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HomeMy WebLinkAboutBRADLEY LT 1Bradley Lot 1 #'015-272-89 Municipality of Anchorage Development Services Department Building Safety Division On Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SWo50198 PID Number. 015-272-89 Name: The Bradley company Ltd., LLC Wastewater System: ❑✓ New El Upgrade Address: 12001 Industry Way, Suite B-8 Anchorage, AK 99515 ABSORPTION FIELD Phone: 345-8153 Number of Bedrooms: Q ❑ Deep Trench A Shallow Trench ❑ Betl ❑Mound ❑ Other. LEGAL DESCRIPTION Soil Rating: 1.2 Total Depth from original grade: 3.8-4.5 GPD/F? Ft. Block: Lot:1 Subdivision- Depth to pipe bottom from original grade: Gravel depth beneath pipe: Bradley 1.8-2.5 Ft. 2 Ft. Township: Range: Section: Fill added above original grace: Gravel Length: 2.9-32 Ft. 71 Fl. Well: 0 New ❑ Upgrade Gravel width: Number of lines: Distance between lines: 5 Ft. 1 Ft. Classification (Private, A. B, C): Total Depth: Cased ta: Total absorption area: Pipe Material: Private 235 Ft 235 Ft. 507 Ft' ASTM D3034 PVC Dnller. Data Dtllled: Static Water Level: Installer. Data Installed; Hefty Drilling 1127/05 162 Ft Alaska Professional Excavating 8/5/2005 Yield: 15 Pump Set at: Casing Height Above Ground: TANK GPM Fl. >2 FL SEPARATION DISTANCES ® Septic ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption LII Holding ublicfPrivate Manufacturer.Capacity: From Tank Field Station Tank Sewer Line Anchorage Tank 1,250 Gal. Material: Numberor Compartinams: well 87'*** >100' N/A N/A >25' Steel TWO sudacewater >100. >100' N/A N/A LIFT STATION ize: Manufacturer Lot Line >51 >10' N/A N/A Gal. "Pump on° level at: 'Pump off level at: High water alarm at: Fountlation >5' >10' NIA N/A in. in. In. Curtain Dram None Noted IL\ Pump Make B Model Electrical Inspections performed by: Remarks: ***See Waiver- Well to Septic Tank. BENCH MARK Location and Description: Garage Slab ssumetl Elevation: 100.00 Fl Inspections performed by: A. Harala Dates: tat 8!5!2005 pkw is `� •'•e'.� 2nd 8!5!2005 � �` `� ��Pfe• Development Services Department Approval 49311 l�1 Conditional Approval Date: ..... ........ .. «........ 0, s E ANDf3MN W :MILIUM ♦6'w� CE -4381 +, /� / �IFB �0 ESSOI Reviewed and approved by: Gv, -9- Date: 6 -� -3 /� ��� M��� (R., palm) ro - GMJ 3aoVI-13 O N N I� N LO O d' m a o 0 Z ,Zg-"l N00,90.00 N M I I I I I I I I I I I I � I o I m I o I w I Z M M n I H m I N \ O MEL 9z I � mE ° J LLJ ❑ L � c W rn I N w O ¢ > �'y'� pq w ai I a Oco .� w cti -- Q �a¢c 0 00 I w O- N> J >o W N z u LU X❑ m J I BOG _E Q 6 III ry I I ^ CL m U � I I I I 1-1 wl I m N O1 N N O � �•♦ � m rn l n I c 'e o c n a��NNP .. � co•• ,•.yV� �•. Y U) I 00? s. ° W " +� �''0 I -P: J 0 `���•• (7% $ Z • �� E ��� �"r°°®' : LIQ"'' = z i � i ,.•i �E I � a I I ,00'981 N,00,90.00 N - Permit Number: SW080088 Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report C� 90.5 87.6 F FinishedGmde xis ng mde 85.8 70.5 No Groundwater 8/5/05 m 1,250 Gallon Septic Tank Drainfield Rock 93.6 90.6 y UU 71' (Trench Length) PROFILE AS -BUILT - No Scale 83.8 Page 3 of 3 PID No. 015-221-89 91.5 U 85.8 -21-2010 03:50P �Ce DrINng, q Water Well Driffin,) apidTivap Servfc:e TO:6777766 P.1 STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES DIVISION OF MINING, LAND & WATER WATER WELL LOG Drilling Started: 10/ 272005Complcted: 10/ 28/2005 Alaska state law requires that a copy of this well log be sent to the Department of Natural Resources within 45 days: Nixes are ttcceptoble. (AKstatutes3g.05.020,38.65.035.41.08.020, 46.15.020 and AK regulations I I AAC 93.140). DNR/ Division of Mining. Land and Nater, 550 W 701 Avenue, Suite 1020 Anchorage, AK 99501- 3562 Phone (907)269-8639 and fax (907)269.8947 Within the City of Anchorage, it is required that it copy of the well log be sent to file appropriate city office within 60 days and that another copy of the well log be sent to the well/property owner within 30 days. Permit Number: SW050198 Date of Issue: !j,{r J -M/,2005 Parcel Identification Number: 015 - 272 - 45 Is well located at approved permit location' (X) Yes or ( ) No Property Owner Name TheBradley Company LTD. BLOCK LOT City/Borough: Subdivision: iddieta;. 12001 Industry ay STE B-8Anchorage, Anchorag n2s2na4se4ne4 Ak9515 Meridian Toumship12n Range 3W Section 21 t/4 of ��, of �/4 of r/4 BOREHOLE DATA(from top of casing))epth Drilling method: (X) Air rotary, ( ) Cable tool, Other Material: Type, Color & wetness 1 From I To Well usc: ( ) Public supply, (X) Domcstie, Other 0 2 Depth of hole: R, Casing stickup: 2 R stickup Casing type: steel _ Thickness: .250 inches Casing diameter: 6 inches Casing depth: 235 R gravel 2 8 - Liner type: Diameter: _inches Depth: - R Static water (from top of casing): 162 Ron 10/�/ 20 5 silty sand w/ rock 8 70 Pumping level &yield: _feet after_ a[ gpm Recovery rate: 15 gpnt, Molhed of testing: airlift Duration: 1 hour moist silty clay wl gravel 70 120 Development method: airlift silty gravel w/ little H2O 120 125 Well intake opening type: (X) Open end, ( ) Open hole, Other Screened; Start: 11, Stopped R Screen type: - Slot/mcsh size: - - moist silty clay w/ gravel 125 170 Perforated: Start. ft, Stopped: It Start: ft, Stopped: - R silty gravel w/ little H2O 170 175 Note:.................................................................................................... moist silty clay wl gravel 175 220 Grout type. bentonite Volume - Depth; from sZround surface , to 20 R wet silty clay w/ gravel220 22$ Pump intake depth: ti Pump size: hp, Brand name: gravel w/ little silt & H2O 228 230 Was well disinfected upon completion'? (X) Yes, ( ) No Method of disinfection:...ChlOnnO.................................................... coarse gravel W/ H2O 230 235 Drillercomments/ disclaimers: ............................................... : ............ ............................................................................................................ . ............................................................................................... .......................................... ............................................................................ Well driller name:... 0 . nnY........y...................................................... Company name: .... He.ftY.Drillingr..lnc........................................... Mailing address:... AkUla Dr. ............................................... City: Anchorage State: ASK, Zip 99516 Phone number: (_907) 345 _ 0593 few.345-4700 Drillers signature: Alaska state law requires that a copy of this well log be sent to the Department of Natural Resources within 45 days: Nixes are ttcceptoble. (AKstatutes3g.05.020,38.65.035.41.08.020, 46.15.020 and AK regulations I I AAC 93.140). DNR/ Division of Mining. Land and Nater, 550 W 701 Avenue, Suite 1020 Anchorage, AK 99501- 3562 Phone (907)269-8639 and fax (907)269.8947 Within the City of Anchorage, it is required that it copy of the well log be sent to file appropriate city office within 60 days and that another copy of the well log be sent to the well/property owner within 30 days. Permit Number: SW050198 Date of Issue: !j,{r J -M/,2005 Parcel Identification Number: 015 - 272 - 45 Is well located at approved permit location' (X) Yes or ( ) No Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage. Alaska 99519-6650 • (907) 343-7904 • Fax (9071343-7997 http://www.muni.om/Onsite Development Services Department On -Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** WR#: OSP101054 HAM OSC101069 Permit#: PID#: 015-272.89 Legal Description: Bradley Lot 1 Engineer: Anderson Engineering Applicant: Derrick and Kelli Melton Your request for a waiver of the required 100 feet horizontal separation from the septic tank to the private well has been approved. The approved separation distance is 87 feet. This waiver approval applies to the existing septic tank to private well separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ........................................................................... a... Waiver is Granted: X Waiver is not Granted: Date: 6/10/2010 Approved by: W D L' .�lr Nam.e..o.Reviewer .. ...................................................................... Rec#: 060056 Amount: $1,050.00 Date Paid: 6/2/2010 **** VARIANCEIWAIVER REVIEW **** May 25, 2010 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 Elmore Road Anchorage, AK 99519-6650 Attention: On Site Services Engineer Subject: Lot 1, Bradley Subdivision Separation Distance Waiver Well to Septic Tank Dear On Site Services Engineer: The well on the subject lot was constructed in 2005 approximately 2 months after the septic system was installed. At the time of installation the rough framing on the structure was complete and a clear line of site to the septic system could not be obtained. Details concerning the placement of the well at its current location are in dispute, but the location must be resolved for the current owner to obtain a Certificate of On Site System Approval (COSA). The well is currently located 87' from the closest edge of the septic tank. We are therefore requesting a waiver be issued allowing the well to remain in its current location. The well is 235' deep with casing the entire depth. The well is drilled through what appears to be impermeable clay with gravel and silty clay layers the entire depth. The aquifer level is not encountered until 228' below the ground level where the pump is placed. The static water level was found at 162' below the surface and more than 140' below the bottom elevation of the septic tank. The septic tank was manufactured by Anchorage Tank to the Uniform Plumbing Code and is 5' in diameter and 10' in length. It is coated with coal tar pitch on the interior and exterior. The bottom of the tank is approximately 10' below ground. The original ground surface on the lot slopes from the well and toward the septic tank at an approximate 12% slope. The original topography of the lot has been contoured with the construction of the house and is now flat near the well head. The ground elevation at the septic tank is approximately 10' lower than the well head. We assume the water gradient slopes away from the well at a slope similar the original ground surface. A recent water quality test taken from the well indicated only a slight amount of nitrate content (.931 mg/L). The absence of nitrates would indicate no contamination of the well water from septiceffluentfrom either the septic tank or the absorption trench on the lot. No coliform or bacteria was found in the water further indicating contamination is not present in the well. Lot 1, Bradley Subdivision May 25, 2010 Page 2 of 2 ADEC POINT ANALYSIS Bottom of Tank to Highest Water Table — 147' Soil Absorption Type — Clay and Sand Equal Permeability — Silt or Sandy Clay Water Table Gradient - +12% Horizontal Separation — 87' TOTAL POINTS 7.25 Points 4.50 Points 2.00 Points 6.10 Points 2.50 Points 22.35 Almost sure to be free from any form of contamination from household sewage. Attached are the well log, water quality results and other drawings showing the proximity of the existing septic system to the well. We hereby request the waiver be issued and the Certificate of On Site System Approval (COSA) be approved. Sincerely, Michael E. Anderson, P.E. Attachments M C' AE- - ANDE4SO\ FRGS-. SS! ct�� MUNICIPALITYOFANCHOR4GE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Permit Number: SWO50198 Date Issued: Jun 30, 2005 Expiration Date: Jun 30, 2006 Parcel ID: 015-272-45 Legal Description: T12N R3W SEC 21 SUBDIVISION N2S2NE4SE4NE4 Design Engineer: 0014 Anderson Engineering Site Address: 11300 ELMORE ROAD Owner Name: THE BRADLEY COMPANY LTD., LLC Lot Size: 91476 SQ. FT. Owner Address: 12001 INDUSTRY WAY STE B-8 Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE, AK 99515 - This permit is for the construction of: 7 Disposal Field 0 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: Date: 1 `6 0 S— Issued By: Date: !7 0 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. 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. f71' '�w2� uJ Permit Number SW Property owner(s) The Bradley Company Ltd., LLC Day phone 345.8153 Mailing address (1) 12001 Industry Way, Suite B-8 Anchorage, AK 99515 !1300 Mailing address (2) Elmore Road Zip Code Legal description (Lot, Block & Sub'd.) N1/2, S112, NE1/4, SE1/4, NE /4 i t2N i23 W SEG. ZI Legal description (Section, Township & Range) Lot Size 91,E Acres/ Ft. THIS APPLICATION IS FOR: Number of Bedrooms Four (4) 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 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: `D Date of Payment: 14ad*oc�f_s Receipt Number: -m fYM (Rev. 12/00) Waiver Fees: Date of Payment: Receipt Number: ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 FAX June 28, 2005 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: N1/2, S1/2, NE1/4, SE1/4, NE1/4 Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of the subject property intends to construct a new four-bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new well and septic system to serve the new home. No conflicts exist with adjacent septic systems or wells and the proposed septic system and well on this lot. The attached Site Plan and backup documentation identify the location and configuration of the proposed well, septic system and alternate site. The current drainage pattern is identified on the Site Plan. The drainage pattern will be maintained after development of this lot is complete. Test holes were recently placed on the lot which indicated well graded to poorly graded gravel with lenses of silty sand in the area of the absorption trench and alternate site. The accepting soils were tested and found to have a percolation rate of 1.4 minutes per inch in the accepting soils. Silt lenses percolated slower at 33 minutes per inch but are located more than 2' below the bottom of the proposed absorption trench. No groundwater was found in the test hole during placement and none was monitored during the ensuing period. Our design includes the placement of a new 1,250 -gallon septic tank along with a 70' long by 5' wide by 2' effective depth absorption trench to collect and treat the sewage generated in the house. The bottom of the trench will be 3.5' below the surface. The distribution pipe will be 1.5' below the surface. A minimum of 3' of cover will be placed atop the trench and a minimum of 4' of cover will be placed atop the new septic tank. The ground surface on the lot slopes at varying grades from north to south as shown on the Site Plan. The absorption trench will be constructed parallel with the slope of the N1/2, S1/2, NE1/4, SE1/4, NE114 June 28, 2005 Page Two ground surface as much as possible in conformance with Municipal requirements. The new septic system will be constructed a minimum of 100' from the well on the adjacent lot. It will also be constructed a minimum of 100' from any surface water in the area. If the system is constructed in accordance with our design the following statements apply: 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, z aL�� Michael E. Anderson, P.E. Attachments OVMJ 38OW1'3\` % g \\�, 9'49 L M„W,90.00 £,90.00 N seep '1 ! o • S L -- ° I O I \ w /I \\ Ng Xk �I�das ea. N A IMINYIIf 11O1I • �� it '• �YI�,•1 G Ob MOV413 Or or ,94'i9t M„l£,90.00 N c to S. i+. \ , � AS'>r •.: Misr. vi I W w I a 0 w I -0 I �� N r N I i M� low gx LL x Z � � N I � N \ Z Q F r Z F o I w U I ^{ W N Z z 'dr Q � I Z N Zww F w w w m r Z Z n ja 11 N 3 00 ^ w w IX am QQ U U V/ Z Z Q Z a 0 w 0 a F S w rc 0 m n � n ,96'991. 3.96,90A0 N N1/21 S1/2, NE1/4, SE1/4, NE1/4 DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom House 5' Wide Trench System Perc. Rate: 1-3 Min./Inch 1,250 Gallon Septic Tank Application Rate: 1.2 GPD/SF 2' Drainfield Rock 4 Bedrooms X 150 GPD/1.2 GPD/SF (A lication Rate) = 500 SF Absorption Area 500 SF/5 LF (Width)* .7(Red. Factor) = 70 LF Trench Length THEREFORE: Construct a 70' Long x 5' Wide x 2' Effective Depth Absorption Trench. Flow Line Elevation in Trench to be 1.5' Below Original Ground Surface. Total Depth to be 3.5' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption Trench. 1114 lY 2'0" Natural Backfill 5' 3' Cover or 2" Insulation and 2' Cover Geotextile Fabric 4" Perforated PVC (Holes Down) Drainfield Rock TYPICAL 5' WIDE TRENCH SECTION (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 DEPARTMENT OF HEALTH & HUMAN SERVICES 825 L STREET, ANCHORAGE, AK 99502-0605 SOILS LOG - PERCOLATION TEST PROJECT #: PERFORMED FOR: Bob Bradley DATE PERFORMED: 6/22/2005 LEGAL DESCRIPTION: N1/2, S1/2. NE1/4, SEI/4, NE1/4 TEST Hol E # 1 SLOPE SITE PLAN 06/01- Poorly G/0L Poorly Graded Gravel GP Silty Gravel Dark Gray Damp NO WAS GROUNDWATER ENCOUNTERED? NO IF YES, WHAT DEPTH? DEPTH OF WATER None AFTER MONITORING: DATE: 6/28/2005 MICHAEL E. ANDERSON No. CE -M E S L 0 P E N See Site Plan READINGDATE GROSS TIME NET TIME DEPTH TO WATER NET DROP Start 6/24 15:42 6.75" 1 15:52 10 13.75" 7" Recharge 15:53 6.69" 2 16:03 10 13.57" 6.88" Recharge 1 16:04 1 1 6.75" 3 16:14 10 13.63" 6.88" PERC RATE: 1.4 MIN./INCH PERC. HOLE DIAMETER: 6° TEST RUN BETWEEN 3.0 FT. AND 4.0 T. COMMENTS: Test Hole Pre Soaked Prior To Percolation Test. TEST PERFORMED BY: ALAN HARALA I, MICHAEL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 10/17/2003 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES 825 L STREET, ANCHORAGE, AK 99502-0605 SOILS LOG - PERCOLATION TEST PROJECT #: _ PERFORMED FOR: DATE PERFORMED: 6/22/2005 LEGAL DESCRIPTION: N1/2, S1/2, NEI/4, SEI/4, NEI/4 Silty Gravel Start 6/24 15:25 TFST Hnl F # 2 SLOPE SITE PLAN I OG/OL Poorly Graded Gravel GP GM WAS GROUNDWATER NET TIME ENCOUNTERED? NO Silty Gravel Start 6/24 15:25 IF YES, WHAT DEPTH? Dark Gray 1 DEPTH OF WATER None Damp AFTER MONITORING: .94" DATE: 6/28/2005 ME S L 0 E N See Site Plan READING DATE GROSS TIME NET TIME DEPTH TO WATER NET DROP Start 6/24 15:25 10.56" 1 15:55 30 11.5" .94" Recharge 15:58 10.56" 2 16:28 30 11.44" 88" Recharge 16:30 1 10.5" 3 17:00 30 11.38" 88" FERC RATE: 33 MIN./INCH FERC. HOLE DIAMETER: 6" TEST RUN BETWEEN 8.0 FT. AND 9.0 T. COMMENTS: Test Hole Pre Soaked Prior To Percolation Test. TEST PERFORMED BY: ALAN HARALA I, MICHAEL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 6/27/2005 Parcel I.D. 015-272-89 Municipality of Anc On -Site Water and Wastewater (907) 343-7904 Certificate of On -Site Systems Ap 1. GENERAL INFORMATION Complete legal description Location (site address) Bradley, Lot 1 Expiration Date: 11300 Elmore Road Anchorage, AK 99516 Current Property owner(s) Burton & Katherine Hanna Day phone _ Mailing address Real Estate Agent 11300 Elmore Road Anchorage, AK 99516 Jamie Harvey 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 227-1059 3. NUMBER OF BEDROOMS: Four 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual Q Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request Received by: U�/I G��LG« h�Ad, e / Date: 11)1-51114 COSA to be released to the engineer, unless otherwise requested by the engineer. - COSA Fee $ Date of Payment Receipt Number 3 COSA# DSCIIo1S-11 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. 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. 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Date 10/2 6 vhf` q.a n-� \� •\ �'9r', 1t McRAEt- A nD$¢SbN. 0'=438-i �© 9 Conditional approval for bedrooms, with the following stipulations: Original Certificate Date: 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 WWe sheet! c If more than 1 septic system is on the lot: COSA Checklist # _of Structure served by this system Certificate of Ori -Site Systems Approval Checklist Legal Description: Bradley, Lot 1 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 10-28-05 Sanitary seal (Y/N) Y Total depth 235 ft. Cased to 235 ft. FROM WELL LOG Date of test 10-27-05 Static water level i m ft. Well production 15 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate mg/L Arsenic ND ug/L Date of sample: 10/20/16 B. SEPTIC/HOLDING TANK DATA Parcel ID: 015-272-89 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) >18 in. AT INSPECTION 10-26-16 . 159 ft 5.1 g.p.m. Collected by: And. Engineering Tank Type/Material Septic/Steel Date installed 5/8/0 Tank size 1,250 gal. Number of Compartments 2 Cleanouts (Y/N) Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) Date of pumping 10-26-16 Pumper Around the Clock Pumping C. ABSORPTION FIELD DATA Y N Date installed 8/26-29/05 1 Soil rating (g.p.d./ft2 orftz/bdrm) 1.2 GPD/SF System type 5' Wide Length 71 ft. Width 5 ft. Gravel below pipe 2 ft. Total depth 7-8 ft. Eff. absorption area 507 ft2 Monitoring tube Y Depression over field N Date of adequacy test 10/26/16 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 16 in. Water added 615 gal. New depth 20 in. Elapsed Time: 1,440 min. Final fluid depth 16 in. Absorption rate >= 600 g p d Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons _ in. 'Pump off" level at E. SEPARATION DISTANCES WELL ON LOT TO: Cycles tested Septic tank/lift station on lot 87'** Absorption field on lot >1 00' Public sewer main >75' Sewer /septic service line >25' Ariimal containment areas >50' SEPTIC/HOLDING TANK ON LOT TO Manhole/Access (Y/N) _ in. High water alarm level at Meets alarm & circuit requirements? On adjacent lots On adjacent lots >100' >100' Public sewer manhole/cleanout >100' Holding tank >75' Manure/animal excrete storage areas >100' _S„ r r Building foundation >5 Property line >5 Absorption field >5 ' Water main > 10' Water service line >10 Surface water > Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water Service line >10' Surfacewater >100' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS **See Waiver No. OSP101054. 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. Date 10/27/2016 COSA brown sheet 10-10-12.doc Water main >10' Driveway, parking/vehicle storage > 1 ®0oa�ueng08 ®` �.OF ALq 409 �0 /VVCHA�l E. ANDERSON CE-A3ot <� a41°a0oF: S in. Municipality of Anchorage Development Services Department Building Safety Division On -Site 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 1. D. 015-272-a9 1. GENERAL INFORMATION Complete legal description Lot 1, Bradley Subdivision Location (site address) 11300 Elmore Road Anchorage, AK 99516 Current Property owner(s) Derrick and Kalil Melton Mailing address Lending agency COSA# Expiration Date: 9_/1_/0 11300 Elmore Road Anchorage, AK 99516 Day phone 351-1713 Day phone .-Mailing-address___- Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Four (4) 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well✓❑ Individual On-site ✓❑ Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site 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 On -Site 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 On -Site Systems 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 sample results. (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 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 Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Phone 522-7773 Engineer's Printed Name Michael E. Anderson, P.E. natp. 6/012010 5. DSD SIGNATURE Approved for _4L bedrooms. Disapproved. 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 Engineer's Report Other n r�_ 5 By: �,- Original Certificate Date: 6_11-10 (Rft tiros) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot 1, Bradley Subdivision Parcel ID: 015-272-89 A. WELL DATA Well type Private If A, B, or C provide PWS ID # _ Well Log (Y/N) Y Date completed 10/28/05 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 235 ft. Cased to 235 ft. Casing height (above ground) >18 in. FROM WELL LOG AT INSPECTION Date of test 10/27/05 5/31/2010 Static water level 165 ft, 157.3 ft. Well production 15 g.p.m. 5.5 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate .931 mg/L Other bacteria 0 colonies/100 mL Arsenic: N/� ug/I Date of sample: 5/12/2010 Collected by: M. Anderson B. SEPTIC/HOLDING TANK DATA Tank Type/Material septic/steel Date installed &/26/05 Tank size 1.250 gal. Number of Compartments Two Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YM) N Date of pumping 6/0112010 Pumper Denali Sewer and Drain C. ABSORPTION FIELD DATA Date installed 8/26-29105 Soil rating (g.p.d.tft2 or ft2/bdrrn)1.2 GPD/SF System type S wide Trench Length 71 ft. Width 5 ft. Gravel below pipe 2 ft. Total depth 7-8 ft. Eff. absorption area 507 ft2 Monitoring tube Y Depression over field N Date of adequacy test 5/31/2010 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 3 in. Water added 661 gal. New depth 9.3 in. Elapsed Time: 1.152 min. Final fluid depth 3 in. Absorption rate >= 600 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at _ in. "Pump off' level at_ in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot ST" On adjacent lots >100' Absorption field on lot >100' On adjacent lots >100' Public sewer main N/A Public sewer manhole/cleanout N/A Sewer/septic service line >25' Holding tank N/A Animal containment areas None Manure/animal excrete storage areas None SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ' >6 Property line >6 Absorption field >5' Water main N/A Water service line >10' Surface water >100' Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO - Properly kne --40 - - -Building fbdnd- lam- »0' Water -main Water Service line >10' Surface water >100' Driveway, parking/vehicle storage >25' Curtain drain None Noted Wells on adjacent lots >100- F. COMMENTS: Sell Well to Septic Tank Waiver. 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. Engineer's Printed Name Michael E. Anderson, P.E. Date - 6/01/2010 COSA Fee $ 7� Date of Payment Receipt Number (Rev. 11105) Waiver Fee $ ®r' /O v Date of Payment %I / S - -) - %r / Receipt Number O 4 O D l� (Ds P10io�-t-1 GI 111=30' 2005-108 BRADLEY SUBDIVISION LOT 1 48,692 S.F. S 89'52'25"E 193.00' N 86"15'11"E 148.76' I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO 90.6' ENCROACHMENTS EXIST EXCEPT AS INDICATED. -------- — — — — — — — — — — — — — — — — — — — — — — — — — — — — — COVENANTS OR RESTRICTIONS WHICH DO NOT --------5_SNOWSiORAGEESM. APPS ON THE RECORDED SUBDIVISION PLAT. PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR • • 11/7/2006 ;6 M ANCHORAGE RECORDING DISTRICT, ALASKA F.B. JOB NO. 05-13 BS1 • 'd d' SEPTIC SYSTEM CONC. STOOP 0 41.5' e o N • 2' CANT 14.5' GRAVEL DRIVE EXISTING BUILDING 3 O o 000 a 24.0' 0 0 o p 4'X 8.5' `D COVERED PORCH Z DECK 32.0' 4' 0 WELL 2' % 5.3' B.W. CANT F.P. CANT n a ur J VJ J/ TV l VT�.TV AS -BU I LT I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO GASTALDI LAND ENCROACHMENTS EXIST EXCEPT AS INDICATED. SURVEYING, LLC IT IS THE RESPONSIBILITY OF THE OWNER TO JEFF A. GASTALDI, R.LS. DETERMINE THE EXISTENCE OF ANY EASEMENTS, 4726 WEST 88TH AVENUE COVENANTS OR RESTRICTIONS WHICH DO NOT ANCHORAGE, ALASKA 99502 APPS ON THE RECORDED SUBDIVISION PLAT. PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR 2635 11/7/2006 ESTABLISHING BOUNDARY OR FENCE LINES. ANCHORAGE RECORDING DISTRICT, ALASKA F.B. JOB NO. 05-13 BS1 NOTE: NO CORNERS SET THIS DATE 40'