HomeMy WebLinkAboutKASILOF HILLS BLK 1 LT 8Ailof Hill
Block
Lot 8A
#051 - 161-02
Municipality of Anchorage Page I of 3
Development Services Department
On-Site Water and Wastewater Program
4700 South Bragaw Street
P,O, Box 196650 Anchorage, AK 99519-6650
www, ci,anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number, SW020269 PID Number: 015-161-02
~: Wastewater System: New
Steve and Michelle Powers
Address:
P.O. Box 110928 Anch., AK 99511 ABSORPTION FIELD
p~,: .~ ~ 8.~,: 5' Wide Trench
345-9964 Four {4)
LEGAL DESCRIPTION 1.2 GP~, 7.5
I 8A Kasilof Hills 3.5 r,. 4
1 r,. 50
Well: New 5 rt. 1I Ft.
Private 260 .. >40 F~ 500 F~ ASTM D3034 PVC
Hefty Drilling 911712002 90 Ft. Alaska General Ind. 9114-1612002
~,.,~: PM s~.~ I c.,~, ,,v. ~,, ~ TANK
4 GP~ F,.. 2 r~
SEPARATION DISTANCES ~ Septic I-I Holding [] S.T.E.P. I-] Other:.
Septic Absoq3tion Lift Holding )ublic/Private Marius&crater; ~,apac4y a3
Tank Field Station Tank Se~rU~ Anchorage Tank 1,250
wo, >100' >100' NIA NIA >25' Steel Two (2)
s~.w.,~>100' >100' NIA NIA ~ / LIFT STATION - NONE ON LOT
~o,u,. >5' 3' NIA N/A
>5' >10' NIA N/A ..~ o~-.~.,.,. -~o~ ~..,.~
Fc~ndat~n
c~ c~ None Noted e~, ~.~. & ~.~ E~,,,.~.~.,~ ~
See Lot Line Waiver. Insulation Over Sewer BENCH MARK
Line Under Driveway.
Basement Floor Slab,
t00.0 Ft.
Engineer's Stamp
Inspections performed by: A. Harala Dates: 1" 9114102 -..- .. .;~:.. .~.,
2"d 9116102 ~ ~ ~,c.^~,~ ~'."^~'~'~'~:;?'~
Department of.,~ ~/Health'agd Hum,an~.~ .-.~-~Services approval ~'... No. c~-,~, ,.';~.#
· * Municipality'e,f Anchorage Page 2 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Str.e. et Anchor~,ge, AK. 99519-6655 - 343-7904
On-Site Wastewater D~sposal Syst~n or Well Inspection Report
Permit Number: SW020269 ~ PID No 015-161-02
EAST~198.76 ' '
,,.,, 8A
r-/- Site
"~. ?.:'..'.'~'.~ ..____1 / Four Bedroom
:...'..~': ...' .: ..... .'..: -......
.,3. "~.".: :.. '~"" ..~...;.4.:...
,; .,...-:..... ' '" :' ::': '~.il1
~~ ~' ~,~il;~i'"'~~. o ...,; . · ..' '~'.. , .., . .o .?,. '[ .~.
~1 .... ~' """' '~'' ·
10' Utility Easement
S1
S2
M1
C4
C5
A
66.8
66.8
98.3
B
21.3
31.0
C
33.4
41.6
54.7
53.5
97.7
EAST 193.00
PLAN AS-BUILT
SCALE 1"= 30'
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Slreet Anchorage, AK, 99519-6655 - 343-7904
On-Site Wastewater Disposal System or Well Inspection Report
Permit Number: SW020269
Page 3 of 3
PID No. 015-161-02
8~.0
87.3
/
....... _~ e o_.![ex.J;jt e F'cd0_Cj C .............
Rock
L78.0
50' (Trench
70.0
PROFILE AS-BUILT
Scale: 1" ,, 10'
11/06/2020 09:59 FAT 90?3485218
STUD£~ ~i'~ITION
~001/001
Permit Number3 ~O~o .,.3, /.<i Date Of Issue ~) - ~ I . 0 ~__ Parcel Identification Number. 0
Date Started~ ¢~ .|~ .0~ate Completed ~ - ~7-~_~_.~,, Is well located at approved permit location? D Yes D No
Legal DescrJption~_ Block Lot Property Owner Name & Address:
Boreh~le Data: .... Depth ' ' Method ~f Drilling: ~ ~tr rota~ D cable tool
Soil Type & Thickness & Waler Strata From To
.......... Casing Type:, ~ ~ Wall Thickne~,O~lnches
~' Liner Type~ ,Diameter inches, depth ,feet
~ ~ , ~ ~. V~ [ ~ ~7 , Casing Sti~up Above Ground: ~ feet '
~ Static Water Level (from groun~ level): ~ feet
~- ~ ~ ~ ~ 0 Pumping Level: feet aRer. , , bm. pumping qpm
Recove~ Rate:~ ~pm
~ ~ ' '~ ~ - Well In~ke op~nlng Type: 0 Open End ~ Open Hole
~vo~ ~ ~,~_. ~ ~ D S~eened: Sra. feet"Sioppe~ ,feet
~ ~ ~ Perforations Sta~ ,fe~t Stopped feet
.... Gro~Type:~Molume.
Depth; from reM, to , ,feel
" Pump Intake D~{h: leer
Pump Size hp Brand Name
Well Disinfected Upon C~Eletion? ~Ye~ D No
Method O[ Dislnfection~ ~ ~ '
Core.ems:
Attention: The well driller shall provide a well log to Ihe property owner within 30 days of completion
and the property owner or the well driller shall provide a well log to the Dept. of Health & Human
Services within 60 days of completion.
Received Time Nov. 6. 8:02AM
May 28,2003
Municipality of Anchorage
Development Services Department
On-Site Water and Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject:
Lot 8A, Block 1, Kasilof Hills Subdivision
Separation Distance Waiver
Absorption Trench to Lot Line
Dear On Site Services Engineer:
The absorption trench recently constructed on Lot 8A, Block 1, Kasilof Hills Subdivision
was placed within 3' of the west property lot line. The property line was not accurately
marked during construction and the contractor inadvertently encroached into the 10'
setback area. The property line fronts on the Glazanof Drive Right of Way, which is a
total of 60' wide. The absorption trench does not conflict with wells or septic systems in
the area and is more than 15' from the edge of the existing roadway.
All required separation distances can be met between the new trench location and all
wells and septic systems in the area. We therefore recommend a waiver be issued
allowing the new trench to be located 3' from the west property line,
Sincerely,
Michael E. Anderson, P.E.
Municipality of Anchorage
Development Services Department
Building Safcty Division
On-Site Water and Wastcwater Program
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www. ci.anchorage.ak.us
(907) 343-7904
Waiver Review Worksheet
WR#: WE030040 PID#: 015.161-02
Date Received: 5129103
Legal Description: KASILOF HILLS BL 1. LOT 8A
Engineer: MICHAEL E. ANDERSON
PO BOX 240773 ANCHORAGE. AK 99524
Applicant: STEVE & MNICHELLE POWERS
HA#: 030222 Permit~:
Waiver Requested: LOT LINE
Criteria: Geology Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Total:
Waiver is Granted: (,/ Waiver is not Granted:
List Conditions or Reasons for above:
Rec~: 96167 Amount: $150.00 Date Paid: 05129103
MUNICIPALITY OF ANCHORA GE
Development Se/vices Department
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 I WATER SUPPLY PERMIT
Initial
Date Issued: Aug 01, 2002
Expiration Date: Aug 01,2003
Permit Number: SW020269
Legal Description: KASILOF HILLS BLK 1 LT 8A
Design Engineer: 0014 Anderson Engineering
Owner Name: Steve & Michelle Powers
Owner Address: PO Box 110928
Anchorage, AK 99511-
Parcel ID: 015-161-02
Site Address: 011101 GLAZANOF DR
Lot Size: 29073 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
[] Disposal Field [] Septic Tank [] Holding Tank [] Privy
[] Pdvate 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.
ReceivedBy: //~~ /~'~ 0 00~
Date:
Parcel I.D.
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 SEWEPJVVELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Permit Number
Properly owner(s) Steve and Michelle Powers
Mailing address (1) P.O. Box 110928 Anchorage, AK 99511
Mailing address (2). Zip Code
Legal description (Lot, Block & Sub'd.) Lot SA, Block 1, Kasilof Hills Subdivision
Legal description (Section, Township & Range)
Lot Size ~)q O'77--~ Acres/Sq.Ft. Number of Bedrooms Four (4)
Day phone 345-9964
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 cedify that the above information is correct. I fudher cedify 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. 1~00)
Waiver Fees:
Date of Payment:
Receipt Number:
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 (FAX)
MEMORANDUM
DATE:
September 10, 2002
TO:
FROM:
Dan Roth
Mike Anderson, P.E.7~/{~
SUBJECT:
Lot 8A, Block 1, Kasilof Hills Subdivision
Septic System Construction Permit No. SW020269
Revised System Location
We have moved the location of the septic system proposed for the subject lot to avoid
the use of a lift station. The new location is down slope from the proposed house and
between the protective radius for the well on this lot and the adjacent lot. Soils
encountered in this area are similar to identical to those located near the back of the
lot. The placement of the system in this new area will have no impact on wells or septic
systems on adjacent lots. The area originally proposed for the septic system will now
be used as the altemate site.
Please let me know if you have any questions.
.O0'Ogt
I
· TH5 ®
~° , I
Alternate
si~
r, .-Jo~
TH4
Four
~droom
o-~ome
:.iJ :!:::i:i:i::::
* 22.0
Proposed
L00
· o'zf
Way
X 5' Wide
Effective Dept]
Abso~ )tion, Trench
.00,00.00 N
GLAZANOF DR
SITE PLAN
SCALE 1" = 30'
VE
Municipality of Anchorage
Development Se~ices Dept./On-Site Water and Wastewater Program
P ,CO T O, EST ....
~ ~. ~0 ~ [ SS~~ .
Pe~ormed For: Sieve Pow~r~ D~Je Pe~ormed'
Legal Description: Lo~ 8A. Block i. Kmsilof Hills Subdivision
8LOPE SITE P~N
No~h
5
6
7
8
9
10
1
OGIOL
TESTHOLE NO. 3
Gap Graded
1/2" to 1"
GP/GM
15% - 20%
SiFt
South
Was Groundwater
Encountered? No S
If Yes, What Depth? L
Depth to Water O
After Monitoring None P
Date: 9112/01 E
30'
/
1:
13
14
15
16
17
18
21
Bottom of
Hole
Reading Date Gross Net Depth To Net
Time Time Water Drop
1 9/5/01 7:55 2.13"
2 8:05 10 Dry 9.37"
3 8:06 2"
4 8:16 10 Dry 9.5"
5 8:17 2"
6 8:27 10 Dry 9.5"
Perc. Rate: 1.1 Min./Inch Perc. Hole Diameter: 8"
Test Run Between 4 Ft. and 5 Ft.
Comments: Testhole Presoaked Prior to Percolation Test.
Performed By: Alan Harala. I, ~ Certify That This Test Was Performed
In Accordance With All State and Municipal Guidelines In Effect On This Date: 9/10/02
ANDERSON .ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 (FAX)
July 16, 2002
Municipality of Anchorage
Development Services Department
On-Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject:
Lot 8A, Block 1, Kasilof Hills Subdivision
Septic System Design and Pe[mit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 8A, Block 1, Kasilof Hills Subdivision intends to construct a new four-
bedroom home on the lot. We are therefore requesting a permit be issued for the
construction of a new well and septic system to serve the proposed home. The
attached Site Plan and backup documentation identify the location and configuration of
the new well and septic system and the parameters used in the design. Also identified
on the plans are the test hole locations and the locations of the wells and septic
systems on the adjacent lots. Drainage arrows are also shown and current drainage
patterns will be maintained after construction.
The test holes placed near the location of the proposed absorption trench and alternate
site indicated clean well graded gravel with varying amounts of silt and a percolation
rate of 1 to 2 minutes per inch. No groundwater was found during the placement of the
test hole and none has been noted since. We are therefore proposing to construct a 5'
wide shallow absorption trench with 4' of drain field rock beneath the distribution pipe.
The total depth of the trench will be 7.5' with the distribution line at 305' below the
surface. The total length of the trench will be 50'.
The ground surface on the lot slopes as shown on the attached Site Plan with faidy
shallow slopes from west to east in the area of the new trench. The new absorption
trench will be constructed in a fairly flat area in conformance with Municipal
requirements and parallel to ground contours where possible. Ail components of the
new trench will be constructed a minimum of 100' from the well on the lot. The system
will also be constructed a minimum of 100' from any surface water in the area.
If the system is constructed in accordance with our design the following statements
apply:
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.
:Lot. 8A, Block 1, Kasilof Hills
July 16, 2002
Page Two
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,
Michael E. Anderson, P.E.
Attachments
I~t 3 'Septic.
Septic
.00'0<3 t 3.00.00.
1,250
Septic
O' X 5' 'del
~ 4 ' L~.~ectxv~p~h
Absorption TrTch i
Four :. :: o.:r:
House
,sed
).00
GLAZANOF
SITE PLAN
SCALE1"=30'
0~00 N
DRIVE
LOT 8A, BLOCK 1, KASILOF HILLS SUBDIVISION
DESIGN FACTORS:
4 Bedroom House
Perc. Rate: 1 to 2 Min./Inch
Application Rate: 1.2 GPD/SF
SYSTEM REQUIREMENTS:
5' Wide Trench System
1,250 Gallon Septic Tank
4' Drainfield Rock
4 Bedrooms X 150 GPDII.2 GPD/SF (Application Rate) = 500 SF of Absorption Area
500 SF/5 LF (Width)*.5 (Red. Factor) = 50 LF Trench Length
Therefore: Construct an Absorption Trench 50' Long X 5' Wide X 4' Effective Depth.
Fiowline Elevation in Trench to be 3.5' Below Original Ground Surface. Total Depth to be
7.5' Below Existing Ground. Maintain 100' Separation From All Wells in the Area.
5~
NOTE:
TYPICAL WIDE TRENCH SECTION
(NO SCALE)
Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock.
Minimum 4' Separation From Groundwater.
Minimum 100' From Wells in the Area.
Minimum 10' Separation From Water Service Line.
Municyality o~ Anchorage
Development Services Dcparlment
· 4700 So~th Bragaw Street Anchorage, AK 99519-6650
SOILS LOG - PERCOLATION TEST
PERFORMED F~R: Steve' Pow'ers ..
L~[GALDESCRIFTION: Lot 8Ai, BLK 1~
~/~r Xasilof
.~'
~.~.
2-
12
13
14
15
16
17
18
19'.
20-
COMMENTS
DATE PERFORMED:
Township. Range,, Section!
WAS GROUND WATER
ENCOUNTERED? .
IFDEPTH?YES. AT WHAT ~j/~7. poL
E'
SITE PLAN
9 '~ 5 -/ 01
Read;n9 Date Gro~s Net Dq~th to Net
Time Time ' Water Drop
.
O: I1'. ~ · ... (,5" ..
PERCOLATION RATE __ (mlnutes/mch) PERC HOLE DIAMETER - ' *
TEST RUN BETWEEN-- ~ · FTAND ~'~J FT
Test Hole PreSoaked Prior ~o P~r~_nl~{nn ~h
PERFORMED B'~: /~'
· ACCORDANCE WITH A[.[ STATE AND MUNICIPAL GUIDELINES IN Ei:FECT ON THIS DATE. DATE:
PERFORMED FOR: Steve ?overs ·
L~GALDESCRIFTION: ]Jot; 8A! ~:ILK Ir
11
12
13-
14-
:- 16
17
18
19.
20-
Municipality of Anchorage
Development Services Department
· . 4700 So~th Bragaw Street Anchorage, AK 99519-6650
SOILS LOG - PERCOLATION TEST
Township. Range. Section!
Kasilof Hills Subd
SLOPE.
· :~ -I.II~.'
I.II.
· .I I~
·I1~
Ii1:
III
.I 1'1'
'. I1_1.
II I'
WASGROUNDW~TER ': ' ; ' ' '
· ENCOUNTERED?
· . IF YES. AT WHAT
SITE PLAN
DEPTH?
Date Gross Net . O~p~ to Net
~:~RCOL.ATION PATE
__ (mint~es.'mch) ['ERE HOLE DIAMETER · FT AND ~ FT
ACCORDANCE ~TH gL STATE AND MUNICIPAL GUIDEUNES IN EFFECT ON THIS DATE DAT~ '
THAT %HIS TET WAS E_J:IFORUE) I~ ·
q-lq.O~ ·
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 8A, BLOCK 1, KASILOF HILLS SUBDIVISION
GENERAL:
The scope of this project includes the procurement and placement of a
new 1,250 gallon septic tank at the location shown on the site plan. It
also includes the construction of a 50' long by 5' wide by 4' effective
depth absorption trench also shown on the Site Plan. The total depth
of the trench will be 7.5' below existing ground and the distribution pipe
will be placed at 3.5' below the surface. All components of the
absorption trench must be constructed a minimum of 100' from the
well on this and all adjacent lots.
e
Construction shall be in accordance with the approved site plan,
design drawings, Municipal Permit with any special provisions or
conditions, and all applicable State and Municipal Wastewater
Disposal Regulations.
The Contractor shall be responsible for obtaining all underground utility
locates and for the layout of the septic system and verification of the
location of all lot lines.
Unless specifically agreed otherwise, the contractor shall be
responsible for final grading areas subsequently depressed from soil
settling. Property owner shall be responsible for revegetation of
affected areas unless specifically agreed otherwise.
Contractors installing wastewater disposal systems must be certified
by the Municipal Department of Health and Human Services for
system installations. Owners installing their own systems must receive
prior approval from D.H.H.S. before beginning system installation.
SEPTIC TANK INSTALLATION
1. The 1,250 gallon septic tank must be procured from an approved
septic tank manufacturer and installed at the location shown.
A septic tank is to be constructed by a certified septic tank
manufacturer. Construction shall include two 4" cleanouts for pumping
access.
3. The septic tank shall be sufficiently bedded to prevent settling or
shifting of the tank.
4. All standpipes on the septic tank shall extend a minimum of 12 inches
above final grade.
5. Tanks installed without 4' of cover shall have a minimum of 2" of direct
burial insulation.
A foundation cleanout shall be installed one to four feet from the
building foundation. Two cleanouts are required between the tank and
the drainfleld.
· '.. Lot 8A, Block 1, Kasilof Hills
July 16, 2002
Page 2 of 3
7. Final grading over the tank shall be such that a positive slope exists
away from the septic tank.
DRAINFIELD CONSTRUCTION:
1. The drainfield shall be constructed to the dimensions shown on the
design. The bottom of the trench shall be within 2" of level.
o
Distribution piping must be placed level with perforations down atop a
level bed of drainfield rock. Rock should then be placed over the pipe
to provide a minimum of 2" of cover.
3. A silt barrier or geotextile fabric must be placed between the drainfleld
rock and the natural soil backfill.
4. Monitor tubes must be 4" in diameter and installed at the locations
shown on the design. The portion below ground must be perforated.
o
Contractor shall verify the septic tank and drainfield are a minimum
100' away from any pdvate water wells in the area, 150' from a Class
"C" Well or 200' from any community well.
Direct bury insulation must be placed over the distribution system if
less than 3' of backfill depth is available. Finish grade over the trench
must be mounded to prevent settlement or depressions.
7. Grade area surrounding the absorption trench to drain away.
o
A minimum 2' of accepting soil is required below the drainfield rock for
a 5' wide trench. Contractor shall verify this condition prior to
placement of the rock. All pockets of unacceptable materials must be
removed and replaced.
MATERIAL SPECIFICATIONS:
1. Septic tanks must be constructed by a municipally approved septic
tank manufacturer.
2. The following pipe materials are approved for use in septic system
installations in the Municipality of Anchorage:
Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated
and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and
ASTM D2662 or A.B.S. (perforated and solid).
3. Insulation shall be at least 2" thick extruded direct burial polystyrene
(Dow Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings
(Caulder, Fernco, or equal).
5. A permeable geotextile fabdc (Typar, Mirafi or equal) must be installed
between the final drain rock layer and the native soil layer.
Eot 8A, Block 1, Kasilof Hills
July 16, 2002
Page 3 of 3
6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing
the #200 sieve.
INSPECTIONS:
Municipal Ordinance requires a minimum of two inspections. These
inspections must be conducted under the supervision of a professional
engineer registered in the State of Alaska. The first inspection must be
conducted after the excavation of trenches, beds or pits and before the
installation of any gravel. A septic tank may be set in place, but may not
be backfilled.
The second inspection must be conducted after the placement of the
geotextile fabric, gravel, distribution piping, standpipes, cleanouts and
insulation. No backfill should be in place at the time of inspection.
Contractor shall provide a copy of all field survey layout and construction
notes for use in preparing the cedified as-built of the completed system.
MunicipalitY of Anchorage
Development Services Department
Building Safety Division
On-Site Water and 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
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 015-161-02
Expiration Date:
GENERAL INFORMATION
Complete legal description Lot SA, Block 1, Kasilof Hills Subdivision
Location (site address) 11101 GlazanofDrive Anchorage, AK99516
Current Property owner(s) Steve and Michelle Powers
Mailing address P.O. Box 110928 Anchorage, AK 99511
Day phone 345-9964
Lending agency
Day phone
Mailing address
Real Estate Agent
Day phone
Mailing Address'
Un/ess otherwise, requeSted, COSA wi//be he/d by DSD for
pickup.
NUMBER OF BEDROOMS: Four (4)
=
TYPE OF WATER SUPPLY:
Individual Well []
Individual Water Storage []
Community Class ~ 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 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 ~ex_cept. b~een ~pouses) for properties served by a single-family omsite ~/astewater disposal and/or water
supply system. DSD also isSues C~sAS upon reque'st' to h0~e0~nersl -c-ertifi~{~ 0f'bs,si{~' sy§t~m'~ Appr0~,al
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm Anderson Engineering
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name
DSD SIGNATURE
~v,,/ Approved for
Disapproved.
Conditional approval for
Phone 522-7773
Michael E. Anderson, P.E.
bedrooms.
Date _ 10/4/2010
bedrooms, with the following stipulations:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
(Rev. 11/05)
X
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date: / C) '- '-~'--//O
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: Lot SA, Block 1, Kasilof Hills Subdivision Parcel ID: 015-161-02
A. WELL DATA
Well type Pr~ate IfA, B, or C provide PWSID #
Date completed 9/17/2002 Sanitary seal (Y/N) Y
Total depth 260 ft. Cased to >40 ft.
FROM VVELL LOG
Well Log (Y/N) Y
Wires propedy protected (Y/N) Y
Casing height (above ground) >24 in.
AT INSPECTION
Date of test 9/17/02
Static water level 9o ft.
Well production 4
WATER SAMPLE RESULTS:
10/3/10
63.7 ft.
g.p.m. 5.3 g.p.m.
Coliform 0 colonies/100 mL Nitrate 7.56 mg/L Other bacteria 0 colonies/100 rnL
Arsenic: N/D mgll Date of sample: ..9/21/2010 Collected by: A. Harala
SEPTIC/HOLDING TANK DATA
Tank Type/Material Sep~S~l Date installed 9/14/02
Tank size .1,250 gal: Number of Compartments Two Cleanouts (Y/N) Y
... F0undati~n.c!ean°~ (Y/N). Y_ .Depression 0vertan~.(y!N) .N . High_wa_ter- alarm (Y!!~!) N
Oateofpumping - -11l~15/209 Pumper No Sludge-Neted inSeptic Tank
C. ABSORPTION FIELD DATA
Date installed 9/15/2002 Soil rating (g.p.d./ft2 or'ft2/bdrm) 1.2 GPD/SF System type 5' Wide Trench
Length 60 ft. Width 5 ft. Gravel below pipe 4 ft.
Total depth 7.5 fL Eft. absorption area 500 ft2 Monitoring tube , Y Depression over field N
Date of adequacy test 10/3/2010 Results (Pass/Fail) Pass For 4 bedrooms
-FlUid-depth-irvabsorPfior~eld~efore*test*-n 8
Elapsed Time: 120 min. Final fluid depth 18 in. Absorption rate >= 600 g~.p.d.
in.' -Water a(jded~gaL -NeW~depth-'-2~5 ....... in.-
Any rejuvenation treatment (past 12 mo.) (Y/N & type).. ' If Yes, give date
D. LIFT STATION
Date installed
~ :Pump on' level at in.
Datum
E. SEPARATION DISTANCES
Size in gallons
"Pump off" level at
Cycles tested
Manhole/Access (Y/N)
in .... High water alarm level at in.
Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot >100' On adjacent lots >100'
Absorption field on lot >100'
PUblic sewer.main N/A
Sewer ,septic service line >25'
Animal containment areas >5o'
On adjacent lots >100'
Public sewer manhole/cleanout
Holding tank N/A
Manure/animal excrete storage areas
N/A
> 100'
SEPARATION DISTANCES FROM SEPTIC, HOLDING TANK ON LOT TO:
Building foundation >5' Property line >5'
Water main N/A Water service line >10'
Wells on adjacent lots >100'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 3'*** Building foundation >10' Water main
Water Service line >10' Surface water >100'
Curtain drain None Noted Wells on adjacent lots >100'
COMMENTS: ***See Lot Line Waiver.
Absorption field >5'
Surface water >1oo'
>10'
Driveway. parking/vehicle storage >25'
G. ENGINEER'S CERTIFICATION
... . ..
I ~ that, have dete~ined through ~,d in~pe~ion~and
mwew of Mumc~pal m~s that the above syae~ am ~n
~nfo~an~ wEh MOA COSA guidelines in effe~ on this' date.
Engine,s Printed Name Michael E. Andemon. P.E.
Date 10/5/2010
"' -
COSA F~ $
Date of Payment
............ Ee--ce-Jp_tNumbe~! ....
(Rev. 11/05)
Waiver Fee $
5"-1 ~
Date of Payment
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. O~5:!¢:z1.~22
Expiration Date: ~' - ~)- '"'O .~
Day phone
GENERAL- INFORMATION
Complete legal description _.Lo~ ,5,A._DJ~cl~ t~ :Ka~ilo~ H~,c_Sul~tiv~ion
Location (site address or directions) _~l~za,o~
Current Property owner(~) _.EzJ;~-v~,_a~d_l~lLich~l~
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
Unless otherwise requested, HAA will be held by DSD for pickup.
NUMBER OF BEDROOMS: FQur (4-)_
Day phone
Day phone
TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class
Public Water System
Well
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 Authority Approval are
valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with
new water sample results 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 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 Health Authority 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(ara) in compliance with all applicable Municipal and State codes, ordinances,
and regulations in effect at the time of installation.
Name of Firm
Phone _52-2:2215
Address ~'.0. ~_o~?..~O~bo~:a~j~_~K 99524-
Engineer's Printed Name
Date
DSD SIGNATURE
--J.'""~ Approved for
Disapproved.
bedrooms.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments Tha-wall--far--this--proper~y-meets-ex-ist~lnE--St. ete and
Municipal Codes. there are nitrates present...It,is suggested that ,p_e.r~_odic ....
testing be performed to insure the wells continued suitabilit~. C~rren~at~
concentration is 6.84 mg/1. EPA maximum concentrat_$jMl_~s_lO~Cgmg/]. Hnr,
information on nitrates is available from the On-S~te Serv~ee~'~rogram, at
343-7904.
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
..×
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date:..pr-_ 3 0 - 0._~
Municipality of Anchorage
Development Services Department
Building Safety Oivislon
On-Site Water & Wastowater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK gg519-6050
www. cl.anchorage.ak, us
(907) 343-7004
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: Lot SA. Blo~kl. Ka$itof hqll$$ubdMslon
IfA, B, or C provide PWSlD #
Sanitary seal (Y/N) !
Cased to >40fL
FROM WELL LOG
9117J'2002
A. WELL DATA
Well type Private
Date completed ~1/17/2002
Total depth :260 .fL
Date of test
Static water level
Well production
g.p.m.
WATER SAMPLE RESULTS:
Coliform ...Q._colonles/100 mi. Nitrate ..$,~ mg./I.
Date of sample: 6/22/~03 Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel,.
Tank size 1.25o gal. Number of Compartments
Foundation cleanout (Y/N) Y Depression ever tank (Y/N) 14
Date Of pumping Pumper New ConstrucUoTl.
C. ABSORPTION FIELD DATA
Parcel ID: 0]~-161~2
Well Log (Ye,') y
Wires propedy protected (Y/N) y
Casing height (above ground) ~4
AT INSPECTION
g.p.m.
Other becterla g colonies/100 mi.
Date Installed 9114/2002
Cleanouts (Y/N) ¥
High water alarm (Y/N) H
Water added gal.
in. Absorption rate >=
If yes, give date
For bedrooms
Now depth, in.
g.p.d.
Fluid depth in abeorpUon field before test. in.
Elapsed Time: min. Final fluid depth
Any rejuvenation treatment (past 12 mo.) (Y/N & type)
Date Installed 9~15/2002 Soil rating (g.p.d./ft2 or ft2/b(:lrm) !.2SF/BDRM System type 5' Wide Trench
Length ..~) fL Width ~i fl. Gravel below pipe .4
Total depth 7,6 ff. Eft. absorption area 600 .~ Monltoriog tube Y Depression ever field N
Date of adequaw test Results (Pass/Fal0
LIFT STATION
Date installed
"Pump on" level at
Datum
in.
E. SEPARATION DISTANCES
Size in gallons ,,
'Pump off' level at .,,
Cycles tested
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot >10o'
Absorption field on lot >100'
Public sewer main >100'
Sewer/septic service line >25'
In.
Manhole/Access (Y/N)
High water alarm level at
MeMs alarm & circuit requirements?
On adjacent lots >100'
On adjacent lots >100'
Public sewer manholelcleanout
Holding tank
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >5'
Water main >10'
Wells on adjacent lots >100'
Property line >5'
Water service line
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Building foundation
Surface water
Wells on adjacent lots, >100'
AbsoH0tion field >5'
Surface water >100-
Water main ,..>lo-
Driveway, parkingNehicle storage
Property line 3'
Water Service line
Curtain drain None Noted
F. COMMENTS
in.
m~ew of Munl~pal m~s that t~ abo~ s~ems
Engineers Pdnted Name Michael E. ~d~on. P.E.
HAA Fee $.
Date of Payment
Receipt Number
(Rev. 12/(X))
Waiver Fee $ /~'~ ~
Date of Payment
Receipt Number
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