HomeMy WebLinkAboutMCMAHON BLK 3 LT 15McMahon
Block 3
Lot 15
#017-042-15
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program, 4700 Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650 Page of
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL iNSPECTION REPORT
Permit Number: 0SP101079 PID Number: 017-042-15
Name:
Merit Homes, Inc. Wastewater System: [] New [] Upgrade
Address:
P.O. Box 111982 Anchorage, AK 99511 ABSORPTION FIELD
Phone: Number of Bedrooms:
334-9233 4 [~ Deep Trench [] Shallow Trench FI Bed [] Mound [] Other:
LEGAL DESCRIPTION Soil Rating: Total Depth f .... dgina, grade:
1.2 GPD/Ft2 11.0 Ft.
Block: 3 Lot: 15 Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe:
McMahon 3.0 Ft. 8.0 Ft.
Township: Range: Section: Fill added above original grade: Gravel Length:
1-2.5 Ft. 34 Ft.
Well: [] New [] Upgrade Gravel width: Number of lines: Distance between lines:
3 Ft. 1 - Ft.
Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material:
Private 85 Ft. 85 Ft. 544 Ft2 ASTM D3034 PVC
Ddiler: Date Ddlled: Static Water Level: Installer: Date installed:
Alpine Drilling 10/02/2010 74 Ft. Red Dog Excavating 6/19-22/2010
Yield: 7 GPM Pump Set at:61 Ft. Casing HeightAboveGround:>l.5 Ft. TANK
SEPARATION DISTANCES [] Septic [] Holding [] S.T.E.P. [] Other:
T~ To Septic Absorption Lift Holding ~ub]ic/Private Manufacturer: Capacity:
From~
Tank Field Station Tank Sewer Line Anchorage Tank 1,250 Gal.
Material: Number of Compar[ments:
Well >100' > 100' N/A N/A >25' Steel Two
surface water >100' >100' N/A N/A ~ ,/ LIFT STATION
Size: Manufacturer:
Lot Line >5' >10' N/A N/A Ga[,
"Pump on" level at: "Pump off" level at: in. High water alarm at:
Foundation >5' > 10' N/A N/A in. in.
cudain Drain None Noted Pump Make & Model = Electrical Inspections performed by:
Remarks:
BENCH MARK
Location and Description:
Garage Slab
Assumed Elevation:
100.00 Ft.
Inspections performed by: A-Harala Dates: 1st 6/20/2010
2nd 6/21/2010 ,~ ,x,,,¥.o It .'~.L~,.~'~
~' (,9:
Development Services Department Approval ~ ·
Conditional Approval Date: ~.~tj.~_.~.,.~. i ..~LV~.._~t..~.m-.--~....'~.~',~,~ ',~'~.~...~...o..-
-..,,,,--
Permit Number: OSP101079
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904
Page 2 of 3
PID No. 017-042-15
FURROW CREEK ROAD
163.28"
WELL
A.C. DRNE
/
/
Alternate Site
LEGEND:
C - Cleanout
S - Septic Vent
TH - Test Hole
M - Monitor Tube
EXISTING BUILDiNg//
PLAT NO. 65-86
McMAHON SUBDIVISION
LOT 15, BLOCK 3
30,940 S.F.
S2 I 8.5'
C4 12.4'
C5 [ 44.9'
M 1 40.2'
~TH3M1
· ~C5
B
20,6'
28.8'
37.3'
71.2'
67.0'
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904
On-Site Wastewater Disposal System or Well Inspection Report
Permit Number: OSP101079
Page 3 of 3
PID No. 017-042-15
94.58 /
/
94.4 · ·
99.7
Finished Grade
Existing Grade
79.5
NO Groundwater
6/26/10
97.5
Geotextile Fabric
Drainfield Rock
34' (Trench Length)
99.8
86.3 --~
94.4
PROFILE AS-BUILT
No Scale
$-
6-
8-
@-
19-
20-
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Road
P.O. Box 196650 Anchorage, AK 99507
www.ci.anchoraqe.ak, us
(907) 343-7904
Soils Log - Percolation Test
Slope Site
WAS GROUND WATER ~,/
ENCOUNTERED?
S
IF YES, AT WHAT DEPTH? ~"
L
O
Depth to Water After
Monitoring? ',~` ~
PERCOLATION RATE ~ (minutes/inch) PERC HOLE DIAMETER
/ ,1 TEST RUN BETWEEN ~, I~'i; ,~'-~'~' FT
COMMENTS ,~et'~ ¢~V~ly W~ ¢r~.¢K~L
Reading Date Gross Time Net' Time Depth to Water Net Drop
PERFORMED BY: v,,¢~ I '~-'~,~-.~-t~ CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~ O ~ Z,?-~ ·
FRC~
r~oya~ ~menors ~u fL~;bAM !
:~lpine Drillin9 FRX NO. :90? 345 02[a2 0c'c. 26 2818 139:09RP1
Alpine Drilling & Enterprises
~orehole Data:
Soil Type, Thickness & Water Strata
Well Log
Permit Number: #$V~OSPfOf~02 Date of Issue: 7-9-f0 Parcel Identification Number.' ~
Date Started: 10-2-fO Date Completed: 10-2-1...0 Is welt located at approvec[ permit location? · Yes
Legal Description: McMahon BIk 3 Lt 15 G:2835
Property Owner Name & Address: Merit Homes LLC
· ~ Box 'f 11982
Ant, boracic, Alast~a 995 7'~
Depth (fi) Method of Drilling x air rotary [] oabte tool
]=rom To Casing type:
0 2 Wall Thickness'..£5._.__.~0 inches
Diameter: ~ inches O~: ~ f~
2 4
Liner Tfpe: ~
~ ~ ~ Di~e~: ~ inches ~:
ii ]~ Casing s~p a~ve gromnd:
/d 8~ S~fic water l~el (~m ~o~d
83 85 ~umping l~l: ~ fe~ ~
~ hours pump~g ~ ~m
R~ve~ ~te: ~ ~m
Me. od of T~ng: air ~[~ . ·
Well Inm~ Opening
x O~n ~d ~ Op~ Hole
6~ut ~pe: bent~lte
De~: S~ 0 f~
Pump: In.he ~p~ ....
Pump si~ ~p B~d N~
W~ll Dtsinf~ Upon Comgl~on? x Y~
M~tho~ of~s~fioa: cMorine table~
Cammen~:
PO Box 110~96
~nchorage ~K 995'11
Volume: I bg
gtopped,,? fe~t
Mark Begich
Mayor
Development Services Deportment
Building Safety Division
On-Site Water & Wastewater Program
4700 Elmor¢ Street
PoO. Box 196650
Anchorage, AK 99519-6650
www.muni.orq/onsit¢
(907) 343-7904
Pump Installation Log
Well Drilling Permit Number: SWOSPlOi079
Date of Issue: 10/9/2010
Parcel Identification Number: OI 7-042-15
Replacement Only: YES NO
Legal Description
Lot 15, Block 3 McMahon
Property Owner Name & Address:
Merit Homes
Pump Installation Date: 10/9/2010
Pump Intake Depth Below Top of Well Casing: 61 feet
Pump Manufacturer's Name: Goulds
Pump Model: 10 GPM
Pump Size 1/2 hp
Pitless Adapter Burial Depth: 13 feet
Pitless Adapter Manufacturer's Name: Campbell
Pitless Adapter Installer: Red Dog
Well Disinfected Upon Completion? [] Yes [] No
Method of Disinfection: Recirc
Comments:
Pump Installer Name:
Aarow Pump & Well Service LLC
PO Box l10496,Anchorage, AK. 99511
(907) 346- 9355
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
OSP101079
01704215000
WelISeptic
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
Permit Effective Dates: June 17, 2010 to June 17, 2011
Design Engineer: ANDERSON ENGINEERING
Subdivision: MCMAHON
Site LegalAddress: MCMAHON BLK 3 LT 15 G:2835
Owner/Address: MATTSON DAN R LIVING TRUST
MATTSON DAN R/TRUSTEE PO BOX 112174 ANCHORAGE AK 995112174
Site Mailing Address: 3900 Furrow Creek RD, Anchorage Lot Size In Sq Ft:
Total Bedrooms:
30940
4
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 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.
Received By: ~,
~, -ZI '/~'
Date:
Municipality of Anchorage
Development Services Department
Building Safer7 Division
On-Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
www.muni.orglonsite
(907) 343-7904
ON-SITE SEWER/VVELL PERMIT APPLICATION
FOR a SINGLE FAMILY DWELLING
o~OlOIOT-~
Parcel I.D, 017-042-15
Property owner(s). Medt Homes, Inc.
Mailing address P.O. Box 111982 Anchorage, AK
Site address Furrow Creek Road
.Day phone 334.9233
Zip Code 99511
.Zip Code 99516
Legal description (Sub'd., Block & Lot) McMahon Subdivision, Block 3, Lot 15
Legal description (Township, Range & Section)
Lot Size 30,940 Sq. Ft. 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
P~vy []
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)
Waiver Fees:
Date of Payment:
Receipt Number:.
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
June 10,2010
Municipality of Anchorage
Development Services Department
On-Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject:
Lot 15, Block 3, McMahon Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 15, Block 3, McMahon 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. Also identified on the
plans are the existing wells and septic systems on surrounding lots. No conflicts exist
between the proposed well and septic system and wells or septic systems on adjacent
lots. 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 recently placed on the lot in the area of the absorption trench and
alternate site indicate silty gravel and sand (GM/SM). The percolation rate of the soil
was determined to be 4 minutes per inch. No groundwater was found during the
placement of the test holes and none was noted during the monitoring Period. An
application rate of 1.2 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 a
new 32' long by 3' wide by 8' effective depth absorption trench to treat and dispose of
the effluent generated in the house. The elevation of the distribution line in the
absorption trench 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.
The ground surface on the lot in the area of the septic system slopes to the north at
approximately 5%. The new trench will be constructed parallel with 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.
Lot t5, Block 3, McMahon Subdivision
June 10, 2010
Page Two
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.
Sincerely,
Michael E. Anderson, P.E.
Attachments
17
//,~6
VACANT
25
",:] 6
.. 7
24
AREA MAP
SCALE /,' = 100'
McMAHON SUBDIVISION
LOT 15, BLOCK 3
30,940 S.F,
FURROw CREEK ROAD
PractiSed I
I
SITE PLAN
SCALE 1' = 30'
LOT 15, BLOCK 3, MCMAHON SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Four Bedroom Home Deep Trench System
Perc. Rate: 34 Min./Inch 1,250 GaIIon Septic Tank
Application Rate: 1.2 GPDISF 8' Drainfield Rock
4 Bedrooms X 150 GPD/1.2 GPD/SF (Application Rate) = 500 SF Absorption Area
500 SF/16 SF/LF = :31.25 LF Trench Length
THEREFORE: Construct a :32' Long x :3' Wide x 8' Effective Depth Absorption Trench at the
Location Shown. Flow Line Elevation in Trench to be 3.0' Below Original Ground Surface. Total Depth
to be 11' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption
Trench. Maintain 100' Separation from WeIIs in the Area.
Natural
Backfill
Geotextile
-- Fabdc
Perforated
PVC (Holes Down)
DrainfieldRock
TYPICAL DEEP TRENCH SECTION
(NO SC^LED .........
NOTE: Grade Area Over Trench to Drain Away. ,' ~.."" z~,,
M~n~mum 6 Separation From Bedrock.
Minimum 4' Separation From Groundwater. ,,.?...~.~~
Minimum 100' Separation From Wells in the Area. ~'~
Minimum 100' Separation From SurfaceWateror Streams.' ~.~-... No. c~-,,~.
~700
DEPTtl
(f~t)
1
2
3
4
$
8
9--
11
20
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
BRAGAW STREET ANCHORAGE, AK, 9c)51g-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION:
PERFORMED FOR:
DATE: 5/10/2010
PARCEL ID#:
LOT 15t BLOCK 3r MCMAHON SUBDIVISION
MFRIT
PROJECT No.:
TECHNICIAN:
ItEst,o . . I
OB/OG
SILTY GRAVEL
SAND
GM/SM
BOH @ 18'
A. HARALA
SLOPE
NO
$1T[~ PlAN
SEE SITE pL,a,N
READING GI~OSS TIM, El NET TIMEI DEPTHwATERTO NET DROP
(INCHES)
tN NUTES) J(MINUTES) J (INCHES)
TEST HOLE PRESOAKED PRIOR TO TESTING:
2
14:42/14:52
14:42/14:52
14:42/14:52
14:42/14:52
10
I0
10
10
5.88/8.19
5.63/8.06
5.56?7.88
5.50F/.94
2.31"
2.44"
2.31"
2.44"
3
4
5 14:42/14:52 10 5.63/8.12 2.50"
6 14:42/14:52 10 5.56/8.06 2.50"
PERCOLATION RATE; 4.0 (Mnq/mCH) PERC. HOLE DIA, 6" cnqCHES)
TEST RUN BETWEEN: 5.0 FT. and 6.0 FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. !, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE.'. 6/10/2010
/~700
DEPTII
(feet)
1
2
3
4
$--
6
7
8--
9--
11
20
IvlUNICIPALITY OF ,ANCHORAGE
DEVELOPP1ENT SERVICES DEPARTHENT
BRAGAW STREET ,ANCHORAGE, ,AK 9c)51c)-0050
SOILS LOG - PERCOLATION TEST ]
LEGAL DESCRIPTION:
PERFORMED FOR:
DATE: 5/10/2010
PARCEL ID#:
LOT 15~ BLOCK ..3~ MCMAHON SUBDIVISION
MERIT HOMES
PROJECT No.:
TECI~qlCIAN: A. HARALA
I TEST.OLE2 I
OB/OG
SILTY (;RAVEL
SAND
GM/SM
BOH @ 18'
SLOPE
WAS GROUteD WATER £NCOUNTEREI~' NO
PLAN
SEE SITE
DATE REAmNG G~OSS T~.E ~ET T~M,~ ~[~.~o NeT DRQP
[HINUTES) I",HINUTES) I (INCHES) ] [INCHES)
TEST HOLE PRESOAKED PRIOR TO TESTING:
5/21 I 18:12 9.44"
2 18:42 30 13.81" 4.38"
3 18:45 9.50"
4 19:15 30 14.12" 4.63"
5 19:16 9.38"
6 19:46 30 , 14.06" 4.69"
PERCOLATION RATE; 6.5 (MINflNCtl) PERC. HOLE DIA, 6"
TEST RUN BETWEEN: 5.5 FT. and 6.5 FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT
TI'IlS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE.'. 6/10/2010
Parcel I.D. 017-042-15
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
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
COSA#
Expiration Date:
GENERAL INFORMATION
Complete legal description Lot 15, Block 3, McMahon Subdivision
Location (site address) 3900 Furrow Creek Road Anchorage, AK 99516
Current Property owner(s) Merit Homes, Inc.
Mailing address P.O. Box 111982 Anchorage, AK 99511
Day phone 334-9233
Lending agency
Day phone
Mailing address
Real Estate Agent
Day phone
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup.
NUMBER OF BEDROOMS: Four (4)
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 on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal end,rathe 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.
bedrooms.
DSD SIGNATURE
~.-~'J Approved for L~
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Attachments:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
(Rev 11105)
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 Elmore Road
P.O. Box 196650
Anchorage, AK 99507
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description:
A. WELL DATA
Well type Private
Date completed 10/2/10
Total depth 85 f.
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Lot 15, Block 3, McMahon Subdivision
Parcel ID: 017-042-15
If A, B, or C provide PWSID #
Sanitary seal (Y/N) Y
Cased to
FROM WELL LOG
10/2/10
74
7
Coliform 0 cOloniesll00 mL
Arsenic: N/D ug/I
B. SEPTIC/HOLDING TANK DATA
85 ff.
g.p.m.
Nitrate 2.36 rhg/L
Date of sample: 10/19/10
Well Log (Y/N) Y
Wires properly protected (Y/N) Y
Casing height (above ground) >18 ' in.
AT INSPECTION
g.p.m.
Tank Type/Material Septic/Steel
Tank size 1,250 gal.
Foundation cleanout (Y/N) Y
Date of pumping New Const.
ABSORPTION FIELD DATA
Date installed 6/21/2010
Length 34 ff.
Total depth 13.5 ft.
Number of Compartments Two
Depression over tank (Y/N)
Pumper
Soil rating (g.p.d.l~ or ft2/bdrm) 1.2 GPD/SF
Width 3 ff.
Eft. absorption area, 544 ft2 Monitoring tube
Date of adequacy test New Const. Results (Pass/Fail)
Fluid depth in absorption field before test in.
Elapsed Time: ~ min. Final fluid depth
Any rejuvenation treatment (past 12 mo.) (YIN & type)
Other bacteria 0 colonies/100 mL
Collected by: A. Harala
Date installed 6/20/2010
Cleanouts (Y/N) Y
High water alarm (Y/N) N
System type Deep Trench
Gravel below pipe 8 ft.
Y Depression over field N
For bedrooms
Water added .......... gal. New depth in.
in. Absorption rate >= g.p.d.
· N If yes, give date
D. LIFT STATION
Date installed
"Pump on" level at ~ in.
Datum
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM VVELL ON LOT TO:
Fe
Septic tank/lift station on lot >100'
Absorption field on lot >100'
Public sewer main N/A
Sewer/septic service line >25'
Animal containment areas >50'
Size in gallons
"Pump off" level at
Cycles tested
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 N/A
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 >10'
Wells on adjacent lOts >100'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line >1o' Building foundation >1o'
Water Service line >1o'
Curtain drain None Noted >100'
COMMENTS:
Absorption field >5'
Surface water >100'
Water main >10'
Driveway, parking/vehicle storage >25'
Surface water >1oo'
Wells on adjacent lots
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engfneer's Printed Name Michael E. Anderson, P.E.
Oate 10/26/2010
COSA Fee $
Oate of Payment
Receipt Numb~,,-
~_ (Rev, 1WOS)
%
io- ,27- /o
Waiver Fee $
Date of Payment
Receipt Number
SGS Ref.# 1105636001
Client Name Anderson Engineering Printed Date/Time 10/22/2010 14:07
Pro. iectName/# McMahon S/D , L15,B3 Collected Date/Time 10/19/2010 10:21
Client Sample ID Private Well From Crawl Space Received Date/Time 10/19/2010 12:00
Matrix Drinking Water Technical Director Stel~hen C. Ede
Saml31e Remarks:
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) 10/19/10 10/21/10 NRB
Waters Department
Total Nitrate/Nitrite-N 2.36 0.100 mg/L SM20 4500NO3-F B (<10) 10/20/10 AYC
Microbiology Laboratory
E. Coli Negative 1 100mL SM20 9223B A 10/19/10 DLC
Total Coliform Negative I 100mL SM20 9223B A 10/19/10 DLC
PLAT NO. 65-86
McMAHON SUBDIVISION
LOT 15, BLOCK 3
30,940 S.F.
FURROW CREEK ROAD
WELL
S 86o40,11,,E 163.28'
~ ~C. DRIVE
CONC. WALK ~
20.0'
EXISTINO BUILDINO
Z
0
0
54.0'
52'0'
55.5'
SEPTIC STSTEM
10' UTIL. ESMT.
S 88°05'00-E 165.09'
1"=20'
SURVEY lNG, LLC IT IS THE RESPONSlBIETY OF THE OWNER TO
JEFF A. GASTALDI, R.I-S. DETERMINE THE EXISTENCE OF ANY EASEMENTS,
2000 E. DOWUNG RD., SUITE 8 COVENANTS OR RESTRICTIONS WHICH DO NOT
ANCHORAGE, ALASKA 99507 APPEAR ON THE RECORDED SUBDIVISION PLAT.
PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA
GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR
ESTABUSHING BOUNDARY OR FENCE UNES.
2855 10/25/2010
ANCHORAGE RECORDING DISTRICT, ALASKA
F.B. JOB NOG
NOTE: NO CORNERS SET THIS DATE.
10-08 MS155