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HomeMy WebLinkAboutL & T LT 2L & T Lot 2 #051-282-41 Municipality of Anchorage Development Services Department r Building Safety Division On -Site Water and Wastewater Program, 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 Page of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SWO90015 PID Number: 051-282-41 Name: BONNIE KING Wastewater System: ❑ New ✓❑ Upgrade Address: PO BOX 670089 CHUGIAK, AK 99567 ABSORPTION FIELD Phone: Number of Bedrooms: 244-7176 3 ❑Deep Trench I� Shallow Trench El Bed ❑Mound El Other: LEGAL DESCRIPTION Soil Rating: 16.0 Total Depth from original grade: 1.2 GPD/Ftz 10 Ft. Block: Lot:2 Subdivision: L&T Depth to pipe bottom from original grade: Gravel depth beneath pipe: Ft. 4.0 Ft. Township: Range: Section: Fill added above original grade: Gravel Length: 0.6-1.1 Ft. 38 Ft. Well: ❑ New ❑ Upgrade Gravel width: Number of lines: Distance between lines: 5 Ft. 1 -------------- FL Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material: EXISTING PRIVATE Ft 380 Ft' ASTM D3034/1`810 Driller. fate ed: Static Water Level: Installer: Date Installed: Ft. TWEED EXCAVATING 2/18/2009 Yield: Pump Set at: �CdSRtg kleQ t �Ground: TANK- GPM Ft. SEPARATION DISTANCES p Septic ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption Lift Holding ublic/Private Manufacturer: Capacity: From Tank Field Station Tank Sewer Line PREMIER PLASTICS 1000 Gal. Material: Number of Compartments: Well 103' 122' ------------ ------------- 7' HDPE 2 Surface Water 1001+ 100'+ ------------- ------------- LIFT STATION Size: Manufacturer. Lot Line 52' 36' ------------ ------------- al. Pump on" level at: I High water alarm at: Foundation 71' 89' ------------- ------------ i . Curtain Drain ------------- NONE KNOWN - ---------- V Pump Make & M Electrical Inspections performed by: Remarks: EXISTING SEPTIC WAS ABANDONED COMPLETELY. BENCH MARK Location and Description: LINE FROM HOUSE TO TANK COVERED WITH 2" BOTTOM BRACKET OF CONDUIT ON POWER POLE Assumed Elevation: DIRECT BURIAL INSULATION. 100 Ft. SW Engineering Engineer's Stamp Inspections performed by: 15MI S. Birchwood Lp. Rd. Dates: 1St 2/17/2009 u d Alaska 99567 .�," A�_.. t._ � 1 � /. 2nd 2/18/2009 yy000es0a a 4 � ih Development Services Department Approval `r' ,� �''_° � `®'T_ E -" Conditional Approval ;", Q7 ti pP Date: r,�nte n�auB©EG2-0a(ia90y A. Ettara.t; Reviewed J a`1 ©j �' C V `� and approved by: o Date: o� (Rev. 04/06):-,. �'';�;,=�'" �,�• ����, �• t)+`i:J J cAsn PERMIT NO. SWO90015 PACE 2 OF Municipality of Anchoraqe DEVELOPMENT SERVICES DEPARTMENT - BUILDING SAFETY DIVISION ON-SITE WATER AND WASTEWATER PROGRAM, 4700 BRAGAW STREET P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone (907) 343-7904 • www.ci.arnchorage.ak.us ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 2, L & T S/D P.I.D. NO. 051-282-4 PIONEER DRIVE SERVATION EASEMENT` `' ' POWER POLE & ELECTRIC — — — — — — — EASEMENT — — TBM — — NEW TRENCH — — — — — — — — — — — — MT1 — — — — — _ — — .'�CO1MT2 CO2 . • TMT S -DBL1 & DBL2 ST NEW 1000 GALLON NOPE SEPTIC TANK C :. SHED EXISTING HOUSE LOCATION OF OF ABANDONED B CESSPOOL LAOO OGU \ 000 FCO SEPTIC AREA 1 00, i W AppROXE(� �4p ftis 0 1. - ,a' F< Rq OiUs , GIN ENC d1P •: .� OF q� a• • �• Yew •I• 1 t V •Mr �MM•Mwy}• 1 A. Lb;dw jToo PERMIT NO. SWO9001 5 PACE 3 OF 4 Municipality of Anchorage DEVELOPMENT SERVICES DEPARTMENT - BUILDING SAFETY DIVISION ON-SITE WATER AND WASTEWATER PROGRAM, 4700 BRAGAW STREET P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone (907) 343-7904 • www.ci.anchorage.ak.us ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LECAL LOT 2, L & T S/D P.I.D. NO. 051-282-41 ------------------------------------ _. 15' B.L.M. RESERVATION CASEMENT `\ ; \ _—__._____- ___--_—_—_—_-- \\ PIONEER DRIVE 20' B.L.Y. RESERVATION EASEMENT .•POWER ROLE -----------------TB-Y------ -- - - -- ----- - - - - - - - - - - - - - - - - -- _ 30' 1[ f LCCERIC EASEMENT MLI TRLNCN Yil OI YTI CO2 TYI T DELI t OBL] ////// ST NEW 1000 GALLON / NOPE SEPTIC0000 LTANK LON / Jy !a 4� SHED EXISTING p NOUSC -\_+LOCATION Of / ♦O CEESSPSSPOOL L m� sooSEPTICEXISTING 1 EEO AREA / N "OUSE !00' �$c � EWj11 SEPTIC EANR a APP O}pal IPo / h LOT I ..plus LOT 3 / i47 / 4— e��Q SCA eC R. ulp V� o•,o.. .;7 •ti9 tt J.. r .,.. •• Rn A. Shaw •y d 0 PERMIT NO. SWO90015 PACE 4 OF 4 Municipality of Anchorage DEVELOPMENT SERVICES DEPARTMENT - BUILDING SAFETY DIVISION ON-SITE WATER AND WASTEWATER PROGRAM, 4700 BRAGAW STREET P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone (907) 343-7904 • www.ci.onchorage.ak.us ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 2, L & T S/D P.I.D. No. 051-282-41 1 ST2 .,- 98.9' FINAL GRADE NEW 94.0' 1000 GALLON POLYETHYLENE SEPTIC TANK ORIGINAL GRADE 99.4 MT2 = 89.4 OhF5tl FROM HOUSE 2" INSULATION 95.1' 93.7' CO1 CO2 hiTI CO, = 100.5' CO2 = 100.0' FINAL GRADE C01 = 93.4' SR CO2 = 93.5' MT1 = 89.5' NO WATER FOUND 82.9' B.O.H. N. T. S. A B FCO 15.0 - '6.0 ST1 113.5 92.5 38.0 ST2 117.0 95.0 41.5 TMT 119.0 96.0 43.5 DBL1 119.0 97.0 43.5 DBL2 120.0 98.0 44.5 C01 - 103.5 58.0 MT1 - 107.5 62.0 CO2 133.0 - 60.5 MT2 1 135.0 - 62.0 OhF5tl FROM HOUSE 2" INSULATION 95.1' 93.7' CO1 CO2 hiTI CO, = 100.5' CO2 = 100.0' FINAL GRADE C01 = 93.4' SR CO2 = 93.5' MT1 = 89.5' NO WATER FOUND 82.9' B.O.H. N. T. S. MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade 2'/7• �Y E 2:3a Date Issued: Feb 12, 2009 Expiration Date: Feb 12, 2010 Permit Number: SW090015 Parcel ID: 051-282.41 Legal Description: LST LT 2 Design Engineer: 0003 S & S ENGINEERING Site Address: 18234 Pioneer Drive Owner Name: Bonnie King Lot Size: 0 SO. FT. Owner Address: 18234 Pioneer Drive Total Bedrooms: 3 Permit Bedrooms: 3 Chugiak , A 99567 - This permit is for the construction of: ❑✓ Disposal Field ❑? Septic Tank ❑ 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 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 WELL MUST BE APPROVED BY THE ON-SITE DEPARTMENT BEFORE A COSA IS ISSUED. -�/-71�t lJrel e c..✓sc .� �v-f'�...7���ru�.r,.-�-i��✓le 7`✓c..�.L w.l�� Received By: Issued By: Date: Date: Z /Z Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 05S I — a W - Property owner(s) L A0A?,V1C f'114,;re Mailing address Site address I $a 3N f IOjomi2 Legal description (Sub'd., Block & Lot) 1-4 D. L -t T!5 Legal description (Township, Range & Section) Lot Size L{ q -(-{ b L{ Sq. Ft. Number of Bedrooms THIS APPLICATION IS FOR (® all that apply): Absorption Field Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ I certify that the above Single Family Dwelling (Signature of Permit/Rush Fees: Date of Payment: Receipt Number. (Rev. 11105) phone a4q--71 71,, Code Code THIS APPLICATION IS AN: Initial ❑ Upgrade Renewal ❑ in is correct. I f rther certify that this application is being made for a accordance wA applicable Municipal Codes. Waiver Fees: Date of Payment: Receipt Number: ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CML ENGINEERS (907)694-2979 FAX(907)694-1211 PE C0W:0N TEST Enclosure STHOCTUrJ & MECHANCLL R:.III PECi:OIL` ONSITE WACMVW.En OurXAL5Y5TEM DES.au 15861 S. Birchwood loop Road — Chugiak, Alaska 99567 November 14, 2008 HCMHAnHORTY MIYIOVALS MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 EM NEXTC OW Anchorage, AK 99519 REFERENCE: Lot 2, L&T Subdivision SEWEaa WATCR WSPECTIM It is requested that you issue a permit to install a new septic system to scree the existing three bedroom house on the referenced property. The existing system has no documentation that can be found. ENGNECH'N3Stt1D:E5 MD REromS A 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 (11/6/2008) was not found. After seven days of monitoring, no ground water was found. WEU INSPECTIONwater S FlAW TEST 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 S:TE PIANS properties. If you require additional information, please contact us. ROADDESIGN SinceSO:I TEsr Z. PE C0W:0N TEST Enclosure STHOCTUrJ & MECHANCLL R:.III PECi:OIL` ONSITE WACMVW.En OurXAL5Y5TEM DES.au 15861 S. Birchwood loop Road — Chugiak, Alaska 99567 SITE—PLAN I DESIGN I 1" = 40' 7u At r r -----_—_---_ Cb b b D� rn� ►-3 Fl�l CAD 5 1+ 5 M UIOW� '•N o—co \ N O r- I C mM 00 Q Z6 nm W N A I Is n H( `=Rg nw � A-0 _� f+',.• X80 I rn 5 cn O I m D C I I I N I I� k �I. I I Izn yN _ •: I: i m zyX 00 Q I I 1 01 N 11 Ct m 10I I `? I m S r�> In a I AI yao O z k • "1 I I D o^ µ µ I rI m -z. Oc I yI 2y o c ISI .'. m . 11+ SnOH 4 _ .. ..�. ,. CNts y OI 10 ; ► y y nonnn Ft y I µ W y y OI I O mx0 R -OZ y: I ^^� cmr " of I co >xm o c 0y voo S m 0 I I �o hC rz� Ayz µ mDm .mm cIF� Nzz yro --ns zm oo I S C=2 O �_ r zAD i z M I I m C R ox yy l y + ow m ,moo c I I >oL< JC f O2 1 1 D� rn� ►-3 Fl�l CAD 5 1+ 5 M N r UIOW� '•N o—co \ N O r- 00 Q W N A I Is n H( `=Rg nw Ar A-0 _� f+',.• X80 rn 5 cn O D C N I I� k I Izn = n _ I P, N r UIOW� f o—co \ N O 00 Q W N A Cn L O O CA O O XD rn 5 cn O D C N k N O O co Q N SITE -PLAN I DESIGN I 1" = 60' --------------------------------- SHIMS STREET 20' 9.LN. RESE"ATON E•iEUENT 1 I I I I I I I I I N � w OM yr) fie^ \ o „ \ W ^o tyt4tN \`` TAV ^ZZP 1 D1 o -V V-VAZ rnj4 �Ib tivp +b 9 E•3 IX II II I I I Y j N 0 V � S : .. .. •� I 0 Eb I I I . I I N I 0 I SS. � •o�t N I to n .'�� •• • •� eE I wT' vz, [cam c, n si- I �I I I ' lil N C [ ��I 4 s Ai "fig I [[ I I fie^ \ o „ \ W ^o tyt4tN \`` TAV ^ZZP 1 D1 o -V V-VAZ rnj4 �Ib tivp +b 9 E•3 IX II II I I I Y j N 0 V � S : .. .. •� I 0 Eb I I I . I I N I 0 I SS. � •o�t N I to C � I I zbN^ iRo "�• r V � S : .. .. •� `\ I I �^ ^off �� •a � A � 1I n .'�� •• • •� eE vz, [cam c, n si- Municipality of Anchorage l Gross Tlmo — Development Services Department Depth to Water ,cj Building Safely DMslon On-Sile Water and Wastewater Program 4700 South Biagaw SI. / —� P.O. Box 196650 Anchorage. AK 99519.6650 F www.muni.orglonsilo 5 (907)343.7904 �D Soils Log - Percolation Test o 1 Perlormed Foe Date Pei ormed:- Legal lA!saip6on: ' L� !'7-' d Township, Range, Secllow eh..,. 0 _ 3- 4- 5- 6- 7 8- 9- 10- 1 t- 12- 13- 14- 15- 16- 17- 18- _wIL - 6pbp Ceorry 3cmr,;IL.T) EV am i Tl1 A. Shafa Site Plan WAS GROLIIID WATER D ENCOl1NTERE07 a 1F YES. AT VAMT DEPTH7 '� L T Depth to Water After v D Monlloring7 -r E OMe' II r --- -- Reading Dale Gross Tlmo Net Time Depth to Water Nei Drop �2t / —� 5 all o o 1 " 0 30 9°2; e !U 00 91 1 a'r got o so rr PERCOLATIONRATEI��I..yaiM✓axAl PERC HOLE DIAMETER TEST RUN BETWEEN SFT AND_FT /1 C1 PERFORMED BY: ;5 rtl 4/ I CERIIFV THAT THIS TEST WAS PERTORMrD IN ACCORDANCE WITII ALL S JATE AND MUNICIPAI`.'lyItift IN EFFECT ON TIIts DATE. DATE: SR ROBERT C. COWAN, P.E. ROBERTA. SHAFER. P.E. CIVIL ENGINEERS (907)694-2979 FAX (907) 694-1211 NEALTHAWHORI APPROVALS ON-SITE NVASTENVATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and SEWERAWATEn MATERIAL SPECIFICATIONS MAN EXTEN`;IOWS REFERENCE: Lot 2, L&T Subdivision November 14, 2008 SEWM& WATER INSPECTION GENERAL: EN MEENNGSTLOES 1. The scope of this project includes the abandonment of the existing septic mompO"TS system, installation of a new 1000 gallon I IDPE septic tank and septic trench to serve the existing three bedroom residence located on the referenced property. Existing well and septic system to be abandoned according to MOA Y+ELLINSPECTION specifications. 6 ROW TEST 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all WE PLANS applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. rovccslcN 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. SOIL TEST 5. Contractors installing wastewater disposal systems must be certified by the Municipal Development Services Department or ADEC if required, for system installations. Owners installing their own systems must also receive PERCOLATION TETT prior approval from the respective agency. SEPTIC TANK INSTALLATION: STrNCTto AL& - MECILM1.CAi. 165rE.C1iOl1. 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. All IIDPE septic tanks are required to have a 4" monitoring pipe installed next to the oN,ITE tank extending to the bottom of the tank. WA;TEWATER CLS:OSAL SYSTEM CE';.l N 15801 S. Rirchnvood Lonp Road — Chugiak, Alaska 99567 Page 2 Lot 2, L&T Subdivision November 14, 2008 2. 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. 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. All IIDPE septic tanks are required to be covered with a minimum of 2" direct burial insulation, and a maximum of 4 feet of cover. 5. 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. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCII/DRAINFIELD INSTALLATION: 1. 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. 2. 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. 3. 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. 4. 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. Page S Lot 2, L&T Subdivision November 14, 2008 5. 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. MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 2. The following pipe materials are 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 (IIDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam III or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi WON, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever requirement applies. Page 4 Lot 2, L&T Subdivision November 14, 2008 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: 1. 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. 2. 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 the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 s A E T Y CERTIFICATE OF ON-SITE .SYSTEMS APPROVAL, Parcel I.D. 051-282-41 Expiration Date: itiq I o c� 1. GENERAL INFORMATION Complete fegal'description L & T Lot 2 Location (site address) 18234 Pioneer Dr. Eagle River, AK Current Property owner(s) Patrick & Natalie. Brewer Day phone Mailing address 18234 Pioneer Dr. Eagle River, AK Real Estate Agent Day'phone 2. TYPE OF: DWELLING: M Single, Family (w/wo_ADU) ❑ Duplex ❑ Multiple"Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual Individual Well ® Holding Tank ❑ Individual Water Storage ❑ Community ❑ Community Class —Well ❑ Public Sewer ❑ Public Water System ❑ WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $s � 12- SO Waiver Fee $ Date of Payment 411a (21D Date of Payment ' Receipt Number V Z I COSA# osG��F�sp� Receipt Number Waiver # co V) sa t>� SW �4 VTt 6. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the. validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING, INC. Phone 696-6111 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH. M. DUFPUS Date Engineers Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen .r OF t� encroachments, deficiencies or discrepancies exist. �or --MA o TH 6. DSD SIGNATURE System #1 Approved for 3 System #2 Approved for Disapproved. Conditional approval for _ t i VX" -1�\e we-� � 4 o r i C S it bedrooms. bedrooms. +�a KENNETH H. D F A z V Alf Bch 2 AW ti �� �sssoN`� �► bedrooms, with the following stip;\`\`"lOF «f_ 4," (O, S HC_ U�ere_ -SITE �e �oLL,-rr (19 70) �� wpTER A i �fn W A -I=mo SU oira:`Ho ✓\ 91RDORAN "l-, l i � �e�� � � i s ����Zrtow n o �--� r1��-f�a�eS ri S O�,boVE ////��NT SER 1���1��• �J By: �(�� A2 u�/� 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 Septic System Advisory Well Flow Advisory Cosa blue sheeLIa10-ts.da Nitrate Advisory Arsenic Advisory Other Date: 4-14-20 P.O. Box 670269 Chugiak, AK 99567 P: (907) 688-2759 F: (907) 688-2259 TO: Natalie Brewer 18234 Pioneer Drive Eagle River, AK 99577 Flow Test Report Resting static: 18.6’ Max Drawdown: 23.6’ This well is inside the house and has a suction jet pump with a drop pipe roughly 24’ from top of casing. Unable to get total depth of well without disassembling system. Total Yield: 2 GPM Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage. AK 99507 www.muni.orglonsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. �� ' ZgZ COSA # (090041 -6 - Expiration t0041Expiration Date: 1. GENERAL INFORMATION Complete legal description LOT 2; L a r S/D Location (site address) 18294 PIONEER DRIVE. CHUGIAK AK. 99567 Current Property owner(s) BONNIE KING Mailing address Lending agency Mailing address Real Estate Agent Mailing Address P.O. BOX 670089. CHUGIAK AK. 99567 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well ❑� Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone 244-7176 Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site❑ Individual Holding Tank ❑ Community On-site ❑ 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 Slate 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 sample results. (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 INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm S 8 S ENGINEERING Address 15861 S. BIRCHWOOD LOOP, GHUGIAKAK.99567 Engineer's Printed Name ROBERTA.SHAFER 5. DSD SIGNATURE _L� Approved for 3 bedrooms. Disapproved. Phone 907-694-2979 Date._ V -,—?so— o f Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineers Report Other By: �/ • Original Certificate Date: ✓�" L (n.,. I IAS) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519.6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: LoT e? ; Lil glb Parcel ID: OS/- .2 s+z-' J1 A. WELL DATA ►�J Well typeQ NATE If A, B. or C provide PWS/ID_# = Well Log (Y® e' o Date completeeL13D Sanitary seal (DN) YES ' 31 ft. Total depth 23 ft.� Cased to rgcsnroc-rv�nLF.P06 15ftc�.cz �7rIi1JeAL 3r' r'u'in P-) FROM WELL LOG Date of lest Static water level ft. Well production g.p.m. WATER SAMPLE RESULTS: Coliform D colonies/100 mL Nitrate a?.. (O'? mg/L Arsenic: �J D ug/L date of sample: d* B. SEPTIC/HOLDING TANK DATA / L T Tank Type/Material `.j tyn F -b.1 E Tank size /COO gal. Number of Compartments .2 Foundation cleanoutifollJ) -lam Depression over tank (Y& A Wires properly protectedON) JET Casing height (above ground) la? tin. 6 PAbe AT INSPECTION 1 2 rev !'� Wr OF o?• D N( f g.p.m. Other bacteria 0 colonies/100 mL Collected by: 54- J FiltA<.INiE 1C►I(7(� . Date installed Cleanouts 0) g High water alarm (Y® Date of pumping --ILS A — Pumper ^ iVE-ick sVs7�n') C. ABSORPTION FIELD DATA Date installed Soil rating g.p.d./ftp rft2fft... System type r ' Length � ft. Width r��1 S ft. Gravel below pipe Total depth /01 GG ft. Eff. absorption arrear�'U.``t/fe QM{onniittooring tube Depression over field �I AXUD JVST5fn Date of adequacy test A Results (Pass/Fail) For 3 bedrooms Fluid depth in absorption field before test — in. //) a added= gal. New depth= in. Elapsed Time: =min. Final fluid depttf 'd' i Absorption rate >= — g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N 8. type) If yes, give date D. LIFT STATION JJ /ft Date installed Size in gallons 'Pump on" level at _ in. 'Pump off Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: r Septic tank/lift station on lot SCO / Absorption field on lot lr7O ri Public sewer main Sewer /septic service line Animal containment areas 601+ High water alarm level at in. Meets alarm & circuit requirements? r On adjacent lots /Cb 4 r On adjacent lots /Co / Public sewer manhole/cleanout Holding tank .UJ/l3 Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation $ Property line S + Absorption field S f Water mainAJ.!3 Water service line /O t Surface water /� f Wells on adjacent lots yam' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line !O Building foundation /O Water main A -)k Water Service line V /f Surface water /L4PO +r Driveway, parkingtvehicle storage Z f Curtain drain A)OXX, lCtXxyNWells on adjacent lots 10 •fl - F. COMMENT0 &>" suevEy r£rr��6 EY Re -TIC 7'vmp i &OEtC � • rNuv»,3 • �r c[ f5 IFS avA.)xtZ o"LrEFr kkVSE• foWA-i Me0. GF}N OC400- . G. ENGINEER'S I certify that I have determined h ugh field inspections and review of Municipal records that a above Sys ems are in conformance with MOA COS gui line in ff ct n thi ate. Engineer's Printed Name/ Date — o of COSA Fee $_ Date of Payment Receipt Number t�oCCJ%� (Rev. 11/05) - Waiver Fee $ Date of Payment Receipt Number: ry rn,. Y\N •••.N•NM �IM� iii.:"s.Ti''�� fpzty Pio.rt f�1 _ /q X fT� 1. R•.v�s�d ��PJ�l.; a -r7 -oar ' *'49th �l{�; •; 'I.NN,Y.•.•M.•-..s.,.1 M.I�... y, No. iso s ;i7r t / s_eeH•LM•�'f-S-•.rv.e,�lion G!.hl'f% G tT+ C; tr 36 7iJtsc :rn EEL LTfM AS -BUILT I hereby certify that I have surveyed the following described propert 1 off�nAz� Anchorage Recording Precinct, Alaska, and that the improve- ments situated thereon are within the Property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Eagle River, Alaska this - day of 11 '— 2(X1 ROBERT C. JOHNSON � m 5., SCALE: Registered Land Surveyor I ho`.t14L 9S 1" Lf -O • Box 77-0456, Eagle River, Alaska 995:7 Phone (907) 6942543 r 13Zx111 pio.,L4.r v •,_ S `y • tTa � k_K. 1 SM a 5-0 " O� R 7 149th4 See" t A •.•O N•MNN N• •Nq+•N•w t ^obart C. 1zhnson f `•a;;1 ' s7 AP y��Cl.irt R► so 0 fj, �-/ • ea S_4. T- v R. i f'v. E t e, 7- AS -BUILT I hereby certify that I have surveyed the following described property.: L o `� ;2-- , _ L F T ; Anchorage Recording Precinct, Alaska, and that the improve- ments situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on property Iving adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Eagle River, Alaska this day of 200_j ROBERT C. JOHNSON � SCALE: Registered Land Surveyor No. 990 -LS 1 Li C' Box 77-0456, Eagle River, Alaska 99577 Phone (907) 694-2543 jl mat am - Bonnie Fang 244-7176 PO BX 670089 RX, 18234 Pioneer Arctic Pump & Well Jim Sullivan, CPI PO Box 770197 Cagle River, AK 99577 (907)688-2510 (907)258-2510 (907) 7.15-2510 nmv?ednel Well survey 18' Static + 23' Deep No perforations in casing All measurements taken at top of casing that is in basement 8'13elow natural grade. Confer with Dan Roth C MOA Install MOA Well Seal Total Charges $325.00 Thanks Jim Sullivan Arctic Pump & Well, Inc. Page 1 of I