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Home My WebLink AboutMACBETH BLK 2 LT 3MacBeth Block 2 Lot 3 #015-511-04 U Municipality of Anchorage Development Services Department -o`r •. Building Safety Division -fir Onsite Water and Wastewater Program. 4700 S. Sragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 Page 1 of 3 www.cLanchorage.ak.us (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM ANDIOR WELL INSPECTION REPORT Permit Number. S k10 2 O 2 / f PID Number. OIS' -S// - o y Ham: Wo Y-1 a Fr;1Un Wastewater System: ® New ❑ Upgrade 1d°"`« /IIY1 ijrt991 CF, /inch 99511 ABSORPTION FIELD prone. Mahn °y '« PLDa.p T and t7m 5n.rTrarcH Dead p Mona D OtherIS-1 -940,00 soill Rating: Ter Depth himLEGAL DESCRIPTION O.6 Gporre original?/ F Depth to D'p, bolas Yon a" pGrand vel depth baneant Pa: D . a 2 L3 M CrtH 2.0 Ft. IO. I Ft FA a00ed.mra ertsetar pad« chiral LwVft C Township: Flange: Samws I.0 f Ft. �O Ft. chiral teem HorLarafatax Dutahtu bak"wtirf: Well: ® New ❑ Upgrade -2-s- Ft. ! — FL CtassRrmtion(limme. A R. C= Tar DepamCaAd"' Total stsapimni area Pp ssredat F-8 /0 Perf Prt/", a ke '221 Ft. 221 FL 767 FIs D-?o3y New-ntrf Dnoer. Dna Drim¢ sr wma Levet YruMr. ome installed Alrip e I 7/16/02 I 16Y Ft OLuner -7/ IS' /OZ Yield: "Sox Casts Hsgd AW" rrNA'd TANK "yo f GPMI FL Z FL SEPARATION DISTANCES ® Septic ❑ Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption Lift Holding PubriciPdvate Ma'ada w. cavawr. From Tank Field Station Tank Serer Line heitcho r alt a ire n tr 1250 Gr k mei ✓ marler, of Cpnpan"erel wan 126' 139 — - >2s a Sf PB/ Z Swfawwater > ICG• 7 ICG, — _ LIFT STATION N.i} g¢., Maraar9aar. LNUM .3'y t 19' — Gr. •Pump on' W401 K 'Ptarp dP MrN at H{,n r"In harm n: For"dmt 13 • 'LS i — h in h Pune Make 6 Modal E:amakr hspectiar W.tonned W Curtain Drain -- — — R*.wka a, BENCH MARK 2 I;fy nai Fnnu 1a lTun P lilt.! ✓ LaotiOn well Wsmpacrs onicr fccnk piuc/iur,7t line so%6in OF PIY"x OC ShiotfAin/,/ J Asau:.l7 E:eraucrc an et &O)Art earner coc 404ve /OZ� PL Engineers Stamp yy-ewrlsa Ti of A�`►• x';41:; • �.• '• '.•s.'6 Inspections performed by: Fta{>�i T-ecb 5e". Dates: 1" 7//;/02 *3: 49TH , •; fT� t 2nd 7/IS/ r...�.:/.f.................:...� Development Services Department Approval P ..e�`:�::a............� le THEODORE F. MOORE ; Reviewed and approved by: Date: /�/7//L !� ' CE -3589 •r� Pr.,•/�...••••ae 1 rt. V PERMIT NO: SWO20214 PAGE 2 OF 3 T.36 -FOOT LONG PID NO: 015-511-04/-#' SOIL ABSORPTION TRENCH w. 101 FEET EFFECTIVE GVL. ; , ^ 1250 -GALLON 'G"-- «E.. SEPTIC TANK »F.. SWING TIES: TOM FROM: COR. "A" COR. "B" TO: ; S.T. C.O. "D" 3S' 19' ; + , S.T. C.O. "E" 43' 24' ; DBL. C.O. "F" 45' 26' ; �'TR. C.O. "G" 52' 26' ; - TR. M.T. "H" 49' 41' ; r TR. C.O. "I" 50' 61' ; DRIVE . LOT 3, BLOCK 2 MACBETH SID ; 1 ' r-• WELL ' l � ; OF uAt,, 11 L •�i.)TH tw } d . Y. '+` C: • 3550 �'`. EAST 112th AVENUE ----------------------- LOT 3, BLOCK 2, MACBETH SID SEPTIC SYSTEM INSTALLATION AS -BUILT PLAN VIEW >I N FLATTOP TECHNICAL SERVICES SCALE:1"=30' 14530ECFIOSTREET DRAWN BYTFM ANCHORAGE, ALASKA 99516 OCTOBER, 2002 PERMIT NO: SW020214 PAGE 3 OF 3 PID NO: 015-511-04 2'+ SOIL COVER 2"RIGID DINSnULATION _ �, II INV. INV., 1250 -GALLON 95.7 SEPTIC TANK 38 -FOOT LONG SOIL ABS. TRENCH w 10.1' EFF. GRAVEL ! ; BOTTOM TRENCH ELEVATION 84.0' BOTTOM T.H. #1 ELEVATION 77.6 / M.T. DRY 7110102 \—INV. 95.9 LOT 3, BLOCK 2, MACBETH SID SEPTIC SYSTEM INSTALLATION AS -BUILT PROFILE VIEW FLATTOP TECHNICAL SERVICES NOTTOSCALE 14530 ECHO STREET DRAWN BY TFM ANCHORAGE, ALASKA 99516 OCTOBER, 2002 Rick Mystrom Mayor Municipality of Anchorage Department of Health and Human Services 825'L' Street P.O. Box 196650 Anchorage, Alaska 99519-6650 httpW wN.d.anchorage.ak.us Permit Number: #SW 020214 Date of Issue: 7-8-02 Date Started: 7-15-02 Date Completed: 7-16-02 Legal Description: Macbeth blk 21t 3 Property Owner Name & Address: Wayne Frison 12815 Alpine Drive Anchorage, Alaska Parcel Identification Number: 015-511-04 Is well located at approved permit location? ® Yes ❑ No 99516 Borehole Data: Depth (ft) Method of Drilling ® air rotary ❑ cable tool Soil Type, Thickness & Water Strata From To Casing type: steel stick-up 0 2 Wall Thickness: .250 inches silt 2 15 Diameter: 8 inches Depth: 221 feet gravelly silt 15 97 Liner Type: Diameter: inches Depth: feet gravel 97 110 Casing stickup above ground: 2 feet silt 110 126 Static water level (from ground level): 164 feet gravelly silt 126 183 Pumping level: 220 feet after silt 183 205 2 hours pumping 40+ gpm gravelly silt 205 219 Recovery Rate: 40+ gpm water sand 8 gravel 219 221 Method of Testing: air Well Intake Opening Type: ® Open End .❑ Open Hole ❑ Screened Start feet Stopped feet ❑ Perforations Start feet Stopped feet Grout Type: Bentonite chips Volume: 1 bes Depth: Start 0 feet Stopped feet Pump: Intake Depth feet Pump size hp Brand Name Well Disinfected Upon Completion? ® Yes ❑ No Method of Disinfection: chlorine tablets Comments: Pump test will follow Well Driller. Alpine Drilling & Enterprises PO Box 110496 Anchorage Alaska 99511 Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property .......... LL..... 11 J..!.1.. .L.O .'J ..111.... L. T...• .f 11..1A 0 rl......- P.. '......'d:.. 1. J.... . 0....... 1 ...... (, /2--02 44:yS MUNICIPALITY OFANCHORAGE Development Services Department G' /5—. 02 - On -Site 2 -On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM 1 WATER SUPPLY PERMIT Initial Permit Number: SW020214 Legal Description: MACBETH BLK 2 LT 3 Date Issued: Jul 08, 2002 Expiration Date: Jul 08, 2003 Parcel ID: 015-511-04 Design Engineer: 0019 Flattop Technical Services Site Address: Owner Name: Wayne Frison Lot Size: 50336 SO. FT. Owner Address: 12815 Alpine Dr. Total Bedrooms: 4 Permit Bedrooms: 4 Anchorage , AK 99516 - This permit is for the construction of: 0✓ Disposal Field Q✓ Septic Tank Holding Tank Ej Privy 0✓ 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. ReceivedBy:li741Ltj AA &-%,r. V—jCj �CC�r«-( Date: -% Da4�1Issued By:/ - /OTZ�— Date: %/t/0Z 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 SEWERMELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. n /5--5-1I — O,—/ Property owner(s) (,ver L f-rvC., Mailing address (1) 1 Z 8 rr A117:n c O r - --< '0 Y � sur.♦ Permit Number SWO202/4 Day phone T S l - 9B66 Mailing address (2) /-} C'Auorcaf� /)-k Zip Code 199rix" Legal description (Lot, Block & Sub'd.) C of 3 B /ac k 2 /`t ac 6c h� S'/ A Legal description (Section, Township & Range) Lot Size SC) 3b<p Acres .Ft. Number of Bedrooms i THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ® Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 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: 1 �SSO.Do Waiver Fees: Date of Payment: 7/2-/ ZGGO 2, Date of Payment: Receipt Number: ZZ!•g p S -} Receipt Number: (Rev. 12/00) y i ttt i } ATTOP TE(;HNIGAL SERIES CnTL & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. 14530 ECHO ST. Pit: (907) 345.1355 ANCHORAGE. ALASKA 99516 July 2, 2002 M.O.A. DSD P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: The purpose of this letter is to provide the required design narrative in support of our application for a permit to construct wastewater disposal facilities on Lot 3, Block 2, Macbeth S/D, located at 6780 East 1 p Avenue. Soils logs, pert test results, a site plan, design drawings and specifications are enclosed for your review. The proposed system will be constructed in the vicinity of test hole # 1. As can be seen from the soil log, the native material below 1.5 feet consists of silty and overlying silty sandy gravel, both with a measured Pere rate of 5 minutes per inch or less. Using a somewhat conservative soil application rate of 0.8 gpd/sq. ft. this proposed 4 -bedroom residence requires a total absorption area of (4 x 150)/0.8 = 750 square feet. The proposed 38 -foot long trench design with an effective gravel depth of 10.0 feet has a total absorption area of 760 square feet. The 25 -foot long replacement trench designated on the site plan is sized on the basis of 1.2 gpd/sq. ft., which corresponds to the actual measured pert rates. The topography of the lot in the area of proposed construction slopes down towards the north northwest at approximately 15% The proposed project will have no significant impact on present or future water supply and wastewater disposal systems serving adjacent properties, nor will it have any significant impact on reserved space -surface and subsurface, or on drainage. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, JT c Ted Moore, P.E. LOT 2, BLOCK 2 MACBETH SID\00 ,HOUSE SEPTICA� I I SITE FOR REPL.TRENCH ; SIZED 1.2 GPD/SO. FT. ; ---- � --- '''_ T.H. CONSTRUCT 38 -FOOT LONG ; SOIL ABSORPTION TRENCH ; W. 10' GRAVEL BELOW PIPE ; R 10C' INSTALL 1250 -GALLON ; SEPTIC TANK ; PROPOSED HOUSEr F 4 - IE RM - a HOUSE I a ; O I WELL DRIVE ; LOT 3, BLOCK 2 ; % / LOT 4, BLOCK 2 % % MACBETH S/D '1 ; MACBETH SID _ PROPOSED f WELL SITE ; 1 I I -------------- I 1 I 1 1 I 1 I I 1 � 1 _SEPTIC AREA I ` / I \ / 1 ------------------ ----------------------- ----------J------J EAST 112th AVE. LOT 2, BLOCK 3 LAKE O' THE HILLS SID N LOT 2, BLOCK 1 STONY BROOK SID THEODORE F. MOORE ,a' �•. CE -3589 40 ' d LOT 1, BLOCK 2 .KE O' THE HILLS SID LOT 3, BLOCK 2, MACBETH SID PROPOSED WELL AND SEPTIC SYSTEM SITE PLAN \FLATTOP TECINICAL SERVICES 1 INCH = 50 FEET 14330 ECI IO STREET DRAWN BY TFM ANCHORAGE, ALASKA 99516 JUNE, 2002 NOTE: THIS IS NOT A SURVEYED PLAT. ALL LOCATIONS SHOWN ARE APPROXIMATE. 4" DIA. F-810 PERF. DIST. PIPE 38 M.T. C.O. - - ,.A.. � CONSTRUCT 38 -FOOT LONG SOIL ABS. TRENCH W. 10' GVL BELOW DIST. PIPE BETW. 2.5' 812.5' BGL 4" D-3034 WASTE LINE FROM HOUSE PLAN VIEW SCALE: 1" = 10' CLEANOUT MONITOR MOUND BACKFILL — ORIGINAL GROUND 4" DIA. D-3034 DOUBLE C.O. .1250 -GALLON TANK FILTER FABRICS 2" RIGID INSULATION-/ 12.5 4' F-810 PERF PIPE � 10 10.5 1J2" - 21n" GRAVEL BOTTOM OF EXC. CROSSECTION "A - A" LOT 3, BLOCK 2, MACBETH S/D SCALE: 1" = 5' SEPTIC SYSTEM INSTALLATION PLAN AND CROSS-SECTION FLATTOP TECHNICAL SERVICES SCALE: AS Sl 10%%'N 14530 ECHO STREET DRAWN BY: TFM ANCIIORAGE, AK. 99516 JUNE, 2002 613 z 'i i+3 B►K A Ala r 5 C --G �a.^ t I7 •. •�� ,s Arb �A /t p✓e ✓ 114 � 1 I ' DV /' i 3 o^.!f L,/ 7"'�nt /4j'4- /O y/0./J Oi✓ �t :/,�✓N� • �../< ((.)t� • � R/�^ QN �/QG�I�IW� C17N S�Isa t�iy..� IrOYIMM/Y iCi f^'G. CkAfo QM I; (OUv VoWl�.i✓[ a 6n tKG,p.e, iY`oh+ 1M . 17 j .v S k (( 'e, 4-4. ,•r i t 6"1A r y4. .�..� o w .' PI e44 -Al c c. w.�l� h� oo,, c. h y ysci�c, rf fattop 7ecknicalSeMkes 14530 EchoStreet,.Anclmrage,,XX99516 Ohm (907) 345-1355 Lot 3, Block 2, Macbeth SID 6780 East 112'" Avenue Wastewater disposal system installation Specifications 1.0 General: 1.1 The scope of the project consists of installing a 1250 -gallon septic tank that discharges effluent into a 38 -foot long soil absorption trench containing a total of 10.5 feet of sewer gravel. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform to Municipal and State requirements. All separation distances shall be in conformance with Municipal requirements, unless specifically waived. 1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. 1.4 The contractor shall provide adequate cover material and rough grading over all system components to ensure that proper drainage is achieved after settlement and that there are no residual depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas. 1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the construction. 2.0 Septic Tank: 2.1 The new 1250 -gallon, 2 compartment septic tank shall be Municipally approved and shall be set level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover and a 4" cleanout. If the tank is buried less than 4 feet, it shall be insulated with 2 inches of approved burial type, rigid insulation. 2.2 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The waste line from the residence to the septic tank shall have a minimum slope of 1/4"' per foot, and the waste line between the tank and the soil absorption system shall have a minimum slope of 1/8" per foot. A cleanout shall be installed 1 - 4 feet from the building foundation, and a double cleanout shall be installed within 5 feet downstream of the septic tank. 3.0 Soil absorption system: 3.1 The soil absorption system shall be constructed by excavating a trench to a total depth of12.5 feet below ground level. The long axis of the excavation shall parallel an existing contour 3.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked to allow proper infiltration. Sand for leveling or serving as filter material shall comply with Municipal specifications. 3.3 A total of 10.5 feet of approved sewer gravel shall be placed in the bottom of the excavation with the perforated distribution pipes laid level such that the pipe inverts are no less than 10.0 feet above the bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing the #200 sieve. 3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on the design drawings. The portion of the monitor tube extending through the sewer gravel shall be perforated. 3.5 Approved filter fabric shall be placed over the entire top surface of the sewer gravel. A minimum of 2 feet of soil cover is to be placed over the filter fabric. If the soil cover thickness is less than 3 feet, two inches of rigid, burial type insulation is to be placed over the entire top surface of the gravel, in addition to the filter fabric. 3.6 The top surface of the cover material shall be raised a minimum of 6 inches higher than the surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill slopes shall be no steeper than 3:1. 3.7 Unless specifically agreed otherwise the homeowner shall be responsible for arranging to have the site finish graded after the backfill material has stabilized, and for placement of adequate topsoil and seed to promote rapid revegetation of all areas disturbed by the construction. 4.0 Inspections: 4.1 A minimum of 4 engineering inspections will be required during the course of the project: (1) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the native material has been excavated to expose the infiltrative surface to ensure that it is level and at the right elevation, and conforms with the soil test information, (3) after the sewer gravel is in place and the distribution pipes have been laid and connected up to the septic tank, but prior to placement of insulation or filter fabric, and (4) after rough backfill and grading is complete. The septic tank requires one inspection after it is set level and the piping connected, but prior to backfill. This inspection may be incorporated with any of the above inspections. 4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 TEST HOLE # 1 I SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION:_Lot.3..13I0ck_2.MacBeth_$/D DATE PERFORMED:_June1Z.2002 PERFORMED FOR: ____yayneFPson DEPTH Pt. (feet) 1- SM Reddish sandy loam 2- .3 - SM Gray silty sand 4- Dry 5 - GM Gray silty sandy gravel Dry B.H. Depth to Groundwater No groundwater .Monitor_tube Cry_ SLOPE 10% 10% Date OF AtRat• �••v9TN jr Vt t< fr ir.... •......• Y.:•••.�•. THFUDUA! F. M'%ORE j 4'. .. CL -3589 SITE PLAN 1 / 62 23 .1 1=7 15% 0% Date Reading Clock Net Time Percometer Net Drop Time (minutes) Reading (inches) 20 i PERCOLATION RATE_5_ (minutesAnch) PERC HOLE DIAMETER fi _ TEST RUN BETWEEN 8.0_FTAND 8.5—FT COMMENTS:_$eesest. Hole #ta for_second perc test conducted inffieshallowefSM stratum. PERFORMED BY FLATTOP TECHNICAL SERVICES. I�i�a„�_ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 7 / 2 / O Z FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 TEST HOLE # la I SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION:__LO(.3..Biock 2..MaCBet4S/D DATE PERFORMED: --June-17a002, PERFORMED FOR: Wayne F(ison DEPTH Pt (feet) 1- SM Reddish sandy loam 2- 3 - SM Gray silty sand 4- Dry 5- 6- 7- g _ GM Gray silty sandy gravel Dry 9- 10' Depth to Groundwater 11' Nn nmunrhw tar 113- 14- 15- 16- B.H. 3'14'15- 16- B.H. Date Reading -6/1812"-Presoa 12" ResoaF Start #1— Add water_ #2 Add_water #3_ SLOPE 10% 10°/. OF AL 2 L * d;9TN F v • k d ...................:... 4 THiODOPL F. MOORE : S C:.3539 �.• t�.P SITE PLAN Data IV02 15% ?4/02—SLOPE Clock Net Time Percometer Time (minutes) Reading 31 31 3:03:30 77 i. II N 0% Net Drop (inches) 112 4 5/8_ -7q 49116 _ �. PERCOLATION RATE 4_ (minuteslinch) PERC HOLE DIAMETER_5"_ TEST RUN BETWEEN 2.75_ FTAND_3.25_ FT COMMENTS: This is a 2nd pert that was conducted in the shallower SM stratum at test hole #1 PERFORMED BY FLATTOP TECHNICAL SERVICES. I,' CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: u)ta Y,J �e— Ft i so,✓ Municipality of Anchorage -� Development Services Department e < 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. O 1 C -511 - o y COSA # i)inf),12dz Expiration Date: 8-30-04 1. GENERAL INFORMATION Complete legal description L.o f 3, 13 /ac k 2, H a c l3rM S/6 Location (site address) /it If/ 13 P -i r ,%c Coti. f Current Property owner(s) _ WeLXne FNfo., Day phone T V - 9er6�5 Mailing address Lending agency Mailing address Day phone Real Estate Agent -Mmeru ke/16 Re Mo), Dayphone ZS7-017/ Mailing Address Ito W, 36fh,4 e, t1 Irx,/}.,�� A -Cc 99S03 Unfess otherwise requested, COSA will be held by DSO for pickup. PIra1e a<t/ W"& F -,,fon 2. NUMBER OF BEDROOMS: @ 3.4-1-946o 4 +hen CexS4 ray fa,- p rc le- V* 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site 10 Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of Onsite 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 Onsite 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 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. l 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 F1a14&og Ser&;re Phone 7 VS- )7 &7S - Address 1,Y6W �clb eanyo� A."e-4 99516 Engineer's Printed Name Date S1 ZY / uaC 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By. Original Certificate Date: .S- 30 -6 (Rev. I M) 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/onsde (907)343-7904 CERTIFICATE OF ON—SITE SYSTEMS APPROVAL CHECKLIST Legal Description: "f 3-, Bloc k ; 1- ac SeAh S /D Parcel ID: o IS- S/! - oy A. WELL DATA Well type P&,/ If A. B, or C provide PWSID # Date completed -ZLt6/O Z Sanitary seal (YIN) Y Total depth 22! ft. Cased to eft. FROM WELL LOG Date of test -7/ t6 / O Z Static water level 16Y ft. Well production 9 - p.m -WATER SAMPLE RESULTS: Coliform _,_colonies/100 mL Nitrate $Z mg/L Arsenic: 7.1.3 ppb date of sample: 3 /ZO/G G S'/ 14' /off B. SEPTIC/HOLDING TANK DATA Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) _18 n. AT INSPECTION 3/Po /G6 !Ba ft. g.p.m. S/ /s" / zoa6sa.r/dG Other bacteria _0_colonies/100 mL Collected by: %tin:cv/ Cuc Tank Type/Material �S- W he / t /+a/ Date installed 7 / rS/ O Z Tank size 17-Si7 gal. Number of Compartments Cleanouts (YIN) Y Foundation cleanout (Y/N) Y Depression over lank (YIN) M High water alarm (Y/N) P. A,_ Date of pumping H/ Z 7 / OK Pumper A + h6^& Strvrc i C. ABSORPTION FIELD DATA Dale installed 7/'S/02- Soil rating (g.p.d./ft2 or ft2/bdrm)O. 8T& System type 3:e s Length 3s ft. Width 2• S ft. Gravel below pipe IO. ! ft. Total depth 12-1 ft. Eff. absorption area 767 ft2 Monitoring tube Y Depression over fieldII i Date of adequacy test 3 / ?C+ /Oul Results (Pass/Fail) Pau For 51 bedrooms Fluid depth in absorption field before test IS' in. Water added69S gal. New depth3a Lsin. Elapsed Time:),I-L min. Final fluid depth33, In. Absorption rate >= 60.6 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date 04 D. LIFT STATION P. A, 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 tank/lift station on lot 126 Absorption field on lot 139 Public sewer main N. A. Sewer /septic service line 7 Z' ' Manhole/Access (YIN) High water alarm level at in. Meets alarm & circuit requirements? On adjacent lots > rte' On adjacent lots > /4&1:+ ' Public sewer manhole/cleanout Holding tank A1..f, Animal containment areas 6/• A. Manure/animal excrete storage areas >✓. A. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 13' Property line 31y, Absorption field S' Water main N• A. Water service line 7 10' Surface water > /moo Wells on adjacent lots > /uo' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /9' Building foundation 25"' Water main N•A, Water Service line > 10 r Surface water > rc^o' Driveway, parking/vehicle storage > 4W Curtain drain 110iw2e S ts'7 Wells on adjacent lots��' F. COMMENTS G. ENGINEER'S CERTIFICATION o ' • ` •%` '�^ I certify that I have determined through field inspections and .. review of Municipal records that the above systems are in ��r��1F. conformance with MOA COSA guidelines in effect on this date. £� r • •0CRE ••• RL . TNEO[,CRC F. 45CCRe Engineer's Printed Name 7-A fo�w✓e �•r`rda+e <<_,'•;'`�� 35s9•,�,�' Date Mav 2'!r 2U0 `'I'"'•y�oT�` �, COSA Fee $ H3 9 G o Waiver Fee $ _ Date of Payment .51 7-S- / 042 Date of Payment Receipt Number � G Receipt Number (Rev. 11/05) SGS RcCp 1061323001 Client Name Flattop Technical Srv. Project Nome/# Lot 3 Block 2 MacBeth SD Client Sample ID Lot 3 Block 2 MacBeth SD Matrit Drinking Water PWSID 0 Sampic Remarks: All Dstes/rimes are Alaska Standard Time Printed Datdrime 03/272006 16:57 Collected Date/rime 03202006 12:50 Received Date/time 03202006 13:50 Technical Director Stephen C. Ede Allowable Prep Analysis Parernetcr Results PQL Units Method Container ID Limits Date Date Ing Metals by ICP/MS Arsenic 7.13 5.00 ug/L EP200.8 C (ti10) 0321/06 0322/06 SCL Waters Department Nitrate -N 0.136 0.100 Microbiology Laboratory Total Coliform 20 OB. No Coli mg/L EPA 353.2 D (<-10) cot/l00mL SM209222D A (<-1) 0320/06 AZS 0320/06 DPT 69-106 MACBETH -SUBDIVISION LOT 3 BLOCK 2 56,336 S.F. SEPTIC SYSTEM ww t4o- EXISTING BUILDING M oaoceon llo nne nn. I I • 1 I I I I I . I ,ah I I a s ----------- - - -I.-- .. ensu w.wwu I I I PTI I , I 1 I � I I 1 I I I I I I I I I 1 1 I -- - - - - - - - - - - - - -I 10' LML ESMT. yO EAST 113TH AVENUE FINAL STRUCTURE AS -BUILT AS -BU I L TI HEREBY CSF' THAT I HAVE SURVEYED THE 55.3' PROPERTY DEPICTED ABOVE AND THAT NO GASTALDI LAND SURVEYING z JEFF A. GASTALDI, R.L.S. IT IS THE RESPONSIBILITY OF THE OWNER TO a, DETERMINE THE EXISTENCE OF ANY EASEMENTS, ANCHORAGE. ALASKA 99502 COVENANTS OR RESTRICTIONS WHICH DO NOT PHONE 246-5454 APPEAR ON THE RECORDED SUBDIVISION PLAT. p GRID 36.2' C4 2638 10/10/2002 ESTABLISHING BOUNDARY OR FENCE LINES. C4 +. F.B. JOB NO. 02-14 MBS32 GRAVEL DRIVE o O ww t4o- EXISTING BUILDING M oaoceon llo nne nn. I I • 1 I I I I I . I ,ah I I a s ----------- - - -I.-- .. ensu w.wwu I I I PTI I , I 1 I � I I 1 I I I I I I I I I 1 1 I -- - - - - - - - - - - - - -I 10' LML ESMT. yO EAST 113TH AVENUE FINAL STRUCTURE AS -BUILT AS -BU I L TI HEREBY CSF' THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO GASTALDI LAND SURVEYING ENCROACHMENTS EXIST EXCEPT AS INDICATED. JEFF A. GASTALDI, R.L.S. IT IS THE RESPONSIBILITY OF THE OWNER TO 4726 WEST 88TH AVENUE DETERMINE THE EXISTENCE OF ANY EASEMENTS, ANCHORAGE. ALASKA 99502 COVENANTS OR RESTRICTIONS WHICH DO NOT PHONE 246-5454 APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR 2638 10/10/2002 ESTABLISHING BOUNDARY OR FENCE LINES. ANCHORAGE RECORDING DISTRICT, ALASKA F.B. JOB NO. 02-14 MBS32 NOTE: NO CORNERS SET THIS DATE. J V t V 1 "=30' 0 0 N