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Home My WebLink AboutAUDUBON HILLS BLK 2 LT 1Audubon Hills Block 2 Lot 1 #015-231-51 Municipality of Anchorage Community Development Department Page 1 of 3 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: OSP131198 PID Number: 015-273-56 ❑ New 2 Upgrade Name: ABSORPTION FIELD Alex and Ann Carter ❑ Deep Trench ❑✓ Shallow Trench ❑ Bed ❑ Mound Address 12201 Audubon Drive Anchorage, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 1.2 GPD/SF 5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 1 Ft. Gravel depth beneath pipe 4.0 Ft. Subdivision - Block Lot Audubon Hills 2 1 Fill added above original _grade 1-3 Ft, Gravel length 58 Ft. Township Range Section Gravel width 5-7Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches Tank Field Lift Station Tank Line 580 Ff One Ft. From Well>100' >100' NIA NIA >25' TANK p Septic ElS.T.E.P. [_]Holding ❑ Other Manufacturer Anchorage Tank Capacity I 1, 250 Gal. Surface Water >100' >100' NIA N/A Material Steel Number of compartments Two Lot Line >5' >10' NIA N/A NA Foundation >5' >10' NIA NIA LIFT STATION Manufacturer Capacity Gal. Curtain Drain None Noted Pump on level at Pump off level at High water alarm at Remarks Existing Absorption Bed Abandoned in Place. in. in. in. Existing Septic Tank Decommissioned in Accordance Pump make and model Electrical Inspections performed by with Municipal Code. PIPE MATERIAL Housetotank D3034 raankto D3034 drainfleld Installer G & R Excavating Drainfield HDPE CO/MT D3034 Inspector BENCH MARK (Assumed elevation) 100.0ft MEA Inspection 8/8/2013 1a 8/7/13dates: 2 Location and description Garage Slab. 3m 8/9/2013 4n 8/13/13 COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer •�� ... 11 Conditional Approval: Date ..OF ..OF• �tPr.S�IIe 49L tyy •'� i ... ... ...............yr MICHAEL E. ANDERSON : C, ! ♦ CE - 4381 gam® Fo • . � �4 .1.y- .�vi r Date )- 3 Approved 2 f4PR1 `':' Inspection Report_1-1-12.doc Municipality of Anchorage Page 2 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Brogow Street Anchorage, AK. 99519-6655 — 343-7904 PID No. 051-231-51 Permit Number. OSP131198 ?.0, S1 37.5 51.4' S2 43.5 52.a' C3 54.9 58.3' M1 75.1 14.5' C4 75.g 13.4' ----- Tract A-2 N Y `� 'tb'y J5 • � P Existing Absorption Bed Abandoned in P1a48. WOODEN FENCE Q� 'lSP 8 4 J/f. kF'4EryT C3 Jj Q WELL ' TH3 Three ®TM2 Bedroom 10' x b' GW House EASEMENT m[aerior 4'It Sl � tion �,• M1 NOTE: .' < ,O Ca Existing Septic Tank \/ (18COmmi39i0lied in ACCOrdOnce with Municipal Cade. Lot 1 46,395 s.f. _ 9y �yry .q GD ti y eyry�ryy Lot 2 G s� t! Ow• /, °o J4% � OF A�q LEGE D `��^+fir^,`Q. .♦.. Mt - Monitor Tube `l n -l' •• Si - Septic Tank Vent CD 49th A�� TH - Test Hole %,,,,,;,. .... _ Cl - Clean Out R'O .R ...................... F` MICHAEL E. ANDERSON --Z 5�, PLAN AS BUILT ••� No. CE -4381 ti: .T.. FESSq.' SCALE 1' = SO' +�� Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: OSP131198 PID No. 051-231-51 N UU U N N Interior Lift Station 1,000 Gallon Septic Tank 8/1112013 PROFILE AS -BUILT No Scale On -Site Wastewater Disposal System Permit Permit Number: OSP131198 Tax Code Number: 01523151000 Work Type: Septic Permit Effective Dates: July 30, 2013 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 to July 30, 2014 Design Engineer: ANDERSON ENGINEERING Subdivision: AUDUBON HILLS Site Legal Address: AUDUBON HILLS BLK 2 LT 1 G:2739 Owner/Address: CARTER ALEX R JR & ANN R 12201 AUDUBON DR ANCHORAGE AK 995162423 Site Mailing Address: 12201 AUDUBON DR, Anchorage Lot Size in Sq Ft: Total Bedrooms: This permit is for the construction of: S .7-13 46395 3 Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage C/,* 6 a All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. G'01 reY;� die �>tik �✓d dt�aAl��e.ld. Received Issued By, MUNICIPALITY OF Community Development Department Development Services Division On -Site Water & Wastewater Program ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 015-231-51 Property owner(s) Alex & Ann Carter Day phone Mailing address 12201 Audubon Circle Anchorage, AK 99516 Site address 12201 Audubon Circle Anchorage, AK 99516 Legal description (Sub'd., Block & Lot) Audubon Hills, Block 2, Lot 1 Legal description (Township, Range & Section) Lot Size 46,395 Sq. Ft. Number of Bedrooms Three (3) APPLICATION IS FOR: (® all that apply) Absorption Field Fxj Septic Tank El Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ APPLICATION IS AN: TYPE OF DWELLING: Initial ❑ Single Family (SF) El (w/wo ADU) Upgrade Duplex (D) ❑ Renewal ❑ Multiple Dwellings ❑ (SF and/or D) c0i �eU; 4d i, ae,P sld, c ar I certify that the above inforr applicable Municipal Codes. er r...(. F_ (Signature of property owner or authorized agent) tance:"P, Permit/Rush Fees: 530 Waiver Fees: 9LW Date of Payment: `i ( l I 113 ( Date of Payment: t 13 —z Receipt Number: biLt5l G Receipt Number: 01451G Permit No. 0 e I3 ting Waiver No. CsrI31k aol Permit App_9-1 -1 2.doc with Col ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) August 8, 2013 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 Elmore Road Anchorage, AK 99519-6650 Subject: Lot 1, Block 2, Audubon Hills Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The existing absorption bed on the subject lot has failed and must be replaced prior to the issuance of a Certificate of On Site System Approval (COSA). We are therefore requesting a permit be issued for the upgrade of the septic system to accommodate the three-bedroom home on the lot. The attached Site Plan and backup documentation identify the location and configuration of the existing and proposed septic system. The existing Septic Tank will be decommissioned in accordance with Municipal Code. The existing absorption bed will be abandoned in place. Also identified on the plans are the locations of the existing well on this and adjacent lots and adjacent septic systems. No conflicts exist between the proposed septic system and the wells on this or adjacent lots. Protective radii are shown to the adjacent wells. Contour lines are shown indicating the current drainage patterns. The drainage patterns will be maintained after construction. The test hole placed on the lot indicated Silty Gravel with Sand (GM/SM) to a depth of 11'. No groundwater was encountered in the test hole. The percolation rate in the GM soil lense in the trench was determined to be 14.1 minutes per inch. We have designed the new trench with an application rate of .8 gallons per day per square foot. We are proposing to place a 57' long by 5' wide absorption trench with a 4' effective depth. The total depth of the system will be 5' to remove the organic layer with the distribution line at 1' below the existing surface. The ground surface on the lot slopes to the southwest in the area of the absorption trenches. The trenches will be placed parallel to the contours of the ground as much as possible and in conformance with design criteria. A minimum of 100' will be maintained COQ. Lot 1, Block 2, Audubon Hills August 8, 2013 Page Two between all components of the septic system and the proposed well and from any surface water in the area. 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 septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Q p +"�I'z z Michael E. Anderson, P.E. Attachments tq 49th W_~.°.* MICHAEL E. ANDERSON chi / AUDUBON HILLS SUBDIVISION LOT 1, BLOCK 2 / 1 46,395 S.F. 2-57' Long x 5' Wide F� / �a / x .5' Effective Depth Absorption Trenches 0 o / Q 1Exist! j Absor tion B (A ndon in Place) JO eco is on istin Septi Tan in ccord no Aa Drwewa'f with Muni�lpal ode. ac / , New 1,00 Gallo Septi k onn ct o Exists g Lift to n. / n. SITE PLAN SCALE 1" = 40' 5' LEGEND MT — Monitor Tube FCO — Foundation Clean Out TH —. Test Hole CO — Clean Out MH — Man Hole FSV — Flow Splitter Valve LOT 1, BLOCK 2, AUDUBON HILLS SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Three Bedroom Home 5' Wide Trench System Pere. Rate: 14.1 Min./Inch 1,000 Gallon Septic Tank Application Rate: .8 GPD/SF 4' Drainfield Rock 3 Bedrooms * 150 GPD/Bedroom = 450 SF Absorption Area 450 SF/.8 GPD/SF/5 SF (Width)*.5(Red. Factor) = 56.25 LF Trench Length THEREFORE: Construct a 57" Long x 5' Wide x 4' Effective Depth Absorption Trench. Flow Line Elevation in Trench to be 1.0' Below Original Ground Surface. Total Depth to be 5' Below Existing Ground. Provide 3' Cover Over Absorption Trench and 4' Cover Over Septic Tank. 5' TYPICAL 5' WIDE TRENCH SECTION (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. _.`.....; Minimum 4' Separation From Groundwater. 'r�{ Minimum 100' Separation From Private Wells in the Area. �` Minimum 100' Separation From Surface Water or Streams: �j ;, MICHAEL E. ANDERSON No. CEJ381 EN a MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 DEPTH ( feet) 1 - 2 3 4 5 6 7 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: Lot 1 Block 2 Audubon Hills PERFORMED FOR: Alex Carter DATE: 8/7/13 PROJECT NO.: PARCEL ID#: TECHNICIAN: MEA TEST HOLE 3 SLOPE GRASS GRASS Mar I 1 I— Bottom of Trench WAS GROUND WATER ENCOU'. IF YES n. WH/ DEPTH OF WATER AFTER MOD DATE OF MOI NT" Iy� E 49th l'V ?'L E. ANDERSON CE -4381 . �IT DEPTH? - 0 ITORING' JITORWG DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH TO WATER (INCHES) NET DROP (INCHES) 8/7/13 TEST HOLE PRESOAKED PRIOR TO TESTING - 1 3:35 1.25" 2 4:05 30 3.375" 2.125" 3 4:06 1.125" 4 4:36 30 3.25" 2.125" 5 4:37 1.25" 6 5:07 30 3.375" 0.75" PERCOLATION RATE: 14.1 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 4 FT. and 5 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY ANDERSON ENGINEERING. 1, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 8/8/13 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: Lot 1, Block 2, Audubon Hills PERFORMED FOR: Alex Carter DATE: 7/20/13 PROJECT No.: PARCEL ID#: TECHNICIAN: JB DEPTH TEST HOLE 2 (fee[) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 OB/OG GM/SM SILTY SAND AND GRAVEL WAS GROUND WATER ENCOUNTERED?No S IF YES @ WHAT DEPTH? LO B. 0. H. DEPTH OF WATER AFTER MONITORING: None P DATE OF MONITORING: 7/2 E F 49th E. ANDERSON CE -4381 DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH T WATER (INCHES) NET DROP (INCHES) 7/22/13 TEST HOLE PRESOAKED PRIOR TO TESTING: 1 2:09 4.25" 2 2:39 30 5.625" 1.375" 3 2:40 4.375" 4 3:10 30 5.625" 1.25" 5 3:11 4.125" 6 3:41 1 30 1 5.3751111.25" PERCOLATION RATE: 24 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 3 FT. and 4 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 7/30/13 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ,,~NEW [] UPGRADE MAILING ADDRESS LEGAL )ESCRIPTION LO DISTANCE TO: Manufacturer r uq. ca~__, iy~ons ,F .OMEMADE: ~S~A.C. ~O: Manufacturer No. of ,ines ~ I L~ngthAf/.ach~ine / I ~--R~' ~' Top of tile to finish gra~ - ' Length Width Type of crib Crib diameter Well DISTANCE TO: ~Class Depth Building foundation DISTANCE TO: J Material Foandatil;~' Nearest lot lin~i~" ,/ Tot~en~th o~-~'~,~s/<~ [ Trench width inches Material beneath tile g inches NO. OF BEDROOMS ~ PERMIT NO. ~'2oqoq No, of compartments Liquid depth Dwelling PERMIT NO. Liquid capacity in gallons Depth PERM,T NO. ?.Z O 4',~2 Crib depth Building foundation Driller Sewer Dine OTHER PIPE MATERIALS Pt,'(- SOIL TEST RATING 2-5' o ~'/~/~o ~ m INSTALLER REMARKS Distance between linesz / Total effective absor, ption area PERMIT NO. Total effective absorption rea Nearest lot line Distance to lot line Septic tank PERMIT NO. Absorption area(s) APPROVED 72-013 (Rev, 3/78) DATELEGAL 7-- A 14,'I t., MUNICIPALITY OF ANCHORAGE Departmen~of Health and Environmental, Protection 825 = Street, Anchorage, AK. J9501 264-4720 * * * HANDWRITTEN PE~RMIT * * * Perm±t ~ ~'~)~¢ WELL AND/OR ON-SITE SEWER PERMIT Applicant: ~/d~f~ ~D~3~' Mailing Address: Location: ~~ ~, , Phone N~er: Leqa! Description: LT , p. T~e of Soil ~sorption System IS:~n~/~~ Trench: . .. Drainfield: . Holding Tank: ~ax~ N~er of Bedrooms: ~ q.ft/br) The Required Size of the Soil ~sorption System Is: DEPTH __ ~ LEN6TH __. . GRAVEL DEPTH WIDTH The length d~ension is the length(in feet) of~¢~h or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minim~ depth of gravel between the outfall pipe and the bottom of the excavation(in feet). ' ' S ZE = ~e~it applicant has the responsibility to info~ this department during the .nstallation inspections of any wells adjacent to this property and the n~ber ~f residences that the well will serve. ~ ~ ~ TWO(2) INSPECTIONS ARE REQUIRED ~ackfilling of any system without final inspection and approval by this departmen Jill be subject to prosecution. ~~,~- ~ ~~ 'Iin~ distance between a well and any on-site sewage disposal syste~ is 100 fee /. 7or a private well or 150 to 200 feet from a public well depending upon the type ~f public well. Minim~ distance from a private well to a private sewer line _s 25 feet and to a co--unity sewer line is 75 feet. Well logs are required iud must be returned to this department within 30 days of the well completion. )ther requirements may apply. Specifications and construction diagr~s are ~vailable to insure proper installation. ~ ~ ~ PERMIT EXPIRES DECEMBER 31¢ 1 9 S 2 I certify that: (1) I ~ f~iliar with the requirements for on-site sewers and wells as set forth by the M~icipality of ~chorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if ~esidence~r~modeled to include more ~t 3 bedr?~ Signe~~ ~ ~~~ ~ ~ Issued by :~~~~ ~App 1 ic an t Date: RETURN TO: DlvlsJon of Geological and g -- yslcal Surveys (DGGS) 3001 Porcupine Drive (Tale, ,et 277-6615) Anchorage, Alaska 99501 WATER WELL RECORD Vern' s Drilling U.S.G.S. Loca, liD. Drilling Company Name Drilling Permit No. STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES iLOCATION OF WELL I Please complete either la, lb, or lc. A.U.L. r4o. Meridian jla. Borough Subdivision Lot Block lb. Fraction Section No, Township Range 1 2 / / / N/S E/W lc. Distance and Direction from Road Intersections 3. OWNER OF WELL: Forest Ridge Homes Add ress: Audubon Hills Street Address and Area of Well Location 2. WELL LOG Feet Below 4- WELL DEPTH: (completed) Surface Elevation Date of Surface ~7~i°n Material Type Top Bottom 4o ft. gray clay 0 10 s. []Cable tool r~ Rotary []Driven []Dug silty sandy 10 1 5 []Auger []Jetted []Bored []--lot:her: ~ravSiltyb~nsandY.~fi I t. pn15 12039 6. USE: ~ Domest $C []Publ lC Supply ~ Industry ~em~nted g=avel lense~ ~ J40 F~,~r,gation ~Recharge [-~Co~mercial " H~O J-~ Test Well J---J Other: 7. CASING: ~ Threaded ~----~Welded / j ~_ in. to IJ 1. ' ~)~tt Depth Weight ~lbs/ft, (// t in. to ft. Depth ,0 8. FINISH OF WELL: Type: Diameter: ~ % Slot/Mesh Slze: Length: Set between ft. and ft. Fittings: 9. STATIC WATER LEVEL: ~ ft. ~Above ~"~Below land surface Type of Measurement: k/dINICi?ALJTY OF .ANC,HOR~ GE ID. PUMPING LEVEL below land surface [)F~T ~ ~ ' ~ ~ ft. after -- hrs. pumping 8 g.p.m. ENVIR ,.i;, ',,,. ~ ft. after ~ hrs. pumping ~ g.p.m. 1 "~;' ~ 11. WELL HEAD COMPLETION: [] In Approved Pit I []Pitless Adapter inches above grade ~ CF C ! \i I; :~ 12. GROUT,.G: We,; Grouted: []Yes [].~ Naterlal: F-~Neat Cement [] Other: 13. PUMP: (if available) HP ,, Length of Drop Pipe -- ft. capacity -- g.P-~ Type: I--') Submers I hie [] Rec i~roca t lng [] Jet []Other: t~. REMARKS: Water Temperature: t5. WATER WELL CONTRACTOR'S CERTIFICATION: This well was drTlled under my jurisdiction and this report ~s true to the best of my knowledge and belief: Vern's Drilling & Enterprises AA 3327 Registered Business Name Contract License Number Address: 122~41 Avion St. ~ SRA Box 1560 Anchorage. Ak 99507 Author iz~'d -P~epresen'ta t Form 02-WWR Copy Oistributlon: WHITE - State DGGS, PINK - Driller, CANARY - Customer PERMIT NO. blU~4 I I3: I. AL I T'T" I:IF DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 'L' STREET, ANCHORAGE, AK. 99501 2~4-4720 ~.-IELL P'EI~r~ It 820994 ) APPLICANT LOCATION LEGAL FOREST RIDGE HOMES L1 B2 AUDOBON HILLS SRA BOX 475-S 0050? LOT SIZE 276-4501 999999 SQUARE FEET MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS 8RE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PER~I I T E.~?~P I RES [-',ECEr~BER _--~-'l.. 1982 I CERTIFY THAT l: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2~ I WILL INSTALL THE_SYSTEM IN ACCORDANCE WITH THE CODES. 5I 'NE:: ................ APPLICAN~ ~T RIDGE HOMES ISSUEE BY .... i~}' -..~,'~'"~'-'~.___DATE___d:d.' V4. 0 • -� Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 ° r Certificate of On -Site Systems Approval f Parcel I.D. 015-231-51 Expiration Date: 1. GENERAL INFORMATION Complete legal description 12201 Audubon Drive Anchorage, AK 99516 Location (site address) Audubon Hills, Block 2, Lot 1 Current Property owner(s) Alex ct Ann Carter Day phone 12201 Audubon Drive Anchorage, AK 99516 Mailing address Real Estate Agent 2. TYPE OF DWELLING: Fx� Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Three 4. TYPE OF WATER SUPPLY Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public water System ❑ WaiverNariance request for: Received by: Day phone TYPE OF WASTEWATER DISPOSAL Individual 0 Holding Tank ❑ Community ❑ Public Sewer ❑ COSA to be relea6ed to the engineer, unless otherwise requested by the engineer. COSA Fee $ Date of Paymentlo��//� Receipt Number COSA# QcSC/3l 837 - Date: e ' Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Phone 522-7773 Date 8/19/2013 �. w ,...,e:� Wj r'F�®®P 7 G. DSD SIGNATURE S,S System #1 Approved for —3—bedrooms c: MtcHaEt g`5 o'er System #2 Approved for bedrooms ,j sf -4381 0 �4. Disapproved k pRp� a®m Conditional approval for bedrooms, with the following M Original Certificate The N nicipalit cfi chorage Development Services Division (DSD) issues certificates of On -Site Sy upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Septic System Advisory Well Flow Advisory COSA blue sheet_: 1., c Nitrate Advisory Arsenic Advisory Other If more than 1 septic system is on the lot: COSA Checklist # _of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Audubon Hills, Block 2, Lot 1 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 9/82 Sanitary seal (Y/N) Y Total depth 40 ft. Cased to 40 ft. FROM WELL LOG Date of test 9/82 Static water level 2 Well production 8 WATER SAMPLE RESULTS: ft. e• Coliform 0 colonies/100 mL Nitrate LZ mg/L Arsenic My 111) ug/L Date of sample: 8/13/13 B. SEPTICIHOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1,000 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Depression over tank (YIN) N Date of pumping New Const. Pumper C. ABSORPTION FIELD DATA Parcel ID: 015-231-51 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) >12 in. AT INSPECTION 8/7/13 Artesian ft 3.5 P.P.M. Collected by: Anderson Engrg. Date installed 8/7/13 Cleanouts(Y/N) Y High water alarm (Y/N) N Date installed 8/8/13 Soil rating (g.p.d./ftz or ft2/bdrm) 1.2 GPD/SF System type 5' Wide Length 58 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth 6-7 ft. Eff. absorption area 580 fe Monitoring tube Y Depression over Feld N Date of adequacy test New Const. Results (Pass/Fail) For _ bedrooms Fluid depth in absorption Feld 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 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons in. "Pump off' level at Cycles tested _ E. SEPARATION DISTANCES WELL ON LOT TO: Manhole/Access (Y/N) in. High water alarm level at Meets alarm & circuit requirements? in. Septic tank/lift station on lot > 100 On adjacent lots > 100' Absorption field on lot >1 00' On adjacent lots >1 00' Public sewer main N/A 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' SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5 Water main >10, Water service line >10' Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line >10 Building foundation >10 Water Service line >10' Surface water >100' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS House has an interior lift station which G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. Date 8/19/2013 COSA brown sheet 10-10-12.doc Absorption Feld >5' Surface water >100' Water main N/A Driveway, parking/vehicle storage >1 0, effluent to the septic tank. Municipality of Anchorage 4p t Community Development Department ° Development Services Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 131737 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 2, Lot 1 of Audubon Hills subdivision. This inspection revealed a nitrate concentration of 6.62 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. FENCE PLOT PLAN AS BUILT X SCALE 1" = 40' GRID SW 2739 Project No. 13-150 Lang & Associates, inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 (907) 522-6476 Phone oo��pp Registered Land Surveyors (907) 522-4625 Fax o� kenOlangsurvey.com / jonothanOlongsurvey.com OF ACppp4 v� •..••• ..• qs�o I hereby certify that I have surveyed the following described property: LOT 1, BLOCK 2, AUDUBON HILLS SUED. (Plat No. 77-307) * 49TH J 7 �� Anchorage Recording District, Alaska, and that the improvements situated thereon are Q.. f ......:....D 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 c KEN EfFIFpN" o easements on said property except as indicated hereon. QO c t, 0� I 'o Dated this the _� Day of /�;��•�>.— , 'Ls i;--, , at Anchorage, Alaska Q .� '•j -:?-520.•'•: yJ�O �4OpRO�s8a� It is the responsibility of the owner to determine the existence of any easements, loNn1-� pp4O00000 covenants, or restrictions which do not appear on the recorded subdivision plat. (/ MUNICIPALITY OF ANCHORAGE ~) /''~ -~' DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL ~.,~(~_ ~)/,~'~ OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address,~f~f_~ ~¢/~°r dire. ctions) (b) Applicant Name J~n ~i//~ Telephone: Home Applicant Address (c) Applicant is (check one): Lending Institution ~ · Owner/builder~ Buyer D; Other ~ (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent ~'~-&'~)")--~ /~'-~ / ~ Address Telephone (f) Mail the HAA to the following address:/' TYPE OF RESIDENCE Single-Family~ Multi-Family [] Number of Bedrooms Other WATER SUPPLY Individual Well~' Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conserv'ation attesting to the legalitY and status. SEWAGE DISPOSAL Onsite~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page I of 2 72-025 (11/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with ali Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. /',4 . Name of Firm J~"~/~'/--.-C'///L-,-.~./~r-~, f~--'~ Telephone Address Date Engineer's Seal 6. DHEP APPROVAL Approved for:,__3 · :, APpi.;Ved ..,, '/ Terms of Conditional A~Proval bedrooms by ! Disapproved Conditional CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) MUNICIPALITY OF ANCHORAGE (MO/~/ HEALTH AUTHORITY APPROVAL (HAA) MUNICIPALITY OF ^N£HORAGECHECKLiST . FEBRUARY 1984 ENVIRONMENTAL SERVICES DIVISION 264-4720 ,/~[/G ~'~']987 Legal Description: WELL DATA Well Classification Well Log Present (Y/N) ! Total Depth T¢~' Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N} Separation Distances from Well: To Septic/Holding Tank on Lot RECEIVED F~~; /~-~ If A, B, C, D.E.C. Approved (Y/N) /~ Date Completed //~,'//~'~--- Yield Cased to =~./ ~, of Grouting '/'~/~7/4 2¢¢2/, ~r~_~ Pump Set At · ~'~, / Sanitary Seal on Casing (Y/N) ~' Depression Around Wellhead (Y/N) A/ ' On Adjoining Lots To Nearest Edge of Absorption Field on Lot ¢~'!~-'~ · On Adjoining Lots ,~./E:~::¢2 / To Nearest Public Sewer Line ~~' To Nearest Public Sewer CleanouVManhole ~%~ To Nearest Sewer Service Line on Lot ~ Water Samnle Collected by ~ J~ ~~. 'Date ~/~ ~ Water SamPle Test Results ~~~~%~ ' ~ -- ~ , Comments ~/~/~ ~// ~ ~~ ~~~~ __ ~ ~~., { {/ I B. SEPTIC/HOLDING TANK DATA Date installed ~//~/'¢~ ~__~ Size /~- ~'~2~ No. of Compartments ,~ Standpipes (Y/N) F Air-tight Caps (Y/N) ~ Foundation Cleanout (Y/N) ~ Depression over Tank (Y/N) ~ Date Last Pumped ~/~ 7 Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) ,/~J2/~ .for /~',/~' Temporary Holding Tank Permit (Y/N) ~'/~~/Z~c' Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line To Water Main/Service Line Course To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed "~/~--~Z//~ Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation ¢~'- ,-~ / Lot To Water Main/Service Line ~:~i~ Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) , D te of Last Adequacy Test / To Property Line To Existing or Abandoned System on 'On Adjoining Lots ~----~'~/--~' FI~LP To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course ~/'~ To Driveway, Parking Area, or Vehicle Storage Area Comments ~~~ ~ ~~ ~ '~ ~~. ~~ LIFT STATION Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Date Installed Size in Gallons "Pump On" Level at,~~'~L High Water Alarm Level Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) ~/ Comments ///~ ..~:~¢_.Z.// ,.~.~,_.~____~_~. ~'~_~-~'"~.,¢~P ~ ~/~~. Check Per~d Bedroo~ng Against HAA Request ~ ¢¢~~~. ~ I ce~ify that fled, or conformed to all M A ~.nd HAA guidelines in effect on the date of this inspection. Signed ~~~e~ :~ ~~ , ~ ~te ~ .ece . .o. //0 dOC Date of Payment ~ ~~ A ou,t: $ / ¢ Page 2 of 2 72-026 (11/84) & associates,inc. Consulting Engineers 4790 Business Park Blvd. · Bldg. D · Suite One · Anchorage, Alaska 99503 · (907) 561-6151 August 13, 1987 Municipality of Anchorage Department of Health & Human Services 825 "L" Street Anchorage, Alaska 99502-0650 SUBJECT: LOT 1, BLOCK 2, AUDUBON HILLS SUBDIVISION Gentlemen: On this date we certified that an additional stand installed on the septic tank by Acreage Systems, Inc. performed as requested by Mr. Dan Roth of your office. We trust that this will take care of any concerns and the required information for final approval of the authority. Please let us know if you have any questions. rlry trul~ yours, /CE~RW, IN &! A~SOCIATES, ~ prl/Br~p~AtCorwin, P.E. INC. MUNICIPALiTy DEPT. OF ENVIRoNI~EN7 RECE. IV£ D pipe was This was provide health C1 r^ n 'HEMICAL & GEOLOGICAL LABORATORIES OFALASKA, INC. 5633 B STREET ANCHORAGE. ALASKA 99518 TELEPHONE (907) 5622343 FEDERAL TAX ID N 920040440 RMYSIS RMRI BY SAXPLE Client PGt : MAL Req is Client Sr;l ID: Li, B2 AUXT71 FILLS I)M AIRS BATELQCCtf Sade Recd : AUG 3 87 Crdered By : BJC Send Reports To: CCR,'IN 6 ASSCC 479E USIAESS PI BLVD BLDG E STE I VI.2Qo?CE, Al. 99503 Special POL'T127 SAME BY BJC, 8-3-87, 1330 0. Instruct: Cheslab Pef R: 7169 Lab Snpl ID: 1 Gatriz: Yater Para -ter Tested Revilt/Cnits __-------------- —------------- -------- -------- ---- HITRATE-H 5.6 LVI Sad e ME" SWLE Remarks: A,YALYSIS C0!?LETED: 8-5-87 LABCRATCRY SJPEPVISJR: SIUMI C. EDE �! 1 Tests Performed HD= Ecce Detected HA- Not Analyzed f;/c-v II See Special Irstructlons Above eN See Sa:ple Re?a:ks Above LT=Less Than, Cl=C:eater Than York Crder No. : 2032 Client Account : CCRYIQ Date Report Printed: AUG 6 87 9 10:42 Released By : 2,yCL Reports Address 12 All (vabl e Hethod Limits 10 n CHEMICAL & GEOLOGICAL LABORATORIES OFALASKA, INC. 5633 B STREET ANCHORAGE. ALASKA 99518 TELEPHONE (907) 562.2343 FEDERAL TAX ID M 920040440 ARALYSIS REPCRT BY S.74TLE Client PCI : VVBAL Req is Client Spl ID: Ll, B2 AODOBuI BILLS ICV=AIPS BAMCLw S=ple Rec'd : AUG 3 87 Ordered B! : BJC Scrd Reports To: CC: iIN 6 A37C 4790 B21= PI BLVD BLDG E STE I Al. M3 Special 1=112 SA,'TLE BY BJC, B-3-87, 1330 M. Instruct: Chemlab Ref t: 7160 ParaLeter Tested TOTAL CCLIFcm Sacple Rczarks: Lab &-p1 ID: 2 Matrix: Vater Result/Unit9 0 col/looml Vork Order No. : 2032 Client Account : C07WIN? Date Report Printed: ACG 6 87 9 10:43 Releawd B7 : 2 Reports Address 62 Allcvable Method Limits I Tests Performd , e See Special Instructions Above ND- None Detected Of See Sac71e Pt--,rks A.Kove NA- Not Analyzed LT -Less Than, CT -Greater Tian APPLIC IT FILLS OUT UPPER HAL )NLY Proper~- G~er ~.~' 7('- L/~ ?> / ~ ~ Phone _ Zip Code Mailing Addre~ ..~,; A ~' ,~ Buyer ~j ~'//~ L ~(~ Address Zip Code Lending Institution ~ ~ A .J~ ~ 7 ~ 7~ Z: ~'~ Phone Address ~o ~ /'7,- Realty Co. & A~nt Phone Address i ,~ ~ ,.~ ,, Legal Descript~n ~ 0 T / Street Locati~ A / ~ t~ / Type of Resi~nce SingleFamily Multiple Family No. of Bedroo~ ~ Other Water Supply ~lndividual : / A~ACH WELL LOG. A w~t log is required for all wells drilled since June 1975. ~ Community For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utility1 Sewer Disposal ~lndividual Year Indiv~ual Installed: ~ Public Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time C~L_~[4 Date Date Date Date Inspector Inspector Inspe ?.~~ ~--~ Inspecto~r.~(~ · ' MUNICIPALI~ OF ANCHORAGE ~ ~ ~ DEPT. OF H~ALTH ENVIRONMENTAL PROTECTION EC iVEB Soils Rating Date ~wer Installed Well To ~sorption Area Well Log Received ~ -- ~ ~ Well to Tank Septic T~k Size 72-023 (3182)