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Home My WebLink AboutTHERESA MAE LT 2BTh esa Mae Lot 2B #015-081-41 Municipality of Anchorage ONSITE WATER & WASTEW.ATER PROGRAM CHANGE ORDER PERMIT # OSP101068 PID No' 015-081-41 SUBD Theresa Mae TRACT BLOCK LOT 213 CONTACT PERSON Michael E. Anderson, P.E. PHONE 522-7773 FAX 677-7766 PLEASE GIVE A DESCRIPTION OF THE CHANGE: The owner of the lot moved the house 12' east and 47' North of the south property line. The septic system was moved to the west side of the house and the Well to the east side to accommodate the house move. Test holes were placed revealing better soils Than on the east side. Septic systems. CUSTOMER SIGNATURE No conflicts exist between the new locations and the neighboring wells and On-Site Reviewer: Comments Issued (date) Review Time (hours) APPROVED (date) TOTALHOURS _~,q HOURLY RATE $130 ToTA, To SE.A,O -~//~ ~ Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program, 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 Page of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: OSP101068 PID Number: 015-081-41 Name: Brandon and Shanni Rinner Wastewater System: [] New [] Upgrade Address: 6461 Teshlar Drive Anchorage, AK 99507 ABSORPTION FIELD Phone: Number of Bedrooms: 4 [~ Deep Trench [] Shallow Trench [] Bed [] Mound [] Other: Soil Rating; Total Depth from odginal grade: LEGAL DESCRIPTION .45 GPD/Ft2 13.5 Ft. Block: Lot: Subdivision: Depth to pipe bottom from odginal grade: Gravel depth beneath pipe: 2B Theresa Mae 5.5 Ft. 8 Ft. Township: Range: Section: Fill added above original grade: Gravel Length: 0-1 Ft. 84 Ft. ~rm New bl~-~upg ace ' "--r--'- Orava, width: Number of Ii .... Distance between lines: Well: 3 Ft. 1 - Ft. Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material: Private 104 Ft. 104 Ft. 1,344 Ft~ ASTM D3034 PVC Ddller: Date Drilled: Static Water Level: Installer: Date Installed: Alpine Drilling 10/29/2010 61 Ft. Sanders & Sanders 7/30-8/2/2010 Yield: GPM Pump Set at: Ft. Casing Height Above Ground: 8 99 >2 Ft. TANK SEPARATION DISTANCES [] Septic [] Holding [] S.T.E.P. [] Other: T~ To Septic Absorption; Lift Holding ~ublic/Pdvate Manufacturer: Capacity: From% Tank Field Station Tank Sewer Line Anchorage Tank 1,250 Gal, Material: Number of Compartments: we~l >1 Off > 100' N/A N/A >25' Steel Two (2) Suffaca WaterLot Line >100'>5, >100'> 10' N/AN/A N/AN/A ~ Size: Gal. Manufactu~r:LIFT STATION "Pump on" level at: "Pump off level at: in. High water alarm at: Foundation >5' >10' N/A N/A in. in. Pump Make & Model Electrical Inspections performed by: Curtain Drain None Noted Remarke: BENCH MARK Location and Description: Garage Slab Assumed Elevation: Ft. I n cf in A. Harala .ns~.ev..vnsno, fin rnCrl ~v..vr,.,~_h,,~¢: Dates: 4.st 7/30/2010 2nd 8/2/2010 Development Services Department Approval Conditional Approval Date: Reviewed and approved by: .'_~&""" '/" ~d; ~ te:~' - ~/'// (Rex. 04/06) ,.,~ ~ ~ NOISIAIGSQS '_L'S'S ,,,,,~~ ,9 I.'CJ9 1. ~,,6 I.,~0.00 N 20' DRAINAGE EASEMENT / Zo'~ I c~°r' '~ ® / ~ ~ ~ · =¢ m I m z / / I I / / / / / / ,O~'Cj~ I, 3,,t~,~0o00 S I-- C) 0 O~ -- m ~m ~0 $m2 ~z~' > o~ P-- o<~ ~> ~>~ Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On-Site Wastewater Disposal System or Well Inspection Report Permit Number: OSP101068 Page 3 of 3 PID No. 015-081-41 ,-- /~ 96.1 1,250 Gallon I~, / SepticTank J ~89.9 89.6 95.1 Existing and Finished Grade Geotextile Fabdc Drainfield Rock 81.6---~ 84' (Trench Length) 75.1 No Groundwater 89.6 PROFILE AS-BUILT No Scale Alpine Drilling & Enterprises Well Log Permit Number: #SWOSP101068 Date of Issue: 6-23-10 Parcel Identification Number: 01508141000 Date Started: 10-27-10 Date Completed: 10-29-10 Is well located at approved permit location? x Yes [] No Legal Description: Theresa Mae Lt 2B G:2439 Property Owner Name & Address: Rinner Brandon & Shani L. 6461 Tesh/ar Drive Anchorage, A/ask~ 99507 Borehole Data: Depth (ft) Soil Type, Thickness & Water Strata From To Stick-up 0 1.5 silt 1.5 12 gravelly silt 12 41 silt 41 51 gravelly silt 51 80 silty gravelly sand H20 2 gpm 80 102 water sand & gravel 102 104 Method of Drilling x air rotary [] cable tool Casing type: steel Wall Thickness: .250 inches Diameter: 5 inches Depth: 104 feet Liner Type: ~ ::~ Diameter: ~ inches Depth: ~ feet Casing stickup above ground: 1._~5 feet Static water level (from ground level): 6_Lfeet Pumping level: 104 feet after 2_ hours pumping _8 gpm Recovery Rate: _8 gpm Method of Testing: air l~fi Well Intake Opening Type: x Open End [] Open Hole [] Screened Start ___ feet Stopped ~ [] Perforations Start~ feet Stopped,, Grout Type: bentonite granules Depth: Start 0 feet Pump: Intake Depth ~ feet Pump size hp Brand Name Volume: 1 bg Stopped ? feet Well Disinfected Upon ComPletion? x Yes [] No Method of Dis'~afection: chlorine tablets. Comments: Well Driller: Alpine Drilling & Enterprises PO Box 110496 Anchorage AK 99511 Mark Begich Mayor Building Safety Division O~-Sit~ Wot~r & W~stcw~te~ Program 4700 Eimor~ Ro~d P~O, Box 1~6650 Ancho~ge¢ AK 99507 (907) 343~7904 Pump Installation Log Well Drilling Permit Number: SW__ Date of Issue: Parcel Identification Number: Legal Description LOT 2B TERESA MAE Pump Installation Date: 3/29/11 Proper¢' Owner Name & Address: HOUGHTON CONSTRUCTION Pump Intake Depth Below' Top of Well Casing: 99 feet Pump Mant*faeturer's Namd: GRUNDFOS Pump Model: 15 SQE 07-180 Pump Size 3/4 lip Pitless Adapter Burial Depth: 10 feet Pitless Adapter Manufacturer's Name: CAMBEL Pitless Adapter Installer: Well Disinfected Upon Completion? [] Yes [] No Method of Disinfection: RECtRCULATED USING CHLORINE PELLETS Comments: Pump Installer Name: BRIAN WlLLE Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. Permit Number: Tax Code Number: Work Type: On-Site Water & Wastewater System Permit OSP101068 01508141000 WellSeptic MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 EImore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Initial Permit Effective Dates: June 23, 2010 to June 23, 2011 Design Engineer: ANDERSON ENGINEERING Subdivision: THERESA MAE Site Legal Address: THERESA MAE LT 2B G:2439 Owner/Address: RINNER BRANDON S & SHANI L 6461 TESHLAR DRIVE ANCHORAGE AK 995072221 Site Mailing Address: Lot Size in Sq Ft: 52516 Total Bedrooms: 4 This permit is for the construction of: Y Disposal Field Y SepticTank 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 April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: Change Order #1: Disposal field moved to new location. Date: Date: '~/~//~ / ? ? m.m Z I,I aa E / o~ °o o._O ~ LO-+-' ! lU~WeSD3 '3 · '/ ,0~ / / W I I,I LOT 2B, THERESA MAE SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home Deep Trench System Perc. Rate: 31 to 60 Min./Inch 1,250 Gallon Septic Tank Application Rate: .45 GPD/SF 8' Drainfield Rock 4 Bedrooms X 150 GPD/.45 GPD/SF (Application Rate) = 1,333.3 SF Absorption Area 1,667 SF/16 SF/LF -- 83.3 LF Trench Length THEREFORE: Construct an 84' Long x 3' Wide x 8' Effective Depth Absorption Trench at the Location Shown. Flow Line Elevation in Trench to be 5' Below Original Ground Surface. Total Depth to be 13' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption Trench. Maintain 100' Separation from Wells in the Area. 1611 1011 Natural Backfill Geotextile Fabric 4" Perforated PVC (Holes Down) Drainfield Rock TYPICAL DEEP TRENCH SECTION (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. f~?'"':" .. M n m ' ' . um 6 Separabon From Bedrock. _-.....~.....~, ................ .,~.~.....~..._.~ Minimum 4' Separation From Groundwater. ~_ ~L,..~__ J~. ~-~'~(.,&~.~ Minimum 100' Separation From Wells in the Area. ~~;~;£;;&'~'"':" Minimum 100' Separation From Surface Water or Streams.- ~,~'-.. No. Performed For: Legal Description: 10- 11- 12- 13-'-- 14- 15- 16- 17- 18- 19- COMMENTS Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road· P.O. Box 196650 Anchorage, AK 99507 www.cLanchorag~,ak~s (907) 343-7904 Soils Log -Percolation Test Brandon and Shani Rinner Date Performed: -?~-'~I'~L~..~,J-'~,~Y~ ' Theresa Mae Lot 2B Township, Range, Section:' Slope · .. WAS GROUND WATER ENCbUNTERED? NO: S IF YES, ,AT WHAT DEPTH7 XXXXX L 0 Dept~ to Water After P Monitoring? No Water E ·" Site Plan Reading Date Gross Time Net Time Depth to Water Net. Drop : (minutes/inch) TEST RUN BETWEEN '~ FT AND This Perc Cavity was presoaked prior to testing' PERC HOLE DIAMETER 1 FT' Municipality of Anchorage Development Services Department Building Safety Division , 4700 Elmore Road P.O..Box 196650 Anchorage,AK 99507 ~,ci.an chora_qe.ak.u s Soils Log -Percolation Test Performed For: On and Shani Rinner Date Performed: Theresa Mae Lot 2B Township, Range, Section: 1 2 3- Slope ti1: II1' Ille Ill ILl 10- -11- 12- 13- 14- ¸15- 19- 20- COMMENTS WAS GROUND WATER . ENCOUNTERED? ~ NO IF YES, ATWHAT DEPTH? XXXXX Depth to Water Aft~ Monitoring? No Water s L. O P E Site Plan .I [ :1 Reading Date ,' Gross Time . ' Net Time ' Depth to W~ter Net Drop I PERCOLATIOI RATE ~.J~ (minutes/inch) PERC HOLE'DIAMETER TEST RUN BETI/~EN FT AND ' ,~ FT' This Pore Cavity was presoaked prior to testing- PERFORMED BY: A. Harala .~,~ I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SiTE SEWER/WELL PERMIT APPLICATION FOR a SINGLE FAMILY DWELLING Property owner(s) Brandon and Shani Rinner Mailing address 6461 Teshlar Drive Anchorage, AK Site address Theresa Mae Circle Anchorage, AK Legal description (Sub'd., Block & Lot) Lot 2B, Theresa Mae Subdivision Legal description (Township, Range & Section) Lot Size 52,616 Sq. Ft. .Day phone Zip Code 99507 ,Zip Code 99516 Number of Bedrooms Four (4) THIS APPLICATION IS FOR (~;~ all that apply): THIS APPLICATION IS AN: Absorption Field [] Initial [] Septic Tank [] Upgrade [] Holding Tank [] Renewal [] Privy [] Private Well [] Water Storage [] 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 agent) Permit/Rush Fees: Date of Payment: Receipt Number. (Rev. 11/05) Waiver Fees: Date of Payment: Receipt Number, ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) June 8,2010 Municipality of Anchorage Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 2B, Theresa Mae Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 2B, Theresa Mae Subdivision intends to construct a new four- bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new well and septic system to accommodate the home. The attached Site Plan and backup documentation identify the location and configuration of the proposed well and septic system along with the alternate site. Drainage arrows are shown on the site plan showing the grade and direction of flow on the lot. The drainage pattern will not be changed as a result of this project. The test holes placed on the lot in the area of the absorption trench and alternate site indicated silt with sand and gravel. The percolation rate of the soil was determined to be between 31 and 60 minutes per inch. No groundwater was found during the placement of the test holes, but was noted at 15' below the surface dudng the monitoring period. An application rate of .45 gallons per day per square foot was used in the design of the absorption system. We are proposing to place a new 1,250-gallon septic tank and 2-42' long by 3' wide by 8' effective depth absorption trenches to treat and dispose of the effluent generated in the house. The elevation of the distribution line in the absorption trenches will be 3.0' below the surface and the total depth will be 11.0'. A minimum of 3' of fill or 2" of insulation and 2' of fill will be placed over the absorption trench and 4' over the septic tank. A flow splitter valve will be placed to insure even flow to each trench. A test hole will be placed prior to construction to verify the lack of bedrock on the lot. The well log on the adjacent Lot 2A indicates no bedrock to depths in excess of 200'. The ground surface on the lot in the area of the absorption trench slopes to the southwest at constant grade approximating 5%. The new trench will be constructed Lot 2B, Theresa Mae Subdivision June 8, 2010 Page Two parallel with the contours of the slope as much as possible in conformance with Municipal requirements. The new septic system will be constructed a minimum of 100' from all wells and any surface water and 10' the proposed and existing water services in the area. If the system is constructed in accordance with our design the following statements apply: The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. o The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Michael E. Anderson, P.E. Attachments DEVELOPMENT SERVICES DEPARTMENT/BUILDING SAFETY DIVISION '-r~x..TM s ON-SITE WATER AND WASTEWATER PROGRAM -: ~ '. LT00 BRAGAW STREET ANCHORAGE, AK ggsIg ~.~....~.....~..~.....~ SOILS LOG- PERCOLATION TEST J~.'~....J PERFO~ED FOR: SHAWN COOLEY DA~: ~/7/2006 pROJE~ No,: N0608 PARCELID~: TEC~CIAN: T.L. KIHBROUGH DEPnlTEMP: 48°ITESTHOLE2B-I J (~l~ 1 ~. OB/OG SLOPE SITE PLaN 2 ~ ]' LOT ~B WELL COMPACTED DAMP 8 ~J~] SILTY SANDS W/GRAVELS SM-GM ~ ~ WAS GROUNDWATER J 0~ ENCOUNTE~D~ NO IF YES, WHAT DEPTH~ 1 v 0% AFTER HONITORING: 12-- L) ~J~ ] DATE: 5/20/06 DEPTH OF 13-- '~lgi DATE RE'DIN6 GROSS TIHE NET TIHE WATER NET 16~ BO~ 2 1400 30 10.375 0.625 3 1400 12.0 17~ 4 1430 30 11.125 0.875 18~ 5 1430 11.125 19~ 6 1500 30 10.25 0.875 2o2 PERCOLATION ~TE~.~(M~/INCH) PERC. HOLE DIA, 6 (INCHES) ~STR~BETWEEN:~.S ~. md B.B ~. COMMENTS: TEST HOLE PRE SO~KED PRIOR TO PERCOLATION TEST. TEST PERFORMED BY: A~ J, M~CH~EL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ~t STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 5/~0/06 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT/BUILDING SAFETY DIVISION ON-SITE WATER AND WASTEWATER PROGRAM &700 BRAGAW STREET ANCHORAGE, AK 99519 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: THERESA MAE S/D PERFORMED FOR: SHAWN COOLEY DATE:. g/T/Z000 PROJECT No.: M0608 PARCEL ID#:. TECHNICIAN: TEMP: 48° J ] D~P'm TEST HOLE 2B-2 (fccO OB/OG SLOPE 1 2 3 4 5 WELL COMPACTED DAMP 7 SILTY SANDS W/GRAVELS SM-GM 8 9 WAS GROUNDWATER ENCOUNTERED~ NO IF YES, WHAT DEPTH~ DEPTH OF WATER AFTER MONITORING: DATE: T. L. KIMBROUGH BOH 20 5/20/06 SITE PLAN LOT 8B 0% DATE /./7106 I! READING GR, OSS T'UEI .NET TIM,Ri DEPTHwATEROF ,tM MUTES) J (.M NUTES) J (INCHES) NET DROP (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: I 2 1415 8.375 8.0 CHARGE 0.375 1445 30 3 1445 9.125 CllARGE 4 1515 30 8.75 0.375 5 1515 9.5 CHARGE 6 1545 30 9.0 0.5 PERCOLATION RATE;,~&.3(MIN/INCII) PERC. tlOLEDIA, 6 (INCtlES) TEST RUN BETWEEN:. fi.5 FT. and ,5.5 FT. COHHENTS: TEST HOLE PRE SOAKED PRIOR TO PERCOLATION TEST. TEST PERFORMED BY: AH I, MICHAEL E. ANDERSON. CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 5/20/06 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 2B, THERESA MAE SUBDIVISION GENERAL: The scope of this project includes the procurement and placement of a new 1,250-gallon septic tank at the location shown on the Site Plan. Work also includes the construction of 2 new 42' long by 3' wide by 8' effective depth absorption trenches also at the location shown on the plan. The distribution line in the trench will be placed at 3.0' below the existing ground surface. Total depth of the trench will be 11.0' below the existing ground surface. The new absorption trench must be placed a minimum of 100' from the well proposed for this lot and those on adjacent lots and 100' from any surface water in the area. A minimum of 3' of cover is required over the absorption trench and 4' of cover over the septic tank. A flow splitter valve must be placed to assure even flow to each trench. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. The Contractor must also verify the location of wells in the area and assure that the separation distances are met. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. Contractors installing wastewater disposal systems must be certified by the Municipal Division of Building Safety On-Site Water and Wastewater Program for system installations. Owners installing their own systems must receive prior approval from the On-Site Water and Wastewater Program before beginning system installation. SEPTIC TANK INSTALLATION 1. A new 1,250 gallon septic tank must be procured from an approved source and installed at the location shown. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. Lot 2B, Theresa Mae Subdivision June 8, 2010 Page 2 of 3 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. Distribution piping must be placed level with perforations down atop a level bed of drainfield reck. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below the distribution pipe must be perforated. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. Direct bu~y insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trench to drain away. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. All pockets of unacceptable materials must be removed and replaced. Lot 2B, Theresa Mae Subdivision June 8, 2010 Page 3 of 3 MATERIAL SPECIFICATIONS: 1. Septic tanks 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: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as-built of the completed system. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWEPJVVELL PERMIT APPLiCATiON FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-081-41 Property owner(s) Brandon and Shani Rinner Mailing address 6461 Teshlar Drive Anchorage, AK Site address Theresa Mae Circte Anchorage, AK Legal description (Sub'd., Block & Lot) Lot 2B, Theresa Mae Subdivision Legal description (Township, Range & Section) Lot Size 52,516 Sq. Ft. .Day phone Zip Code 99507 .Zip Code 99516 Number of Bedrooms Four (4) THIS APPLICATION IS FOR ([~ all that apply): Absorption Field [] Septic Tank [] Holding Tank r-~ Privy [] 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 agent) PermitJRush Fees: Date of Payment: Receipt Number. (Rev. 11/~$) Waiver Fees: Date of Payment: Receipt Number. CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343-7904 Parcel I.D. 015-081-41 GENERAL INFORMATION Complete legal description Location (site address) '7 t O -~ Theresa Mae Circle COSA # ~: ¥.) (~ i i i ~- '~ ¢i Expiration Date: I i - - 17 Lot 2B, Theresa Mae Subdivision Anchorage, AK 99516 Current Property owner(s) Brandon and Shani Rinner Mailing address 6461 Teshlar Ddve Anchorage, AK 99507 Lending agency Day phone Day phone ' Mailing address Reai Estate' Agent Mailing Address::-:. Unless otherwise regu~sted, COSA will be held by DSD for pickup. Day phone NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual Well [] Individual Water Storage [] Community Class Well [] Public Water System [] Four (4) 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 o 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 Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. DSD SIGNATURE ~ Approved for L7J bedrooms. Disapproved. Date 8/9/2011 Conditional approval for bedrooms, with the following stipulations: Attachments: ' COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: (Rev. 11/05) Original Certificate Date: Municipality of AnChorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Bregaw 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 Well type Private Date completed 10/29/10 Total depth 104 ft. Lot 2B, Theresa Mae Subdivision Date of test Static water level 61 Well production 8 WATER SAMPLE RESULTS: Coliform .- 0 colonies/100mL Arsenic: N/D mg/I B. SEPTIC/HOLDING TANK DATA Tank Type/Material septic/Steel Tank size 1,250 gal. Foundation cleanout (Y/N) Y Date of pumping New Construction C. ABSORPTION FIELD DATA Date installed 8/2/2010 Length 84 ft. Total depth .13.5-14,5 ft. Parcel ID: 015-081-41 IfA, B, or C provide PWSID #~ Sanitary seal (Y/N) Y Cased to FROM WELL LOG 10129110 104 ft. g.p.m. Well Log (Y/N) Y Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION fto g.p.m. Nitrate 3.26 mglL Date of sample: 7/12/11 Collected by: A. Hamla Number of Compartments Tw_...~o Depression over tank (Y/N) N Pumper Soil rating (g.p.d./ft2 or ~/bdrm).45 GPD/SF Width 3 ft. Eft. absorption area 1,344 ~ Monitoring tube Date installed 7/30/10 Cleanouts (Y/N) Y High ~vater alarm (Y/N) Y >24 System type Deep Trench Grovel below pipe 8 Y Depression over field .. N Date of adequacy test New Conat. Results (Pass/Fail)' For ~ bedrooms Fluid depth in absorption field before test in. Water added gal. New depth Elapsed Time: ~ min. Final fluid depth in. Absorption rate >= Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date in. in. g.p.d. LIFT STATION Date installed 'Pump on' level at Datum in. E. SEPARATION DISTANCES Size in gallons 'Pump off' level at Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot >100' Absorption field on lot >100' Public sewer, main N/A Sewer/septic service line >25' Animal containment ames in. Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? in. On adjacent lots >1oo. On adjacent lots >1oo' Public sewer manhole/cleanout Holding tank NIA Manure/animal excrete storage areas N/A >100' SEPARATION DISTANCES' FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Water main N/A Water service line >1o' Wells on adjacent lots >1oo' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Absorption field >5' Surface water >1oo' Property line >10' Building foundation. >10' Water Service line >10' Surface water >100' Curtain drain None Noted WallS on adjacent lots >100' CO~t~'=NTS: Water main >10' Driveway, parking/vehicle storage >25' G. ENGINEER'S CER~FICATION ! certify that I have determined through fie/d inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Pri~ed Name Michael E. Anderson, P.E. Date 8/9/2011 · COSA Fee $ .Date of Payment ~'} °t ~ ~,\ Receipt Number (~ ~, ~"1 c~ (~ (Rev. 11/05) / .~ ~" e~I~ Waiver Fee $ / Date of P~ment Receipt Number SGS SGS Reft# 1113103001 Client Name Anderson Engineeritig Printed Date/Time 07/20/2011 14:26 Project Name/# Theresa Mae Lot 2B Collected Date/Time 07/12/2011 14:07 Client Sample ID Theresa Mae Lot 2B Received Date/Time 07/12/2011 15:01 Matrix Drinking Water Technical Director Stephen C. Ede Sample Remarks: 4500NO3-F - Total Nitrate/Nitrite - MS recovery is outside of QC criteria. Refer to LCS for accuracy requirements. Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 07/12/11 07/13/11 NRB Waters Department Total Nitrate/Nitrite-N 3.26 0.100 mg/L SM20 4500NO3-F B (<10) 07/12/11 AYC Microbiology Laboratory E. Coil Negative I 100mL SM20 9223B A 07/12/11 DLC Total Coliform Ne~;ative 1 100mL SM20 9223B A 07/12/11 DLC g LLJ / / I S 00'02'54-"E g 115.20' xo ~ II Z .J LEI U~ 0 0 I I100' PROTE :TIVE WELL RADIUSI Z Ld n Z -I / / / / <( o .il N 00"02'19"W 1 65.18' S.S.T. SUBDIVISION PLOT PLAN AS BUILT X SCALE 1" = 40' GRID Project No. 10-137 La n g (907) 522-6476 Registered Lend Surveyors (907) 522-4625 kglanglsOalaska.nef / ]clanglsOalaska.nef & Associates, inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-5049 Phone Fax I hereby certify that I have surveyed the following described properlT: LOT 2B, THERESA MAE SUBDIVISION, (Plat 2006-157) Anchorage Recording District, Alaska, and that the Improvements situated thereon are within the properly lines and do not encroach onto the property adjacent thereto, fhaf no improvements on the property lying adjacent thereto encroach on the surveyed premlses and fhaf there are no roadways, fransmlssion lines or other visible easements on said property except as indicated hereon. Dated this the Day of , , at Anchorage, Alaska If Is the responslbillfy of the owner fo determine the existence of any easements, covenants, or resfrlcflons which do not appear on the recorded subdivision plat.