HomeMy WebLinkAboutMARYLAND LT 2Maryland
Lot 2
#015-082-25
Municipality of Anchorage
Community Development Department 3
On -Site Water & Wastewater Program
4700 Elmore St. • P.O.
Bax 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907)343-7904
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSPI41081
PID Number: 015-082-25 ® New E] Upgrade
Name:
JOHN WAGNER
ABSORPTION FIELD
® Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound
Address:
3040 ADMIRALTY BAY DR,
ANCHORAGE, AK, 99515
❑ Other
Phone:
No. of Bedrooms:
Soil Rating:
Total Depth from original grade:
(907) 360-4884
4
1.0 GPD/eq. Ft.
11.0 MAX Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade:
3.33 MAX Ft.
Gravel depth beneath pipe:
7.67 Ft.
Subdivision:
MARYLAND
Block: Lot:
— 2
Fill added above original grade:
Gravel length:
SEE DWG. n.
45 Ft.
Township: Range:
— —
Section:
—
Gravel width:
Bede Number of lines:
Distance between lines:
2.5 Ft.
Ft.
SEPARATION DISTANCES
Total absorption area:
690
Number of trenches:
1
Dist between trenches:
—
Ta
Septic
Absorption
Lift
Holding
Public/Private
From
Tank
Field
Station
Tank
Sewer Lines
SQ.Ft.
Ft.
Well
100'+
100'+
—
—
25'+
TANK ® Septic ❑ S.T.E.P. ElHolding El Other
Manufacturer:
capacity:
Surface water
100'+
100'+
—
—
ANCHORAGE TANK
1250
cal.
Lot Line
5'+
,o'+
-
-
N/A
Material:
Number of compartment.:
STEEL
2
Foundation
5'+
10'+
—
—
LIFT STATION
Curtain Drain
NONE KNOWN
Manufacturer: c ir
Col.
Remarks:
Pump on' level at:
"Pump off I
High water alarm at:
ump Mak¢ &
:71
Electrical Inspections performed by:
PIPE MATERIAL
House to tank D3034 Tank to D3034
drainfield
Installer
NORTHERN EXCAVATION
Drainfield D3034 CO/MT D3034
Inspector GEG, Ltd.
BENCH MARK (Assumed elevation)
100.00 Ft.
Inspection
Location and Description:
Dates: 1st 5/19/2014
2nd 5/19/2014
3rd —
4th —
TOP OF WELL CASING
Community Development Department Approval
ENGINEER'S SEAL
o
......... qS�O
Conditional approval:
Date:
00
0 ..... ... .....................
�
..
.If .y.A.....
ness:...
pdo"
—7953
C.' `
A
Approved:
�%
2
Ok
fa�G 7�
4 n o
pp
Date: �/3
�' ofessioPa\q
p n
�040000��
PERMITNUMBER:
OSP141081
TH92
TOP OF TANK
AT INLET= 92.83
INVERT OF BUNG
AT INLET = 92.22
AS -BUILT DRAWING
INSULATION
r FINAL GRADE = 96.51-96.76
1 ST2
TOP OF TANK
AT OUTLET = 92.78
NEW 1250 GALLON
SEPTIC TANK
ORIGINAL GRADE
= 94.82
RELATIVE ELEVATION OF BOTTOM
OF TESTHOLE = 77.82 (DRY)
INVERT OF BUNG
AT OUTLET = 92.03
FINAL GRADE _
94.53-95.08
�T'INSULATION
INVERT OF PIPE
= 91.49
- BOTTOM OF
TRENCH = 83.82
GARNESS ENGINEERING GROUP, Ltd,
CIVIL & ENVIRONMENTAL ENGINEERS
NO E. TU WR RAD. SIHTE 101 -ANCHOR NAR W507 -PHONE (pW)M78179-FMON) W3 N8•WE66NE: wNigameeem9MeMp.wm ���
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: �•
JOHN WAGNER (907) 360-4884 3 OF 3
LEGAL DESCRIPTION:DRAWN BY: #.J
MARYLAND SID; LOT 2
A.J.G. 4
TYPE OF WORK: DATE:
SAS -BUILT DRAWING OF NEW SEPTIC SYSTEM 7/3/2014
PARCEL ID NUMBER:
015-082-25
N.T.S.
Certified Drilling Log
-DOC CO 12M
ULLIM WATER WELLS
A ` P.O. Brix 670269, Ghugiak, AK 99567 688-2759
OWNER OF LAND: Jonathon & Lindsay Wagner
ADDRESS:
LEGAL DESCRIPTION Maryland Lot 2
DATE: 5/5/14
PERMIT NUMBER: 141081 DATE OF ISSUE: 4/28/14
TAX IDENTIFICATION NUMBER 01508225000
Is well located at approved permit location: ®Yes ❑No
Method of Drilling: ®air rotary ❑cable tool
Depth of Well: 203
Casing Type: steel Wall thickness .250 inches
Diameter: 6 inches, depth 202 feet
Linertype none
Static Water Level: 60 feet
Recovery Rate 40 ® gpm gph
Method of Testing air
Well Intake Opening Type: ® open end open hole
❑ Screened Start feet Stopped
❑ Perforations Start feet Stopped
Grout Type: Bentonite chips Volume:
Depth: from 0 feet, to 22 feet
Well Disinfected Upon Completion: ®yes ❑ no
Method of Disinfection: Chlorine 50 ppm
Comments:
Bore Hole Data
Depth
From To
0 2
2 4
4 34
34 46
46 84
84 90
90 102
102 135
135 165
165 175
175 185
185 196
196 203
Casing stickup
overburden
Silt & sand & gravel
Silt & sand w/ gravel
Silty sand & gravel tight
Sand gravel & water —2gpm
Clay & gravel
Hardpan w/ clay
Hardpan
Silty gravel —7gpm
Sand & gravel w/ clay
Sand & gravel silty
Sand gravel & Water
Drillers Name: Cole Sullivan
ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority.
Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation.
Matsu Borough: Department of Environmental Conservation.
()evelopmen Services bepartment
Buildier Safety Biater
On -Sitz �.Veter I& Wastewater Program
�I
` 4r 0 Brogew Street
P.C. Box -196650
Mark Begich Anchcr oe, AK 99519-6550
Mayor w,v.v.m�.mi.mn/onsite
(907" 343-7904
Pump Installation Log
Well Drilling Permit Number: SW Date of Issue: _
Parcel Identification Number:
6( fq(ji
Legal Description j
i\
�—
Property Owner Name & Address:
J cnn vCk1A h W wg nsrt-
G68%'TOu-y fah Rb
h'hc1,ORA G Y1
Pump Installation Date: 5-ci- lK
Pump Intake Depth Below Top of Well Casing: 110 feet
Pump Manufacturer's Name: of D xP—k rr
Pump Model: J 00G?3)1 \d514-1
Pump Size hp
Pitless Adapter Burial Depth: /0 feet
Pitless Adapter Manufacturer's Name: !•
Pitless Adapter Installer:
Well Disinfected Upon Completion? Yes ❑ No
Method of Disinfection: CA -P-0 v
Comments: e
e
Anchorage PUMP & VVell Service
Pump Installer Name: 330 East 76th Avenue
Anchorage, Alaska 99518
Phone: 907-243-0740
Fax: 907-243-0742
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 OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number: OSP141081
Tax Code Number: 01508225000
Work Type: WellSeptic Initial
Permit Effective Dates: April 28, 2014 to April 28, 2015
Design Engineer: GARNESS ENGINEERING GROUP LTD
Subdivision: MARYLAND
Site Legal Address: MARYLAND LT 2 G:2439
Owner/Address: WAGNER JONATHON M & LINDSAY C
3040 ADMIRALTY BAY DRIVE ANCHORAGE AK 995152401
Site Mailing Address: 6701 JOLLIPAN CT, Anchorage
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank N Privy
Lot Size in Sq Ft: 49493
Total Bedrooms: 4
Y Private Well N Water Storage
aria
L7
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 wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Receivi
Issued
MUNICIPALITY OF ANCHORAGE
e �
Community Development Department
Development Services Phone: 907-343-7904
On -Site Water & Wastewater Program Fax: 907- 343-7997
Mayor Dan Sullivan
On -Site Sewer/Well Permit Application
Parcel I.D. 015-082-25 For A Single Family Dwelling
Property owner(s) JOHN WAGNER
Day phone 360-4884
Mailing address 7 120 HUFFMaN an
Site address
Legal description (Sub'd, Block & Lot) MARYLAND S/D; LOT 2
Legal description (Township, Section & Range)
Lot Size Sq. Ft.
Number of Bedrooms 4
APPLICATION IS FOR:
(®allthatapply)
APPLICATION IS AN:
TYPE OF DEWELLING:
Absorption Field ®
Initial ®
Single Family (SF)
Septic Tank ®
Upgrade ❑
(w/wo ADU)
Holding Tank ❑
Renewal ❑
Duplex (D)
Privy ❑
Multiple Dwellings
❑
(SF and/or D)
Private Well
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR:
I certify that the above information is
Distance: —
correct.
applicable Municipal codes.
I further certify that this is
in accordance with
(Signature of property owner or authorized agent)
Permit/RushFees:r,�(pq �ajs-�j1?Q
Waiver Fees:
Date of Payment: !
Date of Payment:
Receipt Number: via g'
Receipt Number:
Permit No. CK)o14/108I Waiver No.
(Rev. 01/11)
GARNESS ENGINEERING GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGINEERS
April 14, 2014
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907)343-7904
Ref: Proposed Septic System for Maryland S/D; Lot 2,
To whom it may concern:
The proposed 4 bedroom house is to be served by a private well and septic system. The lot is vacant
property with nothing yet developed on it. We are proposing to install a new 1250 gallon septic tank and
deep trench type drainfield. Two test holes were excavated on the property. The drainfield will be
designed around the 30 foot radius of test hole #2. Comments regarding the design are summarized as
follows:
1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the
percolation test results. NOTE: The percolation rates were both faster than 1 minute per inch. A sieve
analysis was performed on the soil from both testhole sites and classified as SP -SM. We believe the insitu
sandy soils will protect the aquifer from contamination and are therefore proposing a drainfield without a
sand filter (see attached sieve analysis reports).
2. TRENCH DESIGN: See attached design drawing for drainfield specifications.
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system.
4. TOPOGRAPHY: As can be seen on the attached topography site plan, the average slope in the area
is approximately 0-5% percent running southeast to northwest. In short, there are no slope concerns.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems.
tions, please contact us at 337-6179. Thank you for your assistance.
'.E., M.S.
Note: Attached is a site plan, design drawing, 2 soil logs, 2 sieve analysis reports and an 8 page
construction specification letter which are all part of the design package for this septic system.
3701 E. Tudor Road, Suite 101 *Anchorage, AK 99507-1259
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com
1100' WELL RADIUS
I 0 /WE RADIUS
i O WEL
O
/ \
SE
EA
D
NETTLETON ACRES S/D #2; LOT 11
Esnt MARYLAND S/D; LOT 3A
CSEPTIC
AREA
1100' WELL RADIUS/
i
\ I 00' WELL RA IL
\ i
\
MARYLAND S/D; LOT 4
/ MARYLAND 3/0; LOT 5 ),
100' WELL RADIUS
RADIOI 1� CSEP°G ARi/ _ !n iF2• LOS 1 k /
I
CARPTI
E \ Q
\
\ \3H
NETTLETON ACRES S/D #2; LOT 12 \ \
------------ ----------- —
\
1
/ PROPOSE \
HOUSE \
PROPOSED SEPTIC SYSTEM `\
\
PROPOSED 100' i
\
NETTLETON ACRES S/D #2; LOT 13
— — — — — — — — — — — — — —
MARYLAND S/D; LOT 1� L c
600'
WELL RADIUS
I\
WELL RADIUS _I
> LL e
�0 L0z
GARNESS ENGINEERING GROUP, Ltd.
-- CONSULTANTS & GENERAL CONTRACTORS
3701 E. NDOR ROAD, SURE 101 • ANCHORAGE, W 88507 • PHONE (807)337-61'!8 • FM (901)530-3248 KB - ww. omeexnglneMng co
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
JOHN WAGNER 907-360-4884 1 OF 2
LEGAL DESCRIPTION: DRAWN BY:
MARYLAND S/D; LOT 2 1 A.J.G.
I APPROXIMATE 100'
I WELL RADIUS N
a \
LN \\ o
_00600 O
4�p
.... ... ........
•.J ff .. Gar s.
dn9.' E.7 aO
OF WORK:
SITE PLAN OF PROPSED WELL & SEPTIC SYSTEM 4/14/2014
(Rev. 01105)
NETTLETON ACRES S/D #2; LOT 13
— — — — — — — — — — — — — —
MARYLAND S/D; LOT 1� L c
600'
WELL RADIUS
I\
WELL RADIUS _I
> LL e
�0 L0z
GARNESS ENGINEERING GROUP, Ltd.
-- CONSULTANTS & GENERAL CONTRACTORS
3701 E. NDOR ROAD, SURE 101 • ANCHORAGE, W 88507 • PHONE (807)337-61'!8 • FM (901)530-3248 KB - ww. omeexnglneMng co
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
JOHN WAGNER 907-360-4884 1 OF 2
LEGAL DESCRIPTION: DRAWN BY:
MARYLAND S/D; LOT 2 1 A.J.G.
I APPROXIMATE 100'
I WELL RADIUS N
a \
LN \\ o
_00600 O
4�p
.... ... ........
•.J ff .. Gar s.
dn9.' E.7 aO
OF WORK:
SITE PLAN OF PROPSED WELL & SEPTIC SYSTEM 4/14/2014
(Rev. 01105)
OF BEDROOMS: 4
TO OBTAIN A COPY OF THE LETTER
'
PER DAY (GPD): 600
CONTACT GEG. BY PROCEEDING FORWARD
\
"ION RATE/S: <1 MIN/IN
WITH THIS INSTALLATION, THE ENGINEER,
D APPLICATION RATE: 1.0 GPD/FT'
WELL DRILLER, CONTRACTOR AND
DRAINFIELD SQ.FT.: 600
PROPERTY OWNER AGREE THAT THEY
ACTUAL SQ.FT.: 630
HAVE READ THESE SPECIFlC (IONS AND
.._. _ _ �... _..
AGREE TO ACCEPT THE TERMS AND
MAXIMUM DEPTH: 11' MAX
GARNESS
WIDTH: 2.5'
_
LENGTH: 45'
0-5% SLOPE
M.O.A. APPROVED SAND FILTER: N/A
�-------
EFFECTIVE: 7' O_S
REDUCTION FACTOR: N/A SLOAf
.: .. :.40
'b •) !i-- • ••
ACTUAL SQ.FT.: 630
.•PRO:POSED DRIVEWAY:
DOUBLE
ALTERNATE SITE WILL CLEANOUTS
UTILIZE ADVANCED TREATMENT MT
0
zRop
Z'
FCO
.PROPOSEDMT
/
PROPOSED 4 \
\
BEDROOM HOUSE \
:W,•%•• DRAINFlELD PROPOSED'1250
GALLON SEPTIC TANK
\
1 \ rCpp
PROPOSED 100' WELL RADIUS I
RE V SIGN C I IA: �
�
NUMBER OF BEDROOMS: 4
GALLONS PER DAY (GPD): 600
PERCOLATION RATE/S: <1 MIN/IN
/ PROPOSED APPLICATION RATE: 3.0 GPD/FT
MINIMUM DRAINFIELD SQ.FT.: 200
RESERVED DRAINFIELD DESIGN:'
N
MAXIMUM DEPTH: 11' MAX
WIDTH: 2.5'
LENGTH: 15'
R
M.O.A. APPROVED SAND FILTER: N/A
\
EFFECTIVE: 7'v
REDUCTION FACTOR:
/
ACSQ.F2 \
0o
/
ENGINEERING GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGINEERS
31!11 E MU 8000. SURE 101 • INWH E. M 89507 • PHONE (907 M7-6179 r FM (907)339 1906 • WE95RE: rrw.99mrrcNM�ccHM.com
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
JOHN WAGNER 907-360-4884 2 OF 2
LEGAL DESCRIPTION:
MARYLAND S/D; LOT 2
TYPE OF WORK:
DESIGN DRAWING FOR PROPOSED
(RW. 01105)
A.J.G.
AND SEPTIC SYSTEM I 4/14/2014
.........,ys���
P
GARNESS ENGINEERING GROUP, Ltd *X
��'
3701 E. WWR ROAD, 51111E 101 • ANCHORAGE, W. 99807 • PHONE (9073W-61]9 FA%: (90])538-3246 • W M- 9arneemn9in dn9. ...........
SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: MARYLAND S D; LOT 2 e arness,
PERFORMED FOR: JOHN WAGNER DATE: 2/28/2014 °s CI-1.7957`�m�
rO� 1fi�F�°v
PTH
(feet)ORGANICS ��aProfesslona
1
TEST HOLE #1 �00000�o
�•• SOIL CLASSIFICATIONS
GW OR
••.
311110 91 GP ML
GM CL
: GC OL
4 :�: °° 0°0 o SW MH
5 �`i •: 0 `• : SP CH
:e0 SM / OH
6 SC
••• k'
7 •'� SP – SM GROUNDWATER DATE
DRY 2/28/14
Sl
DRY 3/7/2014g •� SCALE:
10 `i� 100'
N �
DATE READING CLOCK NET TIME WATER LEVEL NET DROP
11 TIME (MINUTES) READING (INCHES)
12 ••. 3/3/2014
00.0
13 `•'
14
15 •••
••i
••• ABSORBED 6" OF WATER IN LESS THAN 1 MINUTE, 4 TIMES.
••'•
16-
17
6 17 B.O.H.
18
19� PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 5.5 FT. AND 6.5 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED:
❑ YES NO
SOILS LOGGED BY: ROB CAMPBELL PERCOLATION TEST PERFORMED BY: ROB CAMPBELL
COMMENTS: SEE ATTACHED SIEVE ANALYSIS
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS ER ,ORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: l
GARNESS ENGINEERING GROUP, Ltd
3701 E. I WR ROAD. SURE 101 • ANCHO E• M. 99501 - PHONE: (90])33]-8179 • FAX: (907)338-3248 WE M
SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: MARYLAND S/D; LOT 2
PERFORMED FOR: JOHN WAGNER DATE: -
DEPTH ^ ORGANICS
(feet) ^� ,fee
TEST HOLE #2
7
DATE
'•
2/28/14
SOIL
CLASSIFICATIONS
••�
SP - SM
GW
2
9
9-
ORG
10
10-
ABSORBED 6" OF WATER IN LESS THAN 1 MINUTE, 4 TIMES.
0963
11
11
GP
•
ML
2
12-
13-
13
GM
CL
4
GC
SW
OL
MH
5
.•.
••:
B.O.H.
SP
CH
...•
• • • •
i
SM
OH
6
SC
7
DATE
'•
2/28/14
DRY
3/7/2014
••�
SP - SM
8-
9
9-
10
10-
ABSORBED 6" OF WATER IN LESS THAN 1 MINUTE, 4 TIMES.
11
11
•
2
12-
13-
13
14-
14
15-
15
16-
16
17
17
B.O.H.
18
DEPTH TO
GROUNDWATER
DATE
DRY
2/28/14
DRY
3/7/2014
it �.
r��rcilE
-79 3 a'�Zl
NEfTLETON ACRES S/D J2; LOT 12 h
T' TH'2 TH#1
1 �
� I
1
1 � / SCALE:
100'
DATE READING CLOCK NET TIME
TIME (MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
3/3/2014
ABSORBED 6" OF WATER IN LESS THAN 1 MINUTE, 4 TIMES.
19� PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 5.5 FT. AND 6.5 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES ONO
SOILS LOGGED BY: ROB CAMPBELL PERCOLATION TEST PERFORMED BY: ROB CAMPBELL
COMMENTS: SEE ATTACHED SIEVE ANALYSIS
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PE FORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: Lk �4
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Municipality of Anchorage
On -Site Water & Wastewater Program
(907)343-7904
CERTIFICATE OF ON—SITE SYSTEMS APPROVAL
Parcel I.D. 015-082-25 Expiration Date: 9—S7 -1'5-
1.
3"S1,5-
1. GENERAL INFORMATION
Complete legal description MARYLAND SID; LOT 2
Location (site address)
Current Property owner(s)
Mailing address
Real Estate Agent
6701 JOLLIPAN COURT, ANCHORAGE, AK, 99507
JOHN WAGNER Day phone 360-4884
3040 ADMIRALTY BAY DRIVE, ANCHORAGE, AK, 99515
2. TYPE OF DWELLING:
E Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY:
Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual Well
0
Individual On-site
E
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
WaiverNariance request for: IV/A Distance: -
Received by: / Date: 7
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ o�(D $. °JD Waiver Fee $ _
Date of Payment 5-h//5- / t /".0s, Date of Payment
Receipt Number u/l a l UG Receipt Number
COSA # MCf 5 I Waiver #
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, f 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. t 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 GARNESS ENGINEERING GROUP, Ltd.
Address 3701 E. TUDOR ROAD, SUITE 101 "ANCHORAGE, AK, 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, GEG provided an engineering evaluation of the well end/orseptic system in accordance with the
guidelines and regulations established by the Municipality of Anchorage and industrypractices. The repodedresulls describe the
condition of the systems on The date/s of the evaluation. Separation distances were measured to readily idenfifiable features.
Hidden defects or encroachments may Mat that were not idenfified during The evaluation. The operational life of all wells and septic
systems depend on a variety of variables including, but not linuled to, sal conditions, groundwater levels (that may fluctuate during
the year), quality of construction (materials and workmanship), and the wafer usage of the family, utilizing the systerrus. These
conditions can vary, and are outside the control of GEG. satisfactory test results do not guarantee future performance ofthe
sysfertds therefore, GEG makes no warranty (express or implied) regarding the inure performance of the well or septic system.
GEG makes no representation whether an alternative wa# or septic system can be installed an the property in the event either of the
current systems fail. The content of this report is for the sole benefit of the persorApadywho retained GEG. Reliance upon the
information provided in this report by any other person orpodg including but not limited to subsequent property purchasers, is not
authorhad. In short, GEG disavows any legal duty to anyone other than the persoNpady, who paid for This report.
6. DSD SIGNATURE
__Z System #1 Approved for _�k_ bedrooms.
System 92 Approved for
Disapproved.
Conditional approval for
bedrooms.
Iwo 0=1
337-6179
Date �_t /I;
-
bedrooms, with the following stipulations:
,,kau,lu„
OF AIV,, rrr�`
=J2 ON-SITE
WATER AND
=� WASTEWATER o_
v
gy; d Original Certificate Date: S--
The
`—The MuniLlpal' chorage Develop, emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the rep r natations given in paragraph 5 by an independent professional civil engineerregistered in the State of Alaska.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTCHMENTS: /
COSA Checklist V Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
(Rev, 10112/12)
If more than 1 septic system is on the lot:
COSA Checklist # _of_
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description:
A. WELL DATA
MARYLAND SID; LOT 2
Well type PRIVATE if A, B, or C provide PWSID# NIA
Date completed 5/5/2014 Sanitary seal (YIN) YES
Total depth 203 ft. Cased to 202 ft.
FROM WELL LOG
Date of test 5/5/2014
Static water level 60 ft.
Well production 40 g.p.m.
WATER SAMPLE RESULTS: N 1
Parcel ID: 015-082-25
Well Log (Y/N)
Wires properly protected (Y/N)
Casing height (above ground)
AT INSPECTION
NEW
YES
18+ in.
Coliform �0 colonies/100 ml. Nitrate�� mg./L Collected by: GEG, Ltd-
Arsenic:
td.
Arsenic:! o ug./L. Date of sample: 4/21/2015
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL Date installed 5/19/2014
Tank size 1250 gal. Number of Compartments 9 Cleanouts (YIN) YES
Foundation cleanout(Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A
Date of pumping NEW Pumper
C. ABSORPTION FIELD DATA BELOW FINAL GRADE
Date installed 5/19/2014 Soil rating .p.d./ft r ftlbdrm) 1_0 System type DEEP TRENCH
Length 45 ft. Width 2.5 ft. Gravel below pipe 7.67 ft.
Total depth *10.7-1.2.3 ft. Eff. absorption area 690 ft2 Monitoring tube YES Depression over field NO
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 >= 600+ g,p.d.
Any rejuvenation treatment (past 12 mo.) (YIN &type) —
NONE KNOWN If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access
"Pump on" level at in. "Pump off' level at
E. SEPARATION DISTANCES
level at in.
Cycles tested Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption Feld on lot 1001+ On adjacent lots 100'+
Public sewer main NIA
Sewer/septic service line 251+
Animal containment areas 50'+
Public sewer manhole/cleanout NIA
Holding tank NIA
Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 51+
Water main NIA Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation10'+ Water main N/A
Water service line 10'+ Surface water 1001+ Driveway, parking/vehicle storage 51+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I 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.
Engineer's Printidparne JEFFREY A. GARNESS
Date
(Rev. 10112/12)
o PCE, �'4. VOD�ppo
'SHANE A. HOLT �G
pOno _L9-6914.odd
i
GRID 2439
THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY
CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS: AND IS
NOTTO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES.
EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT, ARE NOT SHOWN
HEREON (UNLESS INDICATED)
NOTE: FENCELINE5 THAT MAY APPEAR ON THI5 DRAWING ARE NOT TO BE USED TO DETERMNE
PROPER TY LINES OR POSITION ADDITIONAL IMPROVEMENTS.
ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO Ek CE SSIVE SNOW AND/OR ICE.
AS BUILT SURVEY 1" = 30'
I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY
OF THE FOLLOWING DESCRIBED PROPERTY
LOT 2, MARYLAND SUB,
ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE
VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN
THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS
EXIST OTHER THAN NOTED,
DATED AT ANCHORAGE,ALASKA THIS IST
-JULY , 2014 - DAY OF
10445, FB 163-37,167-5
HOLT LAND SURVEYING
600 HIGHVIEW DRIVE
ANCHORAGE,AK 99515
345-5513
i