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Home My WebLink AboutT12N R3W SEC 33 LT 21 Onsite File T12N R3W Sec 33 Lot 21 #018 - 191 - 15 `.- VJIVL! IV) Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191387 PID Number: 018-191-15 Dwelling: X Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 01 Upgrade Name Donna Grant ABSORPTION FIELD El Deep Trench XWide Trench EJ Bed [:]Mound ss Site Address 3021 E 142nd Ave ❑ Other Phone Number of Bedrooms Soil Rating depth from original grade 4 1.2 GPD/SF JTotal 10.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 6.0 Ft. Gravel depth beneath pipe 4.0 Ft. Subdivision Block Lot 21 Fill added above original grade 0.0 Ft. Gravel length 50 Ft. Township Range Section 12N 3W 33 Gravel width 5.0 Ft. Beds: Number of Lines n/a Distance between lines n/a Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 500 Ft? 1 n/a Ft. Well 100.3 100'+ 25'+ TANK X Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1250 Gal. Surface Water 100'+ 100'+ Material Number of compartments Lot Line 5'+ 10'+ NA Plastic 2 Foundation 10'+ 10'+ LIFT STATION Manufacturer Capacity Gal. i Remarks Alarm location Electrical installed by Installer PIPE MATERIAL House to tank 3034 Tank to 3034 drain k to Dean's Construction Drainfield 3034 CO/MT 3034 Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 250.5 ft Inspdection i5` 10/28/19 10/28/19 Location and description 3rd 10/29/19 2"d 4'h 11/12/19 Bottom Trim @ house point A ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineers Stamp Conditional Approval: DateO ®� A/ $ F A TH 9 -ei,ILF. P�nnof, Septic System* Approved Date / Fg ✓ t tir.. ,�. Note: this appy val does not include well permit requirements. `.- VJIVL! IV) O rn m n -p O i 0-- = D -ICT1IC_�(n D�aDUi -u-IZ -0 �0 CO 00 V) —I' m -<om;;QOmDOA Z(nCOm—HOZ' m Irl D� o >c> nxCO Zu mnI�D p (n �00�00 r0 -X A m "oC zOCmN 0 (!n < Dz �7U' Dip G�r,..I DOp -{N� G� c>a��izn- n + Dr OtnOZZ O S D r0A'p�c: F rno D -1.. z.. zm.. 0 =N N �G3 -Om z M O O rC�0 0M cnx �D O>O— NNK N) w D Wm z O� �� U) WOil.G t0�0 0 �J zm�c�o 0z rri x rn D m m r0 0) -,-1 2 -O O O— O m cn D M C. z 0 -(i � rn O A D _ O cil c0 m C z O A to> r mo o z o m O -rl z Q -{ n F,-1 41(n -4 o m m K LI —� �I I (7 A m (Fl 1 SABINE Sl O 33' SECWN v \,EASEMENT VV�> i 0 /m 0m 0;u N r 0 \ _ ..� < DN rn o m I 0 > C? < \ Z 7Nz > < �� om { mono I I Ci > o / omm> n o ^\ <z �> ZCO m >Z n0OA ;u 0 MO> o mn o 0 � / l cmm�FTI > z MA t DZ o00 -100 A_ 0 <a tJ oo �mC 0 t m om m> D =. S y �- z 0 i \ m r m � D > I K > Fi O N > 08 C Zm 0 r* c0 cO Co 0c) - 0 m o o` O) N O rn D m N -4 z l GG v +� Co ; CO c0 ED O CO J m I LY S I p m— O W c0 H - (A --,i cn J � 00 c0 _ NOTES: PANNONE ENG SVC, LLC REVISIONS DATE RECORD DRAWING P.O. BOX 1807 PALMER, AK 99645=�fGQA1gS�l, 11/27%19 PHONE 907 745-8200 FAX 907) 745-8201 �ig�P•'' F SCALE /*' * 1" = 60' T12N R3W SEC33 X21 '• •' r P.I.D. NO / 018-191-15 DRAWN ACP DONNA GRANT an oneCE PERMIT NO. SITE PLAN ANCHORAGE, 2ND 99516 ��tss—�'i�/ SHEET P0F387 a.« 0< 0 a 0,0 ::,!� > — 0 1. :$ =r (D rri �7 5 0 3 =r a) y 3° Z I :03 0. 4 5:,0, co In 0 < c D 01 1— CD 0 > 0 a 3 ID oCD 0 :3 69.9, o o 5: 12 cc" < (D tD 0 00 :3 0 "0 (D It (A 0 z ::r 1 CD D 5 :1. 0 -0 0 m La 'z z> 0 CD o I 0 -< V X M>-4 c 0 In 0 o 0 N) CD 0 f 0 67 In tb o Lq a .2: 0, It mn r 57 1 o- :3= > — 0 —;u 57 0 0 :3 3 o CD to ID CL Sm I CD M CD CD0 —0 -T -0 � 0 W CD .0 , 3 0' 2 Z; CD -0 < > cr Z (D O0 0 In 0 :3 0 0 0 w c CL =X 0C: 1 0 3,0 :3 > =r 0 CL 0 CD ::r 3 0 CD to < 8.0 > —13 =r n Co T.0 CF - 0 :5 D co C/) U) 0 II > U) C/) 0 r) (A U) (D 0 ,-I U) 0 4- 30.0, I 33.0' 1 4 z 0 > U) > m C X W m a C) D ILI AMIS 3NIGVS Ci LZ'02C M„00,/-0.00 N Iz X 4� 0 cn 30.0' 33.0' (D rri CL, Z co M 4�- L A LA M O ;o > > CL o 69.9, > < (D tD C) D ILI AMIS 3NIGVS Ci LZ'02C M„00,/-0.00 N Iz X 4� 0 cn 30.0' 33.0' rri CL, Z co M 4�- L A LA M O ;o > > CL o 69.9, > < (D tD z> G" C) D ILI AMIS 3NIGVS Ci LZ'02C M„00,/-0.00 N Iz X 4� 0 cn 30.0' 33.0' ,6t'0CC 3„00,/-0-00 S co L4 0 u) cn ----------- To, co to ctl to M cD Ul KQ C !A m > 0 z 7- 0 (AC U) m L4 rri o CL, MO' C: M 4�- L A LA M O ;o > > ,6t'0CC 3„00,/-0-00 S co L4 0 u) cn ----------- To, co to ctl to M cD Ul KQ C !A m > 0 z 7- 0 (AC U) m L4 rri o MUNICIPALITY OF ANCHORAGE On-Site Water&Wastewater Program �c� '- ' Sc„ l '. 1 PO Box 196650 4700 Elmore Road i 1 Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 v r,' http://vnvw.muni.org/onsite �• Department ^f'CHOAtr°E On-Site Wastewater Disposal System Permit Permit Number: OSP191387 Effective Date: 9/9/2019 Work Type: Septic Upgrade Expiration Date: 9/8/2020 Tax Code Number: 01819115000 Site Legal Address: T12N R3W SEC 33 LT 21 G:3034 Site Mailing Address: 3021 E 142ND AVE, Anchorage Owner: GRANT DONNA JEAN Lot Size in Sq Ft: 108900 Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 4 This permit is for the construction of: Disposal Field Q 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 Special Provisions: Prior to construction, the undocumented field is to be located to confirm that the field-to- field separation is met. • / // 9 / q Received By: ` Date: � Issued By: / / / Date: °AV /p Pt/b'.f.S MUNICIPALITY OF ANCHORAGE • 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. 018-191-15 Property owner(s) Donna Grant Day phone Mailing address 3021 E 142nd Ave Anchorage, AK 99516 Site address Same Legal description(Sub'd., Block& Lot) Legal description(Township, Range & Section) T12N R3W SEC33 L21 Lot Size 108,900 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field x❑ Initial ❑ Single Family(SF) x❑ (w/wo ADU) Septic Tank Upgrade x❑ Duplex(D) El Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ 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. '41-11111bi AIL (Signature of property owner or authorized agent) Permit/Rush Fees: 5-95- Waiver Fees: Date of Payment: 8130//4 Date of Payment: Receipt Number: D32'764 Receipt Number: Permit No. OSP!9`3S?? Waiver No. Permit App_:-:•:...:t: Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191387, Deb Wockenfuss, 09/09/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191387, Deb Wockenfuss, 09/09/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191387, Deb Wockenfuss, 09/09/19 E-PLAMS MUNICIPALITY OF ANCHORAGE Ar Development Services Department WE)Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 018-191-15 1. GENERAL INFORMATION Expiration Date: :L11z_0 Complete legal description T1 2N R3W Sec33 L21 Location (site address) 3021 E 142nd Ave Current property owner(s) Donna Grant Day phone Mailing address Real estate agent Day phone 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well F Private Septic 0 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. COSA Fee $ 5_0Waiver Fee $ Date of Payment (' zL l i Date of Payment Receipt Number olJ5i I i�Receipt Number COSA # 0:5Cfg 15-1 0"' 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 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. 6. DSD SIGNATURE System #1 Approved for _LL bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for Phone (907) 745-8200 Date /0,/- OF. 9l/OF Ak4 Aw Steven R 'Panncne �F CE 8149 c� QA bedrooms, with the following st fti[T1�PC ��l' OF �h6,,, i .- J o �1ASTEW � •- 1 L,�T SFIR ►)))))»1,41 By: & Original Certificate Date: Z 1,/9 The Municipality of Ancho ge 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 Legal Description: T12N R3W Sec33 L21 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled uk Total depth uk ft Cased to uk ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA 9/12119 Static water level at beginning of test 150 ft. Comments B. TANK DATA Age of tank(s) 0 years Tank type/material Measured operating fluid level in septic tank n/a ❑ Standpipes/foundation cleanout per record drawing Date of pumping n/a D. ABSORPTION FIELD DATA Shallow Trench Which system tested (date installed) 10/28/19 ❑ ALL standpipes present per record drawing Total measured depth from grade 10.0 ft (max) Measured depth to pipe invert from grade 6.0 ft (min) ❑ N/A — pressurized field FMI Monitor tubes go to bottom of effective. If not, state depth into effective ❑ 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: COSA Checklist yellow sheet Parcel ID: 018-191-.15 Structure served by this system 1 Well production at time of test 2.4 gpm Water storage tank volume n/a gallons Well disinfected for coliform test? ❑ Yes ❑✓ No F01 Coliform bacteria is Negative Nitrate mg/L Q Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Sullivan Water Wells Date of Sample 11/8/19 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date n/a Results [DPass For 4 bedrooms Fluid depth prior to test 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' CE: Yes Community Sewer Manhole/Cleanout > 100' Q Yes if No ft 7 Yes if No ft Neighboring Tank > 100' M✓ Yes if No ft Private Sewer/Septic Line > 25' ✓� Yes if No ft Absorption Field on Lot > 100' M Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' Yes if No. Water Main > 10' Animal Containment > 50' Q Yes if No ft 0 Yes if No ft Yes if No Water Service Line > 10' 0 Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway comment below Community Sewer Main > 75' MV Yes if No ft M Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10'x✓ CE: Yes if No ft Surface Water > 100' ,Q Yes if No. Property Line > 5'✓Q Yes Yes if No ft Wells on Adjacent Lots: ✓Q Absorption Field > 5' if No Yes if No ft Private Wells > 100'✓Q Yes if No. Water Main > 10' ft Yes if No ft Community Wells > 200'✓Q Yes if No 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' CE: Yes if No ft If absorption field is under driveway comment below Property Line > 10'C1✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10' ✓Q Yes if No ft Private Wells > 100' U✓ Yes if No Water Service Line > 10' F✓ Yes if No ft Community Wells > 200' Yes Jf No Surface Water > 100' ✓M Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I 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 ft ft ft ft ft CE: 8 - 9 ft ft ft ft ft