HomeMy WebLinkAboutTHUNDERBIRD FALLS LT 5"LAWDM-6UlliD
Municipality of Anchorage
On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3
ON -SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP231234
PID Number, 05141117000
Dwelling, [I Single Family (SF)
0 with ADU El Duplex (D) El Two Single Family Project: El New [9 Upgrade
Name
KELLEY LEONARD
ABSORPTION FIELD
Deep Trench n Wide Trench n Bed n Mound
Site Address
26535 KERRY LOOP
El Other ,
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
529-9395
13
2 G PD/SFI
I
10 Ft
LEGAL DESCRIPTION
Depth to pipe invert from original grade
5 Ft.1
Gravel depth beneath pipe
5 Ft
Subdivision Block Lot
THUNDERBIRD FALLS LT
5
Fill added above original grade
Ft.
JGravel length
45 Ft
Township Range Section
Gravel width
3 Ft.
Beds: Number of Lines
Ustance between lines
Ft
SEPARATION DISTANCES
i
Toi Septic Absorption
Lift Station
Holding Sewer
Total absorption area
Number of trenches
Dist. between trenches
From, Tank Field
Tank Line
450 Fe'
1
Ft
well 11001+ 100'+
na
na 125' +
TANK' N Septic, El S.T.E.P. 0 Holding El Other
Manufacturer
Greer
Capacity
1000 Gal
Surface Water 1001+ 1001+
na
na
Material
Plstc
Number of compartments
2
Lot Line 1+
110,+1 10
na
I na NA
na
Foundation 110,+1 10 1+
na
LIFT STATION
Manufacturer
Capacity
Remarks
Gal
Alarm location
Electrical installed by
Tankto D3034
PIPEMATERIAL 14ousetotankD3034
Installer
J R's
drainfield
Drainfield CO/MTD3034
Inspector NorthRim Eng.
BENCH MARK (Assumed elevation) 100 ft
Inspectestion 10116/23
da:
d 10117123
Location and d scription,
2n
IDeck
3,-d 10/18/23
4"',
ON -SITE WATER AND WASTEWATER SECTION APPROVAL
s Stamp
OF
Conditional Approval-
Date
CID'.
Steve Eng Ao
CE-6256
Septic System
Approved_
Date 11
i %/. 10
Note: this approval does not include well permit requirements.
tmev Vw U4( -! 0)
Q
rr^^
vl
TT
''I
O 1
,�
00
Z
,op' x
r
° C)
.
v
n
��
Z�V
VJ
O • /�
R)
C3 •'
V)
V)
F9
M
(9
l J TV
-0
H
/v ;�I
d
^H
l J
z
C V)
—I
n
V)
70 ---'
7C
f'l
D F9
z
d
d
a
<
TI
ITHI
rH
Im
I I
I I
0
fu
W
0
r9
TI
Q
�%
11
-9 1
<
O
Q
�
c+
�
O
Q
�
Q
ry
0
oFrn
o (D �,
�
D (
O
c
<-F
v� z <
O �
ro � o Q
--
p c+
�
Fr] O
�
O
-0 O
Q
Q
p
n
�}
Q
Q
� o ro
n
Q
O
� W
fp
(O
Q
C
O
Ln
m
�o
Q
1+
0
ro
00
W
F7 :K
X Q
�n
5- s
(D
-7ro
n <
O Q
c+
�o
F
ro
0
Fri
r� ro
ro Q
< <+
Q 0
o
�0
ro
O
LArQ10
5 fU
(O Co
co
n `
Q
5
O
w
ro
c+
ro
ro
4•r
ro
n
S
SHED
DECK
SHED
ANTENNA
SHOP
LEGEND
A A., 9O#� 0 FND. 5/8" REBAR, NO CAP
*: 49 TH • • ,* �rJ �) RECORD DATA PER PLAT #70-385
rr Ryan G. Johnson
�+ �'• No. 192159
�liF9��0ROF 20/2023-
OS��
PX
� o
/ C,'
ANTENNA
LOT 5 /4' PVC / . SEPTIC PIPE
0I
`1b i81GRAVEL DECK
100' WE2L �i9A
o<E ��' �F1DIli WEL
(20' ESMT.) \ F \� \ RESIDENCE
E
OVERHEAD \ FENCE ,
UTILITIES
HAND
WELL
KER IN 7g'�'9%' W • 37
.... 49.3
{� \ 16� [3lzo p Sao
S �5 29AS� OF .............
B
RrIVG
0' 60' 120' 1 MEAS
LOT 6
i SCALE: V = 60 FEET
ASPLS MORTGAGE LOCATION SURVEY NOTES:
NO TITLE REPORT WAS PERFORMED FOR THIS SURVEY,
EASEMENTS SHOWN PER THE RECORD PLAT, THERE MAY BE
ADDITIONAL EASEMENTS NOT SHOWN HEREON. THIS
MORTGAGE LOCATION SURVEY HAS BEEN PREPARED IN
ACCORDANCE WITH ASPLS MORTGAGE LOCATION SURVEY
STANDARDS. IT IS A REPRESENTATION OF THE CONDITIONS
THAT WERE FOUND AT THE TIME OF THE SURVEY. THIS
SURVEY DOES NOT CONSTITUTE A BOUNDARY SURVEY AND
IS SUBJECT TO ANY INACCURACIES THAT A SUBSEQUENT
BOUNDARY SURVEY MAY DISCLOSE. THE INFORMATION
CONTAINED IN THIS DRAWING SHALL NOT BE USED TO
ESTABLISH ANY FENCE, STRUCTURE, OR OTHER
IMPROVEMENTS. UNLESS GROSS NEGLIGENCE IS DISCOVERED,
THE LIABILITY EXTENT OF THE PREPARER SHALL BE
LIMITED TO THE AMOUNT OF FEES COLLECTED FOR
SERVICES IN PREPARATION OF THIS PRODUCT.
(L=9.47')
(R=70.00')
SHOP N I
i
l
SEPTIC
TANK I
�I
I
SHEIP
. I
m
LOT 11
e- :I LOT 10
Ll
(20' UTILITY
Ll ESMT.)
AS -BUILT OF:
u
=la
CD
Zlm
LOT 5
THUNDERBIRD FALLS SUBDIVISION
PLAT #70-385
ADDRESS: 26535 KERRY LOOP, CHUGIAK, AK
LOCATED IN: ANCHORAGE RECORDING DISTRICT
TIMBERLINE SURVEYING AND MAPPING DRAWN BY: R.G.J.
17035 BARONOFF AVE FILE NO.: 23.50
EAGLE RIVER, AK 99577 SCALE: F' = 60 FEET
907-242-5320 DATE: 10/20/2023
ryan@timberlinealaska.com SHEET: 1 OF 1
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP231234 Effective Date:
Work Type: Septic Upgrade Expiration Date:
Tax Code Number: 05141117000
Site Legal Address: THUNDERBIRD FALLS LT 5 G:1764
Site Mailing Address: 26535 KERRY LOOP, Chugiak
Owner: KELLEY LEONARD T 2005 TRUST 50 Lot Size in Sq Ft:
Design Engineer: NORTH RIM ENGINEERING Total Bedrooms:
This permit is for the construction of:
vl, Ys
i
Department
9/18/2023
9/17/2024
93006
Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ 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
Received By: l SS j-0 A/0 aq-)-f— -Z tM
Issued By:
Date:
Date: 5 t sZ 2
3
MUNICIPALITY OF ANCHORAGE
Development Services Department s Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 05141117000
Property owner(s) KELLEY LEONARD
Mailing address 26535 KERRY LOOP
Site address same
Day phone 529-9395
Legal description (Sub'd., Block & Lot) THUNDERBIRD FALLSLT 5
Legal description (Township, Range & Section)
Lot Size 93,006 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
Initial ❑
Single Family (SF) 0
Septic Tank
0
Upgrade Q
(w/wo ADU)
Duplex (D) ❑
Holding Tank
ElRenewal
❑
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION
INCLUDES A WAIVER REQUEST FOR:
Distance:
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: 5-9 S_ Waiver Fees:
Date of Payment: 51, A3
Receipt Number: 02-92. 0
Permit No. $ P IL 3 / 2, 3 L(
Date of Payment:
Receipt Number:
Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
OF
* 49 Thi !�
0TNI
F�NGINEERING SteveEng.com Thunderbird Falls Lot 5 ,�°: 7/27/23
SPECIFICATIONS & DESIGN GUIDELINES
Wastewater System Sizing: The current septic system is undocumented. A new septic
tank & absorption trench is planned. The replacement site is as depicted in the plans. This
lot is very large and on a private water well, another hand -pump well is present. No
adverse impacts are expected from trench addition. Easements are depicted in the
drawing, distant from the proposed trench. The slope is indicated in the area of the septic
system. No conflicts to neighbor properties. A new test hole was completed; an
application rate of 1.2 GPD/FT 2. Trench Length = 375 FTI/5'x 2 = 37.5' trench, 5'
effective. Design to meet Steep Slope Provisions of AMC 15.65.210.
Specification Requirements: All components and work must comply with the
Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water
Regulations and Wastewater Regulations.
Y Minimum 3' of cover or insulation is required for trench; an equivalent of 1 "
insulation for 1' foot soil cover. Solid pipe must be set on well compacted, stable soil.
• 10' minimum between the house/ trench, 5' tank to trench, 10' to property lines,
• 4" diameter cleanouts with airtight caps are required 1 ' to 4' from foundation wall,
prior to any 90 degree bend in 4 inch line, in 2nd tank compartment, and two adjacent
opposing cleanouts between the tank and the absorption field, not more than 10' from
the tank positioned to provide cleanout access towards the tank and towards the
absorption field. Manhole Riser required in 1" tank compartment.
® All cleanouts must extend to at least ground level.
• In solid pipe nets, ASTM D-3034 may be used in lieu of cast iron.
® Trench to be placed level, minimum of 4' to groundwater, 6' to bedrock from drain -
rock.
• Drain rock to be '/2 inch to 2 inch screened. Drain rock to be distributed uniformly
throughout the trench.
Perforated pipe to be installed level with perforations down.
• Silt barrier (filter fabric) to be installed above the drain rock.
• Smeared trench sides must be raked or scarified before drain rock placement.
The finish grade must be mounded to promote drainage away from trench.
• Insulation must be placed over any pipe installed under driveways or parking areas.
• Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789,
ABS ASTM D2661,
• Sewer Service Line is minimum 2% slope.
• Septic Tank to be pumped every two years or when required.
Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI/equ
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231234, Curtis Townsend, 09/18/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231234, Curtis Townsend, 09/18/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231234, Curtis Townsend, 09/18/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231234, Curtis Townsend, 09/18/23
ZZOZ/ZO/ZO :3IV0 ,09 = „l :31VOS ZM33V *ON V03
LgZ9-*LZ(L06)
AN 30 IS38 3HI Ol
LO-ZZOZ8:>1008 01313 *LU-ZZOZ :'ON Sof £0966 AV '30VQd0HONV 318VO Amin ab3HaMO nHio � 1tlN01SS3 �
21d
IOZ 'M 03311113b1� M 109 103212100 321V SlIVl3a 213HI0 (INV SNOISN3W10 = v1, . • ,'��bd ��
30N33 a00M o 11V 1VHI ONV NOISIA83dnS 1032110 AN N3aNn
*L8Z-ZZOZ :'ON 'f`021d 21f'8 A8 a3NO3HO 210 3W AG 30Vw A3AHnS V SIN3SMId38 IVId / sP £ZOZ'ZO'9aj'•.
ONVH213/I0 30021 - - - - - - - SIHI IVHI 'V�ISVIV d0 3IV1S 3HI NI ONUl ANnS /a4�.'.J 3N0N66M 'ON
Id 0210JaVb8 ••' �i�',,%
1�9L1MN 01210 VOW Sd/I A8 NMV21a 3NIl 3LL .l3/I21nS-------------- \ aNVI 3OLLOV21d Ol a3SN3011 (INV a32131SIO321 / .......................'..�. 1
IN3W3SV3 � �.11213d021d WV 11VHI �13LL2130 A83213H 'I
00,
A3AmnS .L'11n9-Sd 3NIl 101 1N3OVf aV �t '..'...• •' • • • •' • •. •�
Siida a2118b3aNAH1 1� 4I 'g 5'1 saohmns 3NIl IOl �; w jl ;-T
Hl6�.yc,�
saaauibue a3lSnf aV 1NV89 (o)
clooa3NOLL210dO8d (d) 7 \ `
•1On00Md SIH1 30 NOLLVNVd321d NI S30IA83S NOd 031031100 S33d d0 1NnoWV 3H1 Ol a311Wn al3H (H)
38 IIVHS 21321Vd321d 3HL d0 1N31X3 A LIl18Vll 3H1 '03213A00SI0 SI 3ON3OIl03N SS080 SS3lNn
S1N3W3A021dW1 213HIO NO a3lndwoo (o) ; I ss>, M M0,8� �N `
'321n1on2LLS '30N3d .INV Hsn8V1S3 Ol 03sn 38 ION INNS N0383H 03NIVINOO NOLLVV480JNI a38nSV3W (W) \
3so1�s10 ,IVW �I3Aans (58£—OL IVld) aa003d (a) z 0 1 dvnld \ —
A21VONn08 1N3n03S8nS V 1VHl S31OV21nOOVNI JINV Ol 103f 8nS SI 0NV A3MnS A21V0Nn08 V 1nONV3l0 o ONnONO 3n08V (N H) ,99'61
o 3snOH 3wVdJ
31MLLSNOO ION S300 aNV 03W210d213d SVM .I3ANnS NOLLVOOI 3H1 3WLL 3H1 IV aNnOd 383M o 12101S -3N0 '
IVHI SNOLLIONOO 3H1 d0 NOLLV1N3S38d3N V SI k3A8ns (i -line -SV) NOLLVOOI 30VO1210W SIHl 113M 83IVM QQ N m (8) IN3W3SV3
2IOHONV 388 knO � N � ALlllln ,OZ (21) 99.61
Sa2lV0NV1S k3ANnS NOLLV001 30VOINOW SldSV 3H1 N N I M
HIM 30NVa21000V NI 03NVd3Nd k3ANnS NOLLV301 30VO1210W V SIN3S38d3N ONIMVNCI SiHl 3lOd unLLn w ,0 95 n (`J) .19.61
213I3W 01a03 -13a V= " o \
43HS
ZZOZ cn z to I L LX,o
`SL N380IO0 (INV 'ZZOZ '*1-£l 3Nnf NO a31OnaN0O J�3/�2lnS Z 8313V4SV9 9 ��y " ��\ �o
13S NO aNn03 ONIHION X o I 43HS \
QQ
*N0383H NMOHS ION 38V '1Vld a3GNO0321 lZx,� l
3HI NO NMOHS 3SOHI NVH1 213HI0 '02100321 30 SIN3W3SV3 L ISOd N081 aNno3 0
HV8321 .2/9 aNno3 �v '
Sl10N I ` £98l J3J0
1210
30N3J (100M0M � v
/ Ol 10� GN3933 ,� .s L I N~ I3AVAV21
A030
,Z'L C.L (H) .99'08* 3,69.68S ; I I IIVM ONINIVIlld
(0) ,99'08* M.0t.99.68N
m (W) .*9•Z£9 3.0t.99.68S
/ ....... .............. - I VNN3INV HIM
/ �
, '
1110d I,VIIN
43HS 1
(a) 9ow Mj0.L*s szx Oe 6Z LZ(0) .98x£ M.00lal*s GNno�jO8V
/(�) ss 0s(O
),48S�
•as914=
0
3snoHlno3SnOH3W26lL`Z6
6'oZ,.
,Idois-3No 9101 (0) *Z,L9.LZ�O (0) 3.Sl,L£.ON=B '40 VM3nI�a a3nVd a),00•oclO (0) ZL*OOl=l •40 30V21VO O) 6lZi=1
80 (o) .s9,00.Zs� 6Z X S' -VZ •o 'a.9678 (0).OL'ZB=Ia
NXH),00'OL=N
o� (a),Z£Z11 (0),Z*Zll=l I I a
IVLLN30NVI-NON %1030
Cl
\ s
(0) M.L0,94.89N=8 '43\ \
(0) ,9Z'£9=l •40
W(H) .o0'OL=a—z
(0) .6/-'8Z=1
(a),£o'99 (3),£9's9=1
IVLLN30NVl-NON- -
'J'S 6L5'20 L
� � 101
,6•£L
(8) ,9Z'*9£ 3,69.688
o (0) ,03,9£ 3.9t.£9.68S
3Nd7 SICIVMVd -
w
C
(a),co•*oZ H1aoN I I ' 3AVdO �,�. e�� •dam
(d) .LL'£0Z 3.00'00,00.ON
(21) IN3W3SV3 .IIIILLn ,ozZx I I �,06ti�� �/ ,0£ = „1 :3lVOS
(N)(H),00'01- =21
(a),Zo'6Z (3),60.6Z =l o
_ (0) M.1Z,L*.*LS=B '40 Z • L
(0),1-0'8£=l '40 (a)(H),OWOL =21
11Vl3a 33S J _ (0) .9£,££.1£=v (21)(H) .L*'6 =l
a)(H) ,00'OL=a
(0) .91-'61=1 oe = .L
(21).6 •8£ (0),99'9£=1 31v0S oiHd"D
IVLLN30NVI—NON rmJ
A 0 02 /
& Xu icipalit3ro
825 "L" STREET
ANCHORAGE, ALASKA 99501
(907) 264-4111
GEORGE M. SULLIVAN,
MAYOR
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
December 31, 1980
North Star Construction
Post Office Box 413
Eagle River, Alaska 99577
Permit # 800525
Subject: Lot 5 Thunderbird Falls Subdivision
A permit issued by this department for well and/or sewer
system has expired as of this date.
Permits are issued on a calendar year basis, as stated on
the permit, by authority of Municipal Ordinance.
If you have drilled the well, a well log should be sent
to this department to document the installation date.
If an engineer inspected the installation of the on-site
sewer system, please have them send us the as-builts for
our files.
If there are any further questions, please call this
office at 264-4'120.
Sincerely, / / /~
Senior Environmental ~p~cialist
LNB/ljw
enc: Copy of Permit
SWP/057
PERMIT NO. (
825" STR. EET, RNCHORRGE., BK. 9L Z~i
264-4720
i] ~'-JJ -- __--'-; I TE SEI.~EF' F"ERf'I I -r
8E'~0525 )
RPPLICRNT NORTH STRR CONST. P.O. BOX 4i3 E.R.
LOCBTION EDMONDS LRKE RORD
T~T ~I~E
LEGRL LO HUNDERBIRD FRLLS SUB LOT '- ~
TYPE OF SOIL RBSORPTION SYSTEM IS: DRRINFIELD
688-2394
88800 SQURRE FEET
MRXIMUM NUMBER OF BEDROOMS
SOIL RRTING (SQ FT?BR)= 125
THE REQUIRED SIZE OF THE SOIL RBSORPTION SYSTEM IS:
[:.EPTH= r:~,. 5 LE~'-~"]TH= --~-:5 6RR"'-CEL C..EP-rH,= 4. 5
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE
GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET).
THE TRE[-~CH ;4I[:~TH IS 5. ~30~ FEET.
THE GRBVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE
RND THE BOTTOM OF THE EXCRVRTION (IN FEET).
RE[) SEPT I C TR~-~-'. S I ZE= '-:LO~='~i.Z'i ,]RLLONS
PERMIT RPPLICRNT HFS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE
INSTRLLRTION INSPECTIONS OF ANY WELLS 8DJRCENT TO THIS PROPERTY RND THE
NUMBER OF RESIDENCES THRT THE WELL WIL~ SERYE.
T~41]i (2) Z ~-~_-"5. F'EE:TI~]~-~--'-5-. RRE REQLII ~:E[:.
BRCKFIbLING OF RNY SYSTEM WITHOUT FINRL INSPECTION RND RPPROYRL BY THIS
DEPRRTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTRNCE BETWEEN A WELL RNB RNY ON-SITE SENRGE DISPOSRL SYSTEM IS
±00 FEET FOR R PRIVRTE WELL OR ±50 TO 200 FEET FROM R PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTRNCE FROM R PRIYRTE WELL TO R PRIYRTE SEWER LINE IS 25 FEET RND
TO R COMMUNITY SEWER LINE IS 75 FEET.
OTHER REQUIREMENTS MRY RPPLY. SPECIFICRTIONS 8ND CONSTRUCTION DIBGRRMS RRE
RVRILRBLE TO INSURE PROPER INSTRLLRTION.
PERf4 I T E,'~--'. P I RES D, EG:EMBEF.."
I CERTIFY THRT
i: I 8M FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET
FORTH 8Y THE MUNICIPRLITY OF RNCHORRGE.
2: I WILL INSTRLL THE SYSTEM IN 8CCORDRNCE WITH THE CODES.
3: I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE TH"N ~ BEDROOMS.
R ' ~-NORTH STBR CONST.
ss, , , _ ........... __
Russell Oyster
694-2774
. O & E ENG,NEERING & DEVEL MENT CO.
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
Performed for:
Legal Description: ~ o ':'-'
Depth (feet)
SOIL LOG
Name: ,,/~, ~'~
Mailing Address:
Soil Characteristics
Earl Ellis
688-2280
10__
11__
12__
13__
PLOT PLAN
PERC. TEST
15__
16__
Ground Water Encountered: Yes
Proposed Installation: Seepage Pit
Comments:
No J If yes, what depth_
Drain Field
Performed by:
Date:
MUNICIPALITY OF ANCHORAGE
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. 051-411-17
Legal description THUNDERBIRD FALLS LT 5
Site address 26535 KERRY LOOP Chugiak AK
Current property owner(s) KELLEY
Expiration Date: 2 0 Z
X The On -site system(s) is/are approved for 3 bedrooms
Conditional approval for
Comments or advisories:
bedrooms, with the following stipulations:
Original Certificate Date: 11 /20/2023
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of
Anchorage, Development Services Department (DSD) issues COSAs based upon
representations provided by an independent professional engineer. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
COSA Approval_June 2022
MUMCIPALITY OF ANCHORAGE
Development Services Department I Phone
: 907-343-7904
On -Site Water & Wastewater Section - Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 05141117000
Complete legal description THUNDERBIRD FALLS LT 5
Location (site address) 26535 KERRY LOOP
Current property owner(s) KELLEY LEONARD Day phone 529-9395
2. ON -SITE SYSTEMS SIZED FOR 3 BEDROOMS
3. TYPE OF WATER SUPPLY: ❑® Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ❑ Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: ❑o Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ❑ Steel ❑® Plastic ❑ Concrete ❑ Fiberglass
Age new - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑® Deep Trench ❑ Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: ❑
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On -site staff
to verify the accuracy of the information provided.
COSA Fee $ ZT50 Waiver Fee $
Date of Payment I l y �"zo Z Date of Payment
l i
COSA # 05027, 1 L- L` 1 Waiver #
COSA Application —June 2022
COSA Checklist
Legal Description: THUNDERBIRD FALLS LT 5 Parcel ID: 05141117000
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system _
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled unk Total depth unk ft
Cased to unk ft
❑■ Sanitary seal is functioning correctly
❑■ Wires are properly protected
Casing height (above ground) 18 in.
Date of flow test for COSA 10/3/23
Static water level at beginning of test 17 ft.
Comments
B. TANK DATA
Measured operating fluid level in septic tank na
Date of pumping new
❑ Required maintenance completed, if AWWTS
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed) na-new
❑■ ALL standpipes present per record drawing
Total measured depth from grade 10 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: New Drainfield
Well production at time of test 5+ gpm
Water storage tank volume0 gallons
Well disinfected for coliform test? ❑ Yes ❑■ No
❑■ Coliform bacteria is Negative
Nitrate mg/L ❑■ Nitrate less than MRL (ND)
Arsenic ug/L ❑■ Arsenic less than MRL (ND)
Collected by NRimEng
Date 10/3/23
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments:
Adequacy test date 10/3/23
Results g Pass
Fluid depth prior to test
Water added gal
New fluid depth in
Elapsed time min
Final fluid depth 0 in
in
Absorption rate gpd
FIELD STATUS — POST RECOVERY
Effective depth (per record drawings) 60
Effective depth used 0 in
Effective depth remaining 60 in
in
COSA Checklist June 2022
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if oommu pity well on lot)
SepticTanklLA Station on Lot > 100' Community Sewer ManholelCleanout > 100'
�■ Yes if No ft ❑■ Yes if No ft
Neighboring Tank> 100' EYes if No ft Private Sewer/Septic Line> 25' [C Yes if No ft
Absorption Field on Lot> 100' [■ Yes if No ft Holding Tank > 100' R]Yes if No ft
Neighboring Absorption Fields > 100' Animal Containment > 50' ,�■ Yes it No it
0 Yes if No It
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' MYes if No ft ■ Yes if No ft
❑ N/A— Served by Community Well (net 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'
■-1 Yes
if No
ft
Surface Water > 100'
■❑ Yes if No It
Tank to Property Line> 5'
❑■ Yes
if No
ft
WelIs on Adjacent Lots:
Field to Property Line > 10'
K Yes
if No
ft
Private Wells > 100'
0 Yes if No ft
Water Main > 10'
❑■ Yes
if No
ft
community Wells > 200'
Q Yes if No ft
Wafer Service Line > 10'
■0 Yes
it No
ft
If lank or field is under driveway comment below
F. ENGINEER'S COMMENTS
G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal nffixed hereto and as of t he va I i dation date shown below, I verify that my investigntion, based
on procedures outlined in the Certificate of ()n-Site Systems ApprovnI Guidelines, indicates that the on -site water
supply and/or wastewater disposal system nppenrs to comply with npplicnble Municipnl and Stnte codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise_
Name of Firm NorthRimm Engineering
Phone 694-7028
Engineer's Printed Name Steve Eng Fate
COA Checklist June 2022
11/9/23
Aw
OFAV
-49TH*
0 Steve Eng
��• GE-6256 �=
1