HomeMy WebLinkAboutHIDEAWAY LAKE BLK 2 LT 5Hideaway Lake
Block 2
Lot 5
#015-471-16
Municipality of Anchorage
Development Services DepartmentBuilding 1�t
Safety Division
On -Site Water and Wastewater Program, 4700 Elmore St.
P.O. Box 196650 Anchorage, AK 99519-6650 Page I of 0X_
ve ve.ci.anchorage.ak.us (907) 3417904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: 'SW R L4 (ie`ty PID Number: 015 ^14 •4 ( — E "p—
pName'
Nam
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Wastewater System: []New ❑ Upgrade
Addles,
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ABSORPTION FIELD
Plwne: Number of Bedrooms
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LEGAL DESCRIPTION
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SEPARATION DISTANCES
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Engineer's Stamp
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Development Services Department Approval
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Conditional Approval Date:
.y
49TH a
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Ib • MICHAEL N.
ANDERSON . /
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Reviewed and approved by: W t Date:
cRr awal
��\� RQFES����e-`t`
Permit No. SW940084
Page 2 of 3
DATE: 7/8/2009 Municipality of Anchorage
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
Legal Description: HIDEAWAY LAKE, BLOCK 2, LOT 5 PID No.: 015-471-16
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1�EL N. ANDERSONr i
�No. CE 9469
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Michael N. Anderson, P.E.
Civil/Structural Engineering
4661 Natrona Ave.
Anchorage, Alaska 99516
Phone 345-3377
Far 345-1391
July 19, 2009
Municipality of Anchorage
Department of Health and Iluman Services
P.O. Box 196650
Anchorage, Alaska 99519-6650
Re: Lot 5 Block 2 Hideaway Lake Subd.
Dear Jet,
Please consider this my official letter requesting that the replacement site for the above lot, be an Advantex
system due to well radius and o5pp5eenwateroffsets. A5 ori �r;s�t•K, i..n.ti t—+vpbre� w�
tJ*W Str4{TM % J�(�r40 i"r,.
If you have any question please call me at 345-3377
Sinc/e�An
Mic 6n, P.E.
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURCES
DIVISION OF WATER
WATER WELL RECORD
LOCATION OF WELL
BOROUGH
SUBONISION
LOT
BLOCK
SECTION OTItS
SECTION
TOWNSHIP
RANGE
MERIOIAN
I
ON
0
I
Os
OW
LOCATION/SKETCH: y
WELL OWNER:
DEPTHS MEASURED FROM:❑casing top ❑ground surface
WELL DEPTH: DATE OF COMPLETION
Depth of hole: ft
BOREHOLE DATA: Depth
Depth of casing: --/ It %
Material Type and Color From TO
DEPTH TO STATIC WATER LEVEL -
It below ❑ top of casing ❑ ground surface
Date*
+ ,
METHOD OF DRILLING: ❑ air rotary ❑ cable tool
❑ other
USE OF WELL: ❑ domestic ❑ irrigation ❑ monitor
❑ public supply ❑ other
CASING STICK-UP: I Diam: in. toit
Casing type:.', , � in. to G, 'r ft
WELL INTAKE OPENING TYPE: ❑ open end ❑ screened
_
❑ perforated .❑ open hole
Depths of openings: to It
SCREEN TYPE: Diam: in.
Slot/Mesh Size: Length: It
GRAVEL PACK TYPE:
Volume used: Depth to top:
GROUT TYPE: Volume:
Depth: from ftto It
DEVELOPMENT METHOD: •'1
Duration: 1/1'.
PUMPING LEVEL AND YIELD:
/` ? ftafter hrspumping • g
] pm
PUMP INTAKE DEPTH: It Horsepower.
WELL DISINFECTED UPON COMPLETION? EI YES ❑ NO If
CONTRACTOR INFORMATION:
Registered Business Name
Signature of Authorized espresentative Uatm e
REMARKS:
PLEASE MAIL WHITE COPY OF LOG TO:
DNR/DIVISION OF WATER
PO BOX 772116
EAGLE RIVER AK 99577.2116
MUNICIPALITY OF ANCHORAGE 16r
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
PAGE 1 OF 1
9/3/5q c "lop'n
2"%44T12.kv e) q 3O
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW940084 DATE ISSUED: 4/21/94
DESIGN ENGINEERS & S ENGINEERING EXPIRATION DATE: 4/21/95
OWNER NAME:AUGDAHL ROGER W &
OWNER ADDRESS:11101 HIDEAWAY LAKE CIR
ANCHORAGE, ALASKA 99511
i
PARCEL ID:01547116 QO Non\\w
LEGAL DESCRIPTION: HIDEAWAY LAKE BLK 2 LT 5 �� @
LOT SIZE: 52596 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT:
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS
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:
RECEIVED BY:
ISSUED BY:
DATE:
DATE:
A
HEALTH AUTHORITY
APPROVALS
SEWER WATER
MAIN EXTENSIONS
SEWER 8 WATER
INSPECTION
AND REPORTS
k=
April 10, 1994
PA )
of Anchorage
NT OF HEALTH AND HUMAN SERVICES
25 'L' Street
.O. Box 196650
nchoraae. Alaska 99519-6650
Hideaway Lake Subdivision, Block 2, Lot 5
Permit #SW910129
ROBERT SHAFER, P.E.
ROGER SHAFER, P.E.
CIVIL ENGINEERS
(907)694-2979
FAX 694.1211
guest you re -Issue a permit #01547116 with a design change to eliminate
spill-over trench as shown on attached site plan.
WELWSPECTION
8 FLOOW TEST Test holes were excavated and percolation tests performed. The approximate
location of the test holes are located on the attached site plan. At the time of
excavation water was encountered at 10.5 feet & 10 feet in test holes one and
two respectively and after seven day water monitoring water was found at 10.5
517E PLANS feet and 10 feet respectively.
This property has enough area for a future septic upgrade which can be seen on
ROAD DESIGN the attached site plan. We do not anticipate any adverse effects on neighboring
properties by the installation of the proposed septic system.
SOILTEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ON SITE
WASTEWATER
DISPOSALSYSTEM
DESIGN
If you have any questions, or require additional information for your review,
Shafer, P.E.
17034 NORTH EAGLE RIVER LOOP - SUITE 204 - EAGLE RIVER, ALASKA 99577
SCALE
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ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES
and
MATERIAL SPECIFICATIONS
REFERENCE. Hideaway Lake Subdivision, Block 2, Lot 5
GENERAL:
1. The scope of this project includes the installation of a 1250 gallon septic
tank and a leachfield trench to serve the proposed four bedroom residence
on the referenced property.
2. Construction shall be in accordance with the approved site plan and design
drawings, Municipal permit with anyspecial provisions or conditions, and all
applicable State and Municipal Wastewater Disposal Regulations.
3. The contractor shall be responsible for obtaining any necessary
underground utility locates.
4. Unless specifically agreed otherwise, the property owner shall be
responsible for final grading areas subsequently depressed from soil
settling. On all leachfield mound systems, the property owner shall be
responsible forensuring a satisfactory vegetation growth over the mounded
area.
5. Contractors installing wastewater disposal systems must be certified by the
Municipal Health Department for system installations. Owners installing
their own systems must also receive prior approval from the Municipal
Health Department.
SEPTIC TANK INSTALLATION:
A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shall include two 4' cleanouts for pumping access.
2. The septic tank shall be sufficiently bedded to prevent settling or shifting of
the tank.
3. All standpipes on the septic tank shall extend a minimum of 12 inches
above final grade.
Page Two
Hideaway Lake Subdivision, Block 2, Lot 5
April 10, 1994
4. Septic tanks installed with less than 4 ft. of cover shall be insulated.
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 /t. 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 TRENCH/DRAINFIELD INSTALLATION.
Excavate the proposed trench to the dimensions shown on the design. The
bottom of the excavation shall be within 2 inches of level. if the sidewalls
of the excavation become smeared, they must be raked or scratched
(ruffed -up) before gravel (sewer rock) placement.
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 barriermust be installed between the final gravel layerand 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 and installed approximately
in the locations shown on the design. 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.
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.
Page Three
Hideaway Lake Subdivision, Block 2, Lot 5
April 10, 1994
MINIMUM MATERIAL SPECIFICATIONS:
1. Any septic tank proposed for installation must be constructed by a
Municipally 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 (HDPE) Yes No
ASTM D2662 (ABS) Yes Yes
Use of a type of pipe other than listed above must be approved by the
inspecting engineer.
3. Insulation shall be at least 2' thick extruded direct burial polystyrene (Dow
Chemical Company Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings
(Caulder, Femco, or equal).
5. A permeable nontoxic silt barrier (fypar 3401, Mirafi 140N, 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, it's gradation specifications
must conform to current M.O.A. or D.E.C. requirements.
Page Four
Hideaway Lake Subdivision, Block 2, Lot 5
April 10, 1994
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:
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/OWNER
Munlclpality of Anchorage `
...
DEPARTMENT OF HEALTH 11 HUMAN SERVICES '
825'L" Street, Anchorage, Alaska 99502-0650 .......
SOILS LOG — PERCOLATION TEST A, Er.sa
F.�CiG I`�` 1 'Vim,/��` '��,..�I1'r .'•. \;•r�\77�� I✓
PERFORMED FOR: OA PERFORMEW '�"'Y••�•'•�
LEGAL DESCRIPTION: l.)yv V�j064 w./ L44.• Township, Range, Section:
1
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17-
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19-
20
7181920
COMMENTS
SLOPE
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Depth to Willer Alter/
Mmllerinpl I O Due. !6L
.�' el
PERCOLATION RATE (minuteyneh) PERC HOLE DIAMETER
TEST RUN DETWEEN R FTAND --+— FT
PERFORMED BY) 7 J34 f.a0lo River Loop Road fl ,104
77 ff""
ACCORDANCE W -tH ALL ST TE AND MUNICIPAL GUIDELI
72-008 (Rev. 4185) lllll���..
�—
CERTIFY THAT THIS TEST WAS PERFORMED IN
ON THIS DATE. DATE: 2—. G
— ` r
�� ' _ - •
lJ�ilE�lit�
MIMI
-KSPMWI
.�' el
PERCOLATION RATE (minuteyneh) PERC HOLE DIAMETER
TEST RUN DETWEEN R FTAND --+— FT
PERFORMED BY) 7 J34 f.a0lo River Loop Road fl ,104
77 ff""
ACCORDANCE W -tH ALL ST TE AND MUNICIPAL GUIDELI
72-008 (Rev. 4185) lllll���..
�—
CERTIFY THAT THIS TEST WAS PERFORMED IN
ON THIS DATE. DATE: 2—. G
— ` r
I *
PERFORMED
LEGAL
. 2
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3
4 1,F.
:{ /
7-
8-
9-
12-
13-
14-
is-
16-
17-
18-
19 -
2o4 891213 14151617181920
COMMENTS
.;SSG(f19i31NE fiS�EAL)
• .> •„ •SEE}
Municipality of Anchorage 211
DEPARTMENT
> : '�..3° `•. ti G' �d
DEPARTMENT OF HEALTH d HUMAN SERVICES
825 `L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST eoe•A• [,;%u':vk
r•:'J. r
• '• w t4i%i � J�•O
F.TA
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1/S?
0
Township,
DATE
Section:
1 /`� WAS GROUND WATER • /��
/,/K' ✓t— ENCOUNTERED?�%((j7_
S
IF YES, AT WHAT L
DEPTH? 0
P
E
Depth to Water Alter I OI 2-167L
' I
Q Monitoring? Dale:
1�
PERCOLATION RATE —A—Le— (minuteLinth) FERC MOLE DIAMETER
TEST RUN BETWEEN ,�qZp — FT AND 'I FT
PERFORMED 837034 Eaolo River Loop Road No. 204
Eag a IvCrl—i'�I2Skr97SI/
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDEL14
72-008 (Rev. 4185)
CERTIFY THAT THIS TEST WAS PERFORMED IN
ON THIS DATE. DATE: Z r J ---v r
o L4[T•��!•�C1�L'�I�f�TEi�
1�
PERCOLATION RATE —A—Le— (minuteLinth) FERC MOLE DIAMETER
TEST RUN BETWEEN ,�qZp — FT AND 'I FT
PERFORMED 837034 Eaolo River Loop Road No. 204
Eag a IvCrl—i'�I2Skr97SI/
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDEL14
72-008 (Rev. 4185)
CERTIFY THAT THIS TEST WAS PERFORMED IN
ON THIS DATE. DATE: Z r J ---v r
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW910129
DESIGN ENGINEER:S & S ENGINEERS
OWNER NAME:AUGDAHL ROGER W &
OWNER ADDRESS:P.O. BOX 110711
ANCHORAGE, ALASKA 99511
PARCEL ID:01547116
LEGAL DESCRIPTION: HIDEAWAY LAKE BLK 2 LT 5
LOT SIZE: 52596 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
PAGE 1 OF 1
DATE ISSUED: 6/04/91
EXPIRATION DATE: 6/04/92
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM
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 FOLLOWING SPECIAL PROVISIONS.
SPECIAL PR
RECEIVED B
ISSUED BY:
DATE• `
DATE:6� 7 - /
ROBERT SHAFER, P.E
ROGERSHAFER
CIVILENGINEERS
(907) 8942979
FAX 694.1211
May 31, 1991
NEALTH AUTHORITY
APPROVALS
Municipality o6 Anchotage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
SEWER&WATER
P.O. Box 196650
MAIN EXTENSIONS
Anchorage, Atka 99519-6650
REFERENCE: Lot 5; Btock 2; Hideaway Lake Subdivision;
SEWER& WATER
INSPECTION
PERMIT REQUEST NARRATIVE
Request you .issue a permit to .inatatt the proposed on-a.ite wett and
ENGINEERING STUDIES
AND REPORTS
septic system aA shown on the attached site. tan.
P y P
We have proposed dtain6ietd trenches to be .insta.tted down the existing
atope o6 approxFinatety 10%. The trenches ate to be ahattow with the
Rine exiting the house at app4oximatety 1 6t. betow ot.i.ginat
WELLINSPECsewer
•FLOW TESTTION
grade due to gtoundwatet encountered at 10 6t. betow the ground
suAjace. The atietnate teach6.ie.td trench wilt tegwiAe a Ri6t station
to be .inatatted.
SITE PIANS
The ptopettiea .in the area a4e tetativety .targe and we 6o,%uee no
negative .impact on adjacent ptopetties by the .inatattation o6 the
proposed wett and septic system.
It shou.td be noted that the southwest pottion o6 the property .is a
ROAD DESIGN
te.tati.ve.ty .tow, wet a4ea with amatt aptfnga draining .into an existing
c4eek maintenance easement. The proposed septic .is in ex.cea6 o6 100
6t. to these apti.ngs.
SOILTEST
16 you have any questions of Lequ.iAe additiona.t in6o4mation 6o4 your
e contact us.
i:7
PERCOLATION
TEST
i
A. SHAFER, P.E.
STRUCTURAL&
MECHANICAL
INSPECTIONS
ONSITE
WASTEWATER
DISPOSAL SYSTEM
DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
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Muof Anchorage
OF ti
DEPARTMENT OF t1EALTH d HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: Jr� ��
LEGAL DESCRIPTION: L.
he
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19
20
COMMENTS
Section:
SLOPE
WAS GROUND WATER /i•/
ENCOUNTERED?
S
IF YES, AT WHAT L
DEPTH? 0
P
E
Depth to Weter Atter
Monitoring? I c:> Detr. 7
It
t, qtr, A. Et?!a
�cocnoil[r..41f /tiY..•TJ /+e
PERCOLATION RATE (minutestinch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND --+— FT
!1
PERFORMED BY17T34 F.a:fo Rivar Loop Road Nn 104
laska
ACCORDANCE W
II ALL STle ATE AND MUSNICIPAL GUIOELIei
72 -ON (Rev. 4r95)
�— CERTIFY THAT THIS TESTI WAS PERFORMED IN
ON THIS DATE. DATE: 2��
��
lel
.. •
treat'—
- �'�•
PERCOLATION RATE (minutestinch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND --+— FT
!1
PERFORMED BY17T34 F.a:fo Rivar Loop Road Nn 104
laska
ACCORDANCE W
II ALL STle ATE AND MUSNICIPAL GUIOELIei
72 -ON (Rev. 4r95)
�— CERTIFY THAT THIS TESTI WAS PERFORMED IN
ON THIS DATE. DATE: 2��
PERFORMED
LEGAL D
2-
3-
4-
7 34 t !�
9-
12-
L L 12 _l___
13-
14-
15-
16-
17-
is -
1 9
3141516171819
20
COMMENTS
Municipality of Anchorage
DEPARTMENT OF HEALTH 6 HUMAN SERVICES r
825 `L' Street, Anchorage, Alaska 99502-0650 •/
SOILS LOG — PERCOLATION TEST YI
FA
1�
Township,
DATE
Section:
1 /� ENCOUN ERE WATER , //'
1/f ENCOUNTERED?
IF YES. AT WHAT
DEPTH?
Depen to Wrier lino 10
i r
Monitoring? - Date:
.1I
• f'1
osr, R..F,�l:.r • ,v.
F:u twi': •i S•.�'s
1r
PERCOLATION RATE 1' � (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND dl FT
PERFORMED
7034 Eag1a River loop Road No. 204
E .ag a rvcrT:M77--
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELI�
72.009 (Rev. 4/85)
CERTIFY THAT THIS TEST WAS PERFORMED IN
ONTHISDATE. DATE: Z — J-r-c?r
iiYL--Sii7f.'3�
1r
PERCOLATION RATE 1' � (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND dl FT
PERFORMED
7034 Eag1a River loop Road No. 204
E .ag a rvcrT:M77--
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELI�
72.009 (Rev. 4/85)
CERTIFY THAT THIS TEST WAS PERFORMED IN
ONTHISDATE. DATE: Z — J-r-c?r
u56789707
rV ii � -y: ty c�
G` *Akjl
•
• JUL t n
• A Municipality of Anchorage �� 3
'� On-Site Water and Wastewater Program
(907) 343-7904 O! s A F _
g`11 '
Certificate of On-Site Systems Approval
Parcel I.D. 015-471-16 Expiration Date: 11 - 7- J
1. GENERAL INFORMATION
Complete legal description Hideaway Lake B2 L5
Location (site address) 11101 Hideaway Lake Cir.
Current Property owner(s) Lisa & James Huffman Day phone
Mailing address 11101 Hideaway Lake Cir Anchorage, AK 99507
Real Estate Agent Day phone
2. TYPE OF DWELLING:
▪ Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well Q Individual
Individual Water Storage ❑ Holding Tank . ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
Received : � �� � .�:�, 1.0410,... Date: g
w ` Jj U
COSA to be released to the engineer,unT€ss otherwise requested by th-engine-r.
COSA Fee $ • C �L3 °� Waiver Fee $
Date of Payment a g Date of Payment
Receipt Number 0 0 Receipt Number
COSA# 52co-0(,) Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined
in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater
disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that
based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply
and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances,and regulations in effect at
the time of installation.
In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA
guidelines and regulations.The reported results describe the performance of the system under the conditions encountered at the time of the test,
and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil
condition,ground water levels that may fluctuate during the year,and the water usage of the family being served by the system.These conditions
are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future
performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty
for future performance, nor can we estimate remaining life of the system.The content of this report is for the sole benefit of the owner listed
above.
Name of Firm Pannone Engineering Services LLC Phone (907) 745-8200
Address P.O. Box 1807 Palmer, AK 99645
Engineer's Printed Name Steven R Pannone Date 7/30/2018
AM'K+�G OF a.Qs k
1
6. DSD SIGNATURE •
%* ••STM ./� *y
System#1 Approved for L/ bedrooms Steven R. Pannone
r �*- CE-8149 =
System#2 Approved for bedrooms �� �f . ��
Disapproved �kkV'PROFESSt4NA�'�+.�
Conditional approval for bedrooms, with the following stipulations:
Q`,6r\( OF f iii;
�
ON-SITE ,....„,
G-
WATER ANn r
m WASTEWATER •�"
%<, PROGRAM it
..".?.(,,_rn.j1r--
By: w ,- ` Original Certificate Date:�— 2- (g
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 vTcwv\[ Z'`{ yv,
COSA blue sheet f •. ..
If more than 1 septic system is on the lot:
COSA Checklist# 1 of 1
Structure served by this system 1
Certificate of On-Site Systems Approval Checklist
Legal Description: rHideaway Lake B2 L5 Parcel ID:015-471-16
A. WELL DATA �`30`7 4f
Well type Private /
If A, B, or C provide PWSID# Well Log (YIN) Y
Date completedSanitary seal (Y/N) Y Wires properly protected (Y/N Y
Total depth 103 ft. Cased to 64 ft. Casing height (above ground) lg-t in.
FROM WELL LOG AT INSPECTION
Date of test 08/30/94 06/21/18
Static water level 4 ft. 52.8 ft.
Well production 3 4 g.p.m. 3 2 g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 mL Nitrate 3.88 mg/L
Arsenic ND ug/L Date of sample: 7/20/2018 Collected by: PES
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/ STEEL Date installed 06/14/94
Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N)
N/A
Date of pumping 04/30/18 Pumper A+ HOME SERVICES, INC
C. ABSORPTION FIELD DATA
Date installed 6/14/1994 Soil ratingi z 0.6 GPD/SF WIDE TRENCH
(g.p.d./ft or ft /bdrm) System type
Length 50/80 ft. /�� Width 5/5 ft. Gravel below pipe 3/3 ft
-CriTotal depth y ft. Eft, absorption area 1100+ft2 Monitoring tube Y Depression over field N
Date of adequacy test 07/5/18 Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test 0/36 in. Water added 600 gal. New depth 0/38 in.
Elapsed Time: 1440 min. Final fluid depth 0/36 in. Absorption rate >= 600+ g p d
Any rejuvenation treatment (past 12 mo.) (Y/N &type) N If yes, give date
Seyet, r
D. LIFT STATION
Date installed Size in gallons Manhole/Access (YIN)
"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 100+ On adjacent lots 100+
•
Absorption field on lot 100+ On adjacent lots 100+
Public sewer main 75+ Public sewer manhole/cleanout 100+
Sewer/septic service line 25+ Holding tank 100+
Animal containment areas 50+ Manure/animal excrete storage areas 100+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 10+ Property line 10+ Absorption field 5+
Water main 10+ Water service line 10+ Surface water 100+
Wells on adjacent lots 100+
ABSORPTION FIELD ON LOT TO:
Property line 10+ Building foundation 1 0+ Water main 10+
Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+
Curtain drain 50+ Wells on adjacent lots 100+
F. COMMENTS
Survey on file./f. NIL-.G/ el.,s `f-G�L:,/tt�L
Lower field is inundated with liquid / installed proper flowsplitter
G. ENGINEER'S CERTIFICATION r~��"`L
��OF A��s11
I certify that I have determined through field inspections and �''"4P• Ar �t
review of Municipal records that the above systems are in 0*: •• TH �/\ *y
conformance with MOA COSA guidelines in effect on this date. •••• •• �OW
Steven Pannone � e"-----
Steven Printed Name •Steven R. Pannone • y
Date 07/30/2018 ���c-�,. CE-8149 i/
i���� A\X
k oFEsst
COSA canary sheet_2-6-15.doc
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Pannone Engineering Service, LLC JOB TITLE dP(i' 0. __
P.O. Box 102954
SUBJEC ,
Anchorage AK 99510 O7 /1 --- —_____..
Phone 907-272-8218 • FAX 907-272-8211 - . . �-•►tet=HECKED DATE� 'SHEET OF
Ecklund, Timothy J
From: Steve Pannone <Steve@panengak.com>
Sent: Monday, August 6, 2018 4:25 PM
To: Ecklund, Timothy J
Cc: jameshuffman65@gci.net
Subject: RE: Hideaway lake blk 2 lot 5
Attachments: doc04035520180806153058.pdf
Tim,
I reviewed my technicians notes in detail, and developed the attached sketch showing the depths of cover over the pipe.
It appears that the last 20 feet of the upper trench has less than the required cover. However, there is sufficient length
of the remaining 110 If of drainfield that has sufficient cover to adequately absorb the expected daily flow. Additionally,
the owner has indicated that he has not had any issues with the system freezing since he has owned this property.
Therefore, I request you approve the system as installed.
Steven R. Pannone, P.E.
Pannone Engineering Services, LLC
907.227.3522 Cell
907.745-8200 Office
907.745-8201 fax
Please Check Out the NEW www.panengak.com
Agents/Clients can order tests online, check status and email staff
PES give our Active Military/retired Vets a 5% discount on Engineering services.
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT � • F r\`, 907-343-7904
On-Site Water and Wastewater Section Fax: 343-7997
www.muni.org/onsite \ __.:
Septic
Septic Tank Advisory
Certificate of On-Site Systems Approval # OSC181382
Subdivision: Hideaway Lake Block:2, Lot: 5
The septic tank for this property is 24 years old. The average life for a steel septic
tank is 20 years. Typical replacement costs range from $6,000 to $9,000.
This advisory must be attached to all copies of the subject Certificate of On-Site
Systems Approval.
This is an example of what the metal of a 20 year old steel tank MAY look like.
, AV" --. s.,1, ,,:4-0,. 40.., - kv ;;--:-i
--,-: lir
, ...i.t.e.., ......t.
:� asc' 3a ,a
77
X91 r w -A.: s
.s
g ' , ,rd- ' '
. ' -4 4 4,:•`• ;?....,,-)4 \ 5.e - '
la
\, •
e'er . `Y '' °y. '4,0>.f -- ((ii.« 0*.-22 ryi
Mailing Address:P.0.Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Elmore Street
1 P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
*9`11sh!i
FOR A SINGLE FAMILY DWELLING
Parcel l.D._00S'-4?(—I (c COSA# 0902AC
Expiration Date:
GENERAL INFORMATION
Complete legal descripti
Location (site address)
Current Property owner(
Mailing address
Lending agency
Day phone
p 4
l
S
�•
Real Estate Agent
*9`11sh!i
FOR A SINGLE FAMILY DWELLING
Parcel l.D._00S'-4?(—I (c COSA# 0902AC
Expiration Date:
GENERAL INFORMATION
Complete legal descripti
Location (site address)
Current Property owner(
Mailing address
Lending agency
Day phone
Mailing address
Real Estate Agent
Day phone
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
$1 Individual On-site
Individual Water Storage
�❑ Individual Holding Tank
Community Class Well
❑ Community On-site
❑
Public Water System
❑ 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
Address
Engineer's Printed Name
5. DSD SIGNATURE
Approved for bedrooms.
Disapproved.
Phone
ru cu/I Date -7/19,/017
MICHAEL N. ANDERSON
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:6 _e Original Certificate Date: 7— o` 3'
(Ra. 11105)
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: I d taw0y t-0 Ar .1 Q 'Z- L Parcel ID: O rS -t47t -f (0
A. WELL DATA
Well type -PL-t If A. B, or C provide PWSID ft L Well Log (Y/N)
Date completed'Sanitary seal (Y/N) Wires properly protected (Y/N)
Total depth f l) ft. Cased to &r�ft. Casing height (above ground) in.
FROM WELL LOG AT INSPE TION
Date of test 7 O
Static water level ft. �% ft.
Well production g.p.m. ?7.'7r g.p.m.
WATER SAMPLE RESULTS:
Coliform JPcolonies/100 mL Nitrate I mg/L Other bacteriacolonies/100 mL
Arsenic: ug/L date of sample: Q �, Collected by: k h rA
B. SEPTICIHO DING TANK DATA
Tank Type/Material 4 Date installed
Tank size ZSD 'gal. Number of Compartments Z- Cleanouts (Y/N) '
Foundation cleanout (YIN) Depression over tank (Y/N)',/High water alarm (Y/N)
Date of pumping 7 Pumpert �uu
C.
ABSORPTION FIELD DATA
Date installed Soil rating (g.p.d.If? or ft2/bdrm) D Lo_ System typer7�c C 40 ewG►
Length I e? V ft. Width S.O ft. Gravel below pipe7i��� ft.
Total depth ft. Eff. absorption area r00'ft= Monitoring tube Y Depression over field N
Date of adequacy, test ! 0 Results (Pass/Faiq 0%. 4 y For � bedroo s rr
Y
Fluid depth in absorption field before test n� Water added g New depth � in.
rr
Elapsed Time: M Amin. Final fluid depth Absorption rate >= 600-i- g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) �� If yes, give date
D. LIFT STATION
Date installed Size in gallons
'Pump on' level at _ in. 'Pump off" 1
Datum Cycles tested.
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAR station on lot lip 0 J -
Absorption field on lot tot) Q
Public sewer main
Sewer/septic service line /o0rZe-
Animal containment areas 100) r14
High water alarm level at
Meets alar & circuit requirements?
In.
On adjacent lots (uV f f
On adjacent lots C D 6 r (-
Public sewer manhole/cleanout
Holding tank
Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HetOING TANK ON LOT TO: S r
Building foundation Z� /� Property line l=z4- Absorptiorrfield---�� aipr f
Water main t� _ Pr service me .� Surface water / C� d r'f-
V , latent lots f Od ''f'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: w�
Property line �0 f Building foundation (� Water main /'
Water Service line S'D Surface water /B b /f Driveway, parking/vehicle storage ' Z-0
Curtain drain too 11 4 Wells on adjacent lots 100'4-
F. COMMENTS
O At 1
G. ENGINEERS CERTIFICATION
I certify that I have determined through field inspections and �; ; 49?H•••'•. k /
review of Municipal records that the above systems are in �....... —/�j �
conformance with MOA COSA guidelines in effect on this date. ',1.. �
Engineer's Printed Name /`fr >m ���n� 6wf �/ c�.eva+AE4N,'ANocescNCE- 46
Date % IK/w!t
COSA Fee p Waiver Fee $
Date of Payment 0 "I Date of Payment
Receipt Number Receipt Number
(Rev. 11/05)
N 69°5924"W 1 15.96'
SCS ReLM
1093390001
Client Name
Mike N. Anderson, P.E.
Project Name/M
Roger Augdahl
Client Sample 11)
11101 1lideaway Lake Circle
Matria
Drinking Water
PWSID
0
Sample Remarks
Printed Datelrime
Collected Datefrime
Received Date/rime
Technical Director
07/16/2009 16:10
07/13/2009 8:00
07/13/2009 9:00
Stephen C. Ede
Allowable Prep Analysis
Parameter Results POL Units Medal Container ID Limits Date Date [nit
Metals by ICP/MS
Arsenic ND 5.00 ug/L EP200.8 C (<10) 07/13/09 07/15/09 NRB
Waters Department
Total NitratefNittite-N 4.40 0.100
Microbiology Laboratory
Colony Count 0
Total Coliform 0
Fecal Colifurm 0
mgfL SM204500NO3-F B (<10)
col/100ml- SN1209222B
col/100mL SM209222B
col/100mL SM209222B
A (<200)
A (<I)
A (<I)
07/13/09 LCE
07/13/09 DLC
07/13/09 DLC
07/13/09 DLC