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HomeMy WebLinkAboutWILLIAMSON #3 BLK 2 LT 16W illiamson
Block 2
Lot 16
#015-074-28
Municipality of Anchorage
Community Development Department Page 1 of 2
On -Site Water and Wastewater Program
4700 Elmore St. - P.O. Box 196650 Anchorage, AK 99519-6650 - http://www.muni.org/onsite - (907) 343-7904
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP181406 PID Number: 015-074-28 ❑ New ❑✓ Upgrade
Name:
JIM LANE
ABSORPTION FIELD
❑ Deep Trench El Shallow Trench El Bed El Mound
Address
5130 E 98TH AVE
✓❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
4
2.0 GPD/SF
3.75 FL
LEGAL DESCRIPTION
Depth to pipe invert from original grade
3.5 Ft.
Gravel depth beneath pipe
0.25 Ft.
Subdivision Block Lot
WILLIAMSON #3 2 16
Fill added above original grade
0.0 Ft.
Gravel length
38 Ft.
Township Range Section
Gravel width
10 Ft.
Beds: Number of Lines
3
Distance between lines
2.5 Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
300 z
Fl
N/A
N/A Ft.
Well
N/A
107.2
N/A
N/A
107.7
TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
EXISTING
Capacity
Gal.
Surface Water
N/A
100+
N/A
N/A
Material
Number of compartments
Lot Line
N/A
35.3
N/A
N/A
NA
Foundation
N/A
16.6
N/A
N/A
LIFT STATION
Manufacturer
Capacity
Curtain Drain
N/A
1 50+
N/A
N/A
EXISTING
Gal.
RemarksD RAIN FIELD UPGRADE ONLY
Pump on level at
in.
Pump off level at
in.
High water alarm at
in.
Pump make and model
Electrical Inspections performed by
PIPE MATERIAL House to tank 3034(E) Tank to E034
3 ( )
Installer
drainfield
DOUG GREY
Drainfield 3034 CO/MT 3034
Inspector PANNONE ENGINEERING SERVICES
BENCH MARK (Assumed elevation) 96.0 ft
Inspecttiones: 15 12/4/18 12/4/18
Location and description
2nd
3rd 12/14/18 4'h
BOTTOM TRIM AT HOUSE POINT A
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
Engineer's Stamp
Conditional Approval: Date
tte n - ♦�onnorae �d
fa %gE 814 0
.�
Approved Date G
RROFES5.-Aw
X See Ui+&e_ked ce o Cz mmon
Inspection Report_1-1-12.doc a�:k d 'be C a t Zo IFs V e �o Lo: f 1 `0
�L�7ll
-�=A
7
B
M 1
19.9
41.8
FV1
33,0
29.2
FV2
34.2
31.2
FV3
35.5
33.1
M2
31.7
26.8
M3
37.3
35.7
0
O.G./F.G,
2- Rj,
-;�l ITYPIF 0.25 84.0
1.25"o QRAIN PIPE __FDRAINROCK
14" AIR LINE T"!
EVENLY SPACED
THROUGHOUT FILER 1.25 AO 5
SAND (E)
SECTION A -A
SCALE:NTS
WW
7
m
FFABRICm
[FILTER
_ AN R.
0 ABOVE PIPE INV
z
RAIN PIPE
L - - - - - - - - - - - - - - - - - - - - 2.0' - SAND -(NEW) . . . . . . . . . 80 .5
i_ I
PROFILE
SCALE: NTS
NOTES: iPANNONE ENG SVC, LLC
I RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211
DRAWN BY:
ACP
WILLIAMSON #3, BLOCK 2, LOT 16
JIM LANE
5130 WOODCREST CIRCLE
PLAN ANCHORAGE, AK 99516
SW/ DRY:
S-'-4 5/18/98
BOH
DATE PERFORMED: 5/9/98
Dote
OF 12/31/2018
C
Scale
r
TH 1"=50-
P.1,I). NO
015-074-28
Steven
* �� PPa'nnone
tev�*� PERMIT NO.
CE 8149
OSP181406
lF Aw
A— Sheet
ssmA- —
vi-41��OW — 2 OF 2
Steven R.Pannone, Principal
Registered Professional Engineer
E-mail: steveCcDpanengak.com
31 December 2018
Municipality ofAnchorage
Development Services Department
On -Site Water & Wastewater Program
47UUElmore Road
POBox l9G65O
Anchorage, Alaska 99519-66SO
Subject: Williamson S/dNo. 3Block 2Lot 1G
Response toComments
Ladies and Gentlemen:
|amwriting toaddress your review comments mnthe Record Drawings vvesubmitted for this property. | will address
the comments in order:
Comment: Provide signed inspection report and record drawings.
Response: Record Drawings will be signed when the Owner pays us.
Comment: Replacement IDSF was to be installed per the original design (permit SVVO00078). Original design was
approved with 4 laterals (spaced 2.5 ft apart, in accordance with the IDSF design manual), 0SFinstalled inZ0O8had
Slaterals, spaced 1.7ftapart. Inspection report for this permit, as well as submitted photos indicate only 3 laterals
were provided, spaced at3.Oft. This does not meet the lateral spacing shown inthe /DSFdesign manual. Please
address.
Response: The soil type calls for an Application Rate of 2 GPD/sf. For a four-bedroom house, that is a minimum area
of 300 sf. The system is 38 feet long. The minimum width would be 7.9 feet wide to achieve an absorption area of
300 sf. The IDSF manual Approved indicates that the pipes in the bed shall have a maximum spacing of 2.5 feet
between lateral pipes, and a maximum of 1.16 feet from the outer pipe to the bed edge. With three distribution
pipes, the bed width would be a maximum of 7.64 feet wide, which is three inches short of the allowable width, A
7.64 by 38 foot bed gives an area of 290.3 sf, which is 9.7 sf short. However, the bed was constructed ten feet wide,
with the air hoses extending to the edge of the bed. Given that the average daily flow from a four bedroom house is
250 gpd, and the "calculated" area is 9.7 sf shy of the minimum required, and that the bed is constructed larger than
the minimum area (the bed is constructed to an area of 380 sf, which is larger than the minimum of 300 sf) and the
air hoses extend to the edge of the aerated bed, the bed as constructed will provide adequate treatment as
constructed.
Comment: On the profile drawing, please show the 2 ft sand layer and air line on the profile drawing (indicate if it is
existing ornevvj
fResponse: VVerevised the details toshow that the sand isnew.
Comment: Profile drawing shows o2O17test hole. Please submit soils log
Response: Test hole was excavated in 1989 for the original system. We revised the drawing accordingly.
Kvllai{ing:P.[).Box 18O7,P�|rne�AK8�645-1OO7
Telephone: /9O7^475-8ZOO FAX.- ('907) 745-8201
Page 2of2
Comment: Please provide bottom oftest hole elevation on profile drawing.
Response: Test Hole elevation revised.
Comment: As -built survey only shows two septic pipes for the |DSF. Provide as -built survey that shows all
monitoring tubes and flushing valves.
Response: The surveyor was hired by the Owner. PES's Record Drawing was sent to the Surveyor for Modification.
If you have any questions or concerns, please contact me at 907.745.8200.
Steven RLPannone, P.E.
Ovvner/[ivi|EnQineer
K4ai|ing:P.O,Box 10]Z17,Anchoraga AK91951O-O2l7
Physic3|: 352Easty/1aoorAve, AnchOr�lge,AK99SO1
Te(ephone:/9O7\272'82l8 FAX�(9O7)Z72-Q2l1
PLOT PLAN AS BUILT X SCALE 1" = 60' GRID SW 2437 Project No. 18-561/R2
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & Associates, inc. (907) 522-6476 Phone oo000pO0
(907) 522-4625 Fax oo F A p04
Professional Land Surve ors kenOlangsurvey.com o
y jonothanOlongsurvey.com OOP '. �S4o�
I hereby certify that I have surveyed the following described property:
LOT 16, BLOCK 2, WILLIAMSON SUBDIVISION, ADDN. No. 3 (PLAT No. 99-106) o* 49TH*0�
Anchorage Recording District, Alaska, and that the Improvements situated thereon are
within the property lines and do not encroach onto the property adjacent thereto, that
no Improvements on the properly lying adjacent thereto encroach on the surveyed �'A':
KEN ... LZ''6
premises and that there are no roadways, transmission lines or other visible
easements on said property except as Indicated hereon. p
0 �-P�' •,LS— 20.2 ' 411 41
Dated this the z�'D Day of .IAyvAry 20� a4 Anchorage, Alaska 40n�'?..........�.�%oo�
It Is the responsibility of the owner to determine the existence of any easements, �"vOpoo�
covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963
Page 1 of 1
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MUNICIPALITY OF ANCHORAGE
Pf y` On-Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://.,Av4v.muni.org/onsite
f
•. 1 ,:fir 2 r ,:�
On-Site Wastewater Disposal System Permit
Permit dumber: OSP181406
Work Type: Septic Upgrade
Tax Code dumber: 01507428000
Site Legal Address: WILLIAMSON #3 BLK 2 LT 16 G:2437
Site Mailing Address: 5130 E 98TH AVE, Anchorage
Owner: LANE JAMES J & SHAUN K
Design Engineer: PANNONE ENGINEERING SERVICES
This permit is for the construction of:
Q Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy
Effective Lute
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
i�t'iYtl'C171Cat
11/16/2018
11/16/2019
67590
❑ 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
Special Provisions: The as -built survey submitted with the inspection report shall include the creek and
associated easement that runs through the lot.
Received By: X --
Issued By: , • p,^�
Date: ////&//, _
Date: I I ' f (' bol3
4
LJ 59 Ef U N M P A U ti EI F
Community Development Department`s
Development Services Division
On -Site Water & Wastewater Program
f
Phone: 907-343-7904
Fax: 907-343-7997
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 015-074-28
Property owner(s) James & Shaun Lane
Mailing address 5130 E. 98th Avenue, Anchorage, AK 99507
Site address 5130 E. 98th Avenue
Day phone
Legal description (Sub'd., Block & Lot) Williamson #3, Block 2, Lot 16
Legal description (Township, Range & Section)
Lot Size 67,590 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑X
Initial ❑
Single Family (SF)
❑X
(w/wo ADU)
Septic Tank
❑
Upgrade
Duplex
❑
(D)
Holding Tank
❑
Renewal ❑
Multiple Dwellings
❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION
INCLUDES
A VARIANCE / WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
re of property owner or authorized agent)
Permit/Rush Fees: 25.6 / Waiver Fees:
Date of Payment: / f / 1.311-g Date of Payment:
Receipt Number: 6130 'bc1 Receipt Number:
Permit No. © .a le 3 iyv4 Waiver No.
Permit App_:-:• "—.,:c :
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP181406, Rebecca Carroll, 11/16/18
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP181406, Rebecca Carroll, 11/16/18
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP181406, Rebecca Carroll, 11/16/18
PLOT PLAN AS BUILT X SCALE 1 " = 60'
GRID SW 2437 Project
No.
18-561 /R1
Lan & A S S d c i a f£ S n C®
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
(907) 522-6476 Phone
�' '
Professional Land Surveyors
(907) 522-4625 Fax
ken®iangsurvey.com
a �
O F q4��d
jonathon0longsurvey.com
I hereby certify that I have surveyed the following described property:
LOT 16, BLOCK 2, WILLIAMSON SUBDIVISION, ADDN. No. 3 (PLAT No. 99-106)
Anchorage Recording District, Alaska, and that the improvements situated thereon are
within the property lines and do not encroach onto the property adjacent thereto, that
no improvements on the property lying adjacent thereto encroach on the surveyed
premises and that there are no roadways, transmission lines or other visible
easements on said property except as Indicated hereon.
Dated this the Day of 1111 of of Anchorage, Alaska
It Is the responsibility of the owner to determine the existence of any easements,
covenants, or restrictions which do not appear on the recorded subdivision plat.
,�? 49 .17-1
KE ..
S15202.
6Q40nRO�ssiaNA�. �' �`�
AECC963
Municipality of Anchorage .':'..'-?,
Development Sen/ices Department . ,v -....:
Building Safety Division
On-Site Water and Wastewater Program. 4700 S. Bragaw SL
P.O. Box 196650 Anchorage, AK g9519-6650 Page
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. ..~ ~ CoCO '-/~ PIDNumber: O I
""": · I ~1 L. ~r ~J E. Wastewater System: J~ New J--I Upgrade
~'": .~O1.~' ~,t~:r q~'r~3~%/t~c/~./~,~q ~'IC ABSORPTION FIELD
LEGAL DESCRIPTION 1.
Well: ~ New [] Upgrade c,,,,~ -~ J O Fi. ~'~'I /- ~ Fl.
TAN
K
SEPARATION DISTANCES ~'s~p~ic D Holding ~ S.T.E.P. ~ Othec
· .-.. ~ ~o --~r / c.,.~,~
Septic ~so~t~on L~ Holding Pubfi~vate
Tank Field Sta~on Tank S~rLine ~ ~ ~/~f ~(~4~,( ~ 6~.
~'*~ ~~ ~.0.4.
"'~: BENCH MARK
~'/ ~.'~'t,
Inspections pe~ormed DyL_. Dales: ~ ~~ .
"----::;o. ,',r Loop Roaa No. 2~ 2~
Development Se~ices Depa~ment Approval . ~.'~,~..~..~.,> ..c5'83°1 .,'/~/~. ~'"
P£RU~ NO. SW000078 PAC£ 2 OF 3
Municip. o[it oF Anchorooe
DEPARTHENT OF HEA~_THAND HUFFAN SERVICES
ENVIRONHENTAL SERVICES DIVISION
P.D. Box ]96650 ®Anchor=ge, At=skc~ 99519-6650® Tetephone, 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LECAL LOT 16, BLOCK 2, WILLIAMSON t~3
T2
P.I.D. NO. 015--074--28
C01'~
U~'T
NEW 1500
SEPTIC
PRIVATE
ACCESS
EASEMENT
/
/
/
/
/
DRIVEWAY
/ /
40*
ROBERT C-
CE - 8801
PERMIT NO $W000078 PACE: $ OF 3
Mumicipcz[ity oF Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 oAnchor~ge, Al~sk~ 99519-6650m Telephone, 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
L£OAL LOT 16, BLOCK 2, WILLIAMSON #3
P.I.D. NO. 015--074--28
FINAL GRADE-N ST1 ST2 C01
.r ,n ~ ::..,,.,
I/ 11~-9.~O' II] IH"""' '°
2" INSULATION-~ I/ II ' Iit \IIi. ,,,,,.,.t
x-- 88.4'
),ITl =90.4'% MTI ~-FINAL CRADZ MT,2: MT2=88.7' ,
I~ /' ~[i ORIGINAL GRADE
i /,,-..-.,/:=-
,,,.,.,U / ........ /
MTZ=84.4'J~BO~O~ OF SAND=B4.4'
DIST. UNE=86,7'~ N.T.S.
A B
FCO 7.5' 84.5'
$T1 20.0' 103.5'
$T2 23.5' 106.5'
C01 26.0' 108.5'
MH 28.0' 110.5'
MT1 31.0' 103.5'
MT2 47.0' 79.0'
FY1 41.5' 74.5'
FV5 46.5' 78.0'
·
NO GROUND WATER
7~r.4' B.O.H.
Municipality of Anchorage
Department of Health and Human Services
825 "V Street
P.O. Box 196650 Anchorage, Alaska 99519.6650
Rick Nystrom hap It w.cl.anchorage.ak.us
Mayor
Permit Number. #SW D00078 Date Oflssue 4128ND Parcelldentirkation Number: 015-074-28
Date Started: 6.8.00 Date Completed: 6-9-00 Is well located at approved permit location? ® Yes ❑ No
Legal Descriptio ni
'�[l,,Willlamson #3 81k 2 I 16
Property Owner ame & Address: Jim Lane
5015 E 9e Ave
A~.hn~e9- Ak9951&
Borehole Data:
Soil Type, Thickness & Water Strata
Depth (fl)
From To
Method of Drilling ® air rotary ❑ cable toot
Casing type: s e 1
stick-up
organic 8 at
grave fly silt
silty gravel
sift
sandy silty grovel
0
2
8
41
62
69
2
8
41
62
69
101
Wall Thickness: ,025 inches
Diameter: 6 inches Depth: 123 feet
LlnerType:
Diameter: inches Depth: feet
Casing stickup above ground:,? feet
Static water level (from ground level): 63 feet
Pumping level: 123 feet after
silly sandy gravel 81120
101
104
2 hours pumping $ gpm
clean sandy gravel -wet-
104
109
Recovery Rate: .� gpm
gravelly sandy sill 8 water
109
118
Method of Testing: airlift
sandy silt and water
gravelly silt 8 waterless 11ow,clearer
118
120
120
123
Well Intake Opening Type:
® Open End ❑ Open Ilole
❑ Screened Startfeet Sloppal feet
[]Perforations- Startfeet Stopped feet
Grout Type: Rentonite # 8 Volume: J�
Depth: Start 0 feet Stopped ± feet
Pump: Intake Depth feet
Pum size hp Brand Name
Well Disinfected Upon Completion? ® Yes EllNo
Method of Disinfection: Clorine Tablets
Comments:
Well Driller: Alpine Drilling 8 Enterprises
P O Box 110496
Anchorage AK 99511
Attention: The well driller shaft provide a well log to the property owner within 30 days of completion and the property
Inn tn'ihn rin of N. t1h k 4 Inrrwn C...nr.r'.4th:n And.,, of rmm�l.rinn
907 6'94 1211 P.~P_/~_
PROPERTY OWNER AGREEMENT
FOR THE MAINTENANCE OF AN
ON-,SITE ~¥AS'TEWATER DISPOSAL
SYSTEM
nchorage Department of HealthVand llumali l~ervlc~s (DllfI$) and the properly
owner(s) of:
ThE agreement Is made lot' Ihe purpose of maintaining an on-s fie wastcwater disposal
system on the subject property,
The property owners agree Io tile following:
Submit to the Municipality of Anchorage, on ~n annual basis, ~n inspection and
operation statement from ~t teglstered professional engineer. Tlds h~spectlon and
eperatlod statement shall verify that [he engineer has Inspected all effluent and air
pumps, tLmers, and altnn.% ~nd that alty deficiencies have been repaired and that thc
system is fUnctloni~g as designed.
(Signature)
(Printed Name)
(Printed Name)
Commiss,on Ex p i r e d J__~_ff7 ~_!.__c~_J
37f1'~ OF
DA3'I~: I -- 'Z.~~ Ol
ROBERT C. COWAN, RE,
ROBERTA. SHAFER, P.E.
CML ENGINEERS
(907) 694-2979
FAX (907) 694-121 !
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
4
REFERENCE:
The septic in. spgctions for the referenced property, were
performed on~/7/0o and ~/~/~o . Prior to submitting
the On-site Wastewater Disposal System and/or Well Inspection
Report we are waiting for the £~cr~,¢~- ~- to be
completed. ~f~r $~"~y
If we may be of further service please contact us.
Sincerely,
Robert C. Cowan, P.E.
17034 NORTH EAGLE RIVER LOOP · SUR'I: 204 · EAGLE RIVER, ~KA 99577
,t
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: Apr 28, 2000
Expiration Date: Apr 28, 2001
Permit Number: SW000078
Legal Description: WILLIAMSON #3 BLK 2 LT 16
Design Engineer: 0003 S & S Engineering
Owner Name: JIM LANE
Owner Address: 5015 E. 98TH AVENUE
ANCHORAGE, AK 99516-
Parcel ID: 015-074-28
Site Address: 005130 98TH AVE E
Lot Size: 67590 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
[] Disposal Field [] SepticTank [] Holding Tank [] Privy
[] Private Well [] Water Storage
All construction must be in accordance with:
1. The attached approved design,
2. Ail 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.
5. The following special provisions.
THIS PERMIT IS ISSUED FOR THE CONSTRUCTION OF AN ALTERNATIVE INTERMITTENT DOSING SAND
FILTER WASTEVVATER DISPOSAL SYSTEM. THE A'I-rACHED PROPERTY OWNER AGREEMENT SHALL
BECOME A PART OF THIS PERMIT PACKAGE.
Received By:
,ss.edB,:
Date: ~--/-OO
ROI3ERT C. COWAN, P.E.
CIV1L ENGINEEFL.~
(907) 694-2979
FAX (907) 694-1211
April 11, 2000
MUNICIPALITY OF ANCHORAGE
Depmhnent of Health and Human Services
P.O. Box 196650
Anchorage, AK. 99519
REFERENCE: Lot 16, Block 2, Williamson Subdivision #3
It is requested that you issue a permit to install an advanced treatment system with
an Intermittant Dosing Sand Filter to serve the proposed structure on the
referenced property.
A test hole was excavated and a percolation test was performed. The approximate
location of the test hole is located on the attached site plan. Ground water was
monitored and found to be dry as shown on the attached soils logs.
We do not anticipate any adverse effects on neighboring wells, septic systems, reserve
areas or drainage patterns by the installation of the proposed septic system. The
construction of this system will not prevent any future development on any of the
adjacent pmperlies.
If you require additional information, please contact us.
Sincerel~~
~nclosure
17034 I~IRTI-I EAGLE RfVER LOOP · SUfTE 204 · EAGLE FdVE FL AJ-A~KA 99577'
~ LOT 16, BLOCK
J.H.M. R. SHAFER 4-11-2000 I OF 3
DESIGN CRITERIA:
( r~n~ 3 BDR~ ' 450 GPD SHO~'N ON
SOI~ 450 GPD/SQ.~.
450/Z.0 ' 225 SQ.~. ~Q'D.
CRITERIA: ~o
,.,,..-,,,,
......... .s or SYSTtU / .~.//
· / / ~.~ . ~C~
" = O A
meerin~
(907)694-2979
(gO7)&94-t21!
LOT 16, BLOCK 2, [SON S
J.H.M. R. SHAF£R 4-10-2000 2 OF'
.36'
I 1/4' DIA FLE~ABLE-%
P¥C HO~E ~
I 1/4'
3/.4; DZA. SH 40 PVC I~T£R~.
IV8 DIA. Old'ICE SPACED 27 O.C.
TOP VIEW
10' x 36'
BOTTOMLESS SAND
FILTER
TUBE
(rfP. or 2)
VALVE
ENCLOSUR~
10'
I ~~~~,~ Z~OT 16, 2, WILLIAMSON
S/D #~
I~.u~ 3 OF' 5
f
OR1GINAL GRAOE
SIDE VIEW
36' X 10'
BOTTOMLESS SAND FILTER
DEPARTMENT OF HEALTH & HUMAN SERVICES ' *°° *** * ** '*
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COSA Checklist.docx
COSA Checklist
Legal Description: WILLIAMSON #3 B2 L16 Parcel ID: 015-074- 28
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____
A. WELL DATA
Well log is filed with Onsite (or attached)
Date drilled 6/9/2000 Total depth 123 ft
Cased to 123 ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) 18+ in.
Date of flow test for COSA 8/30/24
Static water level at beginning of test 54 ft.
Well production at time of test 3 gpm
Water storage tank volume None gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by Date 8/29/24 & 9/26/24 (SULLIVAN)
Comments __________________________________________________________________________________
B. TANK DATA
Measured operating fluid level in septic tank 47”
Date of pumping 8/30/24
Required maintenance completed, if AWWTS
Comments:
C. LIFT STATION
Required maintenance completed
Age of lift station 24 years
Lift station material Plastic
Comments: SEE LIFT/IDSF MAINT LOG
D. ABSORPTION FIELD DATA
Which system tested (date installed) 12/14/18
ALL standpipes present per record drawing
Total measured depth from existing grade*3.9+ft (max)
Measured depth to pipe invert from grade ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
Monitor tubes (MT) go to bottom of effective. (ED)
If not, state depth into effective
Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months) N
If yes, enter date
Adequacy test date 8/30/24
Results Pass
Fluid depth prior to test 0 in
Water added 600 gal
New fluid depth 1 in
Elapsed time 30 min
Final fluid depth 0 in
Absorption rate 600 gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) 3 in (MOA 0.25’ ED)
Effective depth used 0 in (Final Fluid Depth)
Effective depth (ED) remaining 3 in
Comments/Deficiencies: Approximate total measured depths from existing grade. ED per measured / visual observations per MOA
record documents & appears approximate. *The southern MT with more depth & cover was clogged & the northern MT total measured depth
from existing grade is shown.
COSA Checklist.docx
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100’
Yes if No ft
Neighboring Tank > 100’ Yes if No ft
Absorption Field on Lot > 100’ Yes if No ft
Neighboring Absorption Fields > 100’
Yes if No ft
Community Sewer Main > 75’ Yes if No ft
Community Sewer Manhole/Cleanout > 100’
Yes if No ft
Private Sewer/Septic Line > 25’ Yes if No ft
Holding Tank > 100’ Yes if No ft
Animal Containment > 50’ Yes if No ft
Manure/Animal Excreta Storage > 100’
Yes if No ft
N/A – Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10’ Yes if No ft
Tank to Property Line > 5’ Yes if No ft
Field to Property Line > 10’ Yes if No ft
Water Main > 10’ Yes if No ft
Water Service Line > 10’ Yes if No ft
Surface Water > 100’ Yes if No ft
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No ft
Community Wells > 200’ Yes if No ft
If tank or field is under driveway comment below
F. ENGINEER’S COMMENTS
G. CERTIFICATION & 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, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm FIRST WATER CONSULTING Phone 907-350-9566
Engineer’s Printed Name CURTIS HUFFMAN, PE Date 9/5/2024
Comments: This investigation was completed in compliance with MOA guidelines, regulations,
and best industry practices / methods. The assessment of the condition of the well and septic
applies only to the conditions as of the day tested. The flow and absorption rates may change
due to subsurface conditions that may not be observed from the surface, changes in land use,
local soil characteristics, groundwater levels that may fluctuate during the year, quality of
construction (workmanship & materials), the water usage of the family being served by the
system and maintenance. The operational life of all well and septic systems are subject to
these various and dynamic characteristics and are outside the control of the evaluator of the
well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory
for current or future occupants or guarantee that no unseen encroachments, deficiencies or
discrepancies exist can be given by First Water Consulting &
9/5/24
PAR
AN IDSF - INTERMITTENT DOSING SAND FILTER
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~ ' ~ APR-R6-~O 1~.al ~5 ENGINEERING 907 69a 1211 P.01/01
PROPERTY OWNER AGREEMENT
:FOR TH~ MAI:KI'ENANCE OF.AN
ON-SITE WASTEWATER DISPOSAL
SYSTEM
This agreement, dated F3r)~i ~ ~"/ :~ooo
~, is made be~eeu the Municipality of
Anchorage Department of Health and Human Services (DHHS) a~d the property
0w~r(s) of:
Lot 15~ Block 2t ~illiams..o.n Subc~ivision tit
This agreement is made for the pu~ose or maint.)nbg an on-site wastewater dispos~l
system on the ~ubject property.
The property owner~ agree to Re following:
Submit to the Mutdcipality of Anchorage, on an ~u~ual basis, ~ inspection
operation statement from a registered professional e-gineer. This im'pcction and
operation statement sh.~ll verify that the engineer bas i~spected all effluent and air
pump:, timers, and alarms, and ~bat any'deficiencies l~ve been repaired a~d that the
system is functioning as designed. ' ' '
($igmture)
(Printed N~e)
~.111~,~//~ ,
= :NOTARY: -
~-.. .. ~
Z/l/II/ilI illl~x~x'
(Printed Name)
TOT~L P.01
• Municipality of Anchorage
On -Site Water and Wastewater Program
(907) 343-7904
Parcel I.D. 015-074-28
Certificate of On -Site Systems App
�g678g
3
NOV
a 2019 a
Expiration Date:
68L9
T
�'rz_ � .) q, ")=
1. GENERAL INFORMATION:
Complete legal description WILLIAMSON #3; BLOCK 2, LOT 16
Location (site address) 5130 E.98T" *ANCHORAGE, AK 99507
Current Property owner(s) KIM LANE Day phone 720-5060
Mailing address 5130 E.98TH *ANCHORAGE, AK 99507
Real Estate Agent Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
4
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
®
Individual
Individual Water Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
WaiverNariance request for: Distance:
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 1 r90 Waiver Fee $
!
Date of Payment C �5-1C q Date of Payment
Receipt Number 9aRr� Receipt Number
COSA # ®J (_015" i 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.
Name of Firm: Garness Engineerinq Group, Ltd (GEG) Phone: 907-337-6179
Address: 3701 East Tudor Road, Suite 101- Anchorage Alaska 99507 /
Engineer's Printed Name: Jeffrey A. Garness Date:' ` y
In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system o
OF
in accordance with the guidelines and regulations established by the Municipality of Anchorage and p .. • • • • • . •. Q
industry practices. The reported results describe the condition of the system/s on the date/s of the O S
evaluation. Separation distances were measured to readily identifiable features. Hidden defects or P 4 T SOI
encroachments may exist that were not identified during the evaluation. The operational life of all wells
and septic systems depend upon a variety of variables, including but not limited to, soil conditions, • • • • • • • • • • • • • • • • • • • • • • •
groundwater levels (that may fluctuate during the year), quality of construction (materials and
workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and .... .. .. .
are outside the control of GEG. Satisfactory test results do not guarantee future performance of the ffr A. ss:
system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of �Q49 CE— 9 3��
the well or septic system. GEG makes no representation whether an alternative well or septic system . �c G
can be installed on the property in the event either of the current systems fail to perform adequately in 44 e��'
the future. The content of this report is for the sole benefit of the person/party that retained GEG to aprofessio�oo�
perform the evaluation. Reliance upon the information provided in this report by any other person or ��OOpOoo�
party (including subsequent property purchasers) is not authorized, nor will it confer any leg`l``j��iY tOF (r(((�///
whatsoever.
A4jisr //� #AECC884
6. DSD SIGNATURE
ON-SITE
��/ System #1 Approved for
y pp
Ll bedrooms �� WATER AND
System #2 Approved for
bedrooms lca WASTEWATER oz 1
Disapproved
�rn PROGRAM
Conditional approval for
bedrooms, with the q� � �r,4i �plis:
By: vu OA7A k, 'Ti, luo Original Certificate Date: a� 7/(9
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_ Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet 10-10-12.doc
COSA Checklist
Legal Description: Williamson #3; Block 2, Lot 16
If more than 1 septic system on lot: COSA Checklist # 1 of 1
A. WELL DATA
❑■ Well log is filed with Onsite (or attached)
Date drilled 6/8/00
Total depth 123 ft
Cased to 123 ft
❑■ Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ground) 18+ in.
Date of flow test for COSA 4/17/19
Static water level at beginning of test 65.1 ft
Comments
B. TANK DATA
Age of tank(s) 19 years
Tank type/material -pt. HDPE
\A ❑■ Standpipes/foundation cleanout per record drawing
" Date of pumping tv /01 /.5
D. ABSORPTION FIELD DATA IDSF
Which system tested (date installed) new
❑■ ALL standpipes present per record drawing
Total measured depth from grade *3.75 ft (max)
Measured depth to pipe invert from grade *3.5 ft (min)
❑ N/A — pressurized field
❑■ Monitor tubes go to bottom of drainfield. If not, state
depth into effective*
Parcel ID: 015-074-28
Structure served by this system 1
Well production at time of test 4.7+ gpm
Water storage tank volume n/a gallons
Well disinfected for coliform test? ❑ Yes 561 No
■❑ Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L■❑ Arsenic less than MRL (ND)
Collected by GEG, LTD.
Date of Sample 4/17/19 /
C. LIFT STATION
❑ Required maintenance completed
Age of lift station 19 years
Lift station material unknown
Comments: LIQUID LEVEL AT 48" ON 4/23/2019
Adequacy test date new
Results Z Pass For 4 bedrooms
Fluid depth prior to test in
Water added - gal
New depth in
Elapsed time - min
0 Code -required soil cover over field Final fluid depth in
❑ System presoaked Absorption rate 600+ gpd
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) new
date of test) If yes, enter date y n/a
Gallons introduced n/a gallons
Comments/Deficiencies: `Per Pannone Record drawings dated 12/31/18. Both IDSF MT's dryon 4/17/19.
COSA Checklist yellow sheet
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 *5+ ft
Community Sewer Manhole/Cleanout > 100'
❑✓ Yes
if No
ft
❑✓ Yes
if No ft
Neighboring Tank > 100' QYes
if No
ft
Private Sewer/Septic Line > 25' Yes
if No ft
Absorption Field on Lot > 100' Q✓ Yes
if No
ft
Holding Tank > 100' Q✓ Yes
if No ft
Neighboring Absorption Fields > 100'
Water Service Line > 10'
❑✓ Yes
Animal Containment > 50'✓0 Yes
if No ft
❑✓ Yes
if No
ft
G. ENGINEER'S CERTIFICATION
_0060000
OF..q.
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' 7 Yes
if No
ft
✓QYes
if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
Yes
if No *5+ ft
Surface Water > 100'
2 Yes if No ft
Property Line > 5'
❑✓ Yes
if No ft
Driveway/Parking > 0'
Yes if No, comment
Absorption Field > 5'
DYes
if No ft
Wells on Adjacent Lots:
Water Main > 10'
Q✓ Yes
if No ft
Private Wells > 100'
F, -(]Yes if No ft
Water Service Line > 10'
❑✓ Yes
if No ft
Community Wells > 200'
❑✓ Yes if No ft
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10' r,/ Yes if No ft
Driveway/Parking > 0' F✓ Yes
if No, comment
Property Line > 10' 0✓ Yes if No ft
Wells on Adjacent Lots:
Water Main > 10' 0 Yes if No ft
Private Wells > 100' ❑✓ Yes
if No ft
Water Service Line > 10' F/ Yes if No ft
Community Wells > 200' F,/ Yes
if No ft
Surface Water > 100' ❑✓ Yes if No ft
F. ENGINEER'S COMMENTS
*met code at time of installation.
G. ENGINEER'S CERTIFICATION
_0060000
OF..q.
Spy
Oo
1 certify that I have determined through field inspections and review
Municipal that the in
of records above systems are conformance
with
MOA COSA guidelines in effect on this date.
D
Je e Garn
�O •'•
s.-
9. E 79 3
.• ���0
�04Ofro
COSA Checklist yellow sheet
f ess-io
#AECC884 ���QO o
P: 907-343-794-F: t',:7_343-7997 -P-0. Box 196650 AnebomnAK954S19-6650
Intermiftent Dosing Sand Filter
Maintenance Log
asineriaa_l. Street Address 513o E, 99'4' 4c-
Phon'___&3 Le�921 DOM PID
S-el3kc Tank:
-Sludge level _-O— _ inches -Pumping: requiredyL5 Cnjo -Pumping completed
Absorption Field: 16 .)1.1$/
-Liquic level im.'I.fin -Flushing valves per approved design es no
-Alt Rushing valves opci-I _- J, distribution fines flushed, and flushing valves closeri yes no
Lift station:
-Pump basket cle-aried Cy—et, no-Blotube effluent fifter cleaned EesJ_Io
-Timer float settingiv inches -High level float setting,5(�inches -Reference pointe D I)
*Pump on—�--seconds -Pump off —l'i—Dminutes
-Cumulative lifetime cycl."!i-55-7JE -Cumulative run time hours
-Operation _-;absIjactojy res no
Air SVstcrn:
-Air pump filter cleanevc: 'cPeP5 no -Air pressure psi
F.-, -I -Air system operation
,E)ate of Wuast fristali or '�)Uild <s aat i �s:la::ct :a '+�no t satisfactory
t i s �fact o
Alarm System:
-Dedicated elechiml ciTcui-, cy_&aq -Audible and visual alarm inside dwelling GQ no
-Floatsetting rG inches -Alarm system operation &369factory notsatisf2efory
Comments:
5Y . ..... 0G_.'7 ..... POIT �. ........... ..............................................
T -----
.................................... ................................ .... I ............................................................... I. ................
................................... .......................... . ............................................................................ ..........
.............................. 1- ............................................................ I I I I
-11.11.1 ....................... I., ....... 11 ..............
............................................................................. ....................... 1-1.1, ...............................
............................. .. ... - . ....................................... I ................................ t-.•-----------------------• --.........
Maintenance Provider:
Techniolan J rT 6
Company ei'L4-A tkw '!�er
Signature
IDSF Mairekenanne L.rx
j_0z.G``.dce_
Sent from my Whone
N
Date of mairitenanee
aq4d-7
Data....!H PAC a
I -
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of this Day of 4iVei`!/1�&y of 20 , by and between
i'1 �("�,�,herein the "OWNER," and the Municipality of
Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as
located at (legal description)
��- lig; �. i���.... � E ���.��`�'�1r1 ��v�f� U� ���� �,�.-� ���- �►�. � t�..�
2. Maintenance, Repairs and Alterations.
(Owner is required to read, understand and initial each section)
41�� Throughout the term of this Agreement, the Owner shall enter into a service agreement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
accordance with the equipment's approval for operation in the Municipality.
CQ�t shall be the responsibility of the Owner during the term of this Agreement to pay for all l )i
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $600).
Owner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
Owner acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement.
(rev. 05/18/2018) Page 1 of 3
`Ag Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
QA)o__Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AWWTS.
Owner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7. Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
(rev. 05/18/2018) Page 2 of 3
M71k,,-(signature)
Date: ll (aLe C(
PVC (M (A G ( �oyi (print name)
STATE OF ALASKA )
ss.
THIRD JUDICIAL DISTRICT )
The foregoing instrument was acknowledged before me this 2k_ day of Alov&,01rr ,
NO ARY PUBLIC FOR ALASKA STA TE OF ALASKA ='
My Commission expires: J,- 1!3 R, 2,7Z3 NOTARY PUBLIC
Joseph W. Vallie
tJy Commission E_(pires: July 9, 2023
MUNICIPALITY:
By:/�/�� C�%�6 (signature) Date:I Ila 7/1 q
Abe ee� 6cr?) (print name) Title:
(rev. 05/18/2018) Page 3 of 3