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HomeMy WebLinkAboutTIMBERLUX #1 BLK A LT 13ATi*mberlux #1 Block A Lot 13A #018-271-32 Municipality of Anchorage L.L On -Site Water and Wastewater Section • (907) 343- 04 agewenof 1 ON -SITE WASTEWATER INSPECTION REP Permit Number: OSP231033 PID Number: 018-271-32 Dwelling: ❑ Single Family (SF) ❑ with ADU ❑ D Duplex p ( ) ❑Two Single Family Project: ❑New El Upgrade Name Vickie Wikoff & Rodney Allen ABSORPTION FIELD Site Address WE Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound 15301 Elmore Rd ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 2 0.6 GPD/SF 10 Ft, LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot A 13A 4.5 Ft. 5'5 Ft. Timberlux #1 Fill added above original grade Gravel length Township Range Section 0.0 Ft 50 F Gravel width 2.0 Ft Beds: Number of Lines n/a t. Distance between lines n/a Ft. SEPARATION DISTANCES To From Septic Tank Absorption Field Lift Station I Holding Tank Sewer Line Total absorption area 550 Ftz Number of trenches 1 Dist, between trenches n/a Ft. Well 100'+ 100'+ NA NA 25'+ TANK QQ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1000 Gal. Surface Water 100'+ 100'+ NA NA NA Material HDPE Number of compartments 2 Lot Line 51+ 10'+ NA NA Foundation 10'+ 10'+ NA NA LIFT STATION Manufacturer Capacity Gal. Remarks ADU Septic Only rm location Electrical installed by Installer PIPE MATERIAL House to tank 3034 Brownson Bros, LLC Drainfield 3034 Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 97.0 Inspection ection v, 4/17/23 2�d 4/18/23 Location and description Tank to 3034 drainfield CO/MT 3034 ft 3 ° 4/18/23 4" Bottom Siding @ A 2/7/24 ON -SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp :onditional Approval: Date Al `itevoin Septic System — ¢ 'J ;,E J81 a cl Approved Date Z Z_ 2 Note: this approval does not include well permit requirements. 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BOX 1807 PALM, AK 99645 OF 2024.02.08 RECORD DRAWING PHONE 907) 745-8200 FAX (907) 745-8201 P SCALE *A61� ;* NTS DRAWN ACP TIMBERLUX #1 BA L13A •• P.I.D. NO CHECKED SRP VICKI WIKOFF & ALLEN RODNEYOWNER "seven an pie 018-271-32 CE 6149 PERMIT NO. 15301 ELMORE RD 03X12X2021OSP231033 SECTION ANCHORAGE, AK ISHEET 2 OF 2 Lot 13A, Block A, Timberlux No. 1 Subdivision As-built Land Surveying Land Development Consultants Subdivision Specialists Construction Surveying AEC# 173042 S4 Group 124 E 7th Avenue Anchorage, Alaska 99501 (907) 306-8104 mail@S4AK.com 3/7/2024 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 hftp://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP231033 Work Type: Septic Initial Tax Code Number: 01827132000 Site Legal Address: TIMBERLUX #1 BLK ALT 13A G:3136 Site Mailing Address: 15301 ELMORE RD, Anchorage Owner: WIKOFF VICKI E & RODNEY ALLEN Design Engineer: PANNONE ENGINEERING SERVICES This permit is for the construction of: Effective Date: Expiration Date nient n 1)epart5III elit , f Lot Size in Sq Ft Total Bedrooms: 3/28/2023 3/27/2024 R1 Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Issued By: Date: Date: Z $ 2-o'2- 3/28/2023 .o'L 2 UNICIPAUTY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 018-271-32 Property owner(s) Vicki Wikoff & Rodney Allen Mailing address 15301 Elmore Road, Anchorage, AK 99516 Site address 15301 Elmore Road Day phone Legal description (Sub'd., Block & Lot) Timberlux #1, Block A, Lot 13A Legal description (Township, Range & Section) Lot Size 68,800 Sq. Ft. Number of Bedrooms 2 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field X❑ Initial ❑X Single Family (SF) ❑X (w/wo ADU) Septic Tank FX] Upgrade ❑ Duplex (D) ElHolding Tank ❑ Renewal F]Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 54?5 Waiver Fees: Date of Payment: 0/01A3 Date of Payment: Receipt Number: Q*8l3-1(3 Receipt Number: Permit No. ©JP Waiver No. Permit App_-'-:- :'-:c; Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E‐mail: steve@panengak.com Mailing: P.O.Box 1807, Palmer, AK 99645 Telephone: (907) 745‐8200   FAX: (907) 745‐8201 20 March 2023 Subject:   Timberlux #1, Block A, Lot 13A          Septic System Permit Request     Design Narrative This is a design narrative for a permit to install a septic system serving a proposed ADU on the subject property. The proposed system will serve a proposed two bedroom ADU. Currently the lot is developed.  The existing system serving the existing house will remain undisturbed.  The ADU system will be removed and replaced as a reserve. Currently there are no wells within 100 feet of the proposed installation. 1. Soils. Two test holes were perfomed on the lot by Ted Moore in 1995, and groundwater was monitored for at least seven days. Ground water was not observed at a depth of 16.0’ at the time of the test and seven days later. Bedrock was not encountered in the test hole. PES performed a partial test hole in January of 2023 on the lot to verify the soils, but the log is not included as the hole was just outside the 30‐foot required radius.  Based on the results of the percolation tests, overall soils appearance and the selection of the proposed drain field; an application rate of 0.6 gallons/day/square feet was used for a conventional wastewater system in the area of the test hole (See soils logs in on‐site file). 2. Soil Absorption System Design. a. See Sheet 1 of the design package. 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field. The proposed septic tank and drain field upgrade will maintain at least 100 feet from all surface water. 4. Topography: See attached site plan for area topography.  There are no steep slopes in the vicinity of the septic system. 5. Drawing Markings: The Drawings are marked “For MoA Review Only”. When written notification that the review is complete and no further comments are received from MoA On‐Site Department, the note will be removed and “For Construction” drawings will be issued. The proposed installation will not affect the future development of this or the surrounding lots. If you have any questions or concerns, please contact me at 745‐8200. Sincerely, Steven R. Pannone, P.E., F. ASCE Owner/Civil Engineer Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231033, Curtis Townsend, 03/28/23 LOT 13A 11AWWWWWWWWWW W W W W W WWSS SS Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231033, Curtis Townsend, 03/28/23 INSTALL NEW SEPTIC TANK AND SOIL ABSORPTION SYSTEM. 16 FEET 16 FEET Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231033, Curtis Townsend, 03/28/23 499 *9 2 �Clooc/ O.OS G VO & -3cVO N 7-3 mv �*s 07..40 • WER co 0 w 0 0 LLJ GCt kil 03 0 z cl� w z Eli 7 Ci < => 0 0 0 Gi _j X I— W o Z ui COO 20 4-j 0 z J Of PA © co 0 r- 00 0 p O . �—I : : •� (n OPA 1 14- Q. C .• 0 an 0*0 X\ 0 0-4-1 (D 41 0 L E cn 0- 0 > 00 CIL 4-j CN LjHLJ -0 0 L- -4-a - 0 j -Z ® U) 0 C) >1 C: 0- t 0 - 0 4-j Q) '_7) > r- C: 0 _0 0 -f-j 0 Q 0 6"N 0 U Ti -0 C: -0 -0 E -o U D 0 cCP c C: U) o a) -0 ow 0 Q) 00 -0 E 0 -0 a) C: CO C- -C 4-j :3 C)- > 0 0 0 U) ®6 o 0 a) a) C > 0 0 © 4-j c 0 >11 1 * Q) 00 C 0 m > :3 CO 0. � C— an I%khh'i 171 Ll 0 0-4-1 (D 41 0 L E cn 0- > 00 CIL 4-j 0 0-0-0 4-1 0 0 -0 0 L- -4-a - 0 j -Z ® U) 0 >1 C: 0- t 0 - 0 4-j Q) '_7) > r- C: 0 _0 0 -f-j 0 Q 0 6"N C: CL 0 U) :3 U Ti -0 C: -0 -0 C: U) o ow 0 Q) 0 C: CO C- -C 4-j o 0 0 U) c: 0 C) 0— U -1., — CN N C) © 4-j c 0 >11 1 * Q) 00 C 0 m > :3 CO 0. � C— 0 0 (h C: 0 z 0 0 o - I%khh'i 171 Ll IT —LOT /A 30e +Q EAST LAI 3A WELL PAVRL) .O'qWAY N& LOT 11A\ cubo ve- qraAc- Per CoAe— O 0 ElY L -V. EAM Lot3A , Block -.A-. 09 NO. OA IS -1192 e Anchored e Recording District, Alaska, Eften"is of. record O"w than fb*"xba" on4w or4 we set sb*wn tow"o is 2=��a Slaty 104 "b SM(P-Y CERTIFICATION LEGENDsated. I hereby certify that I ifts the PC*Wty Maim and d"eribed 8M43 or Aluminum coMed monument recovered IMMOMMts situated therm are within The pftp. arty 4fw1`VVQr1QP GCORCrOO 0 tron Pipe and/or rebar recovered. 11W� 04 adja*W -pW" on er snereaft as "d that 13 2 X 2 hub &'took recovered QM4QP the F�Wjwes .0 rebar set this' survey Mwe Gra no MadwaYs, utility Wws, or-amer yisibia easewaft on said Property neam 06 indicated k. n.---*— Fence Une, (Approx. Location) SCctle rpt Date a A-/ (D 04-/(5-0,9 Ref. 3136 F B. No. 03-020 Prepared by: R. L. SlirrolV RegIsteradLoAd (907)279-6200 519 W Eighth Ave. AMIWW Alvaq -OSWI 7(operty of. Municipality of Anchorage Page—L_of�- DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: S1" 9S0 Z Z 3 PID Number: O I b Z 713 2 NaTe' HCIkn S�¢a Wastewater System: ❑ New C9 Upgrade Y P9 Address. IS301 El moet Rd. AAc1e 99s1e ABSORPTION FIELD Phone: No. of Bedrooms: 3 NS- 12 y8 3 lei Deep Trench O Shallow Trench O Bed O Mound ❑Other LEGAL DESCRIPTION Soil Rating: o. YSGPO/Sq Total Depth from original grade' 10.01 Ft Lot. 13A Block: Subdivision: �t Depth to pipe bottmfr a original grade Gravel dept _�ath pipe oerlae Ft Ft Township: Range: Section: Fill added above original grade' Gravel length: air• 1.0 Ft FI WELL• E%ItT 13 New ❑Upgrade • Gravel width: e 2•.t Number1 oflines Durance between liner Ft Ft Classification (Private. A.B.C): Total Depth: Cased To: Total absorption area' Pipe material: f-arlo Peef Ft. I Ft 1096 SO Ft 0-303M Non -Pt-f Driller Date Drilled: Static Water Level: Installer. Carl's Exea-vik Date installed: 9/ZI/9S- Ft Yield:Pump Set at: Da>tnq Height AAboveGrouts: TANK CE 7E/S r m d: ) GPM Ft. Ft. SEPARATION DISTANCES s septic ❑ Molding ❑ S.T.E.P. To Septic Absorption Un 1lp4ding PutsictPrivate, Manufacturer. Capacity in gallons: From Tank Field Station Tans S~Lino E.ClOsAffirgil 1000 I Well, Ila 10Ze - - >LS•k Material: ealterefe Number of Compartments: 1 Wates >IW' > ICG' - - - LIFT STATION N.A. LotSize Sig, is' - - - In gallons: Manufacturer: Line Foundation x/ •w k /s, k C — - — "Pump on" level at: -Pump of - level at: Nigh water alarm at: Curtain Pump Make 8 Model Electrical Inspections performed by: Drain - - ' The ererrb eonerrhe rp//t tank BENCH MARK Remarks: too v SA r d pnivif 4upwAae Ap In Seo CenafhOA WO 110 Yefl il/ /er %I Location and Description: O n tt aA rV. 3141% 7rte, Sa4rfaC/ of ic"Ceaia p/Ilk iLt/ P1of r "fit 40 Frpe o..Nef 6. 1 1AfJollea. Th r. s1 , , coo-per Of /10e.cle try /1.... vA GtAO( 6/ek Fi/6t We/* tai, Assumed Elevation: e fa all eJ e w l u i Ws n /at'i.O Le The j tai/ a r�P,/164 lrtnch Wa! avV Ilrve /2/r *sle ENGINEER'S SEAL 0 at If n 714 +1► � L3• ryl(� 11 W/l l'CI •01 /A /11e Ir fp rl d �•re ea'ill w PI",f S'D• f ose fAe Ma, r rid &py f4o, frMAc 0 a !• a �..e Flaf/e Tirlknrrael SVt. Inspections performed by: P Dates: ist 9/19196 'r'k�; (�STNw� ,f m...i...-...,.............:.a 2nd 9/ z/ / 9J- �...4r"..d�a........ proval•' Department of Healto and Human ServicesnnnnnnDateP�O�s �TMEODORE F. MOORED• 0 �i1t�'riyc��.��•�p Reviewed and approved by: q ^5 ,� 72-013(Rev 9/91) MOA 25 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE "lll� DEPARTMENT OF HEALTH AND HUMAN SERVICES `1' )c1-06 P.O. BOX 196650, 825 "L" STREET, ROOM 502 % oLD ANCHORAGE, ALASKA 99519-6650 q-ao-qS ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW950223 DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES OWNER NAME:SHEA MARY ELLEN OWNER ADDRESS:15301 ELMORE RD ANCHORAGE, AK 99516 PARCEL ID:01827132 LEGAL DESCRIPTION: TIMBERLUX #1 BLK A LT 13A LOT SIZE: 68800 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 8/16/95 EXPIRATION DATE: 8/16/96 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 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: IF EXISITING'SEPTIC`TANK-`IS OF GOOD INTEGRITY, THEN INSTALL DIVERTER.VALVE BETWEEN OLD AND NEW SYSTEMS. -ffll _ if. RECEIVED ISSUED BY DATE• t91171.7,5- DATE: 91/7/.7,5- DATE • O3/6 In Y {e � , '% � 'i '� "'ms.µ✓ iLA'TOP TF-CHNICAL SERi,CS CIVIL& ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. 14530 ECHO ST. Pit: (907) 345.1355 August 3, 1995 ANCHORAGE, ALASKA 99516 M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK 99519 The purpose of this letter is to provide the required design narrative in support of our application for a permit to upgrade the wastewater disposal facilities on Lot 13A, Block 3, Timberlux Subdivision, Unit #1. The present seepage pit is no longer able to accept the wastewater load generated in the house. 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 16' below ground level is a gravelly silty sand with a measured pert rate of 22 minutes per inch. There is another stratum of clean sand between 2' and 2.75' below ground level. Using a somewhat conservative soil application rate of 0.45 gpd/sq. ft. specified in the wastewater ordinance for soils with pere rates between 30 and 60 minutes per inch, this 3 bedroom residence requires a total absorption area of (3 x 150)/0.45 = 1000 square feet. The proposed 80 foot long deep trench design has 8 feet of sewer gravel, but discounting the 1.75' thick silt stratum, it has an effective gravel depth of 6.25 feet yielding an effective absorption area of 1000 square feet. The topography of the lot in the area of the proposed trench slopes down towards the southeast at approximately 10%. 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. HOUSE 0 SEPTIC LOT 1A SYS T. o :-------------------- -------- rr) -- - - - - - - - - - WELL PAVED DR LOT 3A �O A 900 R1oo. IVE iy �� OF HOUSE \ SITE FOR NEW SEPTIC TANK - (IF NEEDED) EXISTING SEPTIC TANK (RETAIN IF SY) --------- II O 50'/, EXISTING SEEPAGE PIT T.H. 02 iL 50% LOT 13A, BLOCK A, �\ TIMBERLUX S/D, UNIT#1 \AYE/FW +o��r lk \ \ r*�. 49TH* •' *, �THEppERE F. Nppgp j lI 3589 Y NEW 80' LONG SOIL ABS. TRENCH W. 8.5' SEWER GVL. R 100 L13A, BLK. A, TIMBERLUX SID WELL AND SEPTIC SYSTEM SITE PLAN FLATTOP TECHNICAL SERVICES I 1 INCH - 50 FEET 14530 ECHO STREET DRAWN BY TFM ANCHORAGE, ALASKA 99516 JULY, 1995 NOTE: THIS IS NOT A SURVEYED PLAT. ALL LOCATIONS SHOWN ARE APPROXIMATE. NEW 1000 GALLON SEPTIC TANK (IF EXISTING TANK NO LONGER O.K.) O DOUBLE CLEANOUT O ' DIA. ASTM D-3034 PIPE "Ag. EDGE OF TRENCH EXCAVATION 4"DIA. ASTM F-810 PERF. PIPE 3 1 m SECTION "A - A" SCALE: 1"=5'-0" 80 PLAN VIEW SCALE: 1" -15' - 0" 49T" R TUBE :.................... �....... .h..t7 �u.r + • THEODORE F. NOORE 4d .CE -3589• •.......• COVER MATL.12" 1�l- )RIGINAL GROUND 'ILTER FABRIC I' DIA ASTM F-810 PERF, PIPE 12"- 21/2' SEWER GRAVEL OF EXCAVATION LOT 13A, BLK. A, TIMBERLUX S/D SEPTIC SYSTEM UPGRADE PLAN AND CROSS-SECTION FLATTOP TECHNICAL SERVICES SCALE: AS SHOWN 14530 ECHO STREET DRAWN BY: TBI ANCHORAGE, AK, 99516 AUGUST,1995 j(attop 7echnicaf Services 14530 Echo Street, Anchorage, .91x99516 !phone (907) 345.1355 Lot 13A, Block A, Timberlux S/D, Unit #1 15301 Elmore Road Wastewater disposal system installation Specifications 1.0 General: 1.1 The scope of the project includes inspection of the condition of an existing 1000 gallon concrete septic tank and either connecting to it or installing a new 1000 gallon septic tank. A new 80 foot long soil absorption trench with a total of 8.5 feet of sewer gravel is to be constructed. 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 with 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. The contractor shall tale particular care to minimize damage to existing trees. 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 construction. 1.6 The homeowner shall be responsible for locating the northeast property boundary and the edge of the utility easement paralleling that property line. 2.0 Septic Tank: 2.1 The existing septic tank may be retained in service, only if it's structural integrity and presence of a functional outlet baffle has been verified by the inspecting engineer, and if it has cleanout pipes allowing pumping access to each compartment. Any existing septic tank or seepage pit which is not retained in service must be properly abandoned by thoroughly pumping, removing the top and backfilling with soil. 2.2 If needed, a new 1000 gallon, Municipally approved septic tank shall be located outside the 100 foot radius of the well 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. 2.3 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 within 5 feet of 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 an 80 foot long trench to a total depth of 10 feet below ground level. The alignment of the trench shall be roughly parallel to the 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 8.5 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 8.0 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 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. FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 TEST HOLE x 1 SOILS LOG — PERCOLATION TEST LEGAL DESCRIPTION: Lot 13A, Block A, Timbaluz S/D, Unit N 1 DATE PERFORMED: July l3, 1995 PERFORMED FOR: Mellen Shea & Jimmy Jackson DEPTH (feet) 1 0.11 2 ::r:•b:J^::, Pt SM Reddish sandy loam SP Clean, brown sand 4 [///� ML Gray sandy sill "�/ Dense, sidewalls smear r' sosasodbdw tas S 8 Sibs Cray gravelly silty sand 9 Hard digging, many cobbles . SidLwalls do not smear — 10 Harder digging below 12' Lm SLOPE Depth to Groundwater Date O GROUNDWATER 7/13/95 M.T. DRY 7124/95 i) `�� '• V--'4�Ty���.� r 0000 0006...........: �.. 66666 66. .t't6'6.. n THEODOne F. StOORE; 1 t�= •�� CE -2589 :14 a4 i?,r,�•......•. o tv'4—' SITE PLAN WELL 410NHOUSE 181 �SEPTIC 7 TANK SEEPAOL_,,r- Prr J TEST HOLE N2 — ......................................... 10.. Date Reading Clock Time Net Tune (minutes) Percometer Reading Net Dro (inches 7/13 1 12" Presoak :14 4:11.)23 1 Add water ; N I 221316 1116 Add water 23 1 M2 5 227 1116 dd water V4.41: 6N3 IS 221516 34 PERCOLATION RATE Y2 (minutesAnch) PERC HOLE DIAMETER 6. TESTRUNBETWEEN 525 FTAND 5.75 FT COMMENTS: T)ue to densely con•olidlit d soil, Comm n t ba<ing.dcsign on arcrite of 38-60 minsuch. Fill sewer ¢ravel e �p to 2' to utilize _ shallow clean sand stratum. PERFORMED BY FLATTOP TECHNICAL SERVICES. I -.•— �/ � CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: �� /99s- TESTHOLEN 2 FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: Lot 13A, Block A, Timberluz S/D, Unit N 1 DATE PERFORMED: July 13, 1995 PERFORMED FOR: Mellen Shea &. Jimmy Jackson DEPTHS SLOPE (I Pt. S.1 Reddish sandy loam SP Clean, brown sand NIL Gray silt SM Gray, gravelly silty sand Dane. hard digging Many cobbles Similar to Test Hole #I B.H. COMMENTS: Soils similar to Test Hole tl l Depth to Groundwater I Date ur 0- 0 N SITE PLAN WELL I "0d TEST HOUSE HOLEsI 101 SEPTIC TANK �� v SEEPAG�.o PIT TEST HOLE k2 PERCOLATION RATE (minuteMnch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT PERFORMED BY FLATTOP TECHNICAL SERVICES. I—, "( � CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:.__L'T(�I� MCITcii J.'.': HOA 1GE 1 rEA £ :i,CUGH DepartmeatclEnvuonrnen'alQuality G"ATER ANCHORAGE AREA BOR0113H 3500 Tudor Road — Pouch 6.650 HEALTH DEPARTMEM'I No 988 Anchorage, Alaska 99502 E _ _ . - fA_G��•iTAKCNOlA4E #t713_lcA' �s_CL' *'�791.351�" INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING NAME y/V/V � �"'7194`1 ADDRESS�/�5• -g� • ",52/ PHONE SEPTIC TANK: / NUMBER OF DISTANCE FROM WELL �� MATERIAI �/cc�-1%G1idL'h�r�c COMPARTMENTS %9%/��f✓/i�F'f� /3/irCt��' LIQUID LIQUID CAPACITY le�'e9G GALLONS. INSIDE LENGTH a.. INSIDE WIDTH « DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS OUTSIDE DIAMETER ✓ OR WIDTH .23 , LENGTH --2-3 , DEPTH .LOQ C/z/B ef'X✓X/ / i9✓/-cJf LINING MATERIAL DISTANCE FROM WELL �"� , BUILDING FOUNDATION j NEAREST LOT LINE TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SO. FT. TILE DRAIN FIELD: 16� DISTANCE FROM WELL TOTAL LENGTH LOT LINE , OF LINES NUMBER OF IINES�DISTANCE BETWEEN LINES TRENCH WIDTH IN. 70TA1 EFFECTIVE ABSORPTION_AR // SO. FT. LENGTH OF EACH LINE - DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE.IN. ABOVE TILE WELL; viz / DISTANCE FROM WATER TYPE DEPTH— ,BUILDING FOUNDATION. ,7o SAMPLE NEAREST NEAREST / SEPTIC / SEEPAGE / '/ OTHERV�Z LOT LINE 24 � , SEWER LINE /� �`; TANK , SYSTEM ��y , CESSPOOII�� '��SOURCEbtA�� DIAGRAM OF SYSTEM DISTANCES: NK i.ri: •.y 1 1 Q tT 1 DATE kl6e�• �3 //�� APPROVED ✓� �G G.tA6a �1 � ,`Ptd L GRE TE. AV-ORAGE AREA ''')OR UG CaseNo. �lf IIEALTII DIETARDIENT ���� � . 3'7 Eagle St. Anchorage, AlaskaFOI `r 4� - k' 17 S Pcr f� '!s-7 �N " 279.2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPLICANT yam. � /��?C�ir MAILING ADDRESS f PHONE O%77-395/3 RESIDENCE ADDRESS— S'44AW_ LOCATION OF INSTALLATION��'1i LEGAL DESCRIPTION -64---r /3 APPLICATION TO INSTALL: SEPTIC TANK_, SEEPAGE PIT_ DRAIN FIELD , OTHER TO SERVE THE FOLLOWING FACILITY%%tce— FINANCED THROUGH %14' FH4 • TO BE INSTALLED BY 7`*�**mac/ PERCOLATION TEST RESULTS ANTICIPATED DATE OF COMPLETION / BE/�LOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS --11 �Jarltti PERMIT TO INSTALL A -42z'ey llis� AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED —1 lyll,'tl + . SEPTIC TANK SIZE 000 TYPEf"� wS SEEPAGE AREA 41�, iJ� TYPEN� DIAGRAM OF SYSTEM *"T D[STAN CES:,.V�.T . a,-C:ft'1 /-led -tz7d. Z' 71 HEALTH AUTHORITY OR LICENSED DESIGNER 1 certify that 1 am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. �J DATE Lfit� /� �� 0 APPLICANTS SIGNATURE GREATER ANCHORAGE AREA BO�;p HEALTH DEPARTMENT L'' t' C! � SFS f! 327 EAGLE STREET 71 OQ 3 ANCHORAGE, ALASKA 99501 SfP I, 7 C 8Cn� iU ILj ftrforned For hwi t lgy-ILern Performed Legal Description: LotiWlock--A—Subdivison This Forn Reports a: Soils Log .-rercolatiomie$tT'--� Depth VISOCLI Feet Soil Characteristics Location Sketch s� Was Ground Water Encountered? /yo �A /I 0 If Yes, 4t W''at Depth Reading, Gross ':ire r✓t- O�yani c,-. Net Drop e ,Q srty ca-relcy, S0.hd 4 � 3 4 S jA 6 4 GravellySx-lJ s,�/f • •/ �Sl4cj, • .4 4. s� Was Ground Water Encountered? /yo �A /I 0 If Yes, 4t W''at Depth Reading, Gross ':ire Net Time Depth To H2O Net Drop t== _._ .mute Test Performed Data Certified Dy: Date: .S•e Drain Field It Cr Trenc=767-� rP1 I RSM CONSULTANTS. INC. 9034 COPOOVA f •Ox •of] f •NCNONwOf. wLASNA •+set f 1N. 9072" -*.Sl f TLE. 0+6.2,360 •NOINf •Pf O�OLOOIf t• PLANNf P• f UP Vf YO Pf August 24, 1978 R&M No. 851584 Marston Realty 2060 W. Dimond Blvd. Anchorage, Alaska 99502 Attention: Linda Switzer; flarl3arn Qac\ N�e�sev\w Re: Adequacy Test on Exisitng Sanitary Sewer System; Lot 13A, Block A, Timberlux #1 Subdivision, Anchorage, Alaska. For Professional Services Rendered August 22 and 23, 1978. Dear Ms. Switzer: The following is our invoice for professional services rendered on the above - referenced project. Professional Services Fixed Fee Invoice No.851584-1 Total Invoice No. 851584-1 $155.00 $155.00 Please note our invoice number on your remittance. Should you have any questions concerning this invoice, please contact me or the Project Manager, Mr. Gary Smith. Thank you, R&M SONSULTANTS, INC. 1M. A Jaz chorage Office Manager N 'SIAM/kky/20-N ANCNOPwcc I.IN.AN MS JUN[wv VALOCz wASILLw rN r1. R&M CONSULTANTS, INC, SBZ! CORDOVA B BOR 9087 B ANCHORAGE. ALASKA s»ca B PH. Sl T 210'!487 B 1Lx. 0912S%40 •NOINIIRB OI OLOO,B tB PIYNNIRt BURVIVOR• August 24, 1978 R&M No. 851584 Marston Realty 2060 W. Dimond Anchorage, Alaska 99502k Ci�x1 Nie.\sa.� Pc-��rh� Attention: Linda Switzer; Parbare 4aeobs preko,Ley6 Re: Adequacy Test on Existing Sanitary Sewer System; Lot 13A, Block A, Timberlux PI Subdivision, Anchorage, Alaska Dear Ms. Switzer: Per your request of August 21, 1978, we conducted a test of the sanitary sewer system on the above described property. The septic tank was pumped prior to the performance of the test on the see- page pit. During the test the liquid level in the seepage pit was measured before and after the addition of 1000 gallons of water. The total depth of the crib was 9.5 feet. All liquid levels were measured below the top of the standpipe and are shown in the following table: Initial Water Second 24 hour Total Reading Added Reading Reading Drop (gallons) 9.5' 1000 7.0' 9.0' 2.0' The meter used during the test was a Neptune 1k" standard water meter which had previously been calibrated by R&M Consultants, Inc. The water level rose 30 inches with the addition of 1000 gallons of water, indicating a capacity of 33.4 gallons per inch. Twenty-four hours later the liquid level was again measured and found to be 9.0 feet. It had dropped 2.0 feet or 24 inches. This indicates an average effluent acceptance rate of 802 gallons per day for the surrounding soils. If the 2 bedroom residence on the property is to house 4 people, the average load on the system can be expected to be 300 gallons per day. We can therefore conclude that the system is disposing of effluent at an adequate rate for a 2 bedroom residence. ANCHORAGE IAIRBANKS JUNEAU VALOEZ WASILLA August 24, 1978 h Marston Realty Page -2- r^+ We appreciate this opportunity to be of service to you. Please contact us if you have any questions regarding this letter or if we can be of additional service to you. Very truly yours, R&M CONSULTANTS, INC. �y� � Lyme Kosikowski 4 Staff Geologist GS:LK/kky/12-F Gary Smith Proj t Manager MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section - Fax. 907-343-7997 Certificate of On -Site Systems Approval Parcel 1. D. 018-271-32 iwe] 21►1A 7_1a1►1to] Vt►i/elIEel i, Expiration Date: 11-27-21 Complete legal description TimberlUx #1, Block A, Lot 13A Location (site address) 15301 Elmore Rd, Anchorage, AK 99516 Current property owner(s) Gregory Bilberry & Camilla Madden Day phone 907-350-1892 Mailing address same Real estate agent 2. TYPE OF DWELLING: Fx7l Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well E Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ --SO Date of Payment F0712 Receipt Number (')0 30 COSA # O -DCZ I / y'30 Waiver Fee $ Date of Payment Receipt Number 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Crewdson Engineering LLC Phone 907-280-9493 Address 18368 Amonson Rd, Chugiak, AK 99567 Engineer's Printed Name James Crewdson Date 8-25-2021 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved .� O F A Tom, Jam s A. Crewdson i 011527 .•ma00y10 Conditional approval for bedrooms, with the following stipulations: V� Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory_ Other COSA Checklist blue sheet COSA Checklist Legal Description: Timberlux #1, Block A, Lot 13A If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled Unknown Total depth Unknown Cased to Unknowf ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 8-9-2021 Static water level at beginning of test 151 ft. Comments . B. TANK DATA Age of tank(s) 49.6 years Tank type/material Concrete Measured operating fluid level in septic tank 49"* ❑ Standpipes/foundation cleanout per record drawing Date of pumping 8-11-2021 D. ABSORPTION FIELD DATA Which system tested (date installed) 9-21-95 ❑ ALL standpipes present per record drawing Total measured depth from grade 11.6 ft (max) Measured depth to pipe invert from grade 3.4 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 018-271-32 Structure served by this system Well production at time of test 0.9 gpm Water storage tank volume 500 gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L OR Arsenic less than MRL (ND) Collected by Crewdson Engineering LLC Date of Sample 8-9-2021 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: *1/4" above double cleanout invert Adequacy test date 8-9-2021 Results EJ Pass For 3 bedrooms Fluid depth prior to test 45 in Water added 450+ gal New depth 52 in Elapsed time 60 min Final fluid depth 45 in Absorption rate 450+ gpd Any rejuvenation treatment (past 12 months) No If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) 7 Septic Tank/Lift Station on Lot > 100' 71 * ft Community Sewer Manhole/Cleanout > 100' Water Main > 10'✓i Yes if No ft ✓M Yes if No Neighboring Tank > 100'✓0 Yes if No ft Private Sewer/Septic Line > 25' Yes if No Absorption Field on Lot > 100'✓71 Yes if No ft Holding Tank > 100' Yes if No Neighboring Absorption Fields > 100' Animal Containment > 50' P/1 Yes if No 0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' F/� Yes if No ft FVJ Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' Property Line > 5'✓� Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 0 Yes if No ft Private Wells > 100' ft ft ft ft ft El Yes if No ft F,71 Yes if No ft Water Main > 10' ✓Q Yes if No ft Community Wells > 200' Q Yes if No ft Water Service Line > 10'✓� Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10'✓® Yes if No ft If absorption field is under driveway comment below Property Line > 10' 7 Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓i 1 Yes if No ft Private Wells > 100' ®✓ Yes if No Water Service Line > 10' Yes if No ft Community Wells > 200' Yes if No Surface Water > 100' Q Yes if No ft F. ENGINEER'S COMMENTS * approved at time of construction G. ENGINEER'S CERTIFICATION I certify that / have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet d Avw 1H . .. .. Jam s A. Crewdsnn : '� C11527 $�1�OpFERSSI ft ft Municipality of Anchorage ,s R Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # OSC211490 During a recent COSA on-site inspection and test of the potable water supply well on Block A, Lot 13A of Timberlux#1 subdivision, the well's productivity was determined to be .9 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is .31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. Municipality of Anchorage Development Services Department Building Safety Division _ On -Site Water and 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 FOR A SINGLE FAMILY DWELLING 6"Fioert Parcel 1. D. Or 6 -2T I - 3 Z COSA # q %R Expiration Date: % -A l O Cl 1. GENERAL INFORMATION Complete legal description L_ of '7A, 13/k A , -rj n, & ee-f4 x .0/d *f/ Location (site address) IC 3a I G -I," o -r Rot.' Current Propertyowner(s) Tf'#r"my Ue.ckrbn Dayphone 2S0-tY19 Mailing address 15,361 imw/n.or[ R.t,I}� 995-1'e' Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. P f«,rt col/ t..ye. Ca, We, rsao(cee„ of 230-Z 719 c•nsC u&- SC/tei TMT'VawcLcto, 2. NUMBER OF BEDROOMS: I— QF Psp-fvr9 w/irr CafA ir•,o! .4,- 3. TYPE OF WATER SUPPLY: Individual Well 19 Individual Water Storage El Community Class Well ❑ Public Water System El dock-..r, G/crn 9�2Y/o9 Y TYPE OF WASTEWATEk DISPOSAL: Individual On-site R 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 State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water 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 Fla /-W Ti c to, cw / Ce~,c W� Phonest'<— Address IYS'3o Ecom 6v e,yw- Rd, +"es "5'/1 Engineer's Printed Name Date 9/16/4o9 ��ff f I e,?e,./QTI o r0j'A � 09 of -•6 1t . ;" �. '.1:� ;,f Z)� f. �'a.1.••..� s`� ..�y 5. DSD SIGNATURE CE Approved for bedrooms. -3569 Disapproved. 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: —L. ( — D q (Rev. 17105( FM SCS Re L# 1094774001 Client Name Spurk land Engineering Project Name/# Timberlux kl DA L13A Client Sample ID Timberlux #I DA Ll 3A Matrix Drinking Water Sample Remarks: Parameter Metals by ICP/HS Arsenic Waters Department Total NitratclNitritc-N Microbiology Laboratory Colony Count Total Coliform Fecal Coliform Results ND Printed Datefrime Collected Date/time Received Date/time Technical Director 09/182009 14:35 09/092009 12:45 09/092009 13:30 Stephen C. tide Allowable prep Analysis Units Method Container ID Limits Date Date Ink 5.00 ug/L EP200.8 C (<10) 09/14/09 09/16/09 NRB 0.100 mg/L SM204500NO3-P It (<10) 09/15/09 LCB 0 coU100mL SM20922211 A (<200) 09/09/09 DLC 0 coU100mL SM209222n A (<I) 09/09109 DLC 0 coUl00mL SM209222B A (<I) 09/09/09 DLC Municipality of Anchorage --1 Development Services Department Building Safety Division `^ On -Site Water and Wastewater Program 4700 Elmore Street ' " r ` P.O. Box 196650 Anchorage, AK 99519-6650 vnvw.muni.org/onsite (907) 343-7904 r�lc CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 0 (J9 - 2 71 - B Z COSA # Q9 0178 Expiration Date: C1 - " O 9 1. GENERAL INFORMATION Complete legal description 1, of 13A. Q 1 k A! U 1 Location (site address) 15" 301 E 10" 0 re R rf Current Property owner(s) _,3'sa M er Day phone 3 VS - 17 -VE Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 15'301 Elmore Rol, 4"Ch'anim A -1c 995-16 Day phone Day phone Unless otherwise requested, COSA will be held by DSD for pickup. 17(1a re CC, 11 awn er @ 3 tr- 12Y8 2. NUMBER OF BEDROOMS: 3 er uf'-STYS tmh A Caf4 A&W'r Ar 3. TYPE OF WATER SUPPLY: Individual Well IR Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ 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 State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water 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 Fla f4blo TecAn iced Sefv2*ca Phone Address 1 S'30 Ee-Av A -n cl,or'eaan 99.1' 16 Engineer's Printed Name Date S/ ii ii a �•1 ti r � Q�'`'t i•.•. e••••••••••.•?ANI y : TI+ECD07.E F. AECC 5. DSD SIGNATURE i,^ '. CE-asn :U •.,4�,�i�r Approved for �L bedrooms. '' c ••^ Disapproved.' T Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Arsenic Advisory Septic System Advisory Well Flow Advisory Nitrate Advisory rrpJl . IvIXVW Maintenance Agreements Supplemental Engineer's Report Other By 01 l&/ Original Certificate Date: Cy ' " (R•r. 11A5) Municipality of Anchorage .° ' Development Services Department i Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsfte (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: I.o f 13 A•0 Q lock A, Tirn b ee l ak S /D #/ , Parcel ID: -Gr 8 G 7I — 3 Z A. WELL DATA Well type Pvl If A. B, or C provide PWSID # — Well Log (Y/N) N Date completed . _±9 Sanitary seal (YIN) Y Wires property protected (Y/N) Y Total depthlift. Cased to> ko ft. ` Casing height (aboveground) min. FROM WELL LOG AT INSPECTION Date of test '4/ / l y 109 Static water level ft I `I 3 Well production g.p.m. L g.p.m. WATER SAMPLE RESULTS: Coliform g colonies/100 mL Nitrate Gb. r mg/L Other bacteria _6) colonies/100 mL Arsenic: ug/L date of sample: L#Zioy Collected by: iFlo/ue._T, ehS t B. SEPTICIHOLDING TANK DATA TankType/Material SaPl+c / CCaAcreil - Date installed ! rz-/ 13 /? i Tank size 1000 gal. Number of Compartments I Cleanouts (Y/N) Y Foundation cleanout (Y/N) YO Depression over tank (Y/N) _N High water alarm (Y/N) P. A Date of pumping _Y 170 1 0' Pumper _ Stat a cf C. ABSORPTION FIELD DATA * Fn(n f.p, if .n CiY?tu/ Sp••cr o„t.dt huwe Date installed i /21 /9S Soil rating (g.p.d./ft2 or ft2/bdrm) o•yS qPW System type 'iiv^ ch Length SS ft. Width 2 -r ft `Gravel below pipe `P. Z ft. Total depth O.O ft. Eff. absorption area LL9Lfe Monitoring tube Y Depression over field N Date of adequacy test '•1 / IS / O 9 Results (Pass/Fail) Poul'For_;L_bedrooms it Fluid depth in absorption field before test y 9 in. Water added 20Sgal. New depths in. Elapsed Time: 19 min. Final fluid depth S? -Z in. Absorption rate >= •fine g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date P. A I D. LIFT STATION N A Date installed 'Pump on' level at _ in. Datum Size in gallons Manhole/Access (YIN) 'Pump off" level at _ in. High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 7/1 On adjacent lots > t ao Absorption field on lot t c, 2' On adjacent lots > tom' Public sewer main N• A. Public sewer manhole/cleanout ?--I - A._ Sewer /septic service line '> 2S' Holding tank P. A. Animal containment areas N- A- Manure/animal excrete storage areas N- A, SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation IS' Property line &S, Absorption field *Zr' Water main N- A. Water service line > 10 ' Surface water er (coo Wells on adjacent lots > (CIO' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 1-7' Building foundation .To' Water main N• A. Water Service line (oSurface water !> to c ' Driveway, parking/vehicle storage 2.6-' Curtain drain Nonc stir) Wells on adjacent lots > 1G0 F. COMMENTS well -Ste hr karate ftna/�tiFYe n u.a✓ G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineers Printed Name 7A4e&,:P&.e t= r+o o ^[ Date r/26/ Zoog COSA Fee $ q 90== Date of Payment 6 /7 15 -/ o� Receipt Number I r - (Rev. 11/05) leOa/ of o /'�me e� rRr%rlahi,:n Waiver Fee $ Date of Payment Receipt Number !Y.•.�....... ...... ., ....... •1, C cc 302 e =LOT lA . EAST :. i0' UTIL. \ Y9 \ PAVED .ORI'AY • /09 4 to e0 w -LOT 3A 0 G LOT /lA Lor =73A , Block A101 �� � ; ..eatron o e e e ,+}. •.� 151192 �6�etlux . _ Sufxli_v�sion Un/t ..No l �� `�9s •• •••� Anchorage Recording District, Alaska eo.. lot o n of mord other then mora shown on 1,\"�== no plat of oordroora Not shown hereon Dolan. otberwlee Noted. 0¢ /8-09 LOT SURVEY CERTIFICATION . LEGEND 1 Poo by aernry tM+IMw evrveyod the property shown end doaarlbed 0 Bross or Aluminum capped monument recovered Mreon. end that the 1pp monte altuoted Meroon art within the prop. 0 Iron pipe and/or rebar recovered. arty Mnoe and do not overlap er enof ph on od Jaoent property and that 0 . x 2 hub to tack recovered M hnpro.rme,de on odlaoont property evertap or sneroach M the prrmleeo • 5/8e x W rebar tet this survey In euntlon end Mat then we no roadways aunty Ihme, or othw visible Fence Lirie (Approx. Location) easements on sold property eaoopt n indicated hereon. Scale/n -^I o , Date © 04 -/g - 0,9 ap6P,1aR.\ Sr WELL � i � �� C) Property of: -.mc clock- -- ih' -, � �N v h \ .i//&�N � e 0 G LOT /lA Lor =73A , Block A101 �� � ; ..eatron o e e e ,+}. •.� 151192 �6�etlux . _ Sufxli_v�sion Un/t ..No l �� `�9s •• •••� Anchorage Recording District, Alaska eo.. lot o n of mord other then mora shown on 1,\"�== no plat of oordroora Not shown hereon Dolan. otberwlee Noted. 0¢ /8-09 LOT SURVEY CERTIFICATION . LEGEND 1 Poo by aernry tM+IMw evrveyod the property shown end doaarlbed 0 Bross or Aluminum capped monument recovered Mreon. end that the 1pp monte altuoted Meroon art within the prop. 0 Iron pipe and/or rebar recovered. arty Mnoe and do not overlap er enof ph on od Jaoent property and that 0 . x 2 hub to tack recovered M hnpro.rme,de on odlaoont property evertap or sneroach M the prrmleeo • 5/8e x W rebar tet this survey In euntlon end Mat then we no roadways aunty Ihme, or othw visible Fence Lirie (Approx. Location) easements on sold property eaoopt n indicated hereon. Scale/n -^I o , Date © 04 -/g - 0,9 Prepared by: R.L. BUTTON ReDiatdred [ono SLrvdyoi (907)279-6200 5/9 W. EighrhAve. Anchorage Alas -09501 Ret 3136 F.B. No. 0,9-020 Property of: -.mc clock- -- ih' -, 1 1♦ TpiiaTr 5. LEGAL DESCRIPTION � 0 I STREET LOCATION Nati MUNICIPALITY OF ANCHORAGE (, , . ��•� DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ` \ 825 L Street • Anchorage, Alaska 99501 9. TYPE OF RESIDENCE .ENVIRONMENTAL ENGINEERING DIVISION `tf \' Telephone 264-4720 it REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER ,FACILITIES �- Q7� Two ❑ Five ❑ Three ❑ Six 7. WATER SUPPLY (� INDIVIDUAL' 'ATTACH WELL LOG. Awell log is required forall wellsdrillI DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be Processed. Please allow ten 110) days for processing. ed since June 1975. For wells drilled prior to that d te, give well 1. PROPERTYOWNER depth (attach log if available.) F& PHONE VJ INDIVIDUAL/ON-SITE" _ **If individual/on-site, give installation date % 9 , CD PUBLIC UTILITY If system is over two (2) years old an adequacy test is required MAILINGADDRESS NJLL NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. StJi+ r �T.s l ovt D � ' n Q�De�. ' �, PROPERTY RESIDENT (If different from above) PHONE U cu — o - 2. BUYER - 11 H MAILING ADDRESS 83S, ►- aIDS cra e9950 / 3. LENDING INSTITU N ION PHONE MAILING tQ/TCI✓ n WI `'j V%G/ `Qi'%r 1. �/• l� /V. Lam% 4 f �/J �EXY• 4. REALTOR/AGENT PHONE MAILING ADDRESS . 5. LEGAL DESCRIPTION � 0 / / I %% 1n Zi e r ! -#y STREET LOCATION Nati /:)Y.: 9. TYPE OF RESIDENCE NUMBER OF BEDROOMS - ❑ One ❑ SINGLEFAMILY -Four ❑ Other ❑ MULTIPLE FAMILY Q7� Two ❑ Five ❑ Three ❑ Six 7. WATER SUPPLY (� INDIVIDUAL' 'ATTACH WELL LOG. Awell log is required forall wellsdrillI ❑ COMMUNITY ed since June 1975. For wells drilled prior to that d te, give well ❑ PUBLIC UTILITY depth (attach log if available.) F& B. SEWAGE DISPOSAL SYSTEM VJ INDIVIDUAL/ON-SITE" _ **If individual/on-site, give installation date % 9 , CD PUBLIC UTILITY If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. »nsma nul 4 I �PG S{ �O/'ltGtC� &X4 d P� Linalc, o sc� ed. 1{ r,7 s / -eC 7 � ,3 74 w 3-4/V - --7 -7 el 3 Ao THIS SIDE FOR OFFICIAL USE ONLY - INSPECTION APPOINTMENTS DATE RECEIVED TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPEOF RESIDENCE a{ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY CO, INDIVIDUAL ❑ COMMUNITY ❑ PUBLICUTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SS AGE DISPOSAL SYSTEM L NUIVIDUAL/ON-SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED 11 — —71 INSTALLER ❑SepticTankor ❑Holding Tank Size:1000 If Tank is homemade give dimensions: SOILS RATING pZ - TYPE OF TANK MA ACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELLTO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS e. CL, APPROVED FOR _ BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY (Title) LEGALDESCRIPTIONDESCRIPTION 72-010 (Rev. 3/78) ✓r'