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HomeMy WebLinkAboutSUMMIT ESTATES BLK 2 LT 11 Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number OSP171292 PID Number: 015-072-08 Dwelling: 10 Single Family (SF) ❑ Duplex(D) El Multiple (SF and/or D) Project: ❑ New ® Upgrade Name: ABSORPTION FIELD NANCY BRANDT-ERICKSON THOR Address ❑i Deep Trench ❑ Shallow Trench El Bed ❑ Mound El Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 1.2 GPD/SF 10 Ft LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Loth(/ .77, iti Ft.6.02- Ft. SUMMIT ESTATES BLK 2, LOT 11 Fill added above original grade Gravel length Township Range Section 2.0 + Ft 43 Ft Gravel width Beds Number of Lines Distance between lines SEPARATION DISTANCES 2.0 Ft. Ft To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist.between trenches Tank Field • Lift Station Tank Line a From 510 Ft Ft. Well 100'+ 100'+ 50,+ TANK ❑� Septic 0 S.T.E.P. 0 Holding 0 Other Manufacturer Capacity Surface Water 11001+ 1001+ ANCH 1250 Gal. Material Number of compartments Lot Line 10'+ 2'+* STEEL 2.0 NA Foundation 10'+ 10'+ LIFT STATION Manufacturer Capacity Curtain Drain UN UN Gal. Remarks * LOT LINE WAIVER APPROVED Pump on level at Pump off level at High water alarm at in. in. in. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank 3034 Tank to 3034 Installer drainfield MIKE N ANDERSON, P.E. Drainfield 3034 CO/MT 3034 Inspector MIKE N ANDERSON, P.E. BENCH MARK (Assumed elevation) 100.6 ft Inspeection ction "110-23-17 2 ' 10-24-17 Location and description 3'd 4m CORNER OF HOUSE, BOTTOM OF SIDING COMMUNITY DEVELOPMENT DEPARTMENT APPROVALiair, la VAcitrkol ! y •.. .;,:.�; Conditional Approval: Date ow p"?... �F r*:49TH . ! MICHAEL N. ANDERSGN •`. . ' if•. CE-9459 c Approved II U�.t“S, ea. -(J Date 1 0/Z5/1 7 1k ' �ffss o..x Inspection Report_9-1-12.doc Permit No. 0SP171292 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: SUMMIT ESTATES BLK 2, LOT 11 PID No.: 015-072-08 MARK A B `■ \,t,, / TCO1 10 41 C04 H2O N. 51 N. ,,��� MT — 45 �7.Q v� ��_ � CO6 i/ 49 �77 _--_ — -- ( —�_ /— — __- \— ) NEW 1250 STEEL TANK I ` 0� NT1 \ 1 } T OjJ] 04 II -' ��� COt GOlz .� II / d5 /' /• �\ ■ / / / ( 0 \ / OLD SYSTEM DECOMMISSIONED • f 1 1 1 ' l DRIVEWAY ` .. -y— — — � EXISTINC WELL— — 1 Jr ( 1' 1 1 / 1 / \ \ / \ \ / \ \ / \ / \ \ / \/ ______\____ \ / / \ ■ / f N � / ' \ ASBUILT ` , . . ,� y - SCALE: 1"=50 co,iCo2 TC01 TCO2 �Co3 rCO4 COrs MT cos L '..+ ��� Il Il 722 a t� � "�F% ..<1 ..f ��tr>hWr :� -.'''''''''''' -�♦+ • 9 �nEa. .-„ '4a- (ice . E /yJ T • 91.1.1 t.250 ULLp. `414 Z ` ,m m i / f • STEEL MK 9!p �y� / / • , . 67_6.— R7 6 ` • :. ,•1 ■ �� 1 94 7 \90 S• No. C: -59 �,�1.- � /Jf��jL��J SEPTIC SECTION 81.6 _ 4 J.. • N.T.S. WATER AT ea., +/, L-+ LSS\-Agris" 2--(,•7`' MUNICIPALITY OF ANCHORAGE �F On-Site Water& Wastewater Program \ 1, / a.l\ PO Box 196650 4700 Elmore Road ' I Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 http://www.muni.orglonsite Dep. tmcnt ktaiiii MN .6 On-Site Wastewater Disposal System Permit Permit Number: OSP171292 Effective Date: 10/10/2017 Work Type: Septic Upgrade Expiration Date: 10/10/2018 Tax Code Number: 01507208000 Site Legal Address: SUMMIT ESTATES BLK 2 LT 11 G:2437 Site Mailing Address: 5511 E 98TH AVE, Anchorage Owner: BRANDT-ERICKSEN THOR & Lot Size in Sq Ft: 18000 Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING Total Bedrooms: 4 This permit is for the construction of: 0 Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well El 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 Received By: )04. Date: (i / Issued By: tat te, A ar..4..ell Date: /0 /6 Municipality of Anchorage � ; ^ P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http://www.muni.ord/Onsite Development Services Division On-Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV171118 COSA#: Permit#: OSP171292 PID#: 015-072-08 Legal Description: Summit Estates Block 2 Lot 11 Engineer: Mike N. Anderson Applicant: Nancy Brandt-Ericksen Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 1.0 foot. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ® The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. ❑ Adjacent properties are not affected by this waiver. , Waiver is Granted: X Waiver is not Granted: Date: /6//0/020/ 7 Approved by: Patitt,ejk. G2-JVCX Name of Reviewer **** VARIANCE/WAIVER REVIEW **** • MUNICIPALITY OF ANCHORAGE 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. 015-072-08 Property owner(s) NANCY BRANDT-ERICKSEN Day phone Mailing address 5511 E 98TH AVE Site address 5511 E 98TH AVE, ANCH AK Legal description (Sub'd., Block & Lot) SUMMIT ESTATES BLK 2 LT 11 Legal description (Township, Range & Section) Lot Size 18000 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: IN all that apply) Absorption Field ❑x Initial ❑ Single Family (SF) x❑ (w/wo ADU) Septic Tank ❑x Upgrade 0 Duplex (D) ❑ Holding Tank ❑ Renewal ❑ le ❑ Privy ❑ or- Private Well ❑ Q Water Storage CIa s�Pd, `!�,> THIS APPLICATION INCLUDES A VARIANCE I WAIVER REQU S FOR: LOT LINE WAIVER flee: ' I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. //4/‘—' (Signature of property owner or authorized agent) Permit/Rush Fees: 549 Waiver Fees: 0021//5- Date of Payment: ei/27/19- Date of Payment: /4/0//?' Receipt Number: c21V13, Receipt Number: air,93) Permit No. V SPPIAA Waiver No. QSV t71(I7 Permit App__-. • Sept. 28, 2017 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: New Septic Permit Legal: SUMMIT ESTATES BLK 2 LT 11 To Whom it may concern: This is a request for a septic permit plus a lot line waiver on the above referenced lot. A single test hole was excavated and found 16 feet of silty gravels,GM, with damp soils at 16 feet. The old crib system could be causing this moist soil, reviewing the neighboring designs showed no water. The perc rate was 4 minutes, but we will be using the standard calculation with a small safety factor for system longevity. A lot line waiver has been requested to allow separation between the new and old system. The slope of the land is very flat with a small bowl area in the back yard where the new system is located. No cut-banks or slopes greater than 25 percent within 200 feet. This system will not impact any of the neighboring properties due to the lot layout and the type of septic system being installed. Please call me if you have any questions. Sincerer /144_ Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 SIGN CRITERIA: I MOUND OVER (TH#1) o M— GRADE 4 BDRM X 150 = 600 GPD -DRG I SOILS = 600/1.0 = 600 GPD 1 0 W FILTER FABRIC 600 GA/14 =43' USE 45' GM s o 4.,0 PIPE (1) TRENCH SEWER ROCK 10.0' DEEP 7.0' EFFECTIVE -10 0 2.0'WIDE 12 I 45' LONG 16 SEPTIC FIELD SECTION I I OII {1 IT _ _ I II ':---- i_.,,_ _` i-E 97TH AVEN�E- -------..._ _1 S' .10 1'� y�� /+{�� i++ PROPOSED _\` - - 11 -- - PROPERTY LINE— , ,. _ DRAINAGE FIELD r ....",,,,/__ l 1 - �� -VC EXISTING WELL + + 0 I I r r +I ' Ny�100'RADIUS m �� I I Jfn C C. I• .. I AVENUE- __ 1 \ �J_ �` r T A/ -E 98TH VENUE- - \ - T- - I I -- EXISTING HOUSE II y / / I { \ F. I _ -E 99TH AVENUE- - _ - I I Septic Design Prepared for '��s.,�1%%1, NANCY BRANDT-ERICKSEN .••-�E Or q4�♦•�• SUMMIT ESTATES, BLOCK 2, LOT 11 s • • �� '1 . 49 r!+ . r� 1* Anchorage, Alaska • /2v1/4., Michael N. Anderson, P.E. DATE: 9/27/2017 114• sMICHAEL N. ANDERSON: ` No- CE 9469 4601 NATRONA AVE • e DRAWN: DJR �� ••lp/�y ••' • ANCHORAGE,ALASKA 99516 • - ••••• "''� • (907) 727-8864/FAX: (907) 345-1391 SCALE: 1"=200' ••f•�a��•• •s• - / \ ' / 1 1I -E 97TH1tAYENUE- \\ !1 / ' 1 \11 t 1 V Y� — II e ® II I /1 I WELL WELL Ii WELL 1 1 t \ 0 1 1 1 1 / --r-S-- 1 1 / \ 1 1 1 / \ / \ 1 / 1 / \ / 1 / \ \ / 1 / 7 \ • • ` \\ ` / / \ \ /LINT \ / /._- / `• \ / \ / // ss N. • • • St1fYMIT ESTATES / ESTATES / -N SUMMIT ESTATES ... r /i----SLI K•2.LOT9 r� ' BLOCK 2,LOT -/ . BLOCK 2.LOT 7 I1 j �/ L1' EXISTING CRIB TO BE USED FOR \ SEPTIC 1 SEPTIC • SECONDARY SYSTEM W/ \• 7 PROPERTY LINE 1 ADVANTEX. - �/ / .0 NEW 1250 TANK / ---. EXISTING GARAGE 10'UTILITY EASEME LOT LINE WAIVER — — — _� — _•=r„..,_ TANK TO BEST -0 - — REQ • --- / -- — I SEPTIC { DECOMMISSIONED D . I 14111111 \1c EXISTING SEPTIC>THAN 14' 1I 1 \ / PER UPC iq� r 1I 1 FROM NEW SYSTEM <<_J • I I \1 _./—----- . • T- II f _ . // / / �ti� �, / / / \ — \ / / / \ / /// // Q \\ CO \ //\\ EXISTING WELL / / •\ / \�-100'RADIUS / / \ / \ I \ / / // \ \\ ) �/ \\ r CARPORT % • \d / t r t , \ Q I EXISTING I SUMMIT ESTATES I WELL SUMMIT ESTATES j '®W L HOUSE I SUMMIT ESTAg S ` BLOCK 2,LOT 10 i BLOCK 2,LOT 11 • I 1I I BLOCK 2.LOT'S a j1 r 1 1 \ PROPERTY LINE r \ r I , 1 \ 1 ! \ /_E 98TH AVENUE- \\ // - - - 1 - - - - \- I- - - - — — - \ \ / \ / \ \ / •\ / \ / \ \\ •\ / \ / \ / \ `� \ / / < \ \ / / \ \ ' . \ i! N SUMMIT ESTATES •\\ ./ SUMMIT ESTATES ./ N N SUAIN;T ESTATES / •� BLOCK 3 LOT9 .\ /. / � BLOCK 3.LOT ,. BLOCK3 LOT' N T` -/ Septic Design Prepared for .ssILStiiit, NANCY BRANDT-ERICKSEN �.�p� ---- ----------F tt . "J;•' 1. ••• •• SUMMIT ESTATES, BLOCK 2, LOT 11 49 TH %\ ' •% Anchorage, Alaska ,•ir - A /Vt. • • Michael N. Anderson, P.E. DATE: 9/27/2017 itj tc;MICHAEL N. ANDERSON.-i 1\ -./ f CE9469 : a 4601 NATRONA AVEANCHORAGE,ALASKA 99516DRAWN: DJR • (907) 727-8864/FAX: (907) 345-1391 SCALE: 1"=50' X444 ;�� 4. Municipality of Anchorage plc �1tvEEl :s'� �� -----PIPPIFPFP' Development Services Department ,'Lj�•" •yi++ Building Safety Division `*:49TH `•ytc+e �On On-Site Water and Wastewater Program r 4700 Elmore Road f ç — P.O.Box 196650 Anchorage,AK 99507 / �;� / www ci.anchorage ak us o. MICHAEL N. ANDERSON ;Z7 ',,_,______,-/',,_,______,-/ (907)343-7904 fi ! yr" •. CE-9469 .``4' ‘ If Soils Log - Percolation Test g11s�o p•..• ••._•,c,:, ��,, � �,� �ll ('If�`f�qti Performed For: (J t 11 t 7 611641 t i ' ,r'► L h r im`? Date Performed: 1( T Legal Description: Ljtoi,yY,r,,P .,-L9 le-T 4j Township.Range,Section: R, 2- 1 rjic tt Slope Site Plan Depth ` 6t / - - - (Feet) 2- 47? '� 16(9ri 3 4- 5- 6/ir 6- 7 8- WAS GROUND WATER 9- ENCOUNTERED? 744) " 10- IF YES,AT WHAT DEPTH", I Depth to Water After 11 Monitoring �� •L� r 12- _ i 44.V ,�, ` 7`v' / ' 13- - r HI 2 ,r)/''/ 14- Reading Date Gross Time Net Time Depth to Water Net Drop 15- yl .r cr//0 h' /i-04ir1 6,// 2t 'r 16:----- 0 r,,,, 4', 2,, " 17- “I 7,15/f 18- �. ,6 „ 19- 20 PERCOLATION RATE 1.1 immuic.,n PERE HOLE DIAM1,'ET-P Y TEST RUN BETWEEN "3 FT AND l FT COMMENTS PERFORMED BY: MNA I CERTIFY THAT THIS TEST AS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 7 ? Gi~: ?ER ANCHORAGE AREA BORGI' ? D~.,wARTMENT OF ENVIRONMENTAL OUAL~ 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION ~-¢'1 SEPTIC TANK: MAILING : I ADDRESS ,~ ~.f' .-'C/.:~~- /.C~"~/~ __PHONE_ LEGAL DESCRIPTION .'~ '(J~ /~/M~' , ~J/~J~)/Y ~r~' DISTANCE FROM WELL LIQUID CAPACITY GALLONS. MATERIAL .~/~-~t¢'~' NUMBER OF Z COMPARTMENTS .~.~'~-~/~ r~"~-~-~" ~,~/~'~ ~'~:~/'~ LIQUID INSIDE LENGTH INSIDE WIDTH DEPTH __ SEEPAGE SYSTEM: SEEPAGE PIT: NEAREST LOT LINE .... OR WIDTH /'/~ . LENGTH _~'~ , DEPTH DISTANCE FROM WELl /~'~ / , BUILDING FOUNDATION TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) '~'~ SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WEL[ /~ATION ~LOT LINE NUMBER OF LINES / DISTANCE BETWEEN LINES TRE~ ABSORPTION AREA / SQ. FT. LENGTH OF EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE TOTAL LENGTH · OF LINES / L EFFECTIVE IN. ABOVE TILE ~) DISTANCE FROM WELL: TYPE~),~//~,~ , DEPTH ,, BUILDING FOUNDATION. NEAREST SEPTIC ,~,?" SEEPAGE LOT LINE ~:;~-~/''~ '~ , SEWER LINE ., TANK ~ , SYSIEM~,/~'~ WATER , . SAMPLE~, NEAREST ~ OTHER CESSPOOL , SOURCES DISTANCES: DIAGRAM OF SYSTEM APPROVED G .A..~. Gr~,/ER ANCHORAge AREA BOAr, Ugh DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCH 6-630 ANCHOBAGE, ALASKA 99502 TELEPHONE 279-8686 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT INSTALLATION OF: SEPTIC TANK SEEPAGE Pit COMPLETION DATE ANTICIPATED ~)( /~ FINAL INSPECTION= 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. . : / 4 ;.. ,,. , / MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK / FOUNDATION TO seePaGE PIT J--x~ DRAIN field SEPTIC TANK TO SEEPAGE PET WALL SEpTIc TANK ~ / ~' C~ / · SEEPAGE PIT _, DRAIN FIELD TO N eA.ESTLOTL,NE. 5-o c / WELL TO SEPTIC TANk SEEPAGE PIT DRAIN FIELD /~ ~ [ also CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK /~ SEEPAGE PIT. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SO]L. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. ~ EA LTH AUTHORITY OR LICENSED DESIGNER I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DA ~ ICANT'S SlgNATUR~ ~ ~' r/~/L&~:- ~ Performed For Donald Dahl B~o~n aandy alit f I 3 ~ay sandy g~avel to velly sand (SW) 4~ with silty gravel seams 6~ 7~ 8~ Reading Drain Fi eJ.d Depth Of .inlet ~r ,v .', ' .;'g -- · ........... ~ ~c ,. ~ om Of Pit Or 'i'renc.~ _ 13~5___square feet ~zna~e -re~ ~ ....... =~--~ Test- Performed By :~,~~ Data Certified By: National Testin~ Service'~ Inc. l } • • Municipality of Anchorage ,, .,. -'-,,'!Q On-Site Water and Wastewater Program (907) 343-7904 S A r r T CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 015-072-08 Expiration Date: Jar? 02.51 cO 7S 1. GENERAL INFORMATION Complete legal description SUMMIT ESTATES. BLK 2, LOT 11 Location (site address) 5511 EAST 98TH ANCH, AK Current Property owner(s) NANCY BRANDT-ERICKSON THOR Day phone Mailing address _SAME Real Estate Agent Day phone 2. TYPE OF DWELLING: 9, .:•-•-...- . . �t ® Single Family (w/wo ADU) ❑ Duplex uLJ ❑ Multiple Dwellings (Single Family and/or Duplex) 4 " rte,., c l� 3. NUMBER OF BEDROOMS: 4 �o� 6 �.�'; \ c9� ,s , 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:`o'• Individual Well ® Individual Individual Water Storage ❑ • Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer E WaiverNariance request for: Distance: Received by: '-v :r¢itia;�, ,\-! Date: w/7J/'IP- COSA to be released to the engineer, unless otherwise j ue b ��y the engineer. .. 242017 \,i_ k COSA Fee $ Ll Lizei.EI4 `'`,,. W - e Fee $ Date of Payment la/ 1(3- '''--6----9-! 9 to of Payment Receipt Number £• (C)&? Receipt Number COSA# ftC•«'H 6-06 Waiver # 9 y it a 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm MIKE N ANDERSON. P.E. Phone 727-8864 Address 4661 NATRONA AVE. Engineer's Printed Name MIKE N ANDERSON, PE Date 10/23/17 ."•.9 7 t-t 6. DSD SIGNATUREX61:, :' rMlcl:Ac. N. \/ System #1 Approved for 171 bedrooms. N,1 System #2 Approved for bedrooms. • Disapproved. Conditional approval for bedrooms, with the following stipulations:1i �!l� �rttltrri: �N S---z - Np P,vAti pIE‘k SNSovikoGRPi� OMS Alan'Se By Qi2%tU^ eaxusU Original Certificate Date: 10/25 02017 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 blue sheer 10-10.12.aoc If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: SUMMIT ESTATES, BLK 2, LOT 11 Parcel ID. 015-072-08 A. WELL DATA Well type Private If A. B. or C provide PWSID # Well Log (YIN)$/.[ Date completed 1971 * Sanitary seal (YIN)Y Wires properly protected (YIN) Y Total depth 98' ft. Cased to 98* ft. Casing height(above ground) 12"+ FROM WELL LOG AT INSPECTION Date of test 1017/2017 Static water level ft. 73 ft. Well production g.p.m. 3+ g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 3.6 mg/L Arsenic: ND ug/L Date of sample. 10-5.17 Collected by. Mike Anderson B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL Date installed 10123/2017 Tank size 1250 gal. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (YIN) Y Depression over tank (YIN) N High water alarm (YIN) NA Date of pumping NEW Pumper NEW C. ABSORPTION FIELD DATA — 1985 SYSTEM TESTED Date installed 10/23/2017 Soil rating (sf/bedroom) 1.2 System type DEEP TRENCH Length 43 ft. Width 2 ft. Gravel below pipe 6.0 ft. Total depth 10 ft. Eff. absorption area 516 ft2 Monitoring tube Y Depression over field N Date of adequacy test NEW Results (Pass/Fail) NEW For 5 bedrooms Fluid depth in absorption field before test_ in. Water added_gal. New depth in. Elapsed Time: min. Final fluid depth _ in Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) UNKNOWN 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: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 100'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 50'+ Holding tank 100'+ Animal containment areas 100'+ Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10'+ Property line 10'+ Absorption field 10' Water main 100'+ Water service line 50'+ Surface water 100'+ Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line 1;'+ t.' }-`/4" Building foundation 10 Water main 100'+ Water Service line 50'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain 50'+(None Known) Wells on adjacent lots 100'+ F. COMMENTS WELL IINFO YEAR AND DEPTH WAS FROM THE ORIGINAL OWNER MEMORY G. ENGINEER'S CERTIFICATION (,•.... ........ - • , 1 certify that 1 have determined through field inspections and ,i h~• • •Y, rte review of Municipal records that the above systems are in '*r :49! / conformance with MOA COSA guidelines in effect on this date. b, }� Engineer's Printed Name MIKE N. ANDERSON. PEI? . MICHA�- N. ANDERSGN :ty ' G!•• C 9 6g .` Date 10/23/2017 1 • !�'• ll�?► • �,,y COSA canary sheet_2-6-15.doc A N 89'57'30" E. 120.00 ":31 ii;IP' \ G% , . ci GPRPfG� ! • 42 O J • OO \--- - O /�� O O ,' BAR -B-WE o O O M O O r0 �I/. �O SFr Z O�'F�P Z 1 .ir. `rl .WELL /w � N 89'57'30" E. 120.00 o 'n arn E . 98TH AVENUE Bobby F. Burnett GRAPHIC SCALE: 1 Inch = 30 Feet 2941 arriage Drive Anchorage, Alaska 99507 I I 11 I (907) 350-5541 15 0 15 30 60 S\\� Date Scale Legal Description OF A4`lk 10/24/2017 1" = 30' <S• `�� Lot 11 Block 2 Grid f A. . i.- if- SW 2437 AS-BUILT SUMMIT ESTATES /*:4� T_:• * ; Drawn by Field Book SUBDIVISION / 0� , BFB ASB-2017 PLAT # P-628 I hereby certify that the property described hereon has been surveyed , ;•(O‘e : by me, or at my direction, and that the improvements situated thereon Y F. BURNETT / are within the property lines and do not overlap or encroach on the LS-5484 AOproperty lying adjacent thereto unless otherwise shown. That no 1 1J_�[J .1; �/.7 Air improvements on the property lying adjacent thereto encroach on the `` premises in question and that there are no roadways, transmission 1, SSIONAL�' Aar ,000/ linea or other easements on said property except as shown. �`!.11110- f . sGs SCS Rci# 1177123001 (lien)Name Mike N.Anderson, P.E. Printed Date/Time 10/12/2017 12:32 Project Name!# East 98th Collected Dale/Time 10/05/2017 9:00 (Tient Sample II) East 98th Received Dale/Time 10/05/2(117 9:26 // Matrix Drinking Water Technical Director Stephen C.Ede Sample Remarks: Allowable Prep Analcsis I'1ramcter Results LOQ t'mt> Method Container ID Limits Date Date Ina Metals by ICP/MS :\r.�nir ND 1 5.00 ug/L EP200.8 C (<10) 10/09/17 10/10/17 VDL Waters Department Total Nitrate/Nitrite-N 3.60 0.100 mg/1. SM2I 4500NO3-F B (<10) 10/10/17 AYC Micro Lab—Provisionally Certified as of 092117 I/:.Coli Negative 1 IOOml, SM2I 9223B A 10/05/17 K.W "total CoIi1'orm Negative 1 100m1, SM2I 9223B A 10/05/17 K.W . sGs SGS Ref.# 1177124001 Client Name Mike N.Anderson.1'.E. Printed Date/Time 10/13/2017 10:01 Project Name/4 East 98th Collected Date/Time 10/05/2017 10:00 Client Sample ID East 98th Received Date/Time 10/05/2017 10:26 Matrix Drinking Water Technical Director Stephen C.Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init TotalDissokedSolids 235 10.0 mg/L SM21 2540C A (<500) 10/4)6/17 EWW Metals by ICP/MS lardness as CaCO3 213 5.00 mg/L SM21 234013 B 10/09/17 10/10/17 VDI, Private Individual Analysis Chloride 22.1 1.00 nig/L EPA 300.0 A (<250) 10/10/17 10/10/17 DSII Conductivity 433 1.00 umhos/cm SM21 251013 A 10/06/17 AYC Fluoride ND 0.200 mg/L EPA 300.0 A (<2) 10/10/17 10/10/17 Mill Sulfate 15.6 0.200 mg/L EPA 300.0 A (<250) 10/10/17 10/10/17 DSI1 Alkalinity 165 10.0 mg/L SM21 232013 A 10/06/17 AYC Aluminum 50.0 20.0 ug/L EP200.8 B 10/09/17 10/10/17 VDL Antimony ND 1.00 ug/L EP200.8 B (<6) 10/09/17 111/10/17 VDI. Arsenic ND 5.00 ug/L EP200.8 B (<10) 10/09/17 10/10/17 VIA. Barium 9.89 3.00 ug/I. EP24)0.8 B (<2000) 10/09/17 10/10/17 VDL Cadmium ND 0.500 ug/L [P200.8 13 (<5) 10/09/17 10/10/17 VDL Calcium 63900 500 ug/L [P200.8 B 10/09/17 10/10/17 VDL Chromium ND 2.00 ug/L EP200.8 B (<100) 10/09/17 10/10/17 VDL CO3 Alkalinity ND 10.0 mg/L SM21 232013 A 10/06/17 AYC Copper 95.9 1.00 ug/L EP200.8 B (<1000) 10/09/17 10/10/17 VDI. IC03 Alkalinity 165 10.0 nig I. SM21 2320B A 10/06/17 AYC Iron ND 250 ugrL EP200.8 B (<300) 10/09/17 10/10/17 VDI. Lead 1.50 0.200 ug/L EP200.8 B (<15) 10/09/17 10/10/17 VDI. Magnesium 12900 50.0 ug/L EP200.8 B 10/09/17 10/10/17 VDI. Manganese 2.52 1.00 ug/L EP200.8 B (<50) 10/09/17 10/10/17 VDI. Nickel ND 2.00 ug/L EP200.8 B (<100) 10/09/17 10/10/17 VDI. 011 Alkalinity ND 10.0 mg/L SM2I 232013 A 10/06/17 AYC p11 7.9 0.100 pH units SM2I 4500-H B A (6.5-8.5) 10/06/17 AYC I LS. i t SGS Ref.# 1177124001 Client Name Mike N.Anderson,P.E. Printed Date/Time 10/13/2017 10:01 Project Name/# East 98th Collected Date/Time 10/05/2017 10:00 Client Sample ID East 98th Received Date/Time 10/05/2017 10:26 Matrix Drinking Water Technical Director Stephen C.Ede Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Private Individual Analysis Selenium ND 5.00 ug/L EP200.8 B (<50) 10/09/17 10/10/17 VDL Silver ND 1.00 ug/L EP200.8 B (<100) 10/09/17 10/10/17 VDL Sodium 4500 500 ug/L EP200.8 B (<250000) 10/09/17 10/10/17 VDL Thallium ND 1.00 ug/L EP200.8 B (<2) 10/09/17 10/10/17 VDL Zinc 76.5 5.00 ug/L EP200.8 B (<5000) 10/09/17 10/10/17 VDL