AVENUE #3 Becomes cleaner SP, bottom two feet Date Reading Clock Net Time Percometer Net Drop Time (minutes) Reading (inches) 6/8 12" Presoak 27 3/8 Add water & start 9:52 23 7/8 #1 9:54 2 21 1/2 2 3/8 Add water 9:54:20 23 3/8 #2 9:56:20 2 21 1/8 2 1/4 Add water 9:58;30 23 3/8 #3 9:58:30 2 21 1/8 2 1/4 Add water 9:58:40 23 112 ~ 10:00:40 2 21 3/16 2 5/16 PERCOLATION RATE 1 (minutes/inch) PERC HOLE DIAMETER 6" TEST RUN BETWEEN 8.0 FT AND 8.5 Fl' COMMENTS: __Recommend sizing trench on basis of 1.2 gpd/sq, ft. PERFORMED BY FLA3q'OPTECHNICALSERVICES. I ~'-~ ~ ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THiS DATE. CERTIFY THAT THIS TEST WAS PERFORMED IN TEST HOLE LEGAL DESCRIPTION: Lot 11, DATE PERFORMED: June 8, 1998 PERFORMED FOR: DEPTH Pt. (feet) FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 SOILS LOG -- PERCOLATION TEST Crestwood S/D Vickie Vermillion SM Reddish sandy loam GP Clean, black, sandy gravel Small, rounded pebbles SM Light gray, gravelly, silty sand GP/GM Dark gray Somewhat silty Sandy gravel Rounded, many cobbles & bldrs. SLOPE Depth to Groundwater Date No Groundwater 6/8/98 Monitor tube dr~ 6/18/98 ~,'~, ~_-~,.-y .~-13/9 SITE pLAN BARRY AVENUE #3 Clock Net Time Percometer Net Drop Date Reading Time (minutes) Reading (inches) PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FTAND FT COMMENTS: Test hole dug to assess continuity of soils in T.H. #1. No perc test done, but should perc comparably to T.H. #1. Material less desirable than that encountered in T.H. #1, because less sandy. PERFORMED BY FLAq-FOPTECHNICALSERVICES. I .~'-~? ~ ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: MUNICIPALITY OF ANCHORAGE a , Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-361-53-000 Legal description CRESTWOOD LT 10A-1 Expiration Date: 10/14/2023 Site address 5900 BARRY AVE Anchorage AK 99507 Current property owner(s) STEINKRUGER BARRY J &VERMILLION VICKI L X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 7/14/2023 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory x Arsenic Advisory Other COSA ApprovdJune 2022 �UM, 0 C � P A L � T Y OF H1 C 0l ;E Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax. 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel 1. D. 015-361-53 Complete legal description Crestwood Lot 10A-1 Location (site address) 5900 Barry Avenue Current property owner(s) Barry J. Steinkruger & Vicki L. Vermillion 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: ❑i Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ❑O Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑■ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 24 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑O Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ Waiver Fee $ Date of Payment COV Date of Payment COSA # ffc Z � / 2 Waiver # COSA Applicalionjune 2022 COSA Checklist Legal Description: Crestwood Lot 1OA-1 Parcel ID: 015-361-53 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 06/05/1999 Total depth 121 ft Cased to 121 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA 05/04/2023 Static water level at beginning of test 42.8 ft. Comments B. TANK DATA Measured operating fluid level in septic tank 49" Date of pumping 09/22/22 ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 08/04/1999 ❑ ALL standpipes present per record drawing Total measured depth from grade 14.87"` ft (max) Measured depth to pipe invert from grade 5.04 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) No If yes, enter date Well production at time of test 6.2 gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 3.35 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by PES Date 06/13/2023 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 05/04/2023 Results ❑ Pass Fluid depth prior to test 0 in Water added 600 gal New fluid depth 0 in Elapsed time 100 min Final fluid depth 0 in Absorption rate 600 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 85.2 in Effective depth used 0 in Effective depth remaining 85.2 in Comm ents/Deficiencies:*Garden Bed addition over drain field monitor tube —2.8' tall COSA Checklist June 2022 From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No 5.0#* Community Sewer Manhole/Cleanout > 100' Yes if No ft ❑ Yes if No Neighboring Tank > 100' ❑ Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' ❑ Yes if No Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ❑ Yes if No ❑ Yes if No ft ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Q Yes if No ft ❑ Yes if No ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No 5.0#* ft Surface Water >100' _ ❑Yes if No_ Tank to Property Line > 5' no Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' ❑ Yes if No ft Private Wells > 100' 0 Yes if No Water Main > 10' no Yes if No ft Community Wells >•200' ❑ Yes if No _ Water Service Line > 10' M Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS **SYSTEM INSTALLED UNDER 1999 CODE ft ft ft ft ft ft ft ft G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Pannone Engineering Services Engineer's Printed Name Steven R Pannone P.E., F. ASCE COSA Checklist -June 2022 Phone 907-745-8200 Date «t ,en R. Fannore j 0 rq BARRY AVENUE I� 0 n S89'48'41 "E 251.91'(M) S89'58'27"E 252.47'(R) GRAVEL DRIVEWAY LOT 10A-1 75,581 S.F. 1.74 AC. 10'X30' TELECOMMUNICATION & ELECTRIC EASEMENT (R) WOOD DECK =r 2 -STORY P DWELLING s 94.6' 10' UTILITY EASEMENT 8.0' 10'X30' TELECOMMUNICATION & Lr 2.0 ELECTRIC EASEMENT (R) — — — — --I— I---- ----------- N89'58'44"W 252.44' (M) LOT L LOT o N89'56'53"W 252.50' (R) 3 4 J NOTES 1. EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HEREON. q�gsrll ��`••'•••• •� 1 � r r l•WERNER •MACEDO • • •o t % NO. 141895 •.' ,ry, / it �F9'•, Jun. 21, 2023•,• l�\� 90FESSIONAL vw I HEREBY CERTIFY THAT AN ACCURATE SURVEY OF THE FOLLOWING DESCRIBED PROPERTY; LOT 1OA-1 CRESTWOOD SUBDIVISION WAS MADE ON 06/09/2023 AND THAT THIS PLAT REPRESENTS A SURVEY MADE BY ME OR UNDER MY DIRECT SUPERVISION, AND THAT ALL DIMENSIONAL AND OTHER DETAILS ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. 25 0 50 GRAPHIC SCALE 1"=50' LEGEND ® FOUND 1-1/2" AC O rj Q FOUND PLASTIC CAP Qw LOT 0 SEPTIC TUBE o 12 4.5' GAS METER ,L ELECTRIC METER _ © Lf) M pr) UTILITY POST O RECORD PLAT N M (M) MEASURED 3 w ALUMINUM CAP COMM cV N —o/HU— OVERHEAD UTILITY C O /28.4' O 0 4 p O N w Z Z 94.6' 10' UTILITY EASEMENT 8.0' 10'X30' TELECOMMUNICATION & Lr 2.0 ELECTRIC EASEMENT (R) — — — — --I— I---- ----------- N89'58'44"W 252.44' (M) LOT L LOT o N89'56'53"W 252.50' (R) 3 4 J NOTES 1. EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HEREON. q�gsrll ��`••'•••• •� 1 � r r l•WERNER •MACEDO • • •o t % NO. 141895 •.' ,ry, / it �F9'•, Jun. 21, 2023•,• l�\� 90FESSIONAL vw I HEREBY CERTIFY THAT AN ACCURATE SURVEY OF THE FOLLOWING DESCRIBED PROPERTY; LOT 1OA-1 CRESTWOOD SUBDIVISION WAS MADE ON 06/09/2023 AND THAT THIS PLAT REPRESENTS A SURVEY MADE BY ME OR UNDER MY DIRECT SUPERVISION, AND THAT ALL DIMENSIONAL AND OTHER DETAILS ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. 25 0 50 GRAPHIC SCALE 1"=50' LEGEND ® FOUND 1-1/2" AC 00 FOUND REBAR Q FOUND PLASTIC CAP Qw WELL 0 SEPTIC TUBE o DRAIN 8 GAS METER ,L ELECTRIC METER _ © COMM PEDESTAL UTILITY POST (R) RECORD PLAT (2008-54) (M) MEASURED AC ALUMINUM CAP COMM COMMUNICATION —o/HU— OVERHEAD UTILITY THIS DRAWING REPRESENTS A MORTGAGE LOCATION SURVEY PREPARED IN ACCORDANCE WITH THE ASPLS MORTGAGE LOCATION SURVEY STANDARDS. THIS MORTGAGE LOCATION (AS -BUILT) SURVEY IS A REPRESENTATION OF THE CONDITIONS THAT WERE FOUND AT THE TIME THE LOCATION SURVEY WAS PERFORMED AND DOES NOT CONSTITUTE A BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THAT A SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE INFORMATION CONTAINED HEREON SHALL NOT BE USED TO ESTABLISH ANY FENCE, STRUCTURE, OR OTHER IMPROVEMENTS UNLESS GROSS NEGLIGENCE IS DISCOVERED, THE LIABILITY EXTENT OF THE PREPARER SHALL BE LIMITED TO THE AMOUNT OF FEES COLLECTED FOR SERVICES IN PREPARATION OF THIS PRODUCT. / b gineers veyors 101 W. FIREWEED LN. #201 ANCHORAGE, AK 99503 (907)274-5257 CoA No. AECC582 LOT 10A-1 CRESTWOOD SUBDIVISION AS -BUILT SURVEY PREPARED FOR: VICKI VERMILLION DRAWN BY: WEM FIELD BOOK: CHECKED BY: BJR FRBA23-01 JOB NO.: 2023-2945 MOA GRID: SW 2438 1 " = 50' DATE: 06/21/2023 M UN%CIPAU Y OF ANCHORAGE HORAGE DEVELOPMENT SERVICES DEPARTMENT o„M1( On -Site Water and Wastewater Section www.muni.org/onsite Septic Tank Advisory Certificate of On -Site Systems Approval # OSC231220 Subdivision: Crestwood Block: , Lot: 10A-1 907-343-7904 Fax: 343-7997 The septic tank for this property is 24 years old. The average life of an asphalt coated steel septic tank is 20 years. Typical replacement costs are $10,000 or more, not including engineering, surveying or MOA permitting fees. 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 30 year old steel tank MAY look like. Municipality of Anchorage Department of Health and Human Services Division of Emironrnental Services On-Site Services Section 825 "L" Street Reom 502 P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak.us (907) 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 1, GENERAL INFORMATION Complete legal description ,L,o Expiration Date: Location (site address or directions) Current Properly owner(s) ~, ~ ~,' Mailing address Lending agency 1~ Mailing address Real Estate Agent ~o¢ ~ Day phone Mailing Address Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [] [] Individual Holding Tank [] [] Community On-site [] [] Public Sewer [] The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) on properties served by a single family on-site wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners. Certificates of Health Authority 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 sample results less than 30 days old. Cedificates 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. 72 025 ;Rev 01 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 Health Authority Approval Guidelines for the Health Authority Approval application show 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 fudher 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 applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ~/~/~,/¢ ~ c.~,,'~' ~ / Address 1 ~/~' ,'~o /'"'---~P,o ~/, ~ c~ o ~, Engineer's Printed Name ~4 ~o ~o~z ~ ~oo ~e DHHS SIGNATURE / Approved for ~ bedrooms. Disapproved, Conditional approval for Phone "~ Date __~-~ bedrooms, with the following stipulations. Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other Expiration Date: / /- ',-~' - o ? Original Certificate Date: Reissue Date: Legal Description: L.~,~ A. WELL DATA Well type 12u/' Date completed ~'/~¢ / _¢? Total depth / ?- / ft Date of test Static water level Municipality of Anchorage 6' Department of Health and Human Services Division of Environmental Services On-Site Services Section 825 "L" Street Room P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak.us (907) 343-4744 HEALTH AUTHORITY APPROVAL CHECKLIST MUNICIPALITY OF ANCHORAGE .... ~kIMEh!TAL SERVICES Parcel I.D.: If A, B, or C provide PWSID # __ Well Log Sanitary seal Y Wires properly protected Cased to ! '~/ ft Casing height (above ground) ~ in. FROM WELL LOG AT INSPECTION ~1~'17~ NI'~ (' I~ ~.~"~ y~ Well production 8¢2 WATER SAMPLE RESI~LTS: Coliform ¢ colonies/100 mi Date of sample: 7/ B. SEPTIC/HOLDING TANK DATA g.p.m g.p.m Nitrate '~. 8J mg/I Other bacteria Nc~ colonieS/100 mi Collected by: /~ Io/./~/¢ 7-~¢A .('~'c. TankType/Material ~'e~';-~ /£/-~ ( Date installed ,~/"/I 9c) Tank size Cleanouts '¢ Foundation cleanout Date of pumping N; ~', ~,, z...,-¢ gal Number of Compartments Depression over tank ~/ High water alarm Pumper ~'. C. ABSORPTION FIELD DATA Date installed. ~¢'/'/! ¢~ Length ~/¢ ft Width "Z. ~ ft Gravel below pipe -7. / Total depth I~.~ ft Effective absorption areaS'~',¢ ft2 Monitoring tube Date of adequacy test ~/, ,~. ('N~,-.,) Results (Pass/Fail) Soil rating (g.p.d./ft2 or ft2/bdrm) ~System type ft Fluid depth in absorption field before test ¢ in Water added__ Elapsed Time: min Final fluid depth in Any rejuvenation treatment (past 12 mo.) (Y/N & type) /~' t' Depression over field M For ~ bedrooms gal. New depth___ in. Absorption rate >= d'o~ g.p.d. If yes, give date M.,4. 72-026 (Rev. 01/00)* D. LIFT STATION Date installed "Pump on" level at in Datum E. SEPARATION DISTANCES Size in gallons __ "Pump off" level at__ Cycles tested in Manhole/Access High water alarm level at __ in Meets alarm & circuit requirements SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot J 3~2 ' Absorption field on lot I ~' '~ ' Public sewer main ~/, A,, Sewer/septic service line On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Water main _~ I,¢, Drainage ~ Property line ,..¢ ~, ' Absorption field Water service line '~ ~¢' ' Surface water Wells on adjacent lots ~> /~,o, SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line NS-' Building foundation '8 8' Water main Water Service line ;> ~¢ ~ Curtain drain ,t,',¢,,~ ~-,¢..,n COMMENTS Surface water > I~-',¢" Driveway, parking/vehicle storage Wells on adjacent lots G. ENGINEER S CERTIFICATION ,, ,,,., ,~ . ~,~ ; L I cerhfy that I have determined through field ~nspechons and ~.~:~ ¢ ~, ,.~., .. ?~,.,- o,~'~r~NEER,S reviewof Municipal records thatthe above systems arein ~¢~?;~,o?:::~!;~i¢,~: 5 ~ conformance with MOA HAA guidelines in effect on this date~}' ~/~,~ ~" ~°~L~AMP Engineers Printed Name ~h ~ ~: .~ , ;. :.. . t~' f . .~, ,~¢'~ ~ ~-~"¢ ,. HAA Fee $ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72;026(Rev. 01/00)*