HomeMy WebLinkAboutAUTUMN RIDGE LT 24Autumn Ridge
Lot 24
#015-054-27
Municipality of Anchorage Page 1 of 3
Development Services Department
Onsite Water and Wastewater Program
4700 South Bragaw Street
P.O. Boz 196650 Anchorage, AK 99519-6650
www ci anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. SWO50134
PID Number. 015-054-27
PWne
Northwood Homes Inc.
Wastewater System: New
P.O.Box 92301 Anch., AK 99509
ABSORPTION FIELD
Phone
e90
e s % g �a
Deep Trench
LEGAL DESCRIPTION
SW NWng
TOW Depth rran ongnel grade
13
.45 oroIFP
Ft.
8r Lal S�
Depth b Fps lrhan trap Ongs grata
Growl depN barrWt pre
1 24
Autumn Ride
3 Ft.
10 FL
TO.WW Range
sa n.
FA added above onvw pace
Gravel Length
1.2.5 Ft.
100 Ft.
Well: New
Growl eMh
3.5
Narver of W
We
2
&ance benwo n Yrs.
M
>20
Ft.
FL
CYud m (Nnnee. A 8, C)
Tata Depth
Cr w
dW abaapben area
,p htalenw
Private 1
244
244
2,000 Fe
ASTM 3034 PVC
Drdw
Data DnaadSWc
W.n Level
Data Installed
Alpine
12/512005
217 FL
Sanders & Sanders
6130.715/05
Yrld
Prro Set`
La" AbOre rand
TAN
K
10 rpm
Fl.
>2 Ft
SEPARATION DISTANCES
® Septic ❑ Holding ❑ S.T.E.P. ❑ Other.
To
From
Septic
Tank
Absorption
Field
Lift
Station
Holding
Tank
ubl*TW ate
Seeerune
Anchorage Tank
2,000
Wel
>100,
>100,
WA
NIA
>25'
Steel
a
Two (2)
Sar.w"er
>100'
>100'
NIA
NIA
LIFT STATION — NONE ON LOT
WLine
>5'
>10,
WA
NIA
cal
Faa"atm
>5'
>10,
N/A
N/A
unpnanp
. a a
I
In
ti
in
I None
Noted
Frnp LW,. aLtad.l
"a" in pect"" p"ie"r°°"
Caton Dr.
Ren.ka
BENCH MARK
Well oca )on oved North to Allow LasierACCeSS
FOrUniling
Garage Slab.
a
100.0 FL
Engineers Stamp
. / #i
#
Inspections performed by: A. Harala
Dates: 1" 6130105
49tn
?-- A 0
2nd 7/1105
fi NiCHALL •E. ANDERSON
Department of Health and Human Services approval
•� s4 No CE -43e1 !\:
Reviewed by:
Date:
and approved
CIO
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Municipality of Anchorage Page 3 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-0655 - 343-7904
Onsite Wastewater Disposal System or Well Inspection Report
Permit Number. SWO50134
L
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2,000
PID No. 015-054-27
U
SOUTH LEG
U 99.2 = U
93.67 +-1 Drelnfleld Rock
50' (Trench Length)
NORTH LEG
3j 49th !N
;2S1jMICWELE-4381ANDERSON
PR❑FILE AS -BUILT
. 1�� \ No. c[-aeI r
No Scale �. ..... • ...
�
:
ALPINE DRILLING ���_,•. FAX NO. 907 345 0202 Apr. 10 2006 01:08PM P1
■r
■1t
ALPINE DRILLING & ENTERPRISES
Permit Number: 0SWQ50134 Date of Issue: 5-23-05 Parcel Identification Number. 015-054-27
Date Started: 12-3-05 Date Completed: 12-5-05 1s well located at approved permit location? ® Yes ❑ No
Legal Description: Autumn Ridae Lot 24
Property Owner Name & Address: Northwood Homes, Inc.
Anchora a Alaska
Borehole Data:
Depth (ft)
Method of Drilling ® air rotary ❑ cable tool
Soil Type, Thickness & Water Strata �.
From
To
Casio steel
E type:
stick-up
gravelly silt
silty sand
gravelly slit
0
2
5
16
2
5
16
24
Wall Thickness: 1.50 inches
Diameter: ¢ inches Depth: 244 feet
Liner Type:
ter: inches Depth: feet
stickup above ground: feet
silty sand
24
35water
level (from ground level): 217 feet
silly gravel
35
52ing
level:,�44 feet after
silt
52
67s
pumping.L0 Spm
silty gravel
67
73ery
Rate: L gpm
I[]
gravelly silt
73
203d
of Testing: it '
silt
gravelly silt
wafer sand &gravel
203
219
241
219ntake
241en
244
Opening Type:
End ❑ Open Hole
ened Startfeet Stopped feet
forations Startfeet Stopped feet
Grout Type: bentonite granules Volume: 1
Depth: Start Q feet Stopped.Zfeet
Pump: Intake Depth feet
Pump size hp Brand Name
Well Disinfected Upon Completion? ® Yes No
Method of Disinfection: chlorine tablets
Comments:
Well Driller. Alpine Drilling & Enterprisos
PO Box 110496
Anchorage AK 99511
Attention' The well driller shall provide a well log to the property owner within 30 days of completion and the property
MUNICIPALITY OF ANCHOR4GE
Development Services Department
On -Site Water 8 Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519.6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT
Initial
Permit Number: SWO50134
Legal Description: AUTUMN RIDGE SUBDIVISION LOT 24
Design Engineer: 0014 Anderson Engineering
Owner Name: NORTHWOOD HOMES, INC.
Owner Address: 9263 AUTUMN RIDGE CIRCLE
ANCHORAGE. AK 99507 -
Date Issued: May 23, 2005
Expiration Date: May 23, 2006
Parcel ID: 015-054-27
Site Address: 9263 AUTUMN RIDGE CIRCLE
Lot Size: 40378 SO. FT.
Total Bedrooms: 6 Permit Bedrooms: 6
This permit is for the construction of:
0 Disposal Field Q✓ Septic Tank E] Holding Tank [:] Privy Q Private Well Ej Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations (18AAC80 ).
3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 (24 hours). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
Date:
Date:
Municipality of Anchorage
Development Services Department •'�
Building Safety Division : � - ••
On -Site Water and Wastewater Program `
4700 South Bragaw St. S' "'
P.O. Box 196650 Anchorage, AK 99519.6650
www.ci.anchorage.ak.us
(907)343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 015.054.27 Permit Number SW
Property owner(s) Northwood Homes Inc. Day phone 694.5890
Mailing address (1) P.O. Box 92301 Anchorage, AK 99509
Mailing address (2)_9263 Autumn Ridge Circle Zip Code
Legal description (Lot, Block & Sub'd.) Lot 24, Autumn Ridge Subdivision
Legal description (Section, Township & Range)
Lot Size 40,378 SF Acres/Sq.Ft.
THIS APPLICATION IS FOR:
Number of Bedrooms Six (6)
Sewer Only ❑ Well Only ❑
Sewer and Well ® Water Storage ❑
Sewer Upgrade ❑
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit FeesA/1S~ �'"— '�tFi 7 " Salrt C_ Iver Fees:
Date of Payment: 15-_'6V'05 Date of Payment:
Receipt Number: bum 144 Receipt Number:
(Rev. 12/00) — 1
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 (FAX)
MEMO
DATE: 5/21/2005
TO: Joe Goodall
WITH: MoA/OnSite Water and Wastewater
FROM: Mike Anderson
SUBJECT: Lot 24, Autumn Ridge Subdivision
Septic System Construction Permit
We recently checked the groundwater levels in Test Hole Nos. 5, 6 and 75 located on
Lot 24, Autumn Ridge Subdivision. All holes were dry indicating groundwater is not a
factor in the septic system design proposed for Lot 24. Please let me know if you have
additional questions.
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 FAX
May 3, 2005
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 24, Autumn Ridge Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer.
The owner of Lot 24, Autumn Ridge Subdivision intends to construct a new six -
bedroom home on the lot. We are therefore requesting a permit be issued for the
construction of a new well and septic system to accommodate the home. The attached
Site Plan and backup documentation identify the location and configuration of the
proposed well and septic system along with the alternate site. Also identified on the
plans are the locations of the adjacent wells in the subdivision. No conflicts exist
between the proposed septic system and the proposed well and those on adjacent lots.
Drainage arrows are shown indicating the current drainage patterns. The drainage
patterns will be maintained after construction.
Test holes placed in the area of the absorption trench and alternate site indicated
gravel with varying amounts of silt and sand. The percolation rate was determined to
be 20 to 34 minutes per inch. We are proposing to place a new 2,000 -gallon septic
tank and 2 - 50' long by 3' wide by 10' effective depth absorption trenches to treat and
dispose the effluent generated in the house. The elevation of the distribution line in the
absorption trench will be 3' below the surface and the total depth will be 13'. A flow
splitter valve will be placed to insure even flow to each trench. A minimum of 3' of fill
will be placed over the absorption trenches and 4' over the septic tank.
The ground surface on the lot slopes at varying grades from west to east and north to
south. The new trench will be constructed parallel with the slope as much as possible
in conformance with Municipal requirements. The new septic system will be
constructed a minimum of 100' from the existing well and any surface water in the area.
If the system is constructed in accordance with our design the following statements
Lot 24, Autumn Ridge Subdivision
May 3, 2005
Page Two
apply:
The system, if constructed as designed, will have no adverse impact on the wells
in the area or those to be constructed in the future.
2. The system, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
3. The system, if constructed as designed, will have no adverse impact on reserve
space, either surface or subsurface, on any lots located in the area.
4. The system, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
Sincerely,
70 EL�
Michael E. Anderson, P.E.
Attachments
OF Its
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A-
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0 S WCNAEL E. ANDERSON y,
•i� A No. CE -4381 � l
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LOT 24, AUTUMN RIDGE SUBDIVISION
DESIGN FACTORS:
Six Bedroom Home
Perc. Rate: 20 to 34 Min./inch
Application Rate: .45 GPD/SF (Average)
SYSTEM REQUIREMENTS:
Deep Trench System
2,000 Gallon Septic Tank
10' Drainfield Rock
6 Bedrooms X 150 GPD/.45 GPD/SF (Application Rate) = 2,000 SF Absorption Area
2,000 SF/20 SF/LF = 100 LF Trench Length
THEREFORE: Construct 2 - 50' Long x 3' Wide x 10' Effective Depth Aborption Trench at the
Flow Line Elevation in Trench to be 3' Below Original Ground Surface. Total Depth to be
13' Below Existing Ground. Provide 3' of Cover Over Trench and 4' Over Tank or Provide
2" of Insulation and 2' of Cover. Maintain 100' Separation Between Existing Wells in the Area
and the Absorption Trench and Septic Tank. Place Flow Splitter Valve to Insure Even Flow.
1rgul
Natural
Backfill
2'6"
Geotextile
Fabric
6" 4" Perforated
PVC (Holes Down)
10'0"
174
3'
Drainfield Rock
NOTE: Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock.
Minimum 4' Separation From Groundwater. i
Minimum 100' Separation From Private Welts in the Area.
Minimum 100' Separation From Surface Water or Streams. .
Minimum 10' Separation From Water Service Line.
5 Gravel/Sand
Some Silt
6
GM/SM
7
NO
8
Municipality of Anchorage
9
1 7 -Dec
Departmerit of Health & Human Services
1
2.5"
825 L Street, Anchorage, AK 99502-0650
SOILS LOG - PERCOLATION TEST
2
Performed For. Bob Klein
` Date Performed: 11/30/99
.. .
Legal Description:, Lot 24.
Autumn Ridge Subdivision
13
SLOPE SITE PLAN
.
1
11:46
OG/PT
3.38"
16
• 5
.11:47
2
• .
18
.12:17
•30
3.38'
-.88" '
TgSTHOLE
1
',•\
.
3
NO. 5
L
4
r
k, .4s11 C
5 Gravel/Sand
Some Silt
6
GM/SM
7
Was Groundwater
Encountered? . No
If Yes, What Depth?
Depth to Water
After Monitoring 'None
Date: 1/22/00
Date
Gross
Time
8
. Depth To
Water
9
1 7 -Dec
10
2.5"
2
17:15
12
.. .
Y..
3
13
2.5"
.
14
11:46
15
3.38"
16
• 5
.11:47
- 2.5"
• .
18
.12:17
Was Groundwater
Encountered? . No
If Yes, What Depth?
Depth to Water
After Monitoring 'None
Date: 1/22/00
Date
Gross
Time
Net
Time
. Depth To
Water
Net
Drop
1 7 -Dec
.10:45.
2.5"
2
17:15
30
3.56"
1.16'
3
11:16
2.5"
4
11:46
30
3.38"
.88"
• 5
.11:47
- 2.5"
• .
6
.12:17
•30
3.38'
-.88" '
Reading
19Bottom of 'Pert. Rate: 34 MinAnch Perc. Hole Diameter. 6"
Hole Test Run Between. 4 FL and 5 Ft.
ILI
Comments: Percolation Cavity Presoaked Prior to Testing.
Performed By: A. Harala. I, Michael E. Anderson • Certify That This Test Was Performed '
In Accordance With All State and Municipal Guidelines In Effect On This Date: 1/20160
12CF
•��waq��
13
�i
14 i '....49th.
15 i R E Miciwtt c. ZDER' a+.
.. ��
16 �i •�•.. t...•'' ••
�. 17 . .
18
Reading
Date Gross
Time .
Net
Time
Was Groundwater
Net
Drop
Municipality of Anchorage
7 -Dec • 10:45
Department of Health & Human Services
•
2
825 L Street, Anchorage, AK 99502-0650
SOILS LOG - PERCOLATION TEST
If Yes, What Depth?
'.
10
1.16"
.3
Performed For: Bob Klein
' Date Performed: 11/30/99
2.5"
Legal Description: Lot 24.
Autumn Ridge Subdivision
30
•3.38"
SLOPE SITE PLAN
'
1
OG/PT
6.
12:17
'
3.38" '
2
L
3
TESTHOLE
NO. 6
\
\
5
Grave!/Sand
sq.
L
Some silt..
6
.
GM/SM
7
12CF
•��waq��
13
�i
14 i '....49th.
15 i R E Miciwtt c. ZDER' a+.
.. ��
16 �i •�•.. t...•'' ••
�. 17 . .
18
Reading
Date Gross
Time .
Net
Time
Was Groundwater
Net
Drop
.9
7 -Dec • 10:45
Encountered? No
2
11:15.
If Yes, What Depth?
'.
10
1.16"
.3
Depth to Water
-After Monitoring None:
11
2.5"
Date: 1122/00 -
12CF
•��waq��
13
�i
14 i '....49th.
15 i R E Miciwtt c. ZDER' a+.
.. ��
16 �i •�•.. t...•'' ••
�. 17 . .
18
Reading
Date Gross
Time .
Net
Time
Depth To
Water
Net
Drop
1
7 -Dec • 10:45
2.5"
2
11:15.
30
.3.56"
1.16"
.3
11:16
'
2.5"
4-
11A6
30
•3.38"
.88"
5
11:47
•2.5"
6.
12:17
30
3.38" '
.88"
19 Bottom of Perc. Rate: 34 Min./lnch ' Perc. Hole Diameter. ' 6"
Hole Test Run Between 4 FL,and 5 Ft.
Comments: Percolation Cavity Presoaked Prior to Testing.
Performed By: A Harala • I, Mi .ha I . Anderson ' Certify That This Test Was Performed
In Accordance With All State and Municipal Guidelines In Effect On This Date:. 1120/00'
Municipality of Anchorage
Department of Health & Human Services
825 L Street, Anchorage, AK 99502-0650
SOILS LOG - PERCOLATION TEST
Performed For: Bob Klein . Date Performed: 12/13/99
Legal Description: Lot 24. Autumn Ridge Subdivision
SLOPE
1 . ' OG/PT
2
3 TESTHO NO. 75
61..
7
9
..
I0
Depth To
Water - ' •
_ 11
1
12
.
4.44" .
-
- 14
244
15
6.06"
16
.
17
4.5"
SM
Some
Glazing Was Groundwater
Encountered? No
if Yes, What Depth?
Depth to Water
After;Monitoring None'
Date: 1=00
•
�; ` `9'•.
� :'
? 49th
»... .. ,.....
r:�:--
�? NICIMQ E ANDERSON !--
GM
Reading
Date: Gross
' Time
Net
Time
Depth To
Water - ' •
Net
Drop
1
14 -Dec - 2:14
4.44" .
-
2
244
30
6.06"
1.61"
3
2:46
4.5"
:4.
3:16
30 .
6.06"
1.56-
5
3:17
4.5".
6
3:47
30
6.06"
1.56" .
19 1 Bottom of Peic. Rate:. 20 MinAnch Perc. Hole Diameter. 6.....
Hole Test Run Between, 4 Ft. and.5 FL
Comments: Percolation Cavity Presoaked Prior to Testing.
:? Performed By: A. Harala.' i, Mirha J F. Anderson Certify That This Test Was Performed
In Accordance With All State and Municipal Guidelines In Effect On This Date: 1/20/00
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 24, AUTUMN RIDGE SUBDIVISION
GENERAL:
The scope of this project includes the procurement and placement of a new
2,000 -gallon septic tank at the location shown on the Site Plan. Work also
includes the construction of two new absorption trenches. Each will be 50'
long X 3' wide X 10' effective depth. Absorption trenches must be placed at
the location shown on the Site Plan. The distribution line in the trenches will
be placed at 3' below the existing ground surface. Total depth of the
trenches will be 13' below the existing ground surface. A Zabel Flow Splitter
Valve must be placed to insure even flow to each trench. A separation
distance of 100' from any well and 100' between the septic tank and
absorption trench and any surface water must also be maintained. A
minimum of 3' of fill is required over the absorption trenches and 4' over the
septic tank. In lieu of the required fill 2" of insulation and 2' of fill may be
placed.
2. Construction shall be in accordance with the approved site plan, design
drawings, Municipal Permit with any special provisions or conditions, and all
applicable State and Municipal Wastewater Disposal Regulations.
The Contractor shall be responsible for obtaining all underground utility
locates and for the layout of the septic system and verification of the location
of all lot lines. The Contractor must also verify the location of wells in the
area and assure that the separation distances are met.
4. Unless specifically agreed otherwise, the contractor shall be responsible for
final grading areas subsequently depressed from soil settling. Property
owner shall be responsible for revegetation of affected areas unless
specifically agreed otherwise.
5. Contractors installing wastewater disposal systems must be certified by the
Municipal Department of Health and Human Services for system installations.
Owners installing their own systems must receive prior approval from
D.H.H.S. before beginning system installation.
SEPTIC TANK INSTALLATION
1. A new 2,000 -gallon septic tank must be procured from an approved source
and installed at the location shown.
2. A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shall include two 4" cleanouts for pumping access.
Lot 24, Autumn Ridge
May 3, 2005
Page 2 of 3
3. The septic tank shall be sufficiently bedded to prevent settling or shifting of
the tank.
4. All standpipes on the septic tank shall extend a minimum of 12 inches above
final grade.
5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial
insulation.
6. A foundation cleanout shall be installed one to four feet from the building
foundation. Two cleanouts are required between the tank and the drainfield.
7. Final grading over the tank shall be such that a positive slope exists away
from the septic tank.
DRAINFIELD CONSTRUCTION:
1. The drainfield shall be constructed to the dimensions shown on the design.
The bottom of the trench shall be within 2" of level.
2. Distribution piping must be placed level with perforations down atop a level
bed of drainfield rock. Rock should then be placed over the pipe to provide a
minimum of 2" of cover.
3. A silt barrier or geotextile fabric must be placed between the drainfield rock
and the natural soil backfill.
4. Monitor tubes must be 4" in diameter and installed at the locations shown on
the design. The portion below ground must be perforated.
5. Contractor shall verify the septic tank and drainfield are a minimum 100' away
from any private water wells in the area, 150' from a Class "C" Well or 200'
from any community well.
6. Direct bury insulation must be placed over the distribution system if less than
3' of backfill depth is available. Finish grade over the trench must be
mounded to prevent settlement or depressions.
7. Grade area surrounding the absorption trench to drain away.
8. A minimum 2' of accepting soil is required below the drainfield rock for a 5'
wide trench. Contractor shall verify this condition prior to placement of the
rock. All pockets of unacceptable materials must be removed and replaced.
Lot 24, Autumn Ridge
May 3, 2005
Page 3 of 3
MATERIAL SPECIFICATIONS:
1. Septic tanks must be constructed by a Municipally approved septic tank
manufacturer.
2. The following pipe materials are approved for use in septic system
installations in the Municipality of Anchorage:
Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and
solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662
or A.B.S. (perforated and solid).
3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow
Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings
(Caulder, Femco, or equal).
5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed
between the final drain rock layer and the native soil layer.
6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the
#200 sieve.
INSPECTIONS:
Municipal Ordinance requires a minimum of two inspections. These inspections
must be conducted under the supervision of a professional engineer registered
in the State of Alaska. The first inspection must be conducted after the
excavation of trenches, beds or pits and before the installation of any gravel. A
septic tank may be set in place, but may not be backfilled.
The second inspection must be conducted after the placement of the geotextile
fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No
backfill should be in place at the time of inspection.
Contractor shall provide a copy of all field survey layout and construction notes
for use in preparing the certified as -built of the completed system.
Niiiiiiiiiii
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET
To: ANDERSON ENGINEERING
Legal description: AUTUMN RIDGE SID LOT 24
ZD
The attached paperwork has been reviewed and is being returned for the following reasons:
❑ Original signature or stamp missing on
❑ Calculation error in design. _
❑ Additional soils information needed.
❑ Water monitoring results inadequate. _
❑ Discrepancy in information submitted.
❑ Topographic information missing or inadequate.
❑ Incomplete; missing _
❑ Incomplete; missing
❑ Additional adequacy test information needed.
❑ Water sample unacceptable. _
❑ Measured/proposed distances/dimensions missing. _
❑ Locations of all soils, percolation and water monitoring tests not shown.
❑ Proposed system too deep for soils information submitted.
❑ Well log required.
❑ Omission in narrative.
❑ Insufficient fill over tank or field._
® Other. NEED TO DO GROUNDWATER MONITORING THROUGH MAY 15TH. THE RESULTS OF GROUNDWATER
TESTING MUST BEAR ORIGINAL SIGNATURE AND STAMP OF ENGINEER,
Name of reviewer: JOE GOODALL
Date: 5/10/2005
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK
Municipality of Anchorage
• -• Development Services Department
Building Safety Division
On -Site Water and Wastewater Program `
4700 Bragaw Street
P.O. Box 196650
Anchorage. AK 99519-6650
www.muni.org/onshe
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 015-054-27
1. GENERAL INFORMATION
Complete legal description pct z°•
COSA # Q t7j2
Expiration Date: 7-1 q- o6
Autumn Ridge subdivision
Location (site address) 9263 Autumn MdgeCircle Anchorage. AK99516
Current Property owner(s) Northwood Homes. Inc.
Mailing address
Lending agency
Mailing address
P.O. Box 92301 Anchorage. AK 99509
Day phone 694-5890
Day phone
Real Estate Agent Day phone
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
six (6)
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
0
Individual On-site
0
Individual Water Storage
❑
Individual Holding Tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an Independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems 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. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B welts or a public water system.
The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineer's work.
4. 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 Anderson Engineering Phone 522-7773
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E. Date
6. DSD SIGNATURE
✓ Approved for S bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Attachments:
COSA Checklist X Arsenic Advisory
Septic System Advisory Maintenance Agreements
Well Flow Advisory Supplemental Engineer's Report
Nitrate Advisory Other
By: f ' Original Certificate Date: q_/47,041
(R.o.11M)
r:
a;
Municipality of Anchorage
' Development Services Department
Building Safety Division i
Oft -SRO Water & Wastewater Program
4700 Bragaw, Street
i P.O. Bolt 198850
Anchorage, AK 9951943850
www.muni.orgkmfte
(907) 3437904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: La124, .., :* &U. RMp SubdMolon
Parcel ID: 015-054-27
A. WELL DATA
Welltype Procne 0 A, B, or C provide PWSID 9 _
WON Log (YIN) Y
Date completed 1215A5 Sanitary seal (YIN) V
Vales Property protected (YIN) Y
Total depth 2! R. Cased to 244 ft.
Casing height (above ground) >24
in.
FROM WELL LOG
AT INSPECTION
Date of test 1215105
Static water level 21r
Well production 10 9 -P.M.
g.p.m.
WATER SAMPLE RESULTS:
Co iform _-2—colonies/1 00 mL Nitrate •88 nglL
Other bacteria 0 colonies/100
mL
Arsenic: No ngfi Date of sample: 9127109
Collected by: L. HemwWaz
B. SEPTICIHOLDING TANK DATA
Tank TypeNAaterlid sepods"
Date Installed sre m
Tank size 2.000 gal. Number of Compartments Two
Cteanouts (YM) Y
Foundation cleanout (YIIV) Y Depression over tank (YIN) N
High water alarm (YIN) N
Date of pumping N°mv Q01181f"m0O Pumper
C. ABSORPTION FIELD DATA
Date Installed 71501 Soil rating (g.p.dJe or fe/bdrm) •45 OPINSFSystem type Ow TrenWit
Lente too R, Width 3 fl.
Gravel below pipe 10
R.
Total depth u R Eftabsorption area 2 aoe le Monitoring tube Y Depression over field
N
Date of adequacy teat Nw Cons. Results (POSWG g
For _ bedrooms
Fluid depth in absorption field before teat in. Water added gal. New depth
ln.
Elapsed Time: min. Final fluid depth In.
Absorption rate >=
g.p.d.
Any rejuvenation treatment (peat 12 mo.) (YIN 6 type)
H yes. give date
D. LIFT STATION
Date installed Sae in gallons
'Pump on' level at _ in. 'Pump ofr level at _ In.
Datum Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
ManholelAeeeaa (VIN)
High water alarm level at in.
Meets all mr b dradt nKK*wnents?
Septic tank= station on let >taa On adjacent lots >1W
Absorption field on lot >iw On adjacent lots
Public sewer main MA
>100'
Public sewer manhole/cleanout WA
Sewer /septic service fine >25' Holding tank WA
An" containment areas WA Manurelanimal excrete storage areas WA
SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO:
Building foundation >6 Property fine W Absorption field >S
Water main WA Water service line >ta Surface water >1W
Wells on adjacent lots >tee'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line >to' Building foundation >1s' Water main WA
Water Service fine >ta Surface water >1W Driveway. l3aftokmhide storage >2s
Curtain drain Now Noted Wells on adjacent lots >tw
F. COMMENTS:
O. ENGINEER'S CERTIFICATION
I ceRdy that I have determined through field insperdlons and
review of MU11004 l records that lite above systems are in 9th
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name MichaW E. AnWwwn. P.E. a MMKMX c
Date 4111 008 '
COSA Fee S 57.66
Date of Payment _ 4/11/06
Receipt Number _ 119ION
(Rev. 1 V0b)
Walver Fee S
Date of Payment
Receipt Number
Municipality of Anchorage
Development Services Department
• +� Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.orglonsite
(907)343-7904
ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET
To: Mike Anderson
Legal description: Autumn Ridge Lot 24
The attached paperwork has been reviewed and is being returned for the following reasons:
❑ Original signature or stamp missing on
❑ Calculation error In design. _
❑ Additional soils information needed. _
❑ Water monitoring results inadequate.
® Discrepancy in information submitted. Well location moved from permitted site.
❑ Topographic information missing or inadequate. _
® Incomplete; missing Lot 25 well on Inspection Report.
❑ Incomplete; missing _
❑ Additional adequacy test information needed. _
❑ Water sample unacceptable. _
❑ Measured/proposed distances/dimensions missing. _
❑ Locations of all soils, percolation and water monitoring tests not shown.
❑ Proposed system too deep for soils information submitted.
❑ Well log required. _
❑ Omission in narrative. _
❑ Insufficient fill over tank or field._
® Other. Test Holes #5 and #6 exactly the some.
Name of reviewer: Poet
Date: 4-19-06
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK
SGS Ref.M
1061431001
ClienlName
Anderson Engineering
Project Name/8
Lot 24 Autumn Ridgc
Client Sample ID
Lot 24 Autumn Ridge
Matrix
Drinking Water
PWSID
0
Sample Remarks
All Dates/fImes are Alaska Standard Time
Printed Dale fame
04/05/2006 8:18
Collected Date/time
0327/2006 13:40
Received Dateffime
03272006 14:04
Technical Director
Stephen C. Ede
Allmxahle Prep Analysis
Parameter Results PQI. Units Method Container ID Limits Date Date Init
Metals by ICP/MS
Arsenic
Waters Department
Nitrate -N
Microbiology Laboratory
Total Coliform
ND 5.00 ug/L EP200.8 C (r--10) 0328/06 0329/06 SCL
0.860 0.100 mg/L GPA 3532 D (<=10) 0328106 ALR
TNTC l)
col/100m], SM209222D A («I) 0327/06 JEM
ANALYTI CA
GROUP
DRINKING WATER ANALYSIS REPORT FOR TOTAL COLIFORMS BY MEMBRANE FILTRATION
Attn: Mike Anderson
Anderson Engineering
P.O. Box 240773
Anchorage, AK 99524
Phone: 907522-7773
Fax: 907577-7768
Method Of Analysis:
Total Coliforms by Membrane Filtration
Comments:
Public Water System ID #:
Date Received: 4/3106 Time Received 15:44
Chlorine Residual:
Date Reported: 4!7106 Time Reporte 15:40
Comments:
S = Satisfactory
U = Unsatifactory
POS = Positive Test Result
ND = None Detected
TNTC = Too Numerous to Count (>200 Colonies)
CG = Confluent Growth
HSM = Heavy Sediment Masking, Results May Not Be
Reliable
The cert fixebw status of"Arcnorape neaob0bVdepart rwN Aaboratotyb asronay TLIT = Sample Age > 30 Hours. Too Long in Transit
poWsbna4 whip msponses to recent awn issues am being prepared and corrective actions R = Resample Required
anplemented whereracessery The Mkrobbbgy data generated by Me laboratory am NM
usable brState orAleska c piance purposes. The provft&wf oMfication wig be upgraded NT = No Test
once Me corrective adiaos have been approved An Me neer hnum.
Sampled Sample Sample Analysis Analysis Total Other
Sample Name Sample Location By Date Time Lab / Date Time Coliform Bacteria Comments
AX 2178 Lot 24 Autumn LH 4/3/06 15:30 AD604017-01A 4/3106 16:30 <1
Ridge
Steve Gaither, Project Manager
Ana"ca International, Inc. Anchorage, AK
<1 Satisfactory
Results in CFU/100 ml
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 FAX
MEMORANDUM
DATE: April 18, 2006
TO: Jeff Poet
FROM: Mike Anderson, P.E.
SUBJECT: Lot 24, Autumn Ridge Subdivision
Certificate of On -Site Systems Approval
We have revised the Plan As -Built to include the neighboring well and 100' protective
radius. A note has been added to the inspection report regarding the movement of the
well and the correct data for Test Hole No. 5 has been submitted.
Please advise if you have further questions.
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