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Home My WebLink AboutAUDUBON HILLS #1 BLK 3 LT 8 Onsite File Audubon Hills # 1 Block 3 Lot 8 #015 - 231 - 75 �r -/V_ 101 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191367 PID Number: 015-231-75 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑S New ❑ Upgrade Name Spinell Homes Inc ABSORPTION FIELD ❑ Deep Trench ❑® Wide Trench E] Bed E] Mound Site Address 12200 Waxwing Cir ❑ Other Phone Number of Bedrooms Soil Rating depth from original grade 4 1.2 GPD/SF JTotal 4.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original 1.0 grade Ft. Gravel depth beneath pipe 3.0 Ft. Subdivision Block Lot Audobon Hills #1 3 8 Fill added above original grade 2.5 Ft. Gravel length 70 Ft. Township Range Section Gravel width 5.0 Ft. Beds: n/a Number of Lines Distance between lines n/a Ft. SEPARATION DISTANCES To Septic Absorption Lift Station 1 Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 603 Ftx 1 n/a Ft. Well 1001+ 1001+ 1001+ n/a 25'+ TANK ❑ Septic 9 S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1500 Gal. Surface Water 100'+ 100'+ 100'+ n/a Material Number of compartments Lot Line 51+ 101+ 5'+ n/a NA Plastic 2 Foundation I 101+ 101+ 101+ n/a LIFT STATION Manufacturer Capacity Remarks Orenco 250 Gal. Alarm location House Electrical installed by Solid Ground PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield Installer Pomraining Excavation Drainfield 3034 co/MT3034 Inspector Pannone Engineering BENCH MARK (Assumed elevation) 101.5 it Inspdection v 7/11/20 7/25/20 Location and description 3rd 7/25/20 2nd 4" 7/28/20 Bottom House Trim @ C ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date co Steven Pcnri6ne� �� S Septic Sys Approve '�-� Date —2� �� ,. CE 8149 ^` 9 �Ii Fes`'' Note: this approval does not includ well permit requirements.��z'�� r -/V_ 101 z Jo z 133HS ' �'aT°'� ''�, AV '30V' JOHONb Nv�d 3l IS LKL6[dSo '�' .' ?110 ONIMXdM OOZZ L :311S ON IM83d = '�' ' stile -3a ;� `-----------S'.� ONI S�WOH ��]NIdS doe Nnnvao SL-1CZ-s10 oN -a�rd ............. 9� 28 L# SETH NOoocind 33vOs — �y .. y`? ` WZ2-9bL (LO6) XVi OOZB-SQL (L06) 3NO111d OZOZ OCILSd>b jp Sys Sv96 XV '>J3`1lVd L081 X08 '0'd ONIMb'a0 0a00321 31V0 sNOISIA38 (888L '1'3) 311 Ons ON3 3NONNVd :S310N I --_ �r 1N3W3Sd3 Jiniin ,OL_ Ili 0 ! 0-0 -0 (n N CL O J Lan 1Ljz O J Z H `S I W F_ � O W O H W } O \ N N to U) .-. 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IDENTIFICATION NUMBER 01523175000 Is well located at approved permit location: ®Yes ❑No Method of Drilling: ®air rotary Rcable tool Depth of Well: 260 Casing Type: Steel Wall thickness .250 inches Diameter: 6 inches, depth 80 feet Liner type 2 8 8 48 48 77 77 210 1260 210 Static Water Level: 6 feet Recovery Rate 1® gpm gph Method of Testing Air Well Intake Opening Type: ❑open end ®open hole Ej Screened Start feet Stopped El Perforations Start feet Stopped Grout Type: Bentonite Volume: 50 Depth: from 2 feet, to 42 feet Well Disinfected Upon Completion: ®yes Ono Method of Disinfection: Chlorine 50 PPM Comments: g-1"1- 20 Casing Stickup Peat/Silt Silt with sand and gravel P ight sand and gravel silty Bedrock Gray Bedrock Gray with Quartz 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. =m MatSu Borough: Department of Environmental Conservation, Well Drilling Permit Number: SW OSP191367 Date of Issue 9-6-19 Parcel Identification Number: 01523175000 Legal Description Property Owner Name & Address Audubon Hills #1 Block 3 Lot 8 Spinell Homes 1900 W. Northern Lights Blvd #200 Anchorage, AK 99516 11 Pump Installation Date: 6-5-20 11 Pump Intake Depth Below Top of Well Casing: 250 11 Pump manufacturer's Name: F&W 11 Pump Model: 4F10G10301 11 Pump Size: 1 11 Pitless Adapter Burial Depth: 10 Pitless Adapter Installer: Pomraning Excavation Disinfected Upon Completion? ® yes ❑ no Method of Disinfection: Chlorine 50 PPM fl Comments: Pitless Manufacturer: Martinson 11 Pump Installers Name: Sullivan Water Wells feet hp feet Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. MUNICIPALITY OF ANCHORAGE On-Site Water&Wastewater Program •' PO Box 196650 4700 Elmore Roadf Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 ` c t' , `. ,;` http://www.muni.orglonsite a v ts;' n Ala Department �'%C N O R AGE On-Site Water & Wastewater System Permit Permit Number: OSP191367 Effective Date: 9/6/2019 Work Type: WellSeptic Initial Expiration Date: 9/5/2020 Tax Code Number: 01523175000 Site Legal Address: AUDUBON HILLS#1 BLK 3 LT 8 G:2739 Site Mailing Address: 12200 Waxwing CIR, Anchorage • Owner: SPINELL HOMES INC Lot Size in Sq Ft: 55565 Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 4 This permit is for the construction of: D Disposal Field RI Septic Tank ❑ Holding Tank ❑ Privy Q Private Well ❑ 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 Special Provisions: -' The Engineer needs to do groundwater confirmation prior to the construction of the septic field. Construction may proceed at your own risk before the 7 day water monitoring is complete. Please submit stamped and signed :; results with the As-built Inspection Report. If the results require a design change, construction of the system will stop pending On-Site review and approval. Received By: / • 14' Date: Issued By: Xi! 9 i / Date: EPUtNS MUNICIPALITY OF ANCHORAGE gh. Community Development Department 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. 015-231-75 Property owner(s) Spinel) Homes Inc. Day phone Mailing address Site address NSN Waxwing Circle, Anchorage Legal description (Sub'd., Block & Lot) Audubon Hills#1, Block 3, Lot 8 Legal description (Township, Range & Section) Lot Size 55,565 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (El 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 ❑X Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR: Dis tance: 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: 720 Fees: Date of Payment: '// Jfi Date of Payment: Receipt Number: oac e.36 Receipt Number: Permit No. OSP/9!31D9 Waiver No. Permit App_:• Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191367, Deb Wockenfuss, 09/06/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191367, Deb Wockenfuss, 09/06/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191367, Deb Wockenfuss, 09/06/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191367, Deb Wockenfuss, 09/06/19 Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fan: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 01523175000 1. GENERAL INFORMATION Expiration Date: _ I I `2 %-Z C) Complete legal description AUDUBON HILLS #1 B3 L8 Location (site address) 12200 WAXWING CIRCLE, ANCHORAGE Current property owner(s) SPINELL HOMES Day phone Mailing address Real estate agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) Duplex F 1p ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well El Private Septic E71 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ go (co u 16 - 19 Date of Payment ?/ IV 010 (} Receipt Number d 5 LA 9 9 G COSA# 03C,201 y.38 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. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. 6. DSD SIGNATURE System #1 Approved for Y bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for Date _2-4915e(_7_ OF k S.L.' * P Pai done • C� 0149 .•.;C; bedrooms, with the following stipulations: \SY (OFAti—,i `g UN -71 I t WATER AND R' J� WASTEV"ATER =: rsERv�G��`�� Original Certificate Date: Z l The Municipality of Anchorage 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 ❑hec�(�jst gal Description: Audubon HIIIs #1 B3 L8 If more than 1 septic system on lot: COSA Checklist # 1 Parcel ID: Of 1 Structure served by this system 1 01523175000 A. WELL DATA Well log is filed with Onsite (or-attaeled) i 1. `� �"� Well production at time of test 1 gpm Date drilled '`1c: Water storage tank volume NA gallons Total depth 260 ft Well disinfected for coliform test? [✓ Yes ❑ No Cased to 80 ^ft f Coliform bacteria is Negative ME Sanitary seal is functioning correctly _ itrate d3E 2- m 9/L ❑Nitrate cess than FURL (ND) c Wires are properly protected o t 4 >✓� Arsenic ug/L Arsenic less than MRL (ND) Casing height (above ground) 18+ in. Collected by PANNONE ENGINEERING Date of flow test for COSA new Date of Sample sr»izo Static water level at beginning of test 6 ft, Comments B. TANK DATA Age of tanks) NEW years Tank typelmaterial PLASTIC Measured operating fluid level in septic tank NSA Standpipes/foundation cleanout per record drawing Date of pumping NEW D. ABSORPTION FIELD DATA Which system tested (date installed) 7r'o2o F0 ALL standpipes present per record drawing Total measured depth from grade V6, ft x) Measured depth to pipe invert from grade 3,5—f, ❑ N/A — pressurized f , ield tn,inl ai- Monitor tubes go to bottom of effective. If not, state depth into effective M Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: NEW COSA Checklist yellow sheet C. LIFT STATION Required maintenance completed Age of lift station 0 years Lift station material PLASTIC Comments: NEW Adequacy test date NEW Results ❑ Pass For 4 bedrooms Fluid depth prior to test 0 in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date 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' ® Yes Neighboring Tank > 100' 0✓ Yes Absorption Field on Lot > 100' 2✓ Yes Neighboring Absorption Fields > 100' Q Yes Community Sewer Main > 75' Fv-� Yes From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' F,/� Community Sewer Manhole/Cleanout > 100' if No ft 7 Yes if No ft if No ft Private Sewer/Septic Line > 25' [✓ Yes if No ft if No ft Holding Tank > 100' 0✓ Yes if No ft ❑✓ Yes Animal Containment > 50' Yes if No ft if No ft Water Main > 10' 0 Yes if No Manure/Animal Excreta Storage > 100' —Q✓ Community Wells > 200' if No ft Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' F,/� Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5' ✓0 Yes if No ft Wells on Adjacent Lots: P/l Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' FV] Yes if No ft Water Service Line > 10' 0 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' 0✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10' ✓l Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' P/l Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' n Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION / certify that l 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. ZO nIs'?1 COSA Checklist yellow sheet OF ALgs�=�� t: A-4—.4- ..... �. CE 8,149- W ., o Ld , U, UO- w W2Oz�oz a z =U) oI in C,w =0o00D LL =1 �. F- ��_� F- W El -(n ( w 00 ZO(nzo U) —0 U F 000— Z N m z U � 0 np to �jjj V tj O a o Z. U W w D p 0 Ir O x w w w w D F�� m w O V =mow 0Om= w w p F 2 W p 0 rxz O�Ztwal�jj —d.lwt=o U� Dmw CO p, cn LO o _3 to N 00 r0 ®z r ~ m C7 CJ pQ p �O N >- aw O U z rn C -4a a cr N o w CL N U U m N C!) Li..