HomeMy WebLinkAboutLYNN DALE LT 3ALynn bale
Lot 3A
#015 - 273 - 73
Municipality of Anchorage
On -Site Water and Wastewater Program - (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP161338 PID Number: 015-273-73
Dwelling: 0 Single Family (SF) M Duplex (D) 17� Multiple (SF and/or D) Project: F -I New Upgrade
Kari Ryerson
ABSORPTION FIELD
Z Deep Trench F-1 Shallow Trench El Bed F-1 Mound
Address
11000 Zelma Circle, Anchorage, AK 99507
El Other
Phone
Number of Bedrooms
Soil Rating
depth from original grade
ITotal
LEGAL DESCRIPTION
Depth to pipe invert from original grade
2.98 Ft.
Gravel depth beneath pipe
6.02 Ft.
Subdivision Block Lot
Lynn Dale 3A
Fill added above original grade
Varies 1.27 — 2.75 Ft.
Gravel length
(2 x 321) 64 Ft.
Township Range Section
Gravel width
2.5 Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION
DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
770 Ft'
2
10 Ft.
Well
100+
100'+
100'+
NA
NA
TANK Z Septic El S,T.E.P. El Holding El Other
ANCHORAGE TANK
1 2000 Gal.
Surface Water
100'+
100'+
100'+
NA
Material
Number of compartments
NA
Foundation
5)+
10'+
5'+
NA
TIFT STATION
Manufacturer
Capacity
I
Curtain Drain
I NA
50'+
NA
NA
Remarks *None known. Existing field left in place
Pump on level at
in.
Pump off level at
in.
High water alarm at
in.
as CAT III reserve per permitted des�gn,
S.T. & service line insulated.
Pump make and model
Electrical Insp ctions performed by
Tank to 3034
Drainfield 3034 CO/MT 3034
Inspector ARCTERRA
BENCHMARK (Assumed elevation) 100 ft
Inspection l't 7/28/17
Location and description
,�d7/28/17
31d 7/31/17 4 U,
Bottom of siding
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
Engin
Conditional Approval: Date
TH
go
7116
Approved Date
I
eer's Stamp
moponUonRepurt-9-1-12.doc
AS -BUILT SYSTEM DETAILS/SITE PLAN Permit OSP161338
LYNN DALE LOT 3A PID# 015-273-73
x
LX-X-Xj
W
0
bo GREENHOUSE
ORIG.FIELD CAT III RESERVE
48.2' SPLITTE CO F
NEW M
000 -GAL 0(\
SEP TANK T
c
12.0' CO
C
H CO
Co Q G
IVIT
C I MT
Co TO
30.5' ORIG. C j
FIELD ST HOLE
3E BARN/ NOT
rn
-ORAGE CONNECTED
FC
86.0' BMI
EXISTING
P, LOT 3A
6 -BR HOUSE
42.o'
PD
44.0' q SCALEi V 30'
0
A- =25,5'
MON
B -C=51.5' FINAL GRADE
A -D=37.5' —nn— , (Rga�
MTM FABRIC',,"",
'w
-B-D=62.0' I UM"TION v I ARMS ORIGINAL GRADE
5 ov
q'i A -E=72.0 (4 2000 GAL
cu TANK T
E3 79
0. —2,7795
<' B -E=90.5' cu SEPTIC
K) SEWER ROCK
A -F=89,5'
B -F=107,5' TRENCH 1
94.3 94,15
A-Cj=98,0'
32'
c B -G=110,0' TOR TUBE MONITOR TUBE
> FINAL GRADE
97.6
A -H=96.0' n
B -H=108,5/ SCALEi NTS MTER FABRW'\",,\ V I ARES
9' A -I=79.5'
B -I=92,0' 9 2=7 2
A -J=78,0'
T
B-J=90V SEWER ROCK 6w
TRENCH 2 KI Gr4a vM
uj
cn 32'
Js Ado,, SCALEi NTS
A, k"� ()F
_j .4
_j PREPARED FOR: E
or
KARI RYERSON
�_'�CT
r 61
11000 ZELMA CIR,
ANCHORAGE, AK 99507
ol CQ TH*
FIELD BOOKS COMPUTED:
0 KENNETH M. D�;a
V)
CE -7116 BOUNDARY- N A DRAWN: Bmw
ip, STAKING: CHECKED:
SLS KIVID
7' Ao
ASSUILT., SLS DATE: 08/21/17
ID '�?onsslo"I" -dir
E Dwc, nLF_ GRID: NW1562
M No-* "�"Po'�'81JLTING gr.
ACAD "LE' FILE 17-178 AK. 995-n
o RITE&,,,
ARcTERRA
CONSULTINCr, INC
212 E. 51" Ave, Anchorage, AK. 99503
Office (907) 868-3791, Fax (907) 868-3793
4 �0HSuITING
Cq �K..5]'1-5�
'F KENNETH Mt AMUS w
SOILS PERCOLATION TEST, rt, s Af
s
Performed for: Kari Ryerson Date Performed: 7/27/2017
Project: Lynn Dale Lot 3 TEST HOLE # TH 17-1
Depth
Feet SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
1 m Org/OL - SM
Was Ground water encountered? NO What depth? NA
2
SP/GP Depth to water after monitoring? NA Date? NA
3
4
PERC BENCH
5-
6-
7-
8-
9-
10-
11-
12-
1.3-
14-
15-
16-
17-
18-
19-
HOLE PRESOAKED
20- PRIOR TO TEST
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
1
7/27/17
1:00
-
6"
-
2
1:10
10 min
1 12/16"
44/16"
3
*
1:11
-
6"
-
4
1:21
10 min
1 13/16"
4 3/16"
5
1:22
-
6"
-
6
1:32
10 min
1 14/16"
4 2/16"
7
*
1:33
-
6"
-
8
1:43
10 min
1 15/16"
4 1/16"
9
1:44
-
6"
-
10
1:54
10 min
1 15/16"
4 1/16"
11
1:55
-
6"
-
12
2:05
10 min
1 14/16"
4 2/16"
Water
Added
Percolation Rate 2.4 (min/in) Perc Hole Diameter 6"
Test Run Between 4 feet and 5 feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State
and Municipal guidelines in effect on this date.
On -Site Wastewater Disposal System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number: OSP161338
Tax Code Number: 01527373000
Work Type: Septic Upgrade
Permit Effective Dates: December 13, 2016 to December 13, 2017
Design Engineer: PANNONE ENGINEERING SERVICES
Subdivision: LYNN DALE
Site Legal Address: LYNN DALE LT 3A G:2635
Owner/Address: RYERSON IAN M & KARI
11000 ZELMA CIRCLE ANCHORAGE AK 995160000
Site Mailing Address: 11000 ZELMA CIR, Anchorage
This permit is for the construction of:
Lot Size in Sq Ft:
Total Bedrooms:
cnr
ail
)JC���U•CI'I1C'llr
71816
.'y 0
Y Disposal Field I Septic Tank N Holding Tank N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Special Provisions: At time of construction, 12 inches of clean water will be added to the
percolation hole (twice). If it seeps away within 10 minutes, construction may begin immediately.
If the 12 inches of water does not seep away in 10 minutes, a percolation test will be ran
continuously until two consecutive water drop readings are within 1/16th of an inch. All readings
shall be recorded and submitted to MOA Onsite. MOA is to be notified 2 hours prior to conducting
this test.
Receive
ate
Issued By: k&010A "S Date
f� C
la 12nar-
3 ko
Municipality of Anchorage
On -Site Water and Wastewater Program
r
(907) 343-7904 s At T
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 015-273-73 Expiration Date:
1. GENERAL INFORMATION
Complete legal description LYNN DALE LOT 3A
Location (site address) 11000 ZELMA CIRCLE, ANCHORAGE, AK 99507
Current Property owner(s) KARL RYERSON
Mailing address
Real Estate Agent
509 LOCUST STREET, RENO, NV 89502
2. TYPE OF DWELLING:
Z Single Family (w/wo ADU)
0 Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
Day phone
3. NUMBER OF BEDROOMS:
6
TYPE OF WASTEWATER DISPOSAL:
4. TYPE OF WATER SUPPLY:
Individual
1Z
Individual Well
Holding Tank
D
Individual Water Storage
El
Community
D
Community Class_ Well
El
Public Sewer
❑
Public Water System
1-1
WaiverNariance request for: Distance:
Received by:
COSA to be released to the engineer,
otherwise requested by the engineer.
Date: A,_ / /
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.
Name of Firm ARCTER.RA CONSULTING INC. Phone 868-3791
Address 20441 PTARMIGAN BLVD., EAGLE RIVER AK 99577
Engineer's Printed Name KENNETH M. DUFFUS Date 8/22/2017
WITH THIS COSA ARE PAID IN FULL AT OR BEFORE CLOSING. Engineers Comments: This investigation was completed in compliance with
ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested.
The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use,
local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the
system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the
control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function
satisfactory for current or future occupants or can ArcTerra guarantee that no unseen
encroachments, deficiencies or discrepancies exist.
t
6. DSD SIGNATURE ,4 9TI1 f
a
System #1 Approved for �_ bedrooms.
System #2 Approved for bedrooms.
Disapproved.
Conditional approval for bedrooms,
s I NTETH M. DU fof
'c (116 cyq
n�PEss 0
with the following stipulations:
WATER AND
VMSTEWA I
Pr,nGRAz. s
By: Original Certificate Date: la/90/17_
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 blue sheet 10-10-12.doc
Legal Description: LYNN DALE LOT
A. WELL DATA
Kmore than 1septic system isonthe lot:
CD8AChecklist #u__
Structure served by this system
Parcel |D: 015 -273 -
Well type PRVT
M6-273
VVel|type{lyT |fA`B.orCprovide PVVS|D#Well Log (YYN)
Date completed 7/2611{03 Sanitary seal (Y/N)Y Wires properly protected (YYN)y
Total depth _i61 ft. Cased ho_161ft. Casing height (above ground) _12±in.
FROM WELL LOG AT INSPECTION
Date oftest 712611983
Static water level 151 ft.
Well production 10 g -p -m-
Co0bnn NEG colonies/100mL Nitrate 2.85 mg/L
Arsenic: ND ug/L Date ofsample: 1B880YT
TonkType/Nabshn| SEPTIC I STEEL
Tank size 2000 gal. Number ofCompartments 2
Foundation cleanout (Y/N) Y Depression over tank (Y/N)
Date of pumping NA - NEW TANK Pumper
C. ABSORPTION FIELD DATA
8-8-2017
140 ft.
g.p.m.
Collected by: ARCTERRA
Date installed 7/28/1
Clemnouts (Y7N)
High water alarm (Y/N) N
Dote installed 7128117 Soil rating (o4d mc or*c»`arn) 1.2System type DEEP TRENCH
Length ft Width 2.5 ft. Gravel below pipe _6lC2ft.
Total depth 10.27+ ft. (Measured 8/8/17) Eff.absorption area 7r»*u Monitoring tube y Depression over field N
Date ofadequacy test Results (Paea/Fai|)___ For bedrooms
Fluid depth inabsorption field before test in. Water added____gal. New depth___in.
Elapsed Time: min. Final fluid depth ___in. Absorption rate >=g.p-d-
Anynejuvenationtnsotment(pasi12mn.)(Y7N&type) N |fyes, give date________
D. LIFT STATION
Date installed
"Pump on" level atin.
Datum
E. SEPARATION DISTANCES
WELL ONLOT TO:
Septic tank/lift station onlot
Absorption field onlot
Public sewer main
Size ingallons
________
"Pump off'leveu\in.
Cycles tested
M(Y/N)_
High water alarm level at
Meets alarm & circuit requirements?
On adjacent lots
Onadjacent lots
Pub|icsewer manhole/cleanout 100'+
Sewer /septic service line Holding tank
Aohna| containment areas Manure/animal excrete storage areas
SEPTIC/HOLDING TANK ONLOT TO:
Building foundation Property line _f/± Absorption field
Water main 10'+ Water service line 101+ Surface water 100'+
Wells onadjacent lots _iO0'+_-__-
ABSORPTION FIELD ONLOT TO:
in.
Property line Building foundation _t8'+Water main
Water Service line _1O'+Surface water Ddvowey.padkingkmhicle storage 10'+
Curtain drain. Wells onadjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
/ certify that /have determined through field inspections and
review of Municipal records that the above systems are in conformance
with MOA C0&4guidelines ineffect onthis date. OF A - -v4
41
Engineer's Printed Name - KENNETH M. DUFFUS
Date ' +
COGAcanary sheet 2-6'15.do
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Municipality of Anchorage
On-Site Water and Wastewater Program
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 015-273-73
Expiration Date:
1. GENERAL INFORMATION
Complete legal description Lynn Dale Lt3A
Location (site address) 11000 Zelma Cir., Anchorage Ak. 99516
Current Property owner(s) Peter & Lori Hackenberger Day phone
Mailing address '~ 1000 Zelma Cir., Anchorage Ak. 99516
Real Estate Agent Day phone
2. TYPE OF DWELLING:
[] Single Family (w/wo ADU)
[] Duplex
[] Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY:
Individual Well []
Individual Water Storage []
Community Class __ Well []
Public Water System []
TYPE OF WASTEWATER DISPOSAL:
Individual []
Holding Tank []
Community []
Public Sewer []
Received by:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSAFee $ ~
Date of Payment
Receipt Number
COSA#
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
5. STATEMENT OFINSPECTION 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 System s 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.
Name of Firm Pannone En.q neer nq Services LLC
Address P;O. Box 1002171Anchoraqe, AK 99510
Engineer's Printed Name Steven R. Pannone
Phone 272-8218
DSD SIGNATURE
System #1 Approved for. bedrooms.
System #2 Approved for. bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
By: ~~"/~ ~~- Original Certificate Date: / ~)'~ ~L.- ~ ~
The ~ iP i~tY f/f c~horageDeveloprnentSelv ices Division (DSD) issues Certificates ofOn-SiteSystems Appr0val(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 orniss[ons in the professional engineer's work.
ATTACHMENTS:
COSA Checklist X
Septic System Advisory .~
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Other
COSA blue sheet_9-1-12.doc
If more than '1 septic system is on the lot:
COSA Checklist # of
Structure served by this system __
Certificate of On-Site Systems Approval Checklist
Legal Description: Lynn Dale Lt 3A
A. WELL DATA
Well type P~v,~e
7/26183
Date completed __
Totaldepth 161 ff.
IfA, B, or C provide PWSID #__
Sanitary seal (Y/N) Y
Casedto 161 ft.
FROM WELL LOG
7/26/83
Parcel ID: 015-273-73
Date of test
Static water level 1 51 ft.
Well production 1 0 g.p.m.
WATER SAMPLE RESULTS:
Coliform ~E~ colonies/100mL Nitrate ~.~[mglL
Arsenic: /~')~ ug/L date of sample: IO--,~-f%~
Well Log (Y/N) Y
Wires properly protected (Y/N) Y
Casing height (above ground) 13
AT INSPECTION
9/28/12
137
5.1
in.
g.p.m.
Other bacteria ~ colonies/100 mL
Collected by: ~ ~ ~-~
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Steel
Tanksize 1250 gal.
Foundation cleanout (Y/N) Y
Date of pumping 12/5/1 1
Date installed 1 1/31/83
Number of Compartments 2 Cleanouts (Y/N) Y
Depression over tank (Y/N) N High water alarm (Y/N) N/A
Pumper Northland Pumping Service, Inc.
C. ABSORPTION FIELD DATA
Date installed 11/31/83 Soil rating (g.p.d.l~ or ~/bdrm) 450 sf/bd
Length 52 ft. Width 1.5 ft.
Total depth 9+ ft. Eft. absorption area 624 ~ Monitoring tube Y
Date of adequacy test 9/28/12 Results (Pass/Fail) Pass *
Fluid depth in absorption field before test 68 in. Water added 600 gal.
Elapsed Time:__144° min. Final fluid depth 68 in.
Any rejuvenation treatment (past 12 mo.) (YIN & type) N
System type Trench
Gravel below pipe 6 ft.
__ Depression ever field N
For 4 bedrooms
New depth 72 in.
Absorption rate >= 600-t' g.p.d.
If yes, give date
LIFT STATION
Date installed
"Pump on" level at__ in.
Datum
Size in gallons
"Pump off' level at__ in.
Cycles tested
Manhole/Access (Y/N)
High water alarm level at
Meets alarm & circuit requirements?
in.
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100+
Absorption field on lot '100+
Public sewer main 75+
Sewer/septic service line 25+
Animal containment areas 100+ **
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5+
Water main '~ 0+
Wells on adjacent lots 100+
ABSORPTION FIELD ON LOT TO:
Property line 10+
Water Service line '~ 0+
Curtain drain 50+
On adjacent lots 100+
On adjacent lots 100+
Public sewer manhole/cleanout 100+
Holding tank 100+
Manure/animal excrete storage areas 100+
Property line 5+
Water service line 10+
Absorption field 5+
Surface water 100+
Building foundation 10+
Su#ace water 100+
Wells on adjacent lots 100+
Water main 10+
Driveway, parking/vehicle storage 10-1'
F. COMMENTS
* This system has used 94% of its operational life.
** Animal containment/shelters have been removed.
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 Pdnted Name Steven R. Pannone
Date ~ '~"i~ g)/'~.~~
COSA brown sheet_9-1-12.doc
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
Septic System Advisory
Certificate of On-Site Systems Approval # oscl21478
During a recent adequacy test on the septic system for Block , Lot 3A
of Lynn Dale subdivision, 68 inches of standing water was observed in the
absorption field. This indicates that approximately 94% of the absorption
area is inundated. Although this system passed the adequacy test, the
remaining life expectancy may be limited.
This advisory must be attached to all copies of the subject Certificate of On-
Site Systems Approval