HomeMy WebLinkAboutNEAR POINT KNOLL BLK 1 LT 4or Point
Knoll
Block I
Lot 4
#041-021-47
~ Municipality of Anchorage Page
Development Services Department
On.Site Water and Wastcwater Program
4700 South Bragaw Street
P.O. Box 196650 Anchorage. AK 99519-6650
www.cLanch~'age.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM ANDIOR WELL INSPECTION REPORT
Permit Number: SW010052 PID Number: 043.-021-47
"~"': Wastewater System: Now
Spinell Homes
9210 Vanguard Drive Anch.y AK 99507 ABSORPTION FIELD
.~,~: ~ ,~ s~o~,: Shallow 5' Wide Trench
344-5678 Five (5)
LEGAL DESCRIPTION 1.2 o.o~e 4 F,.
1 4 Near Point Knoll 3. F,. 3 F,.
2.5 .. 88 F,.
Well: Class A PWSID No. 218642 5 n. 3.I N/A FL
A .. n. 758 ~e ASTM D3034 PVC
n. Spinell Homes 6/12-3.3/03.
*"": c.~ I""'~s"'':~,. ic.~ ,~,,~,,.c,,~:,, TANK
SEPARATION DISTANCES E3 septic n Holding r"l S.T.E.P. ri Other:.
Tank Field Station Tank S~,~U~ Anchorage Tank 3.,500
,~,, >200' >200' N/A N/A >25' Steel Two (2)
s~,.w.., >3.00' >3.00' N/A N/A ~ / LIFT STATION - NONE ON LOT
~t~ >5' >3.0' N/A N/A
>
5'
>10'
N
/A
N
/A
c~.~o.,~ None Noted
.....~: 2' Sand Liner Placed Under Drain Field BENCH MARK
Bottom House Level Concrete Slab.
100.0 n.
Engineer's Stamp
Inspections performed by: Alan Harala Dates: 1" 6/3.2/01 ° ~' 4 ~ \ ~ ·
-,
.~Human
Services
approval
Department of -lealtl~ ' ~. ,,c.^~ c ^.o~.so...' ~,.
Reviewed and approved by: ~ (j ' Date: ~'//"'~'/~Z.. ',.?,~,~'~.~ ~."~?
(a.,.. BO~9)
Municipality of Anchorage
DEVELOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK 99519-6650 - 343-7904
On-Site Wastewater Disposal System or Well Inspection Report
Page 2 of 3
Permit Number SW010052
PID No. 041-021-47
Five
Bedroom
· Home
Lternate
Site
M
A B C D
Sl 15.6 16.3
S2 25.3 21.6
C4 58.7 62.3
M1 55.6 58.0
C5 28.2 28.5
M2 28.7 35.1
C7 57.9 154.2
M2 68.2 44.4
PLAN AS-BUILT-
SCALE 1" = 40' ,OO-~9 t /t&,Zg,90~)O N
z
Permit Number:. SW010052
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904
On-Site Wastewater Disposal System or Well Inspection RepoA
Page 3 of 3
PID No. 041.O21..47
~78.0
PROFILE AS-BUILT
1" = 10'
99-78
NEAR POINT KNOLL SUBDIVISION
LOT 4, BLOCK 1
50,752 S.F.
N 89°58'32"E 297.79'
LOT 4
SEPTIC SYSTEM
EXISTING
BUILDING
(SEE D['rNL)
N 89°58'32"E 328.78'
116.5'
March 7, 2002
Spinell Homes
9210 Vanguard Dr.
Anchorage AK 99507
Subject:
On-Site Water and/or Wastewater Permit.
Permit Number: SW010052
~'Legal Description: Near Point Knoll Block I Lot 4
Dear Spinell Homes:
An On-Site Water/Waste~vater Permit, number SW010052, issued by this office for a single-family
system, will expire on April 03, 2002. This permit was valid for 365 calendar days.
If this was a well permit and the well has been drilled, a well log must be sent to this office for
documentation of the installation and to close the permit.
If this permit was for a wastewater disposal system, an original as-built inspection report must be sent to
this office for review, approval and documentation. This as-built inspection report must be signed by
the licensed Professional Engineer who inspected the installation of the system. As-built inspection
reports are required to be submitted within 30 days of the completion of the system.
If no system was installed under this permit, and you are still planning to install a well or wastewater
disposal system, a new permit must be obtained from this office. A new permit for a second year may
be issued for a fee orS100.00 if the renewal application is received on or before the expiration date of
the original permit.
When applying for a new permit, the fees are: $400.00 for a wastewater permit and $150.00 for a well
permit.
If you have any questions, please call this office at 343-7904.
~es Cross, PE nager
On-Site Water and Wastewater Program
Ene: Copy of permit
MUNICIPALITY OF ANCHORAGE
Development Services Depadment
On-Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Date Issued: Apr 03, 2001
Expiration Date: Apr 03, 2002
Permit Number: SW010052 Parcel ID: 041-021-47
Legal Description: ~IEAR POINT KNOLL SUBDIVISION BLOCK 1 LOT 4 "'
Design Engineer: 0014 Anderson Engineering Site Address: NHN KALMIA DRIVE
Owner Name: SPINELL HOMES Lot Size: 50752 SQ. FT.
Owner Address: 9210 VANGUARD DRIVE Total Bedrooms: 4 Permit Bedrooms: 4
ANCHORAGE, AK 99507-
This permit Is for the construction of:
[] Disposal Field [] Septic Tank [] Holding Tank [] Privy
[] Private Well [] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. Ail requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify 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.
T5.:;The following special provisions. ' ' --,
*"' ;.AT THE TIME OF CONSTRUCTION THE ENGINEER SHALL PERFORM AN ADDITIONAL .
;; SOILS/PERCOLATiON/BEDROCK AND GROUND WATER MONITOR IN ACCORDANCE WITH AMC 15.65 AND-,'
~ SUBMIT IT WITH THE INSPECTION REPORT. ~ '
Received By: ~
Date:
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/VVELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. O~[ I --O 2, / -- ~ 7
Permit Number
Property owner(s) Spine, Homes
Mailing address (1) 9210Van.quard Drive Anchora.qe, AK99507
Mailing address (2)/'V/'/~/ ~'~/../'//~ DRIVE
Legal description (Lot, Block & Sub'd.)
Day phone 344-5678
7ip Code
Lot 4, Block 1, Near Polnt Knoll Subdivision
Legal description (Section, Township & Range)
Lot Size 50,752 SF Acres/Sq. Ft.
Number of Bedrooms Four
THIS APPLICATION IS FOR:
Sewer Only
Sewer and Well
Sewer Upgrade
THIS PROPERTY CONTAINS:
Hot Tub
Swimming Pool
Therapy Pool
[] Well Only []
[] Water Storage []
[] Jacuzzi []
[] Water Softening Unit []
I 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:
Date of Payment:
Receipt Number:
(Rev. 12/O0)
Waiver Fees:
Date of Payment:
Receipt Number,
, .!
ANDERSON ENGINEERING
'1
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 (FAX)
MEMORANDUM
DATE: June 10, 2001
TO: Dan Roth
FROM: Mike Anderson, P..
SUBJECT:
Lot 4, Block 1, Near Point Knoll Subdivision
Septic System Design Revision
Permit No. SW010052
We have revised the design for the septic system for Lot 4, Block 1, Near Point Knoll
Subdivision to include a five-bedroom system and provide a gravity system. Two
additional test holes were placed behind the proposed house as shown on the attached
Site Plan. These holes revealed coarse clean gravel to depths of over 8' underlain by a
tight silty gravel. We are proposing to place a 5' wide absorption trench in the coarse
gravel layer. The material will require a sand layer to slow the percolation rate as it is
much faster than I minute per inch.
The attached documentation shows the location of the trench along with the cress
section of the absorption area with the sand liner. No groundwater was noted during
placement of the test holes and none has materialized in the ensuing week. We are
confident groundwater will not be a problem on this lot. Please review the attached
design revision and modify the permit to allow the new septic system design. Thank
you for your assistance with this modification.
Four ]~mdroom
Hom~
.00"~9 ~ ~/~.,E~;,90.00 H
SITE PLAN ~,,~,L~..oE,~o. ~'
SCALE 1" = 40' CE - 438'1 "'"~
LOT 4, BLOCK 1, NEAR POINT KNOLL
SUBDIVISION
DESIGN FACTORS:
SYSTEM REQUIREMENTS:
Five Bedroom Home
Perc. Rate: <1 Min./Inch
Application Rate: 1.0 GPD/SF
5' Wide Trench System
1,500 Gallon Septic Tank
3' Drainfleld Rock
2' Sand Liner
5 Bedrooms X 150 GPD 11.0 GPD/SF = 750 SF of Absorptlon Area
750 SFI5 LF {Width)*.58 (Red. Factor) = 87 LF Trench Length
Therefore: Construct a 87' Long X 5' Wide X 3' Effective Depth Absorption Trench.
Flowllne Elevation in Trench to be 1' Below Original Ground Surface. ,Total Depth to be 6'
Below Existing Ground. Mound Over Trench to Provide Minimum of 3 of Cover or Provide
2" of Direct Bury Insulation.
2" Insulation & 2'
or
Geotextile Fabric & 3'
6"
2t
Sand Liner
4" PVC ASTM D3034
Drainfield Rock
50% Passing No. 4 Sieve
2% Passing No. 100 Sieve
1% Passing No. 200 Sieve
5~
NOTE:
TYPICAL WIDE TRENCH SECTION
(NO SCALE)
Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock.
Minimum 10' Separation From Lot Line.
Minimum 4' Separation From Groundwater.
' Minimum 10' Separation From Water Service Line.
De admen . xx.4;~';'n~ .... :~ ~
p t of Health & Human Services ~ · .,~,~.L ~. A~O~SC~. ,~ ~
S25 L S~t, ~o~ge. AK ~502~650 ~1~:;'~ CE-43~3 .*;~
SOILS LOG - PERCO~ON TEST '~?.. .'"~
Pedo~ Fo~ Soinell Homes Date Pedo~: ~ ~
L~al Des~ption: Lot 4. ~l~k 1. Near Point Knoll SubdsNision
SLOPE SITE P~
3
OGIOL
GP
GM
Was Groundwater
9 Dense Encountered? No S
If Yes, What Depth? L
lC Depth lo Water ' 0
After Monitoring None p
11 Date: ' 6/10/01 E
See Site Plan
~Reading Date Gross Net Depth To inet
Time Time Water Drop
I 4-Jun 10:10 2'
2 10:15 5 Dry 8"
3 10:16
4 10:21 5 Dry 8'
5 10:22
6 10:27 5 Dry 8"
12
13
GP
1~4
Bottom of
Hole
17
18
19 Perc. Rate: <1 Min./Inch Perc. Hole Diameler: 6'
Test Run Belween 4 Ft. and 5 Ft.
Comments: Percolation Cavity Presoaked Prior to Testing. Sand Liner Required.
Performed By: &~:L~Ja,caJ~ I, ~ Certify That This Test Was Performed
In Accordance VV~th PJI State and Municipal Guidelines In Effect On This Date: 6/10/01
Municipality of Anchorage
Department of Health & Human Services
825 L Street, Anchorage, AK 99502-0650
SOILS LOG - PERCOLATION TEST
Performed For: Soinell Homes
Legal Description: Lot 4. Block 1 Near Point Knoll Subdsivision
SLOPE
Date Performed:
SITE PLAN
9
1l~
11
12
13
14
15
17
18
OGIOL
GP
GM
Dense
Boffom of
Hole
Was Groundwater
Encountered? No S
If Yes, What Depth?. L
Depth to Water O
After Monitoring None p
Date: "6/10101
See Site Plan
Reading Date Gross Net Depth To inet
Time '13me Water Drop
1 4-Jun 10:50 2-
2 10:55 5 Dry 8"
3 10:56 2'
4 11:01 5 Dry 8'
5 11:02 2'
6 11:07 5 Dry 8"
Perc. Rate: <1 Min./inch Perc. Hole Diameter: 6'
Test Run Between 5 Ft. and 6 Ft.
Comments: Percolation Cavity Presoaked Prior lo Testing. Sand Liner Required.
Performed By: ~:t.lJaJ:i~ I, Michnel IF Andersq~ Cedify That This Test Was Performed
In Accordance With All State and Municipal Guidelines In Effect On This Date: 6/10101
MEMORANDUM
DATE:
TO:
FROM:
SUBJECT:
Mamh 28, 2001
Dan Roth
Mike Anderson, P.E.
Lot 4, Block 1, Near Point Knoll Subdivision
Septic System Design and Permit Application
The pemolation test submitted with the septic system design for Lot 4, Block 1, Near
Point Knoll Subdivision indicates soils with a percolation rate of less than 5 minutes per
inch. This is typical of the soils in the subdivision based on our experience with the
design and construction of the roads and water line for the subdivision. We will,
however, furnish a new percolation test completed in accordance with the ADEC Falling
Head Percolation Test Procedure prior to the completion of construction of the new
system. The developer of the lot needs the septic system construction permit to obtain
a building permit for the new house. It is our intention to provide sufficient information
in compliance with Municipal requirements for the construction of the new septic
system.
Thank you for your cooperation with the issuance of the permit for the septic system
construction on this lot and please call if you have further questions.
ANDERSON ENGINEERING
P.O. BOX 240773
: ANCHORAGE, AK 99524
522-7773 ,522-6779 (FAx) - '
March 14, 2001
Municipality of Anchorage
Development Services Department
On-Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject:
Lot 4, Block 1, Near Point Knoll Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 4, Block 1, Near Point Knoll Subdivision intends to construct a new
four-bedroom home on the currently vacant lot. We are therefore applying for a permit
to construct a new septic system on the lot to serve the new home, The attached Site
Plan and backup documentation identi,fy the location and configuration of the new
septic syst.e.m and the parameter, s used in the design, It also shows the location of the
alternate site and the water service line for the lot. Existing drainage patterns are also
shown and will not be altered by the development of the lot.
Several test holes placed in the subdivi.sion reveale, d well to poody graded gravels with
perco aton rates between .1 and 5 mlnutesper inch. A test hole at the proposed
location for the new absorption trench revealedsimilar well to poorly graded gravel with
some silt to various depths. No groundwater was noted in the test hole during
cxcava.tion nor was any .notod during tho monitoring period. We are therefore
proposing to place a 3' wide by 36' long absorption X 7' effective depth absorption
trench to treat the septic effluent. The pipe will be placed at 3.5' below the existing
ground surface and the total depth of the trench will be 10.5'. A 1,500 gallon STEP
tank and pressure distribution system will be used to pump effluent to the absorption
trench.
The ground surface on the lot slopes as shown on the attached Site Plan. The area for
the new absorption trench, however, is faidy fiat. The new trench will be constructed
parallel to the contours of the surface in conformance with Municipal requirements.
Grading will be accomplished to assure surface drainage is away from the new trench.
The existing drainage pattern on the lot will not be affected during development.
If the system is constructed in accordance with our design the following statements
apply:
The system, if constructed as desLqned, will have no adverse impact on the wells
in the'area or those to be construc-ted in the future. The subdivision is currently
served by a community water system.
Lot 4, Block 1, Near Point Knoll
March 14, 2001
Page Two
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.
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.
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,
Michael E. Anderson, P.E.
Attachments
)RT
RICHARDSON
EASEMENT VACATED BY
THIS pLAT.
(SEE NOTE --
.~- ....... 250.10'(RI ~ HELD)
MILIT
THIS PROJECT
1
/,J 2 SET BY BRG-BRO
(Srr ~OT~ ~=)
(PER PLAT NO. 67-41)
.......... BASIS OF BEARING ..........
N 89'58'52"E 750.56'(R1)
750.66'(~)
168.21' o
LOT 3
43.247 $.F.
0.99 AC.
N 89*58'32"£
297.79'
-' I 0' UT]L & T. &: E. ESUT.
(S~£ No'r[ ~)
LOT 4-
50,752
1,17 AC.
N 89*58'52"E
528.78'
X 20' ANCHOR
;_ EASEMENT LOT 5
tm 50,210 S.F.
,_~ 1.15 AC.
~ 10' X 30'
[ 87.09'
1.5
LOT 6
47,546 S.F.
1.09 AC.
, AREA MAP
/ "~'~ SCALE 1" ~ '
/ ~.~"-~'~ SCALE 1" = 100' '
LOT 7
39.856 S.F'.
O.91 AC.
ARY R
LOT 20
76,083 S.F.
1.75 AC.
%
N 89'~58'32"1
254.50*
%
t
t
LOT 19
%
50,412 S.F
1.16 AC.
10' BUFF'ER
~UE~rl
N 89'58'32"E 2C
' L~-~ecXti ',th
Dtion
, 5~0
/ Gallon
/ STEP /
Tan] .
~ Four Bedroo~
~ ~~u,se .
X ' ..
~~1 . . X'
'JR: '3 ~'/~
,O0'Z:9~, At,Zg.90,00 N
NOTE:
Delivery Line Under Driveway Must
Be Encased In A Steel Pipe Sleeve.
· SITE PLAN
SCALE 1" == 40'
~',. 49 T.--BH
MICHAEL E.
CE -4381
LOT 4, BLOCK 1, NEAR POINT KNOLL
SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Four Bedroom Home Deep Trench System
Perc. Rate: 2-5 MinJInch 1,500 Gallon STEP Tank
Application Rate: 1.2 GPDISF 7' Dralnfield Rock
4 Bedrooms X 150 GPD 11.2 GPD/SF ~ 500 SF of Absorption Area
500 SFI14 SFILF -- 35.7 LFTrench Length
TRher. efore: Construct.an Absorption Trench :36' In Length by 3' W de With 7' of D,ralnfield
OCK ueneath the ulstributlon Latera. Distribution Lateral to Be Placed 3.5 Below
Existing Ground. Total Depth of Trench to Be 10.5' from Existing Surface. Mound Over
Trench if Necessary to Provided Minimum Cover of 3'.
N~ku~al Backfil'l'. '-" ..
'(2': Minimum) ·
j
2" InsulAtion '.'.: '
· ' or 3' Cover . . ..-
1" 'P~C (IIole~ Down)
· Drainfield Ro6k
· Hole' ~amet~ - '3/8'"
· ." Hole Spacing-- '2 '.~
NOTE:
TYPICAL DEEP TRENCH SECTION
(NO SCALE)
Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock.
Minimum 10' Separation From Water Se~lce Line.
Minimum 4' Separation From Groundwater.
Minimum 50' Separation From Break in Grade >25%.
Municipality ot Anchorage,
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 'L' .t;treet, Anchorage. Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFO.MED ~O.: JO~' /-/~b-//--f-Z'
· 7¸
$
IO -/3-
DATE PERFORMED:
Township. Range, ,Section:
SLOPE
49T~ f%
CE-4381
10
11
.12
13
14
SITE PLAN
16
17
18
19
20-
COMMENTS ~"107-- ~ 0
WAS CROUND WATER
ENCOUNTERED?
YES. AT WHAT
DEPTH?
Gross Net I Depth to ' Net
Reading Date Time Time Water Drol3
I
PERCOLATION RATE / ~'''' tm,n~tes,,mct~j PERC HOLE DIAMETER ~-~
TEST RUN BETWEEN ~'/~-- FTAND ~-~--'" FT
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN'EFFECT ON THIS DATE. DATE:
,-72-OO8 I~. 4/85~
ANDERSON ENGINEERING
P.O. Box 240773
ANCHORAGE, AK 99524
(907) 522-7773
Cell (907) 441-4000
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I~ IET DISCHARGE, GPM
[ORENCO SYSTEMS, INC
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
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 041.021-47
1. GENERAL INFORMATION
Complete legal description
Expiration Date:
Lot 4. Block 1. Near Point Knoll Subdivision
Location (site address or directions) Kalmia Ddve
Current Property owner(s) Spinell Homes, Inc.
Day phone 344-5678
Mailing address
92f0 Vanguard Ddve Anchorsqe~ AK 99507
Lending agency
Day phone
Mailing address
Real Estate Agent
Mailing Address
Unless otherwise requested, HAA will be held by DSD for pickup.
Day phone
2. NUMBER OF BEDROOMS:
Five (5)
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class A Well
Public Water System
[]
[]
[]
TYPE OF WASTEWATER DISPOSAL:
Individual On-site []
Individual Holding tank
Community On-site []
Public Sewer []
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Aulhodty Approval are
valid for 90 days from the date of issue for propedies served by a private or Class C well and may be reissued with
new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with
valid water samples.) Certificates are valid for one year for propedies 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 sea~ afl3xed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Health Authority Approval Guidelines fo," this application, shows that the
on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate fo,' the number of
bedrooms and type of structure indicated herein. I fudher 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 En,a, ineedn.q
Address P.O. Box 240773 Anchorage AK 99524
Engineer's Printed Name Michael E. Anderson. P.E.
5. DSD SIGNATURE
~ Approved for 5
Disapproved.
Conditional approval for
bedrooms.
Phone 522.7773
Date 7113/2002
bedrooms, with the following stipulations:
Additional Comments
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By:
(Rev. 12,'00)
Original Cedificate Date:
WELL DATA
Well type Public Water
Date completed
Tot~ depth It.
Municipality of Anchorage
Development Services Department
Building Safety Dlvisien
On-Site Water & Wastewater Program
4700 South Bragew St.
P.O. Box lg6650 Anchorage, AK 99519-6650
www.ci.anchomge.ak.us
(m7) 343-79O4
HEALTH AUTHORITY APPROVAL CHECKLIST
Lot 4. Block 1. Near point Knoll SuNivlelon
If A, B, or C provide PWSID # 21ll642
Sanit~y seal (Y/N)
FROM WELL LOG
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Cetifonn colonlas/100 mi.
Date of sample:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material ~ptlcJStHI
Tank size I~.00 gal.
Foundation claanout (Y/N) Y
Date of pu~ping
C. ABSoRPTIoN FIELD DATA
Date installed 6/13/2001
Length 88
Total depth _8_.~5 It.
Data of adequacy test
Parcel ID: 041.021-47
g.p.m.
Well Log (Y/N)
W'~es propedy protected (Y/N)
Casing height (above ground)
AT INSPECTION
irt.
Nitrate ~. rog JI.
g.p.m.
Number of Compartments
Depression over lank (Y/N)
Pumper
Other bacteria
colonies/lO0 mi.
Data installed ~/12/2001
~eanouts (Y/N) Y
High water alarm (Y/N) N
Soil raUng (g.p.d./ff2 or It2/bdrm) 1.2 GPD/SF System type 5' Wide Shallow Trench
It. Width $ fl. Gravel below pipe 3 fl.
Eft. absorption area 758_it2 Monitoring lube Y Depression over field N
Fluid depth in absorption field before test in.
Elapsed Time: min. Final fluid depth
Any rejuvenaUon treatment (past 12 mo.) (Y/N & type)
Results (Pass/Fail) For bedrooms
Water added gal. New depth in.
in. Absorption rate >= g.p.d.
N If yes, give date
D. UFT STATION
Date installed
'Pump on' level at in.
Datum
E. SEPARATION DISTANCES
Size in gallons
"Pump off' level at __in.
Cycles tested
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tenidlifl station on lot
Absorption field on lot
Public sewer main
Sewer/septic service line
Manhota/Access (Y/N)
High water alarm level at
Meets alarm & circuit requirements?
On adjacent lots
On adjacent lots
Public sewer manhole/deanout
Holding tank
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Absmptionfield >5*
Building foundation >5*
Water service line >10'
Surface water >t00'
Water main N/A
Walls o~ adjacent lots >200'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Building foundation >10'
Water main >t0'
Surface water >100'
Water Sewice line >10'
Wells on adjacent lots
Cu~tein drain Nons Noted
F. COMMENTS
in.
Date 7/13/'2002
HAA Fee $ ~
Date of Payment
(R~. 1~)
Waiver Fee $
Date of Payment
Receipt Number
Lot is set. ed by Class A Community Water System.
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Mun'~pal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name Michael E. Anderson, P.E.
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
~700. BEag .a.~._S~re.e~
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEHS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 041-021-47
1. GENERAL INFORMATION
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
NEAR POINT KNOLL S/D; BLOCK 1, LOT 4
6064. KALM!A DRIVE ~ ANCHORAGE, AK * 99507
CLIFF &: DONNA BOLTZ Day phone 552-2658
6064 KALMIA DRIVE * ANCHORAGE, AK * 99507
Day phone
DAR WALDEN W/ KELLER WILLIAMS Day phone 865-6406
101 W. BENSON BLVD, #505 * ANCHORAGE, AK * 99505
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 5
'3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well [] Individual On-site ·
Individual Water Storage [] Individual Holding tank []
Community Class A Well · Community On-site []
Public Water System [] Public Sewer []
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On-Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certi.ficates 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 val/dafion date shown below, I verify that my
investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this appfication, '
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 Municipafity of Anc,~orage files and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with afl applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 557-6179
Address 5701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Date.
Engineer's Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
con~cien-tious engineering analysis of the system in accord¢ncb ~,Tth ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
DSD SIGNATURE
i/~'' Approved for
Disapproved.
Conditional approval for
bedrooms.
ON-SITE ';
: WATER AND
bedrooms, with the following stipulations:
Attachments: COSA Checklist
Septic System Advisory
Well Flow Advisory
Arsenic Advisory,
Maintenance Agreements
Supplemental Engineer's Report
utner
Original Certificate Date:
Municipality of AnchOrage
Development Se ices 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
Am
.Legal Description: NEAR POINT KNOLL S/D; BLOCK 1, LOT 4
WELL DATA
Parcel 40
Well type CLASS 'A'
Date completed
Total depth ft.
Date of test
Static water level
Well production g.p.m.
WATER SAMP ,L~
Coliform ~ colonies/lO0 mi. Nitrate ~mg./L.
If A, B, or C provide PWSID# 218642 Well Log (Y/N)
(Y/N). i Wires properly protecte.~.J
Sacn~t:ed~oeal __ft. Casing he~round) in.
FROM WELL LOG _~~CTION '
=
.ft.~ ' ft.
Amebic: ~ ug,/L. Date of sample:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL
Tank size 1500 gaL, Number of Compartments 2
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO
Date of pumping 1.0/20/2010 Pumper.
Other bacteria
Collected by:
__ colonies/100 mi.
Date installed 6/12-13/2001
Cleanouts (Y/N) YES
High water alarm (Y/N) N/A
ISAACS PUMPING
C. ABSORPTION FIELD DATA
Date installed 6/t 2-13/01
Length 88 .ft.
Total depth *7.8 ft. Eft. absorption area 758 .f t2 Monitoring tube YES
Date of adequacy test 10/26/2010 Results (Pass/Fail) PASS
Fluid depth in absorption field before test 0 in. Water added 750 gal.
Elapsed Time: - min. Final. fluid depth 0 in.
Any rejuvenation treatment (past 12 mo.) (YIN & type)
I'BELOW EXISTING ORADEI
Soil rating ~or ft2/bdrm) 1.2
Width 5 ft.
System type TRENCH
Gravel below pipe 3 ft.
Depression over field NO
For 5 bedrooms
Newdepth 0 'in.
Absorption rate >= 750+ g.p.d.
NONE KNOWN If yes, give date -
LIFT STATION
Date installed
"Pump on" level at__
in.
Size in gallons Manhole/Access (Y/.~
"Pump off" level.aL~igh water alarm level at
in.
Cycles tested.
Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
COMMUNITY WELL
Septic tank/lift station on lot On adjacent lots
Absorption field on lot On adjacont lots _ ~
Public sewer main ......-,aubflc~eanout
Sewer/septic service liine.~ ~ Holding tank
~ent areas
Manure/animal excrote storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field. 5'+
Water main 10'+ Water service I ne 10'+ Surface water 100'+
Wells on adjacent lots 100'+ PRIVATE/200'+ PUBLIC
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+
Water service line 10'+
Curtain drain NONE KNOWN
Building foundation. 10'-I- Water main. 10'+
Surface water 100'+ Driveway, parking/vehicle storage
Wells on adjacent lots 100'+ PRIVATE/200'+ PUBLIC
10'+
F. COMMENTS
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 / O / ~,"l /i O
COSA Fee $ ~_~O
Date of Payment ~/O / ~.<:~//O
Receipt Number OO '7~ ;~..~. ~,
(Rev. 11/05)
Waiver Fee $
Date of Payment.
Receipt Number.
o
.00'Z9I M, ,ZS,90eO N
ISAACS PUMPING SERV/CE
6218 Quinhagak Street
Anchorage,'Alaska 99507
(907) 563-3300
CUSTOMER'S ORDER NO.. ' ........ ' ~:-~'-'' ..... ...... ' ................. DATE
PHONE
, Cl~~ ' STATE
so~ c,s, c.o.d, ch~a~"~' ~:"'~' '~'ou~'~' ........
.............. ~.)~,~~~ .... ~.. . . ..... ~_~ .......
.., ........
AI.:L ~'~I~IMS AND RETURNED GOODS