HomeMy WebLinkAboutTIMBER RIDGE #1 BLK 3 LT 5Onsite File
#050-321-50
•
Municipality of Anchorage
On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP191485 PID Number: 050-321-50
Dwelling: El Single Family(SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ■❑ Upgrade
Name ABSORPTION FIELD
SIBSON BRYAN & JODI
Site Address ■❑ Deep Trench ❑Wide Trench ❑ Bed ❑ Mound
19424 UPPER SKYLINE DR [' Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
5 4-0'Ire l.(2> 0.6 GPD/SF 10 Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot 3 Ft. 7 Ft.
TIMBER RIDGE #1 BLK 3 LT 5 Fill added above original grade Gravel length
Township Range Section 1+ Ft. 36 Ft.
Gravel width Beds:Number of Lines Distance between lines
SEPARATION DISTANCES 2.0 Ft. 0 Ft.
To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist.between trenches
From
Tank Field Lift Station Tank Line 504 Ft2 1 Ft.
Well 100'+ 1 001+ 50,+ TANK ElSeptic ❑S.T.E.P. ❑ Holding ❑Other
Manufacturer Capacity
Surface Water 1001+ 100'-f- GREER TANK 1500 Gal.
Material Number of compartments
Lot Line 1 0'+ 10'4- NA PLASTIC 2
Foundation 10'+ 101+ LIFT STATION
Manufacturer Capacity
Remarks ..tA (' ^4.' t _ ( L'0C� 1 i 1,.-1`• 12eX Gal.
S._SJ .4.,/ &GO y 4 e A V i0. 11 `1+ Alarm location Electrical installed by
PIPE MATERIAL House to tank 3034Tank to 3034
Installer drainfield
MIKE N ANDERSON, P.E. Drainfield 3034 CO/MT3034
Inspector MIKE N ANDERSON, P.E. BENCH MARK (Assumed elevation) 109.2 ft
Inspection Location and description
dates: 151 11-9 19 2"`' 11-9-19
3rd 4,h GARAGE SLAB
ON-SITE WATER AND WASTEWATER SECTION APPROVAL ��EEn�g�e� lSta)mp
" k .. OF Ar4-�R�
Conditional Approval: Date I
..:7".\'P:•'� ••'/-ti
r i
49TH �.1r //
% dik_
if
r vs..MICHAEL N. ANDERSON :4
Septic System rt J,•.• CE-9469 I 3 •:�'
Approved 1, / . ...4�� _ Date /(7g7q lime .i i.u.ni. ••\%;:` ,-'
Note: this appy j:1 does not include well permit requirements. i���">>-'
(Rev 05/02/18)
Permit No. OSP191485 Page 2 of 2
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744
On—Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: TIMBER RIDGE #1, BLK 3, LOT 5 PID No.: 050-321-50
I
MARK A B
CO1 33 33
CO2 34 34
TC01 36 35
TCO2 41 40
CCo03 4443 422
SPLITTER g52 46 ''''''
MO1 87 78
C06 83 67
C08 79 50
\ i l --- —�-,
\BENARA, .s•8 /
jj \\
TCO2,f, C0i1'///////// \
tCO3 CO4 \
f".4 iC081NEW 1500 GALLON PLASTIC TANK 11\ �#} =a 1 \ NEW 3—WAY • — 1>f • C')oX .
05 MT1 1
� • I ® N
.. 1 (ID OLD TRENCHES
N
' PARKING �
PAD \
\ \
F /-- \ \
/ \ 1 // /1
r 1/
i1
II \\ I
I 1 �ABUILTe.
1 I SCALE—1;'=50' __— -- �
! _
rcol rCO2 TCOI +('CO3j�-CO4 SPLITTER CO5 COB ...,",',,1
C/j /j TCO2 1 1 -MT ..` � OF
,1� ,4.
//,J9.7.5 715
FINISH GR O( .../. ..............7..........:„...1
/ ♦♦
3 0 ORO - • •• '•
RLTER FABRIC
— a 49TH Z. ♦♦
i 1D1.1/ 1,500x v ma ■ • /
CAALCN \100 8\ 97 97 5,I / •
PLA50C •
TAM( ��rr ■
'�� 1 11.MICHAEL N. ANDERSONits
♦ c'Iff
1 SV-18-19
No. CE 9469 •
♦ ,,.•••*�iSEP11C SECTION ez _ f •• ...SS 1 \p .•
N.T.S. CRY,NOV 2019 ,- ��4•
11�„1��
Municipality of Anchorage --ogi1iFtt�. �a)C,
�--�— Development Services Department car.• •••:'`j��1
7,7'----4------'0
On-Site Water and Wastewater Section / , • , /..
�•..E 4700 Elmore St. 0, ; 4 9TH (
lc' P.O. Box 196650 Anchorage,AK 99519-6650 a `� 7A.•••• •• • • •.f`
WWW.muni.org/onsite
(907)343-7904
vs:. MICHAEL N. ANDERSON .�PP
�___- e •. CE-9469 .,•►
Soils Log - Percolation Test i0 ik ppe,(..`J,`,.,,• ���`.•..
�••�,.
Performed For: DOot �, ,(n�v�yn�Yj Date Performed: i� �
Legal Description: 'T�yet h of Y`t 6 s— I Township, Range,Section:
6 3 t—il i- s Slope Site Plan
"4 NA - L/
Depth
(Feet)
.e
1-•-
rn
2-
3- 6 re_, plail
4-
5- /l/
6-
Svvt
7-
8-
WAS GROUND WATER
9- ENCOUNTERED? I 7
• - -
s
10- IF YES,AT WHAT DEPTH? L
Depth to Water After P
P
1 1- Monitoring? tr9 E
12- Date- /A/7 p
13-
14- Reading J Date Gross Time Net Time Depth to Water Net Drop
15- �t 14/14 (../ 2, 5—
16- 1/ 1/ 7,4 4
•
17- '/ 6o�� 71 S t 1
18- (j 0 0 WI i & 'I ?t S 17
19-
20
PERCOLATION RATE ill (minutes/inch) PERC HOLE DIAMETER t.
TEST RUN BETWEEN ll
FT AND 5 FT
COMMENTS A.A( ►�t,,nn'er CI1rtarr[7 t//(P"
PERFORMED BY: Nf!'ty(4 I CERTIFY THAT THIS TEST W S
PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: /i 4
(00..
GRAPHIC SCALE: 1 Inch = 50 Feet
�,p
25 25I
50 100
D
moo,\
5\./r--\\ Vi\? \ i\ 'i.
' \ \ -9,p\
\ \ .,,„„ . V .\- -i-n "..
\ : / 1
\\\
\
O \\' nC I f
. A
\�, \ I WELL
,1l •, r I OF `\
-1\
\ r--_J ` N49'14'35"W 204.23 I *. /‘ *TA
BobbF. Burnett E / BOBBLE.
1 \ 100 WELL RADIAlf
2941 Carriage Drive I \ / / �k'`•%tel+ ff./to
Anchorage, Alaska 99507 \ 4�4'e +
(907) 350-5541 /
3SIONAL i
Date Scale Legal Description
11/12/2019 1" = 50' I hereby certify that the property described hereon has been surveyed
Lot 5 Block 3 by me, or at my direction, and that the improvements situated thereon
Grid are within the property lines and do not overlap or encroach on the
NW 0255 AS-BUILT property lying adjacent thereto unless otherwise shown. That no
TIMBER RIDGE SUBDIVISION #1 improvements on the property lying adjacent thereto encroach on the
\....Drawn by Field Book PLAT# 71 100 premi%es in question and that there are no roadways, transmission
BFB ASB-2019 lines or other easements on said property except as shown.
10/31/19
r p0i�S
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 050-321-50
Property _owner(s)__BRYAN _& JODI SIBSON _Day -phone 9072295531
Mailing address PO BOX 90534, ANCHORAGE, AK 99509
Site address 19424 UPPER SKYLINE DRIVE, EAGLE RIVER, AK 99577
Legal description (Sub'd., Block & Lot) TIMBER RIDGE #1 B3, L5
Legal description (Township, Range & Section)
Lot Size 43,025 Sq. Ft. Number of Bedrooms 5
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
®
Initial ❑
Single Family (SF)
Septic Tank
®
Upgrade F19
(w/wo ADU)
Duplex (D) ElHolding
Tank
ElRenewal
❑
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: f E
Date of Payment:
Receipt Number:
Permit No. ASP 919 9S
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc
Michael N. Anderson, P.E.
Civil/Structural Engineering and Construction
4661 Natrona Ave. Anchorage, Alaska 99516
Phone 345 -3377 / Fax 345 -1391
Support Services
Brent M. Western
907-440-4601
October 25, 2019
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: SEPTIC SYSTEM UPGRADE PERMIT
LEGAL: TIMBER RIDGE #1 BLOCK 3, LOT 5
The existing septic field is functioning adequately, but the owner has requested that we proceed
to upgrade the system to 5 bedrooms. Utilizing the existing test hole data, we propose to install
an additional trench and a 1500-gallon septic tank.
The lot and area is served by private water and the design will not impact any of the neighboring
properties. Please contact Brent M. Western or me if you have any questions.
Sincerely,
Michael N. Anderson, P.E.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP191485, Rebecca Carroll, 10/31/19
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP191485, Rebecca Carroll, 10/31/19
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP191485, Rebecca Carroll, 10/31/19
TE; Fol iTfi Ui1-il :
Ali lll��r Ii I!t Lr
til !`, i
l Iii r
I I.
r 111
pI I 111 i �lkW �
h '11
ofr
�r.
h. _'j.••
l
i sill l� il�� I,III
i
ill
ii
I
W
1
■ Injection molded HDPE
A
I'
�77.l
x —
��Non corrosive
F
7s
■Simple
to installr
■ Easyl�to'level-'
n a septiclenvironment, no other
naterial carnmatch High Density
Snap -in pipe seals
They re permanent
'olye#hylene' in delivering a lifetime
They're patented. Simply insert your
Unlike cement -based pipe grout,
iftrouble-freelser%rI Tuf-Tde;:
PVc pipe and push it through the
flexible, Tuf-T to seal.
Tuf-Tte seals will not crack or corrode
in septic conditions. They stay pliable
Dfstfitution
nolded(usingonlypremiumHDPE
Boxes:are injection',
polyethylene
Pipes fit watertight.Installationcouldn't
and'! watertight permanently.
whlcli'iconta1nsiofllersorfoam:
er.
be easi' I
I
�I INl
til, jllh',
I
l
do r
IFl
,i � :I111 Ill�ll��lilp�l Ir
It
IIIItI�il�li��It
I
�
�I
II r.
�I i:
�
INSTALLATION IS
JUST THIS SIMPLE
1. Position the Distribution Box
on level virgin soil.
Do not place box on a
concrete slab.
2 Install the inlet pipe and
outlet pipes. Be sure the
bottoms of all pipes rest on
virgin soil.
3. Level the Distribution Box
and all pipes as needed.
4. Backfill the pipes to within
two feet of the Distribution
Box. Recheck the level of the
box, then backfill up to the
top lid ridge.
5. Install and adjust Tuf-Tate
Speed Levelers.
6. Place lid on the Distribution
Box and finish backfilling.
Choice of Fittings
S-35 Pipe Seal, for.
■ Sewer and Drain
■ SDR 35 ■ ASTM 3034
■ Thin Wall 01500 Lb. Crush
S40 Pipe Seal, for.
■ Schedule 40
■ 4" Corrugated
P-10 Plug, for unused holes
Choice of Lids
Regular Lid. Molded of rugged
HDPE
Inspection Port Lid. For easy
access and inspection. Accepts
4" riser pipes.
�1 ri .. Water -tight
Drainage and Septic Products"��rj�I`4 gIIIA�� {��➢ by Tuf-Tile°ems
Tuf-Trte° Corporation
1200 Flex Court
Lake Zurich, Illinois 60047
®1998Tut-TRe® CoMomtIon
Farm 6HD2-2. Nnted In USA
Tuf-Tite Speed LevelersTM
Control the flow of effluent from
the Distribution Box. Simply
insert a Speed Leveler into each
outlet pipe. Rotate each Speed
Leveler so the flow is distributed
as desired. Available for 3" or 4"
PVC pipe.
"Parking area, including ingress and egress, sliail b.
witii a concrete or asphah compound, or shall be c
with a layer of crushed .cck of no more thm one
diameter to a minimum of three inches."
IT IS THE RESPONSIBILITY OF THE OWNER OR BUILDER
PRIOR TO CONSTRUCTiasr TO VERIFY PROPOSED BUILDING
GRADE RELATIVE TO FINISHED GRADE AND UTILITY
CONNECTIONS. AND TO DETERMINE THE EXISTENCE OF ANY
EASEMEIOTS, COVENANTS OR RESTRICTIONS WHICH DO NOT
APPEAR ON THE RECORDED SUBDIVISIC^ PLAT.
NOTE:ELEVATIONS ARE ASSUMED DATUM. All work '•hrU he done as shown on this
plot plr med plans and speciH-
cations sirju ,wt he changed, modifUd
or altered toHltout first obtaining a vali''
rh(l>i"r oriler.
PROPOSED CC^STRUCTION PLAN SEWARD & ASSOCIATES LAND SURVEYING 694-0829
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
FOLLOWING DESCRIBED PROPERTY^
AND THAT NO ENCROACHMENTS EXIST EXCEPT AS
INDICATED, IT IS THE RESPONSIBILITY OF THE
OWNER TO DETERMINE THE EXISTENCE OF ANY
EASEMENTS, COVENANTS, OR RESTRICTIONS
WHICH DO NOT APPEAR ON THE RECORDED SUBDI-
VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD
ANY DATA HEREON BE USED FOR CONSTRUCTION
OFFENCE LINES, OR FOR ESTABLISHING BOUND-
ARY LINES.
SCALE*
DATE«
GRID:
FBs
£-^'7 9
DRAWN*
Mark S«ward kg
-6918 .-'^^
^ ^ *• OuBfi* Ml
r
r
Municipality of Anchorage Page of
' DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: -SW 95 O //D PID Number: —50
Name`
'2Yi4N $ -:2)D/ si�3so�l
Wastewater System: bkNeW ❑ Upgrade
Address: Z
0 0\, ? cN 9 95 3
ABSORPTION FIELD
Phone:
No. of Bedrooms:
>j!5eep Trench ❑Shallow Trench ❑Bed ❑Mound ❑Other
LEGAL DESCRIPTION
Soil Rating:0
Total Depth from original grade:
GPD/Sq. Ft.
Lot: Block: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe
Township:
Range:
Section:
Fill added above original grade:
Gravel length:
/I V 67 Ft.
50 Ft.
WELL: ❑ New ❑ Upgrade
Graveldoptha
Number of Ii
Di stance between lines:
kv10 r/t Ft.
7,—nes:
I y Ft.
Classification (Private, A.B.C): Total Depth: Cased T
Total absorption area:
Pipe material:
Ft.
50 SQ. Ft.
Driller: D e-DFilled: Static Water Level:
Installer:
Date instal ed
Ft.
l�A��t.4�/N
9/95
0F%:
Yield: ump Set at:
Casing Height Above Ground:
TANK
GPM Ft.
Ft.
SEPARATION DISTANCES
peptic ❑ Holding ❑ S.T.E.P.
To
Septic Absorption Lift Holding 2u✓ 4e1Private
Manufacturer:
Capacity in gallons:
From
Tank Field Station Tank Sewer Lines
/%.
'%5,2
Well
N% 7 /Fj N1A
Material:
C
Number of Compartments:
C _
Surface
%A
LIFT STATION
Water
Lot�/
/ �/�
Size in gallons:
Manufacturer:
Line
Foundation
/-1
N/n
"Pump on" level at: "Pu level at:
High water alarm at:
Curtain
n// n \
Pump Make el I Electrical Inspections performed by:
Drain
Remarks:
BENCH MARK
Location and Description:
A/ 0% EP_ To,-
Assumed Elevation:
/0
ENGINEER'S SEAL
O F A
tt�
°
Inspections performed b :�S SDS 9S
p p y Dates: 1 s
����
2nd 4 09 9S
'
0--. Louis A. Butera o
Department of Health and Human Services approval
�CIZ
®®sem°0° CE-6 36 sod ���0
Reviewed and approved by: Date: 2
�OFE�s
72-013 (1/91) MOA 25
Permit No.
Page 2 of 2
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: TIMBER RIDGE s1 LOT 5 BILK 3 PID No.:
A
e
krlv:lr
1250 GAL
O / SEPTIC TANK 8RO . -�� N3 9
APp
C G ZOC4770NIlse 74.5p•25., j1'
/ F ___ 3• X 25' 'w
D _�31 X 25• CJ4
�y
B
POINT
LOT 5
POINT
SWING TIES `tib �lC3
A -C=70.7
B -C = 82.1
A -D = 98.2 PROPOSED
B -D = 74.3 PIN WELL
AE = 77.0
B --E = 83.88
A -F = 95.2 s
B -F = 85.9
A -G = 105.L7c9. 20
B -G = I L1.0
SCALE I"=60'
• - MONITOR TUBE
o - SEWER CLEANOUT
PROPOSED LEACHFIELD
— — - EASEMENT
8/11/95
ELEVATIONSREBAR NN LOT CORNER ENGINEER'S SEAL
(NOT TO SCALE) ASSU-MED ELEV = 100.00 oo0�0p�04�
m r �i11
P 4
0
10
ORIGINAL 4
GROUND = QO' \�••••• • ���4oV
LEVEL AT:
TRI L02.5 Im
•.
1' FILL TR2 L00.5 p° �- 4 9TH
GRT 88.7 Ip ...... ......... PA
TANK31 83.7 ..... .......... ........Q
100. 100.3 TRL 100.0 TRI 100.0 �O �.-LOUIS A..:BUTERA•:-�
TR2 98.1 \ TR2 98.1 Q J, CE -6736 CC•\\���p
\MT1 92.5•-••,.....•••••••`\pO
MT2 90.5
�4 � PROFESS\O�Pao
-ryl+r�pOOoo�oo
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW950110
DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES
OWNER NAME:SIBSON BRYAN J & JODI S
OWNER ADDRESS:19424 UPPER SKYLINE DR
EAGLE RIVER, ALASKA 99567
PARCEL ID:05032150
LEGAL DESCRIPTION:
TIMBER RIDGE #1 BLK 3 LT 5
LOT SIZE: 43025 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
<�)Vrr\
DATE ISSUED: 6/13/95 29
EXPIRATION DATE: 6/13/96
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 DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED B
ISSUED BY:
DATE • &/�1-1195
DATE: (9 ` /3 - %r
NEIGHBOR'S
TEST HOLE
(HOUSE
LOCAT
❑T 4
so -
NEIGHBOR'S
TEST HOLE
LOT 6
APpR�k Q 3
�ocgR Ho73c,
IGNECK ISN,ry�C 50 25
SeTB,a�KZQvlN[; �/
Re�!/fREl�NTS] � 4S
LOT 5
PROPOSED
WELL
t6
� c
LOT 14
® — TEST HOLE
• — MONITOR TUBE
o — SEWER CLEANOUT
¢ — WELL
PROPOSED LEACHFIELD
— REPLACEMENT SITE
NO SURFACE WATER _ — — — EASEMENT
NO KNOWN CURTAIN DRAINS
SEPT�C SOTS PLAN �OF������
LEGAL: LOT 5 BLOCK 3 TIMBER RIDGE 1 `�
OWNER/BUYER: SIMPSON
CONTRACTOR: N/A * .-49 TH * ��
JOB # 94-073 DATE: 06/27/95 SCALE 1" = 50'
;! ...00
EAGLE RIVER ENGINEERING SERVICES �,�c^� LOUIS A. BUTERA '
P.O. Box 773294 ��'s�F '. CE -6736 4_AW
EAGLE RIVER, AK. 99577 x#40 ......
(907) 694-5195 FAX.- (907) 694-3297 11\��`` jo�kl`�-
II
I
I
POSSIBLE
ON
Q3
~Z�
FLgY
�.
.IEOO GAL
SEPTIC TANK
/ ®TH2
o
0
0
3 TH1
POINT
f
oo_
POINT
O
2I
,\
O
APPRO
(HOUSE
LOCAT
❑T 4
so -
NEIGHBOR'S
TEST HOLE
LOT 6
APpR�k Q 3
�ocgR Ho73c,
IGNECK ISN,ry�C 50 25
SeTB,a�KZQvlN[; �/
Re�!/fREl�NTS] � 4S
LOT 5
PROPOSED
WELL
t6
� c
LOT 14
® — TEST HOLE
• — MONITOR TUBE
o — SEWER CLEANOUT
¢ — WELL
PROPOSED LEACHFIELD
— REPLACEMENT SITE
NO SURFACE WATER _ — — — EASEMENT
NO KNOWN CURTAIN DRAINS
SEPT�C SOTS PLAN �OF������
LEGAL: LOT 5 BLOCK 3 TIMBER RIDGE 1 `�
OWNER/BUYER: SIMPSON
CONTRACTOR: N/A * .-49 TH * ��
JOB # 94-073 DATE: 06/27/95 SCALE 1" = 50'
;! ...00
EAGLE RIVER ENGINEERING SERVICES �,�c^� LOUIS A. BUTERA '
P.O. Box 773294 ��'s�F '. CE -6736 4_AW
EAGLE RIVER, AK. 99577 x#40 ......
(907) 694-5195 FAX.- (907) 694-3297 11\��`` jo�kl`�-
Louis Butera, P.E.
Registered Civil Engineer
June 2, 1995
Jim Cross, P.E.
Manager, On -Site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Re: Timber Ridge #1 Lot 5, Block 3
Narrative & Permit Application
Dear Mr. Cross:
The proposed well and septic system will have very limited impact on adjacent properties for the
following reasons:
1. The surrounding lots are large, allowing sufficient room for septic sites.
2. Immediate neighboring septic systems are all +30' distance.
3. Reserve space is adequate, due to absorption capacity and large lot size.
4. Drainage will not be affected and is not a major consideration in our design.
If you have any questions please call our office at 694-5195.
Sincerely,
Louis Butera, P.E.
\C : \WPWIN 60\WPD O CS\ 1995\94-073 A. NAR
P.O. Box 773294 • Eagle River, Alaska 99577 • Telephone (907) 694-5195 • Fax (907) 694-3297
TEST HMX.
I
NEEST HOLE O
TEST .E
LOT 6
I =�
I POSSIBLE T
APPh'Ok.Q 3
A oti Sf �� N 74 *S� 96 .
'2
SEPTIC50 TAMC SETS x'�.'XZar'k'. �✓
a $ °eWc�reH�r� 41 4S
/ d O SOi
d / ®TH2
d
TH1
f
POINT
LOT 5
POINT
APPRO
HOUSE
0
LOCATED
S
.
PROPOSED
PIN WELL -
f
VELL
❑T 4 LOT 14
F
® - TEST HOLE
• - MONITOR TUBE
0 - SEWER CLEANOUT
- WELL
PROPOSED LEACHFIELD
REPLACEMENT SITE
NO SURFACE WATER — — - EASEMENT
NO KNOWN CURTAIN DRAINS
SEPTIC SITEP L,®N oF •���''1
LEGAL: LOT 5 BLOCK 3 TI MBER RIDGE #1
OWNER/BUYER: SIMPSON A
AW
CONTRACTOR: N/A 00„� 4.9 TH00
JOB # 94-073 DATE: 10/18/94 SCALE 1” = 50'00jo�
EAGLE RIVER ENGINEERING SERVICES �� LOUIS A. BUTERA
P.O. Box 773294-
EAGLE
73294 I, fjF '. CE-6736
AEAGLE RIVER, AK. 995770
(907 694-5195 FAX.• (907) 694-3297 41111
EAGLE RIVER
ENGINEERING SERVICES
P.O. Box 773294
EAGLE RIVER, AK 99577
(907) 694-5195
JOB
SHEET NO. _
CALCULATED BY.
CHECKED BY_
SCALF
OF_
DATE
DATE
'1 ui,tJ%,X XkAL& l:,. 7/1 1/V!. .7q; "A%JW-11 :J
3 Bedroom Capacity —
450!! GPD
Soil Rate 23 min inch = 0:6 GPD/ft2 application rate for trench system .
Required Absorption Area
= 450 gpd . /
..0.6 application -rate .....= 75.0 -square -feet.....
750 SF / (7.5' rock x 2)
50' length
Trench :Dimensions:_
Gravel Depth
= 7.5'
Gravel Length
= 50'
l.
TotaDepth.
_ 10
c A
i0
............ 1 ' tl yt
1 U4f r7
u0 n o n b v.. Cl^;r t
4
p
C:\WPWIN60\WPDOCS\1995\94-073A.CAL
! _.
PRODUCT 204-1 (Single Sheets) 205-1(Padded) ®® Inc., Groton, Mass. 01471. To Order PHONE TOLL FREE 1-800.225-0380
SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM
LEGAL: Timber Ridge ##1 Lot 5, Block 3
A. GENERAL.
1. The well and septic plan is for a single family residence only.
2. The drawing and or site plan shall be a part of this specification.
3. All materials and workmanship shall meet the Anchorage Department of Health
requirements.
4. All soil tests are advisory to the design and are to be verified or modified in the
field by the engineer.
5. All excavations and depths are advisory and are to be verified in the field by the
contractor to meet Municipality of Anchorage requirements.
6. It is the responsibility of the owner to obtain all necessary permits or easements
and to locate any adjacent multi -family wells.
7. The excavation is to be exactly in the area shown on the site plan, any deviation
requires engineer approval.
8. It is always recommended that a surveyor locate the nearest lot line position and
the location of any easements.
B. TRENCH
1. The trench is to follow the natural land contour to maintain uniform total depth of
the trench bottom.
2. The bottom of the trench shall be level, plus or minus 1.5".
3. The total depth of the trench excavation is not to exceed 10' at any point.
4. The sewer line shall be laid level within 0.10' .
5. The trench gravel is to be covered with typar fabric material.
6. Soil or combination of soil and extruded board insulation to a depth of 3' or
equivalent is to be placed over the leachfield.
7. The area over the trench is to be finish graded to prevent ponding of surface water
runoff.
8. The septic tank and leachfield must not be closer than 100' to any existing private
well, 150' to any Class "C" well, or 200 feet to any community well.
RECOMMENDED ..A .HFI ..D DIMENSIONS:
TOTAL DEPTH= 10 ' GRAVEL DEPTH = 7.5' under pipe, 2" over pipe
TRENCH LENGTH = 50' TRENCH WIDTH = 3'
SOIL RATING = 0.6 GPD/ft2 BEDROOM CAPACITY = 3
SEPTIC TANK = 1,000 gallons minimum
Twenty-four (24) hours notice required for all inspections.
C:\WPWIN60\VvTDOCS\1995\94-073A.SPC
• .elle°- =��1
�.� '95a �lA4Aaava mqm.. nmlao veao�i
® +� Municipality of Anchorage
S t,, , Louis A. Butera i ;4
DEPARTMENT OF HEALTH & HUMAN SERVICES " ' ``�J, 0=-6736
825 "L" Street, Anchorage, Alaska 99502-0650 �,cj�`�a� ��,�mo ,<��`
SOILS LOG — PERCOLATION TEST
��"1 r sass
PERFORMED FOR: 23/Z&, /y S1w1P5ot4 DATE PERFORMED:
LEGAL DESCRIPTION: 1.07 S !R J:. 1 Township, Range, Section: 141V %Z/t-1 SE�
e-7-1 �f
'%1✓ J A .tni ,et/iI 2i drY A.fYA SLOPE SITE PLAN
• .• - (/.Ll%ii. •. �, l„J�.�iV�-- � vii r
1 Lair►. ,error �+IIIy�
2
3
' a
° CJ
4
a •. a.
5
6
V a;
7 4
a a
10
12-
13-
14-
15-
16
213 14 15 16 �\
17-4-
18-
19-
20
7
181920 -L
COMMENTS
(51")
S/�� S,;iND Gv% Sor�f
vEL ,ivy?
ifle
/7/1/67W-'jz 11 CNV ED
70 2 ,% "J:r �/� WAS GROUND WATER
7 ENCOUNTERED?
�y/L�'y/Sf= NSE %yIDiST
Afi �Qf�i/%j�jy IF YES, AT WHAT
DEPTH?
Depth to Water After
/LAS AUv TH�.�,7:Manitoring7
,
N�
S
L
O
P
E
Date:
MEN
Date Gross
Time
Net
Time
■■■■R■MMIMMMMMHIM
Net
Drop
■■
f i,l ri
■■■■■■■■■
NEME
n
---
7/
MEEMEMENIME
■■■■■■■■■■
■■■■■■■■■■
MEMMMMMMM
MIMMMMMMMMMI
MEMMEMMMIME
■■.■■■■■■■
Reading
Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
f i,l ri
7/
PERCOLATION RATE 23//'' (minutes inch) PERC HOLE DIAMETER
TEST RUN BETWEEN "l FT AND FT
— S , le t (
PERFORMED BY: L ' Ha'(� Z m• j*e,01N/ /� S / �'�
CERTIFY THAT THIS TEST (WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE /y/0�/9 / --5
/���i5
i
72-008 (Rev. 4/851
Municipality of Anchorage
4 DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
.rr., .a•c En, %�.,
-(ENGINEER'S SEAL" y?
Fj J eay=,l9a�.• f oonaeooanmo u� n
1';3 �.nca Dasa <. oo no ono.
,3 vo Louis A. Gulera
tla,s�o CE -6736 n';r
(� OFESSA �;
PERFORMED FOR: 3/0,tN 5041PS0Al DATE PERFORMED: lola'�/94
LEGAL DESCRIPTION: 7' A4 -i4 ,3 Township, Range, Section: /Z//V 5E61-/1LI
SLOPE SITE PLAN
1 �
2
3
p,
4
5
6
7 Q
• o
8
9-
10-
12-
131 101213
14
(514 )
SrLrl 5if A/D
Yom= %- Mrd , %•;.'� .-*''
Pis ^ill
MO15T, .F�S SILT .ri��ri`',
�rSM - 61M)
g�Av62) X-OL,4s
WAS GROUND WATER
ENCOUNTERED?
�� jGf31�i1/�y(a IF YES, AT WHAT
ZDEPTH?
!& r
T�
S
L
N/q °
P
E
l I Depth to Water After i
/L";r-z5 1DvC7 TH,ezzl-4monitoring7 /y Date:
i
✓ij"< <P %�' =lam
15
16
17
18
19
20
t --j
COMMENTS Pim G
fel
e-1sl�
Reading
Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
l
/ � r y
g• p /�„
!'59
5 1411-1
9 111b"
'4a
1 FM,"
l Z% 0
M iN
F 17 /lo"
6 °'
z;e)b
17 $ W
IN
?I/& "'
PERCOLATION RATE ' (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND 57 FT
PERFORMED BY: G - Haz-LE,- /'�- 1y"''eq /y/I �� � CERTIFY THAT
THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
(ENGINEER'S SEAL) tet,)
4
(,'� IAS Ii' 'Z8 - Gs VOCU 6A�t r�U •'?
s' r, Lcui> A. uutera
421
QI
PERFORMED FOR: 121,*fN S/sfpseph DATE PERFORMED: /010y/9T
TiNBFe A1017E -W /
LEGAL DESCRIPTION:AlX 3 Township, Range, Section: /Z/tj
E SLOPE SITE PLAN
Z 19467-07111C/ 8g1-4 CF- ?Err,
F,
3 ism . -1L)
4-
5 5/1-� 519/40
6 GR4 1.- t5'4 y . 1-5-
7
s7 4 /- to '- is'/evc /
8
9-
10-
11 1011
12-
13-
14
2 1314 .A
15 b
16
17-
18
19
meFn oErVS e
WAS GROUND WATER , /D
ENCOUNTERED? /y
s
IF YES, AT WHAT L
DEPTH? N O
P
E
Depth to Water After f!6
Monitoring? Date:
ME
Net Depth to
Time Water
Net
Drop
MMMMRMIM
SD
Hell-. % "
fS%1Lo''
11:51
41 1
M„.v.
3
l shz,l
MEMMENMEME
MEMMMENEEM
■■■■■■■■■■
MEMMEMMEME
MIMMMMMMMME
MEMEMMEMEM
■■■■■■■■■■
■■■■■■■■■■
.■■■■■■■■■
Reading Date Gross
Time
Net Depth to
Time Water
Net
Drop
<olt ip 9
SD
Hell-. % "
fS%1Lo''
11:51
41 1
M„.v.
3
l shz,l
20
PERCOLATION RATE (mmutesein�ch)�PERC HOLE DIAMETER
TEST RUN BETWEEN 5 5 FT AND FT
COMMENTS -D %%� !r SL/L�ffTL�I �eGl4�SI!f
PERFORMED BY: �/� S��'-.-_
CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85) /
Trrfiffirb Uritttng
by 2
OOC Co, abaSULLIVAN WATER WELLS
e1 l l l�
P.O. BOX 670272, CHUGIAK, ALASKA 99567 TELEPHONE 688.2759
OWNER OF LAND Y14,J DEPTH OF WELL r<L
ADDRESS PC) /?3 3 / e} !7'rJc, ?'7��T[C LEVEL OF WATER FT.
LEGAL DESCRIPTION L g7 9 -IAC E' `i %Ml.�c/j 1Q 14)45,C -"'pRAW DOWN FT.
DATE - Started Ended GALS. PER HR 0
t!
PERMIT NUMBER KIND OF CASING 6
KIND OF FORMATION:
From Ft. to 3 Ft.
(Q.�i-J6 6 CKJ0 From
Ft. to
Ft.
-
From 2Ft. to n Ft
QJZ44JeA,; n} From
Ft. to
Ft.
From 6 Ft. to . E Ft:
S'� j 7,S`, .t),Q c c'4 4Jtt (,From
Ft. to
Ft.
From 3e Ft. toj�R Ft.
�r� ✓� From
Ft. to
Ft
7:j'-
114- r S id
From Ft. to?_- __Ft.
-� From,
Ft. to
Ft
From Ft. to ( Ft..
49 14 ^j From
Ft.
Ft:
��
to
From- (F -Ft. to l a 3 Ft
J(, t i,4,J4 �`- 694 �' Ft. to
,1
Ft.
From or +Ft. to �r_Ft:
rrFrom
R '�`'� G�Qd« 'From
Ft. to
Ft.
��''
Fromjc_ff: Ft. to= ( Ft.
64 E471 Al//Ei fi r" rom
Ft. to
Ft.
From _Ft. to / 'LFt. �
i4 4 b �� Jn � 5 Fr r_
_ From -Ft.
to
Ft.
From Ft. to Ft.
From
Ft. to
Ft.
From Ft. to Ft.
From
Ft. to
Ft.
From Ft. to Ft.
""`" From
Ft. to.,
Ft.
From Ft. to Ft.
From
Ft. to
Ft.
From Ft. to Ft.
From
Ft. to
Ft.
From Ft. to Ft.
From
Ft. to
Ft.
From Ft. to Ft.
From
Ft. to t- F
MISCL. INFORMATION:
SAY 21 1996
Mutticipality.ul A.ncnoratge
Dept. Health & Human Services
DRILLER'S NAME--t-'�
January 4, 1982
Anderson Bros Const
P.O. Box 129
Eagle River, AK 99577
Permit 7 810255
Subject: L5 B3 Timberridge
. L i tr,I IV,
A permit issued by this department for a well and/or sewer
system has expired as of December 31, 1981.
Permits are issued on a calendar year basis, as stated on
the permit, by authority of Municipal Ordinance.
If you have drilled the well, a well log should be sent to
this department to document the installation date.
If an engineer inspected the installation of the on-site
sewer system, please have them send us the as-builts for our
files.
If there are any further questions, please call this office
at 264-4720.
Sincerely,
L:�4 0 6�dtic,
Les N. Buchholz R. .
Program Manager
Sewer and Water Program
Enclosure: Copy of Permit
��_L R_' g-1 U_ AUNJ- r --u �- �L_: E-1 Cl Fe-_ Fz� F, --:i EE
DEPARTMENT �- HEALTH AND ENVIRONMENTAL -�OTECTION
825 '. STREET, ANCHORAGE, HK. 9i 11
264-4720
KA��--���
PERMIT NO. ( 810255 )
APPLICANT ANDERSON BROS CONST PO BOX 129 ER, 99577 694-]]77
LOCATION SKYLINE
LEGAL L5B3 TIMBERRIDGE LOT SIZE 480000 SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING (SQ FT/BR)= 165
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
��Fo"-T- 1-1 "TO ����!7? 7- 41= at ED ED FZ FA %? EO L_ E> EE F" !F VA= �
THE LENGTH DIMENSION IS THE LEN ?IN FEET) OF THE TRENCH OR DRHINFIELD.
THE DEPTH OF H TRENCH OR PIT ISfdHEfVlSTgNCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION � T)
THERE IS NO SET WIDTH FOR TRENCHES. '
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET).
F"-=, CA 09 1 F-.-' E� E> 05 EO FO, -T- I TV ���� I = FEE= AL A? to C? Eli FA L_ L_ CD 54�
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
___ 1- Aj co ��� 3: PAS> f"IET 10 _T_ I SIR 1400 0=1 FQ Eo FQ EE CA Lj 1 F? E= E>
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL
MINIMUM DISTANCE FROM H PRIVATE WELL Tp HqPRIVHTE SEWER LINE IS 25 FEET AND
TO H COMMUNITY SEWER LINE IS 75 FYET V
OTHER REQUIREMENTS MAY HPPLY.^YFICHTIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
�Eo3v!0l 1 7- E00100" I �EECDEEPIEDEETV! 301 " I Qvi too A
I CERTIFY THAT
1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
]: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS.
SIGNED�_
A NT ANDERSON BROS CONST
U/ zky ,
ISSUED BY_ ------ DHTE_ ___ Y4.0
�OI LS LOG
MUNICIPALITY OF ANCHORAGE
�r*7�11 DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION '"' PERCOLATION
825 L. Street, Anchorage, Alaska 99501 264-4720 TEST
\u� SOILS LOG - PERCOLATION TEST
PERFORMED FOR: _LS DATE PERFORMED: 9—u
l
LEGAL DESCRIPTION: J J I w\ I,
DEPTH SLOPE SITE PLAN
(FEET) U Ol �76
1
-Z '51L j
2
3 Z— �o
4 r=1�1L S�.S
5-
_. 6 -
7-
8-
9-
10-
11 -
12-
3 -
4-15!14-
15-
16-
17-
18-
19 _
16-
17-
18-
19-
20 -
(Sv
5 L l �jJ
5 wl k WAS GROUND WATER V S
ENCOUNTERED? L
/( 0
�3 IF YES, AT WHAT E
DEPTH?
VW
b�
o a � a� cp,�ru9gpe111o1- • �
o
NO. 1732-E
June 22, 196
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
Z
(/Z 11
p PERCOLATION RATE I (minutes/inch)
�EII��ea�`�eseooe®b1�v�`oas � S O
TEST RUN BETWEEN FT AND FT
COMMENTS
PERFORMED BY: ` "� " l// — L� CERTIFIED 8
72-008 (6/79)
j
40 1L ----)DATE
MUNICIPALITY OF ANCHORAGE (,5
Development Services Department p p �` _ Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Parcel I.D. 050-321-50
Certificate of On -Site Systems Approval
Expiration Date: 5 C2 06
1. GENERAL INFORMATION
Complete legal description TIMBER RIDGE #1 BLK 3 LT 5
Location (site address) 19424 UPPER SKYLINE DR, EAGLE RIVER AK
Current property owner(s)
Mailing address
Real estate agent
KEVIN '& SARAH BAKER
SAME
2. TYPE OF DWELLING:
Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
Day phone
3. NUMBER OF BEDROOMS:
5
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
0
Private Septic
Water Storage
❑
Holding Tank
❑
Community Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Waiver request for: Distance:
Received by:
COSA to be released to the engineer, unless otherwise requested by the engineer.
Date:
COSA Fee $ 1 Li 5 1- e7 Waiver Fee $
Date of Payment 5 26 ,?- 0 2 f Date of Payment
Receipt Number 00(015-2, Receipt Number
COSA # DSG?_ k �Z 1 S Waiver #
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the
on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater
disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in
effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted.
Name of Firm MIKE N ANDERSON, P.E. Phone 727-8864
Address 4661 NATRONA AVE ANCH AK
Engineer's Printed Name MIKE N ANDERSON, P.E. Date 5-4-21
6. DSD SIGNATURE
yj System #1 Approved for 5
System #2 Approved for
Disapproved
Conditional approval for
F�� �••e �y•Y .r,
ell 14 A9TH
........... .♦..... •. F!
bedrooms ••-.••...
MICHAEL N. ANIDFRg0p 01c
r.�..
`=�. 464 •`v,v°'
bedrooms ��gLw; C t{(/ 8
SS10'�"�
_ bedrooms, with the following stipulate nV_X_1'����
-X c �"e id s CAXU -hi-sled q-_ paged
-F r S'— Lr_c1roon%o ir, Eie4em1x,' a� Z'1 i JT'het� a ne ra 2 -bedroom
-t t& (rl Sp r -f i ^ — i 1n A n -1 A o _l ` r, - ^ - -i i ` -I—" - - t - — - u
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems A /
y Approval (COSA) based only upon the
representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is
not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA Checklist blue sheet
Legal Description: TIMBER RIDGE #1, BLOCK 3, LOT 5
If more than 1 septic system on lot: COSA Checklist # of
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled 411996
Total depth 318 ft
Cased to LIN ft
❑ Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ground) 24"+ in.
Date of flow test for COSA 9/5119
Static water level at beginning of test 278 ft.
Comments
B. TANK DATA
Age of tank(s) 2019 years
Tank type/material SEPIHOP
Measured operating fluid level in septic tank NEw148°
OR Standpipes/foundation cleanout per record drawing
Date of pumping NEW
D. ABSORPTION FIELD DATA TESTED 2 EXISTING TRENCHES
Which system tested (date installed) %hIlon 5
❑ ALL standpipes present per record drawing
Total measured depth from grade 12.1112.5 ft (max)
Measured depth to pipe invert from grade 4.6/5.0 ft (min)
❑ N/A — pressurized field
❑ Monitor tubes go to bottom of effective. If not, state
depth into effective
Parcel ID: 050-321-50
Structure served by this system
Well production at time of test 5+ gpm
Water storage tank volume NA gallons
Well disinfected for coliform test? ❑ Yes ❑ No
❑ Coliform bacteria is Negative
Nitrate 2.86 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L On Arsenic less than MRL (ND)
Collected by MNA
Date of Sample 4113121
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments:
Adequacy test date 9/5119
Results [D Pass For 3 bedrooms
Fluid depth prior to test 61 in ` PQX- M�4 A
Water added 600 gal
New depth 87/37 in
Elapsed time 1120 min
❑ Code -required soil cover over field Final fluid depth 41/0 in
FOR System presoaked Absorption rate 450+ and
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months)
date of test)
Gallons introduced 1800 gallons If yes, enter date
Comments/Deficiencies: Existing 3 BEDROOM, (2) x 25'Lx7.5' ED=750SF, plus new 2 BEDROOM, (1) X 30'LX7'ED=500SF, TOTAL 1250 SF (0.6GPDISF)
COSA Checklist yellow sheet
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100'
✓D
Yes
Community Sewer Manhole/Cleanout > 100'
E] Yes
ifNo_ft
[Z]Yes if No _
21Yes
ifNo_ft
Neighboring Tank > 100' 0 Yes
if No
_ ft
Private Sewer/Septic Line > 25' Yes
if No _ it
Absorption Field on Lot > 100' 0 Yes
if No_
ft
Holding Tank > 100' Yes
if No _ ft
Neighboring Absorption Fields > 100'
_ it
Private Wells > 100'
Animal Containment > 50' ❑✓ Yes
if No ft
0 Yes
if No _
ft
if No
_ it
Community Wells > 200'
0 Yes if No _
it
Manure/Animal Excreta Storage > 100'
❑v
Community Sewer Main > 75' ❑� Yes
f No _
ft
R✓ Yes
if No it
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
✓D
Yes
if No—ft
Surface Water > 100'
[Z]Yes if No _
ft
Property Line > 5'
0
Yes
if No
_ ft
Wells on Adjacent Lots:
Absorption Field > 5'
0
Yes
if No
_ it
Private Wells > 100'
0 Yes if No _
it
Water Main > 10'v❑
Yes
if No
_ it
Community Wells > 200'
0 Yes if No _
it
Water Service Line > 10'
❑v
Yes
if No
_ ft
If septic tank is under driveway comment below
From Absorption Field on Lot to:
(Please enter distances
if
less than required)
Building Foundation > 10'
❑v
Yes
if No —ft
If absorption field is under driveway comment below
Property Line > 10'
0
Yes
if No_
ft
Wells on Adjacent Lots:
Water Main > 10'v❑
Yes
if No _
it
Private Wells > 100'
0✓ Yes if No _
ft
Water Service Line > 10'
❑v
Yes
if No _
ft
Community Wells > 200'
0✓ Yes if No _
ft
Surface Water > 100'
0
Yes
if No
ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION
/ certify that / 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.
COSA Checklist yellow sheet
a.�
S'
...1,4
•• 9•,0 MICHAEL N. ANDLRSCN;
C Q 69
66
MUNICIPALITY OF ANCHORAGE
( •
Development Services Department '` Phone: 907-343-7904
On-Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On-Site Systems Approval
Parcel I.D. 050-321-50 Expiration Date: 2. q,20
1. GENERAL INFORMATION
Complete legal description TIMBER RIDGE #1 BLK 3 LT 5
Location (site address) 19424 UPPER SKYLINE DR, EAGLE RIVER AK
Current property owner(s) SIBSON BRYAN & JODI Day phone
Mailing address SAME
Real estate agent Day phon t R 9
2. TYPE OF DWELLING: RU SHJ
0 Single Family (w/wo ADU) a NO 8 119 ;
❑ Duplex .,
❑ Multiple Dwellings (Single Family and/or Duplex) �� w
3. NUMBER OF BEDROOMS: 5
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Private Well Q Private Septic
Water Storage ❑ Holding Tank ❑
Community Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
Waiver request for: Distance:
Received by: Date:
COSA to be released to the engineer,unless otherwise requested by the engineer.
a so"+1 c.8 -
COSA Fee $q4Q.6D CUA., Waiver Fee $
Date of Payment i i II��209 Date of Payment
Receipt Number 01Z7 Receipt Number
COSA# lql 55r Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the
on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater
disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in
effect at the time of installation. I acknowledge that On-Site staff may visit the site to verify the information submitted.
Name of Firm MIKE N ANDERSON, P.E. Phone 727-8864
Address 4661 NATRONA AVE ANCH AK
Engineer's Printed Name MIKE N ANDERSON, P.E. Date 11-18-19
`�awe�aa�
�
qq.�,�ti OF A�g1e�e
6. DSD SIGNATURE ,* •49 *-71,11
t/ System #1 Approved for 5 bedrooms �yTM
System #2 Approved for bedrooms �r a,% MICHAEL N. An DCRSCN:
r c' • CE-9 69•
• ``',
Disapproved 1�f4;•PO �1))°fi�1•••• <%'
Conditional approval for bedrooms, with the following stipul ffSSIOl��
;J2 ON-SITE%
WATER AND r"
WASTEWATER
"SP PROGRAM 24o
� SEROG `�.�,
By: kla)rptc)A7/tad,--- Original Certificate Date: /I,4Q/The Municipality of Ancge Development Services Division (DSD)issues Certificates of On-Site Systems Approval (COSA) based only upon the
representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is
not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA Checklist blue sheet
COSA Checklist DRAFT
Legal Description: TIMBER RIDGE#1 BLOCK 3, LOT 5 Parcel ID: 050-321-50
If more than 1 septic system on lot: COSA Checklist# of Structure served by this system
A. WELL DATA
®Well log is filed with Onsite (or attached) Well production at time of test 5 gpm
Date drilled 4/1996 Water storage tank volume NA gallons
Total depth 318 ft Well disinfected for coliform test? ❑ Yes ® No
Cased to UNKNOWN ft ® Coliform bacteria is Negative
® Sanitary seal is functioning correctly Nitrate L'14 41 mg/L ❑ Nitrate less than MRL (ND)
®Wires are properly protected Arsenic ug/L ® Arsenic less than MRL (ND)
Casing height(above ground) 24+ in. Collected by /V/ ,
Date of flow test for COSA 9/5/2019
Static water level at beginning of test 278 ft. Date of Sample 1 1 /0 Cof( R
Comments
B. TANK DATA— NEW TANK C. LIFT STATION
Age of tank(s) 0 years ❑ Required maintenance completed
Tank type/material SEPTIC /HDPE Age of lift station years
Measured operating fluid level in septic tank Lift station material
® Standpipes/foundation cleanout per record drawing Comments:
Date of pumping
D. ABSORPTION FIELD DATA—2 X 25'L x 3'W x 7.5'ED—0.6 GPD/SF = 750 SF+ NEW TRENCH 2019
Which system tested (date installed) 8/8/1995 Adequacy test date 9/5/2019
® ALL standpipes present per record drawing Results El Pass For 4+ bedrooms
Total measured depth from grade 12.1 ft(max) Fluid depth prior to test 61 / 18 in
Measured depth to pipe invert from grade 4_6 ft(min) Water added 600 gal
❑ N/A—pressurized field
New depth 87/37 in
® Monitor tubes go to bottom of effective. If not, state Elapsed time 1120 min
depth into effective
® Code-required soil cover over field Final fluid depth 47 I 0 in
® System presoaked Absorption rate 450+ gpd
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) N
date of test)
Gallons introduced 1800 gallons If yes, enter date
Comments/Deficiencies: ADDITIONAL TRENCH INSTALLED 11/2019 FOR 5-BEDROOM SYSTEM
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100'
® Yes if No ft ® Yes if No ft
Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No ft
Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No ft
Neighboring Absorption Fields > 100' Animal Containment> 50' ® Yes if No ft
® Yes if No ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ® Yes if No ft ® Yes if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10' ® Yes if No ft Surface Water> 100' ® Yes if No ft
Property Line > 5' ® Yes if No ft Wells on Adjacent Lots:
Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No ft
Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft
Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below
Property Line > 10' ® Yes if No _ft Wells on Adjacent Lots:
Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No _ft
Water Service Line > 10' ® Yes if No ft Community Wells >200' ® Yes if No
Surface Water> 100' ® Yes if No ft
F. ENGINEER'S COMMENTS
�
OFAL�4X
G. ENGINEER'S CERTIFICATION ` .
I certify that I have determined through field inspections and review I*49TH�N
of Municipal records that the above systems are in conformance
/edt44, I
with MOA COSH guidelines in effect on this date. i/ &ii/f
MICHAEL N. ANDERSON:44
I1 4� No. CE 9469 /
11114119. s
pESs10106.