HomeMy WebLinkAboutCONTOUR ACRES #1 LT 3Contour Acres
#1
Lot 3
#017-451-21
Inspection Report_1-1-12.doc
Municipality of Anchorage
Community Development Department Page 1 of 3
On -Site Water and Wastewater Program
4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904
ON-SITE
WASTEWATER INSPECTION REPORT
Permit Number: OSP161107
PID Number: 017-451-21 ❑✓ New ❑ Upgrade
Name:
ABSORPTION FIELD
Kathryn. Laurance
❑ Deep Trench ❑✓ Shallow Trench ❑ Bed ❑ Mound
Address _
12570 Birch Rd.
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
4
1 .2 GPD/SF
3 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
2 FL
Gravel depth beneath pipe
1 Ft.
Subdivision
Block Lot
Contour Acres #1
3
Fill added above original grade
1 .5 FL
Gravel length
50 (2) Ft.
Township Range Section
Gravel width
5Ft.
Beds: Number of Lines
N/A
Distance between lines
N/AFt.
SEPARATION DISTANCES
To
Septic
Absorption
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Lift Station
Tank
Line
575 Ft'
2
10A Ft.
Well
100+
100+
100+
100+
25+
TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Anchorage Tank
Capacity
1,250Ga1.
Surface Water
100+
100+
N/A
N/A
Material
Steel
Number of compartments
2
Lot Line
10+
10+
N/A
N/A
NA
Foundation
5+
10+
N/A
N/A
LIFT STATION
Manufacturer
Capacity
Gal.
Curtain Drain
50+
50+
N/A
N/A
Pump on level at
Pump off level at
High water alarm at
Remarks
in.
in.
in.
-
Pump make and model
Electrical Inspections performed by
PIPE MATERIAL House to tank 3034 Tank to 3034
drainfield
Installer
Whitters Excavating
Drainfield 3034 CO/MT 3034
Inspector Pannone Engineering Services
BENCHMARK (Assumed elevation) 100ft
Inspection ,
8/5/2016
8/8/2016
Location and description
dates:
Z"
First Floor Finished Floor
T 8/8/2016
4'"
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
Engineer's Stamp
Conditional Approval:
Date
e .••"
.. 4� .. ......
Steven anno�are
Appro ed w-
Date
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Inspection Report_1-1-12.doc
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LOT 3 SAA
DRIVEWAY
RESERVE DRAIN FIELD (FUTURE) '
(2E4) 50LF x 5'NI x I 01 x 3.0'TO
I o D —I
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C , FC
MI
M2 � 4BR
.� C2 T2��TI l HOUS O
PRIMARY DRAIN FIELD oC \
_
I
(2E4) DOLL x 5 W x 1.01D x 3,0 TO '� � � I � B
C 1 NEW WELL
TH-2� �)
�M3 �' NEW 12.70g SEPTIC TANK -_ I
O —III
M4 G3 r -j
C4
10' UTILITY EASEM-NT \
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I
SEPTIC AREA/,(E) 11
DE SIGN PARAMETERS
,PRIMARY/RESERVE SEPTIC SYSTEM
N0. BEDROOM: 4 (600 gpd)
TANK SIZE: 1250g I
i
PERC RATE: 3.1 MPI
SOIL RATING- 1.2 GPD/SF V f5_.
AREA ROD: 500 OF ABBREVIATIONS
SYS. TYPE- WIDE TRENCH 1.O'ED �M Al _
RF 0.87
MIN LENGTH: 87 LF
USED:
A B
C
D
T1
31.80 23.20
CO
CLEAN OUT N0,
M1
41.10 56.90
TYP
TYPICAL
WELL
108.50
1.18.60
USED:
TEST HOLE
(P)
PROPOSED -
(2EA) 50 LFx5'Wxl.O'
E.D., 3.0' TD
CO
CLEAN OUT N0,
TOTAL AREA. 575 SF
MONITOR TUBE NO-
TYP
TYPICAL
NOTES:
PANNONE
ENG SVC,
LLC
RECORD DRAWING
P.O. BOX 100217 ANCHORAGE, AK
PHONE (907) 272-8218 FAX (907)
99510
272-8211
DRAWN BY:
NJC
PLAN
CONTOUR ACRES n1, LOT 3
KATHRYN LAURANCE
12570 BIRCH ROAD
ANCHORAGE, AK 99516
TH
TEST HOLE
(P)
PROPOSED -
E, (E)
EXISTING
CO
CLEAN OUT N0,
MT
MONITOR TUBE NO-
TYP
TYPICAL
Date
PNL O... (?Cgsll� 11/11/2016
Scale
...... .. ... P.I.D. NO
017-451-21
Steven P, PERMIT N0.
CE 8149 OS,P161107
�U�OESSIONP2� Sheet
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EL. 95.6 J NEW 1,2509 \ EL 95.4
SEPTIC TANK JEL, (E) 94.7
EL. (W)94.2
EL (E) 937
EL (W) 93 2
NOTES
RECORD DRAWING
DRAWN BY:
Ll
DESIGN DETAILS
—35
7 / / rH—,
2 OR
EL (E) 94 7
�.rhva �1 vexrR'art i I,0 EL.(W)94.2 -2.0
-60.0 EACH LE
L. (E) 937 SW
L(W) 932 -5
SM/
TEST HOLE LOCATEDML
BETWEEN THE 2 TRENCHES EL. BJ.o BOH �.0
DRY
S
Scale
PAMONE
ENG
SVC,
LLC
P.O. BOX 100217
0
99510
PHONE (907) 272-8218 FAX
(907)
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SEPTIC TANK JEL, (E) 94.7
EL. (W)94.2
EL (E) 937
EL (W) 93 2
NOTES
RECORD DRAWING
DRAWN BY:
Ll
DESIGN DETAILS
—35
7 / / rH—,
2 OR
EL (E) 94 7
�.rhva �1 vexrR'art i I,0 EL.(W)94.2 -2.0
-60.0 EACH LE
L. (E) 937 SW
L(W) 932 -5
SM/
TEST HOLE LOCATEDML
BETWEEN THE 2 TRENCHES EL. BJ.o BOH �.0
DRY
CONTOUR ACRES #1, LOT 3
KATHRYN LAURANCE
12570 BIRCH ROAD
ANCHORAGE, AN 99516
OFA�gsl��
Dote
I1/r1/2016
Scale
PAMONE
ENG
SVC,
LLC
P.O. BOX 100217
ANCHORAGE. AK
99510
PHONE (907) 272-8218 FAX
(907)
272-8211
CONTOUR ACRES #1, LOT 3
KATHRYN LAURANCE
12570 BIRCH ROAD
ANCHORAGE, AN 99516
OFA�gsl��
Dote
I1/r1/2016
Scale
' AQ '. I
NTS
.... (.... ... ..
P.I.D. NO
017-451-21
Steven R. Pannone
PERMIT
Pf,. CE 8149At, ..���
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OSP161107
O�"`-�-
Sheet
3 OF 3
Cevelopment Services Department
Building Safety Division
On -Site Water 6 Wastewater Program
4700 Elmore Rood
P.O. Box 196650 Anchomge, A K 99507
Mark Sagich www,muni.orq/�RSite
Mayor (907)343-7904
Well Log
Permit Number: OSP161107 Date of Issue: May 20, 2016
Date Started: 07-25-16 Date Completed:07-26-16 Is well located at approved permit location? U Yes U No
Legal Description: Contour Acres N1 Lot3 G,2837
Property Owner Name & Address: Laurance Kathryn
4901 Woodridge Circle
Anchorage, AK 99516
Borehole Data: Depth (ft)
Soil Type, Thickness & Water Strata From To
stickup
0
2
overburden
2
4
silt & gravel
4
150
moist sand & gravel
150
160
bedrock
160
206
WATER QUALITY TES
ING
Feaffoffn a cot
1001711.
WV L
Results:
Arsenic:
Nitrate&:
Total Coliform Bacteria:
Other Bacteria:
N ug/l,
{mg L
t colonies/100mL
col/100mL
Method of Drilling [xf air rotary U cable tool
Casing type: steel
Wall Thicicness: .250 inches
Diameter: 6 inches Depth: 160 feet
Liner Type:
Diameter: inches Depth: feet
Casing stickup above ground: 2 feet
Static water level (from ground level): 141 feet
Pumping level: feet after
hours pumping gpm
RecoveryRate: 13 gpm
Method of Testing: alrllft
Well Intake Opening Type:
F-1 Open End I x Open Hole
❑ Screened Start feet Stopped—feet
FI Perforations Start feet Stopped—feet
20' Start 0 feet Stopped 20 feet
Pump: Intake Depth feet
Pump size lip Brand Name —
Well Disinfected Upon Completion? n Yes ❑ No
Method of Disinfection;.chlonne tablets
Comments:
Well Driller: Hefty Drilling; Inc.
3540 Akula Dr,
Anchorage, AK 99516
Attention: The well driller shall provide a well log to DSD within 30 days of completion.
t:
f,
Rec64ved Time Nov. 14. 20"7t'):20AM No. 1/0)
o
Developmmt Services Department
Building Safety Division
On -Site Water dl Wastewater Program
o '<
4700 Elmore Rood
P.O. Box 196650 a
Mark Begich Anchorage, AK 99507 s ^ s T'
Mayor w .munl.oro/onsite
(407)343-7904
Pump Installation Log
Well Drilling Permit Number: -M( j b) Date of Issue: ap p ap1(,
Parcel Identification Number:—
Legal Description L0f) 4a4.i d cr��ln 2? 1
Lok -j �J7
Property Owner Name & Address.-
: / 1 A
(A"-1Ce VC,
Pump Installation Date: 8_ -t. /(0 --
Pump Intake Depth Below Top of Well Casing: feet
Pump Manufacturer's Name: G ((c, 44C.S
Pump Model: /0 54EU7 — 2LIO
Pump Size I hp
Pitiess Adapter Burial Depth: /0 feet
Pitiess Adapter Manufacturer's Name: p 9 D
Pitless Adapter Installer: A44-7]f4i'n+ 5
Well Disinfected Upon Completion? YYes F7, No
...Method of Disinfection: [A h0, 1�, �
Comments:
Pump Installer Name:
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
Received Time Nov, 14, 2016 9:2041 No. 1767
On -Site Water & Wastewater 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: OSP161107
Tax Code Number: 01745121000
Work Type: WellSeptic Initial
Permit Effective Dates: May 20, 2016 to May 20, 2017
Design Engineer: PANNONE ENGINEERING SERVICE
Subdivision: CONTOUR ACRES #1
Site Legal Address: CONTOUR ACRES #1 LT 3 G:2837
Owner/Address: LAURANCE KATHRYN
4901 WOODRIDGE CIRCLE ANCHORAGE AK 995165312
Site Mailing Address: 12570 BIRCH RD, Anchorage
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank
Lot Size in Sq Ft: 82400
Total Bedrooms: 4
yes`✓
N Privy 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.
Received By
Issued By:
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907 -343 -
Development Services Division Fax: 907-3 u 9 `o 17
On -Site Water & Wastewater Program
N
ON-SITE SEWER/WELL PERMIT APPLICATION a MAY 1 l 2016
017-451-21 �6
Parcel I.D. r ,�
Property owner(s) Kathryn Laurance Day phone e1 O! 6 9 L 9 �'
Mailing address 4901 Woodridge Circle, Anchorage, AK 99516
Site address 12570 Birch Road
Legal description (Sub'd., Block & Lot) Contour Acres #1, Lot 3
Legal description (Township, Range & Section)
Lot Size 82,400 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(® all that apply) -
Absorption Field ❑x Initial ❑X Single Family (SF) ❑X
Septic Tank ❑X Upgrade F1(w/wo ADU)
Holding Tank ❑ Renewal ❑ Duplex (D) ❑
Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well ❑X
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
property owner or
Permit/Rush Fees: 5-6
7 _f a15 = 7 Waiver Fees:
Date of Payment: 5/1206, Date of Payment:
Receipt Number: Cl�135z Receipt Number:
Permit No. 161161 1OSI Waiver No.
Permit App_ :-7:,.:c
Pannone Engineering Services Lac
Steven -R. P-antnone, Principal
Registered Professional Engineer
E-mail: stevePoanengak.com
May 10, 2016
Subject: Contour Acres #1, Lot 3
Septic System Permit Request
Design Narrative
This is a design narrative for a permit to install a well and septic system to be issued for this property. The
proposed system will serve a proposed four (4) bedroom house. Currently the lot is undeveloped..A
conventional septic tank and drain field will be installed. The reserve septic area is shown. This lot and
the surrounding lots are served by private wells. There are no wells within 100' of the proposed septic
system, and there are no septics within 100' of the proposed well.
1. Soils. Two test holes were performed in the vicinity of this system by Pannone Engineering Services in
May 2016, and groundwater was monitored for at least seven days. Ground water was not observed
to a depth of 14.0' below the surface in the test hole monitor tube in May 2016. Bedrock was not
encountered in the test hole. Based on the results of the percolation tests and overall soils
appearance; an application rate of 1.2 gallons/day/square was used for a conventional wastewater
system in the area of these test holes.
2. Soil Absorption System Design.
a. See Sheet 1 of the design package.
3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field.
The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage
ditches.
4. Topography: The existing topography slopes from east to west at approximately 5% to 10% in the
area of the drain field. There are no steep slopes within 50' of the proposed drain field. The proposed
drain field will maintain 50' separation all steep slopes.
5. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that
the review is complete and that there are no further comments is received from MoA On -Site
Department, the note will be removed and "Issued for Construction" drawings will be issued.
The proposed installation will not affect the future development of this or the surrounding lots.
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
NO STRUCTURL-`ON LOT h'
\ w�-
w
;
1
� SEPTIC A)REA (E)�
W
I
v
I
�l\
DRIVEWAY
RESERVE DRAIN FIELD (FUTURE),
,(2EA) 50LF x 5'W x 1.0'ED x 3.01D
o�
�TH-1—
LOT 3
-
=l
,
} 4BR
o HOUSE
1P) c
L
V
PRIMARY DRAIN FIELD (P)
(2EA) 50LF x 5'W x 1.0'ED x 3.0'TD
! `�
- WELL
TH-2
�1250g SEPTIC TANK (P)
(P)
/
- INSTALL DOUBLE CLEAN OUT,
- FLOW SPLITTER, AND
FOUNDATION CLEAN OUT
'
10' UTILITY EASEMENT
W—� W
- /
I
w
I
SEPTIC AREA,<E)
DESIGN PARAMETERS
.PRIMARY/RESERVE SEPTIC SYSTEM
NO. BEDROOM: 4 (600 gpd)
/
TANK SIZE: 1250g / /�
PERC RATE: 3.1 MPI / -
'
SOIL RATING: 1.2 GPD/SF
AREA ROD: 500 SF
SYS. TYPE: WIDE TRENCH 1 .0'ED �M—M
ABBREVIATIONS
RF: 0.87
\iy
TH TEST HOLE -
MIN LENGTH. 87 LF
(P) PROPOSED
�(E) EXISTING
USE: - --- —' /
CO CLEAN OUT NO. -
(2EA) SO LFx5'Wx1.O' E.D., 3-0' TDi _ $/
MT MONITOR TUBE NO.
x'
TOTAL AREA: 575 $F /
TYR TYPICAL
Y
NOTES:
PMODNE7 ENHORASG,EV,
`��� \\
� A�'gS,�a)
Date
FOR CONSTRUCTION
C, 9�A 5L10
J'(�
�y++'
5/20/2016
PHONE (907) 272-8218 FAX (907) 272-8211j
g�P
Scale
/ *."4
50
/
.... . . .. ..
/ P.I.D. NO
CONTOUR ACRES #1, LOT 3
...... .. .. ..
Ul -451-21
KATHRYN LAURANCE
/ Steven R. Pannone'
/#P�,f CE 8149
j PERMIT NO-
12570 BIRCH ROAD
M .\ ��/
OSPI61107
PLAN
ANCHORAGE, AK 99516+�>l9FaP.....IONPV
+'
-
OFF 1\\�
Sheet
1 OF 4
"oA
10
11
12
13
14
BOH
15
16
17
18
19
DATE PERFORMED: 5/2/16
SOILS LOG - PERCOLATION TEST
SLOPE ` \ SITE PLAN
DRIVEWAY
TH-1 L
4BR
HOUSE
X TH I (P) +�
WAS GROUND WATER
ENCOUNTERED? N
IF YES, AT WHAT
DEPTH? -DRY
DEPTH TO WATER AFTER
MONITORING? -DRY
DATE: 519/16
READING DATE
TEST HOLE 1
NETTIME
1
NET DROP
OR
ORGANICS
---
2
---
2
2:30
10 MIN
9.89
3
3
2:30
--
6.15
---
SW
SAND
4
9.87
3.72
5
5
--
6.15
---
6
6
1 10 MIN
i 9.87
1 3.72
7
8
9
SM/
SILTY SAND
ML
AND SILT
10
11
12
13
14
BOH
15
16
17
18
19
DATE PERFORMED: 5/2/16
SOILS LOG - PERCOLATION TEST
SLOPE ` \ SITE PLAN
DRIVEWAY
TH-1 L
4BR
HOUSE
X TH I (P) +�
WAS GROUND WATER
ENCOUNTERED? N
IF YES, AT WHAT
DEPTH? -DRY
DEPTH TO WATER AFTER
MONITORING? -DRY
DATE: 519/16
READING DATE
CLOCK
TIME
NETTIME
WATER
LEVEL
READING
NET DROP
1 5/2116
2:20
---
6.15
---
2
2:30
10 MIN
9.89
3.74
3
2:30
--
6.15
---
4
2:40
10 MIN
9.87
3.72
5
2:40
--
6.15
---
6
2:50
1 10 MIN
i 9.87
1 3.72
I
i
TH-2
� I
c
I
0
0
10' UTI LITY EASEMENT
SLOPE
TH
X
3
READING DATE
CLOCK
TIME
NETTIME
MATER
LEVEL
READING
NET DROP
1 512/16
1:45
---
7.65
---
2
2:15
30 MIN
8.52
0.87
3
2:15
--
7.65
---
4
2:45
30 MIN
8.50
0.85
5
2:45
--
7.65
6
3:15
1 30 MIN 1
8.49
1 0.84
PEROLATION RATE 2.7 (min/inch) PERC HOLE DIAMETER 6 inches PEROLATION RATE 35.7 (min/inch) PERC HOLE DIAMETER 6 inches
TEST RUN BETWEEN 3 FT AND 4 FT TEST RUN BETWEEN 6 FT AND 7 FT -
COMMENTS: Test hole excavated by CURT WHITTERS. Prec hole was presoaked.
Test run for at least one hour. Last 3 readings reported. - -
PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST.
NOTES: ����Date
FOR CONSTRUCTION PAN ONE ENG SVGE,C, 99 L0 r �� OF. A. 1) 5/20/2016
PHONE (907) 272-8218 FAX (907) 272-8211ig�P ..If- 0 Scale
SOILS LOG
CONTOUR ACRES #1, LOT 3
KATHRYN LAURANCE
12570 BIRCH ROAD
ANCHORAGE, AK 99516
fV NTS
.... ..... .. ... P.I.D. NO
-451-21
Steven -RPannone PERMIT NO.
P •, CE 8149 .•e
OSP161107
Sheet
��tiFOpRorEs'sioeP "� 2OF4
TEST HOLE 2
1
OR
ORGANICS
2
NET DROP
1 512/16
3:30
3
3.24
--
2
SW
SAND
a
3.26
3
5
___
3.24
6
4
3:50
7
6.49
3.25
8
SM/
SILTYSAND
3.24
ML
AND SILT
9
1 10 MIN I6.46
10
11
BOH
12
13
14
15
16
17
18
19
DATE PERFORMED:
512116
SOILS LOG - PERCOLATION TEST
SLOPE
LX
TH
ENCOUNTERED? N
IF YES, AT WHAT
DEPTH? -DRY
DEPTH TO WATER AFTER
MONITORING? -DRY
DATE: 519/16
SITE PLAN
DRIVEWVAY
' ' LOT 3
4BR
HOUSE
(P)
I
TH-2
71
I I
10' UTILITY EASEMENTZ�
I
SLOPE
TH
X
READING DATE
CLOCK
NETTIME
WATERTIME
LEVEL
READING
NET DROP
1 512/16
3:30
--
3.24
--
2
3:40
10 MIN
6.50
3.26
3
3:40
___
3.24
---
4
3:50
10 MIN
6.49
3.25
5
3:50
---
3.24
---
6
4:00
1 10 MIN I6.46
3.22
PEROLATION RATE 3.1 (min/inch) PERC HOLE DIAMETER 6 inches
TEST RUN BETWEEN 3 FT AND 4 FT
COMMENTS: Test hole excavated by CURT WHITTERS. Prec hole was presoaked.
Test run for at least one hour. Last 3 readings reported.
PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST.
NOTES: ���� �\ Date
FOR CONSTRUCTION PN�o4 ENG
ORACK 995L0 _ '(��F.A�gsll1 5/20/2016
PHONE (907) 272-8218 FAX (907) 272-8211 %g�P �y#� Scale
NTS
.... .. .... . ... P.I.D. NO
CONTOUR ACRES #1, LOT 3 .. .. .. .. .. / on-asl-z1
KATHRYN LAURANCE S'te'ven R. Pannone PERMIT NO.
12570 BIRCH ROAD �j' s. CE 8149// OSP161107
SOILS LOG ANCHORAGE, AK 99516 tll�PF� RO ESSONP �� Sheet
3 OF 4
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION. SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF
ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF
ON—SITE WASTEWATER DISPOSAL SYSTEMS AND AND IN ACCORDANCE WITH AMC 15.65 AND 15.55.
2. SCOPE OF WORK: INSTALL WELL. INSTALL 1250g SEPTIC TANK AND SOIL ABSORPTION SYSTEM.
3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 11 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL
TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 11 FEET BELOW
EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY.
4. THE CONTRACTOR (BOTH WELL AND SEPTIC SYSTEM CONTRACTORS) SHALL HAVE ANY WELL LOCATION AND SEPTIC
LOCATION STAKED AND ANY LOT LINE AND WELL RADIUS SHOWN ON THE PLAN WITHIN 30 FEET OF THE PROPOSED
SYSTEM STAKED BY A REGISTERED LAND SURVEYOR BEFORE STARTING THE WORK.
5. THE CONTRACTOR IS RESPONSIBLE FOR ALL R.O.W. AND OTHER REQUIRED PERMITS, OTHER THAN THE ATTACHED.
6. THE CONTRACTOR SHALL CALL FOR LOCATING OF ALL BURIED UTILITIES.
7. THE CONTRACTOR SHALL PROVIDE 24 HOUR NOTICE TO THE ENGINEER PRIOR TO START OF WORK. ALL SURVEYING
AND LOCATES SHALL BE IN PLACE PRIOR TO NOTIFYING THE ENGINEER.
8. THE CONTRACTOR SHALL NOTIFY THE ENGINEER OF ANY DISCREPANCY BETWEEN THE APPROVED DRAWINGS AND SITE
CONDITIONS/LIMITATIONS POTENTIALLY CAUSING THE NEED TO MODIFY THE DESIGN.
9. AT THE COMPLETION OF THE WORK, THE CONTRACTOR SHALL SUBMIT RED—LINE AS—BUILT DRAWINGS TO THE
ENGINEER. THE RED-LINES SHALL INCLUDE PIPE LENGTHS, ORIGINAL GROUND ELEVATIONS, PIPE ELEVATIONS, AND
TANK ELEVATIONS.
1C. THE CONTRACTOR SHALL PROVIDE PHOTOGRAPHS OF THE SYSTEM INSTALLATION TO INCLUDE BOTTOM OF EXCAVATION,
TOP OF PIPE WITH CLEAN—OUTS AND MONITOR TUBES INSTALLED, INSTALLED TANK AND FINAL GRADING. -
11. THE CONTRACTOR PROVIDED DATA (UPON WHICH THIS RECORD DRAWING IS BASED) APPEARS TO REPRESENT THE
PROJECT AS CONSTRUCTED. THIS DATA IN CONJUNCTION WITH THE PERIODIC FIELD OBSERVATIONS BY THE ENGINEER
(OR HIS DESIGNEE) AS REQUIRED BY AMC 15.65 DOES NOT GUARANTEE THAT THERE ARE NO HIDDEN DEFECTS BY THE
CONTRACTOR.
12, THE CONTRACTOR SHALL SIGN THE FOLLOWING:
I CERTIFY THAT ALL WORK WAS PERFORMED IN ACCORDANCE WITH THE APPEND PERMIT, AND ANY AND ALL CHANGE
ORDERS, AND THAT THE AS—BUILT REDLINES ARE TRUE AND ACCURATE REPRESENTATION OF THE PROJECT AS
CONSTRUCTED.
CONTRACTOR:
BY: TITLE:
DATE:
NOTES: PANNONE ENG SVC, LLC _—��`oF. a klh SiZoi2a,6
FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 �� qs �)
PHONE (907) 272-8218 FAX (907) 272-8211 %g�p fy''I Scale
* I/ NTS
.... .. ..... P.I.D. NO
CONTOUR ACRES #1, LOT 3 .. ....... .. ... / 0n-451-21
KATHRYN LAURANCE Steven R. Pannone PERMIT NO.
Po. CE 8149 ��
12570 BIRCH ROAD OSP, 61107
I+ 11.
DESIGN DETAILS ANCHORAGE, AK 99516 (tl `��pROfESS10NP�� Sheet
4 OF 4
Parcel I.D. 017-451-21
1
S�(S
Municipality of Anchora
On -Site Water and Wastewater PrograM N_
r
OV 14 201E
(907) 343-7904
Certificate of On -Site Systems Approval-``'
Expiration Date: ^ 7
GENERAL INFORMATION
Complete legal description Contour Acres #1, Lot 3
Location (site address) 12570 Birch Rd.
Current Property owner(s) Kathryn Laurance Day phone
Mailing address 4901 Woodridge Cir. Anchorage, AK 99516
Real Estate Agent Day phone
2. TYPE OF DWELLING:
0 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER(fiFBEDROOMS:
4. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
WaiverNariance request for:,
3 y
I
9d fI;JV ? 5 20`;S ji
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 Systegts 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 riles 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.
In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA
guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test,
and separation distances measured to readily identifiable features. The operational life of 211 wells and septic systems depend on the local soil
condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions
are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future
performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty
for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed
above.
Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218
Address P.O. Box 100217, Anchorage Ak. 99510
Engineer's Printed Name Steven R Pannone
6. DSD SIGNATURE
4L System #1 Approved for —4 bedrooms
System #2 Approved for bedrooms
Disapproved
Date 11/11/2016
*: 49 TH � •'•
CE -8149
Conditional approval for bedrooms, with the following stipulations:
By to n l�E -� Original Certificate Date: Z(- /6
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.
ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory p Y Arsenic Advisory
Well Flow Advisory
COSA blue sheet E - e -
Other
If more than 1 septic system is on the lot:
COSA Checklist # + of 1
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description: Contour Acres #1, Lot 3 Parcel ID: 017-451-21
A. WELL DATA
Well type Private. If A, B, or C provide PWS ID # Well Log (Y/N) Y
Date completed 766 nr(o Sanitary seal (Y/N) Wires properly protected (Y/N) YdQ
Total depth �20(0 ft. Cased to x(00 ft. Casing height (above ground) in.
FROM WELL LOG AT INSPECTION
Date of test 7/;�6/; o (o A)ew
Static water level l l ft. A )Pw ft.
Well production g.p.m. Af%w 9-p m.
WATER SAMPLE RESULTS:
Coliform Neg colonies/100 mL Nitrate 5.91 mg/L
Arsenic ND ug/L Date of sample: 10/19/2016 Collected by: PES"
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel
Tank size 1 ,250, gal. Number of Compartments 2
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N
Date of pumping NSA ' Pumper NSA
Date installed 8/8/2016
Cleanouts (YIN) Y
High water alarm (Y/N) N
C. ABSORPTION FIELD DATA
Date installed $/8/2016 Soil rating (g.p.d./ftz or ftZ/bdrm) 12 GPD/SF System type shallow Trenches
Length 50/50 ft Width 5/5 ft. Gravel below pipe '1 �1 ft.
Total depth 4.5/4.5 ft. Eff. absorption area 575 ft2 Monitoring tube Y Depression over field N
Date of adequacy test New Results (Pass/Fail) Pass for 4 bedrooms
Fluid depth in absorption field before test New in. Water added New gal. New depth New in.
Elapsed Time: New min. Final fluid depth New in. Absorption rate >= 600+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N &type) No 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
WELL ON LOT TO:
100+
100+
Septic,tan0lift station on lot
On adjacent lots
Absorption field on lot 100+
On adjacent lots 100+
Public sewer main 75+
Public sewer manhole/cleanout 100+
Sewer /septic service line 25+
Holding tank 100+
Animal containment areas 50+
Manure/animal excrete storage areas 100+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5+ Property line 5+
Absorption field 5+
Water main 10+ Water service line
10+ Surface water 100+
Wells on adjacent lots 100+
ABSORPTION FIELD ON LOT TO:
Property line 10+ Building foundation 10+ Water main 10+
Water Service line 10+ Surface water 100+
Driveway, parking/vehicle storage 10+
Curtain drain 50+ Wells on adjacent lots
100+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
1 certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name Steven Pannone
Date 11/11/2016
COSA canarysheet_2-6-15.doc
: Steven R. Pannone :
�+`+4 CE -814910
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.muni.org/onsite
(907)343-7904
Nitrate Advisory
Certificate of On -Site Systems Approval # OSC161553
A Certificate of On -Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block , Lot
3 of Contour Acres #1 subdivision. This inspection revealed a nitrate
concentration of 5.91 milligrams per liter (mg/L) was reported for the
property's well water sample. The Environmental Protection Agency (EPA)
has established a maximum contaminant level (MCL) of 10.0 mg/L for
public drinking water systems. While private wells are not subject to this
regulation, EPA standards are based on existing health information and can
therefore be used to gauge the relative quality of water from private wells.
Please see the attached "Nitrate Fact Sheet" for important information
regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
AS -BU I L T
1 HEiREm
PROPERI
GASTALDI LAND
ENCROAC
SURVEYING, LLC
IT IS THE
JEFF A. GASTALDI, R.L.S.
DETERM?t
2000 E. DOWUNG RD., SURE 3
COVaIAI`
ANCHORAGE, ALASKA 99507
APPEAR
PHONE 248-5454
UNDER P
GRID DATE ncrccvw
SW2837 10/21/2016 ESTABUS
ANCHI
F.6, JOS N0. NOTE t
18-04 CAS13