HomeMy WebLinkAboutBIRCHHAVEN LT 3Onsite File
BirchWoods •
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP221094 PID Number: 051-243-14
Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: 41 New ❑ Upgrade
Name
Kourosh Partow
ABSORPTION FIELD
El Deep Trench [C Wide Trench E:1 Bed El Mound
Site Address
176: �S Birchwood Loop Rd
❑ Other
Phone
907-310-2501
Number of Bedrooms
3
Soil Rating
JTotal depth from original grade
1.2 GPD/SF
1.2 / 1.9 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
0.7/1.4
Gravel depth beneath pipe
0.5 / 0.5 Ft.
Subdivision Block Lot
Birch Woods *5Ft.
Fill added above original grade
2.3/2.3 Ft.
Gravel length
2 @ 38
Township Range Section
Ft.
Gravel width
5.0 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
380 Ftz
2
>6 Ft.
Well
>100'
>100'
N/A
N/A
>25'
TANK 9 Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Greer
Capacity
1000 Gal.
Surface Water
>100'
>100'
N/A
N/A
Material
Plastic
Number of compartments
2
Lot Line
>5'
>10'
N/A
N/A
NA
Foundation
>'� O'
>� Q'
N/A
N/A
LIFT STATION
acturer
Capacity
Remarks *Proposed lot 1 B, subdivision in process
Gal.
Monitor tube added next to tank for groundwater monitoring
Alarm location
I installed by
Installer
PIPE MATERIAL House to tank D3034 Tank to D3034
drainfield
Little Dipper Excavating
Drainfield D3034 cO/MTD3034
Inspector J. Millette
BENCH MARK (Assumed elevation) 100 ft
Inspdecctieosn �5, 5/5/22 5/5/22
Location and description
2�a
3'd 4th
Bottom of siding
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
Conditional Approval: Date
A�Q' •..q �0
%* TH $�
. .. .........
Septic System
Benjarr' chiller
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Approve Date �"�-2
CE 12592
��G�Jj'�•, s/5/22 ��
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pROFESSIONa�
Note: this approval does not include well permit requirements.
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1 :
PERMITBIRCH WOODS, LOT 5 (PROPOSED LOT 1 B
■ 0•, PID # 051-243-14
INSULATION
NORTHEAST TRENCH
02E 98.0 FINISH GRADE 95.7 ORIGINAL GRADE 0 2" INSULATION
95.0 DRAINFIELD ROCK 95.0
94.5 94.5
38'
GROUNDWATER @ 87.7 ON 4/5/22
8 7. 2
SOUTHWEST TRENCH
0� 98.0 FINISH GRADE 95.7 ORIGINAL GRADE 0 2" INSULATION
nn
94.3
lNGIN!l RING
DRAINFIELD ROCK 94.3
�- 93.8 93.8
38' —►_I
- GROUNDWATER @ 87.7 ON 4/5/22
87.2 �o
1y••...--mg-t1
x•'49 TM
..`.�..... ;.
PROFILE AS -BUILT o � Benja Schiller
ot �Fj• CE 12592
�TF.
815/2022 • •�Cj�,®
(NO SCALE) t;F�PROFESSI0NP�4
��®®®®0,�'•
DEPTH
(feet)
1-
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
GE SOILS LOG AND PERCOLATION TEST
-�' ENGINEERING
LEGAL DESCRIPTION: BIRCH WOODS LOT 5 (PROPOSED LOT IB)
PERFORMED FOR: KOUROSH PARTOW
DATE: 3/24/22 PARCEL ID#: 051-243-14
TEST HOLE 1
ML/CL (SILTY CLAY)
DATE
READING
START TIME
1' OB
PERC TEST LOCATION
.
NET DROP
(INCHES)
3/24/22
1
SW/SM (SILTY SAND w/
2:20
OCCASIONAL AGGREGATE)
6-1
6 �s
2
10:05
3:23
ML/CL (SILTY CLAY)
DATE
READING
START TIME
NET TIME
(MINUTES)
DEPTH TO
WATER
(INCHES)
NET DROP
(INCHES)
3/24/22
1
10:00
2:20
0
6-1
6 �s
2
10:05
3:23
0
6 -s
6 16
3
10:09
4:57
0
6-16
-s
4
10:15
6:03
0
6-1
6 -s
5
10:22
6:05
0
6-2-
6 is
6
10:296:10
0
616
6-2-
6" DIAMETER PERC HOLE
PERCOLATION RATE: 1.1 (MINANCH)
SITE PLAN
NO WAS GROUND WATER ENCOUNTERED?
N/A IF YES n WHAT DEPTH?
9.0' DEPTH TO WATER AFTER MONITORING
4/5/22 DATE OF MONITORING TECHNICIAN: J. MILLETTE
9.0' DEPTH TO WATER AFTER MONITORING IN MAY
5/31/22 DATE OF MONITORING
COMMENTS:
GE SOILS LOG AND PERCOLATION TEST
1 L r
ENGINEERING
LEGAL DESCRIPTION: BIRCH WOODS LOT 5 (PROPOSED LOT IB)
PERFORMED FOR: KOUROSH PARTOW
DATE: 3/24/22 PARCEL ID#: 051-243-14
DEPTH TEST HOLE 2
(feet)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
1
IINUOT-11
PERC TEST LOCATION
SM (SILTY SAND)
1
17
MUCL (SILTY CLAY)
DATE
READING
START TIME
NET TIME
(MINUTES)
DEPTH To
WATER
NET DROP
INCHES)
(INCHES)
3/24/22
1
10:45
1:49
0
6-1
6 - -
2
10:48
1:38
0
6 s
6 is
3
10:51
1:52
0
6-°-
6-s
4
10:54
1:58
0
6 -1
6 -s
5
10:57
1:49
0
6 a6
1
6
11:01
1:58
0
6-1
6 s
6" DIAMETER PERC HOLE
PERCOLATION RATE: <1 (MINANCH)
SITE PLAN
NO WAS GROUND WATER ENCOUNTERED?
N/A IF YES @ WHAT DEPTH?
8.O ' DEPTH TO WATER AFTER MONITORING
4/5/22 DATE OF MONITORING TECHNICIAN: J. MILLETTE
8.O ' DEPTH TO WATER AFTER MONITORING IN MAY
5/31/22 DATE OF MONITORING
COMMENTS:
Wasilla, AK 99654
(907)376-2041
Name:
Kourosh Partow
Address:
19507 Richner Rd
City:
Chugiak State: AK Zip Code: 99567
Well Site:
Birch Woods
Lot/Block: L5 (proposed LIB)
Additional:
17620 Birchtree St, Chugiak, AK
Well Depth:
205 ft.
From:
To: Formation:
0
2 stickup
Below Ground:
203 ft.
2
18 gravel/sand/dirt
Above Ground:
2 ft.
18
27 blue silt/sand
Gal/Min:
1.75
27
36 sand/gravel/damp
36
38 bedrock grey
Static Level:
TBD
38
51 hard green bedrock- frac 51'
51
57 coal
Casing:
205ft. of 6 in. x.25 in. steel
57
68 hard bedrock
68
77 coal
Liner Pipe:
163' lined, 42'-205'
77
122 green bedrock- frac 143'
122
129 coal- frac 155'
Screened:
N/A
129
205 bedrock grey
Perforated:
N/A
WATER QUALITY TESTING
Comform . to CA
COUI OOML
Grouted:
Yes, 2 bags
Ntrates
Mg/L
Depth:
ug/L
Develop. Method:
Air
Use of Well:
Residential
Drilling Method:
Rotary
Misc:
Other:
The well was pumped 5' off the bottom with 100% draw down fort hours and recovered at 1.75gpm
Date Drilled:
5/6/2022 Driller: Seth Moore
Development Services Department
Building Safety Division
PCa
%. On -Site Water & Wastewater Program oe
4700 Elmore Road`
P.O. Box 196650
Mark Begich Anchorage, AK 99507 s A e r r
Mayor www.muni.org/onsite
(907) 343-7904
Pump Installation L®
Well Drilling Permit Number: SW OSP221094 Date of Issue: 05/04/2022
Parcel Identification Number: 051-251-14
Legal Description Property Owner Name & Address:
Birch Woods L5 (Proposed Lot 1B) Kourosh Partow
17659 S Birchwood Loop Rd 19507 Richner Rd.
Pump Installation Date: 05/30/2022
Pump Intake Depth Below Top of Well Casing: 165
Pump Manufacturer's Name: Goulds
Pump Model: 3/4hp 5gpm
Pump Size 3/4 hp
Pitless Adapter Burial Depth: 13 feet
Pitless Adapter Manufacturer's Name: Campbell
Pitless Adapter Installer: Unknown
Well Disinfected Upon Completion? ✓0 Yes ❑ No
Method of Disinfection: Sterilene
Comments:
Pump Installer Name: Wheaton Water Well, Inc.
1190 N. Wasilla-Fishhook Road
Wasilla, AK 99654
feet
Chugiak, AK 99567
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pomp installation.
Lo -
HOUSE DETAIL
Scale: 1"=30'
\ Lot 2
5.4'x8.2'
PORCH
50.0'
Lot 1
15 T&E EASEMENT ,
PLOT PLAN --- AS BUILT _X_ SCALE _1"_= 60__ GRID _ NW 0954__ Project No. ____Z2-1o1f+Z_—_
9' 11500 Daryl Avenue, Anchorage, Alaska 99515-3049
&
Lang Associates, inc. (907) 522-6476 Phone \\
kenOlongsurvey.com
Professional Land Surveyors jonothanOlongsurvey.com At.
? OF `l ,
travisOlangsurvey.com '.
AWQtY, ,
I hereby certify that I have surveyed the following described property:
LOT 3, BIRCHHAVEN SUBDIVISION (PLAT No. 2022-64) jtt: 49TH
Anchorage Recording District, Alaska, and that the Improvements situated thereon are
within the property lines and do not encroach onto the property adjacent thereto, that
no improvements on the property lying adjacent thereto encroach on the surveyed /
premises and that there are no roadways, transmission lines or other visible/0 KENNETHG.L4NG Q.
easements on said property except as Indicated hereon. 0, 9FG • No.5 02
Dated this the _ 21.___ Day of__LL's-'- ---_, �2Z'2 , at Anchorage, Alaska 1 FDp• � �T+ �D
th l Fq � '� • ' SQQ .r
`i� ROFESSIONP�`P �
It is the responsibility of the owner to determine the existence of any easements,
covenants, or restrictions which do not appear on the recorded subdivision plat. State of Alaska AECC963
wl
BIRCHTREE STREET
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MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Water & Wastewater System Permit
Permit Number: OSP221094
Work Type: WellSeptic Initial
Tax Code Number: 05124314000
Site Legal Address: BIRCH WOODS LT 5 G:0954
Site Mailing Address: 17620 BIRCHTREE ST, Chugiak
Owner: PARTOW KOUROSH
Design Engineer: FORGE ENGINEERING
This permit is for the construction of:
Effective Date:
Expiration Date
Lot Size in Sq Ft:
Total Bedrooms:
o
t cnr
I
Department
5/4/2022
5/4/2023
70270
Q Disposal Field R1 Septic Tank Holding Tank Privy CJI Private Well Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Special Provisions:
1. Prior to IR approval, submit the recorded ingress/egress easement.
Received By:
Issued By:
Date:
Date: Z
3
UNICIPALIT'Y OF ANCHORAGE
�;;,'' ht`s
Community Development Department Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On -Site Water & Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 051-243-14
Property owner(s) Kourosh Partow Day phone 907-310-2501
Mailing address 19507 Richner Road, Chugiak, AK 99567
Site address 17659 S Birchwood Loop Rd
Legal description (Sub'd., Block & Lot) Birch Woods Lot 5 (Proposed Lot 1 B)
Legal description (Township, Range & Section)
Lot Size 70,270 Sq. Ft. Number of Bedrooms 3
(Proposed L1 B — 43,533 SF)
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(N all that apply)
Absorption Field ❑X Initial 0 Single Family (SF)
Septic Tank
❑X
Upgrade El(w/wo AD U)
Holding Tank
❑
Renewal ElDuplex (D)
Privy
❑
Multiple Dwellings
(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.
(Signature of property owner or authorized agent)
Permit/Rush Fees: -*52-0 Waiver Fees:
Date of Payment: L//z,6/z:L Date of Payment:
Receipt Number: OZ072n Receipt Number:
Permit No. 0 -5,02 -?-109y Waiver No.
Permit App_::- : ,-..:c
❑X
E
May 3, 2022
MOA Development Services, On-Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
5/3/22
Subject: Birch Woods L5 (Proposed L1B) – Birch Tree Street
Septic system design
Dear On-Site Services Engineer:
The owner of the above lot intends to build a 3-bedroom home on the property, so we are
submitting this permit application for the construction of a new well and septic system. The
attached site plan identifies the location of the home as well as the proposed well, septic location
and alternate site. No conflicts exist between this proposed system and any other well or septic
system, whether on this lot or adjacent lots. This lot and Lot 1 to the west will be subdivided into
three smaller parcels. The proposed septic location for this lot (proposed L1B) intersects with the
existing west lot line. An easement has been recorded for the purpose of obtaining this permit.
When the subdivision is complete, this easement will be erased along with the conflicting lot line.
The ground surface on the lot is relatively flat. There are no slopes greater than 25% within 50 feet
downslope of either the primary or alternate site. Elevations are shown on the site plan showing
the grade and direction of flow. Stormwater drainage will not impact this septic system. The new
trench will be constructed parallel to the slope as much as possible.
Wells on this and adjacent lots are shown. The new system will be a minimum of 100’ from all
wells and surface water, and more than 5’ away from the septic tank. The alternate site is located
more than 6’ away.
Please refer to the attached test hole logs, soils lab analysis, plan and profile pages for the septic
design. If this design is followed, there will be no adverse impacts to adjacent properties.
Sincerely,
Benjamin Schiller, PE
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221094, Deb Wockenfuss, 05/04/22
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AW'
BIRCH WOODS, LOT 5 (PROPOSED LOT 1B)
TYPICAL TRENCH SECTION
(NO SCALE)
NOTES:
1. GRADE AREA OVER TRENCH TO DRAIN AWAY
2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2'
WITH 2" OF INSULATION
3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER
THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY
Benjamin Schiller
CE 12592R
EGISTEREDPROFE S S I O N ALENGINEER5'
1'-2"
6"
DESIGN FACTORS:SYSTEM REQUIREMENTS:
450 GPD PEAK FLOW
PERK RATE: *<1 MIN/IN
APPLICATION RATE: 1.2 GPD/SF
SHALLOW TRENCH SYSTEM
1000-GAL SEPTIC TANK
w/ 20" MANWAY
BOTTOM OF TRENCH: 2' BELOW GRADE
FLOW LINE ELEVATION: 1'-6" BELOW GRADE
TOP OF TRENCH: 1'-2" ABOVE GRADE
450 GPD / 1.2 GPD/SF /5' WIDE * 1.0 RED FACTOR (0.5' EFF DEPTH) = 75 LF TRENCH REQUIRED
(76 LF SPECIFIED)
5/3/2022
6"
1'
3:1
4" PERFORATED PVC
(HOLES DOWN)
DRAINFIELD ROCK
GEOTEXTILE FABRIC
2" INSULATION
*SEE ATTACHED SIEVE ANALYSIS
MOUND MUST BE TOP SOILED & SEEDED
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221094, Deb Wockenfuss, 05/04/22
DEPTH
(feet)
TEST HOLE 1
DATE READING START TIME NET TIME
(minutes)
DEPTH to
WATER NET DROP
PERCOLATION RATE: (MIN/INCH)
(inches)(inches)
DATE OF MONITORING
WAS GROUND WATER ENCOUNTERED?
DEPTH TO WATER AFTER MONITORING
IF YES @ WHAT DEPTH?
1.1
3/24/22 1
2
3
4
5
6
SW/SM (SILTY SAND w/
OCCASIONAL AGGREGATE)
Professional Engineers Stamp:
NO
BIRCH WOODS LOT 5 (PROPOSED LOT 1B)
3/24/22 051-243-14
KOUROSH PARTOW
10:001
2
3
4
5
6
0
10:05
10:09
10:15
10:22
10:29
1' OB
2:20
Benjamin Schiller
CE 12592R
EGISTEREDPROFE S S I O N ALENGINEER4/14/2022
PERC TEST LOCATION
TECHNICIAN: J. MILLETTE
6 0
16
N/A
9.0'
4/5/22
COMMENTS:
6" DIAMETER PERC HOLE
SITE PLAN
6 0
16
LEGAL DESCRIPTION:
PERFORMED FOR:
DATE: PARCEL ID#:
SOILS LOG AND PERCOLATION TEST
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
ML/CL (SILTY CLAY)
3:23
4:57
6:03
6:05
6:10
0 6 0
16 6 0
16
0 6 0
16 6 0
16
0 6 0
16 6 0
16
0 6 0
16 6 0
16
0 6 0
16 6 0
16
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221094, Deb Wockenfuss, 05/04/22
LEGAL DESCRIPTION:
PERFORMED FOR:
DATE: PARCEL ID#:
SOILS LOG AND PERCOLATION TEST
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
DEPTH
(feet)
TEST HOLE 2
DATE READING START TIME NET TIME
(minutes)
DEPTH to
WATER NET DROP
PERCOLATION RATE: (MIN/INCH)
(inches)(inches)
DATE OF MONITORING
WAS GROUND WATER ENCOUNTERED?
DEPTH TO WATER AFTER MONITORING
IF YES @ WHAT DEPTH?
<1
3/24/22 1
2
3
4
5
6
SM (SILTY SAND)
Professional Engineers Stamp:
NO
BIRCH WOODS LOT 5 (PROPOSED LOT 1B)
3/24/22 051-243-14
KOUROSH PARTOW
10:451
2
3
4
5
6
0
10:48
10:51
10:54
10:57
11:01
1' OB
1:49
Benjamin Schiller
CE 12592R
EGISTEREDPROFE S S I O N ALENGINEER5/4/2022
PERC TEST LOCATION
TECHNICIAN: J. MILLETTE
6 0
16
N/A
8.0'
4/5/22
COMMENTS:
6" DIAMETER PERC HOLE
SITE PLAN
6 0
16
ML/CL (SILTY CLAY)
1:38
1:52
1:58
1:49
1:58
0 6 0
16 6 0
16
0 6 0
16 6 0
16
0 6 0
16 6 0
16
0 6 0
16 6 0
16
0 6 0
16 6 0
16
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221094, Deb Wockenfuss, 05/04/22
% GRAVEL 7.1 USCS SM
% SAND 69.0 USACOE FC N/A
% SILT/CLAY 23.9 % PASS. 0.02 mm N/A
% MOIST. CONTENT 16.6 % PASS. 0.002 mm N/A
N/A
N/A
N/A
SIEVE SIEVE TOTAL %SPECIFICATION
SIZE (mm)SIZE (U.S.)PASSING (% PASSING)
152.40 6"
76.20 3"
38.10 1.5"100
19.00 3/4"97
12.70 1/2"96
9.50 3/8"95
4.75 #4 93
2.00 #10 92
0.85 #20 90
0.43 #40 85
0.25 #60 71
0.15 #100 50
0.075 #200 23.9
ELAPSED DIAMETER
TIME (MIN) (mm)
0
1
2
5
8
15
30
60
250
1440
SOUNDNESS OF AGG.
(ASTM C88)
DEGRADATION
(ATM T-313)
LA ABRASION
(ASTM C131/C535)
SP. GRAV. COARSE AGG.
(ASTM C127)
CLASSIFICATION:
DATE RECEIVED:
TESTED BY:
REVIEWED BY:
UNIFORMITY COEFFICIENT (Cu)
COEFFICIENT OF GRADATION (Cc)
ASTM D1557 (uncorrected)
ASTM D4718 (corrected)
OPTIMUM MOIST. CONTENT. (corrected)
PROJECT CLIENT:
PROJECT NAME:
PROJECT NO.:
SAMPLE DESC.:
NGE-TFT ID #:UNKNOWN
UNKNOWN
Forge Engineering, Inc.
HYDROMETER RESULT
N/A
SIEVE ANALYSIS RESULT
2022 Materials Testing
6309-22
Birchwood LS, TH-2
22-S-3
Silty sand
4/15/2022
Erik Boatwright
Andrew Fortt
TOTAL %
PASSING
11301 Olive Lane ∙ Anchorage, Alaska 99515 ∙ Phone: 907-344-5934 ∙ Fax: 907-344-5993 ∙ www.nge-tft.com
N/A
N/A
The testing services reported herein have been performed to recognized industry standards, unless otherwise noted. No other warranty is made. Should engineering
interpretation or opinion be required, NGE-TFT will provide upon written request.
N/A
115
120
125
130
135
140
145
0 2 4 6 8 10 12 14 16DRY DENSITY (pcf)MOISTURE CONTENT (%)
MOISTURE-DENSITY RELATIONSHIP ASTM D1557
SILT or CLAYCOBBLES
GRAVEL
Coarse Fine
SAND
Coarse Medium Fine
0
10
20
30
40
50
60
70
80
90
100
0.0010.010.1110100FINER BY MASS (%)GRAIN SIZE (mm)
PARTICLE SIZE ANALYSIS ASTM D6913 / C136 / D422
#200#40#101.5 1/2363/4 #4 #20 #60 #1003/8
U.S.SIEVE OPENING IN INCHES U.S.SIEVE NUMBERS HYDROMETER
Tom Fink,
Mayor
Ntunicipality of Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
June 30, 1994
Frank T & Michelle P Zellers
905 Muldoon Road #A80
Anchorage, Alaska 99504 2070
Subject:
Lot 5 Birch Woods Subdivision
Permit #SW930193, PID #051-243-14
The subject permit, issued June 30, 1993 by this office for a
single family well and/or on-site wastewater system, has
expired as of June 30, 1994.
A new permit must be obtained from this office for a well
and/or on-site wastewater system NOT installed by the
expiration date.
If you have drilled the well, a well log must be sent to
this office for documentation of the installation and to
close the permit.
If a licensed Professional Engineer has inspected the
installation of the on-site wastewater system, the original
as-built inspection report must be sent to this office for
review, approval and documentation. All inspection reports
must be submitted within 30 days of construction completion.
When applying for a new permit, the fees are: $320.00 for an
on-site wastewater permit; $120.00 for a well permit and
$440.00 for a combined on-site wastewater and well permit.
If you have any questions, please call this office at 343-4744.
cerely,
~am/es Cross
Acting Program Manager
On-site Services
cc: S & S Engineering
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW930193
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:ZELLERS FRANK T & MICHELLE P
OWNER ADDRESS:905 MULDOON RD.
ANCHORAGE, AK 99504
DATE ISSUED: 6/30/93
EXPIRATION DATE: 6/30/94
PARCEL ID:05124314
LEGAL DESCRIPTION: BIRCH WOODS LT 5
LOT SIZE: 70273 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT:
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM
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 (iSAAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
THE SAND USED IN THE FILTER LAYER MUST BE COARSE, UNIFORM
AND CLEAN WITH LESS THAN 2% FINES PASSING A 200 MESH SEIVE.
A SEIVE ANALYSIS MUST BE TAKEN ON THE SAND USED, AND
PROVIDED TO THE DEPARTMENT.
RECEIVED BY: ' "
ISSUED BY: ~
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SiTE PLANS
ROAD DESIGN
SOILTEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ON SITE
WASTE WATER
DISPOSALSYSTEM
DESIGN
ROBERTSHAFER, P.E.
ROGER SHAFER, P.E.
June 20, 1993
CIVIL ENGINEERS
(907) 694-2979
FAX 694-1211
~unicipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 'L' Street
P.O. Box 196650
~nchorage, Alaska 99519-6650
REFERENCE: Birch Woods Subdivision, Lot 5
Request you issue a permit to drill a well and install a
septic system to serve the proposed three bedroom trailer on
;he referenced property.
~wo test holes were excavated and percolation tests
performed. The approximate location of the test holes are
located on the attached site plan. Water was encountered at
7' in test hole %1, and 6' in test hole %2, at the time of
excavation. After seven day water monitoring, water was
found at 6' in test hole %1 and 7' in test hole %2.
This property has enough area for a septic upgrade which can
be seen on the attached site plan. We do not anticipate any
adverse effects on neighboring properties by the installation
of the proposed septic system.
If you have any questions, or require additional information
for your review, please contact us.
Since~91.~,,
rt A. Shafor~ P.~.
aAS/LSU/lsu
17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577
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3-11 -IO~d/N~'qd 'S'/'N
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR: ~~,(--
LEGAL DESCRIPTION: ~)"('
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
2O
~ ~--/,--~---~ DATE PERFORMED:~
.~ , ~"'/~l~r,.~ ~,.X~ Yd~wwnship, Range, Section:
WAS GROUND WATER
ENCOUNTERED?
SLOPE SITE PLAN
S
IF YES, AT WHAT '"~.. I °L
DEPTH? p
E
Depth to Water After/..? ~tf~ .~., !~.~
Moniloring? ,.,v Dale:
7,/4,
N
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE *'~ (minutes/inch) PERC HOLE DIAMETER
II ._ ~....~ ('" TEST ,RUN BETWEEN ~",~"~ ~FT AND 2Y'~
FT
~.n~*un .770~ Eagle RJ~r L~D R~ N~ ~* I ' I~1~~ .... CERTIFY THAT THIS TEST WAS PERFORMED IN
.............. ~ . _ ...... ~ . ,. ,/
A CCORDANC E"~]~ ~2~)Jt~D'~g~, PAL GUI DEUNES Fj~~lq THIS DATE. DATE:
72-008 (Rev. 4/85)
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR:
LEGAL DESCRIPTION: ~)'~-~,
1
2
3
4
5
6
7
8
9
10-
11-
12-
13
14
15
16
17
18
19
20
DATE PERFOR
Township, Range, Section:
SITE PLAN
SLOPE
WAS GROUND WATER \/~"'t"'"
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Depth to Water After.,,~j.. /
Monitoring? '1 DaLe:
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE ~ ~ (minutes/tach) PERC HOLE DIAMETER I~)-'- ¢/ '
TEST RUN BETWEEN ~ FT AND
ag' R , A a~a 99.577 // //
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ~T ON THIS DATE.
72-~8 (Rev. 4/85)
3 FT
CERTIFY THAT THIS TEST WAS PERFORMED IN
DATE:
Certificate of On -Site Systems Approval
Parcel I.D. 051-243-14
Legal description Birch Woods L5
Site address 17620 S Birchwood Loop RD
Current property owner(s) Partow
Expiration Date:
11-22-22
X The On-site system(s) is/are approved for - bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
Effy: �� �� Original Certificate Date:r 2 - 2?
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of
Anchorage, Development Services Department (DSD) issues COSAs based upon
representations provided by an independent professional engineer. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
COSA Approval_June 2022
MUMCPAUTY OF ANCHORAGE
Development Services Department f -; Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 051-243-14
Complete legal description Birch Woods L5 (Proposed Birchhaven Lot 3)
Location (site address) 17620 S Birchwood Loop Rd
Current property owner(s) KOUrosh PartoW
2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS
Day phone
3. TYPE OF WATER SUPPLY: ❑® Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ❑ Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: K Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ❑ Steel ❑® Plastic ❑ Concrete ❑ Fiberglass
Age C 1 - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ®❑ Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested:®❑
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee $ l _0 Waiver Fee $
Date of Payment �— F1 — 2 Z. Date of Payment
COSA # (9 S� ;—> 21 L4 Waiver #
COSA Application—June 2022
Legal Description:
Birch Woods L5 (Proposed Birchhaven 1-3)
Parcel ID: 051-243-14
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled 5/6/22 Total depth 205 ft
Cased to 205 ft
❑ Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ground) 24 in.
Date of flow test for COSA 5/6/22
Static water level at beginning of test
Comments *Static water level not shown on well log
B. TANK DATA
Measured operating fluid level in septic tank NEW
Date of pumping NEW
❑ Required maintenance completed, if AWWTS
Comments: Installed 5/5/22
D. ABSORPTION FIELD DATA
Which system tested (date installed) 5/5/22
❑ ALL standpipes present per record drawing
Total measured depth from grade 2.3/2.3 ft (max)
Measured depth to pipe invert from grade 0.7/1.4 ft (min)
❑ N/A — pressurized field.
❑ Per record drawings, field is insulated.
❑ Monitor tubes go to bottom of effective.
If not, state depth into effective
❑ Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced N/A gallons N/A date
Any rejuvenation treatment (past 12 months) N/A
If yes, enter date
Comments/Deficiencies:
COSA Checklist June 2022
Well production at time of test 1.75 gpm
Water storage tank volume gallons
Well disinfected for coliform test? ❑ Yes ❑ No
❑ Coliform bacteria is Negative
Nitrate mg/L ❑ Nitrate less than MRL (ND)
Arsenic 3.0 ug/L ❑ Arsenic less than MRL (ND)
Collected by Forge Engineering
Date 5/16/22 & 6/2/22
C. LIFT STATION
Lrfieql.fired maintenance completed
Age of lift station years
Lift station material
Comments:
Adequacy test date New
Results ❑ Pass
id depth prior to test in
Wate added gal
New flui epth in
Elapsed time min
Final fluid depth in
Absorption rate > pd
FIELD STATUS — POST COVERY
Effective depth (per record dr ings) in
Effective depth used in
Effective depth remaining in
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100'
Community Sewer Manhole/Cleanout > 100'
DYes
if No
ft
Fil Yes
if No ft
Neighboring Tank > 100' Q Yes
if No
ft
Private Sewer/Septic Line > 25' ❑ Yes
if No ft
Absorption Field on Lot > 100' Fn� Yes
if No
ft
Holding Tank > 100' ❑Q Yes
if No ft
Neighboring Absorption Fields > 100'
Animal Containment > 50' ❑ Yes
if No ft
Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' Yes
if No
ft
Fm� Yes
if No ft
❑ N/A — Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10' Fm� Yes if No ft Surface Water > 100' Yes if No ft
Tank to Property Line > 5' ❑ Yes if No ft Wells on Adjacent Lots:
Field to Property Line > 10' ❑ Yes if No ft Private Wells > 100' [j] Yes if No ft
Water Main > 10' R Yes if No ft Community Wells > 200' Q Yes if No ft
Water Service Line > 10' FE -1 Yes if No ft If tank or field is under driveway comment below
F. ENGINEER'S COMMENTS
Easement provided. Property is in the process of subdivision and field is
located > 10' from proposed property lines
G. CERTIFICATION & 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, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm Forge Engineering
Engineer's Printed Name Benjamin Schiller, P. E.
COSA Checklist -June 2022
Phone (907) 522-7773
Date 8/16/22
TH
Benjarri�r lchiller
I �F� •. • CE 12592
�) �JJF�• • 8/16/22, •oa�d
�aRROFESSI4NP
2022-016977-0
A Recording Dist: 301 - Anchorage
s 5/4/2022 10:22 AM Pages: 1 of 2
Accortmodat:.:� z;n_•cordbig only
No tine irsurance inVoivtd N@..
examinattor„ made? as to effect
(of this docutment on the t tWto
the estate referanced:herEin
GRANT OF SEPTIC EASEMENT
Whereas the undersigned, Kouroslh Partow, a married man whose address is 19507 Richner
Road, Chugiak, Alaska is the owner of Lot l and Lot 5, Birch Woods Subdivision, according
to Plat 83-427, Anchorage Recording District, Third Judicial District, State of Alaska and
whereas lie needs to construct a septic drain Field for said Lot 5 on a portion of Lot 1 now
therefore the following casement is hereby -ranted on Lot I for the benefit of Lot 5:
Beginning at the Northeast corner of said Lot I, common to the Northwest corner of said Lot 5,
thence S 14' 35'35" W along the common lot line a distance of 49.45 feet. thence N 500 54'05"
W a distance: of 80.51 feet; thence
N 39° 05' 55"E a distance of 45.00 feet to a point on the north property line of said Lot 1; thence
S 50° 54'05" E along said property line a distance of 60.00 feet to the POINT OF
BEGINNING. Containing 3162 square feet
more or less. See attached Exhibit A.
Indemnification The grantees of the easement described herein shall indemnify and hold the
grantor harmless for any liability or loss arising from the grantee's use of the casement and
permitted improvements thereon. No structures whether temporary or permanent shall be stored
or erected on said easement.
Term: In the event that the lots are resubdivided in a way that said casement is no longer
necessary it shall automatically become void.,,
: y
)[ rosh Pat -tow, Owner
STATE OF ALASKA
;.,
THIRD JUDICIAL DISTRICT ) "..; °n
The foregoing instrument was acknowledged bef
by ore me this 3 day of \X`\e�� 2Q22
Kourosh Partom?.
After recording return to:
Kouroslt Partow
19507 Richner Road
Chugiak, Alaska 99567
eRecorded Document
ri
Notar'y.!Public In And For Alaska _
My commission expires_ r < <�'�
a
o BIRCHTREE STREET
i
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