HomeMy WebLinkAboutMCCABE LT 4Lot
Municipality of Anchorage
Community Development Department Page 1 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: OSP181251 PID Number: 018-231-22 ❑ New Upgrade
Name:
BOBBIE KALLAM ABSORPTION FIELD
Address
❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound
13340 MCCABE CIRCLE EAST ❑ Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
3 GPD/SF Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot Ft. Fl.
MCCABE 4 Fill added above original grade Gravel length
Township Range Section Ft. Ft.
Gravel width Beds:Number of Lines Distance between lines
SEPARATION DISTANCES Fl. Ft.
To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist.between trenches
From Tank Field Tank Line Ft2 Ft.
Well 102.3 N/A N/A N/A N/A TANK ❑p Septic 0 S.T.E.P. 0 Holding 0 Other
Manufacturer Capacity
Surface Water 100+ N/A N/A N/A Anchorage Tank 1000Ga1.
Material Number of compartments
Lot Line 76.4 N/A 1 N/A N/A STEEL 2
i NA
Foundation 14.1 N/A N/A N/A LIFT STATION
Manufacturer Capacity
Curtain Drain 50+ N/A N/A N/A Gal.
Pump on level at Pump off level at High water alarm at
Remarks TANK REPLACE ONLY
in. in. in.
Pump make and model Electrical Inspections performed by
PIPE MATERIAL House to tank 3034 Tank to 3034
Installer drainfield
JR'S SEPTIC SERVICES Drainfield CO/MT
Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 430f1
Inspection 1st 8/13/2018 ro Location and description
dates: 2 8/14/2018
3m- 4th AT HOUSE POINT A
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp
Conditional Approval: Date .
�P '�
--- —
*.:49 TM i' :1k
• f
.. .\..i,.. ....
ven A.
CE 8149 •:,
Approved •,.....,,, Date q-6,_(g ,�� �
Inspection Report_1-1-12.doc
ABBREVIATIONS
\ � '
TH TEST HOLE M ; /
(E) EXISTING / /
CO CLEAN OUT NO. 1 CC ABE \ �I **
MT MONITOR TUBE No. t~E , *'' ** x1 •ce
TYP TYPICAL I CIRC 1 ,
- - EAST r`
`\ �43C �-
— WATER LINE / 4S5 / '.,
� WELL RADIUS / � \
1RVE- ani SCALE : 1'.50'
\—SS —SS — NEW SEPTIC7 ,^rL /C 1
\ p0y \ Wr l_-l_ �E
\ 425
A . . 1 '
7 7 1 --
89.8 , \ \
102.3 \
•
'0 \ 1 \
ABR
3 ) l.? W
1 / f T2FD 0/
/ / TiT1 \
L INSTALL 1000. SEPTIC TANK P R MOV 1000. 'PTIC TANK E A B
W DCO BEFORE AND AFTER
/ PER MOA CODE
I DC01 13.9 20.1
l \76.4 Ti 16.6 25.4
\ ~ T2 21.1 31.4
JI _ J ` 1— , I I DCO2 23.2 _
~ 34.1
10•Ula E.mt L /
. _ . s . . — • —� — J— . — . . _ . _ . — . — .
I
10'CEA kANWIEunl —.
°� T — — \ NO WELLS W/I 100' �� 7 NO WELLS W/I 100' /
r- r -- / III
r 1 i I ,
F- I-
1- D D
O 0 j
-Jz Z Z wO
D w W w
O U J J
U
— .-• 0.G./F.G. O U
430
4.0
425.4 / 1000 g SEPTIC 425.2
TANK PROFILE
SCALE: NTS
NOTES: PANNONE ENG SVC, LLC Dote
RECORD DRAWING8/16/18
P.O. BOX 102954 ANCHORAGE, AK 99510 - �G.••• -
PHONE (907) 745-8200 FAX (907) 745-8201 P' •• 'Scale
or:4m LH .* 1.. 50.
•.. . .• P.I.D. NO
MCCABE L4 \_,, : 018-231-22
DRAWN ACP BOBBIE KALLAM ••kleveit .• annale ;PERMIT NO.
13340 MCCABE CIRCLE EAST 8149 � OSP181251
SITE PLAN ANCHORAGE, AK •• 'Sheet
20F2
Iwo ""r,o, MUNICIPALITY OF ANCHORAGE R,enr
On-Site Water&Wastewater Program �o Sc4
/ PO Box 196650 4700 Elmore Road
Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 r,
httpalwww.muni.org/onsite
\ / Art? in livil
t,l, iitn„ nt
4,c R ORO'.
On-Site Wastewater Disposal System Permit
Permit Number: OSP181251 Effective Date: 8/7/2018
Work Type: SepticTank Upgrade Expiration Date: 8/7/2019
Tax Code Number: 01823122000
Site Legal Address: MCCABE LT 4 G:2936
Site Mailing Address: 13340 Mc Cabe CIR E, Anchorage
Owner: KALLAM BOBBIE J Lot Size in Sq Ft: 53184
Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 3
This permit is for the construction of:
❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ 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 ByL Allit j QC )1Date: •v W
10
Issued By: cOlP Date: / g'
EPUITNZ
f c
MUNI P a I 0 A NCHORAGE
.Th
Community Development Department ' i Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On-Site Water & Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 018-231-22
Property owner(s) Bobbie Kallam Day phone
Mailing address 13340 Mc Cabe Cirlce Anchorage, AK 99516
Site address 13340 Mc Cabe Circle
Legal description (Sub'd., Block & Lot) McCabe Lot 4
Legal description (Township, Range & Section)
Lot Size 53,184 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(®all that apply)
Absorption Field ❑ Initial ❑ Single Family (SF) ❑X
(w/wo ADU)
Septic Tank ❑X Upgrade 0
Holding Tank ❑ Renewal Duplex (D) (�
❑ Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE I WAIVER REQUEST 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: — Waiver Fees:
Date of Payment: a r! Date of Payment:
Receipt Number: 07-0-1(16 Receipt Number:
Permit No. �Pl 21ac/ Waiver No.
Permit App_:-:•
Municipality of Anchorage
On-site Water and wastewater
REVIEWED FOR CODE COMPUANCE
Pannone Engineering Services LLC OSP181251,Deb thbckenfuss,07t
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail:steve@panengak.com
August 6, 2018
Subject: McCabe, L4
Tank Replace Permit Request
Design Narrative
EMERGENCY TANK REPLACEMENT
This is a design narrative for a permit to install an upgrade 1,000g Septic Tank to replace an existing
1,000g Septic tank to be issued for this property. The existing tank is in failure it will be decommissioned
per code. Currently the lot is developed. The proposed system will utilize a replacement 1,000g septic
tank that will be connected to the existing drain field. The existing tank is located approximately 100'+
from the well. The proposed tank will be placed outside the existing well radius. All required separation
distances will be met.
1. Upgrade Tank Design.
A foundation clean out installed if needed. I/E'
The tank will be located: 5'+from any property line or building foundation
10'+ from any water line
100'+from any surface water
100'+ from any private wells
200'+from any public wells
The proposed installation will not affect the future development of the surrounding or existing lots.
If you have any questions or concerns, please contact me at 907.745.8200.
Sincer ,
Steven R. Pannone, P.E.
Owner/Civil Engineer
Mailing: P.O. Box 1807 Palmer, AK 99645
Telephone: (907) 745-8200 FAX: (907) 745-8201
Municipality of Anchorage
On-site Water and Wastewater
r REVIEWED FOR CODE COMPLIANCE
ABBREVIATIONS f OSP181251.Deb VV60kenf ,08107
I
TH TEST HOLE — i
(P) PROPOSED 1
(E) EXISTING
CO CLEAN OUT NO.
MT MONITOR TUBE NO.
TYP TYPICAL o
z
—w —w --\W–ATER LINE / M --�� s
WELL RADIUS
44
—ss —ss — NEW SEPTICS ------------ \NN
ti
--/
ig
kl\ \ \ , / \
1CABELE "i \\
N
_.
I CIR \
EAST.3
...... ....... -a30 ` } \
/ 435 / 440
16,.i.
. • N\ WELL (E)/c
I � r ` �o � — WELL E
` ( \ J425
�/ O
/ f 2.0 102.3 \ N \ `
/ I, \1 Ilk 1 \
\ \ 3 V
\ 6.8 –.L, *A' BDR I V
i REMOVE 10000 SEPTIC TANK (E) –
w SFD • ___,__ "
PERMOA CODE \ G4/,
,
L `INSTALL 1000. SEPTIC TANK P 1 • ( 4
W/ DCO BEFORE AND AFTER \ \
1 1-. 745 \• \ � , � _!
I \ — \ i
`�I~I I ' J
1 ) v •
J t \\ 10' UtA Eamt
N 1 10' CEA&ATU UtI Eamt i
—
— 1 --1-
0 _� \ NO WELLS W/I 100' 1 i/ NO WELLS W/I 100' /
rn
i I y i\I�I `
l /i1
4 \
NOTES:
PANNONE ENG SVC, LLC DoteI /
for Con-f i€--hon ' PHONE (907)(907). BOX 1272-8218.4 FAX (907) 272HORAGE, AK 518211 0 cPp� y Scale 6/18^
ff./ %R *I • TH i.‘ •
1" = 50'
• �• P.I.D. NO
MCCABE L4 — ' ``�..•
k 018-231-22
DRAWN ACP BOBBIE KALLAM • A:••
•t}even annope PERMIT NO.
13340 MCCABE CIRCLE EAST • CE 8149•1
ANCHORAGE, AK '%o;
SITE PLAN Sheet
1 OF 1
NAME
I ' 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
LEGAL DESCRIPTION
,~ NEW
[] 0PGRADE
LOCATION
DISTANCE TO: Well Absorption area
u~"<~l--~O ~F_ Manufacturer Gr~rl 0 t?
~ Liq capacity in gallons Inside length
O ~ ~ IF HOMEMADE: ~.
Dwelling
p,,"O
Ma,~erial~
Width....
NO, OF BEDR00%
PERMIT NO. ' ,Q~ --
?co g 7
[ No. of ~mpartments
Liquid depth
DISTA~
Dwelling
PERMIT NO,
Well Foundation
DISTANCE TO: [ O ~
NO. of lines~,~ O~.~ Length of e.~ ~e
Top of tile to finish grade ~ ~ Material beneath tile
Nearest lot line
NO,
between line~
~e ab.%orption area
Length Width Depth
PERMIT NO.
DISTANCE TO:
DISTANCE TO:
ildingfounda
Depth Driller
OTHER
Building foundation
Distance toJot line
PiPE MATERIALS
SOl L TEST RATIN~
I~NS~ALLER
REMARKS
PERM,T NO. ?o0- 5 '7
Sewer line Septic tanI ~ O Absorption area(s)
LEGA~
72-013 (R/cO. 3/78)
DATE
PERMIT NO.
APPLICANT FRANK BETHARD SRR
LOCRTION MCC:RBE "-':IR EAST.
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
'i ,.~.
MR}~IMI. IM NUMBER OF BELt, ROOMS =
SOIL RATING (mO FT,-'"BR)=
THE REQUIRED SIZE OF THE SOIL ABSORPTION S'¢STEM IS:
[:"EZPTH= D L EI'"'~ 6 T H =
344-8006
LOT SIZE m~ m=
· ._4~,~ SQLIRRE FEET
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIEL[:,.
THE DEPTH OF R TRENCH OR PIT I:.q THE DI=,T~NE.E BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE E>,',CRVATION (IN FEET).
THERE IS NO SET NIDTH FOR TF. ENCHE_,.
THE ¢ '",' IS
.~RH~EL DEPTH THE MINIttUM DEPTH OF 6RAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE E~:CRVRTION (IN FEET;,.
REL-].LIIIRED SEPTIC: TRb, IF% :qlZE: 125E1 6RLI C~r~S
PERMIT APPLICANT HAS THE RE~PONz, IBILIT~ TO INFORM THIS DEPARTMENT DURING THE
'- I' ~ ' '"' ,.--
IN'",TALLRTIZ~N IN-PEE. TION_, OF ANY WELLS RD.fRCENT TO THIS PROPERTY AND THE
NLMBER OF RE=,IDENE. E=, THAT THE WELL NILL SERVE.
TN~] ( ;~ ) I ~'~SPECT I O[-~S ARE REL-]L! I RED,
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUB.TECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN R NELL AND ANY ON-SITE SENRGE DISPOSRL SYSTEM IS
t00 FEET FOR R PRIVATE NELL OR t50 TO 200 FEET FROM R PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM A PRIVATE NELL TO R PRIVATE SEWER LINE IS 25 FEET AND
TO R COMMUNITY SEWER LINE IS 75 FEET.
NELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DRYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVRILRBLE TO INSURE PROPER INSTALLATION.
F'ERM I T E>::P I F,:ES DEt--..EI'IBEF.: 32L., :1L980
I CERTIFY THAT
1: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN RCCORDRNCE WITH THE CODES,
~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Pouch 6-650, Anchorage, Alaska 99502 276-222'J
DATE PERFORMED:
SOILS LOG
PERCOLATION
TEST
1
2
3
4,
5-
6-
7
8
9-
10-
11
12
13-
14-
15-
16-
17-
18-
19-
20-
COMMENTS
~ O. Talbot
~ 4~9-E
SLOPE SITE PLAN
WAS GROUND WATER
ENCOUNTERED.
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
Z t';'~ o I'~- .zz" 'o"
f ~ fl: oS~ t o 40" ~'/,"
PERCOLATION RATE ~'" y?~''' (minutes/inch)
TEST RUN BETWEEN "~ FT AND (.~ , FT
PERFORMED BY:
72-008 (7/76)
WATER WELL LOG
FOSS DRILLING ASSOCIATED
909 CHUGACH DR. #37
ANCHORAGE, ALASKA 99503
WELL OWNER Frank O. Bethard
USE OF WELL Domestic
WELL LOCATION Lot 4~ Block --t McCabe Subdivision
SIZE OF CASING6"
STATIC WATER LEVEL
REMARKS
CASED TO 88 FT.
WITH 11 FT. OF DRAWDOWN.
DATE COMPLETED 8/20/80
PUMP TO BE SET AT 87'
o to 30
3o to~8
38 to84
8~ to 88
to
Till: ~rey color and hard
Alluvium: ~rey colorp medium hardness
Till: grey and hard
Sand and Gravel: ~rey~ with water
to
to
to
to
to
to
to
to
to
to
MUNICIPAl lTV r~ ~,JF~HODA.~__~
DEPT. OF HEALTH &
ENVIRONMENTAL Pi~OTECTION
Dr'Frl%/rh
'to
~ ' ~ * DATE RECEIVED
·
°' INSPECTION APPOI NTI~ENTS
INSPECTOR INSPECTOR I NSPECTO~
[)~ ~
~UNICIPALI~ OF ANCHO~GE
~UNIOIPALITY OF ANOHORA~E DEPT. OF HEALTH &
DEPARTMENT OF HEALTH · ENVIRONMENTAL P~OTE~ONMENTAL PROTECTION
82[ L Street - Anchorage, Alaska ~01
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND
DIRECTIONS: Complete aH parts on page 1, Incomplete reques~ will not be proce~ed, Please allow ten (10) days for processing,
1. PROPERTYOWNER J PHONE
MAIL~G ADD, riSS
PROPERTY RESIDENT (If different from above) PHONE
2. BUYER PHONE
MAILING ADDRESS
3. LENDING INSTITUTION I PHONE
I
MAILING ADDRESS
4. ~EALTO~/A~ENT I PHONE
I
MAILIN6 ADDRE88
5, LEGAL DESCRIPTION
STR E,~T LOCATION
E, TYPE OF RESIDENCE
X SINGLE FAMILY
[] MULTIPLE FAMILY
NUMBER OF~BEDROOMS
[] One [] Four
[] Two [] Five
~ Three [] Six
[] Other
7. WATER SUPPLY
INDIVIDUAL*
COMMUNITY
PUBLIC UTILITY
* ATTACH WELL LOG. A well Icg is required for al wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach Icg if~vailable.)
8. SEWAGE DISPOSAL SYSTEM
.~ INDIVIDUAL/ON-SITE**
~ PUBLIC UTILITY
YEAR ON-SITE SYSTEM WAS INSTALLED.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (Rev, 6~79) ~,,) 0
THIS SIDE FOR OFFICIAL USE ONLY ·
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] INDIVIDUAL/ON -SITE DATE INSTALLED
I-]PUBLIC UTILITY
Connection Verified INSTALLER
[]Septic Tank or I-~ Holding Tank
Size: l(~)(~ If Tank is homemade SOILS RATING
give dimensions: ~::~~
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES Septic/Holding Tank Absorption Area ISewer Line ] Nearest Lot Line
WELL TO: [0~
Absorption Area to nesrest Lot Line
5. COMMENTS
~ROVED FOR ..~ BEDROOMS
[] CONDITIONAL APPROVAL {letter must accompany certificate)
[] DISAPPROVED
DATE BY
72-010 (Rev. 6/79)
EPUI
•� .� Municipality of Anchorage 7th.
On Site Water and Wastewater Program
(907)343-7904 .r r r
Certificate of On-Site Systems Approval /, \ Q
Parcel I.D. 018-231-22 Expiration Date: ( 2 - iv � �?,
1. GENERAL INFORMATION
Complete legal description McCabe L4
Location (site address) 13340 McCabe Cir. Anchorage, AK 99516
Current Property owner(s) Bobbie Kallam Day phone
Mailing address 13340 McCabe Cir. Anchorage, AK 99516
Real Estate Agent Day phone
2. TYPE OF DWELLING:
O Single Family(w/wo 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 Q Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
Received b . > L A.L W/!L �.� 4J Date: /I2J/S
COSA to be released to the engineer,unless otherwise requested by th ineer.
COSA Fee $ 52.6. Waiver Fee $
Date of Payment `Z 11411i Date of Payment
Receipt Number /� O9525E! Receipt Number
COSA# tJ'ii(Lf5`f Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation dale 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 Date 8/31/2018
*149 TH
6. DSD SIGNATURE ••••40( `
x- System#1 Approved for 3 bedrooms •.t}even -ar'r 6 e
- .• CE 8149 ;•
System#2 Approved for bedrooms
Disapproved �'
Conditional approval for bedrooms, with the following stipulations:
4 V�
V).
R
S1 PRIG
•
•
BY ! t Original Certificate Date: I 2—( 0-1
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: McCabe Lot 4 Parcel ID:018-231-22
A. WELL DATA
Well type Private If A, B, or C provide PWSID# Well Log(YIN) Y
Date completed 8/20/1980 Sanitary seal (Y/N) Y Wires properly protected(Y/N) Y
Total depth 88 ft. Cased to 88 ft. Casing height(above ground) 17 in.
FROM WELL LOG AT INSPECTION
Date of test 8/20/1980 8/2/2018
Static water level 75 ft. 77.5 ft.
Well production 5.5 g.p.m. 3.0 g.p.m.
WATER SAMPLE1RESULTS:
Coliform IN( .6 colonies/100 mL Nitrate 7.1q mg/L
Arsenic 1`^() ug/L Date of sample: 8/27/2018 Collected by: PES
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Anchorage Tank Date installed 8/14/2018
Tank size 1000 gal. Number of Compartments 2 Cleanouts(YIN) Y
Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm(Y/N) N/A
Date of pumping NEW Pumper N/A
C. ABSORPTION FIELD DATA
Date installed 8/14/1980 Soil rating2 or ft 2/bdr ) 95 System type Deep Trench
(g.p.d./ft m
Length 29 ft. Width 3 ft. Gravel below pipe 5 ft.
Total depth 8'1 ft. Eff. absorption area 290 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 8/2/2018 Results(Pass/Fail) Pass For 3 bedrooms
Fluid depth in absorption field before test 1 1 in. Water added 450 gal. New depth 32 in.
Elapsed Time: 180 min. Final fluid depth 11 in. Absorption rate >= 450 g.p.d.
Non Known
Any rejuvenation treatment(past 12 mo.)(Y/N&type) If yes,give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access(Y/N)
"Pump on"level at in. "Pump off level at in. High water alarm level at in.
Datum Cycles tested Meets alarm&circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100+ On adjacent lots 100+
Absorption field on lot 100+ On adjacent lots 100+
Public sewer main 75+ Public sewer manhole/cleanout 100+
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 10+ Property line 10+ Absorption field 5+
Water main 10+ Water service line 10+ Surface water 100+
Wells on adjacent lots 100+
ABSORPTION FIELD ON LOT TO:
Property line 10+ Building foundation 10+ Water main 10+
Water Service line 10+ Surface water 100+ Driveway,parking/vehicle storage 10+
Curtain drain 50+ Wells on adjacent lots 100+
F. COMMENTS
G. ENGINEER'S CERTIFICATION -, 0f.•
I certify that I have determined through field inspections and
*149TH
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date. •''•'t,•
Steven Pannone 1 "�:`
Engineer's Printed Name •'t.1even A. ' onno e
Date 8/31/2018 . CE 8149 : •
COSA canary sheet_2-6-15.doc
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT • }fr---1 _ 907-343-7904
On-Site Water and Wastewater Section Fax: 343-7997
www.muni.org/onsite
Nitrate Advisory
Certificate of On-Site Systems Approval # OSC181454
Subdivision: McCabe Lot: 4
A water sample revealed a nitrate concentration of 7.19 milligrams per liter
(mg/L). 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.
Mailing Address: P.O. Box 196650* Anchorage,Alaska 99519-6650 *www.muni.org