HomeMy WebLinkAboutTIMBER RIDGE BLK 2 LT 12Timb
r Ridge
Block 2
Lot 12
#050-321-30
()
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program, 4700 Elmore St.
P.O. Box 196650 Anchorage, AK 99519-6650 Page 1 of 3
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: DSP101027 PID Number: 050-32i-30
Name: Hike Ouinn Wastewater System: [] New [] Upgrade
Address: PD 3OX 77P641 ABSORPTION FIELD
Phone: 694-4955 NumberofBedrooms: 3 f-I Deep Trench ~ii~ Shallow Trench i-IBed DMound I-IOther:
LEGAL DESCRIPTION Soil Rating: 1,2 GPD/Ft2 Total Depth from original grade: 4
Ft.
Block:
Lot:
Subd~'i¢ion; Depth to pipe bottom from original grade: Gravel depth beneath pipe:
2 12 um~oer' Ridge
1
Township: Range: Section: Fill added above odginal grade: Gravel Length:
?+ Ft. 47 Ft.
Well: [~ New [] Upgrade o .... Iwidth: ,~ Ft. Numberoflines:l IDistance between lines:Ft'
Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material:
PF'ivate 305 Ft. 49Ft. 405 Ft2 PVC 3034
Driller: Date Ddlled: Static Water Level: Installer: Date Installed:
Suttivan 6/4/1: 40Ft. Sanders 6/8/10
Yield: 0,8 GPM Pump Set at:f 1 Casing Height Above Ground:
~3 2 Ft. TANK
SEPARATION DISTANCES I [~ Septic [] Holding [] S,T.E.P. [] Other:
T~ To Septic Absorption Lift Holding )ublic/Private Manufacturer: Capacity:
nom~
Tank Field Station Tank SewerLine Anchor'age Tank 1000 Gal.
Number of Compartments:
We, 100'+ 100"' NA NA 25'+ Material:Sfl;ee[
Su,aceWeter100'+ 100''- NA NA ~/ LIFT STATION
Lot uno 10' + 10' + N A N I~/~ Size: Manufacturer:
"Pump 9n" level at: ~h water alarm at:
Foundation 10/+ 10/-~- NA NA ,n.~ ~,.
Pump Make & Model ~lnspections performe~t~
Cu~ain Drein NA NA NA NA ~
Remarks:
BENCH MARK
Location and Description:
Deck
Assumed Elevation:
Top
100Ft.
E n~r~,r/~, ~amp
Inspections performed b¢'l.°r'-I:hRim Engineer'ingDates: 1St 6/7/10
2nd 6/8/10
Development Services Department Approval
Conditional Approval Date:
/.,, -ce ~,~O ' '~*; ~'~' (.'C~ ..~
Reviewed and approved by: .? -- .......... / / Date:/¢, -';~- ~" "/O
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Well Log
PennitNumber: OSP .laso2? Date of Issue st2at2o,~o Parcel ldentificationNumber: 05o3213oo0o
Date Started: atari010 Date Completed: 6/4/2~0 [swell Iocatedatapla-ovcdp~rmitlocation? !X [
Section: Town: Range:
Property Descr~on
l~'ope~y Owner Name & Address:
Borehole Data:
Soil T>l~e, Thickness & Wat~ S~a
G~ ~rock
Grin
O~y
Gray & W~ ~mck
TIMBER RIDGE Lot 12 BtoGk 2
MICHAEL QU1NN CONSTRUCTION
Water Sample Resull~:
BOX 772641 EAGLE RIVER, AK 995'7
u
From To
0 2
85 114
t14 '173
173 305
Ax~cnic:
Nitrates
Total Coliform Bacteria
Other bacteria:
mg/l
coionieslt00mL
col;100mL
Method of Orilli~ ~-, air rotary ['~ Cable tool
Wall thicknas~ 0a$ inches
Diamet~' 6 inches Total: 49
Liner tYl~:
D~ inches D~Xh:
Casi~ stick-up above ground: 2 feet
Static Water Level(from top of casing)
Pumpia8 Level: feet after
m hours pumping g,om
Recovery Rate gpm
Method of Testiag: Air
40 feet
Well latake Opeaing Type
l Open End :x{Op~ HO{C
{. Screened Start feet feet
[-- Perforations Start feet £cct
Groat Type: Bamo~ dry granular Vo{um~: 600 Pounds
l~pth 44 Start o feet Stopped 44 feet
Pump Intake Depth: feet
Pump size: HP brand name
Well disiifected up~l Compldio~? X~_ Yes i [ No
Commeats: r OVEI~ SHALLOW BElmOCK BOJREHOL£
PROCEF..DURE$ FOLLOWED IN ACCORDANCE
WITH M.O.A. SPECS. WELL PRODUCES 48 G.PJ-t.
Well Oritlm-:.
Cole Sullivan
18,utfiv~n Water WetL~
P.O. Box 67027~
Stooped
Stopped
: Attention: The property owner shall provide tills log ~o DSD (onsit~) and OlqR withla 30 days ot'complction.
1;8
ARCTIC PUMP & WELL INC.
Jim Sullivan
PO Box 770~ 97
Eagle River, A_K 99577
(907) 688-2510
(907) 258-2510
(907) 745 -2510
Pump Installation Log
Well Drilling Permit Number:
Parcel Identification N umber:
osp101027
05032130000
Date Of Issue:
5/26/2010
Legal Description: Timberidge B2 L12
Lot: 12
Block: 2
IProperty Owner Name Address:
Quinn Constuction
PO BX 772641
Eagle River AK 99577
Pump Installaion Date:
Pump Intake Depth Below Top of Well Casing
10/5/2010
283 Feet
Pump Manufacturer's Name
Pump Model:
Pump Size:
Pitless Adapter Bu rial Depth:
Pitless Adapter Manufacturer's Name
Pitless Adapter Installer:
Franklin
Constant Pressure System: 10SDQP 1.5HP
1.5 HP
10 Feet
B-10
U/K
Well Disinfected Upon Completion?
Method of Disinfection:
Com ments:
Yes
Chlorine
Pum plnstallerNam e:
Arctic Pump & Well, Inc.
II~'e&~e~clay, October 27, 2010
Permit Number:
Tax Code Number:
Work Type:
On-Site Water & Wastewater System Permit
OSP101027
05032130000
WellSeptic
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Initial
] l)epartmen(
Permit Effective Dates: May 28, 2010 to May 28, 2011
Design Engineer: STEVE ENG
Subdivision: TIMBER RIDGE
Site Legal Address: TIMBER RIDGE BLK 2 LT 12 G:0255
Owner/Address: MIKE QUINN CONSTRUCTION
19509 SECOND ST EAGLE RIVER AK 99577
Site Mailing Address:
Lot Size in Sq Ft: 31779
Total Bedrooms: 3
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank N Privy Y Private Well N Water Storage
All construction must be in accordance with: 1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater
Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80).
3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to Apd115, a subsurface soil absorption system under construction dudng freezing weather must either.
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By: ~) ~
Date: 0~//~//'O
Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, Alaska 99507
www. muni.org/onsite
(907) 343-7904
ON-SITE SEWERANELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. (~)~'g) ~.~::~ [-- ~
Proper owne,(s)
Mailing address ~0. /~7'7
Site address //~./'~7~'/~ '"~f ~,~ ~ ¢,r-//,~ ~ ~,,'/~'.~
Legal description (Sub'd., Block & Lot) "7-//ldZ~'/~/'z /'~/'~ G'~
Legal description (Township, Range & Section)
Lot Size Sq. Ft. Number of Bedrooms
Day phone
Zip Code
Zip Code
._7
THIS APPLICATION IS FOR (~ all that apply):
Absorption Field ~
Septic Tank
Holding Tank ~
Priw
Private Well ~'~
Water Storage
THIS APPLICATION IS AN:
Initial '~
Upgrade []
Renewal []
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized a~ent)
PermitJRush Fees:
Date of Payment:
Receipt Number:.
(Rev. 11105)
Waiver Fees;
Date of Payment:
Receipt Number.
MEMO
Steve Eng, PE, PH
P.O. Box 770724, Eagle River AK 99577
(907) 694-7028 tel
northrimeng@aol.com
Date: 5/13/10
To: MOA On-Site Services
Subject: Timber Ridge, Block 2, Lot 12
Septic System Design & Well Siting
Number of Pages: 6
A new house and wastewater system are planned for the subject lot. The test hole showed
bedrock ~ 10', and no groundwater. The design calls for a new trench, new septic tank & private
sewer lines. Private water wells serve the area lots and are shown in drawings. A new water well
is also proposed.
Please review the wastewater system design for the single family home. I have included design
plans & specs, design guidelines, & soil tests. If there is need for additional information or
clarification please give me a call.
Thanks-Steve
' [, _Nx~?=N E Ei~IN~
Timber Ridge S/D, Block 2, Lot 12
SPECIFICATIONS & DESIGN GUIDEI,INES
Wastewater System Sizing: This is a new 3-bedroom, single family home. This is an
older subdivision and some of the neighboring lots are developed. Many lots are still
undeveloped. These lots are large and are served by private water wells. No adverse
impacts are expected from development. No conflicts to the other lots will take place by
this septic system and water well construction. The easements are located on the drawing
and are not encroached upon. Soil tests revealed sandy gravel soil with Iow silt. An
application rate of 1.2 GPD/FT~ with 0.58 reduction factor for utilizing a 5' wide trench.
Trench Length = 375 FT~/5'x .58 reduction factor -- 44'; I line ~ 50'. Bedrock was
encountered at I 0', no groundwater xvas encountered.
Specification Requirements: All components and work must comply with the
Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water
Regulations and Wastewater Regulations.
· Two compartment, 1000 gallon septic tank. Watertight couplings on inlet & outlet.
· 5' minimum between the tank and bed. 1 O' to property lines.
· 3' of cover or insulation is required for trench; an equivalent of 1' insulation for each
foot soil cover.
· Tank & solid pipe must be set on well compacted, stable soil.
· 4 inch diameter cleanouts with airtight caps are required I' to 4' from foundation
wall, prior to any 90 degree bend in 4 inch line, in each tank compartment, and two
adjacent opposing cleanouts between the tank and the absorption field, not more than
10' from the tank positioned to provide cleanout access towards the tank and towards
the absorption field.
· All cleanouts must extend to at least ground level.
· In solid pipe runs, ASTM D-3034 may be used in lieu ofcast iron.
· Trench to be placed level, minimum of 4' to groundwater, 6' to bedrock from drain-
rock.
· Drain rock to be lA inch to 2 IA inch screened. Drain rock to be distributed uniformly
throughout the trench.
· Perforated pipe to be installed level with perforations down.
· Silt barrier (filter fabric) to be installed above the drain rock.
· Smeared trench sides must be raked or scarified before drain rock placement.
· The finish grade must be mounded to promote drainage over the trench.
· Insulation must be placed over any pipe installed under driveways or parking areas.
· Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789,
ABS ASTM D2661,
· Sewer Service Line is minimum 2% slope.
· Septic Tank to be pumped every two years or when required.
· Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI/equal)
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SOILS
LDG - PERCDLATIDN TEST
Dote PerFormed: 8/5/09
PerFormed For~ Mike Quinn
Legat Description: Timber Rid,ge Subdivision, Block 8, Lot 18
5-
6 -
7 -
8-
9 -
10 -
ll -
12 -
13 -
14 -
15-
16 -
17 -
18 -
19 -
20 -
21 -
DEPTH
(FEET)
Drganic
SP
Sand w/Gravel
w/ Low Silt
T.H, Loca'bon. See Attached
Groundwater? No
])ep%h --
Wa*cer Depth
AF~cer Monitoring. None Date, 5/18/10
Design
# Da~e Gross Time Ne% Time Depth Ne~ Drop
I 5/18 0 -- 7, --
2 5/18 10 10 Min, 10.5' 3.5'
3 5/12 12 -- 7, --
4 5/12 22 I0 Min. 10.5' 3.5'
5 5/18 25 -- 7, --
6 5/12 35 10 Min. 10.5' 3.5'
7 5/)2 37 -- 7, --
8 5/12 47 10 min. 10.5' 3.5'
9 5/12 50 -- 7, __
10 5/12 60 10 Min. 10.5' 3.5'
Percolation Rate 3 Min./inch Perc Hole Diameter 6'
Test Run :Between 3' and 4'
ComMent$~ PrP¢;no~pd.
PerFormed By Nori:hRim Fng, I ~ CERTIFY THAT THIS
PerForMed in Accordance with Atl. State/Muni¢ipat Guidetines
ON THIS DATE. DATE, 5/1P/lO
TEST WAS
in EFFect
TESTHBLE LOG
GEBTECHNICAL
TIHBER RIDGE B8
T,H, 1
5/25/10 oF 2
SOILS
LDG - PERCOLATION TEST
Date PerForMed: 5/12/10
PerFormed For: Mike Quinn
Legout Description: TiMber Ridge Subdivision, Brock 8, Lot 18
DEPTH
(FEET)
a-
4 - :.. :,....,..,
8- ':O.'":'".'
9- .'.x'~.'r~.~..,.
10 -
11 -
12 ~
13 -
14 -
15 -
16 -
17 -
113 -
19-
20-
21
Organic
SW
Sand w/Graver
w/ Low Sitt
T,H, Location: See
Attached
Design
Groundwater? No
Depth --
W~ter Depth
AFter Monitorinc.None Date, 5/18/10
" Dote Gross Time Net TIMe Depth Net Drop
! 5/12 0 -- 7, --
2 5/12 10 10 Mir. 10.5° 3.5°
3 5/12 12 -- 7. --
4 15/12 22 10 Min. 10,5' 3.5'
5 5/12 25 -- 7, --
6 5/18 35 10 min. 10.5' 3.5'
7 5/12 37 -- 7, __
8 5/12 47 10 Min, 10.5' 3,5'
9 5/12 50 -- 7- __
I0 5/12 60 10 Min. 10.5° 3.5'
Percotation Rate 3 Min./inch Perc Hote DiaMeter 6'
Test Run Between 3' ond 4'
COMMents: Prpqnnkpd,
PerFormed B~2~g. I
PerFormed ~n Accordance with
ON THIS DATE. DATE, 5/12/t0
~ CERTIFY THAT THIS TEST WAS
Att State/Municipat Guidetines in EFFect
TESTHOLE LOG
GEOTECHNICAL
T.H, 8
8970
•
• Municipality of AnchorageJi
On-Site Water and Wastewater Programn18
(907) 343-7904 >�+�E :4s:)/Y1
s I1,
c
Certificate of On-Site Systems Approval 0i ��w
l 6 8 1,
Parcel I.D. 050-321-30 Expiration Date: ^�' 1
1. GENERAL INFORMATION
Complete legal description Timber Ridge Block 2 Lot 12
Location (site address) 19220 Timberline Dr.
Current Property owner(s) James & Jennifer Everts Day phone
Mailing address 19220 Timberline Dr. Eagle River, AK 99577
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: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
,Received • : Date: (-(2-15i)
I
COSA to be released to the engineer,unless otherwise equested by the engineer.
COSA Fee $ 6-Afa Waiver Fee $
Date of Payment 57a130 Date of Payment
Receipt Number d 1g3R Receipt Number
COSA# 23 ./glaa41 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) 272-8218
Address P.O. Box 100217, Anchorage Ak. 99510
Engineer's Printed Name Steven R Pannone Date 5/22/2018
4�OF AL, tkkk
*: 1HTM Ai 9*g
6. DSD SIGNATURE "" " A"". �
System #1 Approved for 3 bedrooms •S even R. 'annone:
�fig.
CE-8149
System#2 Approved for bedrooms s•••
Disapproved �kk �PROFESSI*' �
Conditional approval for bedrooms, with the following stipulations:
�yOF I\NCyp,
CFS
\10"j
•U OC'RP
/On.hgcPr's c�G
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 blue sheet r
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: Timber Ridge Block 2 Lot 12 Parcel ID:050-321-30
A. WELL DATA
Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y
Date completed 6/4/2010 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y
Total depth 305 ft. Cased to 49 ft. Casing height(above ground) 24+ in.
FROM WELL LOG AT INSPECTION
Date of test 6/4/2010 5/10/2018
Static water level 40 ft 56.9 ft
Well production 0.8 g.p.m. 3.5 g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 mL Nitrate 2.10 mg/L
Arsenic ND ug/L Date of sample: 5/10/2018 Collected by: PES
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel Date installed 6/8/2010
Tank size 1000 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
----T.I
Date of pumping \D/ CC I I PumperS p,( m In1
v
C. ABSORPTION FIELD DATA
Date installed 6/8/2010 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.2 GPD/SF System type Shallow Trench
Length 47 ft. Width 5 ft. Gravel below pipe 3 ft.
Total dep 141.0• ft. Eff. absorption area 405 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 5/10/2018 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test 0 in. Water added 450 gal. New depth 0 in.
Elapsed Time: 120 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d.
N
Any rejuvenation treatment(past 12 mo.) (Y/N &type) If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off' level at in. High water alarm level at in.
Datum Cycles tested Meets alarm&circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 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 5+ 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 10+ 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.
G. ENGINEER'S CERTIFICATION ,1 . OF 4 111
Iggkp c4ft!
I certify that I have determined through field inspections and _Aro.- �4 -..v h
review of Municipal records that the above systems are in 0*; TH .4;:‘ •.*
conformance with MOA COSA guidelines in effect on this date. %•• ••• `4�I,•• ••••• r
Engineer's Printed Name Steven Pannone '911;42:.
i ':S1e;reri .'Nonriorie:'•f
Date 5/22/2018 91%. •• CE-8149 0i/
COSA canary sheet_2-6-15.doc
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
Parcel I.D. 050-321-30 COSA #
Expiration Date:
1. GENERAL INFORMATION
Complete legal description
Timber Ridge, ]~Lock 2 Lo~c 12
TimberLine ])rive
Location (site address)
Current Property owner(s)
Quinn Day phone 694-4955
Mailing address PB ]~ox 77P64~.
Lending agency
Day phone
Mailing address
Real Estate Agent
])ee Quinn Day phone 229-4966
Mailing Address
RE/MAX- Ec~gLe River
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OFBEDROOMS: 3
TYPE OF WATER SUPPLY:
Individual Well []
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~-~sit~ water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal an~ ~tate~[~,.des
ordinan~e~,~.a.':'hd regulations in effect at the time of installation. ' ~ ~' i.~. i~. iii'~'~ii~
~:::~?*? Nor-'thRim En~ineer'in_Q ' 694-70F'8 '~:'
N~,'~f Firm ~ ~ Phone
Address
¥'teve l-n9 10/~7/10
Engineer's Printed Name Date
DSD SIGNATURE
~ Approved for
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Attachments:
COSA Checklist X
Septic System Advisory
Well Flow Advisory X
Nitrate Advisory
By:
(Rev. 11/O5)
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
~Original Certificate Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Bragaw 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:
A. WELL DATA
Timber- Ridoe: Rlock 2 Loi: 1P
Parcel ID:050-3P]-30
Well type P
Date completed 6/4/10
Total depth 3 0 5 ft.
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Coliform 0 coloniesil00 mL
Arsenic: 0,157 mg/I
B. SEPTIC/HOLDING TANK DATA
If A, B, or C provide PWSID # __
Sanitary seal (Y/N) Y
Cased to4 9 ft.
FROM WELL LOG
6/4/10
40 ft.
0,8
g.p.m.
<MRL
Nitrate 0,10 mg/L
Date ofC~'r~ 10
Well Log (Y/N) Y
Wires properly protected (Y/N)Y
Casing height (above ground) ;:> 4" in.
AT INSPECTION
na ff.
na
g.p.m.
Other bacteria 0 colonies/100 mL
Collected by: NRim En9
Tank Type/Material Anchorage Tank/
Tank size 1000 gal. Number of Compartments
Foundation cleanout (Y/N) Y Depression over tank (Y/N~
Date of pumping new Pumper new
6/8/10
Date installed
Y
Cleanouts (Y/N)
High water alarm (Y/I~I
ABSORPTION FIELD DATA
Date installed 6/8/10 Soil rating (g.p.d./ft2 or ft2/bdrm) 1';:>
47 5
Length ft. Width ft.
6,5 405
Total depth __ ft. Eft. absorption area ~ Monitoring tube
na new
Date of adequacy test Results (Pass/Fail)
trench
System type
Gravel below pipe3 ft.
Y N
Depression over field ~
For bedrooms
Fluid depth in absorption field before test __ in.
Elapsed Time': __ min. Final fluid del~th i
Any rejuvenation treatment (past 12 mo.) (YIN & type)
Water added gal. New depth in.
in. Absorption rate >= g.p.d.
If yes, give date
D. LIFT STATION
Date installed Size in gallons
"Pump on" level at ~ in. "Pump off" level at ~
Datum Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL'ON LOT TO:
Septic tank/lift station on lot !00' +
Absorption field on lot 1 an' +
Public sewer main NA
Sewer/septic service line
25' t
Animal containment areas
i00' +
in.
Manhole/Access (Y/N)
High water alarm level at
Meets alarm & circuit requirements?
On adjacent lots 100' + .
On adjacent lots 100' +
Public sewer manhole/cleanout NA
Holding tank NA
Manure/animal excrete storage areas
Property line 10' +
Water service line 10' +
Absorption field
Surface water
5/ +
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 10' +
Water main HA
Wells on adjacent Iots~ nn, +
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Building foundation 10'+
Surface water 100' +
Wells on adjacent Iotst00' +
!00' +
Property line 10' +
Water Service line 10' +
Curtain drain na
F. COMMENTS
Water main NA
Driveway, parking/vehicle storaget0' +
in.
G. ENGINEER'S CERTIFICATION
. .
I ce~i~ that I have determ;~d through field inspections and
review of Municipal records that the a~ve systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer s Pnnted Name S~eve En9
Date 10/27/10
COSAF S W i . FeeS
Date of Payment
Receipt Number
(Rev. 11/05)
Date of Payment
Receipt Number
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. cl. anchorage, ak.us
(907) 343-7904
Water Well Advisory
Certificate of On-Site Systems Approval (COSA) # 101273
During a recent COSA on-site inspection and test of the potable water
supply well on Block 2, Lot 12 of Timber Ridge subdivision, the well's
productivity was determined to be 0.8 gallons per minute. The minimum
well productivity required by this Department (AMC 15.55) for a 3-bedroom
residence is 0.31 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.
ANALYTICA
GROUP
Northrim Eng
Attn: Steve Eng
17237 Bear Paw Circle
Eagle River, AK 99577
907-694-7028
Fax: 907-694-7026
Client Sample ID: Eagle River 5
Sampling Location: 77,,'~
Client Project: Eagle River 5
Sample Matrix: Drinking Water
COC #:
PWS#:
Residual Chlorine:
Comments:
SP-Analytica, Inc.-Anchorage
4307 Arctic Blvd.
Anchorage, AK 99503
Phone: 907-258-2155
Fax: 907-258-6634
Report Date: 10/13/2010
Receipt Date: 9/30/2010
Sample Date: 9/29/2010
Sample Time: 6:00:00PM
Collected By: Steve
Flag Definitions:
MRL = Method Reporting Limit
MCL = Maximum Contaminant Limit
B = Present also in Method Blank
H = Exceeds Regulatory Limit
M = Matrix Interference
J = Estimated Value
D = Lost to Dilution
** = RL higher than MCL; target not detected
TNC = Too Numerous to Count - result rejected
CF = Confluent Growth - result rejected
TCNG = Turbid Culture No Growth - rejected
Lab#: A 1009377-01A
Analysis Method Prep Prep Analysis
Parameter Result Units Flags MRL MCL Method Date Date Analyst
4500-NO3E (Aqueous) - Nitrate+Nitrite pres Test was conducted by: Analytica - Anchorage
Nitrate-Nitrite as Nitrogen <MRL mg/L 0.10 10 10/8/2010 10/8/2010 MC
Lab#: A1009377-01B
Analysis Method Prep Prep Analysis
Parameter Result Units Flags MRL MCL Method Date Date Analyst
9223B-PA (Aqueous) - Coliforms in DW
E. Coli Pass PASS/FAIL 1.0
Total Coliform Pass PASS/FAIL 1.0
Lab#: A1009377-01C
Test was conducted by: Analytica - Anchorage
1 9/30/2010 9/30/2010 KM
1 9/30/2010 9/30/2010 KM
Analysis Method Prep Prep Analysis
Parameter Result Units Flags MRL MCL Method Date Date Analyst
200.8/200.8 (Aqueous) - Family Well Water I
Arsenic 0.157 ug/L
0.15
Test was conducted by: Analytica - Thornton
10 200.8 10/7/2010 10/7/2010 RM
Page 3 of 3
/
/
/ /
I
Lot 1 2
51,779 s.f.
1.5' x 8.2'
129.3'
SEPTIC
N
L°t
ROLLING HILLS
COV[REO-~
PORCH
212.81
I
VIEW
x 5.2' CANT
BALCOfiY
ESTATES
PLOT PLAN AS BUILT ~ SCALE 1' = 40' GRID NW 255 Project No. 10-075
Long (907) 522-6476
Registered Land Surveyors (907) 522-4625
kgtangleOalaska.net / JclangleOalaeka.nef
Associates, inc. ~500 Daryl Avenue, Anchorage, Alaska 99515-;5049
Phone
Fax
I hereby certify that I have surveyed the following de~cribed properly:
Lot 12, Block 2, TIMBER RIDGE SUBD. (Plat No. 70-219)
Anchorage Recording District, Alaska, and that the improvemen~ Mfuated thereon are
within the property lines and do not encroach onto the property adJooent thereto, that
no Improvements on the property lying adJa=enf thereto enoroach on the surveyed
premises and that there are no roadways, transmission lines or other vlslble
easements on said properly except as indloatecl hereon.
Dated this the ~-~-~ Day of ~-r-oC~zC~-- , 7.~.~ , at Anahorage, Alaska
It Is the responelblllty of the owner to detsrznlne the existence of any easement~,
covenants, or re.frictions which do not appear on the reaorded subdivision plat.