HomeMy WebLinkAboutELMORE #2 BLK 9 LT 4Elmore #2
Block 9
Lot 4
#018-173-04
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II
MUNICIPALITY OF ANCHORAGEDEPARTMENT
OF HEALTH& ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
01(*
825 L Street - Anchorage, Alaska 99501 Telephone 264.4720
ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
PHONE
�r
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5L44/8
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MAILIN D
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LEGAL DE RIPT ON
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LOCATION NO. OF BEDROOMS
Use
DISTANCE TO:
Well
Absorpu n r?n
Dwelling PE MIT NQ-
Hz
Manufac[u r +
M serial N . of corypar�n[s
IS _
J
Li c pati ingall IF HOMEMADE:
Inside length
Width Liquid depth
,
DI TANCE TO: Well
Dwelling PERMIT NO.
D2
O Z G
Manufacturer
Material Liquid
q capacity in gallons
D
W =
DISTANCE TO:
Well
O0
Foundati 1
7j
Nearest lot me P MI /
/
LL Z
No. of lines
Length a
Total length f lin s
T n wi t Dista a be wee li et
7-2-
RCc
h
Top of tile to finish grade
M terial benda)h ��le Total fsecuv abio tion eras jl(
l
o
% A. 6. inches 111�.
Length
Width
pth yp Et HMII NU.
W
(7
d F
W 1
Type of crib
Crib diameter
Crib depth
Total effective absorption area
DISTANCE TO:
Well
Building foundation
Nearest lot line
J
Class
Depth
Driller
Distance to lot line
PERMIT NO.
w
W
Sewerlin
Septic tank
sore
Absorption
p
DISTANCE TO:
Buildin da[ion
�y
OTHER
P
An
A
7
PIPE MATERIALS
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SOIeT ST RATING
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PPHOVED DATE LEGAL
[u i S i nev. ai /Or
II
MLJN I C I F�AFL I TY OF ANCHOFzAGFEE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L STREET, ANCHORAGE, AY, 99501
264-4720 5;-7-
C3N—S I TE SEWEFZ PEFtiM I T
PERMIT N0: 840917
DATE ISSUED: 10/29/0/29/ 84
APPLICANT:
ADDRESS:
CONTACT PHONE:
PROGRESSIVE BUILDERS
2600 BROOKE DR.
ANCHORAGE, AY, 99503
243-6926
LEGAL DESCRIP: SUBDIVISION: ELMORE LOT: 4 BLOCK: 9
SECTION: 35 TOWNSHIP: 12N RANGE: 3W
LOT SIZE: 39520 (SQ.FT. OR ACRES)
MAX BEDROOMS: 5
Listed below are the options available to you in designing your septic
system. Choose the option that best fits your site.
131-D W _ nFRA I"
DEPTH TO PIPE.BOTTOM (FT.) 3.0 **
GRAVEL DEPTH (FT.) 0.5 •1.0
TOTAL DEPTH (FT.) 3.5 4.0
GRAVEL WIDTH (FT.) 22.0 5.0
GRAVEL LENGTH (FT.) 43.0 110.0 **
GRAVEL VOLUME (CU.YDS.) 35..1 30.6
.TANK SIZE (GALS) .1,500.0 ** 1,500.0 **
SOIL RATING (SQ.FT./bR) 125 125
** DEPTH TO PIPE BOTTOM < 3.5 FT. REQUIRES INSULATION
** DEPTH TO PIPE BOTTOM < 4.0 FT. MAY REQUIRE A LIFT STATION
** GRAVEL LENGTH > 75 FT. REQUIRES MULTIPLE RUNS (NOT EXCEEDING 75 FT. EACH)
** TANI; MUST HAVE AT LEAST TWO COMPARTMENTS
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
I certify that:
1. I am familiar with the requirements for on-site sewers and wells as set
forth by the Municipality of Anchoyage (MOA) and the State.of Alaska.
2. I will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria of this permit.
3. I will adhere to all MOA and State of Alaska requirements for the set back
distances from any existing well,,wastewater disposal system or public
sewerage system on this or any adjacent or nearby lot.
4. I understand that this permit is valid for a maximum of 5 bedrooms and
any enlargement will require an additional permit.
IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES,
THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS
WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE
ELECTRICALL,WIRZnSIVE
ORY MUST BE DONE.BYLICENSED ELECTRICIAN.
SIGNED / --------- DATE:
APPLICANT BUILDERS
ISSUED BY - .ATE: /(J/��/e!L
rPERMIT NO:
DATE ISSUED:
APPLICANT:
ADDRESS:
CONTACT PHONE:
MUN I C I F t- I TY C]F- ANCHG^ AGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L STREET, ANCHORAGE, AK 99501
264-4720
O N— S I -t-a:
840917
10/29/84
PROGRESSIVE BUILDERS
2600 BROOKE DR.
ANCHORAGE, AK 99503
243-6926
S E tnl'E- Fi
LEGAL DESCRIP: SUBDIVISION: ELMORE
SECTION: 35 TOWNSHIP: 12N
'_OT SIZE: 39520 (SQ.FT. OR ACRES)
MAX BEDROOMS: 3
PERMIT �G
LOT: 4
RANGE: 3W
Listed below are the options
available to
you in ing
system. Choose the option that best fits
r
y sit
V<;N
13ED
W _ I N
DEPTH TO PIPE BOTTOM (FT.)
3.0 **
3.0
GRAVEL DEPTH (FT.)
0.5
1.0
TOTAL DEPTH (FT.)
3.5
4.0
GRAVEL WIDTH (FT.)
17.0
5.0
GRAVEL LENGTH (FT.)
34.0
66.0
GRAVEL' VOLUME (CU.YDS.)
21.5
18.4
TANK SIZE (GALS).
1,000.0
1,000.0 *+�
SOIL RATING (SQ.FT./BR)
125
125
DEPTH TO PIPE BOTTOM < 3:5 FT. REQUIRES INSULATION V
DEPTH TO PIPE BOTTOM < 4.0 FT. MAY REQUIRE A LIFT STATION
TANK MUST HAVE AT,LEAST TWO COMPARTMENTS
- - - - - - - - - - - - - - - - - - - - - - - - - -
certify that:
1. I am familiar with the requirements for on-site sewers and wells as set
forth by the Municipality of Anchorage (MOA) and the State of Alaska.
2. I will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria of this permit.
3..I will adhere to all MOA and State of Alaska requirements for the set back:
distances from any existing well, wastewater disposal system or public
sewerage.system on this or any adjacent or nearby lot.
4. I understand that this permit is valid for a maximum of 3 bedrooms and
any enlargement will require an additional permit.
IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES,
THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS
WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE
ELECTRICAL WOR)' MUST BE DONE BY A'LICENSED ELECTRICIAN.
SIGNED
APPLICANT: FtROGi�'fIVE BUILDERS
DATE:
ISSUED BY � DATE:
r
SSOIL, IOG
8� ENGINEERS, INC. SOILLOG ✓P[A'OLAr1ON
S ®YES;
7125 OLDANCHOR GE. ARD LASKA 9WAY PERCOLATION TEST LT DIiaO�•:
ANCHORAGE. ALASKA 99507
190717496561
UI--J-, Q
T� TT���."� JOB NUML'ER
PERFORMED FOR.. Pk0&- G 7L1G /j IJ IL K� S _._. DATE PERFORMED ZZ OG.�_
LEGAL DESCRIPTION. LOT "(
17-7-1 SLOPE SITE PLAN
9 Tb
10-
11
0 11
12-
13
14
151.:11+
O� •
16 /...• ............. .
17 p�ps�••�rf
18 �6 224E
20
WAS GROUND WATER"�� L
ENCOUNTERED? —_ ..._
O
P
c
IF YES. AT WHAT �' 0
DEPTH?
0-IIO SIL7 W1rif 60&4C
SANG 4R GRAVCZ -OtAMC-1
2
p..
•
[gym 0 LrosE
3
O
0.0 SAti6U C
4
0°
Gas�vt3- - PGt�2[t ! GQitA[�
-
�o If S/G.T St�1�it
6
.. 0.0.
INON cMIN
7
O:0
6
9 Tb
10-
11
0 11
12-
13
14
151.:11+
O� •
16 /...• ............. .
17 p�ps�••�rf
18 �6 224E
20
WAS GROUND WATER"�� L
ENCOUNTERED? —_ ..._
O
P
c
IF YES. AT WHAT �' 0
DEPTH?
MA
E
DEI PTH I PERCOLATION RATE —Vi ._.—,minulesrinthl
FEET)
s� (� TEST RUN BETWEEN -/__ FT AND --4-, 0 - FT
COMMENTS. �`-1G IJ1prJ rCDV Ini��1i/ 1NSTt1L1�'p____/..(6[.E __!LlO.t/ r7Zx - _ . _ 40- — .
._6X0��WA70,Z—ST3i&Z-/ZE7D -.%i�--P.Z�:--. _.._--....._.._._.
Q/�� T.TT��p
PERFORMED BY. M_(%r�L�L�:ISiUL _CERTIFIED BY' _. _, _,__._.. ._...... .. DATE. _- ..
MI
�ElmElmON
INON cMIN
MA
E
DEI PTH I PERCOLATION RATE —Vi ._.—,minulesrinthl
FEET)
s� (� TEST RUN BETWEEN -/__ FT AND --4-, 0 - FT
COMMENTS. �`-1G IJ1prJ rCDV Ini��1i/ 1NSTt1L1�'p____/..(6[.E __!LlO.t/ r7Zx - _ . _ 40- — .
._6X0��WA70,Z—ST3i&Z-/ZE7D -.%i�--P.Z�:--. _.._--....._.._._.
Q/�� T.TT��p
PERFORMED BY. M_(%r�L�L�:ISiUL _CERTIFIED BY' _. _, _,__._.. ._...... .. DATE. _- ..
°""eHD1 GRf—%TER ANCHORAGE AREA BOROI' ^vH
f HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279.2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING �, a _ i (// Z7
SEPTIC TANK:
1566
z
/ NUMBER OF
DISTANCE FROM WELL t< MATERIAL COMP BER
LIQUID CAPACITY; �� GALLONS. INSIDE LENGTH INSIDE WIDTH DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS / OUTSIDE DIAMETER OR WIDTH�LENGTH, DEPTH
LINING MATERIAL � S . DISTANCE FROM WELL / , BUILDING FOUNDATIONI!'0,"
NEAREST LOT LINE �.O , `r TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) 3 4 50. FT.
TILE DRAIN FIELD:
FROM
BETWEEN
ABSORPTION AREA SQ. FT. LENGTH OF EACH
NEAREST
WIDTH
TOTAL LENGTH
OF LINES
DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE
-
/2_ FROM WATER ���
TYPE {�/Ci6LLe_Z , DEPTH-, BUILDING FOUNDATION. ' SAMPLE / t NEAREST
NEAREST / SEPTIC / / / SEEPAGE /C / / OTHER
LOT LINE �D � .SEWER LINE•%4 �' TANK _SQ(Q_ SYSTEM Y CESSPOOL � ,SOURCES_
DIAGRAM OF SYSTEM
ADI(STTANCES: # -
�1 _,N
c:�f1NK
ESQ-�� �: :_9 •_ .; .• .•c� :..�� j::;
DATE /All / I APPROVED 4�fr
Z GREATE17ANCHORAGE AREA TJROUGH Case No. Q
HEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279.2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
NAME OF APPLICANT (7"Ital dcctrkb MAILING ADDRESS P// efz ' PHONE NO.a 7-,' O
RESIDENCE ADDRESS - LOCATION OF INST
LEGAL DESCRIPTIONS'�•f ':2�- r GX4xA-(t2
APPLICATION TO INSTALL:-SEPTICTANKEcco SEEPAGE PIT ti ,DRAIN FIELD OTHER
TO SERVE THE FOLLOWING FACILITY71fW21
FINANCED THROUGH 5' TO BE INSTALLED BY/F'�57�/oC/f�Ii.�f
PERGOtATMI TEST RESULTS n/ -d AN
, TICIPATED DATE OF COMPLETION
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS GNA° -0' ' is et' n , PERMIT TO INSTALL A -4'10"'Ple
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED g A.'_n'
.SEPTIC TANK SIZE .,1,0V_P_dL TYPE C, u'0>> SEEPAGE AREA 42:0,4117 TYPE 14-92"
DIAGRAM OF SYSTEM
DISTANCES: y! N/•
�z 5 c� � % ' /W
Health Authori
I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
above described system is in accordance with said code.
DATE S APPLICANTS SIGNATURE��M
• r
\ Municipality of Anchorage
-• Development Services Department :'.: ';•
Building Safety Division
On -Site Water and Wastewater Program , A , . ,
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
Parcell.D. 0181'73Cn4 COSA# 1000V3
Expiration Date: L-/7-10
1. GENERAL INFORMATION
Complete legal description I:L.MDRc '2L0C,K.R L -o -f- g
Location (site address) JiM FAST 1:16711f 4)f OLAE A WLA.he hsi, Au 2951 I
() FI1\ Dtz1�Day P
Current Propertyowners <r,1�Ttt�1J1 \h�oRS1- Ci\ Da hone 345 - 291
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
Day phone
FR tN ir�_\C E j2tA1 r_- Day phone
Unless otherwise requested, COSA will be held by DSD /or pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
6 -
TYPE OF WASTEWATER
R
Individual On-site
❑
Individual Holding Tank
❑
Community On-site
❑
Public Sewer
DISPOSAL:
N
El
El
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 and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm Pannone Engineering Services, LLC Phone _272-8218
Address P O. Box 100217, Anchorage. AK g9510
Engineer's Printed Name Steven R. Pannone. P.E. Date 1 f2��
Engineers Comments: In conducting an adequacy test, l attempt to provide a thorough, conscientious engineering analysis of the system in
accordance with MOA DSD Guidelines & 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.
Thcse 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. PFS can therefore not provide any warranty for future
performance nor give any estimate of how long the system will continue to meet the operational
requirements of the 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.
Conditional approval for bedrooms, with the following stipulations:
Attachments:
COSA Checklist X Arsenic Advisory
Septic System Advisory Maintenance Agreements
Well Flow Advisory Supplemental Engineer's Report
Nitrate Advisory Other
By: v Original Certificate Date: .2 7"10
(Rev. t INS
Municipality of Anchorage
• Development Services Department
Building Safety Division '
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: Elmore No.2. Block 9. Lot& Parcel ID:_oie-n3-o4
A. WELL DATA
Well type Private If A. B, or C provide PWSID N
Date completed 1121201 Sanitary seal (Y/N) yss
Total depth a6o+ ft. Cased to 16o+ ft.
FROM WELL LOG
Date of test
Static water level Unknown ft.
Well production g.p.m.
WATER SAMPLE RESULTS:
Coliform o colonies/100 mL Nitrate o.S6g mg/L
Well Log (Y/N) No
Wires properly protected (Y/N) Yes
Casing height (above ground) 22 in.
AT INSPECTION
1/141x010
35 ft.
g.o g.p.m.
Other bacteria colonies/100 mL
Arsenic: -g ugA Date of sample: IU2o10 Collected by: EI<_i
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Concrete/Steel Septic Date installed o1112g7o
Tank size 3000/goo gal. Number of Compartments 113 Cleanouts (Y/N) Yes
Foundation cleanout (Y/N) )CO Depression over tank (Y/N) N2 High water alarm (Y/N) NIA
Date of pumping 1/1312010 Pumper Is acs Pumping
C. ABSORPTION FIELD DATA
Date Installed 12/1/1984 Soil rating (g.p.d./fe or fe/bdrm)12; System type _r
Length 43 ft. Width 22 ft. Gravel below pipe o.g ft.
Total depth 3.o ft. Eff. absorption area n46 fe Monitoring tube Yes Depression over field N
Date of adequacy test 1/14/2010 Results (Pass/Fail) Pass For S bedrooms
Fluid depth In absorption field before test Pry in. Water addedM gal. New depthpry In.
Elapsed Time:1440 min. Final fluid depth Pry in. Absorption rate >= 7go+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NIA If yes, give date
D. LIFT STATION
Date installed
"Pump on" level at
Datum
Size in gallons NIA Manhole/Access (Y/N) _
in. "Pump ofr' level at —In. High water alarm level at
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on tot 66775'
Absorption field on lot 81'*
Public sewer main NIA
Sewer /septic service line 41;'
Meets alarm & circuit requirements?
On adjacent lots loo+
On adjacent lots loo+
Public sewer manhole/cleanout NIA
Holding tank loo+
Animal containment areas loo+ Manure/animal excrete storage areas Zoo+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 11' Property line 4o'
Absorption field 1S'
Water main N/A Water service line iX Surface water loo+
Wells on adjacent tots loo+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line %3 Building foundation 29 Water main NIA
Water Service line S9 Surface water loo+ Driveway. parking/vehicle storage loo+
Curtain drain
F. COMMENTS
G. ENGINEER'S CERTIFICATION
Wells on adjacent lots loo+
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.
Engineer's Printed Name Steven R. Pannone P.E.
Date 2I1r/2010
COSA Fee $ 7 go
Date of Payment / ' _21
Receipt Number QZ� fir, In
(Rev. 11/05)
U
,en R. Porn
No. CE 8149
Waiver Fee $
Date of Payment
Receipt Number C, /(I q / (
0
in.
---------------------------
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N 69 56' 17' E 207.90 MEAS.
�����_ S BV56'17°W 208.00' RECORD
THE WFORAUTION HEREON IS FOR THE USE OF LENDING INSMUTIONS SPECIFICALLY TO SHOW ANY CONFUCTS BETWEEN
EXISTING STRUCTURES AND PUTTED LOT ONES OR EASEMENTS AND IS NOT TO Be USED FOR POWTgNING ADDITIONAL
STRUCTURES OR FENCEUNES.
EASEMENTS OF RECORD. OTHER THAN THOSE BNOYM ON THE RECORDED PLAT, ARE HOT SNOWN HEREON (UNLESS IDI TED)
NOTE: ANY FENCEUNES SHOWN ARE LOCATEO APPROXSAATELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY LINES
OR LOCATE STRUCNRES
ANY PAING SHOWN MAY BE APPROXIMATE DUE TO SHOW CONDITONS.
AS -BUILT SURVEY (NO CORNERS SET THIS DATE)
1'•DO
1 HEREBY CERTIFY THAT I HAVE PERFORMED A
MORTGAGEE'S INSPECTION OF THE FOLLOWING
DESCRISEDPROPERTY.
LOT A, BLOCK 9, ELMORE SUB. NO.2
ANCHORAGE RECORDING DISTRICT. ALASKA AND THAT
THE VISIBLE IMPROVEMENTSSITUATED THEREON ARE
WITHIN THE PROPERTY LINES AND NO VISIBLE
ENCROACHMENTS EXIST OTHER THAN NOTED.
DATED AT ANCHORAGE, ALASKA THIS T]TN_
OAYOF_.IANUARY 2010.
NOWT LAND SURVEYING 11211, FB 1B 55
M. 3* 5M13
SCS ReE#
Client Name
Project Name/#
Client Sample ID
1llatri=
Sample Remarks:
1100151001
Pannone Eng. Srv.
Elmore #2 B9 L4
Elmore #2 B9 L4
Drinking Water
Printed Date/time
Collected Datemmt
Received Date/time
Technical Director
01/19/2010 16:08
01/14/2010 12:05
01/14/2010 13:47
Stenhen C. Ede
Allowable Prep Analysis
Parameter Results LOQ Units Method Conlaincr ID Limits Date Date Init
Metals by ICP/M3
Arsenic 5.000 5.00 ug/L EP200.8 C (<10) 01/15/10 01/19/10 NRB
Waters Department
Total Nitratc/Nitrite-N
Microbiology Laboratory
Colony Count
Total Coliform
Fecal Coliform
0.569 0.100 m8/L SN120450ONO3-F 11 (<10) 01/19110 LCE
4
col/100mL
Sh1209222B
A
(<200)
01/14/10
SDP
Negative
col/100mL
Sk120922211
A
(<I)
01/14/10
SDP
Negative
col/100mL
SM209222B
A
(<I)
01/14;10
SDP
Pannone Engineering Services u.c
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: stevefaoaneneak.com
January 21, 2010
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
4700 S. Bragaw Street
Anchorage, Alaska 99519
Subject: Elmore #2 Block 9 Lot 4
COSA Request/Waiver Requests
Ladies and Gentlemen:
I am writing to request that a Waiver be granted for this property and that a Certificate of On-site
Septic Approval (COSA) be issued for this property. PES conducted an investigation on this lot
on January 14, 2010. The well was able to produce in excess of five gallons per minute (5gpm).
The septic system was dry and did not fluctuate at the introduction of more than 750 gallons of
clear liquid. After 24 hours the system was dry. This system is operating adequately for a five
bedroom system. The system has minor code deficiencies that need to be addressed. These
deficiencies are the subject of this waiver request.
1. Waiver Request. I request the following waivers:
a. Well to Septic Tank from 100 feet to 75 feet
b. Well to Soil Absorption System 100 feet to 80 feet.
The Septic tank was installed in 1984 and is constructed of steel it was placed in series
after the existing 1000g concrete tank that was installed in 1970 when the required
separation distance was 50 feet. The septic tank and drain field are located at
approximately the same elevation of the well and a surface contamination is unlikely.
From the well test and surrounding well logs the static water level in the area ranges from
35 to 50 feet below ground surface. The hydraulic gradient is 12 degrees (-20%) towards
the well. According to municipal records, the soils are sandy gravels having an
application rate of 125 sf per bedroom in 1984 (250 sf/br under the current code.) The
organic mat is approximately 1 foot thick, underlain with poorly graded sandy gravel.
with 6" ribbons of silt throughout the strata.
In review of the ADEC Waiver Memorandum the following points are tabulated:
Mailing: P.O. Box 102954, Anchorage, AK 99510-2954
Physical: 11301 Olive Lane, Anchorage, AK 99515
Telephone: (907)272-8218 FAX:(907)272-8211
Page 2 of 2
Section
Points
Water Table (35 ft)
3.4
Soil Sorbtion (Sandy Gravel)
2.5
Permeability
0.9
Water Table Gradient (-20%)
0.7
Horiz. Separation (75ft)
2.9
Total
9.5 points
8-12 points; contamination is unlikely from bacteria but could be possible from chemicals
or virus.
The surrounding lots are developed. The existing septic systems are located greater than
ten feet from the property lines. Granting this waiver will not affect the operations or
availability of the surrounding lots to develop or install an on-site sewer disposal system.
Based on the above information, granting this waiver will not affect the water quality of this well
or public health. The proposed waiver will not affect the future development of the surrounding
or existing lots nor endanger the health and safety of the public. If you have any questions or
concerns, please contact me at 272-8218.
Sincerely,
49th
P
i v�uNoi+t ..
C-8149
Steven R. Pannone, P.E.
Owner/Civil Engineer
Attachments:
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 11301 Olive Lane, Anchorage, AK 99515
Telephone: (907) 272-8218 FAX: (907) 272-8211
t
Municipality of Anchora
e menr
Q
7997 4
L)cpartment
Development Services Department
On -Site Water and Wastewater Program
**** VARIANCE/WAIVER REVIEW ****
WR#: 100004 HAM 100018 Permit#:_
PID#: 018-173-04
Legal Description: Elmore #2. Block 9. Lot 4
Engineer. PES
Applicant Kristina Jacobs 8 Erica Brink
Your request for a waiver of the required 100 feet horizontal separation from the absorption field
and septic tank to the private well has been approved. The approved separation distance is 80
feet to the absorption field and 75 feet to the septic tank.
This waiver approval applies to the existing absorption field to private well separation only. Any
future upgrade to the on-site wastewater disposal system will require all separation distances be
met or another approval from this department.
...............................................................................
Waiver is Granted: X Waiver is not Granted-,
Date: 2 /1 712 0 1 0 Approved by: f t c�1 g", �Jir
i,/. Name of Reviewer
..........................................................................@@
Rec#: 16916 Amount: $1,050.00 Date Paid: 1126110
**** VARIANCEIWAIVER REVIEW ****
t
n
Municipality of Anchorage
P.O. Box 196650.4700 Elmore Road
Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997
hftp:/fwv.rw.muni.org/Onsite
Development Services Department
On -Site Water and Wastewater Program
ON-SITE SEWERMELL SUBMITTAL COMMENT SHEET
To: Steve Pannone
Legal description: Elmore #2 Block 9 Lot 4
Permit ®C.O.S.A. Inspection Report
cc p�cnr .S'^
i
OA
M
epartmrnt
The attached paperwork has been reviewed and Is being returned for the following reasons:
1. Well complete date. At»o3 - A CC� v ,�asT�A�aA-vwt�
2. Well sanitary seal needed. ATT0e.0-8-tf toAt¢ate!�+rte{' wacc
3. Well wires need to be properly protected.'-Pno�4,tc�&G es A AfXew p✓nal .( wta ck
4. Coliform results must be ZERO. C o c -t = s $urLn 0-13 t -t
5. Appears to be plugged M.T. P 1✓PA 1 Q h0*2)
6. Septic pipe is all pert above grade. Rt�A t 2�
Name of reviewer: Jeff
Date: 1-29-10
!06 21.-5
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK
hi
•
DATE1sECEIVED
1
e
STREET LOCATION
TIME
TIME fV\
TIME
❑ One ❑ Four ❑ Other
hi
•
DATE1sECEIVED
INSPECTION APPOINTMENTS
e
STREET LOCATION
TIME
TIME fV\
TIME
❑ One ❑ Four ❑ Other
DATE
DATE
DATE
Three ❑ Six
7. WATER SUPPLY
X INDIVIDUAL'
Ci _ s
❑ COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.)
INSPECTOR
INSPECTOR
INSPEC
R
❑ PUBLIC UTILITY
w � i
MUNICIPALITY OF ANCHORAGE
DEPT. OF 1! -.'LT; I Y
DEPARTMENT OF HEALTH S ENVIRONMENTAL PROTECTI OilKJIRON1LFNiA1
i ..:: TECTION
825 L Street . Anchorage, Alaska 99501
0*�
AUG Z 1980
ENVIRONMENTAL SANITATION DIVISION
Telephone 2844720
RECEIVED
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERT OWNER
d ;Fxv.
PHONE
"0
MAILING DRESS _�
a' A 7
PROPERTY RESIDENT fit different from above)
PHONE
2. BUYER
H
MAILING ADDRESS
3. LEN I GINSTITUTION
PHONE
MAILING ADDRESS /
C . T
0. REALTOR/AGENT
PHONE
MAILING ADDRESS
_L/4
5. LEGAL DESCRIPiIOJ�I
, 14 S- JI
61 -mw a,,dol,
e
STREET LOCATION
6. TYPE OF RESIDENCE
NUMBER OFsBEDROOMS
❑ One ❑ Four ❑ Other
SINGLE FAMILY
❑ Two ❑ Five
❑ MULTIPLE FAMILY
Three ❑ Six
7. WATER SUPPLY
X INDIVIDUAL'
ATTACH WELL LOG. A well log is required for all wells drilled
❑ COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.)
S. SEWAGE DISPOSAL SYSTEM
INDIVIDUAL/ON-SITE"
70 YEAR ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72010 (Rev. 6/79)
P-'
r
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE
❑ SINGLE FAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE
❑ TWO
❑ THREE ❑ FIVE ❑ OTHER
❑ FOUR ❑ SIX
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLICUTILITY
Connection Verified
PERMITNUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAL/ON-SITE
ED PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATEINSTALLED
q —�
INSTALLER
❑Septic Tank or ❑Holding Tank
Size:_[Db0 If Tank is homemade
give dimensions:
SOILS RATING
TYPE OF TANK
MANUFACTURER
S �
TOTAL ABSORPTION AREA
MATERIAL
I�10
4. DISTANCES
WELLTO:
SepticlHolding Tank
AbsorptionArea§
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
-
5. COMMENTS
VC 'APPROVED FOR _ BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE
BY
V
72010 (Rev. 6/79)
