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TELEMARK HILLS LT 3
Telemark Hills Lot 3 #015-231-89 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON -SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211304 PID Number: 015-231-89 Dwelling: ❑■ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single, Family Project: ❑ New ❑■ Upgrade Name Kay & Aryeh Levenson A ORPTION FIELD ❑ De Trench ❑■ Wide Trench ❑■ Bed ❑ Mound Site Address 11600 Moose Rd, Anchorage, AK 99516 Other Phone Number of Bedrooms Soil Rating Total depth from original grade (907)227-8779 Four (4) D/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from origina l de Gravel depth beneath pipe Ft. Subdivision Block Lot Telemark Hills 3 Fill added above original grade Ft. th !!:�Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Dist ce between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between ches From Tank Field Tank Line Ftz t. Well >100' >1 00' N/A N/A >25, TANK ❑ Septic 9 S.T.E.P. ❑ Holding ❑ Other Manufacturer Orenco Capacity 1500 Gal. Surface Water > 100' > 100' N/A N/A Material Steel Number of compartments 2 Lot Line >5' > 10' N/A N/A NA Foundation > 1 0' > 1 0' N/A N/A LIFT STATION Manufacturer Orenco Capacity 250 Gal. Remarks Existing tank was removed from site Alarm location South Exterior Wall Electrical installed by Chambers Elec. Installer Tank PIPE MATERIAL House to tank D3034. dra into N/A Northern Excavation Drainfield N/A Co/MT D3034 Inspector L. Tidwell BENCH MARK (Assumed elevation) 100 ft Inspection 15' 8/18/21 2nd 8/18/21 Location and description 3`d 4th Back sliding door threshold ON -SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp of Akl Conditional Approval: Date ��Q. '4S,lf.�,� '49 TFI *�l All '":.. r� �••, Ben)am�rfSchiller ..:� v2s/2zs2 •���``�s Septic System / Approved Date Note: this approval does not include well permit requirements. � u\ VJ/VL/ I Vi TELEMARK HILLS SUB, LOT 3 PERMIT # OSP211304 LOT 6 �r ;ems PUBLIC USE, DRAINAGE, GAS, TELE., & ELEC. ESIAT. EXISTING WELL r Lpt 2 rf ✓ EXISTING ABSORPTION TRENCHES AND ABSORPTION BED REMAIN IN SERVICE 10' T&E EASEMENT EXISTING WELL C r LOT 3 SHED �f CARPORT rAN o_ DEC MH1 MH2 PI # 015-231-89 I LOT '7 � 1 i 1 t t i' EXISTING WELL r' I %rf NEW 1500 GALLON S.T.E.P TANK 10' T&E EASEMENT rob �P• ' .'p '?�+ •, *¢�i PLAN AS -BUILT • . 0 50 100 �.•• Benja i Schiller 0 FEET I F� CE 2592 / ..vary 5,202 ; 1 =50 l\ i� PR O f E S S l ONP`4o. A B MH1 1 22.8 31.7 MH2 30.5 37.3 LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE TELEMARK HILLS SUB. LOT 3 PERMIT # OSP211304 ENGIHEE RING 88.9 J PROFILE AS -BUILT (NO SCALE) PI # 015-231-89 .......... .. ' .......... Benja ' Schiller • �CErys59zz.•.��� l��j�a PROFESSIONP�'�.o MOOSE ROAD N 88 40' 30" W 13.24 N 88 40' 30" W 8.57 I I / N I I I I I i i N 89 56' 44" W 135.50 f0'TELE. & ELEC. ESMT. ---------------- LOT 1 /V 65 T 001w -------------------------------------- S PUBLIC USE, DRAINAGE, O 3Q GAS, TELE., & ELEC. ESMT. N 89 56' 45" W 354.47 pSPN KNG pREp N.T.S. Ppr; /V GIZ'VEL N S 00, o I o' 89 56' 45" W 358.93 N.T.S. N M O co NOTE: co THIS AREA NOT DRAWN TO SCALE. SEE RECORD PLAT cV FOR EASEMENT AND LOT DETAIL. 04 O o 0 Z LOT 2 OF At 49 LH `y 'ws Ilat'l— U SHANE A. HOLT G LS-6914 0` O 4^ 14 a o Ong°fessiona\ Ls�� THE INFORMATION HEREON IS FOR THE USE OFLENDING INSTITUTIONS SPECIFICALL Y TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT, ARE NOT SHOWN HEREON (UNLESS INDICATED) NOTE FENCELINES THAT MAYAPPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE PROPERTYLINES OR POS17IONADD17IONAL IMPROVEMENTS. ANYPAVING SHOWN HEREON MAY BEAPPROXIMATE DUE TO EXCESSMESNOW AND/OR ICE N CARPORT TREXDECK gr H. 4rH. 1 1AP O 10'TELE. & ELEC. ESMT N 89056'49"W 135.41' AS-BU/L T SURVEY I" = 30' NO CORNERS SET THIS DATE ----------------- OWELL Z O CD 0 N N W O W � W Q c� / I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT 3, TELEMARK HILLS SUB. ( PLAT 85-2) ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE,ALASKA THIS _29 TH DAY OF _NOVEMBER , 2022. HOL T LAND SURVEYING 9309 GROVER DRIVE ANCHORAGE,AK 99507 9072238615 375@G0.1 11208, FB 139-52, 170-32 229-45 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite ®n -Site Wastewater Disposal System Permit Permit Number: OSP211304 Work Type: SepticTank Upgrade Tax Code Number: 01523189000 Site Legal Address: TELEMARK HILLS LT 3 G:2739 Site Mailing Address: 11600 MOOSE RD, Anchorage Owner: LEVENSON ARYEH L & KAY L Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 7/29/2021 7/29/2022 54518 ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Veronica Pope GE 2021.07.29 Received By: 13:20:12 -08'00' Issued By: Date: r� q Date: El U I PAUTY ®F ANCHORAGE ' Community Development Department r Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 015-231-89 Property owner(s) Levenson Aryeh & Kay Day phone (907) 227-8779 Mailing address 11600 Moose Road, Anchorage, AK 99516 Site address 11600 Moose Road Legal description (Sub'd., Block & Lot) Telemark Hills Sub L3 Legal description (Township, Range & Section) Lot Size 54,518 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑x (w/wo ADU) Septic Tank 7x Upgrade ❑x Duplex (D) ElHolding 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. (Signature of property owner or authorized agent) Permit/Rush Fees: 22 Date of Payment: 7/0 3 Ao 2 Receipt Number: dad Y7D Permit No. Permit App_:-:• : Waiver Fees: Date of Payment: Receipt Number: Waiver No. July 22, 2021 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 7/22/21 Subject: Telemark Hills L3- 11600 Moose Road STEP tank replacement Dear On-Site Services Engineer: The owner of the above lot has a STEP tank that is nearing its end of useful life, we are submitting this permit application for its replacement. The attached site plan identifies the location of the home as well as the well and septic location. No conflicts exist between this proposed system and any other wells or septic system, whether on this lot or adjacent lots. The new STEP tank will be a minimum of 100’ from all wells and surface water, and more than 5’ away from the deck and existing absorption field. Please refer to the attached plan for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211304, Rebecca Carroll, 07/29/21 Benjamin Schiller CE 12592R EGISTEREDPROFES S I O N ALENGINEER 1"=50' CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND TELEMARK HILLS SUB, LOT 3 FEET 0 50 100 NOTE: NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. 4-BD RM H O M E July 21, 2021 10' T&E EASEMENT CARPORT SHED DECK 10' T&E EASEMENT PUBLIC USE, DRAINAGE, GAS, TELE., & ELEC. ESM'T. 1500 GALLON STEP TANK MAINTAIN >5' SEPARATION FROM DECK AND EXISTING ABSORPTION TRENCH DECOMMISSION EXISTING TANK PER UPC EXISTING ABSORPTION TRENCHES AND ABSORPTION BED TO REMAIN IN SERVICE EXISTING WELL EXISTING WELL EXISTING WELL Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211304, Rebecca Carroll, 07/29/21 Municipality of Anchorage Page 1 of 3 Development Services Department Building Safety Division/On-Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage. AIC 995146650 www.ci.anchorage.ak.us (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM ANDIOR WELL INSPECTION REPORT Permit Number: SW01041 PID Number: 015-231.89 Ch Chuck Dotson Wastewater System: New (Upgrade) Aadrese: 11600 Moose Road Anchorage, AK 99516 ABSORPTION FIELD pro: NumbsaBedr S: 227.2228 Four 4 5'Wide Shallow Trench LEGAL DESCRIPTION Sal Rawl: Tool Depen hon ongew Wade: .6 GPD/Fe 6 Ft. Block: la: $VbeVte.orl: Depen to pipe boom from almel grade: Cms dept, beneath ppe: 3 Telemark Hills 2 Ft. 4 Ft. Town°mp: Rule: section: Fm added Bowe ong." grade: Grsw Loll,: 1 Ft. 100 Fl. Well: Existing Gravel wqm: Number d artae: Puarca between brtbs: 5 Ft. 2 15+ FL Clasa,f cabwl (Pnvate. A B. C): Tgel Depm: Lssad m: Taal absaplq area. Ppb M°te si. Fl. Ft. 1,000 Fe ASTM D3034 PVC Dr .. Dole Dnead: Slue Wats Law: maturer: Date YwaiNd. Ft. Poor Boy Construction 6112.1312002 Ywa: Resp eel at: Casal ht Above cra.td: TANK Ca WA Ft. Ft. SEPARATION DISTANCES S.T.E.P.-Existing To Septic Absorption Uh Holding blic/Private ° uf8° pitivn : Fran Tank Field Station Tank Sewer Line wall >100, >100, NIA NIA >25' erW. moo pa bnenw: surracewsler >100, >100, NIA NIA LIFT STATION - EXISTING t�tl:le >5' >10' NIA NIA Ge, , WnWacturer. Fandatron >5' >10' NIA N/A po pun, le�a a` P at, gh waters ren at. h. M. M. None Noted Pump Make l Mooel etearxal kdpepeom padomad by: c,utn Drawl Rome":BENCH MARK is mg Absorption Bed Tiedn To New bystern With 13511ave Locellbroad wig . Back Deck — Southwest Comer �Med Ll&vZW- 100.0 Ft. Engineer's Stamp gyp:•... "•w���♦i . �i,>•. Inspections performed by: Mike Anderson Dates: 1" 6112102 'fin/ s��•♦♦ 49th / \ 2"d 6113102 �_ .__ ..__ .. A.. • - Department of Okalth anjd Human Services approval 0 ......................... .................... ,i-LM'CHAEL E. ANDERSON ♦1 f i No. CE -4391 ♦� �♦ #♦♦�,Tfow Reviewed and approved by: Date: Municipality of Anchorage Page 2 of 3 DEVELOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK 99519-6650-343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit NumberSWO10445 PID No. 015-231-89 .t/8 •$%'4'411 /o'TL`tEcorlM. }fECEc7: E4s�r7c�r/" Vhf well Q ' La7-3 3tF4. /A7 A B M1 58.3 77.8 M2 77.6 92.8 CV1 69.2 75.1 CV2 70.1 75.9 Four ` pRMEL Bedroom Homer LEGEND CV - Control Valve M - Monitor Tube TH -Test Hole h Existing 1,500 . Gallon STEP Tank M7 TF12 1 e TIII IN lV M2 TIIA CV2 CVJ N N Q.. Q Existing O Bed Q !/O'T2lZeccp I j•iELe�e� 6AstMl�M 13S. so . ao 00 49th '...i.,. i.w , MICHAEL E. . ANDERSDR. S - °,L No. CE -4301 .��� Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number. SWO10445 N 11 U N N S N s 92.8 Existi 1,500 Galton S.T.E.P. Tank Drain Field Rock 50' NORTH ABSORPTION TRENCH 1 Page 3 of 3 PID No. 015-231-89 V PVC 15 - 31W Orifices 3.3' Spacing Droinfield Rock �i99.1 1'PVC 15- 318' Orifices @ 3.3* Spacing 49th 50' WCHAEE E. ANDERSON 4 fjt. No. CE -4381 li SOUTH ABSORPTION TRENCH �aarr :S:.���• PROFILE AS -BUILT Scale: 1-= 10' ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) MEMORANDUM DATE: June 26, 2002 TO: Dan Roth —/� FROM: Mike Anderson, P.E. 7•' l90�, SUBJECT: Lot 3, Telemark Hills Subdivision Septic System Upgrade Permit No. SWO104AW 4t Attached is the as -built of the septic system upgrade for the subject lot. The location for the upgrade was moved when it was found a "bury hole" had been placed in the area designated for the alternate site. This information was discussed with you on June 12 via phone call and approval for the move was verbally given. The location for the upgrade was then changed to that shown on the as -built plan. Soils encountered in the area were much different than those represented in the test hole log prepared by Arctic Slope Consultant Group in 1993. We found silt with some sand to depths of 16' below the surface. No poorly graded sand was found anywhere on the property. We therefore redesigned the system for the slower soils and deepened the system to a total depth of 6' below existing grade. A test hole was placed to determine the groundwater level. None was found during the excavation, but it rose to 12' below the surface during the monitoring period. This was still nearly 6' below the bottom of the trench. The Arctic Slope test hole indicated groundwater at 11' below the surface, which would be 5' below the bottom of the trench. The existing bed was tied into the new system with two ball valves as shown on the as - built. Please review the attached information and let me know if you have any questions. 0 ARC:[C SLOPE CONSULTING CROUP. 1NC. --- • ArcnitKts • SdrnUtls . SwKYa� �.r.w• rrr r.fuaoa trw.- no+t ao-a.« he pert a« -«u SOIIS LOG - PERCOLATION TEST pERFORMED FOR LEGALDESCRIPI F DEFM 1- 2- 6. 6- 7 6- 7- 9 -7- 9 to- .11- 12- 13 - 14. tj o- 11-12- n- 11- t3 - 16- 17- th - 19- 20 - oL SP P4--r-k-- 5 p erk 5P 1 h SLOPE, DATE PREFORMED: 9: 2 e w aN S WAS GROUND WATER L ENCOUNTERED? IF YES. AT WHAT DMR? �i.�-�- P DWA to WSW A/Ba,,, /� 8 bloBtmin6t� a1e . Otwa Na DrP+h to Na Drop .. nt Rsadf Date �T-uoa � TLae S -Or i 1:10 7 3 25 llo a S iS s i _ . .. 115 p (roiaewfiech) pFRC 110LE DIAMETER pFRCOLATwN RATE '1 'o I TFST Al1N BETWEEN FT AND FI GENTS - 1 . CF aWy THAT THIS TEST WAS pptFoRmED 1 pERFORMED BY: A.W CCCRDANCE,tVTTN - STATE AND LtUNICB'AL GUIDELINES WEFFECT ON Tl{]S DATE DATE: 7 Municipality of Anchorage Department of Health & Human Services 825 L Street, Anchorage, AK 99502-0650 SOILS LOG - PERCOLATION TEST Performed For. Chuck Dotson Legal Description: Lot 3. Telemark Hills 1 � OG/0L 5 ML 6 Silt with 7 Sand 8 9 10 11 12 13 14 15 Bottom of Hole 16 21 Was Groundwater Encountered? No If Yes, What Depth? Depth to Water After Monitoring 13' Date: 6/19/02 Date Performed: SITE PLAN See Site Plan oe„e�Cs\i>tl OF ,q �gSd40 491H A\ NJCNA=L E. ANLERSC4;,moi, CE -4331 •:�� • v .y ��PROEESSlO�eoo Perc. Rate: MinJlnch Perc. Hole Diameter. Test Run Between Fl. and Ft. Comments: Test Hole Placed to Check for Groundwater Only. Performed By: Mike Anderson. I, Michael E. Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Dale: 6/26102 Municipality of Anchorage Department of Health 8 Human Services 825 L Street, Anchorage, AK 99502-0650 SOILS LOG - PERCOLATION TEST Performed For Chuck Dotson Legal Description: Lot 3. Telemark Hills SLOPE North 1OG/OL 27 ML 3 TESTHOLE NO. 2 4 Silt 5 with Sand 6 Bottom of 7 Trench South 11 12 13 14 15 16 17 18 21 Was Groundwater Encountered? No If Yes, What Depth? Depth to Water After Monitoring Date: Date Performed: SITE PLAN ee.,caos�ti1 "* _ 491H MICHAEL E ANDERSON : 4 CE -4331 6/12/04 01l rfssi �0',�o See Site Plan Perc. Rate: 30 MinAnch Pem. Hole Diameter. 8' Test Run Between 4 Ft.and 5 FL Comments: Test Cavity Presoaked Prior to Percolation Test. Performed By: Mike Anderson. I, Michael E. Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 6/26/02 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade /2-02 (off/->/bz Gi ! 2:30 q (D:30A« Date Issued: Oct 22, 2001 Expiration Date: Oct 22, 2002 Permit Number: SWO10445 Parcel ID: 015-231-89 Legal Description: TELEMARK HILLS LT 3 Design Engineer: 0014 Anderson Engineering Site Address: Owner Name: Chuck Dotson Lot Size: 54518 SO. FT. Owner Address: 11600 MOOSE ROAD Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE. AK 99516-2477 This permit is for the construction of: U Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 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. A 12 ft. deep test hole shall be dug at the time of installation. Determine if the ML layer is permeable and monitor for groundwater. Verify integrity of existing septic tank. (o////OZ iffN6iA'L1ER SA/p SO/ZS SIRE TibNr6R TIsE�v OR/Ghveyt PAX C. iNlrJ wan.Ts 1c A�uO EEStbrN TO li f r AMP f `rJtwtcRo[k ! Z —So "L rxEn+C*,r WILL Go '4NeW Sol Lf re.,r 1 L"A Mic AvANlrViT. 1 S 14' R pLiew. faR PRL-fty, Received By: Issued By: 011lJ&1A,*L J -Ort LIP 1'-CJT*Y6,4E 2 A10 6000 pit /T Date: Date: ZL 0 FAX MEMO TO: Dan Roth WITH: MoA/DHHS FROM: Mike Anderson DATE: June 11, 2002 SUBJECT: Lot 3, Telemark Hills Subdivision SW0104451Septic System Upgrade MESSAGE: We originally planned to place the new absorption system where it was shown on the permitted design completed by Cary Meyer In 1993. Unfortunately, this area was used to dispose of the vegetation on the lot We therefore want to move the system over by his Test Hole No. 1. Our test hole Indicates a much saltier material with a slower percolation rate. We are proposing to place 2 new 5' wide trenches with 4' effective depth and a total length of 100' (50' each). The total depth of the trenches will be ti.5', which will provide 4.5' separation from the water level found in his test hole after water monitoring. Let me know If you have any questions. 1 Pages Being Transmitted. Please call 522-7773 if there are any problems. 1/1 'd 90L1'ON NVCO:L ZOOZ 'il,unr Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 015.231.89 Permit Number SW Property owner(s) Chuck Dotson Day phone 345-7523 Mailing address (1)11600 Moose Road Anchorage, AK 99516 Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) Lot 3, Telemark Hills Subdivision Legal description (Section, Township & Range) Lot Size '5q 6-191 Acres q.Ft. THIS APPLICATION IS FOR: Number of Bedrooms Four Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 1 certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: Waiver Fees: Date of Payment: ° 0 Date of Payment: Receipt Number: I ' Receipt Number: (Rev. 12/00) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) October 16, 2001 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 3, Telemark Hills Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: A permit was issued for the construction of a septic system on Lot 3, Telemark Hills Subdivision on August 10, 1993. The alternate site was designated at the time of the design and subsequently approved by the City. Recently, an adequacy test performed on the primary septic system failed and the owner must upgrade the system to obtain a Certificate of Health Authority Approval. We are therefore requesting a permit be issued for the upgrade of the septic system at the location of the alternate site as shown on the original permit issued for this lot. The new system will not be a bed system as originally designed, but two 5' wide shallow trenches. The attached Site Plan and backup documentation identify the location and configuration of the new absorption trenches and the parameters used in the design. Also identified on the plans are the location of the existing absorption bed and well on the lot and the test hole location for the new site. Existing drainage patterns are shown and will not be altered by the development of the lot. Two test holes were originally placed near the location of the primary and alternate absorption systems. These test holes indicate well graded to poorly graded and with silt. Percolation tests in the material resulted in rates of between 7 and 8.6 minutes per inch. Groundwater was found during the placement of Test Hole No. 1 at 11', but none was noted at Test Hole No. 2. We are constructing the new absorption trenches around Test Hole No. 2, but will use an estimated water table of 9'. The total depth of the trenches will be 5' below the ground surface. The distribution pipe will be placed at 2' below the ground surface. Mounding over the trenches will be accomplished to provide a minimum of 3' of protective cover. Each trench will be 44' in length for a total length of 88'. Ball valves will be placed in the transport line from the lift station so effluent may be switched from one absorption system to the other once the existing absorption bed is regenerated. The ground surface on the lot slopes as shown on the attached Site Plan with very little to no slope near the proposed septic system site. The new absorption trenches will be constructed on a fairly flat surface in conformance with Municipal requirements and parallel to ground contours where possible. All components of the new septic system Lot 3, Telemark Hills Subdivision October 16, 2001 Page Two will be constructed 100' from wells 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, �, 7 r W'. L Michael E. Anderson, P.E. Attachments s. V. '!"Q. tK7y U.fL •'•T iiD ,'... ✓ �. AS:cwa E. f'!"DE2X-.N �• c LE -4331 <`v' C4Vy�`eo P OrE.... �°y + B ' �$ZiG'.:a�'o 8 'S(o 44 mss✓ /3.5.5'0' � ® tt 0'1 h ExWelI t�q h Existing 1,500 Ga lon STEP Tank Tee In Line Wit -Ball Valves On Each Leg. P Ovide Access To Surface Existing Absorption,N SN Bed �1 , �TB2 2-4 Long X 5' Wide 3 NEffective Depth O DAbsorption Trenches i 10 1/o'TZ2lFCOHM• i�l�c� F11acMCM-: ? . ,,; '=� - - � � t 491H ;�',"+ SITE PLAN . `714 �••A •. HCHP..L E. AVCEnSCN r 'O fc SCALE 1" = 40' t 0 ., : CE -4331 �� p 0`0' t Lora m Q N � -- 0 Four 3t • - �v,,,,cx Bedro �•" Isom Moose Road --- h Existing 1,500 Ga lon STEP Tank Tee In Line Wit -Ball Valves On Each Leg. P Ovide Access To Surface Existing Absorption,N SN Bed �1 , �TB2 2-4 Long X 5' Wide 3 NEffective Depth O DAbsorption Trenches i 10 1/o'TZ2lFCOHM• i�l�c� F11acMCM-: ? . ,,; '=� - - � � t 491H ;�',"+ SITE PLAN . `714 �••A •. HCHP..L E. AVCEnSCN r 'O fc SCALE 1" = 40' t 0 ., : CE -4331 �� p 0`0' t LOT 3, TELEMARK HILLS SUBDIVISION DESIGN FACTORS: Four Bedroom Home Pere. Rate: 8.6 MinAnch Application Rate: .8 GPD/SF SYSTEM REQUIREMENTS: 5' Wide Trench System Existing 1,500 Gal. STEP Tank 3' Drainfield Rock 4 Bedrooms X 150 GPD /.8 GPD/SF = 750 SF of Absorption Area 750 SF/5 LF (Width) -.58 (Red. Factor) = 87 LF Trench Length Therefore: Construct 2 44' Long X 5' Wide X 3' Effective Depth Absorption Trenches. Flowline Elevation in Trench to be 2' Below Original Ground Surface. Total Depth to be 5' Below Existing Ground. Mound Over Trench to Provide a Minimum of 3' of Cover or Provide 2" of Direct Bury Insulation and 2' of Cover. Place Ball Valve Outside Existing Lift Station and Tic Existing Absorption Bed Into New System. 1.5' .5.. 3.0' `Natural Backfill .(3' Minimum,)-- 5.. Geotextile.Fabric . 1" PVC. (Ilole's Down) Drainfield'Rock Hole Spacing — 3' Hole Size — 3/16" Total Holes — 30 TYPICAL WIDE TRENCH SECTION (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. f Minimum 4' Separation From Groundwater. �` �F•' Minimum 100' Separation From Wells In the Area. ... CE E4391EcscN.:� PRESSURE DISTRIBUTION CALCULATION Elevation at Highest Discharge Point Pressure at Highest Discharge Point Liquid Level In Tank (Elevation) Diameter of Holes in Distribution Line Diameter of Distribution Line Hole Spacing In Distribution Line Length of Transport Line Diameter of Transport Line O =12.4d YFi = 12.4(.1875)(.1875) W— .9748 GPM/Orifice _ .9748 * 30 = 29.2 GPM TDH = (130-115) + .0192(29.2)(29.2) 15 + 16.4 35 Therefore 30 Orifices @ 3' Spacing 125' 5' Head 115' .1875" (318") 1" 3' 50' 1.5" 1.bs' + .000995(29.2) (50) (1.5)Y.e7 + 3.6 M104A EL E. ARDERX-4 . ca p� �� GE -4391 ���� O ARcI c STAPE CONSULTING CROUP. INC. -- { Circ n • ARnR.eu • $cl�nlhla • Sv`R7�" 34 Nfu-aW iw- luPl M -nu /s Mn IS BOAS LOG - PERCOLATION TEST poUvRKM FOR L WAL DESCRIn 0WDU'PLH MMEm t- s- .. s- 6- 7- 9= to- 11 - o -It- u- u - N Is - l6- 17 - Is - U- 20 - oL SP 5 p 5P vgpa.+C r ML EA+D h SLOPE 3 MPREFORMED.�1% - w AN WAS (ROUND WATER ��. L DP YES. AT WHAT DEF:H7 8 DIP& a wast Alkt Mooltmintt %—�' Dm - Gm./ .. NO M,f N« Na Tb" DM --6` p (mi�sut/�aclJ MC HOLE pMCOLATION RATE I / , FC mcI RUN EE[W6EN �F[' I v COhOAEN'" / CMTIFY nTAgT THIS TEST WAS PpLFORMED PERFOLtMFD 8Y: ACCORDANCE WRN ALL STATE AND A(UNICLPAL GUIDEUNFS W EFFEC[ ON TIDS DATE DA . ��4Elgk-! yT.oHB CCpIgULTt7►C GROUP. INC. . Archiel • Seuetl*" • Sur�Y�i OM 7N-•it7 SOIIS LOG. PERCOLATION TEST 2- 4. - - a- 7- f- 9 t2 - a- 14- u- I6- 17- if - 19- 20 - COl,4dum PERFORMED BY: ACCORDANCE W Perk Nt L E14D h SLOPE4) DATE 3 WAS�N WAXER L 0 1P YE4. AT WHAT VMM" P Depth 10Wow AA- O.ts i-1 -193 8 .ye,iy7 neo l?ecv0.1oW a '' II nw pMCO1AT10N RATEV • t= t°" "�,�',•� -". - rccenumEEIv=u�-+�-�AND FT .r WAM / Cm17FY THAT THIS TBT WAS pU"RMP.D 7 C!F- ALL STATE AND MUNICIPAL GUIDEUNB IN EFFECC ON THIS DATE. DATE: C-43 — Municipality of Anchorage — Page of — DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 a Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW X50? BSL PID Number: e Name: Ct2 "P lc(er-s Wastewater System: New ❑ Upgrade f Ott' r- .54o� u, n Address: I -15 1y Snoc.00rCS-'f_(©r� ABSORPTION FIELD Phone: No. of Bed ooms: � — ❑Deep Trench ❑Shallow Trench ❑Bed !31 Mound ❑Other LEGAL DESCRIPTION Soil Rating; Total Depth from original grade;, O GPD/Sq.Fl — Lot: Block: hdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe DI Township: Range: r� Section: Fill added above original grade: Gravel length: 50 Ft. WELL: New ❑Upgrade Gravel width: �'r Number of lines: Distance between lines: K FL W Ft. — Classification (Private, A,B,C): '?r-- Total Depth: Cased To: I Total absorption area: —1L Pipe material: 1 00. +(.' Ali Z- Ft. Lib Fl. lZOO SD. Ft. 1'/4 PVC- UGDriller: Driller: 1 Ir,P prllltn Dale Drilled: a z� Slatic Water Level: s z FL Instay�r: Her S •'+em Date installed: 0/1 �rIg3 Yield: Pump Seta : ' 1 Casing Height Ahove Ground: TANK GPM Hip Ft. z. Ft. SEPARATION DISTANCES -- —_ ❑Septic El Holding ?�S.T.E.P. _ To From Septic Tank Absorption Field un Station Holding Tank Pubtic/Private Sewer Linos Ma/tJ��Ifacturer:.J1w f -}NC 1 �' Capacity in gallons: Well .fe Material: e- e- Number of Compartments: /OD I D0� 100 -- 100 Surfac Water 100 ~ 100 106 IOa� LIFT STATION Lot —Size 10* y5+ IG7+ in gallons: Manufacturer Line -50 00 r- o�� Gn _ Foundation 15'F' 77 qO� •J �O'I' "Pump on" leie�:.l Pump off" le`v�e8a1:/r 1" High water ate at: Curtain Drain ...� loo -I` I00 4- 100 '- .{- 100 Pump Make B�Model Electrical l�tspeclions per form by: �� O.�1®�S' 4I'Ae Remarks:,, 1��(%- MCI rk I�to <tM4— BENCH MARK ^II,`� I Location and Description: g c.k. u) —_�— Assumed Elevation: I I to FL ENGINEER'S SEAL Inspections performed by: Dates: 1st--- DtOs °. .moa.. aaoaaaaaa uue l' .aa. z 2nd — Otto .00..... no Gwf<+r ®®� 1. y S. Mey # 3 ����F� Department of Health and Human Services approval a•a,7"q Reviewed and approved by: _J oIPTQ1— tA1174 Date: I A:<`" 72-013 (flee. Won) MOA 25 Permit No. SW 930282 1 of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519--6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description T. 12 N, R. 3 W, SEC 23 SM AK. PID No: 015-231-89 LOT 3, TELEMARKHIL USSL B D LOT 6 LOT 7 .y, o io' *Ruauu a aLc csur. LOT 3 TELEMARK HILLS LOT 1 LOT 4 PROPOSED MFIL IOC. O 20 PUfiIICUSE OPN C. GAS raFCWM X RLC. Mr. JW�� o5LOT 2 �0'rRLCOYM, a Eac EW, SITE MAP =too ASBUILT BM A BM B NTS -r,Q C I _- wk"g 109 110. OF, q�gtlly 9th A •• Care • Meyer P — 3 /3I 24i4�1 tll 11 ESS IO/p1���` Permit No. '�',1A1 Q ()?RQ 1 of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343--4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description T. 12 N, R. 3 W, SEC 23 SM AK. PID No: 015-231--89 I.OT 3, TELEMARK HILLS SUB LOT 6 10' 1ELECOI!N. h 11C "I". - LOT 3 TELEMARK HILLS LOT 1 Iwwnn IM Loc. O oss. oxvc, cns I& �nccaiuce acc. Esur. _�- LOT 2 5I S' - moo• u ELEc esur_ SITE MAP =loo, LOT 7 ASBUILT BM A BM A BM B BM B SW Cr) r-rr2P Ld 0 g' 29' — C.O.-- N 29' N 31 h C.O.— .O.C.O.-- C. O:_ LIFT STATION LIFT ENLARGEMENT NTS Permit No. SW 930282 Page 2 of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone:343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description T. 12 N, R. 3 W, SEC 23 SM AK. PID No: 015-231-89 LOT 3, TELEMARK HILLS SUB 20' PUBLIC USE, DRNG, GAS TELECOMM & ELEC. ESMT. LOT 2 L}5 9� 51.5 29' C.O. \ o. TFT STATION rn -u P IZZ L TZ15�— 3(3 roP l24° _SYSTEM DIM. 24'x5C of e � T 10' TELECOMM. &ELEC ESMT. SEPTIC SYSTEM PLAN VIEW 1"=50' NOTES 1. CONTRACTOR TO VERIFY MIN. 50. FOOTAGE PRIOR TO PLACING TOPSOIL_ 2. CAUTION SHALL BE TAKEN TO MINIMIZE REMOVAL OF EXISTING VEGETATION OUTSIDE OF SEPTIC AREAS. 3. DISTURBED AREA SHALL BE SEEDED TO PREVENT EROSION. 4. NO WELLS. SURFACE WATER, OR CURTAIN DRAINS WITHIN iOD FT OF NEW ABSORPTION SYSTEM. 5. SYSTEM TO BE INSTALLED A MINIMUM OF 10 FEET FROM PROPERTY LINE. 6. ALL CONSTRUCTION SHALL CONFORM TO M.O.A. A, D.H.H.S. STANDARD SPECIFICATIONS. Z. CONTRACTOR TO VERIFY 100' MIN. SEPARATION FROM ADJOINING WELLS PRIOR TO EXCAVATION OF SYSTEM. 6. BUILDER TO VERIFY FINISH FLOOR ELEV. 15 SET SO PROPER SLOPE IS ASSURED TO SEPTIC TANK. X28 l SG1 C �Ner o •>C � mn liPc-lC BMA IBM A EL -121 _ BM 8 BM B EL=12B "�� OF • •A��III/1 4..th / ... .th / �.... ...... . .i Car S. Me /j FG) '. // 63I$$I3 ?��= I�I�3. •'CliJr� O\Teti z'rmit No. SW 930282 Page 2 of 3 MUnicipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone:343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description T. 12 N, R. 3 W, SEC 23 SM AK. PID No: 015-231-89 LOT 3, TELEMARK HILLS SUB'D I 1i l to 5 (I 20' PUBLIC USE, DRNG, GAS 0 no TELECOMM & ELEC. ESMT. -v o0 ^ i Q pU W / II dO In 111 /I '� C. 0. Inv 1100 1 —.// � , IFT STATIONToP EI•\ 1 a•� LOT 2 F.@IA tri 1042 (ou4le+) Nc, Tap 17..i T 2 5 30 (JTop IZ4� 45 I Y ��• s SEPTIC SYSTEM PLAN VIEW 1"=50' NOTES 1. CONTRACTOR TO VERIFY MRN. SO. FOOTAGE PRIOR TO PLACING TOPSOIL. 2. CAUTION SHALL BE TARED TO MINIMIZE REMOVAL OF EX151ING VEGETATION OUTSIDE OF SEPTIC AREAS. J. DISTURBED AREA SHALL BE SEEDED TO PREVENT EROSION. 4. NO WELLS. SURFACE WATER. OR CURTAIN GRAINS WITHIN 100 FT OF NEW ADSORPTION SYSTEM. 5. SYSTEM TO BE INSTALLED A MINIMUM OF 10 FEET FROM PROPERTY UNE. G. ALL CONSTRUCTION SHALL CONFORM TO M.OA. & D.H.H.S. STANDARD SPECIFICATIONS. Z. CONTRACTOR TO VERIFY 100' MIN. SEPARATION FROM ADJOINING WELLS PRIOR TO EXCAVATION OF SYSTEM. 8. BUILDER TO VERIFY FINISH FLOOR ELEV. IS SET SO PROPER SLOPE IS ASSURED TO SEPTIC TANK. --10' TELECOMM. & ELEC ESMT., -1-28 $l Sj1J C,-NGr 94' FAa, 4- jpeCk AgSBUIt "l 1l6 BM A BM B -E OF q�glllry 1 r Alt '49th•COT) s. MCy •••� 22jI�L�'. 63 3 ••\���� it 111 l)\Pf?O\\ \SO\\\` Permit No. SW 9302 3 OF 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Felephone:343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description T. 12 N, R. 3 W, SEC 23 SM AK. PID No: 015-231-89 LOT 3, TELEMARK FALLS SUB D ---MONITORING TUBE 3'MIN. COVER EI-Izl 7777777� SEPTIC ROCK L ILO Fe I -- SEPTIC SYSTEM PLAN VIEW TYPICAL TORIZ I' =40' VERTICAL 1"=4' AS B U I LT ASSUME EL. 2t3o SPIN 6' ABOVE EXISTING GROUND IN OR FLAMED UIRGH MOUND TOPSOIL L)wr'"l C.nSt. TO ASSURE POSITKIE DRAINAGE 1-1/P' DIA, PERFORATED PIPE CLEANIOUTS FINISH GRADE EXISTING GR EXISTING EL. 123 121 —12" 120 OF ......... . q's, 49th .............. . .... ...... ..... .. ..... LOCATION OF NEW 1500 GALLON Cal S. May 0: STEP TANK C 6M53 ABSORPTION SYSTEM PIIQFILE Ito 11 "ROFESS 0" LORIZ 1"-20' VIRFICAT 1' —10' Permit No. SW 930282 3 OF 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone:343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description T. 12 N, R. 3 W, SEC 23 SM AK. PID No: 015-231-89 !. 24, SEPTIC SYSTEM PLAN VIEW TYPICAL HORIZ 1"=40' VERTICAL 1"=4' ASSUME EL 130. SPIKE 6' ABOVE DUSTING GROUND IN 2'ON RAGGED BIRCH Oe54rayed Dur,N9 Cnnsi: lnlel g El. 1101 LOCATION OF NEW 1500 GALLON STEP TANK ABSORPTION SYSTEM PROFII F HORIZ 1"=20' VERTICAL 1"=10' ASBUILT MOUND TOPSOIL TO ASSURE POSITIVE DRAINAGE —50' o.•I 5' EXISTING EL 123 49th Imz 7 - qS>9 / i ........... ........ ........ CO S. Mey r CT C 6353 .' Q Ito pROFESS`1`0N�� �� GKAIIEt. RDA➢ I _ I ''TELE�MM. �E'LEG7' E�45EMEN7" Z-07-9 EXISTING BU/LD/AJCV GRAVEL DRIVE /SrE OEjA/L Fole 1 l SLLC�. O/ME/JSIO.V,9/ 51.0 s' SEPTIC \J FIEL p V N 0 o I/o'T�LECoMM•!�� /x239056'49"IV 55.9' N 13 m 11 N N 0 E4SFMEN7' /35. so i ���} /L H Z N EXI STI NCS by M BUILD INb ,In N V4 kc yy\\ z• cANr_ p� 24= 41O- N 1 log �, cAN r. d B° PORCH N O GKAIIEt. RDA➢ I _ I ''TELE�MM. �E'LEG7' E�45EMEN7" Z-07-9 EXISTING BU/LD/AJCV GRAVEL DRIVE /SrE OEjA/L Fole 1 l SLLC�. O/ME/JSIO.V,9/ 51.0 s' SEPTIC \J FIEL p V N 0 o I/o'T�LECoMM•!�� /x239056'49"IV 55.9' N 13 m 11 N N 0 E4SFMEN7' /35. so COPHERNSIUM LUILLER'S 507345E+5t39 P.OG C INSPECTION REPO". i'+IIoll- IFnLITY OF ANCHURA(3k:, BUILDING 'inFETY DJY3 ION A" ' TIIIIAR RDAX'I 3600 (: a l E I. % "07)5" In,lS.g f.Nl'IJkrtA'I''LiiN (S70'Y )'%r r.,...,,'t'l) INSP. _.. ., PERMIT 0! 95-065� NAMI % SAl EWA{ (;1 EC.1 PHONE 7: 561-0651. ADDRESS: 11600 MUSE Rl'I LOT: 3 Xs1.l1Ch; SUED: TliLEMARK LIAS'E: 1,'; E"s/.l'1'.' COMMENT t ---------------------------—-- _.... . 'CYPC? UA' fn Pliil:a'.Tf.IN:: ELECTRICAL FINAL 0 0 0 0 LXI bIU NONCOMPLCANEi OBSERVED �.'_I CORRECTIONS kA ENTIAL AS I' :I WILL IREUXAMTHE AT NEXT INSPECTION f '1 Do NOT CONCEAL UNTIL REINSPE(- V211 DATT:;:------------------ 1 I al,Ilt'N CURPE(E T IONS ARE MADE, PLEASE CALL is nR INSPECTION MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW930282 DESIGN ENGINEER:ARCTIC SLOPE CONSULTING GROUP OWNER NAME:CORNERSTONE BUILDERS INC OWNER ADDRESS:17510 SNOWCREST LANE ANCHORAGE, AIC 99516 PARCEL ID:01523189 LEGAL DESCRIPTION: TELEMARIC HILLS LT 3 LOT SIZE: 54518 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 8/10/93 EXPIRATION DATE: 8/10/94 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASICA 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 343--4329 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: GROUNDWATER DEPTH HAS BEEN ADJUSTED UPWARD FOR SEASONAL VARIA7.'ION. THEREFORE, THE MAXIMUM TOTAL SYSTEM DEPTH SHALL BE 4 FT .�j RECEIVED BY: DATE: ISSUED BY:Xul(Altkvw4jDATE: V �� ASIC €"oft,K V"iHAfVi) ENGINEERS • ARCHITECTS • SCIENTISTS • SURVEYORS July 21, 1993 Mr. Dan Roth Municipality of Anchorage Dept. of Health and Human Services 825 L Street Anchorage, AK 99501 Re: Septic System Design Lot 3, Block 0, Telemark Hills Dear Mr. Roth: Attached is the permit application for installing a septic system on the above referenced lot. Below is a narrative of probable impacts to adjacent properties. 1. Adjacent Wells - There are no existing wells within 100 feet of the proposed new septic system. 2. Adjacent Wastewater System - The proposed bed absorption system will not adversely effect the future sites on the surrounding lots. (?XIC o rferrd 3. Reserved Spare - The soil conditions on the lot meet EPA standards. There is enough room for a future system to the east of the proposed system. 4. Drainage - Positive drainage away for the field will be maintained. No concentrated surface water will be directed toward the field and no existing streams are within 100 feet of the proposed field. The installation of this on-site system will have no probable impacts to adjacent well or septic systems. The proposed system's separation distance radius will include parts of adjacent lots, but will not interfere with the on-site systems on these lots. Very truly yours, Carey S. Sr. Civil CSM:KL: CC: 11100026.059 301 ARCTIC SLOPE AVENUE, SUITE 200 • ANCHORAGL, AIASKA 4Q51N-:1035 (907) 349-5148 • FAX (907) 949-4913 �Ym•.aus.•:.....ar=a...�....a--..... �r�V�lLI`y�'l ...... fall ... e��� 3ANQ an 0. e , JL 20 ' 93 10 :20 Hin .00I P . 02 YYpuB — — Y}IYII � 1 � ianAaan � q 'tW I G M1 g J r� Y (�I V.OR VA 10 r I i J System Calculations for LOT 3, TELEMARK SUB'D Tank Size 1250 GA N TANK REQUIRED Absorption Field Sizing Using an acceptance rate of 0.5 gal/SF/day and a daily load for 4 bedrooms of 600 gal/day. ASCG Calculations 29 -Jul -93 Paae 1 of 2 Req'd Absorption Area = 600 gpd / 0.5 gpd per SF = 12.00 System Dimensions 50.0'X 24.0' = 1200.0 SF The laterals are to be spaced 6.0' apart and 3.0' from edge of the bed. it f U J Car S. Me/o ,=t c ci�,S V 353 Vit. �(i0P[ifi\�'. System calculations for LOT 3, TELEMARK SUB'D Flow Calculations ASCD Calculations 29 -Jul -93 Page2of2 Use 1.25 inch perforated pipe with 0.25 inch holes at 4.0' on center. Flow per 0.25 inch hole at a system head of 1.1 ft = 0.77 gpm 0.77 gpm/hole * 11 per lateral * 4 laterals = 33.77 gpm Pump Head Loss Calculations Pressure Head in Field 1.085177 ft Elevation Gain (Lift Station to Field) 10 ft Head Loss in Transmission Pipe 0.46 ft Minor Losses (30% of Field Head) 0.325553 ft Required Head Addition by Lift Stat! 11.87 ft Pump Sizing The lift station must pump 33.77 gpm against 11.87 ft of head. Curve for S.T.E.P. Pump F�(�V, At a flow of 33.71 GPM the S.T.E.P. pump adds 11.87 ft of head. The pump head is within 25% of the desired head Permit No. 1 of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519--6650 Telephone: 3d3--4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description T. 12 N, R. 3 W, SEC 23 SM AK. LOT 3, TELEMARK HILLS SUB D SM A B!d A LL -121 BM B BM B EL=128 MT 1 PID No: 015--231-891 01- 44 -09th i � •• Care S. Mey 1 � � G) E 63 3 �_ '•=tum j 11 I'QFES/SION���` LOT 6 LOT 7 10' IELECIXAFI. k Elft CSMi. LOT 3 TELEMARK HILLS LOT 1 LOT 4 PPCY05(D 11fl1 LOC, O 20PUBLIC USE, MUBI CAS ,I: X..C.. h ELECT ESN1. z' 01.5' SYSIN BE 26'.O LOT 2 M_,. IH -1 M KLD EI LLEI111A1E 1111 �'L` 10' 1RECOMM, h ELEC IKIi. /}k SITE MAP T-- 1 oo, SM A B!d A LL -121 BM B BM B EL=128 MT 1 PID No: 015--231-891 01- 44 -09th i � •• Care S. Mey 1 � � G) E 63 3 �_ '•=tum j 11 I'QFES/SION���` Permit No. Page 2 of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Dox 196650 Anchorage, Alaska 99519-6650 Telephone:343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description T. 12 N, R. 3 W, SEC 23 SM AN. PID No: 015-231 —89 LOT 3, TELEMARK HILLS BSUD 20' PUBLIC USE, DRNG, GAS TELECOMM & ELEC. ESMT. LOT 2 �1 1 T00� SEPTIC SYSTEM PLAN VIEW 1"=50' NOTES 1. CONTRACTOR TO VERIFY MIN. SO. FOOTAGE PRIOR TO PLACING TOPSOIL. 2. CAUTION SHALL BE TAKEN TO MINIMIZE REMOVAL OF EXISTING VEGETATION OUTSIDE OF SEPTIC AREAS. 3. DISTURBED AREA SHALL BE SEEDED TO PREVENT EROSION. C NO WELLS. SURFACE WATER, OR CURTAIN DRAINS V41THIN 100 IT OF NEW ABSORPTION SYSTEM. 5. SYSTEM TO BE INSTALLED A MINIMUM OF 10 FEET FROM PROPERTY LINE. 51.5' SYSTEM DIM. 24'x50' M N o M. T. —a \ TH-2 LM.T. TH-1 LTERNATE 6. ALL CONSTRUCTION GRAIL CONFORM TO M.O.A. & D.H.H.S. STANDARD SPECIFICATIONS. J. CONTRACTOR TO VERIFY 100MIN. SEPARATION FROM ADJOINING WELLS PRIOR TO EXCAVATION OF SYSTEM. d. BUILDER TO VERIFY FINISH FLOOR ELEV. 15 SET 50 PROPER SLOPE IS ASSURED TO SEPTIC TANK, O `F 0' TELECOMM. & ELEC ESMT. �2& D- 1 D-2 D-3 D-4 BM A BM B DESCRIPTION ^\\\\\\\\\\\\\\1� r L of / 9th .. ....... �•�� •C.OfZ •�••.•MCYEf/V/�/YQ�'�� I 6353 (/ • ��,�.r.� 'Ilt- FESS"NP��� t%\\\\\\\\\\\ I�LLO" ARCTIC SLOPE CONSULTING GROUP, INC_ Engineers • Architects •Scientists •Surveyors 301 owns N Hrl.ar9W. "'w 99518-S TNwpm•: (907) J49-8148 r9u (907) 349-4213 SOMS LOG - PERCOLATION TEST PERFORMED FOR: LEGAL DESC'RIPI3 DEPTH (FEET) COMMENTS SLOPE a ER'S •Cor Y .Meyer •� �?> e.,io '•9p . 4,' J �7 DATE PREFORMED: "e .3 �— 517E PLAN N S WAS GROUND WATER r� L ENCOUNTERED? 0 IF YES, AT WHAT DEV II' P Depth to Water After C E Monitoring? Dale Grou Darn _ 2- 3 s 4- rr- Pc rk 6- 7. 9 -�- -- - M L to- 0-12-13- ,, 12 - 13 - 14- 14- 15- 15 - 16- 16- 17- 17- 18 - I8- 19- 19- 20 - 20 COMMENTS SLOPE a ER'S •Cor Y .Meyer •� �?> e.,io '•9p . 4,' J �7 DATE PREFORMED: "e .3 �— 517E PLAN N S WAS GROUND WATER r� L ENCOUNTERED? 0 IF YES, AT WHAT DEV II' P Depth to Water After C E Monitoring? Dale Grou Net Depth to Net Drop .lime Water i N 1 PER('OLATIO ,`1 s- (,i uteslinch) PERC HOLE DIAMETER TEST RUN BEtWEEN -� �• FT AND ,5 �,s•, FT CERTIFY THAT THIS TEST WAS PEIU-Vt nu PERFORMED IIY:"- ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES 1N EFFECT ON THIS DATE. DATE: Darn _ Time rr- Mq. -ZO ,, Net Depth to Net Drop .lime Water i N 1 PER('OLATIO ,`1 s- (,i uteslinch) PERC HOLE DIAMETER TEST RUN BEtWEEN -� �• FT AND ,5 �,s•, FT CERTIFY THAT THIS TEST WAS PEIU-Vt nu PERFORMED IIY:"- ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES 1N EFFECT ON THIS DATE. DATE: PERFORMED LEGAL DESC 2 ARCTIC SLOPE CONSULTING GROUP, INC, Engi!@ere •Architects • SClentists •Surveyors ]01 Omnn Awmn M�Noro]•. Na•N 99lf a-5011 TN.VM1onc (soA J1V-1110 Fac IVO]) SIV -1115 SOILS I.OG - PERCOLATION TEST SP Perk - 5P h SLOPE ��4��:a vttiii J DATE PREFORMED: crrF PLAN WAS GROUND WATER V -- S L 40; 1: COUNTERED? ---' ! b N 0 IF YES, AT WHAT DEPrHl p Depth to Water Atter O Dato �^ %3 -. -' E 1?.1 Monitoring? Oros Net Time Depth to Water Net Drop _�— Reading Date Time 5- O / y S,�2.! F o?!Zr /S zlo a —�3 55 /3, V 6 ;/O 3 N / 1 ( d mII FR PERC HOLE DIAMER PERCOLATION RATE _ FT IT r v TEST RUN BETWEEN -. AND COMMENTS __ CERTIFY THAT THIS TEST WAS PERFORMED PERFORMED BY: ::" , 7—�7 ACCCRDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON TI{IS DATE. DATE: LOCATION OF WELL STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES DIVISION OF WATER WATER WELL RECORD C BOROUGH SUBDIVISION LOT BLOCK SECTION GTRS SECTION TOWNSHIP RANGE MERIDIAN ON ❑E 1 i �� �_ ❑S ❑W� LOCATION/SKETCH: -- WELL OWNER: DEPTHS MEASURED FROM:❑ s 9 top ❑ground surface WELL DEPTH: DATE: OF COMPLETION -- Depth of hole: �� _tt BOREHOLE DATA: Depth Depth of casing:/.42 2 Material Type and Color From To DEPTH TO STATIC WATER LEVEL: - ft below QJ top of casing ❑ ground surface !f/�•r i�e h ^ Date: Z/ /� /�_ Z — / METHOD OF DRILLING: air rotary ❑ cable tool r (l (p ❑ other USE OF WELL: /I domestic ❑ irrigation ❑ monitor /va^ LC l 30 (t 5, (off ❑ public supply ❑ other �S CASING STICK-UP' ft. Diam: toy $ ft Casing type: S in. to ft zz II WELL INTAKI QPEN�G TYPE: open end Z screened perforated ❑ open hole Depths of openings: �/�' -7 F�` to ft � SCREEN TYPE: _Diam:_ in. Slot/Mesh Size: Length: ft GRAVEL PACK TYPE: — Volume used: Depth to top: R� L1 GROUT TYPE: Volume: _ Depth: from ft to ft 1 g 9 DEVELOPMENT METHOD: 61Z -i i1Q_1"Wrag Duration: Munic al Ith 13 Hu on �' --�— PUMPING LEVEL AND YIELD: �[ (p ft after�pumping m_ hrs P s �8P PUMP INTAKE DEPTH; ft Horsepower: WELL DISINFECTED UPON COMPLETION? ❑ YES ❑ NO CONTRACTOR INFORMATION: REMARKS: i Regist d Busin ss Name PLEASE MAIL WHITE COPY OF LOG TO: 'Signature of Authorized R res native Date DNR/DIVISION WATER 9 � P PO BOX 7722 116 EAGLE RIVER AK 99577-2116 MUNICIPALITY OF F ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-231-89-000 Expiration Date: 9/23/2025 Legal description TELEMARK HILLS LT 3 Site address 11600 MOOSE RD Anchorage AK 99516 Current property owner(s) LEVENSON ARYEH L & KAY L X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 11/13/2024 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory X Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-231-89 Complete legal description Location (site address) Telemark Hills Lot 3 11600 Moose Road, Anchorage, AK 99516 Current property owners) Aryeh & Kay Levenson Day phone (907) 227-8779 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: 0 Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: 0 Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑■ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 3 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS *Bed ❑ Deep Trench ❑■ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ -.50 f Waiver Fee $ Date of Payment Date of Payment COSA # 05C 2_1A I gI2q Waiver # COSA Application—June 2022 8.17 Forge Engineering 9/23/24 9/24/24 (One Stop) N/A Benjamin Schiller, P.E. (907) 522-7773 h 19 9 53 L 1/j �oayo pawnlai aol 00 S£$ to aa; dSN y s994 alel anjooe j1p slun000y anpaaAO '901A81 ]S to alep woal sAea 0£ uI4lIM Q3103dX3 si luaw4ed auoyd ayl rano sluawAed pjeo aalsen pue eslA 'JaAOOsi4 adaooe GM aOualuanuoO pappe jno% jod paid Vale(] u014eneox3 pue 6uwdwnd olldaS sa(r (q paldaooy );Tv ale(] aAlleluasaidaa Aawolsno to apll pue ainleu6is 1N3W338EW JNIaNl9 d SI SIHl uMogs suolllpuoo pue swial ayl of sawbe jawolsno sa6jego Ienloy 00009$ 00'0$ 00'0$ 00009$ :sa6jego palewlls3 lelol pueJEJ lelol Xel le3ol algexel lejol algexeluoN Xaa Ox I I -yov oj k3 T Iwq_ 00'09 6$ ON 00'00 6$ 9' 6 Goal._ laneJl 00'09£$ ON 00'09£$ 6 60-1 aoueuejulen ten;atlr uo!sua4x3 Axel yoe3 ao!Jd Alt) ods .L oomjoS 601 aoueua}ulew UOIJBIS 14!-1 6£6£-LZZ-L06-uosuaAOj Ao>j-jaumoO :uelolugoal /(epUOW Odi :sluawwoo qor uae 0606-06£ (LO6) :auoud allgon 'p2j IIeji siaddeii :slam;$ ssao pu0 deW :�oog deN }eadgZj :adAi qop UaAGIS :daisales 0 :% Xel 0£ ION :swjal :jagwnN O d :uollduosap qor AleO :uelolugoal t,ZOZ-AON-6 6 :aiea a0lnUag t,ZOZ-AON-80 :Ole(] JapJO 656690 :jagwnN aapio )Ijom I1a0 ydaso0 ZZOL-ZO9 (L06) 96966 iib' 'abejoyouy M asoOIN 00966 ydasor uo!;euuo;ul a;!S qor 0606-06£ (L06) VZ966 �jV 'abeaououy £LLOVZ XO8 Od buljaaulbu8 abiod Zl£l #at :uo!;euuolul 6uill!8 t,9179 -t769 (L06) Sib£-LL566 XV `ian>:H ajSVH S 1 b£LL xog Od uo><;VnRax:j pue 2uidtund ai;daS sgp i 11 aanleu6ls c� aoueualulew 10 ale(]r ueioiugoal -OA :aapinOJd aoueua !ely pai dent) :s}uawwoo ou sa pajaldwoo aoueuajulew pue suolloadsul paalnbaa aaan}oe}nuew 11V. aayj0 ou so ) painoaS Apadoid ou �saX palelnsul ou sa leuoljoun j :pll alogueW. ou uleuol�oun clog daaM. ou sa-Ci suollealauad adld punoae uoisnalul aa�eM punoa�. ou saA uoiloauuoo � uej of aasla le uolsnilul aa+eM punoaE). aasl�l alayuel�l naoJoeIslJes Iou }oe�sl� uoljeaado wals�(s waely. ou saA Bulllamp apisui wiele lensln pue alglpny. OU SGA IInoalo w:ele leoploale paleolpaa. :uaa}s S Waely lu Ajoloelsl}es uoljeaado. ou saT pewjljuoo s6upas }eoll aadoid. pauealo sleoll loaIuoa. ou sEW peuealo Jaig juenl}}A. pauealo jai seq dwnd. :u01je4s :lll ou sa palaldwoo buldwnd. ou seA pailnbaa :buidwnd. sagoui lana) abpnlS. :)Iuel ash as -0� �) � ssaappy IaaaIS M )^d aaunnp %--IU. I � 60, goueuejuiew linen dwnd/uolje}S jpl L66L-£b£-L06 :xe-d t,06L-£ttr£-L06 :auogd uol}oaS JaWmalseM'8 a91eM 91lS-up juawliedaa saomiaS juawdolanap MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT907-343-7904 On -Site Water and Wastewater Section �� Fax: 343-7997 www.muni.org/onsite Nitrate Advisory Certificate of On -Site Systems Approval # OSC241429 Subdivision: Telemark Hills, Block: , Lot: 3 A water sample revealed a nitrate concentration of 8.17 milligrams per liter (mg/Q. 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. Since nitrates are known to slowly increase, we recommend you monitor the water quality. 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. Nitrate Fact Sheet From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. Municipality of Anchorage On -Site Water & Wastewater Program (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 015-231.89 Expiration Date: 1. GENERAL INFORMATION Complete legal description TELEMARK HILLS S/D; LOT 3 Location (site address) Current Property owner(s) Mailing address Real Estate Agent 2. TYPE OF DWELLING: 11600 MOOSE ROAD, ANCHORAGE, AK, 99516 JOHN EVANS Day phone 11600 MOOSE ROAD, ANCHORAGE, AK, 99516 DAVID WINDSOR W/ REMAX Day phone Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: 884-4598 727-3300 TYPE OF WASTEWATER DISPOSAL: Individual Well E Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ Distance: - Received by: azd 4In >/A�_ Date: COSA to be released to the'ln—gineer, unless otherwise requelitecilby the engineer. COSA Fee $ 5 Z 16 Waiver Fee $ Date of Payment 3 f lg�Ij chP�J Date of Payment Receipt NumbbeReceipt Number COSA # V SC I S I Oaf Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seat affixed hereto and as of the validation date shown below, 1 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 ENGINEERING GROUP, Ltd. Phone Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK, 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date Engineers Comments: In conducting this evaluation, GEG provided an engineering evaluation of the we# and/or septic system in accordance with the guidelines and regulations established by the hfunkipartyofAnchorage and industry practices The reported results describe the condition of the systerrds on the dales or the evaluation. Separation distances were measured to readily identifiable leaf nes. Hidden defects or encroachments may exist that were not idenftrred during the evaluation. The operztkimil #is of all wells and septic systems depend on a variety ofvanabks including, but not limited to, sof conditions, groundwater levels tfhat may fluctuate during the year), qualilyofconstruction (materials and workmanship), and the water usage of the family utilizing the systeriva. These conditions can vary, and are outside the control of GEG. Satis/aday test results do not guarantee future performance of the sysfeMs, therefore, GEG makes no warranty (express or implied) regarding the futwe performance of the welt or septic system. GEG makes no representation whether an alternative well orsepik system on be installed on the property in the event either of the current systems huff. The wntent of this report is for the sale benefit of the person/pady, who retained GEG. Reliance upon the information provided in thk report by any otherperson or parry, including but not limited to subsequent properfypurchasers, is not authorized. In short, GEG disown anylegaf duty to anyone otherthan the person/party who paid forthis report. 6. DSD SIGNATURE System #1 Approved for� bedrooms. System #2 Approved for Disapproved. . Conditional approval for bedrooms. 337-6179 bedrooms, with the following stipulations: tOFt` G`�P Cyc =J$ ON-SITE WATER AND WASTEWATER -PROGRAM Original Certificate Date: S- if TheunicipalityrAr( Drage Develop,emt Services Division (DSD) issues Certificates of Onsite Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineerregistered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTCHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev. 70112/12) ✓__� If more than 7 septic system is on the lot: COSA Checklist # _of_ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: A. WELL DATA TELEMARK HILLS S/D; LOT 3 Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 11/27/1993 Sanitary seal (Y/N) YES Total depth 62 ft. Date of test Static water level Well production Cased to 48 ft. FROM WELL LOG 11/27/1993 WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Arsenic: 1 ug./L. B. SEPTIC/HOLDING TANK DATA Nitrate L —17mg./L. Date of sample: 2/17/2015 Parcel ID: 015-231-89 Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION 2/17/2015 SURFACE ft, 4.2+ Collected by: GEG, Ltd. YES YFS 12+ in. Tank Type/Material STEP/STEEL Date installed 2/14/1994 Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) YES Date of pumping 9/26/2014 Pumper A+ HOME SERVICES C. ABSORPTION FIELD DATA VBELOW EXISTING GRADE 2/14/1994 0.5 BED Date installed 6/12-13/2002 Soil rating (.p.d./ft r ftlbdrm) 0_6 System type DUAL TRENCH 50 0.5 Length 2050 ft. Width 24/5 ft. Gravel below pipe 4 ft. Total depth •6.4&7.9 ft. Eff. absorption area 1000 ft Monitoring tube YES Depression over field NO Date of adequacy test *'2/17/2015 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test DRY in. Water added 875 gal. New depth DRY in. Elapsed Time: = min. Final fluid depth DRY in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date - "*NOTE: BED WAS ACTIVE AT TIME OF TEST AND WAS THEREFORE TESTED. TRENCH LIQUID LEVELS WERE: NORTH -2", SOUTH -DRY. BED MT WAS INSTALLED/REPAIRED BY A+ HOME SERVICES IN 2010. D. LIFT STATION *PER 1994 ELECTRICAL INSPECTION REPORT. Date installed 2/14/1994 Size in gallons 1500 Manhole/Access (YIN) YES "Pump on" level at 42 in. "Pump off" level at 36 in. High water alarm level at 46 in. Datum BOTTOM OF BASKET Cycles tested 3 Meets alarm & circuit requirements? *YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots Absorption field on Public sewer main Sewer /septic service line 100'+ On adjacent lots N/A 25'+ Animal containment areas 501+ 100'+ 100'+ Public sewer manhole/cleanout N/A Holding tank NIA Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 51+ Absorption field 51+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 109+ F. COMMENTS NOTE: PORTION OF 1994 BED MAY HAVE SLIGHTLY LESS THAN 36" OF SOIL COVER. WE ARE UNAWARE OF ANY FREEZING ISSUES. 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 JEFFREY A. GARNESS Date (Rev. 10112J12) Municipality of Anchorage 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 # 151097 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 3 of Telemark subdivision. This inspection revealed a nitrate concentration of 6.17 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. �P�V 1-ys�0 49 S� �, f N' SHANE A. HOLT 1�4.P LS-6914 V a o 4p� resslo�al `o THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND 15 NOT TO BE USE D FOR POSITIONING AD DITIONAL 5TRUCTUkE5,IMPROVEMENT5, OR FENCE LINES. EASEMENTS OF RECORD, OTHER THAN TH05E APPEARING ON THE RECORD PLAT, ARE NOT SHOWN HEREON( UNLE55 INDICATED) NOTE: FENCELINE5 THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCE55IVE SNOW AND/OR ICE. N 89056'49"W 135.41" AS -BUILT SURVEY 1" = 30' NO OUR' VF_RS SET THIS DATE CIHTEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY HE FOLLOWING DESCRIBED PROPERTY 3, TELEMARK HILLS SUB. ( PLAT 85-2) ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ,ANCHORAGE,ALASKA THIS _13TH_ DAY OF _MARCH-___ , 2015. HOLT LAND SURVEYING 600 HIGHVIEW DRIVE ANCHORAGE,AK 99515 11209, FB 139-5Z, 170-32 345-5513 lot 1 MOOSEROAD /N 8840'30"W 13.24 N 88 40' 30" W 8.57 / 'v W ------------------- -?030 «.EEE 8E Y-5MT N S9 56'45" W 354.47 N.T.S. N N r 00, 3 10053 -------- ---_-89 896' 45" W 358.93 N.T.S. /f NOTE: m M THIS AREA 140T DRAWN TO SCALE. SEE RECORD PLAT N FOR EASENNCNT AND LOT DETAIL N zZ 101 2 �O 49 IH�1 ,9 u 4 /� �. `.. SHANE A. HOLT Ls 914 0 I ._ ___ ______ _ ________ _ __ N 89°56'49"W 1356.41' AS-BUILTSURVEY V 30N1— —ErTHAN&Y' z /I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY \ OF THE FOLLOWING DESCRIBED PROPERTY LOT 3, TELEMARK HILLS SUB. ( PLAT 85-2) ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT IN VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS E%IST OTHER THAN NOTED. DATED AT ANCHORAGE,ALASKA THIS _13TH_ DAY OF MARCH , 2015. Mct,Trt—,1 D12Vc �j¢Oe. FMn9-SL llo-Rlang-SLyoaz HO / b O Municipality of Anchorage • '� Development Services Department !� Building Safety Division Onsite Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519519 650 www.muni.o onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEH?A/PP�tOVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-231-89 COSA# QSC 1016q,2 1. GENERAL INFORMATION Expiration Date: Cl — o2 I "/d Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address TELEMARK HILLS S/D: LOT 3 11600 MOOSE ROAD • ANCHORAGE. AK • 99516 ELIZABETH MCKAY Day phone 11600 MOOSE ROAD • ANCHORAGE. AK • 99516 Day phone Real Estate Agent RONA FLORIO W/ HOMES UNLIMITED Day phone 748-4500 Mailing address 2611 LAKE OTIS PARKWAY * ANCHORAGE. AK * 99508 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site N Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional 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 riles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) In compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Finn GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SURE 101 • ANCHORAGE, AK 99507 Engineer's Printed. Name JEFFREY A. GARNESS, P.E. Date 6 fO Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines ti Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily IdenbTiable features. The operational life of all wells and septic systems depend on Me local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will It confer any legal right whatsoever. 5. DSD SIGNATURE _L� Approved for 4 bedrooms. Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By:CX z &4Z""" �/ �I-d'/� Original Certificate Date: �o (Rev. 11105) 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: TELEMARK HILLS S/D; LOT 3 Parcel ID: o 2 3I -,9 1 A. WELL DATA Well type PRNATE If A. B. or C provide PWSID# N/A Date completed 11 /27/1993 Sanitary seat (YIN) YES Total depth 62 ft. Cased to 48 ft. FROM WELL LOG Date of test 11/27/1993 Static water level 0.5 (t. Well production 8 — 9 -p.m - WATER SAMPLE RESULTS: Well Log (YIN) YES Wires properly protected (YIN) YES Casing height (above ground) a � in. AT INSPECTION 6/4/2010 SURFACE ((, 5.01 g.p.m. Coliformy colonies/100 ml. Nitrate . y X mg./L. Other bacteria 0 colonies/100 ml. Arsenic: 140 ug./L. Date of sample: 6/3/2010 Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material S.T.E.P./STEEL Date installed 2/14/1994 Tank size 1500 gal. Number of Compartments 2 Foundation cleanout (YIN) YES Depression over tank (YIN) NO Cleanouts (YIN) YES High water alarm (YIN) YES Date of pumping 6/8/2010 Pumper MCDONALDS PUMPING C. ABSORPTION FIELD DATA Low EXISTING GRADE 1994 BED/ 2002 TRENCHES 2 14/1994/ 0.5 BED/ Date installed 6 12-13 2002 Soil rating .p.d./ =or ft'/bdrm) 0_6 System type DUAL TRENCH 50/ 24/ 0/ ft. Length 100 (2 0 50') ft. Width 5 ft. Gravel below pipe 4 ••••UNKNOWN 1200/_ �•"•NO/' NO/ Total depth 06 06.!5/7-9% Eff. absorption area 1000 ft Monitoring tube Yrs , Depression over field NO Date of adequacy test "'6/4/2010 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 44 in. Water added 665 gal. New depth "51 In. Elapsed Time: 120 min. Final fluid depth 47 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date — **TRENCH WAS SURCHARGED 2" DURING TEST. *"TESTED NORTH TRENCH ONLY. ****NOTE: 1994 BED WAS NOT IN USE. BED STANDPIPES WERE BURIED AND COULD NOT BE LOCATED. D. LIFT STATION Date installed 2/14/1994 Size in gallons 1500 Manhole/Access (Y/N) YES "Pump on' level at 42 in. "Pump off" level at 38 in. High water alarm level at 46 Datum BOTTOM OF TANK Cycles tested 3 Meets alarm & circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ Animal containment areas 50'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 51+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS NOTE: 2002 TRENCHES WERE IN USE. 1994 BED WAS NOT IN USE AND COULD NOT BE LOCATED. 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 Pr' ted Name JEFFREY A. GARNESS Date 6Nho COSA Fee $ I C1 V Date of Payment Receipt Number t%Zii 93 (Rev. 11105) Waiver Fee $ Date of Payment Receipt Number \ Municipality of Anchorage • ^� Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Septic System Advisory Certificate of On -Site Systems Approval # 101092 During a recent adequacy test on the septic system for Block , Lot 3 of Telemark Hills subdivision, 44 inches of standing Water was observed in the absorption field. This indicates that approximately 92% of the absorption area is inundated. 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