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HomeMy WebLinkAboutSKYLINE VIEW #1 BLK 5 LT 4ASkyline View Block 5 Lot 4A #051-191-36 www.sullivanwaterwells.com Pump Installation Log Well Drilling Permit Number: SW Date of Issue Parcel Identification Number: Legal Description Property Owner Name & Address Skyline View #1 Block 5 Lot 4A Christopher Taylor 23110 Sumac Drive Chugiak, AK 99567 Pump Installation Date: 4-21-20 Pump Intake Depth Below Top of Well Casing: 150 feet Pump manufacturer’s Name: F&W Pump Model: 4F07P07305S Pump Size: 3/4 hp Pitless Adapter Burial Depth: 10 feet Pitless Adapter Installer: Unknown Disinfected Upon Completion? yes no Method of Disinfection: Chlorine 50 PPM Comments: Pitless Manufacturer: Unknown Pump Installers Name: Sullivan Water Wells Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. % Municipality of Anchorage Development Services Department icy: Building Safety Division On -Site Water and Wastewater Program, 4700 Elmore Sl. P.O. Box 196650 Anchorage, AK 99519-6650 Page of www.ci.anchorage.ak.us (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW 0900 49 PID Number: OSI —191-3(d Name t Wasewaer stem: ❑ New U St Y P9rade Mdrade Po P),X 15 C1.., , F, AY 9v5(,—i ABSORPTION FIELD Ptwne N.m of Bodro s S F�Dasp Thimh D Sh.11. Thench D Bad D Mound D Other. LEGAL DESCRIPTION WFawg 1 Total DlPth from ongnai grade (0 (]• D GFP FI. BIoG Lot Sugdlvlean: 5 4A sk ia,n� Depth to pi,* Whom tr ong s, Or" depm beneath ppe: —godPDt FI. FI Toanah,p rtenge sscpon FII added adova ong," gloat d —I G'" length GO Ft. FI. Well: n }'1� El ❑ Upgrade Grata wain Nun M of iota l Dlaanu Meeeln tale, GXi Ft. Ft CuasM1uuon (Phvale, , B. C) Total Death I Cased to Total AbWq apt bee Lie Plpa ltutenal. FI. FtU415 %6Fe V all f A-51" 3o3 OrJle, Data DNNd $1a4C Wa1N L4V01 IMta11K t ` Data Ingyia p S il. D0`�jfw t'11�r'1 12 d` nota Pump Set .t Datong H.Ighl Abd» Grp TANK CPM FI. Fl SEPARATION DISTANCES $Septic []Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption LM Holding ublK/Prtvate Thk capsoly 15M From Tank Field Station Tank Sewer Line /� w , Gr weWallDoti 1001+ 2514- Lulenal S4ce p of Nuncompartments Z $,°.«water N.O. NaOe LIFT STATION Lot Una 5 {} 10 *+ Ixe nu aUurer Gal Founda4on I c ,T I} l o 'Pune on. iev at 'P leMat Wghwal �m al .J N in Cun►n Drrn . ♦. , /� I Pump 1Mx ,�N EIeCInFa� Hapeuona pal F Ramerka rr 'r�• S Qtk BENCH MARK r e... ....Aon A Loudon and Daarnpum S151 o e r Wmad Eiarat,. I Do FL 11 Inspections performed by: L0.'5 SDut kl,,, Dates: 1" 5 I2 Ory Engineer's Stamp Development Services Department Approval y? 49TH �� 49 Conditional Approval Date: JARS £PL'P(LA\D: ' , �/ Reviewed and approved by: l ! Date: -2 a—t19 'li����Z��aP��-- (Rev 04m6) SUMMAC DRIVE INSTALLED 5 -BEDROOM SEPTIC SYSTEM 1500 CALLON STEfL TANK LOT 4A TRENCH LENGTH 1 X 60' ; ! WIDTH 2 FEET SWINC TICS TOTAL DEPTH 10 FEET A F811 ROCK DEPTH 8 ACEI C INSULATION 2 IN COVER J fEET 0 J9.0 66.3• l E u.o' 6zs' 1 LOT 4B f sl.o 68.3' C 60.0 86.0 1 HSLOPE NOTE: THE 98.0' 79.0' 1 V THI C BC LOCATED AT BASE Or f/- IO X SLOPE CHUGACH STATE PARK TAKEN FROM ON -SHE WATER AND WASTE WATEI r DOCUMENTATION. ALL LOCATIONS SHOWN ARE 25 0 25 50 75 100 I25 150 SCALE, I' = 50 a ' 49th LARS JYUlf,N"NV LMINLLKlNG I I SKYLINE VIEW 1 BLK 5 LT4A I I SEPTIC SYSTEM ASBUILT 20J W 15TH. AVENUE > DATE. JUNE 9, 2009 ANCH. AK. 99501 ROBERT WILKINSON SHEET 2 3 GR/D:00 1159 (907) 279-J916 2J110 SUMAC DRIVE, CHUG/AK, AK 99567 PERMIT # SVO90049 PID # 051-191-36 Skyline View#IB5L4AD2.dwg Standard Trench.- 2' rench:2' Wide 60' Long 10' Deep 8.0' Sewer rock 3' Cover NO SCALE TN F.G. ELEV.= 90.3' E.C. ELEV.= 89.0' ELEV.= 87.0' Silt Barrier— ELEV.= 79.0' 8.0 'et of Effective B.O.N. ELEV.= 73.0' --oHo 0 00 a ti G V ,li W a, v.. 4 U a a, � V Q W O y ti Monitor Cleanouts 3' Cover Septic Rock NO SCALE 1500 Gal. Septic Tank I JrUK&LRNV LNULNLLKINUI I SKYLINE VIEW 11 BK 5 LT 4A I I SEPTIC SYSTEM ASHUILT I 203 WISth Ave ROBERT WILKINSON DATE, JUNE 9, 2009 An0cho, age Ak 99501 23110 SUNIGC PRIW. CHUCGK, AK 99567 SHEET, 3/3 GRID- NV1159 PERMIT # SV090049 PARCEL ID # 051-191-36 SKYLINEVIEVl11B5L MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: May 06, 2009 Expiration Date: May 06, 2010 Permit Number: SW090049 Parcel ID: 051-191-36 Legal Description: SKYLINE VIEW BLK 5 LT 4A Design Engineer: 0007 SPURKLAND ENGINEERING Site Address: 023110 SUMAC DR Owner Name: ROBERT WILKINSON Lot Size: 45546 SO. FT. Owner Address: PO BOX 1549 Total Bedrooms: 5 Permit Bedrooms: 5 CHUGIAK , AK 99567-0000 This permit is for the construction of: ❑✓ Disposal Field Q 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. Received Issued By: Date: 'S O By Ol 2IL Date: S Municipality of Anchorage - x W:_ Development Services Department �c Building Safety Division ` On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 v ww.muni.org/onsite (907)343-7904 ON-SITE SEPTICMELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 1051- ) q l- 36 Property owner(s) RoixQi M kinlon _Day phone GOB- YDYj Mailing address CH4 r: Site address 23100 .74m2r WriVe . CI Legal description (Sub'd, Block & Lot) Legal description (Township, Section & Range) Lot Size l 5� 6i Lt 6 Sq. Ft. THIS APPLICATION IS FOR (®all that apply): Absorption Field ❑ Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Code 9956' Code 9`I5 -(,'q iP Number of Bedrooms _ J!— Per LS THIS APPLICATION IS AN: Initial ❑ Upgrade Renewal ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. LVA6 &AaW\ (Signature of property owner or authorized agent) Permit/Rush Fees: 00 Waiver Fees: Date of Payment: y� 3oy v `� Date of Payment: Receipt Number: OS 0666 Receipt Number: (Rev. 11105) ffdnt SPUTHalmd Congo[Meerioimg Environmental Consulting and Design SEPTIC SYSTEM DESIGN SKYLINE VIEW 41 BLOCKS LOT 4A Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519 Subject: Ladies and Gentlemen: far L.S 1 am writing to request a rmit for the pgrade of the septic system for the above referenced property. The proposed system will seret a be m single-family residence. The existing septic system has failed and must be replaced. This original sep r- em will be abandoned per MOA code requirements. Septic System Upgrade Permit 23110 Sumac Drive April 27, 2009 System: A 1500 gallon septic tank with a deep trench absorption field. The absorption field will be 60 feet long and contain 8 feet of sewer rock. Soils: A test hole was excavated on April 22, 2009. See the attached soil logs. Ground water was monitored for through April 29'", 2009. Ground water was not observed. Surface Water: No surface waters were observed within 100 feet of the proposed septic system area. Topography: The topography in the area of the proposed septic system slopes down to north at 5 to 15%. Waivers: No waivers are required. The installation of this septic system will not prevent wells and septic systems from being installed on the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. If you have any questions or concerns, please contact me at 279-3916. Sincerely, Lars Spurkl d, P.E. Civil Engineer 203 West 15'" Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, LspurklandCaa`gci.net SpuMand Eimponc enimp Environmental Consulting and Design SEPTIC SYSTEM DESIGN Skyline View #1 Block 5 Lot 4A Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519 April 27, 2009 We are submitting an application for a septic system upgrade of the above referenced property. The submittal consists of three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet I/3), the proposed improvements of the lot, of which only the septic system upgrade is subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable test holes are also enclosed. The septic system design is based on the following: Groundwater < 16 Ft below ground surface. Use 1500 gallon septic tank and deep trench absorption field Soil Rating. From Testhole 4/22/09 5.7 min/in = 0.8 gal per sq.ft/day No. of Bedrooms 5 Required Area per Bedroom: 15010.8 =187.5 sq.ft. Total area required: 188 x 5=937.5 sqft Bonom Rock At 10 feet Top Rock At 2 foot Rock Depth 8 feet Total Tench Length 937.5/16 = 58.6 feet USE 60 FEET SYSTEM CONFIGURATION 1500 GALLON STEEL TANK W/ DEEP TRENCH TOTAL LENGTH 60 FT TOTAL WIDTH 2 FT TOTAL DEPTH 10 FT ROCK DEPTH 8 FT INSULATION 21N. COVER 2 FT(MIN) 203 West 15th Avenue Suite 203, Anchorage, AIS 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net L LOT I Well LX LOT 4? S SUM) M C DRIVE U -M, _71 LOT 4A LOT 4B -J� LOTS vAcANr well - — — — — — — --_dell -- — — — — — — CHU6A S TA TE PARK NOM' W IS NOT A SUM= FUr. OrU & WW LOCATIONS TAKEN fROM ON -97r WATER AND W457r WATER DIFARTMW DOCUMEWA77ON ALL LOCATIONS SNOWY ARE APPROX&MM 50 0 50 jx 150 Rw clw 3w SCALEr I' = 100 FT. 49th No. arUKAI.ANU LNUINUMINU EPTIC 20.3 W 15TH. AVENUE SATME VIENll BIX5 LTV S, SYSTEM DESIGN ANCH. AK. 99501 ROBERT WILKINSON DATE APRIL 27, 2009 (907) 279-3916 11 23110 SUMAC DRIVE, CHUGIAK, AK 99567 SHEET.• 1/3 GRID. -MW 1159 PERMIT #SV090XXX PIP # xx-xxx-xx Skyline View#IB5L 4ADIdwg SUMMAC DRIVE,, INSTALL I -BEDROOM SLPIIC SYSIEM _ 1 - 1500 GALLON STEEL TANK IR£NCH LENGTH 1 X 60' WN 2 FEET " LOT 4A TOTAL DEPTH 10 TELT I - ROCK DEPTH 6 FEET INSULAILON 2 !N COVER 2 fEET =.� LOT 4B G l 1 TNI SULORE NOM THE 0£ 10CA/LD AT RISE OT ♦ - IO X SLOP£ % ABANDON EXIS17HG CR18CFSSP001 I ~ 'r l /S-BCOROOM I / HOUSE i Well ,P r r" CHUGACH STATE PARK 49th `. TAKEN /ROM ON -SAC WATER AND WASTE VAI£A r DOCUM£NTAmm. ALL LOCAAONS SHOWN ARE CE -11500 25 0 25 50 75 100 125 150 SCALE, I' = 50 FT 20 J W/V 5 L/rOIRLLR/h4 SKYLINE VIEW ,/�1 BLK 5 LT4A SEPTIC SYSTEM DESIGN ANC W K. 9 AVENUE %t DATE: APRIL 27, 2009 ANON. AK. 99501 ROBERT WILKINSON SHEET. 2 3 GRID: NW 1159 907 279-3916 23110 SUMAC OR/VE, CNUCIAK, AK 99567 PERMIT # PID # Skyline View#IB5L4AD2dwg Standard Trench: 2' Vide 60' Long 10' Deep 8.0' Sewer rock 2' Cover NO SCALE Sit t 8.0 ft of Effective Monitor NV SCALE 1500 Gat. Septic Tank I 203 W1 th LIVUIIVLLKIIVU I I SKYLINE Mir /1 BK 5 LT 4A I I SEPTIC SYSTEM DESIGN I An orage Ave ROBERT W2KINSON DATE, APRIL 27, 2009 Anchorage Ak 99501 P79_'1at6 _ 23110 SW9CIC ORM, CMM,fAK, AK 99567 SHEET 3/3 GRIDS NVi159 PERMIT # SV0900XX PARCEL ID # XX -XXX -XX _SKruNEVIEV#IB5L4AD3.Dv6l O O 00 0 o' 0 $2 m U w a V d Q W a h Q - V O � Monitor NV SCALE 1500 Gat. Septic Tank I 203 W1 th LIVUIIVLLKIIVU I I SKYLINE Mir /1 BK 5 LT 4A I I SEPTIC SYSTEM DESIGN I An orage Ave ROBERT W2KINSON DATE, APRIL 27, 2009 Anchorage Ak 99501 P79_'1at6 _ 23110 SW9CIC ORM, CMM,fAK, AK 99567 SHEET 3/3 GRIDS NVi159 PERMIT # SV0900XX PARCEL ID # XX -XXX -XX _SKruNEVIEV#IB5L4AD3.Dv6l Municipality of Anchorage krli Development Services Department i .{�r(i.• "' •-4S+�tj Building Safety Division �••' (' I a.1 On -Site Water and Wastewater Program j �A,',' 1700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 % 49 -- www.muni.orglonshe 0 (907) 343.7904 / • •.... • :1^.f,:l+'�:� �Si <<; Soils Log - Percolation Test /� t4L% Performed For. Ro662A Date Performed: Legal Description: 5kyyie. 1 Fkk5 Le{ AA i 'fr1 Township, Range, Section* Slope Site Plan Depth Silt (ML) 3• `� GLa�elly S4.d w 4- , s) 7- 8- 1 -s - t (GMlsrl) Ft. WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water After Monitoring? Date: �O S L O P E Reading Date Gross Time Net Time Depth to Water Net Drop 2 ID:1e An 0 Min I? -516" 70 —1/16- It 10: ItAr•, to M n 13 I I I lif" 11 10: 36 Ar. 20 n n 13 II 1h" It 10:90Arn 30eA•, 13 111b" 3/1f 11 II 3/0 II 11): 50 Am 10 Min 13 116" I "he. 111/2F It 11:06A'n 50 A;,n 13 '1'2- 15/81' 11319 11 11', 16Arh 60 Min 13l " PERCOLATION RATE ) �"} (mv WeN ) PERC HOLE DIAMETER �r 1 TEST RUN BETWEEN .FT AND 5j FT COMMENTS Pre Soa\CED PERFORMED BY: LAR" Sqw u.gn. I � .CERTIFY THAT THIS TEST _ VYAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GU�'IDELi��NIS IN EFFECT ON THIS DATE. DATE: ry123109 a Y JJ m a co X m a 00 D v Y q i �7i G o � d ` V N < Y U a. p Z J Q � od w 7 i 3 y m 0 w 3 u 6 LL h q i �7i G o � d 11 x ::n U a. p S 4't Q V .1CC7 q i �7i G i 11 S 4't H U p rn L N U i { a a w w i i G: S � � t 1N r%i r; c{ •i r w LtCC: wi q i �7i G i 11 H U p rn L N U i { a a w w � � t i 11 H U L U i { � � t w w LtCC: wi Ci �•i "_ i W 4A Lf S t O O O .40� F OH H F OH OH i • 0 H 0 F 0 H 0 H, 0 F 0 F 0 H 0 F 0 F 0 F 0 H 0 H i w 0 p .�: p 0 " O a y� O 0 0 yO � O 0 0 O i O a O is O yOi � O 0 11 H U L U w w LtCC: wi Ci �•i "_ W 4A Lf S t i • 0 H 0 F 0 H 0 H, 0 F 0 F 0 H 0 F 0 F 0 F 0 H 0 H w 0 p a w W5 w a0 w 0 w 0 ce. w a5 w 0z:m% w U. .lk. a0 w a w 0 w z . Municipality of Anchorage • c.cr t� On-Site Water and Wastewater Program e`'' t .l_ (907) 343-7904 K .,aIh SAF CT'! CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-191-36 Expiration Date: ' 2 ' i7 1. GENERAL INFORMATION Complete legal description Skyline View#1 Block 5 Lot 4A Location (site address) 23110 Sumac Drive Current Property owner(s) Richardson & Bryant Day phone 694-4994 Mailing address Same Real Estate Agent Partners Day phone 694-4994 2. TYPE OF DWELLING: 45 �,.�� ® Single Family (w/wo ADU) XMAW' c?\ n Duplex E MAY 22 .2G ;) k` n Multiple Dwellings (Single Family and/or Duplex) tea. j.,3. NUMBER OF BEDROOMS: 5 �� CI E o L 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual E Individual Water Storage I 1 Holding Tank 77 Community Class C Well L] Community H' Public Water System ❑ Public Sewer I I a --- _5-/r-Received by: ��� Date: 07 air COSA to be release to the engineer, unless otherwise requested by the engineer. COSA Fee $ 6-Wo Date: Date of Payment s/a0.-ir7 Date of Payment Receipt Number (17C/0/0 Receipt Number COSA # OC i?"/6/S Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm NorthRim Engineering Phone 694-7028 Address l'O Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 5j17/2017 QF 4 es- es: ^ 4 Ce) = ;?' a.-. tr iy 6. DSD SIGNATURE System #1 Approved for S bedrooms. R 0 Sloven W. Eng • ,'J System #2 Approved for bedrooms. 0 �;, PE /I4256. . Disapproved. g6/?(41 °' l.•�(f)f;Z(C "°ra �R � pFESc';0'`' Conditional approval for bedrooms, with the following stipuraalr61t '"'�� JON-SITE vc 'VVATI=K AND m WASTF>VATEF. • PROGRAM F Original Certificate Date: The Municipality of Anchorage Devlopment 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 blue sheet 9-1-12Aoc If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: Sk t/iy(E VIEW -7r/ 5 L,;/r4 Parcel ID: OS! ! q ( 36 A. WELL DATA / Well type P If A, B, or C provide PWSID# Well Log (YIN) y Date completed s/5/8"3 83 Sanitary seal (Y/N) 1/ Wires properly protected (Y/N) y Total depth/C° ft. Cased to 64 ft. Casing height (above ground) /8 in. FROM WELL LOG AT INSPECTION Date of test S/ a3 /IV/7 Static water level 9a ft. 5 7 ft. Well production g.p.m oC g.p.m. WATER SAMPLE RESULTS: Coliform Q colonies/100 mL Nitrate 7S mg/L Arsenic /\(/ ug/L Date of sample: 5 fie/17 Collected by: A .yr Egli B. SEPTIC/HOLDING TANK DATA Tank Type/Material -5E_PTfc/ Date installed s/,Z fob Tank size / 500 gal. Number of Compartments a Cleanouts (Y/N) Foundation cleanout(Y/N) v Depression over tank (Y/N) /, High water alarm (Y/N) r ,N Date of pumping 5/18/1 7 Pumper <-,4A,117:1-12y ]amu ricS C. ABSORPTION FIELD DATA ep Date installed 5(I z/01 Soil rating (g.p.d./ft2 or ft2/bdrm) ©. S System type l re��l� Length 60 ft. Width Z ft. Gravel below pipe ft. Total depth // ft. Eff. absorption area 760 ft2 Monitoring tube y Depression over field A/ Date of adequacy test 5/07(7 Results (Pass/Fail) / For bedrooms Fluid depth in absorption field before test 30 in. Water added 75 6 gal. New depth 37 in. Elapsed Time: 60 min. Final fluid depth 30 in. / Absorption rate >= 750 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) /Y If yes, give date D. LIFT STATION ASA Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot /Q4 'f On adjacent lots /DD 1- Absorption field on lot 106. f On adjacent lots /BO ‘-f- Public fPublic sewer main / Qa 'T Public sewer manhole/cleanout /OO 11- Sewer/septic service line 0541— Holding tank /dd(4- Animal containment areas SO ''r Manure/animal excrete storage areas /Oo SEPTIC/HOLDING TANK ON LOT TO: Building foundation /D (14- Property line /6 ill- Absorption field .5 14- Water Water main /6 ° ' Water service line /4 'fi Surface water /1610 '1- i Wells on adjacent lots /d 0 " ABSORPTION FIELD ON LOT TO: Property line 't Building foundation AO 1+- Water main /Q i r Water Service line /6 t- Surface water /Dof-f" Driveway, parking/vehicle storage 2 r Curtain drain t/AilK Wells on adjacent lots /40 'l" F. COMMENTS G. ENGINEER'S CERTIFICATION y�-�►`�,3�T� OF 4, tt3 I certify that I have determined through field inspections and ��.,�•.st• 1••" ee•�e�S� review of Municipal records that the above systems are in •4 •• • •e.. S conformance with MOA COSA guidelines in effect on this date. > A •• s � Engineer's Printed Name �TfV� E � 10! iZi- Date .5/l(ff 7 Steven W. Eng u•.S Py271 p r i Rai=ESS\��`•15 COSA yellow sheet_2-6-15.doc 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 SP4(ZKLAND fN&1N6t iLNG Address U5 tJ, ISi".Ave. Sh.-M ANct oizAt-c) AK 995oj Engineer's Printed Name LAOS SfuRK LANID 5. DSD SIGNATURE _1� Approved for 14 bedrooms. Disapproved. Phone 2711-3910 Date -71zc OF A4 1�1 y LAPSE ,d%'URKLAN .- 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 Engineer's Report Other By: Original Certificate Date: (R.v 71,05) 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: ShI' V.o.. BIh5 L4 4A Parcel ID: 05i-151-36 A. WELL DATA Well type pal,rnte Date completed 55 B3 Total depth (_ft. Date of test Static water level Well production If A, B, or C provide PWSID # Sanitary seal (YIN) Y Cased to 60 1. FROM WELL LOG s� e3 90 ft. WATER SAMPLE RESULTS: 0 g.p.m. Coliform colonies/100 mL Nitrate O MAL mg/L Arsenic: Nil ug/L date of sample: _6-at01 B. SEPTIC/HOLDING TANK DATA Tank Type/Material _AoLLCzW TArQ .So 1J I Tank size /500 gal. Number of Compartments 2 Well Log (YIN) y Wires properly protected (YIN) Y Casing height (above ground) +IZ in. AT INSPECTION glr4Lq 83 ft. 2 g.p.m. Other bacteria _X colonies/100 mL Collected by: L n e5 S� Date installed 5117)'09 Cleanouts (YIN) Foundation cleanout (YIN) I Depression over tank (YIN) Al High water alarm (YIN) /V Date of pumping All v Pumper C. ABSORPTION FIELD DATA Dale installed 5 i2 0 Soil rating p.d./tTz r ft2/bdrm)0. 9_ System type Deep TrLr- Nch Length 60 ft. Width a. ft. Gravel below pipe ft. Total depth ft. Eff. absorption area 9�5ft= Monitoring tube Depression over field // Date of adequacy test Abu) Results (Pass/Fail) For _ bedrooms Fluid depth in absorption field before lest — in. Water added= gal. New depth= in. Elapsed Time: — min. Final fluid depth — in. Absorption rate >= — g.p.d. Any rejuvenation treatment (past 12 me.) (YIN & type) If yes, give date — D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) 'Pump on" level a _ in. 'Pump off" level atin. High water alarm level in. Datum Cycles lest Meets alarm 8 cuci� it requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankfift station on lot 1Gb + Absorption field on lot + Public sewer main N�A Sewer /septic service line 50 Animal containment areas N.0 , I On adjacent lots kb + r On adjacent lots 1Q7 Public sewer manhole/cleanout N11A Holding tank A/ (A Manure/animal excrete storage areas M, D, SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: 1 Building foundation to �+ Property line 101+ Absorption field 5 + r Water main "!A Water service line 50 + Surface water A/, O, Wells on adjacent lots 1004- SEPARATION 00+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 101+ Building foundation 101+ Water main N�A r Water Service line 50 t Surface water N, 0 Driveway, parkingrvehicle storage 2 1 1 Curtain drain N. 0, Wells on adjacent lots IDO F. COMMENTS G. ENGINEER'S CERTIFICATION C. Gni T I 1 certify that I have determined through field inspections and 49TH review of Municipal records that the above systems are in C n / conformance with MOA COSA guidelines in effect on this date. r Engineer's Printed NameUrs 3 Pu r�-V ur�-V ,A L Date 'i f 1o1oq I10'��(ir jP`Ft?= COSA Fee $ 2 i t7 Waiver Fee's Date of Payment -7- Z D " oQ Receipt Number m (Rev. 11/05) Date of Payment Receipt Number SCS ReEM 1092545001 Client Name Spurkland Engineering Protect Name/N Skyline View #I B5,L4A Client Sample ID Skyline View #I B514A Matrix Drinking UCawr Sample Remarks: Printed Date/rinse 060.20-W) 15:19 Collected DatefTime 00 09'2009 14:50 Received Date/Time 00/10/2009 12:30 Technical Director Stephen C. Ede Allowable Prep Analvsi, Parameter Results POL Units Method Container ID Limits Date Date Init Metals by ICP/MS EP200.8 Arsenic ND 5.00 Waters Department NRB Total Nitrate Nitritc-N 0.162 0.100 Microbiology Laboratory (<10) Colony Count 0 Total Coliform 0 Fecal Coliform 0 ug'L EP200.8 C (<10) 06/11/09 06 1709 NRB mg/1. S%120450ONO3-F B (<10) 06/15/09 LCE co1100mL SM209222B A (<200) col/100ml. SN1209222B A (<1) col'100mL SM209222B A (<I) 06'10'09 SDP 06 10 09 SDP OW10/09 SDI' X""'4vol '44. .✓.P9'•ts 6- /Ro - sz, ASBUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: ryy�ivFriervfa� �fT.Y4a. «f'9�s AND THAT NO FNC�tOACHMEICTS EXIST &6EPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE TH-: EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONS'TRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. h ASSOCIATES 694-08 SCALE: DATE- GRID: ATE 4F A� qs�` / DRAWN;