HomeMy WebLinkAboutFALLING WATER BLK 2 LT 3Falling Water Block 2 Lot 3 #050-772-04 Municipality of Anchorage Development Services Department =�=� ` Building Safety Division :•_�. '•' _ On -Site Water & Wastewater Program, 4700 South Bragaw St. , , ; T ; P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SW020044 PID Number. 050-772-04 Name: MARTHA REINHOLD Wastewater System: ■ New ❑ Upgrade Address: 3755 WEST 100TH AVENUE * ANCHORAGE, AK 99515 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 622-0160 3 O Deep Trench f Shallow Trench O Bed OMound OOther LEGAL DESCRIPTION Soft Rathp: 1.2 Total Depth from "Irnal grade: 7.5 MAXIMUM GPD/Sy. Ft rt. Block: lot: Subdivision: Depth to pipe bottom from ortylml prods: Drawl depth beneath pipe: 2 3 FALLING WATER 3.89 MAXIMUM FL 3.61 FL Township: Range: Section: Fol added above oryml grade: Growl length: SEE DWG rt 53 FL WELL: ■ New ❑ Upgrade Groh width: 5 Nurnber of groes. 1 Distance between Iln«: 1 — R pt, fYoeNnoatbn Private. A.B.0 : Total Depth: Costa To: Total absorption ono: It" motafth D 3034/ F-810 PRIVATE 235 it 235 Ft 500 so. it Dryer. SULLIVAN WATER WELLS Dole DAled: 5/21 02 Static water Level: 73 Installer. GLW ENTERPRISES Date McWiMd: 10/9-11/02 FL Yleld: Pump Set AL Cc" Height Man Ground: TANK 50 IiPY UNKNOWN ix 2 R SEPARATION DISTANCES ■Septic OHolding OS.T.E.P. OOther To Septic Tank Abso tion Fid Ut Station Holding Tank Publk/PrIwG sewn un« womfoctunr. ANCHORAGE TANK Copadly h potions: 1500 From Well 100'+ loo'+ — — 25'+ Mate": FIBERGLASS Number of compartments 2 Surface Water 100'+ loot+ - - - LIFT STATION Lot Line 5'+ 101+ — — — Size N gallons: Yanufoelurer: Foundation 5'+ 10'+ — — — 'Pump on level at:'Pump o at: Mqh water alarm at Curtain Drain NONE KNOW Punta Yate Decfrkol Inepecuorr performed W. Remarks: BENCH MARK Laeaeon and Deeerlptfon: TOP OF CMU FOUNDATION NEAR FCO Adeumed Eweaaora. 100.00 ., FL ENGINEER'S SOL i1 d4p o '•q Inspections performed by: AKWWC, INC. Dates: 1st 10/9/2002 p'. 4...� 2nd 10/9/2002 0 3rd 10/11/2002 e e A. arne s:' Qdp� DevelopmentSe ices Department Approval i ' . -79 RReviewi�-ed and approved by: Date: ) Z 03 4°p°d�'rafeesta�ooQ�v N t16� �DOO�000 AM PERMIT NUMBER: PARCEL ID NUMBER: SW020044 AS -BUILT DRAWING 050-772-04 •'• *. NEW ' A 3 HOUSE M � Fro B / o� NEW 1500 GALLON FIBERGLASS OPTIC TANK FCO ST1 NEW DRAINFlELD ST2 ALTERNATE SITE \ \ DBL1 � DBL2 C01 MT1 CO2 MT2 DATE: 1: ....___.._ _._ DRAWN BY: ALASKA «'ATL'R & ZVASTL'R'ATL'RSCALE Z.T.G. --^---------�-�- CONSULTANTS, INC. 1" = 40� 6901 OFBARR ROAD. SUITE 29 • ANCHORAGE. AK 90504 • PHONF (007)337.6179 • FAX (907)538-32f.6 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: MARTHA REINHOLD (907) 563-3003 2 OF 3 LEGAL DESCRIPTION: LOT 3, BLOCK 2; FALLING WATER SUBDIVISION AS -BUILT DRAWING OF SEPTIC SYSTEM UPGRADE A B 32.77 22.42 31.58 54.58 38.28 64.24 41.03 67.37 42.27 68.24 53.89 63.03 53.62 64.20 51.40 96.73 52.23 197.13 as GIMP Ci0fI1 3.' •• �cFa PERMIT NUMBER:�nT PARCEL ID NUMBER: SWO20044 AS -BUILT DRAWING ING 050-772-04 TOP OF TANK - 91.08- INVERT 1.08- INVERT OF INLET - 90.17 — FINAL GRADE - 93.6+ (AVG.) FILTER NOTE: TANK AND FIELD INSULATED PER GENERAL CONTRACTOR GREG BOOTHE. —INSULATION PER GENERAL CONTRACTOR P OF TANK - 91.06 ,•� 1300 GALLO•— FIBERGLASS TANK s FINN. GRADE - 92,21-95.94 rORIGINAL GRADE - 9729 O HIGH SPOT INVERT OF PIPE - e9.37 (AVG.) BOTTOM OF TRENCH - 83.76 (AVG.) RELATIVE ELEVATION OF BOTTOM OF TESTHOLE - 79.26 (TESTHOLE DRY) IT OF OUTLET - 89.83 TH/2 003 DRAWN BY: QO ��!• 7 ��0 ALASKA «'ATER & `VASTE«'ATER SCALE: Z.T.G. oaf: I yV( CONSULTANTS, INC. *.:.. ... ... ....... .... 6901 DFSARR ROAD. SUITE 28 • ANCHORAGE. AK 9050L • PHONE (907)337-6179 • PAX (9071338.3246 N.T.S. OA PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0.MARTHA REINHOLD 907 563-3003 3 OF 3 00 .. f y e LEGAL DESCRIPTION: Q�'o •, C 7953 o�G LOT 3, BLOCK 2; FALLING WATER SUBDIVISION TYPE OF WORK: vu4 Zcfprofe691o('oVx O PROFILE AS -BUILT DRAWING OF NEW SEPTIC SYSTEM ��OO000�d Certifieb Dritting log by DOC CO. dba r^ SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 • TELEPHONE 668-2750 OWNER OF LAND: XaAfrm r /t r f 0Jj3a <d BORE HOLE DATA DEPTH ADDRESS: Flom TO LEGAL DESCRIPTION: F&!&, PA uMn g dg< DATE:4A X021 PERMIT NUMBER: 00104Date of Issue TAX IDENTIFICATION NUMBER: (Z$ O Is well located at approved permit location? f� U No Method of Drilling: trair rotary U cable tool Depth of well: 07:5 so*� - Casing Typeyt Wall Thickness inches Diameter 411 inches, depth 01-3s feet Liner Type: /1) J ^J4 r�'ig Stickup Above Ground: C ' feet Static Water Level: %13 feet Recover Rate: So gpm Method of Testing: /41 /z Well Intake Opening Type: G open end U open hole �j Screened; Start -feet, Stopped feet UPerforations SW -feet Stopped feet Grout Type: _!. '.�To "�'TE 'Volum /SO < as Depth: from feet, to J_ feet Well Disinfected Upon Completion? 6-<s O No Method of Disinfection: 0 P aJ&&#IE TO Agei Comments: Driller's Name C/9 -S i..1C ST'/Gt.JA O Jct /3' .Jre4:F=�' I .OYA,<a 0a--1 ' coda< p r 13-C CC rii 044 ��a 664jJd�c' NTION, It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality .ichorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough: Department of Environmental Conservation. MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water& Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Permit Number: SW020044 r Legal Description: FALLING WATER BLK 2 LT 3 Design Engineer. 0041 AK Water & Wastewater Consultan, Owner Name: Martha Reinbold Owner Address: 3755 W. 100th Ave. Anchorage , AK 99515 - tolq 5 � „I Date Issued: Mar 29, 2002 Expiration Date: Mar 29, 2003 Parcel ID: 050-772-04 Site Address: Lot Size: 100181 SO. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy All construction must be in accordance with: 1. The attached approved design. ❑✓ Private Well ❑ Water Storage 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. Received By: Date: 3 " ?L7 — QZ Issued By: _(Z / Date: _3 _2 y— 02 Municipality of Anchorage <+•i4•cecn,� Development Services Department Building Safety Division On -Site Water & Wastewater Program ' Al I T' 4700 South 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 1 Parcel I.D. 50 - /�f % 2 —04 Permit Number 5 W02-004 if Property owner(s) MARTHA REINBOLD Day phone 563-3003 Mailing address (1) 37rr W 1 oo m AVE. Mailing address (2) A61CH08116 1; !4/< 9%S'/,S— Zip Code f95/r Legal description (Lot, Block & Sub'd.) —LOT 3. BLOCK 2: FALLING WATER SUBDIVISION Legal description (Section, Township & Range) N/A Lot Size LO -0.4161 Acres/Sq.Ft. Number of Bedrooms 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 ❑ 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. ALASKA WATER & WASTEWATER CONSULTANTS INC. Permit Fees: k$ 55b`t $ 160 . '0 Date of Payment: 3 - am- o Waiver Fees: Date of Payment: Receipt Number: 017t04-4 Receipt Number: ALASKA WATER & WASTEWATER � CONSULTANTS, INC, April 1, 2002 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Proposed and Well Septic System Design for Lot 3, Block 2, Falling Water Subdivision To whom it may concern: The proposed 4 -bedroom hoose will be served by a private well and septic system. Two test holes were excavated in the area of the proposed septic system. The septic system will be designed around the 30 -foot radii of these test holes. We are proposing that a 1250 -gallon concrete septic tank and a five-foot wide drainfield be installed. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that an application rate of 1.2 gallons/day/ft2 should be used. When the test holes were excavated, they were relatively stable and vertical. This is an indication that there is enough of a silt binder to provide some cohesion to the soil; therefore, it is our opinion that a sand filter is not necessary. Soil logs have been modified to reflect some silt content. 2. TRENCH DESIGN: a. Percolation Rate: <1 & <1 minutes/inch b. Allowable Application Rate: 1,2 gallons/day/fl2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e, Minimum Absorption Area: 500 fe f. Total Depth: 7.5 feet (max.) g. Effective Depth: 4 feet h. Width: 5 feet i. Reduction Factor: 0.50 j. Minimum Length: 52 feet long k. Effective absorption area = 520 fl2 6901 Deban Road, Suite 2B' Anchorage, AK 99504 Ph: (907) 337-6179 " Fax: (907) 338-3246 • Website: akwwc.com 3. SURFACE RATERS: There is a small creek approximately 170 feet from the proposed septic site. In, short there are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: The area for the proposed septic system is a 5% to 10% slope running approximately northeast to southwest; in short, there are no slope concerns. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your 4.S. NOTE: Attached is a site plan drawing, a design drawing, two soils log, and a 7 page constnrction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 213 * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com 1 1 1W MOUS FLOTFAWNC WATER S/D 4 BLOCK 2 I TH/2 f ROAD 1 I I I I PROPOSED SEPTIC SYSTEM (SEE DESIG PAGE 2 OF 21 \ �'Iy ALTERNATE SITE \ \ NC% \ \ \ 1 MME 1/ / � I f�T' wEt�eniu 1 ♦♦� I ' OPTIC ARaD I FALLING WATER S/D LOT 2 BLOCK 2 ALASJU NVAT i R & NNIASTLIVATL,R CONSULTANTS, INC." -- MARTHA REINBOLD PHONE NUMBER: 563-3003 FALLING WATER S/D LOT 1 BLOCK 2 DATE: 3/29/2002 DRAWN BY: C.J.G. SCALE: 1" = 100' 'AGE NUMBER: 1 OF 2 LOT 3, BLOCK 2; FALLING WATER SUBDIVISION I OF WORK: SITE PLAN FOR PROPOSED WELL LOCATION AND SEPTIC SYSTEM LOT 1 MCALOON S/D t yD .3I.3 e ;' o t e s sio���` NOTE: THE CONTRACTOR SHALL HAVE -THE 100 WELL FOOT RADIUS ON THE REFERENCED PROPERTY FLAGGED PRIOR TO CONSTRUCTION. INSTALL DOUBLE •.':`�°�"�.'.> //PROPOSED CLEANOUTS (DBL)PROPOSED 4 HOUSE M /I 4 ALTERNATE SffE 1 17.5' INSTALLFOUNDATION (0) \ \ PROPOSED 1250 CALLON \ / CONCRETE SEPTIC TANK 11 PROPOSED DRAINFlELD. EXCAVATE ATRENCH THAT IS 7.5 FEET DEEP MAXIMUM BY 5 FEET WIDE BY 52 FEET LONG. ADD 4 FEET OF CLEAN. WASHED SEWER DRAINROCKNSTALL 21js� TRENCH PARALLEL TO SLOPE CONTOURS. DATE: r' 3/29/2002 -�$ ♦� __. _ DRAWN BY: ALASKA WATER R NVAST.ENVATER SCALE: C.J.G. CONSULTANTS, INC. �" 50� 6901 DESARR ROAD. SUITE 28 • ANCHORAGE. AK 99506 • PHONE (907)337.6179 • FAX (907)338-3246 PREPARED FOR: PHONE NUMBER: PACE NUMBER: MARTHA REINBOLD (907) 563-3003 2 OF 2 LEGAL DESCRIPTION: LOT 3, BLOCK 2; FALLING WATER SUBDIVISION TYPE OF WORK: DESIGN OF PROPOSED WELL LOCATION AND SEPTIC SYSTEM �4p ` y Go ness, to ��� • CE 7953 e�froressiv\ �0040Caoo� X40 q foo .. �. .` ......- _. _ _.. v�'� . •• • .....-9540 r ALASKA N'VATI✓R & NN ASTRWATI✓R CONSULTANTS, INC. .. . . ... .........:....0 6901 OEWR ROAD, SURE 2B • ANCHORAGE. /JC. 99— • VNONE: 907 337-6179 • rA%: 907 338-32c6 •WEBSITE: o4vwc.com SOIL LOG — PERCOLATION TEST ............... FALLING WATER SUBDIVISION; LOT 3, BLOCK 2 J r y A. Gorness, LEGAL DESCRIPTION: E-7953 cZ"P PERFORMED FOR: KEN BRAZ DATE• 8/8/2001 DEPTHpRGANICS rofessm (feet) "— TEST HOLE #11 O0000 1 4, so �` '•' SOIL CLASSIFICATIONS 2 --------------- GW zzzz:\ ••• Y . �,n.—�•.r� GP ML 3 GM CL i • `^i•: 1 ;,�� • / GC OL — FALLING WATER 5/D 4 •_r'go SW MH LOT 3 BLOCK 2 GP -GM SP CH 5 t<;"'.•:� w/LARGE SM , OH TH#1 ;:. 0;• BOULDERSlilt 6 Sc TH(/2 "' ••• TEST HOLE LOCATIONS 7=^••. ARE APPROXIMATE. -. '`;• 8 ..,n,•. • 10 ��w �y ` , ••"'•`•.8/15Z2001> SITE PLAN •:` ►•: 10 • `�• TWO LARGE II.O.II. BOULDERS CLOCK NET TIME WATER LEVEL NET DROP 11 PREVENTED FU THERD DATE READING TIME (MINUTES) READING (INCHES) EXCAVATION 12 13 qjv 50 14 Gp\�ON EO � 15 PeSORO OAF' 16 9 N 17 0 200, 0 18 19 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6w (INCHES) TEST RUN BETWEEN 4 FT. AND 4.5 FT. 20 COMMENTS: PERCOLATION TEST PERFORMED BY CALEB GALL •VERTICAL SIDE WALLS ON TEST PIT INDICATE PRESENSE OF COHESIVE SOIL (SILT) PERFORMED BY ALASKA WATER & WASTEWATER I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS ERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: DEPTH TO GROUNDWATER DATE DRY 8 8 2001 DRY ALASKA. R'ATER & «'AS1'I✓WATI✓R T....."-,.,• CONSULTANTS, INC. ..,,"-.�.^. 6901 DEBARR ROAD, SUITE 2B • ANCHORAGE, AK. 99504 • PHONE: (907)337-6179 • FAX; (907)338-3246 • WEBSITE: a4n.c.com SOIL LOG — PERCOLATION TEST LEGAL DESCRIPTION: FALLING WATER SUBDIVISION; LOT 3, BLOCK 2 PERFORMED FOR: KEN BRAZ DATE: 8/8/2001 DEPTH ��__ (feet) ORGANICS %�� - TEST HOLE #2 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 "SP -SM GP -GM w/ LARGE BOULDERS SOIL CLASSIFICATION :q,O GW ORG ? GP ML DRY 8/15/2001 GM GC SW SP CL OL MH CH °a o°a o SM OH SC DEPTH TO GROUNDWATER DATE DRY 8/8/2001 DRY 8/15/2001 -------------- 1 � I I FALLING WATER S/0 LOT 3 BLOCK 2 TH#1 TH#2 TEST HOLE LOCATIONS �s ARE APPROXIMATE. 'so i �o� ? SITE PLAN •� 1"=100' DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME I (MINUTES) I READING (INCHES) PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6" (INCHES) 20 1 TEST RUN BETWEEN 4 FT. AND 4.5 FT. COMMENTS: PERCOLATION TEST PERFORMED BY CALEB GALL. "VERTICAL SIDE WALLS ON TEST PIT INDICATE PRESENSE OF COHESNE SOIL (SILT). PERFORMED BY ALASKA WATER & WASTEWATER I, JEFFREY A. GARNESS, CERTIFY THAT THIS AS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 7- Z ZQDa O� !..: .y ..l•t• w WS s :: 0' N 1. 4��p•`,°r�. »`�' f�:. r.•:; " - •00 00 �_..O y�� �....c-- o • i i (Zy� N I = r 6 0 0° 00 S O) � 0 N O En ` �. r 20 �0. 0 0 E 0.Al! �Q i r �o of rXo f I W f °•V y r � 1f r i 0 0® ® CO is En _g ll � 49 � co •��� 3 to I qcr Aj Qp € 49 v `ti� o �S ? Sg I w PG�`l 3S$ y ����Sp• d S7�\ Jeto p `o ` '`-� "�M "�M `•D 4D -at o �$S o48 EU 4� k ,Zb'OL113 61Z, rl OOu6 s` � M ,£Z 00.0 0 �- 0 I a.0S 0 0 �liY 01 Parcel I.D. 050-772-04 Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 s , F E 7 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Expiration Date: Complete legal description Falling Water, Block 2, Lot 3 Location (site address) 2947 Misty Mountain Rd. Current Property owner(s) Martha Reinbold Mailing address Real Estate Agent 2. TYPE OF DWELLING: Day phone. PO Box 772033 Eagle River, AK 99577 Day phone E Single Family (w/wo ADU) ❑ Duplex ONSPEC'nON FEE O) ❑ Multiple Dwellings (Single Family and/or Duplex) SEP 16 2V'143. NUMBER OF BEDROOMS: 3 Od/8T° g OEP�B,�tr €� 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWAI'ER"DPSP69AL: Individual Well 0 Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance f ta" In Received by: ' t Date: o ! U ` COSA to be released to th64gineer, unless otherwise requested by the engineer. COSA Fee $ aJ" 2,(,' Date of Payment 111 �-/ty Receipt Number '0-101,3 COSA 4— 0Wq !t'I3D Waiver Fee $ Date of Payment Receipt Number 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Address P.O. Box 100217, Anchorage Alk. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE Phone (907) 272-8218 Date 9/15/2014 System #1 Approved for� bedrooms ! • • • • n • - y pp 1 • • � Sleven a 12.•F�nnane CE 8149 System #2 Approved for bedrooms s�,•,• r 4 Disapproved ��%�DOFESSItL Conditional approval for bedrooms, with the following stipulations: By: i /If • Original Certificate Date: Th un�cipalitynchorage 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 blue sheet f : .. If more than 1 septic system is on the lot: COSA Checklist # 1 of Structure served by this system I Certificate of On -Site Systems Approval Checklist Legal Description: Falling Water, Block 2, Lot 3 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 3/29/02 Sanitary seal (Y/N) Y Total depth 235 ft. Cased to 235 ft. FROM WELL LOG Date of test 3/29/02 Static water level 73 Well production 50 WATER SAMPLE RESULTS ft. Coliform Par colonies/100 mL Nitrate N a� mg/L Arsenic �.. P ug/L Date of sample: 9/9/2014 B. SEPTIC/HOLDING TANK DATA TankType/Material Septic/Fiberglass Tank size 1'500 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Date of pumping 8/29/2014 C. ABSORPTION FIELD DATA Depression over tank (Y/N) N Pumper JR's Pumping Parcel tD: 050-772-04 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 30 in. AT INSPECTION 11/11/13 72 3.1+ Collected by: PES in Date installed 10/11/02 Cleanouts (Y/N) Y High water alarm (Y/N) N Date installed 10/11/02 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.2 GPD/BR System type Shallow Trench Length 53 ft. Width 5 ft. Gravel below pipe 3.6 ft. Total depth 6.7 ft. Eff. absorption area 500 ft2 Monitoring tube Y Depression over field N Date of adequacy test 11 /11 /13 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 3 in. Water added 468 gal. New depth 3 in. Elapsed Time: 160 min. Final fluid depth 3 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons _ in. "Pump off' level at E. SEPARATION DISTANCES WELL ON LOT TO: Cycles tested Septic tank/lift station on lot 100+ Absorption field on lot 100+ Public sewer main 75+ Sewer /septic service line 25+ Animal containment areas 100+ Manhole/Access (YIN) _ in. High water alarm level at Meets alarm & circuit requirements? On adjacent lots 100+ On adjacent lots 1.00+ Public sewer manhole/cleanout 100+ Holding tank 100+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Water main 10+ Water service line 10+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water Service line 10+ Surface water 100+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that t 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 Steven R. Pannone Date 9/15/2014 COSA brown sheet 10-10-12.doc Absorption field 5+ Surface water 100+ Water main 10+ Driveway, parking/vehicle storage 110+ I -. CE -8149 :.4! in. \ / + - g = , \/ % - . \ ����/se 2 y���� ©w :VC, \— !N dllin9 st«rI 3«Lae0: «22 ¥ /«:am : / a «