Loading...
HomeMy WebLinkAboutCHUGACH PARK VIEW LT 22 8 ti..,„„„.....,..., , , 1 a ipiii Municipality of Anchorage Noy 02 Community Development Department 01�age of 2 On-Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage,AK 99519-6650 • http://www.muni.org/onsite• (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP171009 PID Number: 090-04-220 ❑✓ New ❑ Upgrade Name: TOMMY TREADWAY ABSORPTION FIELD Address ❑ Deep Trench ❑✓ Shallow Trench ❑ Bed ❑ Mound 688 RAND ROAD ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 1.0 GPD/SF 8 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 4 Ft. 4Ft. CHUGACH PARK VIEW 12 Fill added above original grade Gravel length Township Range Section 0.0 Ft. 50 Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES 5Ft. Ft. ToSeptic Absorption Holding Sewer Total absorption area Number of trenches Dist.between trenches From Tank Field Lift Station Tank Line 500 Ft2 1 Ft. Well 182.6 175 N/A I N/A 100+ TANK IO Septic ❑S.T.E.P. ❑Holding 0 Other I Manufacturer Capacity Surface Water 142.6 145 N/A N/A Anchorage Tank 1000Gal. Material Number of compartments Lot Line 10+ 10+ N/A N/A STEEL 2 NA LIFT STATION Foundation 30 47 N/A N/A Manufacturer Capacity Curtain Drain 50+ 50+ N/A N/A Gal. Pump on level at Pump off level at High water alarm at Remarks in. in. in. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank 3034 Tank to 3034 Installer drainfield WILCO CONTRACTING Drainfield 3034 CO/MT 3034 Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 100ft Inspeectionctio 1st 8/21/17 2„a Location and description 8/21/17 3r0 8/22/17 4' 5/18/18 WEST GARAGE SLAB COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp e OF At.A 4 Conditional Approval: Date '��...sx.• •gs,{ia Meyer;of ' .. • annorae•e lCE 81440 Approve. J Date I- lQ' �>r ���4� Inspection Report_1-1-12.doc Y / - . • - -1 ; �• r �/_ � r /`��%� ± 25' CREEK MAINTENANCE- ` DRIVEWAY 1-- / / / EASEMENT l -- YELL ., I I / ../: 7 f / .. / /,4111141r .--- re.-- \ . J. , � 142.6 I / � 2 ;/ / TO CREEK 182.6 II inn 3BR - < I HOUSE `� \LOT 22 r - .-'-' \ _�_, PGK � V� RNW' E�C SE1g CK IN TA LED 1000• PTI TANK W / app C i 1 W/ FOUNDATION CLEAN OUT AND �_ 12 M DOUBLE CLEAN OUT AFTER M-------M-`---, •CO / .�'ss ss M2 \ _DESIGN PARAMETERS ler 2 Cl PRIMARY/RESERVE SEPTIC SYSTEM INSTALLED DRAIN FIELD NO. BEDROOM: 3(450 gpd) TH-1 5OLF x 5'W x 4.0'ED x 8.0'TD TANK SIZE: 10008 \ INSTALLED MT AND CO AT EACH END PERC RATE: <1 MPI A B SOIL RATING: 1 GPD/SF FC 2.8 15.2 7i l AREA RQD: 450 SF 1 90 SYS. TYPE: WIDE TRENCH 4.0'ED T1 37.0 30.5 RF: 0.50 - . T2 41.7 36.2 MIN LENGTH: 45 LF DCO 45.4 40.5 • _ Cl 52.0 47.1 • ��� USED: M1 53.5 49.1 ^ •-'� • 5OLFx5'Wx4.0' E.D., 8.0' TD C2 48.1 59.3 21 \ /-� ' - TOTAL AREA: 500 SF �i M2 46.9 58.2 I \/ \ I z 01- I- I- D <0 0 0 D W Zw w w Dw ,2 m 1_U U U o v o cr FILTER FABRIC o - - __ 0 0 L Z DRAIN ROCK 6"ABOVE PIPE INV z w OG./FG. _1 0 / 7. U 0 90.0 0 - 4..0 DRAIN PIPE- - 088.OG. _ TH-1 1 OR/OL 2 85.4 1000 g SEPTIC \ 45 TANK 85.9 84.0/ 4'SEPTIC ROCK 184.Q GP/ DRY GM 6/30/2017 PROFILE DATE PERFORMED: 6/20/2017 16 711.* 17 18 NOTES: .��.�x�\\ Dete PANNONE ENG SVC, LLC OF Ac q j 12/18/2018 RECORD DRAWING P.O. BOX 100217 ANCHORAGE, A99510 ':� qS l� moo.• 4„,.-..17,710 Scole PHONE (907) 272-8218 FAX (907) 272-8211 ig.• � , DRAWN BY: j*; L}! /..\ •*,, 1"=50' .. •' ..'OSP.... 0 P.I.D. NO ACP CHUGACH PARK VIEW, LOT 22 ��►.v0% -22 TOM TREADWAY Ste en . Pannone / PERMIT NO. r -A•. CE 8149 .•c��� 0SP171009 688 RAND ROAD cs •. ,. PLAN INDIAN, AK 99540 ',{liV, S`=•` '" Sheet 2 ®evelopment Services Depari men i; c= Building Safety Division �,. On -Site Waier & Waste inter' Prorgrain 4700 Elmore P.oad P.O. Box 196650 Anchorage, AK 99507 Mark Begich mm.muni.org/onsite Mayor (907)343-7904 Well Log Permit Number: OSP171009 Date of Issue: 01/30/17 'C'E 8G U O SAF ETY Date Started: 8/17/17 Date Completed: 8/17/17 Is well located at approved permit location? U Yes Lf No Legal Description: Chugach Park View Lt22 G:4456 Property Owner Name&Address: TredwayTommyT 121 Showers Ave Anchorage, AK 99515 Attention: The well driller shall provide a well log to DSD within 30 days of completion. Borehole Data: Soil Type, Thickness & Water Strata Depth From (ft) To Method of Drilling LJ air rotary LJ cable tool Casing type: steel Wall Thickness: .250 inches Diameter: 6 inches Depth: 80 feet Liner Type: Diameter: inches Depth: feet Casing stickup above ground: 2 feet stickup 0 2 silt & gravel w/ boulders 2 74 water & gravel 74 80 Static water level (from ground level): 61 feet Pumping level: feet after hours pumping gpm Recovery Rate- 10 gpm Method of Testing: airlift Well Intake Opening Type: n Open End ❑ Open Hole ❑ Screened Start feet Stopped feet F] Perforations Start feet Stopped feet Grout Type: Bentonite Volumegranules Depth: 20' Start 0 feet Stopped 20 feet Pump: Intake Depth feet Pump size hp' Brand Name Well Disinfected Upon Completion? 0 Yes ❑ No Method of Disinfection: chlorine tablets Comments: Well Driller: Hefty Drilling, Inc. 3540 Akula Dr. Anchorage, AK 99516 Water Sample Results: Arsenic: Nitrates: 0.22'1 Total Coliform Bacteria: Other Bacteria: ug/L mg/L colonies/100mL col/100mL 2 I I I Attention: The well driller shall provide a well log to DSD within 30 days of completion. y 4 Development Services Department Building Safety Division GS Ove -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 ,sn sTv Mark eegich Anchorage, AK 99507 Mayor tyww.muni.ora/onsite (907)343-7904 Pump Installation Log Well Drilling Permit Number:. -_ 05P 171009 Date of Issue: Parcel Identification Number: Legal Description kk nc v,eW Property Owner Name & Address: 5r` r I_✓'CdW4� -rO y T L, k yN 5 (, 1 w ev5 �✓�. 1-�tvto-,ccQ . AV 119S15' Pump Installation Date: 7_ G— /5 Pump Intake Depth Below Top of Well Casing: -7 (7 feet Pump Manufacturer's Name: Pump Model:. /0 D -? _204) Pump Size Yq hp Pitless Adapter Burial Depth: feet Pitless Adapter Manufacturer's Name: �— 10 Pitless Adapter Installer: L/ i I U/ fq C Well Disinfected Upon Completion? 0 Yes n No Method of Disinfection: U ��,� \ A L S Comments: Pump Installer Name: ?hefty Drilling, Znc. P.O. BoX112130 Andwmge, ,AK99511 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. On -Site Water & Wastewater System Permit MUNICIPALITY DFANCHORAGE Development Services Department On -Site Water & Wastewater Program 47OOElmore Road, PDBox 1SGS5O Anchorage, AK8Q51Q-8O5U Telephone: (907) 343-7904 Permit Number: OSP171009 Tax Code Number: 09004222000 Work Type: VVeUSepbc Initial Permit Effective Dates: January 3U.2O17 to January 3O.2O18 Design Engineer: PANNONEENGINEERING SERVICES Subdivision: CHUGACHPARK VIEW Site Legal Address: CHUGACH PARK VIEW LT 22 G:4456 Owner/Address: TREDVVAYTOMMY T 121 SHOWERS AVE ANCHORAGE AK 995150000 LotG�ain�qPb 114258 Site N1ai|in0Addreao' ' Total Bedrooms: 3 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy Y Private Well N Water Storage All construction must beinaccordance 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 (18/V\C72)and Drinking Water Regulations (18/AC8O). 3.The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least hours prior to each inspection. Provide notification by calling (807) 343-7984 (24 hours). 4.From October 15toApril 15.asubsurface soil absorption system under construction during freezing weather must either: A.Open and Close onthe same day. B.Covered, sealed, and heated toprevent freezing. Received B\ Issued By: - -\ ~L~ /)�'`O{ y^ °`~~ l U / ( Date: // � / -"7- ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 090-042-22 Property owner(s) Tommy Tredway Mailing address 121 Showers Avenue, Anchorage, AK 99515 Site address NSN Rand Road Day phone Legal description (Sub'd., Block & Lot) Chugach Park View, Lot 22 Legal description (Township, Range & Section) Lot Size 114,258 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field FX_1 Initial R Single Family (SF) EX -1 (w/wo ADU) Septic Tank RX Upgrade El Duplex ❑ (D) Holding Tank R Renewal Multiple Dwellings ❑ Privy FJ (SF and/or D) Private Well FX] Water Storage R tj1 1 1 111 Ili 111 iiii �� a " Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. gnaiure OT property owner or autnonzea agent) Permit/Rush Fees: If Waiver Fees: / — Date of Payment: Date of Payment: Receipt Number: Receipt Number: Permit No. C3 Waiver No. Permit App_-'- : - . !aoS Engineering eig ea e . LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panenggk.com July 11, 2017 Subject: Chugach Park View, Lot 22 Septic System and Well Permit Request Design Narrative This is a design narrative for a permit to install a septic system and well to be issued for this property. The proposed system will serve a proposed three (3) bedroom house. Currently the lot is undeveloped. The system will utilize a new 10008 septic tank and conventional drain field. This lot and the surrounding lots are served by private wells. There are no wells within 100' of the proposed septic system. 1. Soils. One test hole was performed in the vicinity of this system by PES in June 2017, and groundwater was monitored for at least seven days. Ground water was not observed to a depth of 17.5' below the surface in the test hole monitor tube in June of 2017. Bedrock was not encountered in the test hole to 17.5'. Based on the results of the percolation tests and overall soils appearance; an application rate of 1.0 gallons/day/square was used for a conventional wastewater system in the area of the test hole. 2. Soil Absorption System Design. a. See Sheet 1 of the design package. 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The existing topography on the lot generally slopes from south to north, with a slope of approximately 3% in the area of the drain field. There are no steep slopes within 50' of the proposed drain field. The proposed drain field will maintain 50' separation all steep slopes. S. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On -Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of this or the surrounding lots. Physilcal: 332 East Manor, Anchorage, AK 99501 ZD Telepli-Ione: (007 -7)4' 218 FAX: (907' 272-8211 LOT VACANT DELINEATED WETLANDS WELLS OR SEPTICS �r25' CREEK MAINTENANCE DRNE\NAy WELL (P) EASEMENT 141 1 TO CREEK 3 BR .� / DECK-/ 159.6 /-�-F | ~� �`� . \ ~- 1 Ep�CTANK (P) \_ � |NSTALLF0UNDATDNCLEANOUT INSTALL DOUBLE CLEAN OUT AFTER TANK TH-1J \\\ PR|MARY/RESERVEDR�N RELD(P) °-50LFx51Nx4/]'EDxO'TD INSTALL MT AND CO AT EACH END "DESIGN PARAMETERS PRIMARY/RESERVE SEPTIC 3YST[M— NO. BEDROOM: 3(450 gpd) TANK SIZE: 100Og P[RCRATE: <l MPI �� 0 SOIL RATING: l F �� �� AREAROD: 450 SF SYS. TYPE: WIDE TRENCH 4.0'ED RF: 0.50 / MIN LENGTH: 45LF ~ WITH 50LFx5'Wx4.0' E.D, 8.0' TOTOTAL AREA: 500 SF ( . 15'x15 A IE In_ 1903161 mi, LOT VACANT EXPLORATORY WELL NO SEPTICS NOTES: PAMONE ENG SVC, LLC Date CHANGE ORDER 7/19/2017 P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 O'co - 49 CHUGACH PARK VIEW, LOT 22 W, CE 8149 RAND ROAD OSID1 71009 Sheet INDIAN, AK 99540 m SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS AND AND IN ACCORDANCE WITH AMC 15.65 AND 15.55. 2. SCOPE OF WORK: INSTALL NEW SEPTIC TANK, SOIL ABSORPTION SYSTEM, AND WELL. 3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 14 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 14 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. 4. THE CONTRACTOR (BOTH WELL AND SEPTIC SYSTEM CONTRACTORS) SHALL HAVE ANY WELL LOCATION AND SEPTIC LOCATION STAKED AND ANY LOT LINE AND WELL RADIUS SHOWN ON THE PLAN WITHIN 30 FEET OF THE PROPOSED SYSTEM STAKED BY A REGISTERED LAND SURVEYOR BEFORE STARTING THE WORK. 5. THE CONTRACTOR IS RESPONSIBLE FOR ALL R.O.W. AND OTHER REQUIRED PERMITS, OTHER THAN THE ATTACHED. 6. THE CONTRACTOR SHALL CALL FOR LOCATING OF ALL BURIED UTILITIES. 7. THE CONTRACTOR SHALL PROVIDE 24 HOUR NOTICE TO THE ENGINEER PRIOR TO START OF WORK. ALL SURVEYING AND LOCATES SHALL BE IN PLACE PRIOR TO NOTIFYING THE ENGINEER. 8. THE CONTRACTOR SHALL NOTIFY THE ENGINEER OF ANY DISCREPANCY BETWEEN THE APPROVED DRAWINGS AND SITE CONDITIONS/LIMITATIONS POTENTIALLY CAUSING THE NEED TO MODIFY THE DESIGN. 9. AT THE COMPLETION OF THE WORK, THE CONTRACTOR SHALL SUBMIT RED—LINE AS—BUILT DRAWINGS TO THE ENGINEER. THE RED—LINES SHALL INCLUDE PIPE LENGTHS, ORIGINAL GROUND ELEVATIONS, PIPE ELEVATIONS, AND TANK ELEVATIONS. 10. THE CONTRACTOR SHALL PROVIDE PHOTOGRAPHS OF THE SYSTEM INSTALLATION TO INCLUDE BOTTOM OF EXCAVATION, TOP OF PIPE WITH CLEAN—OUTS AND MONITOR TUBES INSTALLED, INSTALLED TANK AND FINAL GRADING. 11. THE CONTRACTOR PROVIDED DATA (UPON WHICH THIS RECORD DRAWING IS BASED) APPEARS TO REPRESENT THE PROJECT AS CONSTRUCTED. THIS DATA IN CONJUNCTION WITH THE PERIODIC FIELD OBSERVATIONS BY THE ENGINEER (OR HIS DESIGNEE) AS REQUIRED BY AMC 15.65 DOES NOT GUARANTEE THAT THERE ARE NO HIDDEN DEFECTS BY THE CONTRACTOR. 12. THE CONTRACTOR SHALL SIGN THE FOLLOWING: I CERTIFY THAT ALL WORK WAS PERFORMED IN ACCORDANCE WITH THE APPEND PERMIT, AND ANY AND ALL CHANGE ORDERS, AND THAT THE AS—BUILT REDLINES ARE TRUE AND ACCURATE REPRESENTATION OF THE PROJECT AS CONSTRUCTED. CONTRACTOR: BY: TITLE: DATE: ABBREVIATIONS W WATER LINE 1 TH TEST HOLE WELL RADIUS (P) PROPOSED (E) EXISTING SS NEW SEPTIC CO CLEAN OUT NO. MT MONITOR TUBE NO. TYP TYPICAL NOTES: ate P G SVC, L �®�pF AL���� D/11/2017 CHANGE ORDER P.O. BOX 100217 ANCHORAGE, AK 99510 't� """ '�S �� PHONE (907) 272-8218 FAX (907) 272-8211 f 9�� Scale DRAWN BY: NTS DRM "' • • • • P.I.D. NO CHUGACH PARK VIEW, LOT 222-22 Steven R. Pannone TOM TREADWAY PERMIT NO. RAND ROAD ��CE 8149 \�/°' Oheet1009 PLAN INDIAN, AK 99540 $��><�FaFpFESSOO� 3 OF 3 SOILS LOG - PERCOLATION TEST TEST HOLE 1 SLOPE SITE PLAN ORGAN�CS/ 1 — OR/01- ORGAN C SILTS 2 3 4- 5 TH 7 01\ 9 10 SANDY GP/GM GRAVEL WITH TH — 11 SILT 12 Z7 \ 13 WAS GROUND WATER SLOPE 14 ENCOUNTERED? N 15 IF YES, AT WHAT TH DEPTH? -DRY x 16 17 DEPTH TO WATER AFTER MONITORING? -DRY 18 BOH DATE: 6/3012016 19 READING DATE CLOCK TIME WATER NET TIME LEVEL NET DROP READING 20 1 6/20/17 10:00 -- 3.59 -- 2 10:04 4 MIN 9.59 6.00(DRY) DATE PERFORMED: 6/20/2017 3 4 5 6 PEROLATION RATE <1 (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 4 FT AND 5 FT COMMENTS: Test hole excavated by HOMEOWNER PERFORMED BY: Dan Moran. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: PAMONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 A/,, lope w TH . ... ....... 'R.. Date 7/11/2017 CHANGE ORDER Scale NTS DRAWN BY: CHUGACH PARK VIEW, LOT 22 DRM P.I.D. NO -090-042-22 TOM TREADWAY n PERMIT NO. RAND ROAD INDIAN, AK 99540 CE 8149 Aw OSP 171009 Sheet SOILS LOG PROFESSUO- — 2 OF 3 040.002 Client: Pannone Engineering Services Projects: Chugach Park View Lot 22 Date: June 22, 2017 C-0 t I Crowther Associates Particle Size Distribution Table (percent passing) Sample Source Sieve Size 3 inch 100 1-1/2 inch 95 3/4 inch 80 #4 50 910 35 440 14 #100 9 #200 8 0.02 mm Classification Gravely Sand with Silt (SP -SM) 1632 Bellevue Circle lAnchorage, Alaska 99515 Telephone (90 7) 349-2198!E mail: crowther@alaska.net Municipality of Anchorage On-Site Water and Wastewater Program (907)343-7904 Certificate of On-Site Systems Approval [� a Parcel I.D. 09004222000 Expiration Date: 1. GENERAL INFORMATION Complete legal description Chugach Park View L22 Location (site address) 688 Rand Rd Current Property owner(s) Tommy Tredway Day phone Mailing address 121 Showers Ave Anchorage AK 99515 Real Estate Agent Day phone 2. TYPE OF DWELLING: Single Family(wlwo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Distance: Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 73 Waiver Fee $ Date of Payment I/ 8-- let Date of Payment Receipt Number 0 (93-i l7& Receipt Number COSA# ©SC (a ) 007 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. In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations.The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition,ground water levels that may fluctuate during the year,and the water usage of the family being served by the system.These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty for future performance. nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R Pannone<cP.a. Date /5)OIO0 ~'OF �sl� /,-.0o..- TM y*tto e*: 6. DSD SIGNATURE ••• kSystem #1 Approved for 3 bedrooms •••Steven . Pannone• 4 •'t: CE-8149 System#2 Approved for bedrooms ! y' • *� Disapproved llP s Conditional approval for bedrooms,with the following stipulations: t, 1 ON SITF �4 Alt WATER AND CWASTEWATER o PROGRAM '&� \CF- i By: tom•-., `" Original Certificate Date: )_Q—1 ._ :- '''''''' 64 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 sheet f - If more than 1 septic system is on the lot: COSA Checklist# 1 of 1 Structure served by this system I Certificate of On-Site Systems Approval Checklist Legal Description: Chugach Park View L22 Parcel ID:09004222000 A. WELL DATA Well type Private If A, B,or C provide PWSID# NA Well Log(YIN) Y Date completed 8/17/17 Sanitary seal (Y/N) Y Wires properly protected(Y/N) Total depth 80 ft. Cased to 80 ft. Casing height(above ground) 24 in. FROM WELL LOG AT INSPECTION Date of test 8/17/17 NEW Static water level 61 ft. ft. Well production 10 g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform Neg colonies/100 mL Nitrate 0.227 mg/L Arsenic ND ug/L Date of sample: 1/2/19 Collected by: PES B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 8/21/17 Tank size 1000 gal. Number of Compartments 2 Cleanouts(YIN) Y Foundation cleanout(Y/N) Y Depression over tank(YIN) N High water alarm(YIN) N/A Date of pumping NA Pumper NA C. ABSORPTION FIELD DATA Date installed 8/22/17 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.0 g.p.d/Sf System type Shallow Trench Length 50 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth 8 ft. Eff. absorption area 500 ft2 Monitoring tube Y Depression over field N Date of adequacy test New Results(Pass/Fail) For 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) If yes, give date D. LIFT STATION Date installed NA Size in gallons Manhole/Access(YIN) "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 175 On adjacent lots 100 + Public sewer main 75'+ Public sewer manhole/cleanout 1001+ Sewer/septic service line 25'+ Holding tank 100+ Animal containment areas 50+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 1 Property line 10 + Absorption field 5'+ Water main 25'+ Water service line 25'+ Surface water 100'+ Wells on adjacent lots 100 + ABSORPTION FIELD ON LOT TO: 111 Property line 10 Building foundation 10 + Water main 10 + 2Water Service line 5 Surface water Driveway,parking/vehicle storage 100'+ 10+ Curtain drain 50'+ Wells on adjacent lots 1001+ F. COMMENTS Note: System has been in use since November 2018 G. ENGINEER'S CERTIFICATION _r„~��,� _ OF ACS lk I certify that I have determined through field inspections and /,r'''p'�P !1 ��•y�+# review of Municipal records that the above systems are in O*; , • TH /\ • Ir conformance with MOA COSA guidelines in effect on this date. • y •• Steven R. Pannone, PE • Engineer's Printed Name ••.•tleven •. •innone 00 CE-8149 ,��„fe i Date /`oB %r" COSA canary sheet_2-6-15.doc A / F F F . r i t E • 0 -4. • k • W . N O_ x t 04 _ 4 ` , — N '59'15"E 191,23' m MIF k 4 F t ! N iTi 4 •`r F t o --I ... t t F /G • D ! ��N t 0 F/it F t m CO S ` Q `i F F F ,46 -I-FC,I- v v • a k t • X00 '.•>.o1, �ti t t k C) y- l' L M i ,Sa� y5 x,f• 2 0 • t k y00 �'6O �w E -6 Erl 0017..4$,Z, \ rr--rr Y / y4 �' y6 Q. 0 o 72.7' c` 5,),')>c' N o. ri v, \ N W 00, 1J w / fid. m J \y ods Sc\ • . / rnJ \ / rn-i �I. . . cnrn r J. ING. N r c) L=114, -^N j 21-Rz-- o3S• 0 0, 4 S2/-00r9 quo \ 1v ,9'47 • 4 V£NU -- '-4 , PLOT PLAN AS BUILT _X SCALE 1" = 60' GRID SW 4456 Protect No. 17-011/B5 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates , inc . (907) 522-6476 Phone QaoQooOp� (907) 522-4625 Fax ::":4: 0 AC pQ�Professional Land Surveyors kenOlangsurvey.com ,9JonathanOlangsurvey.com SpI hereb certify that I have surveyed the following described property: ff )\ •�vQLOTy22, CHUGACH PARK VIEW SUBDIVISION (PLAT 2005-202) * 4 g.91-. / .tel*Dao Anchorage Recording District, Alaska, and that the improvements situated thereon are 0 D 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 °/i'� KEN H G: LAN etQ premises and that there are no roadways, transmission lines or other visible V c^�, o easements on said property except as indicated hereon. °( s� .. `�/. 1,74 ? ....,gam 1 '•.LS-5 02.•'. g p Dated this the _ "-" � Day of i-f''=.. ,� , , at Anchorage, Alaska 404 ,0 ••'•"" o 0 � c� kQRO�SSIONAL�Q It is the responsibility of the owner to determine the existence of any easements, �000gq�� covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963