HomeMy WebLinkAboutSKYLINE VIEW BLK 2 LT 14Skyline View
Block 2
Lot 14
#051-192-13
.�
Municipality of Anchorage
Development Services Department •-'_` _`_
Building Safety
Division
On-Site Water 8 Wastewater
Program, 4700 South Bragaw St.'
P.O. Box 196650 Anchorage, AK 99519.6650
www.ci.anchorage.ak.us (907) 343-7904
On-Site Wastewater Disposal System and/or Well Inspection Report pose 1 of 3
Permit Number. SW040124 PID Number: 051-192-13
Name:
PREFERRED CUSTOM HOMES Wastewater System: ■ New ❑ Upgrade
Address:
P.O. BOX 8750910-172
e WASILLA. AK 99687 ABSORPTION FIELD
Phone: No. of Bedrooms:
AGENT (907) 694-4200 3
0Deep Trench ■Shallow Trench 0Bed 0Mound Gather
LEGAL DESCRIPTION
Ser Aww
1.2
T" DW" We. e1o� ems:
Bock: Lot:
Subdivision:
GIV/so.
rL 9.0 (MAX.) n
2 14
SKYLINE VIEW
a"% ta pipe bohw Nan drro'dol prude:
SEE DWG.
crow beth be we h pip'
Township: — Range: _
Section: _
ra eae.e oee.o agMa Wes,
n 4.0 R
C o lwwh:
SEE DWG.
r< 45+ rL
WELL: ■ New
❑ Upgrade
aO a ;eftNanber
5.0
of Mw.: awawe a.w rne:
Ckr fkolim Pr 0. A.e.0 •
PRIVATE
folq DWh: Co To:
Total eor
obpaon a
n 1 — n
F"rea: p mweNot:
aa
225 R 141 rt
450+ so.
n D 3034/ F-810
Nr:
WHEATON WATER WELLS
Dote orwW:
10/11/04
slob. watw LtiM:
132
Ino~
EVERETT CALKINS
ox. X9/23-27/2004
rL
nod.Para
set At:
Corns "ht Above Gream:
6 GPN
UNKNOWN rL
2+ rL
TANK
SEPARATION
DISTANCES
■septic 0Holding 0S.T.E.P. 0Other
To
Septic
Absorption
Lift
Holdingbde/Pdvotl
Yarrulxkrrw•.
CopoNtr ti eoraw:
rrom
Tank
Field
Station
Tank
se.w tYw.
GREER TANK
1000
Well
100'+
100'+
—
—
25•+
"enw`Nanb..
STEEL
dr avnpMmenU:
2
Surface Water
100'+
too'+
—
—
—
LIFT STATION
Lot Line
5'+
10'+
—
_
_
y1e N wddde=
Narwleelaw:
Foundation
5'+
10'+
—
_
_
on N.vl 01
d e11 m:
Kah verve ok.m ac
Curtain Drain
NONE KNOWN
�redv tAa. "�
aeCwrd ~epo`tb'w pe�anMe W.
Remarks:
BENCH MARK
tado4on end Dn npmn:
PATIO SLIDING GLASS DOOR THRESHOLD
Aovrwd Ekwo4m:
100.00
r<
ENGINEER'S SEAL
'
o_�oQoo 04
Inspections performed by:
GEG, Ltd. Dates: 1st 9/23/2004
°�;,.
2nd 9/23/2004
,•,y*OQQ
................Q
3rd 9/27/200
G mess N
QUO
Developmen
Services Department Approval
". -795 OPG
Rev=eNwed and approved by
(R., R
Date:
n0%
�00400��
PERMIT NUMBER:
ASPARCEL DRAWING V PARCEL ID NUMBEI
SW040124 051-192-13
II A B
/ / \ TH#2, FCO 25.97 30.18
I I ST1 44.41 49.29
__SU 49.28 53.76
L I 1 I DBL1 52.57 57.10
w 100• WELL RADIUS
T I DBL2 54.22 58.50
—J C01 54.54 73.81
I MT1 54.71 71.54
CO2 76.79 54.30
NEW J`' B I MTCO, I MT2 74.76 54.13
WELL r DBL2 I
I I
W o o � �DBLN
ow u I I 61 1
COX /
I THI3 i
MTti I I v I
•' ' ''.+. L Q �w
C01 v) I �
/ NEW 1000 GALLON I\
SEPTIC TANK NEW
A
ALTERNATE SITE WILL �r _ _ _ _ I I DRAINFIELD \
--�
REQUIRE THE USE OF \
AN ADVATEX SYSTEM TH14
II
II
DATE: _
....,. 1/18/2005
DRAWN BY: v0 '�`.•• ..;9 n4o .
GARNESS ENGINEERING GROUP, Ltd. R.A.L.
SCALE:CONSULTANTS d GENERAL CONTRACTORS
3701 F TUDOR ROAD. $DITF 101 • ANONORACF. AK 00507 • PNONF (90])33)-6119 • FAX (9011338-3TG6 1"
C 30' .... " ...... • • • • • • • • • • VA
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:. 0
PREFERRED CUSTOM HOMES (907) 694-4200 2 Of 3 ry mess P
LEGAL DESCRIPTION: 00 9 0
SKYLINE VIEW SUBDIVISION; LOT 14, BLOCK 2, C -7953 •: F pp
' �1 PI, � 0
TYPES WORK: n� ed Pr,lees oho\ oc
AS-BUILT DRAWING OF NEW WELL AND SEPTIC SYSTEM 1��On ___ o1
SW040124 AS -BUILT DRAWING PARCEL 192- is
AL GRADE
STI / -IN98.77---99.07 ST2
TOP OF TANK AT
INLET - 95.31 TOP OF TANK AT
INSULATION OUTLET - 95.34
INVERT OF BUNGNEW 1000U
AT INLET - 94.86 GALLON SEPTIC TANK INOUTLETF 89461 T
1
TH#3
INSULATION PER
CONTRACTOR -
ORIGINAL GRADE
99.48 O HIGHEST POINT
RELATIVE ELEVATION OF BOTTOM OF
TEST HOLE O 83.48 (TEST HOLE DRY)
►-- 5'
GARNESS ENGINEERING GROUP, Ltd.
��CONSULTANTS 8 GENERAL CONTRACTORS
3701 F TUftfla RDAD. SIKTF 101 • AWAGF. AK 00107 • P NF (007)117.1" • FAX (007)31R.17A6
PREPARED FOR: PHONE NUMBER:
PREFERRED CUSTOM HOMES (907) 694-4200
LEGAL DESCRIPTION:
SKYLINE VIEW SUBDIVISION; LOT 14, BLOCK 2.
TYPE OF WORK-
PROFILE
ORKPROFILE AS—BUILT OF NEW SEPTIC SYSTEM
-FINAL GRADE
97.33-100.11
FILTER FABRIC
-INVERT OF PIPE
- 94.48 (AVG.)
BOTTOM OF TRENCH
90.48 (AVG.)
(18/2005 ! OF r' VQ41y�
4 BY:`........!9S V
R.A.L. 1
N.T.S. .4
m.. .. .... ..
NUMBER: y v t
3 OF 3 �....ti ierr le_ ,a:r
.1
02/13/2005 12:33_ 19076944988 E STILTNER P0,M ER
ii-IAN-IIS-@S-- —
OEM 11227 AM PREFERREDCl18T6MNOMES
■ ■
�y�T..0s 007
1118.- AK 9980
PAGE 01/01
.ALL LOf#
I
Name: P�� Custom Domes of Alaska
p,p, Box 875910 - sc. I72 Zip Code:r97
�
I Address: Stat996e: °� _ --
LCity: �:— 14 Block: 2
line View Subdivision
Well Site. Sky
- _ 225 fLrOtn: To: Formation:
all Depth, p 142 h3rdPm
Below• Ground: 223 R• 142 225 bedrock, M'ntn
I AbOve Groaod:
2 c.
•a11Min: 6
tattc I.r'el�
132 k-
astng 1419ofVID 9
►y100A.
1 (((
Q Iner Pipe: 100 R. I
n� l
prtened: i
erforated: n I I
routed: Scntonirlb
Depth:
velop. Method:
I I
$e of Well: Residenti '
rillingMetlmd: Rouk
L I
nids Used: MI
amp installed: none
her: none I
ateDriUed: 10-11-06 Driller:lasonTicbc'or
I
• ..�ns�alc-1,n �oua401j u4oC d1•02Zt So Et Yer
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 ( WATER SUPPLY PERMIT
Initial
Permit Number: SW040124
Legal Description:gSkyrine View Block 2 Lot 14
Design Engineer: 0041 AK Water & Wastewater Consultarr
`7`/-4311 c6
1:76b
Date Issued: May 14, 2004
Expiration Date: May 14, 2005
Parcel ID: 051-192-13
Site Address: Starflower Circle
Owner Name: o G aoo/n 110mGs Lot Size: 15750 SQ. FT.
Owner Address: 16600 Centerfield Drive Total Bedrooms: 3 Permit Bedrooms: 3
Eagle River , A 99577 -
This permit is for the construction of:
❑✓ Disposal Field 0 Septic Tank Holding Tank ❑ Privy Q Private Well Water Storage
All construction must 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 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:
Issued By:
Date: r
Date: I o q
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw SL
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. OS/' /2 Z— 13 Permit Number
Property owner(s) LAURA HAMILTON Day phone 694-4200
Mailing address (1) c/o BROOKE STILTNER w/ REMAX OF E.R.
Mailing address (2) 16600 CENTERFIELD DRNE • EAGLE RIVER, AK Zip Code 99577
Legal description (Lot, Block & Sub'd.) LOT 14. BLOCK 2: SKYLINE VIEW SUBDIVISION
Legal description (Section, Township & Range) N/A
Lot Size /Sr 1-1�O AcrIS .
THIS APPLICATION IS FOR:
Number of Bedrooms 3
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 ap made for a
Single Family Dwelling and is in accordance with applicablqjxw)qm qMIMN EERING GROUP, Ltd.
00NULTAMS A 0EWE L0OMMCr00.4
ALASKA WATER do WASTEWATER CONSULTANTS. INC. 3701 E. Tudor Road, Suite 101
..b.., .
PHONE: (907) 337-6179 FAX:(907)338-3246
c�
Permit Fees: UCe)- 3 Paiver Fees -
Date of Payment: xS1 111 UL{ Date of Payment:
Receipt Number.0rlg (c 1 tel Receipt Number.
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
August 14,2003
Municipality of Anchorage
Development Service Department
Building Safety Division
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Proposed Well and Septic System for Lot 14, Block 2; Skyline View Subdivision
To whom it may concern:
The proposed 3 bedroom house will be served by a private well and septic system. Two test
holes were excavated on the property in the area for the proposed septic system. The drainfield
will be designed around the 30 foot radius of these test holes. We are proposing that a 1000
gallon septic tank and a 5 -wide type drainfield be installed. The well is to be drilled in the area
shown on the attached site plan and design drawings. Comments regarding the septic 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 1.0 gallons/day/RZ
should be used.
2. TRENCH DESIGN:
a. Percolation Rate: 1.2 & 1.0 minutes/inch
b. Proposed Application Rate: 1.0 gallons/day/flZ
c. Number of Bedrooms: 3
d. Design Flow: 450 gallons per day
e. Minimum Absorption Area: 450 R2
f. Total Depth: 9 feet (maximum — at any point)
g. Effective Depth: 4
h. Width: 5 feet
i. Reduction Factor: 0.50
j. Minimum Length: 45 feet
k Effective absorption area = 450 R2
3701 E. Tudor Road, Suite 101 ' Anchorage, AK 99507
Ph: (907) 337-6179' Fax: (907) 338-3246' Website: akwwe.com
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic
system.
4. TOPOGRAPHY: The area for the proposed drainfield is a 1 to 5 percent slope running
southeast to northwest; 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 ha} any questions, please contact us at 337-6179. Thank you for your
assistance. . /1
M.S.
NOTE: A site plan drawing, a design drawing, two soils logs, and a 7 page construction
specification letter which are all part of the design package for this septic system.
3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507
Ph: (907) 337-6179 • Fax: (907) 338-3246 • Website: akwwc.com
JEWEL RANCH S/D:I JEWEL RANCH S/D: I JEWEL RANCH S/0: I JEWEL RANCH S/0:
LOT 7 LOT 6 LOTS LOT 4
SKYLINE VIEW S/D: 1 i r' row
LOT 1. BLOCK 2
I 9
SKYLINE MEW S/D; 1 Dov
LOT 2, BLOCK 2 1 1 �? •)�
I j
I I
1 1
SKYLINE NEW S/D; 1
LOT 3. BLOCK 2 I I
I I
1
I 1
I I
I I
SKYLINE MEW S/D:
LOT 4. BLOCK 2 1
I 1
I I
SKYLINE MEW S/C
LOT S. BLOCK 2
SKYLINE MEW S/D+\
LOT 7, BLOCK 2 \\
MEW
r---------- -
1 /
I SKYLINE MEW S/0;
I LOT 20. BLOCK 2
I /
1 /
I SKYLINE MEW S/D:
I W LOT 19. BLOCK 2
I n
I �
PROPOSED SEPTIC S'
(SEE DESIGN. PACE 2
SKYLINE MEW S/D;
LOT 18. BLOCK 2
J \1 r7 1 I �►✓-�
I 1 TERNATE SITE
w I o. N A
SKYLINE NEW S/D:
LOT S. BLOCK 2
I
SKYVIEW AVENUE 1<
1
SKYLINE MEW ADDITION 11;
LOT IA. BLOCK 2 /
' I I / TERNATE SITE I
LLJPtSKYLINE NEW S/D: >
LOT 17. BLOCK 2 Q.
` !
.J PROPOSED SEPTIC MTEM I C,
;1 ;I I (SEE DESIGN. PAGE 2 OF 2)'�0
SKYLINE MEW S/0:
LOT 16, BLOCK 2 — ,
ALTERNATE SITE
PROPOSED SEPTIC SYSTEM
(SEE DESIGN. PACE 2 OF 2)
1
I I
I I
I 1
\ SKYLINE MEW ADDITION 11;
\ LOT 2A. BLOCK 2 /
\ / I
ALASKA WATER & WASTEWATER SCALE. J.L.M.
CONSULTANTS. INC. 1" = 100
6001 DFRARR ROAD, SUITE M • ANCHORAGE. AK 99S"• FNONF (007)1]7-6170 • FAX (0071316-3746
PREPARED FOR PHONE NUMBER: PAGE NUMBER:
LAURA HAMILTON c/o BROOKEaSTILTNER 694-4200 1 OF 2
-./ oru.v oono ore r.r.Ir oIvrR
SKYLINE VIEW SUBDIVISION; LOT 13, 14, do 15. BLOCK 2
E OF WORK:
SITE PLAN FOR PROPOSED WELL LOCATIONS AND SEPTIC SYSTEMS
uj��
7953
NOTE: THE CONTRACTOR SHALL HAVE
THE SOUTH & EAST LOT LINES AND
THE 100 FEET WELL RADII FLAGGEDNil
BY A REGISTERED LAND SURVEYOR/PRIOR TO ANY CONSTRUCTION. anTMIPROPOSEDWELL / PROPOSED P
RADIUS I I I! TIC
PROPOSED +� FEET WELL SYSTEM
W II
J I I
FUNSPRO� I I
LJ_ POSED l00 FEET I I /
U WELL RAp,�
PROPOSED
WELL
N I I
ONWJ &n
�4 PROPOSED00CALL
SEPTIC
TANK
W 1 IMT0 O TH/+I I II W
91
II
I I I II o I 0 I
I I I I
LU—///2-
Q I I
INSTALL `OUNOATION CLEANOUT TALTERNATE SITE/STINALL DOUBLE CLEANOUTS I I \
� I
PROPOSED DRAINFIELD. EXCAVATE A TRENCH
THAT IS 9 FEET DEEP MAXIMUM (AT ANY POINT)
BY S FEET WIDE BY 45 FEET LONG. ADD / FEET r 71
OF CLEAN, WASHED SEWER DRAT\ OCK. I 9 I II
W 1
THI+ I �I I PROPY
POSED
d SYS
IT
GATE:8/Op6� p 0
14/2003
T�DRAWN BY: 0 •!v�� •• • . •
ALASKA WATER & WASTEWATER J.L.M.
CONSULTANTS,
INC.-SCALE:a
DI E TUDOR °DAD. SUITE IDI • ANCHORAGE. AK 90507 • HONE (°0))33)-0179 • FAX (90))336.3]46 1"
= 30,
EPARED FOR: LAURA HAMILTON PHONE NUMBER: PACE NUMBER:
c/o BROOKE STILTNER w/ REMAX of E.R. (907) 694-4200 2 OF 2
;AL DESCRIPTION:
LOT 14, BLOCK 2: SKYLINE VIEW SUBDIVISION
'E OF WORK:
DESIGN OF PROPOSED WELL LOCATION AND SEPTIC SYSTEM
mul6"FUlm
SOIL LOG — PERCOLATION TEST
LEGAL DESCRIPTION: LOT 14• BLOCK 2: SKYLINE VIEW SUBDIVISION
PERFORMED FOR: c/o BROOKE STILTNER w/ REMM OF E.R. DATE: 8/7/2003
DEPTH __
(fea7, ORGANICS ITEST HOLE #3
1
2
3
4
5
6
7
B
9
10
11
12
13
14
15
16
17
18
GP/SP
W/ LARGE
COBBLES AND
BOULDERS. MORE
SP W/ DEPTH.
TOP 4 TO 5
FEET HAD THE
MOST BOULDERS
,if
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0.
DEPTH TO DATE
GROUNDWATER
DRY 8/7/2003
E 953olpro
AG
19 I PERCOLATION RATE 1.2 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 5.0 FT. AND 6.0 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES N NO
SOILS LOGGED BY: CALEB CALL PERCOLATION TEST PERFORMED BY: CALEB CALL
COMMENTS:
PERFORMED BY AKWWC, INC. I, JEFFREY A. CARNESS, CERTIFY THAT THIS AS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 03
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SKYVIEW
sITE PLAN
Ir----
AVENUE
-----^�--
1'=100'
19 I PERCOLATION RATE 1.2 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 5.0 FT. AND 6.0 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES N NO
SOILS LOGGED BY: CALEB CALL PERCOLATION TEST PERFORMED BY: CALEB CALL
COMMENTS:
PERFORMED BY AKWWC, INC. I, JEFFREY A. CARNESS, CERTIFY THAT THIS AS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 03
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19 I PERCOLATION RATE 1.2 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 5.0 FT. AND 6.0 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES N NO
SOILS LOGGED BY: CALEB CALL PERCOLATION TEST PERFORMED BY: CALEB CALL
COMMENTS:
PERFORMED BY AKWWC, INC. I, JEFFREY A. CARNESS, CERTIFY THAT THIS AS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 03
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
SOIL LOG — PERCOLATION TEST
LEGAL DESCRIPTION: LOT 14 & 15, BLOCK 2: SKYLINE VIEW SUBOMSION
PERFORMED FOR: C/o BROOKE STILTNER w/ REMAX OF E.R. DATE: 8/7/2003
DEPTH _—
(feet t""••'1ORGANICS ITEST HOLE #41
1
4
5
fi
7
8
9
10
11
12
13
14
15
16
17
18
GP/SP
W/ LARGE
COBBLES AND
BOULDERS. MORE
SP W/ DEPTH.
TOP 4 TO 5
FEET HAD THE
MOST BOULDERS
DEPTH TO DATE
GROUNDWATER
DRY 8/7/2003
t
i
..
a
IIIIIIIII
11;11111
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of
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1 f
_
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1111111;
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i
�.��
•
DEPTH TO DATE
GROUNDWATER
DRY 8/7/2003
19� PERCOLATION RATE 1.0 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 5.0 FT. AND 6.0 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES N NO
SOILS LOGGED BY: CALEB GALL PERCOLATION TEST PERFORMED BY: CALEB GALL
COMMENTS:
PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS M7 PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: O
t
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of
Ui
n� I
1 f
Of
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ex
I
1
u)
AVENUE
s1T= 00
SKYVIEW
__
19� PERCOLATION RATE 1.0 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 5.0 FT. AND 6.0 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES N NO
SOILS LOGGED BY: CALEB GALL PERCOLATION TEST PERFORMED BY: CALEB GALL
COMMENTS:
PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS M7 PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: O
•• aaae■Kamm
a
19� PERCOLATION RATE 1.0 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 5.0 FT. AND 6.0 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES N NO
SOILS LOGGED BY: CALEB GALL PERCOLATION TEST PERFORMED BY: CALEB GALL
COMMENTS:
PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS M7 PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: O
MUNICIPALITY OF ANCHORAGE
1,
!44g �
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 051-192-13-000 Expiration Date: 13, Q Q
1. GENERAL INFORMATION
Complete legal description Sky Line View B2 L14
Location (site address) 19323 Starflower Cir.
Current property owner(s) Jacob & Kari Konrth-Bern Day phone 854-5447
Mailing address
Real estate agent
19323 Starflower Cir.
Audrey & Brent Mason
2. TYPE OF DWELLING:
0 Single Family (w/o ADl0
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
4. TYPE OF WATER SUPPLY:
Private Well
Water Storage
Community Well
Public Water System
Waiver request for:
Day phone 622-3344
TYPE OF WASTEWATER DISPOSAL:
El
Private Septic
El
❑
Holding Tank
❑
❑
Community
❑
❑
Public Sewer
❑
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 55 C7
Date of Payment 511c)
Receipt Number 65
COSA# 0SCaj1�ab
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
Distance:
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. I acknowledge that On -Site staff may visit the site to verify the information submitted.
Name of Firm Eklutna Engineering, LLC. Phone 907.406-1058
Address 19162 Mountain Rd.
Engineer's Printed Name Curtis Townsend Date
6. DSD SIGNATURE
Y System #1 Approved for .3 bedrooms
System #2 Approved for
Disapproved
Conditional approval for
bedrooms
Curtis UT wns nd
�'• Date S ?
F6v' No, C 11904
PROFESSI��I�a;
bedrooms, with the following stipulations:
. "kk((((((W/",
''/))))))))WI I.
By: JULbole-01 00_ t ' Original Certificate Date: -5/1 3 Q DQ
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 Checklist
Legal Description: Sky Line View B2 L14 Parcel ID: 051-192-13-000
If more than 9 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1
A. WELL DATA
❑■ Well log is filed with Onsite (or attached)
Date drilled 10/11/04
Total depth 223 ft
Cased to 141 ft
❑■ Sanitary seal is functioning correctly
❑■ Wires are properly protected
Casing height (above ground) 22 in.
Date of flow test for COSA 4120/21
Static water level at beginning of test 102 ft.
Comments
B. TANK DATA
Age of tank(s) 17 years
Tank type/material steel
Measured operating fluid level in septic tank 50
❑■ Standpipes/foundation cleanout per record drawing
Date of pumping 1120121
D. ABSORPTION FIELD DATA
Which system tested (date installed) 9127104
❑■ ALL standpipes present per record drawing
Total measured depth from grade 8.317.5 ft (max)
Measured depth to pipe invert from grade 413.3 ft (min)
❑ NIA — pressurized field
Q 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
Well production at time of test 7,5 gpm
Water storage tank volume n1a gallons
Well disinfected for coliform test? ❑ Yes ❑■ No
❑■ Coliform bacteria is Negative
Nitrate 5.52 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ❑■ Arsenic less than MRL (ND)
Collected by Brandon L. Jones, Brandon's On -Site Services, LLC.
Date of Sample 4120121
C. T STATION
❑ Require aintenance completed
Age of lift station years
Lift station material
Comments: nla
Adequacy test date 4120121
Results [D Pass For 3 bedrooms
Fluid depth prior to test 010 in
Water added 467.3 gal
New depth 010 in
Elapsed time 62 min
Final fluid depth 0 in
Absorption rate 450+ gpd
Any rejuvenation treatment (past 12 months) none
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
Community Sewer Manhole/Cleanout > 100'
M✓ Yes
if No
ft
2] Yes
if No ft
Neighboring Tank > 100' Z Yes
if No
ft
Private Sewer/Septic Line > 25'71 Yes
if No ft
Absorption Field on Lot> 100' ❑✓ Yes
if No
ft
Holding Tank? 100' Q Yes
if No ft
Neighboring Absorption Fields > 100'
Q✓ Yes if No ft
Water Main > 10'
Animal Containment? 50' ❑✓ Yes
if No ft
❑✓ Yes
if No
ft
Yes if No ft
Water Service Line > 10'
❑✓
Yes
if No
Manure/Animal Excreta Storage � 100'
If septic tank is under driveway
Community Sewer Main > 75' ZYes
if Na
ft
0 Yes
if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
❑✓
Yes
if No
ft
Surface Water > 100'
❑✓ Yes if No ft
Property Line > 5'
❑�
Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5'
0✓
Yes
if No
ft
Private Wells > 100'
Q✓ Yes if No ft
Water Main > 10'
Q
Yes
if No
ft
Community Wells > 200'
Yes if No ft
Water Service Line > 10'
❑✓
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'
❑✓
Yes
if No
ft
Wells on Adjacent Lots:
Water Main > 10'
Yes
if No
ft
Private Wells > 100' Q Yes if No
Water Service Line > 10'
Q
Yes
if No
ft
Community Wells > 200' ❑✓ Yes if No
Surface Water > 100'
✓❑
Yes
if No
ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that 1 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. -40
r Q3 ' • :57 1
�49 TFI
....`I�.... 0...........
COSA Checklist yellow sheet �•,�ro2�j �`
No CE 11904
+���s�FROFE5SL0�t`��
ENGINEER'S
ft
ft
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT 907‐343‐7904
On‐Site Water and Wastewater Section Fax: 343‐7997
www.muni.org/onsite
Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org
Nitrate Advisory
Certificate of On‐Site Systems Approval # OSC211226
Subdivision: Skyline View, Block: 2, Lot: 14
A water sample revealed a nitrate concentration of 5.52 milligrams per liter (mg/L).
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Since nitrates are known to slowly increase, we recommend
you monitor the water quality. Please see the attached “Nitrate Fact Sheet” for
important information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On‐Site
Systems Approval.
Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org
Nitrate Fact Sheet
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate
is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of
ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the
oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners,
food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is
associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of
young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood
stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as “blue baby” disease. The EPA limits the
concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered
from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home
water treatment systems such as softening or iron filtration does not readily remove nitrate. The best
method for limiting nitrate in well water is source control. This can include avoiding overdosing of
fertilizer near the well and maintaining good separation distances between septic tank leach fields and
the well. A special anion exchange filter that contains a medi a with a strong affinity for negatively charged
ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several “wet chemical” methods using a
spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect
the activity of nitrate in water. This laboratory uses several different wet chemical methods approved
under the public water supply laboratory certification program. They also have test kits available, which
the laboratory uses to perform an inexpensive “screening test”, and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test kit results
against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend
using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.
4
Muiiicipility of Ahcho—rage
Developtpent terifices IDepartmelnt
Building Safety Division
OnSite Water S Wastewater Piodrarh
4700 South Bragaw SL
P.O. Box 196650 Anchorage, AK 995196650
www.d.anchorage.ak.us
(907)343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcell.D. x'(15( -I42-13
1. GENERAL INFORMATION
Complete legal description
Location (site address or directi
HAA# 05QD
Expiration Date:
Current Property owner(s) PREFERRED CUSTOM HOMES Day phone _694-4200 (AGENT)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
P.O. BOX 875910-172 • WASILLA. AK. 99687
Day phone
BROOKE STILTNER W/ REMAX PROPERTIES Day phone 696-0214
16600 CENTERFlELD DRIVE * EAGLE RIVER, AK. 99577
Unless otherwise requested, HAA will behold by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual Well
0
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
0
Individual Holding tank
❑
Community On-site
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an Independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority
Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid
water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water
system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's
work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certlrred by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application,
shows that the on-site water supply andlor 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 (les 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.
Name of Finn GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179
Address 3701 E. TUDOR ROAD, SUiTE 101 • ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date
Engineer's Comments:
In conducting this evaluation, GEG, Ltd. attempted to provide a thorough,
conscientious engineering analysis of the system In accordance with ADEC and MOA
DSD Guidelines d Regulations. The reported results described 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 sods condition, groundwater 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 the system. Satislactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
otherperson orpartyis not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
.—{eff Approved for —07'� bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following`Q1i�Aalioris:•"'•;ryQ'�.��
nN.SiTE ��G+
WATER AN �—
..
Attachments:
HAA Checklist_
Septic System Advisory
Well Flow Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
.'A..6. elf \ `l A Q-" i'_ Original Certificate Date:
tRw.+von
Municipality of Anchorage 41— Development Services DepartmentBuilding Safety Division -
On -Site Water 6 Wastewater Program
4700 South Bragew St.
P.O. Box 196650 Anchorage, AK 995194M
www.ciAnchorage.ek.us
(907) 343.79D4
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: SKYLINE NEW SUBDIVISION: LOT 14, BLOCK 2. Parcel ID: SWO40124
A. WELL DATA
Well type PWAX If A, B, or C provide PWSID# N/A
Date completed 10/11/2004 Sanitary seal (Y/N) YES
Total depth 225 ft. Cased to 141 ft.
FROM WELL LOG
Date of test 10/11/2004
Statk water level 132 ft.
Well production 6 0—
p.m-
WATER SAMPLE RESULTS:
Coliform _Q colondes1100 ml. Nitrate a b nlgA.
Wen Log (YM) YES
Wires property protected (YM) YES
Casing height (above ground) 240+ in.
AT INSPECTION
Other bacteria 0 colonies/1 00 ml.
Arsenic: NIA mgA. Date of sample: 1/17/2005 Collected by: GEG. Ltd.
S. SEPTIC(HOLDING TANK DATA
Tank Type/Material STEEL Date Installed 9/23-27/2004
Tank size 1000 gal. Number of Compartments E Cleanouts (YM) YES
Foundation cleanout (YM) —YES Depression over tank (YM) NO High water alarm (YIN) N/A
Date of pumping NEW Pumper
C. ABSORPTION FIELD DATA
Date installed 9/23-27/2004 Son rating fo.p.d ft%dnn) 1_2 System type SHALLOW TRENCH
Length 45+ ft. Width 5.0 ft. Gravel below pipe 4.0 ft.
Toted depth'jM=a•� rt, Eff. absorption area 450+ fe Monitoring tube YES Depression over field NO
Date of adequacy test NEW Results (Pass/Fall)
Fluid depth in absorption field before test _ in. Water
New depth _in.
Elapsed Time: _ min. depth _ in. Absorption rate >- g.p.d.
(past 12 mo.) (YM & type) It yes. give date
D. LIFT STATION
Date installed Stze in gallons
'Pump on' level at _in.
E. SEPARATION DISTANCES
High water alarm level at in.
Cycles tested Meets alar & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tenkAift station on lot 100'+
Absorption field on lot 1009+
Public sewer main N/A
Sewer /septic service line 25'+
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/deanout N/A
Holding tank N/A
SEPARATION DISTANCES FROM SEPTIC(HOLDING TANK ON LOT TO:
Building foundation
51+
Property line 5'+
Absorption field
5'+
Water main
N/A
Water service line 10,+
Surface we
100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 104 Water main N/A
Water service line 10'+ Surface water 10(Y+ Driveway, parking/vehide storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
O. ENGINEER'S CERTIFICATION
1 certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date. ? „ , „ ,,,,,, ,,,,,,,
A m W
Engineers Printed Name JEFFREY A. GARNESS •. 79
v.� ' 1'•0
Date 1„'2�F/eS' eprohnlo"d
HAA Fee $ `j7" , 151e " Waiver Fee S
Date of Payment 11%loe) Date of Payment
Receipt Number ()(,,4),7q van Receipt Number
IRVV.12011
01-25-05 04:18PU FR014-CTEE ESI, SCS ENV SERVICES
SGS RcEH
1050324001
Clieot Name
Garncss Engineering Group, Ltd
Project Name/#
Lot 14 Blk 2 Skyline View S/D
Client Sample ID
Lot 14 Blk 2 Skyline View S/D
Matrix
Drinking Water
Sample Remarks:
9075615301 T-713 P.02/06 F-186
All Dates/rimes are Alaska Standard Time
Printed Date/time 01252005 12:46
Collected Date/rime 01/172005 17:35
Received Date/time 01/18/205 10:50
Technical Director / Step Ede
Parameter Resulis AOowahle Prep Analysis
PC!L Uoiu Method Container lD 1 imirc Ate Dem Utit
Waters Department
Nitrate -N 2.93 0.100
Microbiology Laboratory
Total Coliform 0
mg/l. EPA300.0 A (x-10) 01/18/05 XM
coI1I00mL SM209222B A -(<=1) 01/18/05 DKC
■m 02/26/2005 11:36
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ASSUILT
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1 HEREBY CERTIFY -THAT 1 HAVE SURVEYED THE
SCALE- ,
1
FOLLOWING DESCRIBED PROPERTYr
J,7yxi�,f. jwd:ly; vac mer/y c-f'�
AND THAT NO ENCROACHigNTS GIST EXCEPT AS
DATE]
INDICATED. IT IS THE RESPONSIBILITY OF THE
OWNER TO DETERMINE THE EXISTENCE OF ANY
GRID -
EASEMENTS, COVENANTS, OR RESTRICTIONS
WHICH DO NOT APPEAR ON THE RECORDED SUBDI-
VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD
FB:
ANY DATA HEREON BE USED FOR CONSTRUCTION
OFFENCE LINES, OR FOR ESTABLISHING BOUND-
ARY LINES.
i
i