Loading...
HomeMy WebLinkAboutTUNDRA JEWEL RANCH LT 3ATundra Jewel Ranch Lot 3A #051-193-14 ,? Municipality (if Anchorage �# ,! Development Services DepartmentTd't"� t\' 1 GLlldiiip Saft'.i4' Divj wn �` i-' J -- s)mSde'JtiaterIla lP&ST V IleIProgran#,4700 uln�atvSL `fJ:"E,50 / P.O. Box Anrnnng7j( AK sl;M J f 6Y) Page of lvv:w.cianchar�gc.ak.us (9197)343-7904 ON-SlTE WASTEWATER DISPOSAL SYSTEM ANDIOR WELL INSPECTloN REPORT Permst Number. J Q 67(20 Ulla Number t r�� 0G7 Wastewater System: e y IJ lJpyraJe ABSORPTION FIELD G Flna CI f.1n..n ❑ Jl,:e! Nint LEGAL DESCRIPTION - /, c� 'r 4,ic.,r•n u.. „yl'JIy Jf I c o.. l Awl l I I . I SVi!NOW IF '�� �� j/ n l'!ill l I, ,v I dIN1.1 IwIII 14) q'_ I:rvllY �]Il:..i Lo rIII :IPYt .• rl!•VC Alj1P 1I 11'J2n 1 d+'!n f'J1II IJIr...•t t111 — �r P JAJr-I t l + Upgrade le:J4W Llii i rl vltlu wu.:i;a Jlo-: �00 n Pp, 41 -I (�� u ?y 1"�=J ��� �U:,!"litll:i^. 1a1144:a@u LnpP Ine4Ylf.1:� � Il:aa:LI s, /( L/ :JIIr.U� �� pl !a:: .'� r„a:r�iic: lAl �:Illinlill.]II Sb �:: flin..nt TANK f ,r'In SEPARATION DISTANCES tlpdc El Holding ❑ 1 T,F Fl. L 0.I10r. A13501 r-6011 „nk Field Li': Station H;?Ulna Tam 1b1.c:Pn a a Suvml UI e Nmlpnnn r1�',rte Cx.u:ar �'.I fi `� -!i j [^ Ix� Irl, ......111'1:`1: �V.�11<Y11 1 / Or /flJ /aa (j I ttS. •,\ I LIFT STATION !} P.,r,p Gia .Artnn, ri ,dp:;all �'4�en5t'ln ltJ ::j I -`" BENCH MARK mea .4T C.3 __ tlnln�Pk&U#�rnla r ;) eetinns prir)rmed by:_wZ ✓- Dates: A111' 2nd Development Services Department Approval C(iriditiorial Apprcly l Date: R vi:F„ed and approved tny: i Z �1 %U r � z F- r z < < rm H m n I � I V) i m 3 r �Oz -75 ow i0 D D 3 L tj FTI w7J :cm D m � r Y�1 H A 0 N d O W --i I I I tT- L n UO H _ Q o OD ti C7 U D O 5 Q V1 N O P � o � C j c -I- o -- S_ 00 ` O r n rD s Q n rD rD S 3 C+ rD rD 3 C- .. Q z 3 0 (D 33' Section Line Easement C7 tj (n V) �l n O n p CD n N 0 N WN N W o � N W .� o Ul v �l Ln + 4u 0 Fri !;tit m m p 1+ C-) Fri 0 m cn R 70 ro:- M tj 2w 7c) t:J :> m tj C- 70 m m F- 270 � 1> ��]Q 0 t> v �l p m Y F9 p 0 :3 C-) m CO p 1+ !;tit p m Y F9 p 0 :3 C-) m CO p 1+ MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Jan 26, 2006 Expiration Date: Jan 26, 2007 Permit Number: SWO60010 Parcel ID: 051-193-14 Legal Description: TUNDRA JEWEL RANCH LT 3A Design Engineer: 0838 North Rim Engineering Site Address: 019441 WILDWOOD DR Owner Name: ROBERT BOLTER Lot Size: 38768 SO. FT. Owner Address: 19441 WILDWOOD DRIVE Total Bedrooms: 4 Permit Bedrooms: 4 CHUGIAK , AK 99567-6471 This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specked 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 catling (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. Received By: IN Date: X 4Ql r Issued By. Date: Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. . n 51 — 101 3 14 Permit Number SW Property r1 phone o2s--- 7a2A Mailing address /Z;&Z;" 1•1rldwoopj Qrrve- Zip Code 99.76'7 Site address S.4*f0'0' Zip Code Legal description (Lot, Block & Sub'd.) _ 7—ONi OPO C -q 1_3.4 Legal description (Section, Township & Range) Lot Size 36`Acr o THIS APPLICATION IS FOR: Number of Bedrooms 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 autherlfed agent) Permit/Rush Fees: `jrtl - to Waiver Fees: Date of Payment: t k/a' Receipt Number: 76M 44 . (Rev. 09/04) 1n1_/ Date of Payment: Receipt Number. I\JG2F SIM ENGTINEERING Northilim Engineering 17237 Bear Paw Circle Eagle River, AK 99577 907-694.7028 January 20, 2006 MOA On -Site Water & Wastewater Program 4700 Bragaw St Anchorage, AK 99519 RE: Septic System Design, Tundra Jewel Ranch S/D, Lot 3A A new septic system is being planned for a house renovation in an established neighborhood. Excellent soil was encountered. Lot sizes are large in this area. Private water wells serve the subdivision and no conflicts have been found. Most of the neighboring lots are developed. This site should not negatively impact any of the other area lots. The slope is relatively flat. Please review the wastewater system design for the renovated single family home. I have included design plans & specs, design guidelines, & soil tests. If there is need for additional information or clarification please give me a call. Sincerely, Steve Eng, PE, PH Design Enclosures 1 (�C2TF�;2�M EN(,INEERING TUNDRA JEWEL RANCH S/D, Lot 3A SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is a renovated single family home projected at 4 bedrooms. This requires a 1250 gallon septic tank. This lot is several acres in size, as are neighboring lots. Most of the neighborhood lots have been developed. No adverse impacts are expected from developing this lot. The existing water well is located on the drawing as are the neighboring water wells. The lot is relatively flat with some slope to the northeast. No conflicts to any neighbor lots is anticipated. Two soil tests were conducted; a sandy soil with an excellent percolation rate. An application rate of 1.2 GPD/FT2 with 0.5 reduction factor for utilizing a 5' wide trench was utilized. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • Two compartment, 1250 gallon septic tank. • Watertight couplings on inlet & outlet. • 5 foot minimum between the tank and bed. 10 foot to property lines. • 3 feet of cover or insulation is required for trench; an equivalent of I" insulation for each foot soil cover. • Tank & solid pipe must be set on well compacted, stable soil. • 4 inch diameter cleanouts with airtight caps are required 1 to 4 feet from foundation wall, prior to any 90 degree bend in 4 inch line, in each tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10 feet from the tank positioned to provide cleanout access towards the tank and towards the absorption field. • All cleanouts must extend to at least ground level. • In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron. • Trench to be placed level, minimum of 4 feet to groundwater, 6 feet to bedrock from drain - rock. • Drain rock to be % inch to 2 %: inch screened. Drain rock to be distributed uniformly throughout the trench. • Perforated pipe to be installed level with perforations down. • Silt barrier (filter fabric) to be installed above the drain rock. • Smeared trench sides must be raked or scarified before drain rock placement. • Backfill over drain rock must not be less than 36". • The finish grade must be mounded to promote drainage over the trench. • Insulation must be placed over any pipe installed under driveways or parking areas. • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, • Sewer Service Line is minimum 2% slope. • Septic Tank to be pumped every two years or when required. • Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI or equal) OLQ S EO?tc.- 'TANfe— To BE C.Zu,r f Fd :�Jawasn3 aui-I uompas ,£E U Z c: m O c u O 3 � Q O Uo 3� u c £ N d U1 LW 4, CL >14- O £ M O i N uZL. > +' 0 0 O Cl. n, +> a W 0 0 E V)aJ. N 0 Ln N H Xy - 47 0 Ln W A Z 0 J W U F- CL CL W N W Z 0 r. 0 v W N 0 N, %D t= W Z Q J a- ! . N L 0 c o c CL J O e o�NJ .� E E a� cc) O a C o. f c- E— O u2 C> > E F-•—.— 7 J a Q1 c E >, O p N C i U •- W E0 �� n►-a�O N > O _ o 0 N d V 0 + NCD (1) (n FO t=iI N F�- J Lr) w (U M .= N M -d- U Z c: m O c u O 3 � Q O Uo 3� u c £ N d U1 LW 4, CL >14- O £ M O i N uZL. > +' 0 0 O Cl. n, +> a W 0 0 E V)aJ. N 0 Ln N H Xy - 47 0 Ln W A Z 0 J W U F- CL CL W N W Z 0 r. 0 v W N 0 N, %D t= W Z Q J a- ! . ......... U7 L5' bb=.,00,5Ce0v� Cl) ------ I--- — — u o z n CC CO Q 3 � 0-04 J pi n Ifh OI O 000 W W 3 cq C r. O O M U W N pn pq t\ N M > :W I� I Q E � =a O h Q o E _ +I) \ E� v LO Z �D Nwn - e e =1 ti ::D Woa N xx° W '7 0 I 6 z ••:�.. I I � O 3 S 6'9bb .M.,LZ. ^ � 66'991 oo'zs: 'r;�;rof C7 L d A A UG _ > > F Vvyio A Z •k':. oc LLQ ZS'401 Q ao r � �.. r I 3 C/) CL 0 n N f� 3 ON Z8'ZLZ-- T a o tiW o`e W2 Z�a �- W S U c L L H Y c d a N N c o, a w w tn 3 O L d a, U Ol c N O CL a 0 i a� 301 �N o L F- L S o O c = c Q N CL I Qi W , 0 ~ 0 3 n O L U W W N N pl L iz s +� Q Q � M f CL la q Z F— o D O > F— J :p U �. N i a W W Z 3 a _ L) H LLJ f I LL- W N a a i1:1 q d U L q 0 a W LLI 0 U Z u c Q ~ C: U (� a o Z W U_ • oa, U o >. 1- - F— F_ aN N N NH 4 0) a E O 0 L) 0 0) d 0 3 3 -P O E f 1 W «: :0 b.11 `G d U C5 � [ O UO aE L J. . •tl, OW l,. CD �+i OLNWU�¢ a a3tt : L V O O Ol O. Ow 11 �••.•�: N L -D O O Cod u a) L)41 V N Neal �U d ~C(0Lm�~N e� W Ua C7 0~ NN I_ al i T p o N ZS V72LLN03 ZW y n X41 Z+•Lo CLad 3.°N'd3 V iim N mNNN3NQfk� A D 2 h _; fU (V) v LO %D e 2 LU § � i 5 m 2 ƒ - \§ i L 0 \ $! { / �i a. U; « ¥ k\ 0i V) •;i®i �t�! \ 75 \{/ ���� ■ �± AI tn G G\20 / »L&=� \ -C)> �;i7i � • / L to :8; > ,©� t �uuo=: E- L M -C uc, ,� ®� z2�E£; V)F— �». R.4CUw¥; k r {I in �I j� i 5 E f i®i ff &J ¥ •;i®i \ 2L ���� ■ w � G •;i®i / \ � �;i7i � • -will�i \ •;i®i ,©� t - •;i i ,� ®� }u . �». k L 2 E r {I in �I j� J |'� i®i •;i®i ���� ■ w � •;i®i � �;i7i � • -will�i – •;i®i ,©� t - •;i i ,� ®� . �». �,. . •;i7i – ;;i i - ,� r {I in �I j� J |'� i®i ���� ■ w � -will�i T \ S❑ILS LOG - PERC❑LATI❑N TEST Date Performed: 1/9/06 ENGINEERING Performed For: Robert Bolter Legal Description: Tundra Jewel Ranch Lot 3A 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10 - 11 - 12 - 13 - 14 - 15 - 16 - 17 - 18 - 19 - 20 - 21 - DEPTH (FEET) Organic T.H. Location See Attached Design SP Sand w/ Cobbles Groundwater? No Depth -- Water Depth After Monitorinq.None Dates _1/17/06 # Date Gross Time Net Time Depth Net Drop 1 1/9 0 -- 3' -- 2 1/9 1 1 min. 4' 1' 3 1/9 3 -- 3' -- 4 1/9 4 1 min. 4' 1' 5 1/9 7 -- 3' -- 6 1/9 8 1 min. 4' 1' Percolation Rate 1 min,/Inch Perc Hole Diameter 6' Test Run Between 3' and 4' Comments, PrPaonk Performed By NorthRim Frig, I Performed in Accordance with ON THIS DATE, DATE' 1/20/06 ) i ' CERTIFY THAT THIS TEST WAS I State/Municipal Guidelines in Effect NORTHRIM *�"49m TESTH❑LE LOG ENGINEERING 77257 Bear Pow Clrcle Mn. W '•: Eagle River. Alaska 99577 a� 907.694.7028 GE❑TECHNICAL T. H. 1 � Dab: 1 1/20/06 _11 f 9, \, SOILS LOG - PERC❑LATI❑N TEST Lolr-TH"-M Date Performed: 1/9/06 INEERING Performed For: Robert Bolter Legal Description. Tundra Jewel Ranch Lot 3A DEPTH (FEET) 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10 - 11 - 12 - 13 - 14 - 15 - 16 - 17 - 18 - 19 - 20 - 21 - Organic SP Sand w/ Cobbles T.H. Location: See Attached Design Groundwater? No Depth -- Water Depth After Monitorino.None Datee 1/17/06 # Date lGross Time Net Time Depth Net Dro 1 1/9 0 -- 4' -- 2 1/9 1 1 min. 5' 1' 3 1/9 3 -- 4' -- 4 1/9 4 1 min. 5' 1' 5 1/9 7 -- 4' -- 6 1/98 1 min. 5' 1' Percolation Rate 1 min./Inch Perc Hole Diameter 6' Test Run Between 3' and 4' Comments: PrP-;nnk Performed By NnrthRim Eng, I � Performed In Accordance with Al ON THIS DATE. DATE• 1/20/06 NOR THRIM ENGINEERING 17237 Bear Paw Circle Eagle River. Alaska 99377 907.694.7028 2 CERTIFY THAT THIS TEST WAS L State/Municipal Guidelines in Effect TESTH❑LE LOG GE❑TECHNICAL I T. H. 2 i I Dcie: 1/20/06 12 of 2 GAAB.HD-I G."TER ANCHORAGE AREA BORO�H HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAM', I ,�,�//• MAILING 7C�' G ? 33 9/bv ADDRESS HONE LOCATION LEGAL DESCRIPTION if=t3 SEPTIC TANK: NUMBER OF DISTANCE FROM WELL 94*' � MATERIAL S6 COMPARTMENTS �. S�-1 %Iv LIQUID LIQUID CAPACITY Z S� GALLONS. INSIDE LENGTH INSIDE WIDTH-DEPTH- SEEPAGE IDTH DEPTHSEEPAGE SYSTEM: SEEPAGE PIT: t� NUMBER OF PITS OUTSIDE DIAMETER OR WIDTH ` LENGTH DEPTH LINING MATERIAL�DISTANCE FROM WELL �y�'Q` BUILDING FOUNDATION, NEAREST LOT LINE 12G / � TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) 7k SQ. FT. TILE DRAIN FIELD: TOTAL LENGTH DISTANCE FROM WELL FOUNDATION NEAREST LOT LINE OF LINES NUMBER OF LINES =PnF S REN H WIDTH IN. TOTAL EFFECTIVE ABSORPTION AREA EACH GAAB-11D-2 GREATEI�NCHORAGE AREA TROUGH Case No.cZ� 11EAI.TH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279.2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPLICANTw-7AU'211 j�P_ L[} I MAILING ADDRESS / PH0NEENNOEEL 126 ��RESIDENCE ADDRESS f S7��Q 11, 1111 L ' ll% LOCATION OF INSTALLATION �-t- � 1 L(i to �!<�uk'J A7,11d, LEGAL DESCRIPTION - e —!rZ Z �L' A -T z, -, I ii�!7! APPLICATION TO INSTALL: SEPTIC TANK SEEPAGE PIT , DRAIN FIELD , OTHER TO SERVE THE FOLLOWING FACILITY ,% &C A42 ,�Lf FINANCED THROUGH •fir- L TO BE INSTALLED BY -I T PERCOLATION TEST RESULTS 11, 4 J�NTICIPATED DATE OF COMPLETION'-/ BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS 4! • PERMIT TO INSTALL A SN ex SS<<S AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED J7g/ aC yrA-- . SEPTIC TANK SIZE YPE ,S E' I SEEPAGE AREATYPE DIAGRAM OF SYSTEM DISTANCES: Health Authority I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. DATE'1, /,f APPLICANTSSIGNATU y� .r. 1125 ,.L„ STREET ANCHORAGE, ALASKA 99501 190 4111 1 t I i"ti11 r�9�r r �! Z ! ✓ i7 / GCORGE At SULLIVAN, A 1A YO Al I)[ I' 1:Mr;I O( 111 ACT II AN,'.) 1:NVIRUNh7LNfAI. VIM rEC710'J January 4, 1982 James L. Canady P.O. Box 672 Chugiak, AK 99567 Permit T 810438 Subject: Lot 3A Tundra Jewell Ranch Sub. 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,. /,/> A 66 Les N. Buchholz R. . Program Manager Sewer and Water Program Enclosure: Copy of Permit M �_� t .t I I �• LIT •T OF= n rpt C F-1 n f= A O E DEPARTMENT OE�HEALTH AND ENVIRONMENTAL P!�-OTECTION 825 'L STREET, ANCHORAGE, RK. 99 1 ' 264-4720 i Lam! F=LFL F` F= F= r•7 I T PERMIT NO. C 810438 ) APPLICANT JAMES L. CANADY PO. BOX 672 CHUGIAK Al". cl 688-2849 LOCATION Qp vLV LEGAL LOT 3A TUNDRA JEWELL f 11 SUB LOT SIZE 43560 SQUARE FEET MINIMUM DISTANCE BETWEEN A I -JELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC 14ELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER•. REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER. INSTALLATION. P EF�`M I T aXF=" I FRF= GAF=GF= t'iF= E� = 11 15 L I CERTIFY THAT 1: I AM 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. SIGNED: APPLICANT JAMES L. CANADY ISSUED BY��------- DATE_Z_��Z21J_L` _/ V4. 0 nON �o :-a 00 i 0 ��L�T� 1 G Z i-jFiL I 'i -'at stir FiNGM�i�t�t3� "'� OEP'ARTTefr OFHERL.TH .IW 0W IRt-W*NTAL PROTECr tort 823 'L' STAT, t3F 3E, W. 97501 11 264-4720 PERMIT m C Si0438 J ^.- TVpL:jCANT JPJ4E,5 L CANADY -mien Lcr*lt.. Liar 3A Tunom jEwa-L_ Ri" t r_3 r -T i .�,w .j �yy N * �y �y ,�,�p .yam rr PM -WX b�2 044 tAK f0. *5"-2841 Std LOT St2E --43550 OXIRE Fi .. i rM I r+ IMUN D I S T M SET14EEN H WEL.1_ fM Pt+tt+ ort -SIM o f SPOSAL YS T01 IS i toa Feer FOR A PR I VAFE WE1.!_ OR 150 To 2w Feer F" A PLeL IC weLL mmxj um l IJO M THE T f?E OF Pt.KP.iC mu. 1 mINIt?m DISr "k F" A PRIVATE WELL. TO A PRIVATE Xek LINE t5 2S FE£r Ami To A c3x"jH I r'r Sc3"- L ENE IS 75 .FEE r. W. -v- Lr-sa3 ARE REQU I RED Am rrr-; r sE RE ruw4Eo r4 T -w- moRQ Tmei r w I Tm t N 3a of:rr 9 *F T»- wa.L,. COMPLeriom A on -)ER Reau t f'e4m r5 nw Pi -'PLY. SF'EC IF t cA T t or25 Am Gow muc r t m t1 I Atm s rill£ I AVAIL OLF To Irr_-uW PROPER unrALLRTtorL f=`E 'l•1 S T AXP Z MMES L?ECEt4gEf� -2-4r X331 I cERrtF'1 THtir i s [ Ah FM IL I NR WITH THE PEW t REMEN N FOR ON1S I TE SR`s M) HEWS by SET FORM VjF THE FPJN I G i PfjL I TY r F f*?,- toRfWl 2: i u rti. IM; r?V-L THE s rwat IH A0:31A OX wI TH THE C rWei. 5ICNED: ----- --- ----- /---------------- 1 i i N D o z r A N m 71 O N cnN S ' m {� T z. T 70 •-n M T M T M T m T M T M T M T m T' m T M O O O'S O 0 z O K r 9 9 9 T � r 'S 9 9 T 2,v 3 —1 • O. Z. T T T T T T T T T T T 1 O O O O O O O O O O O' n Z �1 QA " D c� O ' c < � r a T T T n Tn T T T T T T T O O O O O O O O O O O T �+ T .r T r+ T r+ T r+ T T T T T T O O O O O O O O O O O r* r+ N D o z r D N m 71 O N cnN S ' m {� N D N m r D N C m O S n T nO m r r M n C/)< z r ci z r r 7 N r D a C m r Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-193-14 1. GENERAL INFORMATION Expiration Date: D ' _)_ 3 -1 Complete legal description Tundra jewel Ranch Lot 3A Location (site address) 19441 Wildwood Chugiak AK Current Property owner(s) Bolter Day phone 727-3073 Mailing address Real Estate Agent Tracy CcD RE/MAX Day phone 727-3073 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) V L MAY 16 2014 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class C Well Public Water System 8 TYPE OF WASTEWATER DISPOSAL: ® Individual ❑ Holding Tank ❑ ❑ Community ❑ ❑ Public Sewer ❑ Received by: - _ Date: r ,' COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5 Z� Date of Payment ✓ tol 1 Receipt Number od-5Io'1 COSA# 0SC-lTIIg1 Date of Payment Receipt 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 jnstallation. Name of Firm NorthRim Engineering Phone 694-7028 Address PO Box 770724 Eagle River Engineer's Printed Name Steve Eng Date 5/16/2014 6. DSD SIGNATURE System #1 Approved for bedrooms. System #2 Approved for bedrooms. ,Disapproved. 5 r llr t Conditional approval for bedrooms, with the following stipulations: By: l0 C � ` � Original Certificate Date: The Mu 6ipa ity of Anchorage Devlopment 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 Septic System Advisory Well Flow Advisory COSA blue sheet 9-1-12.doc X Nitrate Advisory Arsenic Advisory Other If more than 1 septic system is on the lot: COSA Checklist # Of _ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: IL,nA-u. f/4 Parcel ID: LIS t-173 A. WELL DATA Well type If A, B, or C provide PWSID # Date completed 2 Sanitary seal (YIN) + Total depth __L3 _fft. Cased to l 3 f ft. FROM WELL LOG Date of test Static water level 77 ft. Well production Z g.p.m. WATER SAMPLE RESULTS: Coliform --a—colonies/100 mL Nitrate 3. mg/L Arsenic d. ug/L Date of sample: l B. SEPTICIHOLDING TANK DATA Well Log (YIN) Wires properly protected (YIN) Casing height (above ground) 2y. in. AT INSPECTION % o� ft. 2 g.p.m. Collected by: 121^^ 6KA / Tank Type/Material ,S 'Fcc LP �GS7 c r Date installed 4-1-144; Tank size / 2 SD . gal. Number of Compartments Z Cleanouts (YIN) Y Foundation cleanout (YIN) V Depression over tank (Y/N) Al High water alarm (YIN) Al Date of pumping % l Pumper d Fjr:-- cC (c'o C. ABSORPTION FIELD DATA Date installed %d to C Soil rating (g.p.d./ftz or ftZ/bdrm) Z ?__ System type rle-ta Length SO ft. Width S ft. Gravel below pipe—� ft. Total depth 8 0 o ft. Eff. absorption area fe Monitoring tube Depression over field N Date of adequacy test _ Results (Pass/Fail) P140 For -bedrooms Fluid depth in absorption field before test n in. Elapsed Time: min. Final fluid depth Water added—(—'a0 gal. New depths in. 6 in. Absorption rate >= a l g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NO If yes, give date D. LIFT STATION I Jtq Date installed Size in gallons Manhole/Access (Y/N) _ "Pump on" level at in. "Pump ofP level at in. High water alarm level at in. Datum . Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOTTO: Septic tank/lift station on lot /OD''- On adjacent lots D 0 Absorption field on lot /00 '� On adjacent lots /0 0 'rt Public sewer main /VA Sewer /septic service line Z S Animal containment areas SEPTIC/HOLDING TANK ON LOT TO Public sewer manhole/cleanout IV4 Holding tank AiA Manure/animal excrete storage areas,0o Building foundation Property line Absorption field S r* Water main M4 Water service line /� �� Surface water /00 e;t- Wells on adjacent lots 1610 +` ABSORPTION FIELD ON LOT TO: Property line /1 f Building foundation /0 Water main Nfl Water Service line Surface water 14 0 Driveway, parkingNehide storage Curtain drain Wells on adjacent lotsa F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's /Printed Name Date COSA brown sheet_1010-12.doc AS -BUILT I hereby certifv that I have surveyed the following describe, property: Anchorage Recording Precinct, Alaska, and that the improve merits situated thereon are within the propertv lines and do no overlapor encroach on the property lying adjacent thereto, tha no improvements on prnpertv lvin adjacent thereto eucroact on the pmises in question anti t at there are no roachvay�, transmission lines or other visible easements on said proper[N except as indicated hereon, Dated at Eagle, River, Alaska this At, aay of 'fH) ROBERT C. JOHNSON SCALE; Registered Land Survevor No. Mill's V, = Box 77-0456, Eagle River, Alaska 99577 Phone (4177) 694-2543