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Home My WebLink AboutSUNDI LAKE BLK 1 LT 16Aundi Lake Block 1 Lot 16A #011-131-44 I MuniciP ality of Anchorage Page 1 of 3 i Development Services Department i On-site Water and wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SWO50359 PID Number. 011.131-44 1 Wastewater System: New :helsohn and Daughter 0414 J W. Dimond Blvd. Anchorage, AK 99515 ABSORPTION FIELD a��^e Deep Trench i I 5223375 Five 5 sa+Rewv Tar Degn ham aprW yeas LEGAL DESCRIPTION .8 GPD/Ft' 11 1 Ft. Depth b Pae hmtmn kc- W" eras GM O.M breath PM Bbal Lal 1 t (o Sundi Lake 3 Ft. 8 I Ft TOewwtep Range Seam fil edaea Ove rptrVeae C+ew LrWt. 1.3 FL 60 n. Gravel a R,ror a Mnp arra OaU.een rw Well: New 3 Ft. ClsseOrasm Ipmre, A, S. ck Tar Degh, CsesO b a1r ehvgAttt raa 960 Fr iae MWrel ASTM 3034 PVC Private 482 Ft. 482 FL DrDrs OreW Stria Wrr leer 10112.1312005 AI ine Drillin 4122106 40 FL --"—Regnt Cat's Eye Yrs Fanosr.l 'SOY Gina >1.5 TANK 1 50 cow Ft. Ft SEPARATION DISTANCES El Septic ❑ Holding ❑ S.T.E.P. ❑ Olher. To Septic Absorption lift Holding Anchoro a Tank 9 1,500 Frtxn Tank Field Statlon Tank Sewer tine >100, >100' NIA NIA >25' Steel Two (2) wef NIA NIA LIFT STATION — NONE ON LOT S,et.c wre, >100' >100' Lav» >5' >10' NIA NIA Gr a m >5' >10' NIA NIA in in I k FarMreh P,ntp weAs a waw iew,ra� heFedtre ortrmw hr cat.not.n None Noted Rrarh. BENCH MARK Garage Slab I 100.0 FL I Engineees Stamp Inspections performed by: AH Dates: 1r 10112105 2nd 10113/05 Department of Health and Human Services approval Reviewed and approved by: CfJ / o Date: S Z 9)- O (e tom) l/ ,a_tr e♦ t , 4</ 49th `1 V C-iACL E! ANDERSON Permit No. SM50359 Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage. AK 99519-6655 -343-7904 Onsite Wastewater Disposal System or Well Inspection Report W. 80TH AVE o a S89'56'18"W 110.01'M 30' 10' UnLf1Y EASEMENT r_________________ 1 I 1 I 1 LLI Q 1 O 1 CO 1 1 I er ]re IT W � ru us wv ZI O 1 roceea oo i a "r my (n b cs Ivv o N 1 I 1 I 1 �i1 O. $ �. 'i _i �TH2 LOT 15 I....... W� LOT 16A 10 n W LOT 16B SUNDI LAKE LOT 16a, �81'18'10•E 120.85' SUNDI LAKE PLAN AS -BUIL SCALE 1' - 60' Page 3 of 3 PID No. 011-131-44 SUBDIVISION BLOCK 1 57.203 S.F. :� L ANDERSON Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-0655 - 343-7904 Onsite Wastewater Disposal System or Well Inspection Report Permit Number. SW040199 Y THI Cu f I Page 3 of 3 PID No. 015-054-20 PROFILE AS -BUILT No Scale FROM : ALPINE MILLING i FWS�S O2 Play, 02 2006 12:31PM P1 ALPINE DRILLING & ENTERPRISES Parcel Identification Number. 0 -131-4 ^ za; wed peloaation7 l� Yoe ❑ No Permit Number: `� b-9 #SW Dmp etate ed' 4- Ilene 2-0 is well located at appto rmtt Date Started: t-1� Date Comp n ' Oko BW 1 ftl �9 ycgal pescrtption: (yliohelsohn & Daugh Yropert9 Owner Name de Address: 750 W Dimond SNB. ��org - Alaska 9951I 5 cable tool DriOing ® air rotary 1111111111 1111:11:11 1:=: 1111=1 Depth (n) Method of gorebole Data: Soil Typa'Lbi venter sono From To Casing type: Wall Tlrio]mess: •250 inches 0inches 1.5 Diameter: ¢ Depth: Meet stick-up sandy siltUner 1.5 21 21 57 TY1Pr D�dy feet inches silty sand - 57 65 Diann ung stickup above grommet: !,¢feet gravelly sttity sand 05 ! 81Static water level (froand level)::Mfeet gravelly sandy silt 181 1 pumping level:�5 om af= sandy gravelly silt H2O 165 191 g hours pumPing 50+EPm sr7ty grave! 191 303 ecery Rate: 50+ Orn Rov Clay 305 Method of Tenting: irl gravelly Clay 303 323 well Int sko Opening Type: smy sandy grave► 305 345 ® Open End ❑ Open Hole feet feet Stopped afftY gravel 323 345 436 E] Screened S� fcct [3porforstinns Start feet Stopped day 4305 Grout bcWPntr� ' es I Volame: l gravelly Clay 445 470 Depth Start 0 feet Stopped 2 fast sllfy 52nd 470 479 pump: Intake Depth 'feet gravelly day wafer sand & gradWell 478 482 Pam size 13raadName Upon Completion? ❑ yes ❑ Ho D[sinfocted Method of Disinfection: chlori Comments: & Enterprises Well Driller. po BoD»0496 City 99511 Zip idO a well tog to the propeM owner vrithia 30 days of completion and the propetry The well drilla shall t services Dep=tMCat within 60 days of completion.. Dcvelopmen — Attention. ilx� It log to the owner cr the well driller shall Prow Received iiar02-05 10:55 PrwOOT 343 0202 To MICHELSOHN t DAUGM Pus Ol • MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water B Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Date Issued: Sep 20, 2005 Expiration Date: Sep 20, 2006 Permit Number: SWO50359 Parcel ID: 011-131-44 Legal Description: SUNDI LAKE SUBDIVISION BLOCK 1 LOT 16A Design Engineer: 0014 Anderson Engineering Site Address: 4733 SUNDI DRIVE Owner Name: MICHELSOHN & DAUGHTER Lot Size: 57203 SO. FT. Owner Address: 750 W. DIMOND BLVD Total Bedrooms: 5 Permit Bedrooms: 5 ANCHORAGE. AK 99515 - This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑✓ 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: �S Date: Municipality of Anchorage Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 South Bragaw St P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ek.us (907) 343-7904 ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 011.131.44 Permit Number SW Property owner(s) Michelsohn and Daughter Day phone 522.3375 Mailing address (1) 750 W. Dimond Blvd. Anchorage, AK 99515 Mailing address (2) 4733 Sundi Drive Zip Code Legal description (Lot, Block & Sub'd.) Lot 16A, Block 1. Sundi Lake Subdivision Legal description (Section, Township & Range) Lot Size 57,203 SF Acres/Sq.Ft. THIS APPLICATION IS FOR: Number of Bedrooms Five (5) Sewer Only ❑ Well Only ❑ Sewer and Well ® Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and Is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: _'1(r0 -f- 2175(0 -CL -4i Waiver Fees: Date of Payment 9 / --5 Date of Payment Receipt Number. LIP Receipt Number. (Rev. 12/00) AND SON,`? N l EKING. �p��. ��Q '7 0 _A9; f " 8524 5224 ' 522 T79'�%1X September 14, 2005 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 16A, Block 1, Sundi Lake Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 16A, Block 1, Sundi Lake Subdivision intends to construct a new five - bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new well and septic system to accommodate the home. The attached Site Plan and backup documentation identify the location and configuration of the new well and the proposed septic system along with the alternate site. Also identified on the plans are the locations of the existing wells on adjacent lots in the subdivision. No conflicts exist between the proposed well and septic system and those on adjacent lots. Test holes were recently placed on the lot in the area of the absorption trench and alternate site, which indicated a silty sand (SM) material.. The percolation rate of the materials was determined to be 14 minutes per inch. No groundwater was found during the placement of the test holes and none was noted during the monitoring period. Test holes placed during the subdivision of this lot indicate similar results with percolation rates of 2.5 and 10 minutes per inch. An application rate of .8 gallons per day per square foot was used in the design of the absorption system. We are proposing to - - ----place-a-new -1;500-gallon septic tank -and -a-60' long -by -T-wide by 8' effective depth absorption trench to treat and dispose the effluent generated in the house. The elevation of the distribution line in the absorption trench will be 3' below the surface and the total depth will be 11'. A minimum of 3' of fill will be placed over the absorption trenches and 4' over the septic tank. The ground surface on the lot in the area of the septic system is nearly flat. The new trench will be constructed parallel with the slope as much as possible in conformance with Municipal requirements. The new septic system will be constructed a minimum of 100' from the proposed and existing wells and any surface water in the area. Lot 16A, Block 1, Sundi Lake September 14, 2005 Page Two If the system is constructed in accordance with our design the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, n %� Michael E. Anderson, P.E. Attachments 49th !` :. ANDERSON DE -4381 .. O FOUND LOT 15 • Exlatinq Wall �?...•49t . �.... . • �.... .. ,A%H10iAM E. ANDERSON W. BOTH AVE 0 0 V) S89'56'18•W 110.01' n 30' 1 10' UTUTY EASEMENT L J 1113 217 LOT 16A 1 AllamoG Site 1 �x 50, In Ic ani IYLS ` 11 1 12 I�1Ma Badrooi /ll Houas �Propooaad Wall s/s• ss SUNDI LAKE ;t ro vi co M e Exiatinq Wall FOILM* 2 NUMENT ALUM. MONUMENT 11 SITE PLAN SCALE V = 60' LOT 16A, BLOCK 1, SUNDI LAKE SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Five Bedroom Duplex Deep Trench System Perc. Rate: 6 to 15 Min./Inch 1,500 Gallon Septic Tank Application Rate: .8 GPD/SF 8' Drainfield Rock 5 Bedrooms X 150 GPDL8 GPD/SF (Application Rate) = 937.5 SF Absorption Area 937.5 SF/16 SF/LF= 58.6 LF Trench Length THEREFORE: Construct a Deep Trench 60' Long x 3' Wide x 8' Effective Depth. Flow Line Elevation In Trench to be 3' Below Original Ground Surface. Total Depth to be 11' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption Trench. 26 Natural Backfill Geotextile Fabric 6 I U_ 4" Perforated t PVC (Notes Down) 8'0" 1 I— Drainfield Rock 3' TYPICAL DEEP TRENCH SECTIO' (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 4' Separation From Groundwater. Minimum 100' Separation From Wells In the Area. Minimum 100' Separation From Surface Water or Streams: Municipality of Anchorage doQ " T. Development Services Department •� ' Building Safety Division* y�. On-SAeWater and Wastewater Program �`'� .Q918 „•, ,,,, .. ....... ' 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 • • •• • ••••••••• .••.� �AVCHAEL E. ANDERSON.�� www.El.anchoreoe.ek.ys• (907) 343.79D4I r• °'iJ, :• ' CE -4301 �r 7X1 O"7 Soils Log - Percolation Test p �N*V Performed For. mieheisohn & Daughter Construction Date Performed: Legal Description: Sunda Lake Subd, Lot 16A, Blk 1 Township. Range, Section: Slooe _ Site Plan Depth I .p(r 4- 5- 6- 7- B- 9- 10- 11- 12- 13- 14- 15 - 17- 19 - COMMENTS M IX SM WAS GROUND WATER ENCOUNTERED? - Date IFYES,ATWHAT DEPTH? - E E Depth to Water After,, Monhoring? 11 ��.��• ��/��I��`�uuyyyy..��,,,,,, N E • Date: -7.19 - 7X1 O"7 Reading . - Date Gross Tens ` . Net Tune Depth to Water Net Drop -7.19 - % 71 3 7.L S _I 10 .3o B.l u _t7't5� PERCOLATION RATE .,al PERC HOLE DLKMETER —77_ TEST RUN BETWEEN_ FT 'AND 'rj,o FT , E r PERFORMED BY: /44— I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Municipality of Anchorage Development Services Department Building Safety Division y� On -She Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ct anchoraae. sk.us (907) 343.7904 Soils Log - Percola.tlon Test Performed For. Micheltsohn & Daughter Construction .—Date Performed: t5 P Legal Deisedplion: Sundl Lake Subd, Lot 16A, 81k 1- Township, Range, Section: Slope She Plan eo Li rA V/ S" . 7- 10- V AYIt� 12- 13- 14- 15- 16- 17- =18- - - 18 20-- COMMENTS h• er, rAV14Y z =3� WAS GROUND WATER ` ENCOUNTERED?� Net Tune Depth to Wale r •--i .•—, IF YES, AT WHAT DEPTH? IJ0.�1[4~ 0.0 :t,, Depth to Water Attu S,r 9 ' Monhortng? Date: E l r o,slo 2.31 Reading . •• Dale Gross Time Net Tune Depth to Wale r Net Drop a of :t,, ! S,r 9 ' o,slo 2.31 114 1 2S PERCOLATION RATE (mwe4a✓ Ch) PERC HOLE DIAMETER TEST RUN BETWEEN. FT 'AND -4.7 FT PERFORMED BY: �� I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: i i TN ul Ro A Municipality DEPARTMENT OF HEALTH & HUMAN 6 HUMAN SERVI( 625 'V Street. Anchorage, Alaska 99502-065( SOILS LOG — PERCOLATION TEST PERFORMED FOR: W Ar1.?I w. .1�✓�I LEGAL DESCRIPTION:1x4 I ts, Z""aU L�6.F Township. Range, Section: 1 3 Ms 4 6 , 8 7 8 9 10 11 12 13 14 15 16 il "'Ja6T�tom 01= RtouE 17 19 20 COMMENTS WAS GROUND WATER A ENCOUNTERED) 1�L� S IF YES. AT WHAT L DEPTH? O P E Otp1h to WMtr Alu 1lenitDrtng? =Asalt 11 L Reedin8 Date Gross Not Depth to Net Time Time Wear Drop PERCOLATION RATE jC.J F1 Iminutes4neh) P CHOLE DIAMETER TEST RUN BETWEEN --7— FT AND 7FT PERFORMED BY: - T'S 1 TI -2;1 CERTIFY^,THHAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE: — G.rTl �-i /? 9 Z 72-M (nev. 4ro5) b Munlclpallly of Anchorage O DEPARTMENT OF HEALTH S HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 A J 1S0IILLS LOG — PERCOLATION TEST PERFORMED FOR: Mp1d,IL Lli—�a DATE PERFORM ED:_!f/lfo 122-z— LEGAL 1 2 3 s 1 &Z I� 4 , M� RECEIVED s 6 FEB b 1993 1 M e punlcipahly of Anchc OeL Health d Human S 8 9 Range, Section: 10 WASGFIOUNDWATER ENCOUNTERED? _ Nb 11 a IF YES, AT WHAT L 12 DEPTH? f E 13 Depth is Weu?Ana ManauNp7 D+IK 14 ` ReadingI Tim Date G,oiNet Depth to Net Time Water OroP 16 0l o N a i6 ..e _ — _ 17 18 19 20 PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER —>rL TEST RUN BETWEEN �/L FT AND -/.SFT COMMENTS PERFORMED BY: — 1 �j CERTIFY THAT THIS TEST WASPERFORMEDIN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: I q, 72.00a (Rev. 4/85) I ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 16A, BLOCK 1, SUNDI LAKE SUBDIVISION GENERAL: 1. The scope of this project includes the procurement and placement of a new 1,500 -gallon septic tank at the location shown on the Site Plan. Work also Includes the construction of a new 60' long X 3' wide X 8' effective depth absorption trench at the location also shown on the Site Plan. The distribution line in the trench will be placed at 3' below the existing ground surface. Total depth of the trench will be 11' below the existing ground surface. The new absorption trench and septic tank must be placed a minimum of 100' from the well on this lot and in the area and 10' from the water service line proposed for the lot. A minimum of 100' must separate any surface water in the area and the septic tank and absorption trench. A minimum of 3' of cover is required over the absorption trench and 4' of cover over the septic tank. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. The Contractor must also verify the location of wells in the area and assure that the separation distances are met. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from ----D.H.H.S. before beginning system -installation. – - — ------ -- SEPTIC TANK INSTALLATION A new 1,500 -gallon septic tank must be procured from an approved source and installed at the location shown. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. Lot 16A, Block 1, Sundi Lake September 14, 2005 Page 2 of 3 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. 5. Contractor shall verify the septic tank and drainfield area minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth Is available. Finish grade over the trench must be mounded to prevent settlement or depressions._______ _ 7. Grade area surrounding the absorption trench to drain away. 8. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. Lot 16A, Block 1, Sundi Lake September 14, 2005 Page 3 of 3 MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection.._ Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. 1;__C Lme Municipality of Anchorage Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 Bragaw Street. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 011-131-44 1. GENERAL INFORMATION Complete legal description COSA # bieDL I a I Expiration Date: %— Q — O Lot (4K Block 1. Sundi Lake Subdivision Location (site address) 4733 Sundi Drive Anchorage, AK Current Property owner(s) Michelsohn and Daughter Day phone 522-3375 Mailing address 750 W. Dimond Blvd. Anchorage, AK 99515 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address I Unless otherwise requested, COSA will be held by DSD for pickup. Z NUMBER OF BEDROOMS: Five (5) 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER urarUSAL; Individual Well Q Individual Water Storage Individual On-site ❑ g ❑ Individual Holding Tank 0 Community Class Well 0 Community On-sfte 0 Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of OnSfte' Systems Approval (COSA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of OnSfte Systems 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 COSAs upon request to homeowners. Certificates of OnSfte Systems'ApprovaI 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 sample results. (Certificates may be reissued for a period of up to one year with samples.) Certificates are valid for one year for properties served by Class A or B wells or a pvalid water ublic 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 certified by my seat affixed hereto and as of the valiidaUon date shown below, I verify that my investigation, based on procedures outlined in the Certificate of Onsite 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(am) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage. AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 5. DSD SIGNATURE _Izo� Approved for bedrooms. Disapproved. Date 821/2006 Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineers Report ' Other By it/. Original Certificate Date: rn.r 11usr MnnicipRWY of Anchorage ' Development Services Department Building Safety Division On-site Water 6 Wastewater Program 4700 Bmgaw Street P.O. Box 196650 Anchorage, AK 995194;650 wwmmuni.org/onske (907) 343.7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHI Legal Deaa00a: Lot 1K Nock 1. Sundt take Subdivision Parcel A. WELL DATA Web type Private If A, B, or C provide PWSID 0 _ Date completed L== San" seal (YIN) Y TOW depth 492 R Cased to 4R fL FROM WELL LOG Date of test 4/22108 Static water l" 40 h Web production 5o g.p.m. WATER SAMPLE RESULTS: Cdtform 0 colceies1100 mL Nitrate NID ffq#L Arsenio: WD mgA Date of sample: 811!08 B. SEPTIWHOLDING TANK DATA Tank Tvp&uatertal SeptldSteei Tank site 1.500 gaL Number of Campartmants 2 Foundation cleanW (Yl M Y Depression over tank (YM) N Date of pumping New CwzMxdm Pumper Web Log ndn Y Wires prop" protected (YIN) Y Casing height (above ground) 1$ in. AT INSPECTION R g.p.m. Other bactene 2 coloaleal100 mL Collected by: J. Anderson ! Date installed 1QM212W5 I Cleanouts (YM) Y High water alarm (YM) N C. ABSORPTION FIELD DATA Date installed 10113105 Sob rating (g.p.d.M' or italbdrm) .8 GPDISF System type Deep Trermctm Length 60 fL Wdlo 3 g• Gravel below pipe a 1 IL Total depth 12.14 R Eff. absorption area eN fe MoniWM tube Y Depression over field N Date of adequacy test New Const. Results (PasslFail) For _ bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. wed Timmmin. Float Atdd depth in. Absorption rate >= 9 n d Any rejuvenation treatment (past 12 mo.) (YM &type) K ym give date D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) 'Pump on' level at _ in. `Pump air level at _ in. High water alarm level at in. Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankllift station on lot >1W Meet alarm & await repubemenfs'1 On adjacent lots >11V Absorption field on lot >100 On adjacent kits Public sewer main WA Sewer /septic service fine >29 Animal containment areas None >1W Public sewer manhole/deanout WA Holding tank WA ManureJanknal excrete storage areas Now SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation >S Property line >9 Absorption field >i(r Water main >Icr Wells on adjacent lots >iW Water service line >te' Surface water >1W SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property Inc >19 Building foundation >IW Water main >I(r Water Service fine >1(1' Surface water >1w qty. pailtinghffililde storage >2n Curtain drain None Noted Wells on adjacentlint >1 W F. COMMENTS: G. ENGINEER'S CERTIFICATION I certify that I 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. Engineer's Printed Name Michael E. Anderson, P.E. .rr COSA Fee $ �? - SQ Waiver Fee $ _ Date of Payment V oi?,O Date of Payment Receipt Number 0 5b �361 Receipt Number (Rev. I Ift) C ww� SCS Ref.X Client Name Project Name/X Client Sample ID histris 1064370001 Andlvson Engineering L16A I) I Sundi Lakc Sub LI6A DI Sundi Lakc Sub Drinking Watcr All Dates/rimes are Alaska Standard Time Printed DalelTime 08/11/20(16 8:27 Collected Date/fline 08/01/2006 12:40 Received Date/time 08/01/2006 12:55 Technical Director Stephen C. Ede Sample Remarks: Parameter Results PQL Units Method Allowable Container ID Limits Prep Analysis Date Date Inil Metals by ICP/MS Arxnic ND 5.00 ug/L EP200.8 C (<10) 08/03/06 08/07/06 M11 Waters Department Nitrate -N ND 0.100 mg/L EPA 353.2 D (<10) I 08/02/06 ALR Microbiology Laboratory Total Coliform Qon. NoColi coVI00mL SM209222D A (<I) i 08/01/06 TLF o. LOT 15 Legal Description: 30' W. 80TH AVE 0 0 r1 S89'56'18"W 110.01' M 10' UTILITY EASEMENT ------------------------ 1 I 1 I I I I Q1 I 0 L I (D 1 1 C o o O 1 o 0 V) N � I i I I INO. I I I I I I --- zo' UIL EXISTING S BUILDING LOT 16A The ,VmWn of the *UCture(s) as shown on this record dmwlni (as -bulk) oompHOS with Title 21 co By. Go tate: 8 L O 2 -' 'W Iv t 120.85' SUNDI LAKE NOTE: THIS DRAWING IS NOT TO BE MODIFIED FOR USE AS A PLOT PLAN. Lot 16A, Sundi Lake Subdivision LAND dt CONSTRUCTION SURVEYORS—PLANNERS—ENGINEERS 440 West Benson Boulevard, Suite 200 Phone: 526-5291 —6626 Anchorage, Alaska 99503 Plat: 93-133 Grid: 2224 Work Order. 2005—W-2841Fb/Pg: 666/29 ordered B,<Paul Michelsohn, Michelsohn ona uaul g M Septic Slondpipe QS Water Well Fence —X—X— has a physical property0, shown an lh�draowing and certifies that the Improvements situated thereon we within the property lines and no enoroachmenls esist other than noted. exine the IaM��ce o Many easementsTE: It Is , covenants,e ownwe restrictions for righorl'—naf—way takings which do not opPeor on the recorded subdivision plot. Under no circumstances Mould any data hereon be used far construction, for establishing property Ihes, or for Piot—pian purposes. 08/15/06 IDrown By I NRB By. APH