Loading...
HomeMy WebLinkAboutSKYLINE VIEW BLK 1 LT 12kyl ine View Block Lo1' 12 #051 - 192-43 (Rev 05/02/18) Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191433 PID Number: 05119243 Dwelling: ❑■ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑■ Upgrade Name Hooper ABSORPTION FIELD El Deep Trench El Wide Trench El Bed El Mound Site Address 19325 Lupin St ❑Other Phone Number of Bedrooms Soil Rating Total depth from original grade 351 9343 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Skyline View 1 12 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines - Distance between lines - Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line Ftz Ft. Well 100'+ na na 25'+ TANK N Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1000 Gal. Surface Water 100'+ na na Material Plastic Number of compartments 2 Lot Line 10'+na na NA Foundation 10'+ na na LIFT STATION Manufacturer Capacity Gal. Remarks Septic Tank Replacement- Cleanout added before tank Alarm location Electrical installed by PIPE MATERIAL House to tank Tank to D3034 Installer drainfield Dean Drainfield CO/MT D3034 Inspector BENCH MARK (Assumed elevation) 100 ft Inspection1st 10/11/19 nd 10/12/19 Location and description Deck 3rd 4t" ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date - ro yt / • it Septic P i l/7./.1f9'r Approved WL Date/o—)-,4 `'r4�r Es„cjY Note: this approval does not include well permit requirements. (Rev 05/02/18) N OR THR/ M ENGINEERING i;* ;49gI SteveEng.com "' .. PO Box 770724 � Sim Eng Eagle River. Alaska 99577 VIN, CE-6M qn7_ 6.a4_ 7n2R '�� l0�l7�1Q 0 Well 0 Well atj Slope Flat Slope Well 7m )r,vewayl \l I L N /-8100 Existin "� \ Trench °�6 Flat Slope \ c c L13 Septic I £ £ New 1000 Gallon Q) 0, Septic Tank w/DC❑'s w w Decommissioned ❑W Septic Tank -+> ),t Slope PER UPC I +, 0 0 SKYLINE VIEW 1° = 40' i BLOCK 1 LOT 12 RECORD WASTEWATER UPGRADE LAYOUT Date: REPLACE SEPTIC TANK10/17/19 2" o -F 3 A B dcol 15 11 STI 18 16 ST2 22 21 dco2 25 25 zz N OR THR/ M ENGINEERING i;* ;49gI SteveEng.com "' .. PO Box 770724 � Sim Eng Eagle River. Alaska 99577 VIN, CE-6M qn7_ 6.a4_ 7n2R '�� l0�l7�1Q 0 Well 0 Well atj Slope Flat Slope Well 7m )r,vewayl \l I L N /-8100 Existin "� \ Trench °�6 Flat Slope \ c c L13 Septic I £ £ New 1000 Gallon Q) 0, Septic Tank w/DC❑'s w w Decommissioned ❑W Septic Tank -+> ),t Slope PER UPC I +, 0 0 SKYLINE VIEW 1° = 40' i BLOCK 1 LOT 12 RECORD WASTEWATER UPGRADE LAYOUT Date: REPLACE SEPTIC TANK10/17/19 2" o -F 3 Ln 0 L aj d75 0) d U -Y c d . c F-- L- C, -6 U Y:p u ON C, 0 0i 0 ( d C5 L C F-- U 06 L -Y -0 -P 1 -P ai C) F--- LJ _j 0 Z Cl) I --- U -P F --i d x :2: LLJ LLI u to ON CL < LJ -T Ei Qi • Qi o Qi PCI ovi ZW r4 0 N 0 c d U Ln 0'*, 0) G� LYJ c 01, Lo @j 0 Q.c -0 :p > d > LL] ai Ej- L-�- Ln 0 L aj d75 0) d U -Y c d . c F-- L- 0 -6 U Y:p > ON Ln 0 C 0 ( d C5 0 C =; Q U L > -0 -P 1 -P ai C) F--- LJ _j 0 Z Cl) I --- CD 0 U 4� Ln F --i d x :2: LLJ -6 U Y:p > ON > C 0C Ln 0 0 ( d C5 U @J =; Q +-, -F-- d 0- LD < U 0 IT Ld -0 -P 1 -P ai C) L0 L- C5 C) ai L L 0 > CD 0 F --i LLI u to ON CL < LJ -T Ei • LLI L -D i3i In 11 LLI CL LLJ F --i u to ON CL _j LJ V) • FV- o LLI _j CL LLJ F --i CL LJ V) • FV- ovi ZW r4 0 N aa (L N,,5PALfry MUNICIPALITY OF ANCHORAGE /,.'' S. On-Site Water 8L Wastewater Program vim;` !+ PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 http://www.muni.org/onsite Wpm:trni.nt On-Site Wastewater Disposal System Permit Permit Number: OSP191433 Effective Date: 9/30/2019 Work Type: SepticTank Upgrade Expiration Date: 9/29/2020 Tax Code Number: 05119243000 Site Legal Address: SKYLINE VIEW BLK 1 LT 12 G:1159 Site Mailing Address: 19325 LUPIN ST, Chugiak Owner: HOOPER LESLIE Lot Size in Sq Ft: 15750 Design Engineer: NORTH RIM ENGINEERING Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field 2 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 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: 11":71/_ 9 Issued By: • (_fes �� Date: 9 36 MUNICIPALITY OF ANCHORAGE 0I7 Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-192-43 Property owner(s) Hooper Day phone 351 9343 Mailing address 19325 Lupin St Site address same Legal description (Sub'd., Block & Lot) SKYLINE VIEW BLK 1 LT 12 Legal description (Township, Range & Section) Lot Size 15,750 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑ (w/wo ADU) Septic Tank ❑ U.•! -se8 Duplex (D) ❑ Holding Tank ❑ v5` - -,9: 0 II ❑ Multiple Dwellings Li Privy [ .—ev WWI A! (SF and/or D) Private Well ❑ ii SEP 2 2019 t Water Storage ❑ 4- ti c THIS APPLICATION INCLUDES • �• E' 0; EST 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: 225 Waiver Fees: Date of Payment: 60?-1/11 d— Date of Payment: Receipt Number: n(55 D Receipt Number: Permit No. ©5Y m4 33 Waiver No. G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 2TF-�I M ENGINEERING SteveEng.com Steve Eng,PE, PH 907-694-7028 SteveEngPE@gmail.com Date: 9/26/19 Number of Pages: To: MOA On-Site Services Subject: Skyline View Block 1 Lot 12 Septic Tank Failure The subject septic tank has failed-a new tank will replace the old one.The existing trench appears to be working OK. Please issue a permit so the tank can be replaced. The existing trench will remain. Please review as soon as possible. If there is need for additional information or clarification please give me a call. Thanks-Steve ,ATF-ZI M ENGINEERING Skyline View Block 1 Lot 12 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is an existing 3-bedroom home.Most of the neighboring lots are developed. The current septic tank has failed-the trench still functions. This lot is only about a third of an acre and served by an existing well.No adverse impacts are expected from tank replacement. The easements are depicted on the lot. The slope is indicated in the area of the septic system.No conflicts to neighbor properties,but very limited room available. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications(AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • New 2- compartment, 1000 gallon septic tank. Watertight couplings on inlet&outlet. • 5' minimum between the tank and trench. 10' to property lines&house. • 4' of cover or insulation is required for tank; an equivalent of 1" insulation for 1' foot soil cover. Tank& solid pipe must be set on well compacted, stable soil. • No large rocks for tank bedding. Plastic/fiberglass tanks require special bedding per MOA- sand or pea gravel. • 4" diameter cleanouts with airtight caps are required 1' to 4' from foundation wall, prior to any 90 degree bend in 4 inch line, in each tank compartment,and two adjacent opposing cleanouts between the tank and the absorption field,not more than 10' from the tank positioned to provide cleanout access towards the tank and towards the absorption field. • All cleanouts must extend to at least ground level. • In solid pipe runs,ASTM D-3034 may be used in lieu of cast iron. • Insulation must be placed over any pipe installed under driveways or parking areas. • Approved pipe materials include cast iron,PVC ASTM D3034,PVC ASTM F789, ABS ASTM D2661, • Sewer Service Line is minimum 2%slope. • Septic Tank to be pumped every two years or when required. • Insulation board to be extruded direct burial polystyrene(Dow Styrofoam HI/equal) • ,,r • "40 r o 7726 DESIGN NOTES: 1 . Existing Trench Remains In Place. 2. Sewer Service Line minimum 2% slope. 3. Replace Septic Tank/Decommission Old Tank Per UPC. Connect New Tank To Existing Trench. 4. Lots Served by Private Water Wells. S. No Conflicts Within 200'. 6. Check Condition Of Sewer Service Line— Replace If Nec- _-.ry. 7. Measure Separation Prior To Construction. 8. Add FCO or DCO Prior To Tank If FCO Absent. 9. MOA Spec For Tank Bedding. Sand Or Pea Gravel For Plastic/Fiberglass. p - Well V) 0 Q Well Flat Slope Well Flat Slope 3 Berri Dr veway R100 R 10 •�'+ ` Well Existina� Trench Flat Slope L13 Septic (1 New 1000 Gallon Septic Tank w/DCO's W w Decommission Old I Septic Tank Flat Slope PER UPC I+, +, NOR THRI M At PF_' 1q�! SKYLINE VIEW 1" = 40' ENGINEERING lc') `'�9t DESIGN Steve Eng. cal-r, i * 49TH *i BLOCK 1 LOT 12 PO Box 770724 %V �i LAYOUT ogle River, Alaska 99577 S CE-6255 i WASTEWATER UPGRADE 907. 694. 7028 '49/30/1 - REPLACE SEPTIC TANK Date: EET: 9/30/19 2 of 3 Foundation Cleanout Tank Cleanouts Fin ade Opposing Cleanouts Between Septic Tank & Trench Riser 4 Foot Cover Per or Equal MOA • L—sv� 1000 Gallon To Existing Trench MOA-Approved Septic Tank lid Pipe Match Elevations To DESIGN NOTES: Existing FCO & Line 1. Use Existing Trench, 2. Septic Tank & Solid Pipe to be Placed on Compacted, Stable Soil, Free from Boulders. 3. Sewer Service Line is Minimum 2% Slope & 3' Cover. 4. Water-Tight Couplings. 5. See Specification Sheet. 6. All Work To Conform to Municipality of Anchorage (AMC) Requirements & Specifications. 7. Decommission Old Septic Tank Per UPC. 8. Check Condition Of Sewer Service Line. Replace And/Or Insulate If Necessary. 9. Use MOA Spec For Bedding Depending On Tank Type. 10. Riser Per MDA Specification. NOR THRIM '14 ��i SKYLINE VIEW ENGINEERING Ic-)• '+ SEPTIC TANK PRDEILE SteveEng.com • BLOCK 1 LOT 12 PO Box 770724sew.Erg Eagle River; Alaska 99577 #+ e17�n 4Sr Dote: Drown By: Scale: SHEET 907. 694. 7028 (7 TANK REPLACEMENT 9/26/19 SE � = 5 •3 of 3 SE  MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE ~;;~-N EW NAME~ .. L, ~--'~'Z.Z~ /'~.~ZZ,'~-: ~$.-~?~,d, ~UPG,^~E MAILING ADDRESS LEGAL DESCRIPTION .L~ ~ Z~7' /~, Z~z/~.. i~ ~Z//~x ~'~. LOCATION NO. OF BEDRQOMS Wall z~ Absorption area Dwelling / PERMIT NO.~ ~ DISTANCE TO: /~ ~ ~ i ~- 7'7 0 7 ~ ~ Z ~ Manufacturer ~ ~ ~-~ Materia~'~/~ No. of compartments ~ ~ Liq. capacity in gallons Inside length Width Liquid depth / ~(~ IF HOMEMADE: ~ ~ DISTANCE TO: Well Dwelling PERMIT NO, 0 z ~ Manufacturer Material Liquid capacity in gallons ~ Well -~ / Foundation / Nearest ~ot ]in~ / 7 ' PE~MtT NO. 7'Z'7~ ~7 ~ E ~S~A~C. ~o: / ~ :~ .&~ ~ No, ofHnes / Lengtb of each lin, Total length of lines Trench width Distance between lines ~- 7 ' ~ 7" :~ o in~h.~ ~/~ _ -- Total effective absorption area gH Top of tile to finish 9fade ~ // Material beneath tile ~2- inches .~¢- _~Fr' Length Width Depth PERMI~ NO. ~ ~ m~pe of crib O~ib diamete~ Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance to lot lin~ PERMIT NO. ~ Buildin~ foundation 8ewer line 8eptic tank Absorption area(s) ~ DISTANOE TO: OTHER PIPE MATERIAL8 ~ ~ g~ ..g~ ~ ~ ~. p~.~zi~ SOIL TEST RATIN~ REMARKS ,'~ , ..... ~ ~ / Earl P. Ellis · ~'~ % NO, 1745-~ ' 72-01 : (Rev. 3/78) [)EF'RF.'.THENT OF HEFILTH RF,ID EN',,,'I F'.ONHEN'f'FIL.. PROTECT :[ Obi 825 "L" PEF:H.IT 1'41 ~~ RF'F'L :[ [.':F'tNT R. L PELL I LOCFITIEIN L~]F"'.~NE OFF SKYLINE LEGRL Li2 BJ. SKYLINE SUB STRE:E:T., RNCHORRGE,, RK. 9958± 264--.47'2E~ .'E -IF E ~E; E L-..It E:_' F.: IF::" E~] F~'. r-ll .][ 'T DR PO 146 EREiLE F..'I',,,'EF.: LOT SIZE 15750 SQIJRRE: FEET "f'YPE OF SOIL RBSORBTION :S'T'STEFI IS: TRENCH I"IRXIf'IUM NUMBER OF BEDROOf'IS = SOIL. RRTING (SQ F..'T/81:4:)= 85 THE REQUIRED SIZE OF THE SOIL RBSORPTION SYSTEH IS: THE LENGTH DIHENSION IS THE LF'NGTH '::IN FEET) OF THE TRENCH OR [:,RRINFIE:LD. THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETP.IEEN THE SURFFICE OF' ]'hiE: GROUND FIND THE BOTTOH OF THE ENCR',/R]'ION (IN FEET). THERE IS NO SET HID'iH FOR TRENCHES. THE I.'~RFtVEL DEPTH IS THE f'llNIHUfd DEPTH OF GRFtVEL BETNEEN THE OUTFF:ILL. F'IPE RND THE BOTTOH OF THE[ EXCRVRTION ,::IN FEET). R F'I..-iF:KRGE F'LANT t'IRY ~E ZNSTFtLLEI."., RT THE PEF.:HITTEE"S OPTION SIJB..TECT TO THE FOLLOI.,.tINt':i CONE:,.ITInNS~: 1. EITHER. FI CLRSS I Cli~. II NSF RF'PRI3',,,'ED PLANT f'IR'T' E:E INSTFILI_ED. 2. FI CONTINUOUS HFIINTENRNCE FI(~REEf'IENT .IS REQU.IREI). IF R HRINTENRNCE RGREE£'IENT IS NOT KEF'T CLIF.'.P..ENT YOU f'IFI'T' BE REQUIRED TO ENLRF..'GE THE SOIL ABSORF'T.ION SYSTEf"I FIND,-"I:)R YOU HRY BE SUB..'rECT TO PROSECUTION. .......... "T I...i ~:) ,:: ;.;;.: :::, % I'-.! 5 F' E{ C.:: 'T' I O I%1S F:l R E F..: E ,;:! l.J :]: F-: E-L' BFICK. FILLING OF RNY ':.'iYSTEf,'t b.I.ITHOUT F.INFtL INSPECT.ION RN[:, RPPROVFtL BY TH.I.S DEPFIRTf'IENT NILL BE SUB..'rE:.CT TO PROSECUTION. MINIItUM [)ISTFINCE BETHEEN R HELL FIND ANY ON-SITE SEHAGE DISF'OSRL. SYSTEhl IS ::LIZI~I FEE]' FOR'. R PRI',/Ff/E NELL OR 2EIE1 FEET FOF.'. FI PUBLIE: 1.4ELL.. OTHER REQUIREHENTS FIFIY RPF'LY. SPEF.::IFICRTIONS RND CONSTRUCTION [:,IRGRRf"IS RRE I:'i',,,'R.ILFtBLE TI3 INSIIF.'E PE_FEK INS'I'AI_LR'FII-~N. .... . __ "=;'" /' l ::L '.t'~ ";:' I E:ERT.IFY THRT :[.: I f:tH FRHILIRR H.ITH THE i;.).E:;!JIF;:EfqENTS FOF.: ON--SITE SEI4ER. S RND 1.4EI_I._;:, FIS .:,E.F FORTI4 B'¢ THE ftUNII.'.'.'IPRLITY OF FtNCHORRGE. ,,. I NIL. L INSI'RLL THE SYSTEft IN FiCCOF.'.DFINCE H.ITH THE L.U[.,E;,. 2:: I UNDER':.';TRND THRT THE ON-SITE SEPIER SYSTEIt f'IR'T' REf.:.!UIRE ENI_RRGEHENT IF THIE L. r'ELL. ISSE*: -7/----' ..X' .'r.:., ?/~,.~,.-:":" :.> // ,.~.---, . /, .. . . .,**~-'~'¢:' . .s', ,, .,~'%.-~'.,,. .,%._.z.,,,:-. ........ /' -*' .":? /%/ ,' ./ : ..... ,, .¢"...;:.., ~.,.... !..; ..... ; ..... . .... ,; ;' . . ,; '1.". ,,,,,.: (~ 0 Et E GEO] Russe# Oyster 694-2774 Soils ~ Foundations Performed for: Legal Description: Depth (feet) 0 /wy ~ 1 3 .CHNICAL Et DEVEL( Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 SOIL LOG ~MENT CO. Earl Ellis 68~-2280 Land Development Hame: ,"~; Mailing Address: Z o'~ /'2 ..... ~ '~',')z -' ,s,oll Charactertstic~ 6, 8 9,~ 10 , 12 Ground Water Encountered: Yes Proposed Installation: Seepage Pitm Comments: No / If yes, what depth Drain Field~ Performed by:_ Date: f 3 1 i v ij] / / / / / / / / / / � {/)�� « } / } / / } / / / } / } \ ®® ^d \ k / ( k \ LO t.. 0 0 0 0 0 §§ )) c \ C4 rd 9k 04 W. r4 lu � \ � � � ¢ � \ ( � ( ( � ) ( ( � % . . . *4j 0 0 £) 0 0 0 0 jzzC,�[�: :« In 0 0 0 0 0 0 0 0 0 0 0 0 I-, z C4 = x C4 C4 x C4 14 C4 V,r; od W w J January 4, 1978 RoLo Pellissier Post Office Box 146 Chugiak~ Alaska 99567 Subject: Lot 12 Block 1 Skyline View Subdivision A permit issued by this department for well and/or sewer system has expired~ Permits are issued on a calendar year basis~ as stated on 'the pe~umit~ by authority of Municipal ordinance. If you have drilled the well, a well log sho%lld be sent to this department to doc%unent the installation date° If there are any further questions~ please contact this office at 264-4720. Sincerely, ~{ealth and Environmental Protection Sewer an~ Water Section PERM ;[ T ~F'F:"L ;[ CFINT LOCFI]-I ON L..UPINE OFF SKYI....INE [.'.',IR L.:I..2 .P.',::[. SKYI.... ;[ NE S,.."D F'. O. d.,4.6 '.a.~567 LOT SIZE 688 2S~06 :1.5750 SI:;!L.IFIF.:E FEET 'I"YPE OF SOIl._ ABSORB'f'tON SYSTEM IS: TF;i~ENE:I*I HFIXIMLIM NUMBER E)F' E:E[:,ROOMS = SOIl.. RATING "I"I.4E REE.)UIRE[:, SIZE []iF THE SOIl.... FIBSORPTI(]N SYSTEM IS: THE LENGTH I:::,IflL.N..,;[ON': ¢ IS THE LENGTH i:'IN. FEET) OF ]"HE ]RE. NL.H"" ..... OR [:,RFI;[NF;[ELI}. 'T'HE I..I=F1H OF A IREN_.H tlr PIT THE I=,THN..E 8E EEN THE ~; I~'FI::I-E I]lF THE C~iROtJN[) RND THE EfOT'T'OM OF THE EXCRVATZON THERE [::~', NO SET 1.4]D'f'H FOR TRENCHES. THE GRAVEL E:,EPTH ZS THE PIZN[I"llJM [.EFTH OF GRFI', THE OI...ITI='Ftl....L. P;[PE RND THE BOTTOM OF THE EXCAVR'I"~ON (;[N FEET). I:::1 F::'FIE::KR6E PI_FINT I'"IFIY E',E I NSTFILLEr..:, FIT' I='OI..]..OW ;[ NEi CC]ND 11' I ON.S;;: ::L. E;[THER FI CLFISS I OR I;[ NSF ;;;:.'. FI C:ONTINIjl]IJS i','IflINT'ENFINCE IR A(:~iRREEI','IENT IS NOT KEPT CUI FIE:SC)RPT I E)N SYSTEM TEE"S OPTIC~ ;UBJECT TO 'THlii: :'CANT MRY BE al..L.E:[:,. S REQU I RE[:,. R FIR I NTEI'.,IFIi'.,tCE 9¢ 8E RECqUI TE) ENL. FIRGE THE SO;El SIJBJECT F..'CiSEEC:UT ;[ C~N. EI[:tE::KF ;[ Ll,.[l. ;[ N(3 OF FIN¥ W ;[ I)EI~'FIRTME1,.4T Iq I L.I._ 8E :'RO¥IFIL E:'?I TH I S M ;[ 1'41MIJM D I STANCE BE FIND ::L00 FEET F'OF.' A 200 OTHIER RE6!U I REMENTS t"IR SPEC.'.' I I FIYFI I [..FIBLE TO INSURE PF NSTAL.[ A PI..IE:L I I IS AND SYSTEM I S ..ICI II.']f.4 D I RGRRMS FIRE I E.::ERT I FY "FHFrT ....... EI..IER=, FIND WELLS FIS :!!;ET :1..: ;[ FIM EF:IMILIF:IR I,.I;[TH THE RE(..:!U]'.F.'EMEN'I"S 'TE '='-,-'"'- FE)R'I"H E:Y THE MI...IN;[CIPI::IL. ITY ElF FINC'HORRGE. ;::': I WILL IN.:,IHLL THE SY'.B'rEI~I ;[1'.4 i:~i::C:C) ICE I,-IlTH ]"HE i]:C)[:,ES. ii:: ;[ . I'.IPERSTFIND THRT THE E]I'.,I-S;[TE :SEI.,.IER SY'.F]TEM i'qFIY REE~.UIRE ENLRRGEMENT IF THE I4:ES ;[ [;'ENE::E': ;[ '..=.; E~ELE[:, TE) I I'.,II::I_.I. Jl}E 1,"IOF.~E THAN FIPPI...ICFINf' R.L... F'EI...LISSER I '.:.;SlJliZ[:, 6 'r ........................................................... [:'ATE GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 'C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 27/~-4561 APPLICATION AND PERMIT NAME OF APPLICANT INSTALLATION gOCATIO~l ~ ..~1,. ~, PERMIT NO, SEEPAGE PIT , DRAIN FIELD . OTHER TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH TO BE INSTALLED BY SOIL TEST RESULTS NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE: REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WiLL be SUBJECT TO PROSECUTION. SEEPAGE AREA SIZE TYPE DIAGR~3~M OF SySTI~M SEPTIC TANK SIZE TYPE MINIMUM DISTANCE~, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEPTIC TaNK TO SEEPAGE Pit WALL SEPTIC TANK ,SEEPAGE Pit TO NEAREST LOt LINE. WE'.LTO SEFT,CTANK 1 00 I DRA,N F,eLD / ~0 I WATER MAIN TO SEPTIC TANK DRAIN FIELD SEPTIC TANK, . SEEPAGE PiT TO RIVER, LAKE. STREAM. , DRAIN FIELD , DRAIN FIELD SEEPAGE P'T [ d rd r , ALSO CONSIDER AREA WELLS. , SEEPAGE Pit , DRAIN FIELD CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF ExCaVATION S FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE Pit FITTED WITH AIRTIGHT REMOVABLE CAPS. CONFORM TO BOROUG~REGULATIONS~GA~ING INSTALLATION. I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DATE APPLICANT'S SIGNATURE FORM i rE•jz; MUNICIPALITY OF ANCHORAGE ,\ '. .✓"' Development Services Department �./ Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 05119243 1. GENERAL INFORMATION Expiration Date: View B1 L12 --------------Complete-legal-description _-Skyline -_.y,..__.__ Location (site address) 19325 Lupin St Current property owner(s) Hooper Day phone 351 9343 Mailing address Real estate agent Jeron Day phone 351 9343 589 2. TYPE OF DWELLING: 6 �� u .70 ❑ Single Family (w/wo ADU)� ❑ Duplex F1 Multiple Dwellings (Single Family and/or Duplex) OCT 8 2019 Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 550'al Waiver Fee $ Date of Payment 1011,1k—mg Date of Payment Receipt Number ,) Vz �"t 1� Receipt Number COSA # OSCE ✓ 03 Waiver # 3 3. NUMBER OF BEDROOMS: OZ n� 68L95 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 550'al Waiver Fee $ Date of Payment 1011,1k—mg Date of Payment Receipt Number ,) Vz �"t 1� Receipt Number COSA # OSCE ✓ 03 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm NorthRim Eng. Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 10/17/19 6. DSD SIGNATURE System #1 Approved for 3 --bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, Q. r Cn PE OROFESS����� with the following stipulatio`rr"'� WATER AFvn �r r� By: Vim- \� 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 Septic System Advisory Well Flow Advisory COSA Checklist blue sheet Nitrate Advisory Arsenic Advisory Other X Legal Description: Skyline View B1 L12 Parcel ID: 05119243 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Well production at time of test 6+ gpm Date drilled 9/18/77 Water storage tank volume 0 gallons Total depth 90 ft Well disinfected for coliform test? ❑ Yes ❑ No Cased to ft ❑ Coliform bacteria is Negative ❑ Sanitary seal is functioning correctly Nitrate 8.68 mg/L ❑ Nitrate less than MRL (ND) -_-__-_-__._-_❑-Wires-are-properly-protected _____ Arsenic_ .-.ug/L----MM Arsenic Arsenic. less. than.MRL_(ND) Casing height (above ground) 18+ in. Collected by NRimEng Date of flow test for COSA 9/23/19 Date of Sample 9/27/19 Static water level at beginning of test 77 ft. Comments B. TANK DATA Age of tank(s) new years . Tank type/material Plastic Measured operating fluid°level in septic tank new ❑ Standpipes/foundation cleanout per record drawing Date of pumping new D. ABSORPTION FIELD DATA 5/23/78 Which system tested (date installed) 5/23178 ❑ ALL standpipes present per record drawing Total measured depth from grade 10 ft (max) Measured depth to pipe invert from grade 4 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 9/23/19 Results F71 Pass For 3 bedrooms Fluid depth prior to test 6 in Water added 450 gal New depth Elapsed time 15 in 60 min ❑ Code -required soil cover over field Final fluid depth 8 in ❑ System presoaked Absorption rate 450 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) no date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Yes Septic Tank/Lift Station on Lot > 100' ft If absorption field is under driveway comment below Community Sewer Manhole/Cleanout > 100' 0✓ Yes 0✓ Yes if No ft ❑✓ Yes if No ft Neighboring Tank > 100' R Yes if No ft Private Sewer/Septic Line > 25'✓1 Yes if No ft Absorption Field on Lot > 100' F71 Yes if No ft Holding Tank > 100' F Yes if No ft Neighboring Absorption Fields > 100' ft Animal Containment > 50' ✓0 Yes if No ft Q Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0✓ Yes if No ft Yes if No ft From Septic/Holding_Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' Q✓ Yes if No ft Surface Water > 100' Q Yes if No ft Property Line > 5'✓❑ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Yes if No ft Private Wells > 100'✓❑ Yes if No ft Water Main > 10' F/I Yes if No ft Community Wells > 200'✓0 Yes if No ft Water Service Line > 10' F-1 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10' Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' ✓V Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that l 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. COSA Checklist yellow sheet Nitrate Advisory Certificate of On -Site Systems Approval # OSC191503 Subdivision: Skyline View, Block: 1, Lot: 12 A water sample revealed a nitrate concentration of 8.68 milligrams per liter (mg/Q. 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. From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. _Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, -- - food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. it 16 0' UTILITY ASEMENTS rt 15 30.0 I Lot 13 Lot 14• PLOT PLAN AS BUILT X SCALE 1" = 30' GRID _ NW 1159 Project No. 19-597/A1 �P 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 L li n g i�( Associates, inc. (907) 522-6476 Phone 4000�pQ� (907) 522-4625 Fax o Professional Land Surveyors ken®Iangsurvey.com �...... jonothanQlongsurvey.com ®� s �� I hereby certify that I have surveyed the following described property: LOT 12, BLOCK 1, SKYLINE VIEW SUBDIVISION (PLAT No. P-508) 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 o asernents on said property except as indicated hereon. Oatc,d thi.3 tho Day of _ �=�''� l•U{ at Anchorage, Alaska 11 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. �* 49TH,�� KENNETH `S LANG a_ las "• ��-, � lL� 5i� �� 04q�Fo LS -5202. • gJQG AECC963 Municipality of Anchorage Development Services Del:iaH:ment Building Safety Division · On-Site Water and WasteWater Program 4700 South Bragaw st. P.O. Box 196650 Anchorage, AK 99519-6650 www.cLanchorage.ak. Us (907) 34;~-7g04 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-192-43 GENERAL INFORMATION Complete legal description Lo t 12; Location (site address or directions) Expiration Date: Block 1; Skyline View Subdivision 19325 Lupin St. gaele River Current Propertyowner(s) Bob & Donna 3town Mailing address Lending agency Mailing address Real Estate Agent Cindy Lindbloom Mailing Address 11411 01d Glenn Hwx~. Unless otherwise requested, HAA will be held by DSD for pickup. NUMBER OF BEDROOMS: 3 Day phone (q16) 371-6/4q6 Day phone Day phone 69/1_9125 Eaele P. iver, AK 99577 TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class__ Public Water System Well TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding tank [] Community On-site [] Public Sewer The Municipality of Anchorage Development SerVices Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal ahd/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority 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 less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid roi' 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 emissions in the professional engineer's work. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as o{~ the validation da{e shown below, I verify that my investiga{ion, based on procedures outlined in the Health AuthoritY Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal sy~terri is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further ~erify {ha{ 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 ail applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. NameofFirm S & S En~ineerina _ Address 17034 N. EaRle River Loop Ste. Engineer's Printed Name Robert C. Co~-an DSD SIGNATURE i~'/' Approved for -~ Disapproved. Conditional approval for Phone 694-2979 204 EaRle River, AK 99577 ueurooms. ~ le ..... ~%-' ~, ?-,- · .............. .,q. '. - ~,,.,<0~ ,~ .... c~i',~ ,~o , ~ ~ .c o ~,7,~: r - ~ % ," ~-~ bedrooms, with the following stipulations: Additional Comments Note: The well for this property meets existing State and Municipal Codes. There are nitrates present. It is suggested that periodic testing be performed to insure the wells continued suitability. Current nitratc concentration is 6.29 mg/1. EPA maximum concentration is ~ 0.0 rog/1. Mare information on nitrates is available from the On-Site Services Program, at 343-7904. Attachments: HAA Checklist ~eptic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: /-~L- .I f.A.,iB;.:.O..'.[-:~;provid · .PW.' S]D ~ '...;. ~', :;Sanita~'.s'e~al'. (yl~):,-. -~/ 'qase~d.tO:':.'¢¢,,. .~..: F.ROM.~WELE t:OG . ./ ..:., :. :'" ~ .'~t. i?:r~' g. pzm:' ,.e¢ I;.,L0g .Wire~ 'properly' p~;O~.ected',(~¢/N) .-..-, CaSifig:,he~ht.(ab~e~mund) ./'~ in. - · ,.~ .'A~ INSPECTION ~" ~. ,...: ';~¢ : .,. De~es~ien over'field ::bedrooms E.¢apsedTime:'~¢ rain.. Fnalfluid'depth ~"in." :Abso~tiofi rate >= ~.~ g.p.d. Any rejuvenation t~at~. (past lg. m.0,) (~N.:& ~pe) ' ' ';~ ~¢~' .If.yes .give date D..'LIFT:STATION Date idst~lled /'~///~ "Pump 'on".level at...~_ in. / Datum E. SEPARATION DISTANCES Size in ga!lens ,.-: =:,,, :,:-.,...: ......... M. anhole/Access {Y/N) "Pump.off~ level at ," .,'..,.In... ,..,H~h water, alarm evel at Cycles tested "" ..} Meets alarm & circuit requirements.* SEPARATION DISTANCES. FROM WELL ON LOT TO: Absorption field on lot Public sewer main /~1 ~s'eptic s~rvice: line /~:~' f~-- ' - ,.Helding tafik SEPA:RATI'ON DISTANCES FROM'SEPTI'C/~G TAN~'."(~:!~3T' TO:.' Building foundation ~ '.'P~' :'p-~:&~i:ty line ~-"'~ Absorption~field .~"~ Surfac~.water Water main Water service line __ Wells on adjacent lots ~ OC:) .,r ~.. ' '. On adjacent lets /~=:) ~ 'isBl~lic'sewer manh01eiCleanout...,.....~J,./"~ _ SEPARATION DISTANCE. FROM. ABSORPTION FIELD..ON I:OT TO: ?' .. - PropeAy line t ~) ~ Building foundation .[~)'~ Water main water service line ) :C) f,-~- Surface water ~:'~?~'?~.': -Driveway, pa?king/v~hicle storage, . ,"::,~,~t,?.~<;~,;:y'5 ~?~ ;~i- ~,"t' t,~ "" " ,,~,,, . C.u.k'taio..~l..r, ai.q b~".~. 'Willis on-~dj:ac~r~t";l~t~.":' .iO~--!~--: ": '. .. ' ,'..' "-;:'2' ~ G. ENGINEER'S. cERTIFICATIO'N' "::: I certify that:l have determined through'field inS~'ections a~-~d:- - review.of Municipal records.that the above' systems are,~n ' conformance with MOA HAA guidelines in' effect'O~'t[~7~?'~e. Engineer's Printed Name ~- 0 ~ ~-:-~'- Date " . HAA Fee .$. Date of. PaYment. Receipt .Number (Rev. 12/0~ ) C)~ ~i Jl C~ .!:waiyer~.Fee $ - .- Date:~;'Payment,'_ _ ". · ...... , Receipt N~mber' ~ .. : - 9075615301 T-018 P,02/04 F-672 CT& E Ret:# Client Name Project Name/# Client Sample ID Matrix PWSID 0 Sample Remarks: 1028174001 S & S Engineering Various LI2 BI Skylhae View Driaking Water All DateS/Times are Alaska Standard Time Printed Date/Time 12/04/2002 15:49 Collected Date/Time 12/02/2002 16:30 Reeelve~l Date/Time 12/03/2002 12:05 Teclmital~cto~ Step, finn C. Ede Pmameter Waters Department Nitrate-N 6.29 PQL Uuits Method 9.200 mg/L 'EPA 300.0 Allowable Prep Anulysis Limits Date Date Init (<=10} 12103/02 3S Microbiology r-abora~ory Tom! Coliform 0 col/100mL SM] 8 9222B (<= 1 ) 12/03/02 SKW