HomeMy WebLinkAboutLANG LT 5Lang
Lot 5
#015-273-60
Municipality of Anchorage Page 1 of 3
Development Services Department
Building Safety Department
Onsite Water and Wastewater Program. 4700 S. Bragaw St.
P.O. Box 196650 Anchorage. AK 9951944
www.ci.anchorage.ak.us (907) 3417904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: SW000456 PID Number. 015-273-60
Northwood Homes
Wastewater System: New ® Upgrade
P.O. Box 92301 Anch. AK 99509
ABSORPTION FIELD
694-5890 F ve 5 f
QDwTmKh ®S"'"°"T"b ae.e MaM ooe.
Sod Rat".
Total Deym km a09.0 9n :
LEGAL DESCRIPTION
.8 GRDTr
13 n.
IxKI tat: S�:
DMM p pW 00th^ Yon 0X9'09^00:
Gawl O.W a anaaN t.Ce:
5 Lang
3 Ft.
10 In.
Toenshq: R-W. sfX
FA 00000 Wow 009^07000:
Gavel Lerirn:
50
.5 Ft.
fl.
Well: ® New ❑ Upgrade
Gave r oar:
3
Nvaoar ot b :
1
DarXaO lrewan Yrs:
-
Ft.
FL
cws& fJ4M (R W. A a. c):
ToW Dwm: Gaeta W:
186
T" sb..rpO ras:
1,000
Fps L/YaXW.
ASTM D3034 PVC
Private
186 n. FL
Fr
pier,
Alpine
DM0 DXi00: $YYa Walo Lnwl:
11/3/00 153 FL
YWa1o:
Sanders & Sanders
Dab YOIaYaO:
10/31/00
Yaa:
Pam9sMW
Ce" HoWt �DXa W
>2
TANK
15 cRu
fl.
F,
SEPARATION DISTANCES
®Septic ❑Holding OS.T.E.P. 0Other.
To
Fnxn
Septic
Tank
Absorption
Field
Lift
Station
Holding
Tank
WwJPnvate
sew«une
r:cipoyn
Anchorage Tank
1,500
wed
>100
>100
N/A
N/A
>25'
Steel
Two
swfmwow
>100'
>100'
N/A
N/A
LIFT STATION
tatrm
>5'
>10'
N/A
N/A
>5'
>10'
N/A
N/A
m N:
M:talo
T1h al:
Fautw
b%
in.
ti.
None
INoted
I
w.nRua.eiumat
Ebaee0 Ynp0 potomw00y.
C~Drain
RrXwb:
BENCH MARK
Garage Slab
100.0 FL
Engineers Stamp
OF
�F
Inspections performed by: MEA Dates: 1" 5/24/00
fl k
L 5/24/00
Department of Health and Human Services approval
M'CHAEL E ANDERSON r
CE-4381
`f
Reviewed and approved byG%��;%� Date: g • 3 a �/
a '•
Y
ca... tov9)
4 SS1 1`
Municipality of Anchorage Page 2 of 3
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 - Anchorage, AK 99519.6650 - 343-4744
On -Site Wastewater Disposal System or Well Inspection Report
Permit Number SW000456 PID No. 015-273-60
T117
v�
ltern te
ite
C5 .
I ' -SiteTH6A
S1
TII6
Five
Bedroom
House
•. 1
Well
PLAN AS -BUILT
SCALE I"= 401 I
�.
— —f0'U.ETliTy - Easement
QF
5TH
_A
MICHAEL E. ANDERSCN Q
I%•• CE -4301 •�`rr
A
B
S1
62.3
61.5
S2
71.7
67.0
C4
- 62.3 -
72.7
M1
115.3
91.1
C5
120.1
94.2
PLAN AS -BUILT
SCALE I"= 401 I
�.
— —f0'U.ETliTy - Easement
QF
5TH
_A
MICHAEL E. ANDERSCN Q
I%•• CE -4301 •�`rr
MuriwipartY of raye a yr a
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIMON
P.O. Boz 196650 - Anchorage, AK 99519.6650 - 343-4744
Onsite Wastewater Disposal System or Wen kmpeetion Report
permit Number SW000456 PID No. 015 273 0
0
N Mn
W U o o n to U U
' M2101nsu 9.23.7
58'
H 96.3 EU
PROFILE AS-BUILTz'
,...'1:... ......... ................
�* MICHAEL E. A4bERSCN .�
*� ��. CE -4301
,4fitt4 �ESe�`�w®`
�4 OF /A(�'��
a
Municipality of Anchorage :- 7-1,1A
Department of Health & Human Services 0 m % MICHAEL E. ANDERSCN • ,°',
825 L Street, Anchorage, AK 99502-0650 �j CE - 4381
SOILS LOG - PERCOLATION TEST �I �f�q' •. . . •' t`b
1 ,10 pROFESSIO' 4e
Performed For: Northwood Homes Date Performed: ia/20/00
Legal Description: I of 5 1 nno Subdivision
SLOPE SITE PLAN
'37 OG/OL
2 SP
3
GM
5
Well Graded
6 to
Poorly Graded
7 Gravel
Was Groundwater
9 Encountered? No
If Yes, What Depth?
10 Depth to Water
After Monitoring None
11 Date: 11/3/00
1
14
15
1
See Site Plan
Reading
Date Gross Net
Time Time
Depth To
Water
Net
Drop
1
26 -Oct 2:10
125'
2
2.40
4.25'
3.2F--
3
2:41
1'
4
3:11
4.125'
3.12F-
5
3:12
1.125'
6
3:42
4.25"
3.125'
19[ ... �Bottom of Perc. Rate: 9.6 MinAnch Perc. Hole Diameter. 6"
Test Hole Test Run Between 5 Ft. and 6 Fl.
Comments: Perc. Cavity Presoaked Prior to Test.
Performed By: Mike Anderson. I, Michael F. Anderson Certify That This Test Was Performed
In Accordance With All State and Municipal Guidelines In Effect On This Date: 5120/01
05/22/2001 00:31 9076945091
NORTHWOOD HOMES INC PAGE 02
FROM : ALPINE DRILLING FAX NO. : 907 345 0202 Nay. 22 2001 tk3:4dAM P1
. �Z
unicipality of Anchorage
Department of Health and Human Services
025 *V Street
P.O. Box 198650 Anchora9e,Alasks 83519.6650
NWA~ .eielrJ "061"
Permit N -tuber. NSW _MaM Date of Just: 10-27--2000 reveal Identii ation Namber. ED Ys loo
Dote Started: 11-2-0� Dataga U 5�
is teelt fenced at approved Pp °iIt location?
s _
propp amr & Address: No od l4o res
Anclwrage. A/aslre, 99809
9=010 Data:
Depth (D)
Method of Dn'Itmg ® air rotary' ❑ cable tool
Sea Type, Tnlcbw" & Wetar Soaer
From
To
Casing type. steel
0
2
Wall Th cimcss: 025 iacbcs
Stick,up
2
61
Dmtuder, A itnces Depth j$¢ feet
Gf2V90y edt
61
70
Liw
ysandy grays/
Diane� bwJzs Depth: feet
cobbly sxY9ravel
70
175
Casing etkkep above ground: 2 fed
wafer aand 3 gravel
175
188
Static water levet (from ground kveli 103eet
pptoping kveL 1$Jfxt after
bourn pttmpi B if UM
Recovery gate: 19 gam
Method of Testing, $lid
Well Intake Opening Type:
® Open Bole ❑ Open fed[3Scromed Start f0d 5$09*f d
Q Perforations Start rat Stopped
Grout TYPO: aV9Wke A R Volume: jig
Tlenth: Start Q fat Stopped 4 fod
Pomp: Intake Depth — fed
PUMP:>c bP Brand Name
Well DistatedW UPON, Coma*Ws? ® Yes ❑ No
Method of DpClorine Tabl
infection: ets
Comments:
Wap DrYiar: AlpinO D 16Ente/p►ass
Anch~ AK 095/1
Attrarisa Tho vvett Ater shaft provide a waft log to the properly owner win 30 days of eaapleoon end Ox props')'
o N.� 1W eft d� eA.a :.L..}7n.leF A N......� C..vw. wiA.:� tri ,1.w nr�Mr.nl'1w.
Received Time May -22. 8:26AM
.T �,• l�w��l..��V/ J
MUNICIPALITY OF ANCHORAGE
Department o1 Health and Human Services 1013 /Oay-
On-Site Services Program
825 L Street, Room 502 O/��/�?�
P.O. Box 196650, Anchorage, AK 99519-6650 J
(907) 3434744
ONSITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT
Initial
Permit Number: SW000456
Legal Description: LANG LT 5
Date Issued: Oct 27, 2000
Expiration Date: Oct 27, 2001
Parcel ID: 015-273-60
Design Engineer: 0014 Anderson Engineering Site Address:
Owner Name: Northwood Homes Lot Size: 61194 SQ. FT.
Owner Address: PO Box 92301 Total Bedrooms: 5 Permit Bedrooms: 5
Anchorage . AK 99509 -
This permit is for the construction of.,
Disposal Field Q Septic Tank Holding Tank ❑ Privy Z✓ 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.
Received By:
Issued By:
Date: toL.r'O0
�1ut�T - M� Date: le)—27--ey
ANDERSON ENGINEERING
R.0.,BOX 240773
ANCHORAGE, AK 99524
522-7773 5226779 (FAX)
October 15, 2000
Municipality of Anchorage
Department of Health and Human Services
825 V Street
Anchorage, AK 99502-0650
Subject: Lot 5, Lang Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer: '
The owner of Lot 5, Lang Subdivision intends to construct a five -bedroom home on the
lot. We are therefore applying for a permit to construct a well and septic system on the
lot to serve the new home. The attached Site Plan and backup documentation identify
the location and configuration of the new well and septic system and the parameters
used in the design. It also shows the location of the well proposed to serve the lot and
the 100' protective radius. In addition, the locations of the septic systems and wells on
the adjoining lots are also shown to clarify the separation distances.
Two test holes were placed on this lot, which .indicated gravel with varying
concentrations of silt. This is consistent with all the soils throughout the subdivision.
No groundwater or bedrock was encountered in either of the test holes nor was any
found during the monitoring period. We are therefore proposing to place a deep trench
"absorption system with 8' of drainfied rock beneath the distribution pipe. The pipe will
be placed at 3' below the existing ground surface and the total depth of the trench will
be 11'. The length of the trench has been extended from the required length of 58.6' to
65' because of the varying percolation rates in the two test holes. The length will be
extended further if field conditions indicate soils other than anticipated and found near
Test Hole No. 6.
The ground surface on the lot slopes as shown on the attached Site Plan. The area for
. the new absorption trench, however, is fairly flat. .The new trench will be constructed
parallel to the contours of the surface in conformance with Municipal requirements.
Grading will be accomplished to assure surface drainage is away from the new trench.
If the system is constructed in accordance with our design the following statements
apply
1. 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.
2. The system, if constructed as designed, will have no adverse impact on existing
OONL
• BASIS OF BEARINGS (. 77-123) 'T'p.1 WA.P SET' pN
70.00Rf �•~/ SET'
C FLUSH q/ORN4
4i'EAST 2638.38 MEAS. (263854/77-123) (2639.34/BLM) ANc Suso 0
LOT 2 0
�S ---1319.19 --- 1966
659.59-
314.77 rstr 34482 --------------
7k,
C 2
on N h ~�•
1�r A Od ww
-,EAST 1 659.67... :.
289.58 _ —320.09— p
�tSOUTN «' T— • :a !VT&EESME p
310 Id ^' 10'T/E ESMT. o I
4l/T ANCHOR ESMT.
u • I '
_ e rr2S• oy
1 1--10• T6 E ESMT.
71722•SF 25
1.6465 AC G tiP
This. Project _
O y
A�' T ti—off
,•. `6p•02 C7 173.00 �JAq/.
30S' C4
,.pt.4e � e a
h(R)AD
< .
ctt �.6 of 3
OD N86.01'18'IV Tu •OD .
'n .141.40 )P� V - .Li 'ul
10•T6E ESMT 7617 U .:Ol
Li
M >." hI o00
N .
0 " --
' .. ,..0 I .. , I •O. . c)
e• �
10 TSE ESMT
10• Tb E ES
- Id TSE ESMT. .. _ Id TSE [7 Y.
225.0 —104.92 X71.0 - 259-42.... o
N 8 28 %W 329.92. �_
s+L,� N 89 57' 58'W 330.42
t+0,**
'AREA MAP.`�t`.��
SCALE V =100' � �/
I
Alternate Site
6655 W
EffecgiveXDeptKV
TH6 I
1,500 Gallon I
® Septic Tank I
TH7
Five Bedroom
House I
IM
w
N
IN
3
fD
0
I Cr
I
I
Prosed I
Well
I
1
I
—TorUMI ity Easement
SITE PLAN
SCALE I" = 40'.
rpLon Trench
LOT 5, LANG SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Five Bedroom Home Deep Trench System
Perc. Rate: 8.2 MinJlnch 1,500 Gallon Septic Tank
Application Rate: .8 GPD/SF 8' Drainfield Rock
5 Bedrooms X 150 GPD 1.8 GPD/SF = 937.5 SF of Absorption Area
937.5 SF/16 SF/LF = 58.6 LF Trench Length
Therefore: Construct a New Absorption Trench 65' in Length With 8' of Drainfield Rock
Beneath the Distribution Lateral. Distribution Lateral to Be Placed 3' Below Existing
Ground. Total Depth of Trench to Be 11' from Existing Surface. Mound Over Trench if
Necessary to Provided Minimum Cover of 3'.
Natural Backfill
(3' Cover Min
2.5'
Geotextile Fabric.
PVCA(HolesODowngrforated
Washed Drain Field.Rock-
8.0' . e}4. •
5.0'
TYPICAL DEEP TRENCH SECTION
(NO SCALE)
NOTE: Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock. �� =i. di:• �, /
Minimum 10' Separation From Lot Line.
Minimum 4' Separation From Groundwater. rr� l
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 `L" Street, Anchorage, Alaska 99502-06.10
SOILS LOG — PERCOLATION TEST
qln
4U.{
PERFORMED FOR: 6—rZA4.4 M ty M CS DATE PERFORMED, ee""��
LEGAL DESCRIPTION: �0•r "'-"'e' Suci. Township, Range. Section:
SLOPE SITE PLAN
2-
3-
345
Date
Gross
Time
Net
Time
4-
Net
Drop
*1
g 1
/Z•SD
5
d
stz
a• 1•
30
s
• �'•'a
ti i
•F- to
/%ZI
7-
6
8-
9-
91012
�t5
+ c0
%52.
10-
oto
ZtZZ.
o
/G z~
3'
�7
+A10
Zsb3
12-
rt
Z:53
O
13-.
S Le
14
. D
O
15
EawrA OF IIO LC
16
181 J_r
�34oIE
19
WAS GROUND WATER �p
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
at pie 8 79
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
*1
g 1
/Z•SD
13"
stz
1:1.0
30
ti i
•F- to
/%ZI
l2'L`
�t5
+ c0
%52.
13'
oto
ZtZZ.
o
/G z~
3'
�7
+A10
Zsb3
-'J'"
rt
Z:53
O
/6't"
S Le
20 PERCOLATION RATE S' 6 (minutes/inch) FERC HOLE DIAMETER G e
�J •p TEST RUN BETWEE�NN S FT AND G FT
COMMENTS 72—sr OL.0 P1uSOAXZt PA102 •ra Paz.CdL4770n/ -rZ
PERFORMED BY: S. 671LACOZ7 I Allv�F ASC e{RTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
/0- 14-00
72-M (Rev- 4/85)
MunlcipaW of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "V Street, Anchorage, Alaska 99502-0850
SOILS LOG — PERCOLATION TEST
M.0Swc
PERFORMED FOR: 4;�ZA4APA 40 NiEs DATEPERFORM
LEGAL DESCRIPTION: Lar -5-1 ZA JL 5U8• Township, Range, Section:
SLOPE SITE PLAN
1 � pr,oL
2
3
4 •,
o •'O
5 D a
6-0
7
y.
9 6•:`p.
10 .p'.� .
11 `..�
12 ••.
'•o b
13
:G•
14 0 p!
Is-
16-
5 16 •
:o
17-
18-
19
71819
ML -
6 M GM
BOTrvnA OF AOW
TFT40 C Ak. 7
—rZrfFD LC DCCP0
WAS GROUND WATER 10-
ENCOUNTERED? /V
IF YES, AT WHAT
DEPTH?
Reading
Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
/t/
FT -7 :Z:53
—
/3"
IF
/ : L3
30
/'/"
1 "
e 3
/!2
/Z' L'
w
•
30
WIN
1 '
/► S
/: 55
13
dG
0117
r 9
L:5Z
30
131/w,
/G "
20-� ITm lq' /0-Z6-"0
u t PERCOLATION RATE S3 (mmvm
utecli) PERC MOLE DIAMETER
"I �,{:• TEST RUN BETWEEN L FT AND 7 FT
COMMENTS
6S7-OOLC P/24750i1C.e0 P2,/04L TO 1 0LCV LA-"OPJ T7'
PERFORMED BY: 5 • G/L6f2T I / / �•xr� IF(d&PkMIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE
72-008 (Rev. 4/85)
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 5, LANG SUBDIVISION
GENERAL:
1. The scope of this project includes the procurement and placement of a
new 1,500 gallon septic tank at the location shown on the site plan.
Work also includes the construction of a new 65' long X 3' wide X 8'
effective depth absorption trench at the location shown. The
distribution line in the trench will be placed at 3' below the existing
ground surface. Total depth of the trench will be 11' below the existing
ground surface. All components of the septic system must be a
minimum of 1 00'from the well on this and adjoining lots.
2. 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.
3. 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.
4. 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.
5. Contractors installing wastewater disposal systems must be certified
by the Municipal Department of Health and Human Services for
system installations. Owners installing their own systems must receive
prior approval from D.H.H.S. before beginning system installation.
SEPTIC TANK INSTALLATION
1. A new 1,500 gallon septic tank must be be procured from an approved
source and installed outside the 200' protective radius of the Class A
Well serving the subdivision.
2. A septic tank is to be constructed by a certified septic tank
manufacturer. Construction shall include two 4" cleanouts for pumping
access.
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.
r ' Lot 5, Lang Subdivision
October 13, 2000
Page 2 of 3
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:
The drainfield shall be constructed to the dimensions shown on the
design. The bottom of the trench shall be within 2" of level.
2. Distribution piping must be placed level with perforations down atop a
level bed of drainfield rock. 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 ground must be perforated.
5. 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.
6. Direct bury 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 trenches to drain away.
8. A minimum 2' of accepting soil is required below the drainfield rock for
a 5' wide trench. Contractor shall verify this condition prior to
placement of the rock. All pockets of unacceptable materials must be
removed and replaced.
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 02662 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).
Lot 5, Lang Subdivision
October 13, 2000
Page 3 of 3
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 IL
Building Safety Division ''
On -Site Water & Wastewater Program ) /�
4700 Bragaw Street V
(V I.VI
P.O. Box 19 /
Anchorage, AK 99519519 .6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcell.D. ISI S-a�°J-CrO COSA# (A
ir)((n1
1. GENERAL INFORMATION Expiration Date: 1� — 19 —
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
LANG. LOT 5
3950 JANET LEE CIRCLE 'ANCHORAGE. AK
WILLIAM BOBRICK Day phone 242-0076
3950 JANET LEE CIRCLE *ANCHORAGE. AK
Day phone
JANELLE PFLEIGER W/ REMAX Day phone
110 W. 38TH SUITE 100 *ANCHORAGE, AK 99503
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 5
257-0156
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
0
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (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 engineers 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 riles 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 GARNESS ENGINEERING GROUP, Ltd.
Address 3701 E. TUDOR ROAD, SUITE 101 a ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineers Comments:
In conducting this evaluation, GEG, VD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described 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 ofall wells and
septic systems depend on the local soils condition, groundwater 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 the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements 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 will it confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for bedrooms.
Disapproved.
Phone 337-6179
Date (' O
�1.. ... .. .........
•,Jef e G ess.:
e % 7 53 :, '
.7953
Pig
Conditional approval for bedrooms, with the flowing stipulations:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
L/
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Reort
Nitrate Advisory Other
By:
(Rev. ISMS)
ONSITE
WATER AND •;
WASTEWATER
�•,. PROGRAM
Original Certificate Date: t o — / R - 09
Municipality of Anchorage
l� Development Services Department
Building Safety Division
On -Site Water 8 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: LANG, LOT 5 Parcel ID:Q/S•2 73-4 0
A. WELL DATA
Well type MATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES
Date completed 11 /3/2000 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth 186 ft. Cased to 186 ft. Casing height (above ground) 18+ in.
FROM WELL LOG AT INSPECTION
Date of test 11/3/2000 4/23/08
Static water level 159 ft, 153 ft,
Well production 15 g_p,m, 3.87 g,p,m,
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 ml. Nitrate) —I'/ (o mg./L. Other bacteria colonies/100 ml.
Arsenic: .ug./L. Date of sample: 4/23/2008 Collected by: GEG Ltd.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL Date installed 5/24/2000
Tank size' 1500 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (YIN) N/A
Date of pumping 10/25/2007 Pumper ISAACS PUMPING
C. ABSORPTION FIELD DATA BE ow EXISTING GRADE
Date installed 5/24/2000 Soil rating (g.p.d./ft'o t /bd 0_8 System type TRENCH
Length 50 ft. Width 3 ft. Gravel below pipe 10 ft.
Total depth * 13.08 ft. Eff. absorption area 1000 ft' Monitoring tube YES Depression over field NO
Date of adequacy test 4/23/2008 Results (Pass/Fail) PASS For 5 bedrooms
Fluid depth in absorption field before test 26 in. Water added 813 gal New depth 44 in.
Elapsed Time: 1140 min. Final fluid depth 30 in. Absorption rate >= 750+ g,p,d,
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date —
CO 0 BEGINNING OF TRENCH WAS UNABLE TO BE LOCATED, BUT THE TRENCH IS ABLE. TO BE
JETTED THROUGH C/O 0 THE END OF THE TRENCH
D. LIFT STATION
Date installed
"Pump on" level at in.
E. SEPARATION DISTANCES
Size in gallons Manhole/Access
"Pump off" leve High water alarm level at in.
Cycles tested Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+
Absorption field on lot 100'+
Public sewer main N/A
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Sewer /septic service line 25'+ Holding tank N/A
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line to / Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage I Q'
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION o
t certify that 1 have determined through field inspections and ..:e
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this . . • ... ......
date.a Garn s:
Engineer's Printed Name JEFFREY A. GARNESS oaf CE- `Foo
6���
e
Date oB 4�O0P°ree^)o�°c
COSA Fee c t4 3c). V O -
Date of Payment���y 4
Receipt Number
(Rev. 11105)
Waiver Fee $
Date of Payment
Receipt Number
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SGS Ref.M
1081653001
Client Name
Garness Engineering Group, Ltd.
Project Name/#
Lang Lot 5
Client Sample ID
Lang Lot 5
Matrix
Drinking Watcr
PWSID 0
Sample Remarks:
All DalesfFimes arc Alaska Standard Time
Printed Date/time
05/012008 10:15
Collected Date/time
04232008 15:00
Received Date/Time
04242008 11:10
Technical Director
Stephen C. Ede
Allowable Prep Analysis
Parameter Results PQL Units Method Container ID Limits Date Date but
Metals by SCP/MS
Arsenic
Waters Department
Total Nitrate/Nitritc-N
Microbiology Laboratory
Colony Count
Total Coliform
Fecal Coliform
ND 5.00 ug/L EP200.8 C (<10) 0428/08 04/30/08 NRB
2.46
0.100 mg/L SM204500NO3-F
B
(<10)
0428/08
LCP
0
coV100mL 511209222B
A
(<200)
0424/08
DLC
0
coVI00mL SM209222B
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0424/08
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0424/08
DLC
�■itil.11 f-3-2008 03:02P FROM:
i ■
now AAROW PUMP & WER SERVICE, LLC
P.O. Box 110496
Anchorage, AK 99511
Office: (907) 346-9355 • Fax (907) 333-8976
Eagle River: (907) 622-9335
TO: 3'..,83246
P.1
WOOVE
N° 08027
CUSTOMER(�j' JOB SITE
R>° l-1 r 9S� 0 -ah rt 2 P� _l
L -6-
5-2J L
J
pJyDICIgATE
G
WELL DEPTH
SwL
CHLORINATED
NMP DEPTH
SALESPERSON
allANTrrY
DESCRIPTION
PRICE
AMOUNT
` \ Q e
r
1 eo cle—
LABOR
HOURS
RATE
AMOUNT
TOTAL MATERIAL
TOTAL LABOR
WORK ORDERED BY
DATE COMP,
TOTAL
LABOR
PAY THIS AMOUNT
Thank You
SIGNATURE
(I Hereby Acknowledge the Satisfactory Completion of the Above Described Work and agree that If above work Is not paid for In SO days I agree to allow Aarow
Pump a Wen Service, LLC. the right to remove unpaid for equipment and charge for labor already performed a labor to remove unpaid for equipment.)
TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE.
SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS.
r
Jeff Garness
From:
Poet, Jeff W. [PoetJW@ci.anchorage.ak.us]
Sent:
Monday, June 09, 2008 9:18 AM
To:
Jeff Gamess
Subject:
aaaa-PinkSheet 020107 (2).doc
Attachments:
oledata.mso
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519.6650
www.ci.anchorage.ak.us
(907)343-7904
ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET
TO:.feff Garness
Legal description: Lane Lot 5
Permit C.O.S.A. Inspection Report
The attached paperwork has been reviewed and Is being returned for the following reasons:
1. Survey not to scale. s, ►��\ H�
2. Separation distance driveway, parking /vehicle storage to absorption field, t1' per AA S Iov61t.
3. CO at beginning of trench must be located or a new CO installed. /;� ( �� t .r 1/to �Il ull b b) 4. 1 G
Name of reviewer: Poet Date: June 9, 2008
Municipality of Anchorage
Department of Health and Human Services
Division of Environmental Services
Onsite Services Section'825'1-7 Street Room 502
a' P.O: Boz 196650 Anchorage; AK 99519-6650
www:ci.anchorage.ak us'
(9
07) 343744
CERTIFICATE OF HEALTH.;AUTHORITY APPROVAL
t
FOR A`SINGLE FAMILY, DWELLING'
Parc eHAA
I D `015.273-60 I '
+ ;.,• ExpirationDate:
Complete legal description Lot 5 Lana Subdivision r' a
t-'le }• l r w' k� Il -J, r✓< i n , tl k , t I t .:i� ' ,t <, tr• '
„�, y...... Location (site `laddress or directions) + - Janet Lee Circle
r FDay phone 6945891
" « Current Property owners) Northwood Homes t
i J 'f , !�k 1 r;t-f , t. l t., y < f* � -. ..! t ♦ .( ,.+: .
' • ; Malhngaddress xe , r ; t+ P 0 Box 92301 Anchoiaoe AK 99509 2301
t y .t } �3{, :(t t'. ) a f,. •t F t ` .-� -
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l . E Lendingagency Y
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Mailing address:%; e e
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,t :'t <i >• I}4 tip a `s , 1Z �v {v t ) f.t 1 i'�. • Itr Da hone
Real Estate Agent 1 y p
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,
1>.. ,. 4 •, f � ,� � i Hs/ )t %mY5 , .r c� ' t L i
x Mailing Address
!+'' " nj Unle s offi&iWse requested, HAA wr7l be held by DHHS for pickup HAA picked up by.
i is \ejx
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s. , ( t •
i`;``";2'` NUMBER `OF'BEDROOM
SFive 3
I '� t 1 ! t', rt.�}E i$-, w: lit`' \ `r 1� <tl• ,C lr (•.',+ `, s.
3TYPE OF WATER SUPPLY TYPE OF WASTEWATER DISPOSAL
} '.Individual Well
t' " ❑ Individual On site
,.: a ` Individual Holdin tank ❑
1> s
1 Indnndual Water-Stora9e >. r ❑ 9 .
:: , .,
r % '.Commune Class;' Well ❑, 'Community On-site ❑
ty ❑:
Public Water System ! z ❑ ( Public Sewer
!,,,,..The Municipality of Anchorage Department of Health and Human Seryices (DHHS) Issues Certificates of Health
a Authority Approval (HAA) basedonly upon 6e representations given in paiagraph 5 by an independent professional
crv0 engineer registered in the State of Alaska; Certificates of Health Authority Approval are required for the transfer, ,
1,`•.�. o(tiUe (except be(weenspouses)ori properties served by asingte fam0y on-site wasteviater disposal and/or.water '
s supply; system. DHHS also issues.HAAs'upon request to home owners.' Certificates of Health Authority Approval_.
are valid for 90 days from the date of,issue for properties served by a private or Class dwell and may be reissued
6 with hew4water sample results less than 30 days old.:Cert�cates are valid for one year for properties served by
..-
s (Class A or B.'wells or:'a, public; water system The Municipality;' of Anchorage is not responsible for errors or
omissions in the professional engineers work ' t
t,
� r 1
5.� STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the %alidation'dateishown below, 1 verify that my Investigation f
based on procedures outlined in the Health 'Authority Approval Guidelines for. this Health'Authority'Approval ;
application shows that the:onsde:water supply' and/o�,wastewaterdisposal system is safe,.functonal and`
adequate for the number of bedrooms and type of structure indicated herein: I further verify that based on the
information obtained from the Municipalityof Anchorage files and from my investigation and inspection, the on-
site water supply and/or wastewater disposal system is In compliance with all applicable Municipal and State 1
codesordinances; and regulations m'effe'ct at the time of mstallaflon ,
Name of Firm Anderson Engineering Phone 522-7773
Address P.0. Box 240773--. Anch6rai 99524
Engineer s Printed Name Michael E Anderson, P.E Date'! `5/21107
i s+ ) o c •-1 ' a 1 am -/ .+�e y .•• tndi, =
0 ':A
MJCHAH.''E ANDrRS Yly o d
,7 i,Yt Se CE 5438)
6. DHHS SIGNATURE , x, !
Approved for.;L bedroom§ } 41�PRQFESSID�Avo� ^
Disapproved
Conditional approval for �:bedrooms, vnth the followmg sLpulahons ' " r
+
f
t 1 r t" 1, + A , +• ,`` P •, • i t �ri k"t
ONSITE '; c
m
Additional Comments = EWATER ;;•
ROGRA
1
Municipality of Anchorage •.,
Development Services Department
� Building Safely Division , � � •,
-/ On -Site Water &Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: lot 5 Lane Subdivision Parcel ID: 015.273-60
A. WELL DATA
Well type Private If A, B. or C provide PWSID # _ Well Log (YIN) Y
Date completed 111212000 Sanitary seal (YIN)! Wires property protected (YIN) Y
Total depth 166 ft. Cased to 166 ft. Casing height (above ground) >24 in.
FROM WELL LOG AT INSPECTION
Dale of test 111312000
Static water level 153 ft.
Well production 15 g.p.m. 9•p•m•
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mL Nitrate 1.26 mgJ1. Other bacteria 0 colonies/1 00 ml.
Date of sample: 511712001 Collected by: MEA
B. SEPTICIHOLDING TANK DATA
Tank Type/Material Steel Date installed 1013112000
Tank size 1,500 gal. Number of Compartments 2 Cleanouts (YIN) Y
Foundation cleanout (YIN) y Depression over tank (YIN) N High water atarm (YIN) N
Date of pumping Pumper
C. ABSORPTION FIELD DATA
Date installed 10/3112000 Soil rating (g.p.dJft' or ft2/bdrm) .6 GPDISF System type Deep Trench
Length 50 ft. Width 3 ft. Gravel below pipe 10 ft.
Total depth 13.5 ft Eff. absorption area 1.000 ft2 Monitoring tube Y Depression over field N
Date of adequacy test Results (Pass/Fail) For _ bedrooms
Fluid depth in absorption field before test _ in.. Water added_ gal 'New depth_ in.
Elapsed Time: _min. Final fluid depth in. Absorption rate >= _g-p.d.
Any rejuvenation treatment (past 12 me.) (YM & type) N If yes, give date NIA
D. LIFT STATION
Date installed
'Pump on' level at _ in.
Datum
Size in gallons
'Pump off" level at _in.
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot >100'
Absorption field on lot >100'
Public sewer main WA
Sewer /septic service line >25'
Manhole/Access (Y/N)
High water alarm level at
Meets alar & circuit requirements?
On adjacent lots >100'
On adjacent lots >100'
Public sewer manhole/cleanout WA
Holding tank WA
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >5 Property line >S Absorption field >5'
Water main WA Water service line >10' Surface water >100'
Wells on adjacent lots >IW
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line >10' Building foundation >1(' Water main >10'
Water Service line >10' Surface water >IW Driveway, parkingtvehicle storage >25'
Curtain drain None Noted Wells on adjacent lots >IW
F. COMMENTS
G. ENGINEER'S CERTIFICATION
1 certify that I have determined through field inspections and x 49 -Til y, o�
review of Municipal records that the above systems are in e
conformance with MOA NAA guidelines in effect on this date. - : MICH l �I aEE S••^•••.•
r. •MICN AF, )FRS . V
Engineer's Printed Name Michael E. Anderson, P.E. �/ s.'• LE Tl�J1tP : '\
,,4
Date U2112001 44 P4,0
HAA Fee $ 20(D Waiver Fee $
Date of Payment 5Snu
d 1 1 Date of Payment
Receipt Number Receipt Number
(Rev. 12/00) ..