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Municipality of Anchorage
On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP181027 PID Number: 017-101-65
Dwelling: ❑■ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: X New ❑ Upgrade
Name
ADRIAN JAMIE
ABSORPTION FIELD
0 Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound
Site Address
❑ Other
Phone
Number of Bedrooms
Soil-Rating
Total depth from original grade
4
0.8 GPD/SF
10.0 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
3:0 Ft.
Gravel depth beneath pipe
7 Ft.
Subdivision Block—Lot
TIMBER TRAIL TR 1 C-2
Fill added above original grade
1 + Ft.
Gravel length
56 Ft.
Township Range Section
Gravel width
2 Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
784 Ft'
Ft.
Well
1001+
100'+
50,+
TANK X Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer Capacity
ANCH TANK 1250 Gal.
Surface Water
100'+
100'+
Material
Number of compartments
Lot Line
10'+
10'+
NA
STEEL
2.0
Foundation
10'+
10'+
LIFT STATION
Manufacturer
Capacity
Remarks
Gal.
Alarm location
Electrical installed by
Installer
PIPE MATERIAL House to tank 3034 Tank to 3034
drainfield
MIKE N ANDERSON, P.E.
Drainfield 3034 CO/MT3034
Inspector MIKE N ANDERSON, P.E.
BENCH MARK (Assumed elevation) 112.4 ft
Inspection 1st
dates: r
Location and description
4111
BASEMENT DOOR STOOP
3`d
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
EQgin4bAStamp,
ooe °ems 1 n :;!
Conditional Approval: Date
sua p
O e e e o 0 0 0 e 0 e 0 e o s e e p o e •��
e o e e o 0 o s a e e e ...........
°eoe°eeee• .
� 'V1MICHAEL N. ANDLRSCN :- �)
Septic System
Approved
CE-9469 •:,v',
Date 10 30����gl(Ge
�a�poa,SSn
Note: this approval does not include well permit requirements.
kmuv u0/uz/ 10)
Permit No. OSP181027 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 TRAIL TR 1C-2 PID No.: 017-101-65
MARK A B j
FCO 2 ( 15
col
CO2 71 L .65.
TC01 7 68
TCO2 18 75
03 87 181
'04 - __.._.-I 88 800 _... _ ., .. _,.__._ . _ _.._._ . .., ._ - /-.-. /.� �.... _, _..... ._ ._._. , _ ....._.
11
T1 13¢ 130
C06 1146 144 / WELL I\
BENCH /
I /
I \ I I
— —
NEW 1250 TANK I \\
WELL
Co \ \
CO2 �\ ----�
I \\ CO2 TC01 FCO \
I\
\ ®C05 l B \ DRIVEWAY
\ �X /
/ ASBUILT
I SCALE: 1"=50'
y( -FCO COI tr CO2 //-TCOI Jr COi coz }(-Ccos ®®®®prp
F I I / TC01 I ♦� I /-MT MT�
,M6.5 100 OG OF
FINISH GRADE ®® `�••
/---FlLTER FABRIC .0 ORG V••• Y®®®
Air
� � ® 4 9 TTHH ®®
4 1.250 GALLON%/I+
STEEL TANK CM
•.•��
Lf .................................... p
8. 7 7
9, n : ;MICHAEL N. ANDERSON. �®
® s,'. No. CE 9469 ®
SEPTIC SECTION 92 ®®®E\ ®®®®
N.T.S. DRY, OCT 2017 ® 4
Certified Drilling Log
DOC CO dba
BILL Sc COLE
1�►ULLIVAN
PO. Box 670269, Chugiak, AK 99567 688-2759
OWNER OF LAND: Adrian Jaime
ADDRESS:
- LEGAL DESCRIPTION Timber Trail -Tr -1C2 -
DATE: 5-15-18
PERMIT NUMBER: OSP181027 DATE OF ISSUE: 3/9/18
--TAX-IDENTIFICATION-NUMBER-0171015 000
Is well located at approved permit location: ®Yes ❑No
Method of Drilling: ®air rotary ❑cable tool
Depth of Well: 202'
Casing Type: Steel Wall thickness .250 inches
Diameter: 6 inches, depth 200 feet
Liner type
Static Water Level: 125 feet
Recovery Rate 8 ® gpm ❑ gph
Method of Testing Air
Well Intake Opening Type: ® open end ❑open hole
❑ Screened Start feet Stopped
❑ Perforations Start feet Stopped
Grout Type: Bentonite Volume: 50 lbs
Depth: from 2 feet, to 42 feet
Well Disinfected Upon Completion: ®yes ❑ no
Method of Disinfection: Chlorine 50 PPM
Comments:
Bore Hole Data
Depth
From To
0
2
Casing Stickup
2
4
Overburden
4
27
Silty Sand & Gravel
27
39
Tight Silty Sand & Gravel w/ Clay
39
51
Silt & Sand
51
101
Tight Silty Sand & Gravel w/ Clay
101
162
Hardpan w/ Cobbles
162
189
Silty Sand & Gravel w/ Clay
189
195
Silty Sand & Gravel Water
195
202
Tight Yellow Clay & Gravel
Drillers Name: Cole Sullivan
ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority.
Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation.
MatSu Borough: Department of Environmental Conservation.
Parcel -Identification Number:_ _ _017101351000
t5
Legal Description
Timber Trail Tr 1C2
Pump Installation Date: 9-26-18
Pump Intake Depth Below Top of Well Casing: 170
Pump manufacturer's Name: F&W
Pump Model: 4F07P053015
Pump Size: 1/2
Pitless Adapter Burial Depth: 10
Property Owner Name & Address
Adrian Jaime
Pitless Adapter Installer: Mike Anderson — Anderson Engineering
Disinfected Upon Completion? ® yes ❑ no
Method of Disinfection: Chlorine 50 PPM
Comments: Pitless Manufacturer: Martinson
Pump Installers Name: Sullivan Water Wells
feet
E
feet
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
87*17'3E" E
63.71
BOBBYR BURNETT
2941 Carriage Drive
Anchorage, Alaska 99507
(90 7) 350-5541
r
SEPTIC
f
N 88°06'40 E. 166.47
r100' Well Rack
S 87*17'3E" E
6 3.71
10' UTILITY EASEMENT
4
S 89°59'37" E 280.07
9/13/2018 1"=30'
Grid
SW 3037 AS–BUILT
_EAST 14.._--AVENUE—._---N
on
LOT 1 C-2
TIMBER TRAIL SUBDIVISION
Plat # 2018-19
WELL
52.51
z
0
0
O
D D G
Air,, BF
O p
Poa
s
GRAPHIC SCALE. • 1 Inch = 30 Feet
15 0 15 30 60
AV OF ALS
/ BOBBY F. BURNETT /
/o �
t\ ��SSIONAL 1'
I hereby certify that the property described hereon has been surveyed
by me, or at my direction, and that the improvements situated thereon
are within the property lines and do not overlap or encroach on the
property lying adjacent thereto unless otherwise shown. That no
improvements on the property lying adjacent thereto encroach on the
premises in question and that there are no roadways, transmission
lines or other easements on said property except as shown.
E
J���IPPl/`y O� MUNICIPALITY OF ANCHORAGE
On-Site Water&Wastewater Program
f!�,,,E' PO Box 196650 4700 Elmore Road
l Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 r.
.r / http:/lwww.muni.org/onsite
l)cpar tmen t
On-Site Water & Wastewater System Permit
Permit Number: OSP181027 Effective Date: 3/9/2018
Work Type: WellSeptic Initial Expiration Date: 3/9/2019
Tax Code Number: 01710157000
Site Legal Address: TIMBER TRAIL TR 1C2.G:3037
Site Mailing Address:
Owner: MGJ BUILDING GROUP INC Lot Size in Sq Ft: 90169
Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING Total Bedrooms: 4
This permit is for the construction of:
D Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage
All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Received By: /1/1"-4' Date: 3(TV/V
Issued By: l 1-€/e/ 0, Ca_)v(.,Ca Date: 3// /i
MUNICIPALITY OF ANCHORAGE
Community Development Department t5 ' Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On-Site Water& Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 017-101-57
Property owner(s) MGJ I Day phone
Mailing address 911 T loq s+Vee-ti i\nc4,orale! AK 9ctSO r7
Site address �J
Legal description (Sub'd., Block& Lot) Timber Trail Tr 1C 2
Legal description (Township, Range & Section)
Lot Size 90169 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(E)all that apply)
Absorption Field ❑x Initial ❑x Single Family (SF) ❑x
(w/wo ADU)
Septic Tank ❑x Upgrade ❑ Duplex (D) ❑
Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well W-
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST_F-QR:
7 --
V Distance:
ete
I certify that the above information is correct. I further certify That tl is is in ac o "FTeT " ,fi h
applicable Municipal Codes. I • • 1
4/14,A-- \<r.
(Signature of property owner or authorized agent) ��. % 'i'
Permit/Rush Fees: See ? rm‘} i. P Ill 3Waiver Fees:
Date of Payment: /A/51//�9' Date of Payment:
Receipt Number: yin o2l`73a9 Receipt Number:
Permit No. osio18' /Qa 1 Waiver No.
Permit App__-.• ::..,c
March 7, 2018
Municipalities of Anchorage
Departments of Health and Human Services
P.O. Box 196650
Anchorage, Alaska 99519-6650
Fax 249-7847
Re: New Septic & Well Permit
Legal: Proposed Timber Trial S/D Tract 1C2 (S-12377)
To Whom it may concern:
This is a request for a septic and well permit on the two above referenced lots. A two test hole
were excavated and found silty gravels GM, for the entire depth with no bedrock or water
observed. The perc rate was 12 minutes per for each of the test holes. From the site plan the slopes
are fairly flat (less than 5-10 percent) at the test hole locations. The lots are large (one acre plus)
and the soils are good with no ground water or bedrock.
This permit will not impact any of the neighboring properties due to the lot layout.
Please call me if you have any questions.
Sincerely l
2./c_
Michael N. Anderson, P.E.
4661 Natrona
Anch, Ak 99516
Ph 727-8864
DESIGN CRITERIA: MOUND OVER
(TH#1) (TH#2) o I GRADE
4 BDRM X 150 =600 GPD ORG ORG1 c
SOILS =600/0.8 = 750 GPD 1.0 1.0 FILTER FABRIC
750 GA/12 =63' GM GM 3-3 0\-_T- 4"ø PIPE
(1)TRENCH ~SEWER ROCK
9.0' DEEP
6.0' EFFECTIVE -9.0
2.0'WIDE 2.0'
63' LONG 18.0 18.0
SEPTIC FIELD SECTION
7S5
I
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_ l�
I - E�
*RO SEPTIC ' i w \\�I WELL Z _
POSED4 i •OM HOUSE— i I o i
• WELL I I ‘
\ _ I i' PROPOSED WELL
i\ / ,-N I I�-� ` �`(,�100'RADIUS
\\ // SE�TIC�1 / t. 1 �.,1I �/\ •WELL I _
__ / II•1 Ih`, /,
PROPOSED 1 11, /
i • �1
—DRAINAGE FIELD } I y /��,_-,-'
PROPERTY LINE I I 1 \ i� i
_, , N,-,,'' I ._-'-
J �SE�'TIC
-E 142ND AVE- / \
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— II
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Septic Design Prepared for ..ovoiss�q it1
MGJ BUIDLING GROUP •��P-,v_OF / �!♦♦
TIMBER TRAIL TRACT 1C2, (S-12377) ;' 49 TH %\ .\ '' ♦j,
Anchorage, Alaska ,• 144
•
•
Michael N. Anderson, P.E. DATE: 3/7/2018 W.!v1..!CHAEL N. ANDERSONI:
No. CE 9469 A
4601 NATRONA AVE DRAWN: DJR ♦♦•� ••• ••
.••' '-�
ANCHORAGE, ALASKA 99516 • •
(907) 727-8864/FAX: (907) 345-1391 ! SCALE: 1"=200' ♦444 ��t •�
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RAPTORS KNOLL \ I
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TRACT 1C2 - -DIRECTION OF
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Septic Design Prepared for Imilisiivi it i
z 7:74N... _ .....
MGJ BUIDLING GROUP 4-/\r-...4! 0F----- ----.. v,z57•A
TIMBER TRAIL TRACT 1C2, (S-12377) .„
: --./ 49 TH .41:40c---
Anchorage, Alaska a :
; .7i47/4 : •
•
•
.. . . .. ..,
..10.. . .. .a
Michael N. Anderson, P.E. DATE: 3/7/2018 Icle.A.MICHAEL N. ANDERSONi ar
: s•
•-.0 .... No. CE 9469 ...:!_ ‘:
4601 NATRONA AVE DRAWN: DJR v• '' 0°e.,0
. ..................- 4,
ANCHORAGE,ALASKA 99516
(907) 727-8864/FAX: (907) 345-1391 SCALE: 1"=50'
4 4. .,,..•
'"Illims*"
Municipality of Anchorage „�'E �INU S,WL.�‘
� Development Services Department ,","� ;••''• n }
I_ —
• \ Building Safety Division 6'! fin'yi-�• ' :r"1-`?�
On-Site Water and Wastewater Program •-r:.' 9 �: .,` '• �;
4700 Elmore Road rr, •y
t 0 ,orielf
P.O.Box 196650 Anchorage,AK 99507
www.ci.anchoraoe.ak.us t4
-_� (907)343-7904 0 s^% MICHAEL N. ANDERSON : !'r
iik'5:'-••. CE-9459 `,`',"
Soils Log - Percolation Test ' ••.
.t' . ' .•.....•`�K\u�,
i.' •• �
Performed For: /k4 T C'j Date Performed: j'( re! 3'.._,
Legal Description: l' 1- 4 �
p I l,�rt `, G✓ �'�� ( � �w-1 � (t�� Township.Range.Section:
14Slope Site Plan
Depth
(Feet)
(909 ,
1-
2- 4-,•e,--, Cvl
3-
4-
5-
6-
7-
tel
8-
WAS GROUND WATER
9- ENCOUNTERED? /49
S
10- IF YES.AT WHAT DEPTH? L
Depth to Water After o
P
11- Monitoring? 0 N E
12- Date. 10/! ( t 7-
13- Q/,rsd a k.."
14- Reading Date Gross Time Net Time Depth to Water Net Drop
15- /d(-z/j x
27. , CP ' f 1. 5 "
16- (/ /( 7,S tf
17- i) ?. fir/
18,-- � �r ?••-t-"
130 )40w
U N
19-
20-
PERCOLATION RATE /7_- (minutes/inch) PERC HOLE DIAMETER (,
TEST RUN BETWEEN Lil FT AND 47 FT
COMMENTS
PERFORMED BY: N( NI.--4\ I CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: I?11(i/I .72
-,."CV s'
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Municipality of Anchorage .•�•��1 'GINEER's•4EP );�?.,
•
Development Services Department „'e G;• •a- ••••r,,; ,
Building Safety Division �1 L'}Q;(q .• •i
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On-Site Water and Wastewater Program •:::•.:.
•....• •..........
:• ,4700 Elmore Road ''••
P.O.Box 196650 Anchorage,AK 99507 • •°••°.......• °•••• • 04
fwww.ci.anchorage.ak.us MICHAEL A(907)343-7904 N ANDEscN ; ;A • • •• CE-9469 <�;'#
Soils Log - Percolation Test d lgFo'•• ••,,,,.)• '
ke1�:i1 X11,_,',. .',.::
Performed For: MTA, Date Performed: )\.*'g ;a/7
Legal Description: .)'t rrt'1 cv' -N 6t 'Ivy 4 4' (CA., Township,Range,Section:
Slope Site Plan
Depth
(Feet) 0 v,5
1-
2- c,e p(u y,
3-
4-
5-
7- (�-�
8-
WAS GROUND WATER
9- ENCOUNTERED? o
S
10- IF YES,AT WHAT DEPTH? L
Depth to Water After o
P
11- Monitoring? 9 f\1 E
12- Date: ity/Le/0._ Or
13- OrK4,v•k_,
14- Reading Date Gross Time Net Time Depth to Water Net Drop
15- /t7�(dr/.t. -"Sik,„ to it 2. S"
16- (D�� 2t S' 7
17- (D 't 2(K a
18— ----.(li 0�p►h ito, it -7r ,
19-
20-
PERCOLATION RATE ( 'L (minutes/inch) PERC HOLE DIAMETER (0
TEST RUN BETWEEN y FT AND c". FT
COMMENTS
PERFORMED BY: ni)\(A I CERTIFY THAT THIS TEST WA
PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: i 4/e/2
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COSA Checklist
Legal Description: TIMBER TRAIL TR IC -2
Parcel ID: 017-101-65
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system _
A. WELL DATA
X Well log is filed with Onsite (or attached)
Date drilled 5/15/18 Total depth 202 ft
Cased to 200 ft
❑� Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ground) 24 in.
Date of flow test for COSA 7/12/24
Static water level at beginning of test 133 ft
Comments —
B. TANK DATA
Measured operating fluid level in septic tank 48
Date of pumping 7/18/24
❑ Required maintenance completed, if AWWTS
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed) 8/18/18
0 ALL standpipes present per record drawing
Total measured depth from grade 12 ft (max)
Measured depth to pipe invert from grade 5—ft (min)
❑ N/A – pressurized field.
❑ Per record drawings, field is insulated.
Monitor tubes go to bottom of effective.
If not, state depth into effective
❑ Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months)
If yes, enter date
Comments/Deficiencies:
COSA Checklist June 2022
Well production at time of test 5+ gpm
Water storage tank volume 0 gallons
Well disinfected for coliform test? ❑ Yes ❑fi No
H Coliform bacteria is Negative
Nitrate 0.461 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L 0 Arsenic less than MRL (ND)
Collected by
Date 7/12/24
MNA
C. LIFT STATION
❑ Required maintenance completed
Age of lift station _ years
Lift station material
Comments:
Adequacy test date 7/12/24
Results QPass
Fluid depth prior to test 60 in
Water added 600 gal
New fluid depth 70 in
Elapsed time 1440 min
Final fluid depth 60 in
Absorption rate 600+ gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) 84 in
Effective depth used 60 in
Effective depth remaining 24 in
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100'
Qi Yes if No _ it
Neighboring Tank > 100' Q Yes if No
Absorption Field on Lot > 100' a' Yes if No ft
Community Sewer Manhole/Cleanout > 100'
❑� Yes if No _ ft
Private Sewer/Septic Line > 25' Q Yes if No _ it
Holding Tank > 100'❑ Yes if No ft
Neighboring Absorption Fields > 100' Animal Containment > 50' Q Yes if No ft
Fs Yes if No _ ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' Yes if No _ ft Q Yes if No _ ft
❑ N/A— Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10' g Yes if No _ it Surface Water > 100' 9 Yes if No ft
Tank to Property Line > 5'
Di Yes
if No _ ft
Field to Property Line > 10'
Yes
if No _ ft
Water Main > 10'
❑� Yes
if No_ ft
Water Service Line > 10'
❑� Yes
if No ft
F. ENGINEER'S COMMENTS
Wells on Adjacent Lots:
Private Wells > 100'
Community Wells > 200'
❑� Yes if No it
Q Yes if No _ ft
If tank or field is under driveway comment below
G. CERTIFICATION & 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, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm /\n(l�Lt✓��PYf(✓j
Engineer's Printed Name Owe,
COSA Checklist June 2022
Phone 727-8864
Date 2 Z,_ a
OF AC gs��
r A •
MICHAEL N. ANDERSON ;'�' rol
�.•. E •:'tri