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Home My WebLink AboutGREENLAND BLK 3 LT 3nland Block3 Lot #015-172 -09 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201452 PID Number: 015-172-09 Dwelling: N Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New N Upgrade Name JOHN & CHRISTINA REIMERS ABSORPTION FIELD El Deep Trench El Wide Trench [I Bed El Mound Site Address 4901Ell 5TH AVE, ANCHORAGE AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating 1 Total depth from original grade 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot GREENLAND 3 3 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ftz Ft. Well 100'+ NA NA NA 25'+ TANK ❑® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1250 Gal. Surface Water 100'+ NA NAI NA Material Number of compartments Lot Line 101+ NA I NA i NA NA POLY 2 Foundation 10'+ NA NA ( NA LIFT STATION Manufacturer Capacity Remarks Gal. Alarm location Electrical installed by Installer PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield BEEK EXCAVATION Drainfield CO/MT 3034 Inspector Pannone Engineering BENCH MARK (Assumed elevation) 100 g Inspdeatio 151 20201109 Location and description 2 nd 3rd 4,h BOTTOM OF HOUSE TRIM ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date �� OF ACgs� co . ....° S t even R. F'annr.)e" Septic System ApprovedDate CE 8140 C- �s'F�f (, Note: this approval doest include well permit requirements. 0 -n 0 -p -1r-c')0— =D v m � CC) z Q7 O Z7 c: nm -n - M <O mX;uM moo Cc: zzo=D MM x � z O o O0 — c� a, o m v > Wr 5 U) z m z o m m O A r m mp D r 02 (j C m U v z -D c) z 0 X fel Do DC/-) N M a�,z O m cNJ, ' ' n D o c., -> D O--{� m M n. m ry �i D c rn o m / 3 IC \ I 3 i F9m \ O n D m o -I z — m^ V �` y r 0— _ I �...,c�-'icy\. D.... CNJi m N t* $ I W S 0 0 / A < �mFTI s n J I' / W Ns I Z ` z co ? T z I s m O z rJ fv ' m0 D -i t/ m D U \ I n n rn v, cn L / O O rn 0 cn D _ m — Qo \ J ' / J NOTES: PANNONE ENG SVC LLC (C.I. 1088) P.O. BOX 1807 PALMER, AK 99645OF • REVISIONS DATE 20201116 RECORD DRAWING PHONE (907) 745-8200 FAX 907) 745-8201 P•''" ' • REV: 20201124 SCALE *F497H ;* 1., = 60' GREENLAND B3 L3 ••.• •• • •"•••• P.I.D. NO DRAWN JRL JOHN & CHRISTINA REIMERS }e ain, Q„n'one 015-172-09 4901 E 115TH AVE CE 8149 PERMIT N0. OSP201452 SITE PLAN ANCHORAGE, AK 99516 ."•• SHEET 2 OF 2 :E > � r" > 0 0 (J) > CO c (�R C rvzll o w q U" — ni < OD > Z> o m 00 w > s; m ID o < ' 6. 0' 6 0 0 4-1 R 0 0 z 0 Z 1 3 > E 0 (DI:3 o- z I 0 30' 1 30, m N 00°00'30" E 270.00' cn 26.5' ti M 10 (J) > (D C( - <:;a c (�R -u rvzll o w q U" — ni < 0 z G) > s; m ID o < ' 6. 0' 6 0 0 4-1 R 0 0 z 0 Z 1 3 > G) I , > rn E 0 (DI:3 o- z I 0 30' 1 30, m N 00°00'30" E 270.00' cn 26.5' ti M 10 (J) > (D C( - <:;a c (�R -u (D (D < 0 -< m 2 *0 2. 0 0 z G) OD s; m ID o < ' 6. 0' 6 0 -FD- > > >0 I , rn -j . () Z CA U) 0 -ID c -U �3- 14, 0' - w < 'E < NO 0 > (D ➢ z (D — 3 Z CD -0Fz bo ID o 3CY 0 ID (D v 0 22. 3' �2 3' 0- -0 .572 N 26. 0 3 R- Q� E 0 (DI:3 o- z I 0 30' 1 30, m N 00°00'30" E 270.00' cn 26.5' ti M VJ cn 0 2 *0 2. 0 OD ' 6. 0' 6 0 . CA Ul �3- 14, 0' NO 0 26V T\ I Lj , '26 26.0 1,0 bo 22. 3' �2 3' M .572 N 26. 0 R- Q� 8. 0' 0 CD N' 00*00'30" E 270.00q 0) 30' X30' rn 3: 0 m AIW M, IN 00 cfl I ,30' 1 30' 723, wma MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP201452 Work Type: SepticTank Upgrade Tax Code Number: 01517209000 Site Legal Address: GREENLAND BLK 3 LT 3 G:2636 Site Mailing Address: 4901 E 115TH AVE, Anchorage Owner: REIMERS JOHN A & CHRISTINA J Design Engineer: PANNONE ENGINEERING SERVICES This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: ,,%cnc 0 f .11 DepaI- tmc:tut 10/22/2020 10/22/2021 27000 ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: ) Date: Issued By: / Date: 2O 3 ANCHORAGE Development Services Department / On -Site Water & Wastewater Section ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 015-172-09 Property owner(s) John and Christine Reimer Mailing address 4901 E 115th Ave, 99516 Site address 4901 E 115th Ave, 99516 Legal description (Sub'd., Block & Lot) Greenland S/D B3 L3 Legal description (Township, Range & Section) Lot Size Day phone Sq. Ft. Number of Bedrooms 3 Phone: 907-343-7904 Fax: 907-343-7997 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑ (w/wo ADU) Septic Tank F1 ❑ Upgrade X ❑ Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: # 168,75 CDU I D -1 9) Waiver Fees: Date of Payment: 10-21 - 2'O Receipt Number: U'2-47- O (? Permit No. 0 S P 2 01 y 52 Date of Payment: Receipt Number: Waiver No. G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201452, Deb Wockenfuss, 10/22/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201452, Deb Wockenfuss, 10/22/20 Municipality of Anchorage .__o~ t e Development Services Department Building Safely Division On-Site Water & Wastewater Program. 4700 South Bragaw SL P.O. Box 196650 Anchorage. AK 99519-6650 www.cLanchorage.ak.us (907)343-7904 Page 1 of On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number:. SW000433 PID Number:. 015--172--09 dOHN REIMERS Wastewater System: · New I-I Upgrade Addregs: PO. eox 110273 ABSORPTION FIELD Phone: No. of Redroome: (907) 549-8967 3 IOeep Trench rlShalIow Ti-ench abed nMound n0ther LEGAL DESCRIPTION ~ "~ 0.6 ~/~ ~ 5 5 GREENLAND 2 MAX ~ 6 - - - SEE DWG r~ 6§' WELL: · New [] Upgrade 5.§' n 1 N/A PRIVATE ~,~'r~ ~'r~! r~ ~ ~,~ 7~0~, sa. n D 30~4/ F-810 ALPINE DRILUNG 12/28/00 R~'r~ DAN BEEK 1/6/01 7.o ~, UN~ ~ ~.,,. TANK SEPARATION DISTANCES Is,,u~ ",o~d~n~ OS.T.C,. O0~r From Tunk Reid StaUon Tank S,.., U,,* ANCHORAGE TANK 1000 we, 100'+ 100'+ - - 25'+ ~ STEEL ~ '~ "~"*""~ 2 S,rfo¢. Wot,, lO0'+ 100'+ - - -- LIFT STATION 5.+ ,. - - - Curtain Omen NC~NE KNOW~I/~ ~ ee~s~ v,e~et~'. ~ ~.,~o~k~: BENCH MARK 1.5' TO 2.5' OF THE TRENCH SIDEWALLS WERE BOTI'OM SEPTIC TANK CLEAN. COARSE SAND *..,,,~ e.,~ 91.61' .=. F ~rd ~ ~' ~"- ' .............. "'"~ Department of Health and Human Services approval ~h~' '-.. ~ ...' y~ ~'°~ ........... ~..~__~ R~vlewed and approved b Date: '7°.~.--~''O] - °~, .=. SW000433 ~ O! 5-172-09 I I / ~ WERE R~SED. LOtiONS I I / ~ SHOWN ON ~E DESIGN / INCORRE~ ~EP~C ~/ BEDR~M HO~E 37.2 59.8 / / / DB~ 38.5 60.7 ~1 103.4126.6 7/o=/o B.S,G. GREEN~ND SUBDIVISION; LOT 5, BLOCK 5 DESIGN OF PROPOSED WELL AND SEPTIC LOCATION ~ ~: AS BUILT DRAWING SW000455 ~ 015-172-09 R C~DE 98.5+~ INSU~ON TOP OF T~K AT ~ = = / ~TOP OF T~K AT INL~ - 96.46 ~ ~0~- 96.48 I~RT OF BUNG SEPTIC TANK I~RT OF BUNG AT ~ ~n~L C~DE ~:~ *RENCH ~ 87~0 ~.s.o. ~SI~ ~TER & ~STE~TER JOHN REIMERS (907) 349-8967 2 OF LOT 5. BLOCK 5 GREEN~ND ~"~...d ...."_~ AS-BUILT DRAWIN~ OF SEPTIC SYSTEM UPGRADE Department of Health and Human Services 825 'L' P.O. Box 196650 An~omge, Alaska 99519-~50 /~k M,/stmm I~q):l/www. c~.enchora~.~ u~ Mayor Permit Number:. #SW 000433 Date of Issue: 10-9-00 Parcel Identification Number:. Date St~'t~: ~ Date Completed: ~2-30-00 Is well lecat~ at approved l~rmit location? [] ¥~ [] No Green/and blk 3 (t 3 John & Chl~stina Reirne~ PO Box 1f0273 Anchorage, Ak 9951 Depth (ft) From To 21 63 63 67 67 70 70 79 79 83 Legal Descrtp~on: Property Owner Name & Address: Borehole Data: So~q Type, Thkkness & Water Sm~ta stick-up silty gra vel silt boulder silty gravel silt silty water sand & gravel iI Method of DrilUng [] air rotary [] c~ble tool Casing type: ~ Wall Thlckne~: ~ inches Liner Type: steel D~meter._5 inches Depth: _62-85 feet Casing stlckup above ground: 2 feet Static water level (~om ground level): Pumping level:..~ after _2 hours pumping 7 gpm Recovery Rate: Z gpm Method of T~stlng: eirl~ Well Intake Op~ning Type: [] Olin End [] Of~n Hole [] Scr~n~d S~n [] P=forations $~rt f~et S~Opl~cl Grout Type; B~to~ite # D~th: Start Pump: Intake Depth Pump Brand Name Well DIsin~ected Upon Completion? [] Yes [] Method of Disinfectinn: C/or/ne Tablets Commen~s: Well Driller. Alpine Dn71ing & Enterp#ses P 0 Box 110496 Anchorage AK 9951 Attention: The well driller shall provide a well log to the property owner within 30 days of completlon and thc property MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Date Issued: Oct 09, 2000 Expiration Date: Oct 09, 2001 Permit Number: SW000433 Legal Description: GREENLAND BLK 3 LT 3 Design Engineer: 0041 AK Water & Wastewater Consultant Owner Name: John Reimers Owner Address: PO Box 110273 Anchorage, AK 99511- Parcel ID: 015-172-09 Site Address: 004901 115TH AVE Lot Size: 27000 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] 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 engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Date: /'(~ -- Date: ALASKA WATER & WASTEWATER CONSULTANTS, INC. ~ ~ September 25, 2000 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Reft Well and Septic Design for Greenland Subdivision; Lot 3, Block 3 To whom it may concern: The proposed 3 bedroom house will be served by a private well and septic system. Two test holes were excavated on the property by James P. Williams, P.E., on 4/28/98. The proposed septic system will be designed within the 30 foot radius of test hole/t2. We are proposing that a I000 gallon septic tank and dual five foot wide drainfields be installed. Comments regarding the proposed design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that due to the overall appearance of the soils, an application rate of 0.6 gallons/day/ft2 should be used. 2. TRENCH DESIGN: a. Percolation Rate: 2, 15, & 40 minutes/inch b. Allowable Application Rate: 0.6 gallons/day/ft2 c. NumberofBedmoms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 750 ft2 f. Total Depth: 7 feet (max.) g. Effective Depth: 4 feet h. Width: 5 feet i. Reduction Factor: 0.5 i. Minimum Length: 80 feet (2 ~ 40~ feet long each) j Effective absorption area = 800 flz 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akxvwc.com 4. TOPOGRAPtIY: As can be seen on the attached topography site plan, the average topography of this property is a 8 to 11 percent running from approximately southeast to northwest; in short, there are no slope concerns. The trench is to be installed parallel to slope contours. 5. LOT LINE WAIVE REQUEST: We request that your department issue a 1 foot lot line waiver from the east property line to the proposed drainfields. We are unaxvare of any adverse effects this would have on the adjacent properties. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. tmess, P.E., M.S. NOTE: Attached is a site plan drawing, a design drawing, a topography site plan, two soils logs, and a 7 page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akxwvc.com i I I I I I GREENLAND $/D GReENLAnD S/D CRET]~LA~D e:/£ GREENLAND S/D GREENED S/D Ii ~T 5, B~K 2. ~T 4, B~K 2, ~T 3. B~K 2 ~T 2, B~K 2. ~ 1. B~K 2~ I I I I I I I I I I ~ 114 A~NUE I I - I I 2 OF2. I I I I I I ~ GR~N~D S/D I J ~ ~ / 1, B~K ~. I / I ~ / I ~ / I // I ¥ ~ ~1 1 I I ~R~a ~[ ~ ~ I 01 I I I I I ~ I ~ I / I I I ~, ~ J ? I I -, }~/ ,.' ~ ~ , , ~ ~ I ~ ~ I L ..... _.~~~ .... _ -- -~ ....... ~_I- ---.. ._.___, m~O S/O ~ ~ .1~' ~L ~m~ I ~T 2. B~K 4, S~ ~ LOT 1, B~K 4, ~ / ~"....~ .... LOT 5, BLOCK 3, LOT 4, BLOCK :~, . I \ CREI:NLA'~D S/D I~ 2 OF2. I I ALASILa~ WATER & WASTEV~TER ~.D.W. CONSULTANTS, INC. ,, ~ 6~)01 0~BA.q~t ROAD. ~TE L~ · ANL'~0~AGEI ~ ~50& · PHONE ~007k557-617~) · FAX (~07)$311-~6 1" = 100' PREPAR~.D FOR pHONE NUMBER: aA~E NUMB[R: JOHN RIEUERS (907) 549-8967 1 OF 2 GREENLAND SUBDIVISION: LOT 5, BLOCK 5, SITE PLAN FOR THE PROPOSED WELL AND SEPTIC LOCATION NOTE: THE CONTRACTOR SHALL HAV[ THE EAST 114th AVENUE FOLLOWING FLAOG£D BY A REGISTERED LAND SURVEYOR PRIOR 70 ANY CONSTRUCTION: r-Tt.~¥ HOLE (4/24/98). 1. THE I00' WELL RADIUS FROM LOT 2, t ; GROUNDWAT~:R AT 15' ON ~5/5/98. (APPROXIIAATE BLOCK 5 GREENLAND I. OCA'~ON) 2. THE F.~ LOT UNE FROM LOT 3, BLOCK .3 GREENLAND $/D. ~l FOOT LOT UN£- WANT..R R EQ D t.~¥i:.t) ~ X '\ "1 ""-~,~-- PROPOSED DRAINF~ELD$. INSTALL /'/ 'mENCHES THAT ARE: 7 FEST DEEP ~ / MAXIMU~I, BY 5 F[~I' ~DE, BY 40 ~ ARr:-A~' .... ~ / FEET LONG F.~CH. ADD 4 FEET OF C~s~Pnc -- -- ~ '~' ~"' ~ ~X L ...... J 7 xxx T/ - --_. / II :.:'~.' ~ \ ,~o' ~ ~'~ / ' ' I ~ :'""..-..-.. \ / II \ ~._ ~':::~. \ / I \ ::;.:: \ / / i \..~-~:.:.~.: I / / \ ~ ;.:. ~ I / / \:':' '~ I [ / / X EAST llSth AVENUE / r / "~ ._ --//~ 9/26/2000 K.D.W. " ALASKA WATER & ~STEWATER~ , CONSULTANTS, INC. 1" = 40' "'"'l'l/-~t'-" ~ ........................ JOHN REIMERS (907) 349-8967 2 OF' 2"*~"'t,'[7¥'1":"~-- .............. :'"1 S.EE.L~ND SUaO~WS~ON: LOT ~, ~LOC~ ~ '~[~,:".q .... ... DESIGN OF PEOPOSED WELL AND SEPTIC LOCATION PERFORMED FOR: 2 5 6- 7 8 9 10 11 12 13 14 15 16 17 18 19 20- Township. Range. Section: SLOPE SITE PLAN ENCOUNTERED? /~"~ / ~ IF YES, AT WHAT DEPTH? ~% ~ p ~Wing? T ~ ~ ~A~g~' I Reading Date Gross Net De, th ~' Net Time Time Wate~ DroP yt/; - 6" _ : [; ~o~ ,s//~,. S 'h," PERCOLATION RATE ~ {m,nutes/,ncn) PERC HOLE DIAMETER TEST RUN BETWEEN ~'~'& FTAND /"'~'~ FT ~25 'L" ~tr~t. ~ncbora~e, Alaska ~2~ ~ ~]~ ~1 ~~ ~ I SOILS LOG -- PERCO~TION TEST ~%: ~~/,~ I PERFORMED FOR: LEGAL DESCRIPTION: ~ ~~ ~//~Township. Range, S~tion: 3 4 12- 13- 14- 16- 17. 18- 19- 20- g.o.H. SLOPE .I WAS GROUND WATER ENCOUNTERED? ~w,~ i~~ iil~m*il~? SITE PLAN ~-.9.~ Gross Net De~o t h to Net amm.m Cate Time Time Watar Drop ~,~-~.o ' v/~ ~',oG - ~ " - TEST RUN BETWEEN ~4 ) ° ¥'~' FT AND '~2~. ~.0 FT PERFORMED BY: I ~vl ILj/[ { CERTIFY TI~AT T~IIS TEST WAS PERFORMED IN 72,,00~ {Rev. P;RFORMEO FOR: ~1~ Munlcipellb/of Anchorage. : ,"~4 9[P.~ ~/'/F:* ~ · r'"" ~ ' *~".:'* ' ' ' ~. DEPARTMENT OF HEALTH & HUMAN SERV~ ~:~:~..: '~ ll'~'.?~..- ~- ~. JAMES P. ~LLtAMS 825 'L" Street. Anchora§e. A~aska 99502-065~ ~ .... SOILS LOG--PERCO~TION TES~ ,'.. ~0:~ ..'~ LEGAl. DESCRIPTION: g 10 11 12 13 14. 15 17 /~ ~,/'/. 18 20 Township, Range, Section: SLOPE WAS ( dD WATER V,~,- ENCOUNTERED? IF YES. AT WHAT /~o~' ~' DEPTH? pO E Idoni~ing? SITE PLAN Gross Net DePth I~F Net Date Time Time Water Drop ~:~ - ~,, _ _~:o~ - ~" -- :~ - ~ - _ PERCOLATION RAT (minute's/taCh} PERC HOLE DIAMETER TEST Rt}N BETWEEN ~'0'~"~ FTAND ~.~-~.O FT PERFOR a E D IR y; /t ~I/'Y;a~A- t ~ I /,l./~////t/'~' / ~'~CERTIFy THAT/T~/$ TEST WAS PERFORMED IN AODORDANCEWlt~ALL.$T.ATEANOMUNICI.ALGUlOELINES~/EFFE~T ON THIS OATF- DAT. / 4" co,.,'-m,~' MUNICIPAUTY OF ANCHORAGE £.s - Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax.- 907-343-7997 Certificate of On -Site Systems Approval n ,� Parcel I.D. 015-172-09 Expiration Dater 1. GENERAL INFORMATION Complete legal description Greenland S/D Block 3 LOt3 Location (site address) 4901 East 115th Ave Current property owner(s) Reimer, John & Christine Mailing address Real estate agent 4901 East 115th Ave, 99516 Julie Erickson 2. TYPE OF DWELLING: Fx1 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone Day phone 242-9282 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well El Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ "l I a- �J d (m C� Date of Payment Receipt Number 0 COSA# 0 SC a0 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. 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. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. Date October 19, 2020 OF A�gs��Q� 6. DSD SIGNATURE System #1 Approved for bedrooms B� Steven R. Pannol:ie CE 8149 System #2 Approved for bedrooms' 11 0,6 �- Disapproved kF�?o2sstio�'�� Conditional approval for bedrooms, with the following stipulations: Ml CI -M 3. �v WATER AND m By: 'w �` Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: Greenland S/D Block 3 Lot 3 If more than 1 septic system on lot: COSA Checklist # 1 of A. WELL DATA FE -1 Well log is filed with Onsite (or attached) Date drilled 12/30/00 Total depth 83 ft Cased to 83 ft Fil Sanitary seal is functioning correctly X Wires are properly protected Casing height (above ground) 36 in. Date of flow test for COSA 11„61202' Static water level at beginning of test 71 ft. Comments B. TANK DATA Age of tank(s) new years Tank type/material Measured operating fluid level in septic tank NIA FI�M Standpipes/foundation cleanout per record drawing Date of pumping NEW TANK D. ABSORPTION FIELD DATA Which system tested (date installed) Primary 011 ALL standpipes present per record drawing Total measured depth from grade 10.5 ft (max) Measured depth to pipe invert from grade 4.0 ft (min) ❑ N/A — pressurized field 01 Monitor tubes go to bottom of effective. If not, state depth into effective F Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 015-172-09 Structure served by this system 1 Well production at time of test 4.5 9P Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑✓ No Q Coliform bacteria is Negative Nitrate 3.69 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L H Arsenic less than MRL (ND) Collected by PES Date of Sample 10r16/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date Results [D Pass For bedrl s Fluid depth prior t test `4\ in � Water added 600 New depth 55 in Elapsed time 240 min Final fluid depth 44 in Absorption rate 600+ gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑✓ Yes if No Community Sewer Manhole/Cleanout > 100' If absorption field is under driveway comment below 7 Yes if No ft ❑✓ Yes if No ft Neighboring Tank > 100' ✓❑ Yes if No ft Private Sewer/Septic Line > 25' ❑✓ Yes if No ft Absorption Field on Lot > 100' Fv7l Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' F. ENGINEER'S COMMENTS Animal Containment > 50' ✓❑ Yes if No ft ❑✓ Yes if No ft t c2ia-D f, (d r?'Los (L'Or-16 rn C/0 halbe('r'7 Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑✓ Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' Q Yes if No ft Surface Water > 100' ❑ Yes if No ft Property Line > 5' ✓❑ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑✓, Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10' F,71 Yes if No ft Community Wells > 200' 0 Yes if No ft Water Service Line > 10' F✓] Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ❑✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No 1 * ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' ❑✓ Yes if No ft Water Service Line > 10'✓❑ Yes if No ft Community Wells > 200' Q Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS *-Waiver WRl010064 on File t c2ia-D f, (d r?'Los (L'Or-16 rn C/0 halbe('r'7 r verAr G s ,)iQ PyV-� 11 C/O 0-A -k'U C1LAL/ L/ G. ENGINEER'S CERTIFICATION OF AL,Q !/F 1 certify that / have determined through field inspections and review �. �� of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. ..... Steven l'. r'C7nt 6n= ..� CE F11410 10 COSA Checklist yellow sheet Municipality of Anchorage Development Se ices Department Buildlng Safety Division On-Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.d.anchorage.ak, us (~?) ~4~7904 Parcel I.D. 1. CERTIFICATE OF HEALTH AUTHORITY APPROVAL 01,5-172-09 GENERAL INFORMATION FOR A SINGLE FAMILY DWELLING Expiration Date: / I ' ~.- ~0 / I Complete legal descdption GREENLAND S/D LOT 3, BLOCK 3 Locetion (sIte address or directlons) 4901 EAST 115 AVE. Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address JOHN & CHRISTINA REIMERS Day phone 349-8967/240-3878 P.O. BOX 11027,3 ANCHORAGEI AK. 99511 Day phone Day phone Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBEROF BEDROOMS: 3 3. T~PE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-sita Individual Holding tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificetes of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the lransfer of title (except between spouses) for properties served by a single family on-site wastawater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for prope~es served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up t~ one year with valid water samples.) Ce~ficates 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. Note:Alaska Water and Wastewater Consultants, Inc. shall be paid $645.00 at, or prior . . to closing for the engineering services provfded. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I vari[y that my Invesfl'gation, based on procedures outlined in the Health AuthoriJy Approval Guidelines for this application, shows that the on-site water supply and/or wastewatar disposal system is(are) safe, functional and adequate for the number of bedrooms and ~ of structure indicated herein. I further verify that based on the information obtained from the Munidpality of Anchorage files and from my Investigation and Inspection, the on-site water supp¥ and/or wastewater disposal system Is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations In effect at the #me of installation. Name of Firm ALASKA WATER &: WASTE'WATER CONSULTANTS, INC. Address 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE. AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Phone 337-6179 Date "?'//~ i~ Engineer's Comments: In conducting this evalua#on, AWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system In accordance wfth ADEC and MOA DSD Guidelines & Regulations. The reported results described the perfetmance of the system under the conditions encountered at the time of the test, and separaEon distances measured to readiiy identifiable features. The opera#onal life of all wells and septic systems depend on the Iocal soils condition, groundwater levels that may fluctuate during the year, and the water usage of the fami¥ being sen/ed by the system. These conditions are outside the conb"ol of the evaluator of the system. ,~a#sfectoty test results do not guarantes fulure pedormance of the system, nor do they guarantee that there are no hidden defects or encroachments. AWWC, In= can therefore not provide any warranb/ or future estimate of how long the system wfll continue to meet the operational requlrornents of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor Mll it confer any legal dght whalsoever. 5. DSD SIGNATURE provedfor Disapproved. Conditional approval for __ bedrooms. ' -. ~ .- .. . ON ITE bedrooms, wi~ ~e flI~ing s~pula~ons: ~ ~: WATER AND [- WAST ATER Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Manitenance Agreements Supplemental Engineer's Reort Other Original Certificate Date: Municipality of Anchorage Development Services Department On-Site Water & Wastevmter Program 4700 So~h Bmgaw St. P.O, Box 196850 Anchorage, AK 99519-6650 w~w.~anchomge.akJm (9O7) 343-79O4 HEALTH AUTHORITY APPROVAL CHECKLIST GREENLAND $//D LOT 5, BLOCK Parcel ID:. 015-172-09 A. WELL DATA Well type P~IVATI~ IfA, B, Or (~ provide PWSID~ N,/A Date completed 12/50./00 6anltep/~eal(y/N) YES Total depth 83 ~ Casedt~ 66 ~ Wee Log (Y/N). YES W~ms propedy protected (Y/N) YES Casing belght (above ground) 18+ Date of test Stel]o water level Well production WATER SAMPLE RESULTS: FROM WELL LOG 12//50/00 65 ft. 7 g.p.m. Coliform ~ colonies/100 mL Nllrate /~ 8~'"mg~L. 7, ,~ o, ~ '7/"~/e,, Date of sample: '~' / . Collected by:. B. 8EPTIC/NOLDING TANK DATA AT INSPECTIO,~ g.p.m. Other becterla ~-~ colonies/100 mi. AWWCt INC. Tank Type/Material Tank size 1000 gal. Foundation cleanout (Y/N) YES Date of pumping NEW C. ABSORPTION FIELD DATA Date Installed STEEL Number of Comparlmente 2 Depression over tank (Y/N) NO Pumper ~ rating (i .P~r ~/txtrm) 0.6 Date iP, stalll~J ,.%/1//01 cteanoute (Y/N) YES HiGh water alarm (Y/N) N,/A N/^ System type DEEP TRENCH Length 65 lt. Width 3.5 ft. Gravel below pipe 6 lt. Toteldepth ~-~ It. Eff. absorpl]onama 780 ft~ Monltorlngtube YES Daprasslonoverfleld NO Date of adequacy test NEW Results (Pass/Fall)~ Ruld depth In absorption field before test_ ~~' W~.j~de~---~. New depth In. ~e~ ~. A~rpt]on rate >-~ _g.p.d. on treatment (past 12 mo.) (Y/N & t~jpe) NONE KNOWN If yes, give date - D. UFT STATION Oats installed. Size in g~llon,1 'Pump on' level e~ ~ ~ Cycles teated Meets -latin & circuit requirements? E. SEPARATION DISTANCFJ SEPARATION DISTANCES FROM WELL ON LOT TO: Property line 1' Building foundation 10'+ Water main N/A N3soq~on field 5'+ Surface watsr lOO'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line Watsr main N/A Watsr ae~ce line 10'+ Wells on adjacent lots 1 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: High watsr alarm level at On adjacent lots 100'+ On adjacent Iota lOO'+ Public sewer manhole/cleanout N/A N/A Watsr sewlce line 10'+ Curtain drain NONE KNOWN F. COMMENT~ 8uttsce watsr 1 oo'+ Driveway. paddng/vehlcts storage Wells on adjacent lots 100'+ G. ENGINEER'S CERTIFICATION I cetth'y that I have determined through field Inspections ?nd review of Municipal recon~s that the above systems ere ~n conformance wlih MOA HAA guidelines In effect on this date. Engineer's Pdntsd Name JEFFREY A. GARNESS Dats -?/~l/Ol HAAFee$ Date of Payment Receipt Number (Rev. ~ 2.~0) Waker Fee $ Date of Payment~ Receipt Number 8ept]o tank/lilt stst]on on lot 100'+ Absorption field on k)t 100'+ Public sewer main N/A Sewer Isept]o sew[ce line 25'+ Holding tank Municipality of Anchorage P.O. Box 196650 * 4700 S. Bragaw Strcct Anchoragc, Alaska 99519-6650 * (907) 343-8,301 h t t p://www.cl.anchoragc.ak.us Department Public ~'o rkq AK Water & Wastewater Consultants, Inc. ATTN: Jeffrey Gamess, PE 6901 De Ban: Road, Suite 2B Anchorage, AK 99504- August 02, 2001 Subject: Waiver Request forGREENLAND BLK 3 LT 3 Waiver # WR010064 Lot Line Request for Parcel ID 015-172-09 Dear Engineer: Your request for a waiver of the required 10 feet horizontal separation of the on-site wastewater disposal system to the lot line has been approved. The approved separation distance is 1 feet. This waiver approval applies to the current on-site wastewater disposal system and lot line separation only. Any future upgrade to the on-site wastewater disposal system and lot line will require all separation distances to be met or another waiver approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 3434744. Engineering Technician III On-Site Water Quality Program Municipality o.f 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.ci.anchorage.~.us (907) 343-7904 Waiver Review Worksheet WRO: 010064 PID~: 016-172-09 I-IA~: Petmiff/: Date Received: Legal Description: Greenland BIk :~ I,t ~1 Engineer. Jeffrey Oamess. P.E. Alaska Water & Wastewater Coneul~al~tS, In¢, ' 6901 Debar~ Rd,. Suite 2B Anchora;]e, AK 99504 Applicant: John & Chflstlnta Relmem Waiver Requested: I foot from lot line to on-~ite wastewater dlsoosal system Criteda: Geology A. Water Table B. Soil Soq3fion C. Permeability D. Water Table Gradient E. Horizontal Separation Points: Waiver Is Granted: Waiver Is not Granted: List Conditions or Reasons for above: Date: By: Name of Reviewer Rec~: 8067 Amount: S300.00 Date Paid: 8/2/2001