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HomeMy WebLinkAboutTERI #2 LT 10Onsite File r v Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 1 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP 181164 PID Number: 05075116 Dwelling: Single Family(SF) ❑with ADU ❑ Duplex (D) D Two Single Family Project: ❑■ New ❑ Upgrade Name CMM GENERAL ABSORPTION FIELD Site Address ❑ Deep Trench ❑■ Wide Trench ❑ Bed ❑ Mound 3912 DELORES ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 862-8758 5 1.2 GPD/SF 5.9 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 2.8 Ft. 3.1 Ft. TERI#2 LOT 10 Fill added above original grade Gravel length Township Range Section 0.5 +1- Ft. 77 Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES 5 Ft. - - Ft. ToSeptic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist.between trenches From Tank Field Tank Line 664 Ft2 1 - Ft. Well +100 +100 - - +25 TANK ESeptic 0 S.T.E.P. 0 Holding 0 Other Manufacturer Capacity Surface Water +100 - - +100 GREER 1500 Gal. Material Number of compartments Lot Line +10 +10 - - NA PLASTIC 2 Foundation +10 +10 - - LIFT STATION Manufacturer Capacity Gal. Remarks Alarm location Electrical installed by PIPE MATERIAL House to tank 30034Tank to 3034 Installer drainfield CMM GENERAL Drainfield 3034 CO/MT 3034 Inspector CHARLES BALZARINI BENCH MARK (Assumed elevation) 100 ft Inspection vl 7/24/18 9/25/18 Location and description dates: 2n° 3'° 4th garage slab ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp 2/17/19 ��-‘•-N\\ Conditional Approval: Date _ �,`P�••' S2.1—'0 . ..,,..1...x•... .... .. 00 • CHARLES G BALZARIrU Septic Sy / /0� ��c• CE•13854 .•• % ,re Approved 1ni` Date _S—1—If �1 's>•.. .••F�v��,�� Note: this approval does not include well permit requirements. �il\PROFESSIO*P1+ (Rev 05/02/18) Aso'423.• �� *-17‘,0 UTILITY EASEMENT 0'*, 49 TH \ /(14#, .•• ././7 i,., , 5'x75' SHALLOW — CHARLES G BALZARIM • TRENCH WITH I r111o%. CE-13854 • `%/ 3' EFFECTIVE sTF•• 2/15,^q ••••��r SEWER ROCK 5x78 SHALLOW/ ,l�le, ••.•.-• " TRENCH / l�\\\\���~ SWING TIES o+ \\ J O �<O A B \ 1500 GAL 'Q C 7.5 38.1 \ , POLY TANK �6' D 57.9 25.3 H E 78.3 41.7 \\ G F 83.8 46.7 ,p F 110‘ G 90.5 53.1 \\ WELL H 94.5 56.8 I 150.7112.3 v D GARAGE J 143.1 105 u' - • a, K 82.5 60 K / CLEANOUTS C a 04 /•A -.1k . FOUNDATION / 5BR. HOME CLEANOUT \ `/ \ \ \ TERI#2LOT1O \ \ _ _ f LEGENCLED o ANOUT \ • MONITOR TUBE \ ® TEST HOLE \ PLAN-SCALE: 1"=40' +100.0'GARAGE SLAB FILTER FABRIC MONITOR TUBE 92.0 78.8 FINISHED GRADE TESTHOLE 88 4'COVER II ( COVER j!: 78.3' ORIG.GRADETESTHOLEELEVATIONS BASED 1500 GAL j; P;j�j;j� � ON TESTHOLE#2 87.15 POLYTANK 86.95 �i j-ji ji ji ji r� 75.5 INVERT NO GWT ON 7!24118 72.4 -- 68.3'HIGHEST GWT 4/30/15 4"0 DISTRIBUTION PIPE 3.1'EFFECTIVE SEWER ROCK SCHEMATIC ELEVATION-SCALE:NTS B.O.H 66.3' LEGAL DESCRIPTION:TERI#2 LOT 10 C&M ENGINEERING SERVICES OWNER:CMM GENERAL IDATE:02/15/19 I REV: 1 I DRAWN:CBI REF: 907-854-5558 SEPTIC RECORD DRAWING Certified Drilling Log DOC CO dba BILL 8, COLE 111ULLIVAN WATER WELLS 1111111eP.O. Box 670269, Chugiak,AK 99567 688-2759 OWNER OF LAND: CMM General Contractors Bore Hole Data ADDRESS: Depth LEGAL DESCRIPTION Teri#2 Lot 10 From To DATE: 7-6-18 0 2 Casing Stickup PERMIT NUMBER: OSP181164 DATE OF ISSUE: 7-3-18 TAX IDENTIFICATION NUMBER 05075116000 2 4 Overburden Is well located at approved permit location: NYes No 4 28 Silty Sand &Gravel Method of Drilling: Nair rotary Ucable tool 28 65 Silty Sand &Gravel w/Clay Depth of Well: 320' 65 164 Hardpan & Boulders Casing Type: Steel Wall thickness .250 inches 164 190 Hardpan & Clay w/Boulders Diameter: 6 inches, depth 224 feet 190 193 Silty Sand & Gravel Wet Liner type 100' of 4.5" PVC Static Water Level: 104 feet 193 220 Hardpan w/ Boulders Recovery Rate 15+ ® gpm gph 220 296 Bedrock Gray Method of Testing Air 296 309 Broken Bedrock w/Quartz Well Intake Opening Type: ❑open end open hole n Screened Start feet Stopped 309 320 Bedrock Gray Perforations Start feet Stopped Grout Type: Bentonite Volume: 50 lbs Depth:from 2 feet,to 42 feet Well Disinfected Upon Completion: Nyes no Method of Disinfection: Chlorine 50 PPM Comments: lb LptiMilirlffli • / rfaiNNIAVar4 •I/100nt /' !fes: 'fit ug 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. DOC CO dba 1?L1LL1YAN WATER WELLS P.O. Box 670269, Chugiak,AK 99567 688-2759 www.sullivanwaterwells.com Pump Installation Log Well Drilling Permit Number: SW OSP181164 Date of Issue 7-3-2018 Parcel Identification Number: 05075116000 Legal Description Property Owner Name &Address TERI #2 LOT 10 CMM GENERAL CONTRACTORS Pump Installation Date: 10-18-18 Pump Intake Depth Below Top of Well Casing: 292 feet Pump manufacturer's Name: F&W Pump Model: 4F11P10301S Pump Size: 1 hp Pitless Adapter Burial Depth: 10 feet Pitless Adapter Installer: CMM Disinfected Upon Completion? ® yes ❑ no Method of Disinfection: Chlorine 50 PPM Comments: Pitless Manufacturer: MARTINSON Pump Installers Name: Sullivan Water Wells Attention:The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. ° �P.` °� MUNICIPALITY OF ANCHORAGE �--' On-Site Water&Wastewater Program N,, '�' I. r .s,. r ® /.'r PO Box 196650 4700 Elmore Road • ;" Anchorage,Alaska 99519-6650 Phone: (907)343-7904 Fax:(907)343-7997 ;, http://www.muni.org/onsite 44 oHoa�o� I)(I t'lItti•Ill On-Site Water & Wastewater System Permit Permit Number: OSP181164 Effective Date: 7/3/2018 Work Type: WellSeptic Initial Expiration Date: 7/3/2019 Tax Code Number: 05075116000 Site Legal Address: TERI #2 LT 10 G:0704 Site Mailing Address: 3912 DELORES DR, Eagle River Owner: CMM GENERAL CONTRACTORS LLC Lot Size in Sq Ft: 88514 Design Engineer: C & M Engineering Total Bedrooms: 5 This permit is for the construction of: 0 Disposal Field Q Septic Tank ❑ Holding Tank 0 Privy E Private Well 0 Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72)and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: ' 7 5 -- Date: Issued By: /� `] lg /"'1 ��— � Date: / l MUNICIPALITY OF ANCHORAGE Development Services Department / Phone: 907-343-7904 On-Site Water & Wastewater Section =/ Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 050-751-16 Property owner(s) CMM GENERAL Day phone 862-8758 Mailing address P.O BOX 670972 CHUGIAK Site address 3912 DELORES Legal description (Sub'd., Block & Lot) TERI#2 LOT 10 Legal description (Township, Range & Section) Lot Size 88,514 Sq. Ft. Number of Bedrooms 5 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ID Initial Single Family (SF) El (w/wo ADU) Septic Tank Upgrade ❑ Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: NONE 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: -15.6'-( fi' 2 i 9" Waiver Fees: Date of Payment: -/5l_9"- =6/z6/g Date of Payment: Receipt Number: O 9 5/3 Receipt Number: Permit No. 059/6 I G Waiver No. G:1Development Services\Building SafetylOn Site Water and Wastewater\Forms\Client Forms\Permit Application.doc C&M ENGINEERING SERVICES Ph: 907-854-5558 Municipality of Anchorage Onsite Water & Wastewater Program 4700 Elmore Rd Anchorage, Ak 99507 RE: Proposed Septic System Replacement for TERI#2 Lot 10 Dear Reviewer, The above referenced property is currently un-developed. We are proposing the installation of a new well and septic system suitable for a 5 bedroom home. Though the lot is located in an area known to have steep slopes and high groundwater tables, the topography at the septic location is moderate, ranging from 15-25% The groundwater table is identified on the soils log and does not severely limit the design. Since the lot is un-developed and the permit was submitted initially in 2015, we are requesting that an as built survey not be required as part of this submittal. Installation of the proposed system will not negatively impact adjacent lots. Drainage is not a major consideration in this design. Included with this letter is a permit application, plans, specifications, and calculations. Thank you for your time in reviewing this permit request. Please do not hesitate to contact me at 907-854- 5558 or by email cgbalzarini@gmail.com with any questions or concerns. Sincerely, Charles Balzarini, PE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181164, Deb Wockenfuss, 07/03/18 Residence: number of bedrooms 5 br Water usage/bedroom 150 gpd/br Water Usage 750 gpd Percolation Rate 2.5 min/inch Groundwater Depth 10 ft bgs Test Hole Depth 12 ft bgs system type: conventional type: shallow trench Application Rate 1.2 gpd/sqft required absorption area 625 sqft trench width (W) 5 ft gravel depth (D) 3 ft below distribution pipe Shallow trench factor 0.58 (W+2)/(W+1+2D) Min Required Length: 73 ft Total Depth: 6 ft Cover: 3 ft min Insulation: 2" blueboard Use Length: 75 ft ok Effluent Pipe: System type: Conventional Tank: 1500 gal steel or fiberglass Drainfield: 5'x75'x3' shallow trench Calc By: CGB Date: 6/26/2018 DRAINFIELD (Shallow trench factor * Required absorption area /W) 4" ASTM 3034 Design Summary C&M ENGINEERING SERVICES 907-854-5558 Septic Design Calculations Teri#2 Lot 10 RESIDENCE/LOT INFO Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181164, Deb Wockenfuss, 07/03/18 TERI #2 LOT 10 TERI #2 LOT 11 PROPOSED WELL PROPOSED 5BR. HOME 5'x75' SHALLOW TRENCH WITH 3' EFFECTIVE SEWER ROCK 5'x75' RESERVE AREA TH-1 TH-2 SEPTIC AREA TOE OF SLOPE -22% BUILDING PAD DRIVEWAYPROPOSED 1500 GAL SEPTIC TANK NEIGHBOR'S 100' WELL RADIUS TERI #2 LOT 09 (UNDEVELOPED) D E L O R E S D R I V E TERI #2 LOT 5 TERI #2 LOT 6B APPROX. NEIGHBOR'S 100' WELL RADIUS TERI #2 LOT 6A -25 %-25% -15 % FOUNDATION CLEANOUT 10' UTILITY EASEMENT 1 0' U T I L I T Y E A S EM E N T 10'x25' ANCHOR EASEMENT NEIGHBOR'S 100' WELL RADIUS -19% -25%-25% -25%-30% NEIGHBOR'S 100' WELL RADIUS AWWTS ~ 40' UP SLOPE FROM LOT LINEGARAGE C&M ENGINEERING SERVICES 907-854-5558 SITE PLAN LEGAL DESCRIPTION: TERI#2 LOT10 OWNER: CMM GENERAL DATE: 07/02/18 REV: 0 DRAWN: CB REF: SCALE: 1" = 50' CHARLES G BALZARINI CE-13854R EGISTEREDPROFESSIONALE NGINEER LEGEND CLEANOUT MONITOR TUBE TEST HOLE SLOPE INDICATOR NOTES: 1. THE PROPOSED SEPTIC SYSTEM IS GREATER THAN: 100' FROM ANY PRIVATE WELLS 200' FROM ANY PUBLIC WELLS 100' FROM ANY SURFACE WATER 50' FROM ANY STEEP SLOPES 10' TO ANY PROPERTY LINE OR FOUNDATION 5' TO ANY TEST HOLES0.5% 6/26/18 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181164, Deb Wockenfuss, 07/03/18 C&M ENGINEERING SERVICES Ph: 907-854-5558 SPECIFICATIONS FOR ONSITE SEPTIC SYSTEM - MOA CERTIFIED INSTALLER LEGAL: Teri#2 Lot 10 June, 2018 A. GENERAL 1. The septic design is for a 5 bedroom, single family residence only. 2. The site plan and drawings shall be a part of this specification. 3. The Wastewater system shall be installed by a certified installer in accordance with moa requirements. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. The engineer shall perform percolation tests and groundwater monitoring prior to finalizing design.. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage, Department of Environment of Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi-family wells. A licensed surveyor should locate all nearby lot lines, easements, exact 100’ radius from the existing and neighboring on- site wells, and any nearby surface water. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. Any remaining open test hole excavations shall be filled and monitor tube removed, after construction of the Drainfield. 9. The contractor shall provide the engineer with adequate notice to perform inspections. 10. Insulate the sewer line if it passes under the driveway or parking area, with a minimum of 2” extruded board insulation, rated for burial, and on the moa approved list. B. SEPTIC TANK Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181164, Deb Wockenfuss, 07/03/18 1. Septic tank shall be a fiberglass or steel, 1500-gallon tank capacity of MOA approved construction. Installed to meet MOA requirements. Set Tank 10’ from foundation. 2. Install a foundation cleanout within 5’ of the foundation. 3. Install 2 after tank cleanouts between the tank and drain field. 4. A combination of soil and 2” minimum of insulation shall be placed over the tank, to prevent ponding and promote drainage. The insulation shall be rated for burial and meet moa requirements. C. DRAINFIELD 1. The Drainfield is to be located as shown on the site plan. Notify Engineer of any changed site conditions. 2. The total depth of the initial drainfield excavation is to be at maximum 6’ deep Bottom of excavation shall be level +/- 1.5” max. If bedrock or inconsistent soils are encountered, notify the engineer immediately. 3. In the event of over-excavation, a moa filter sand shall be used to maintain the 6’ separation distance from the bottom of each trench to the bottom of the test hole(s).The top of the sand layer shall be level, plus or minus 1.5”, and raked, prior to placing sewer rock. Care shall be taken to not compact the sand. 4. A 36 inch effective layer of sewer rock is to be placed in the each trench. The effluent piping is to be set on top of this layer ,buried with sewer rock, with 2” of sewer rock cover over the piping. 5. The Distribution pipe shall be 4” perforated pvc pipe conforming to ASTM D3034. 6. The complete Drainfield gravel and piping is to be covered with a geotextile filter fabric. 7. Soil or combination of soil and extruded board insulation to a depth of 3’ or equivalent is to be placed over the drainfield. Mounded side slopes shall not to exceed 3:1. The minimum insulation thickness shall be 2”. Insulation shall be moa approved and rated for burial. 8. The septic tank and leachfield must not be closer than 100’ to any existing private well, or 200’ to any community well. Design Summary: Excavation Depth: 6’ Gravel Depth: 3.0’ under distribution pipe, 2” over Drainfield Length: 75’ Drainfield Width: 5’Soil Rating: 1.2 gpd/sqft 10.5' 5/15/16 pre-soaked prior to test. TH# 1 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181164, Deb Wockenfuss, 07/03/18 10.25' 5/15/16 pre-soaked prior to test. TH# 2 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181164, Deb Wockenfuss, 07/03/18 MUNICIPALITY OF ANCHORAGE Community Development Department ,�' z"' ,I Phone: !% t I !14 Development Services Division �.- F. : '.:tllcLxt. e • On-Site Water&Wastewater Program IP IN I ON-SITE SEWER/WELL PERMIT APPLICATION ; SUN 0 5 2015 11 / ti Parcel I.D. SSD -- 755 1 6 t Property owner(s) L14 -Ki2oiv3ER4E x... Day phone Mailing address //6/9 S DEZDAES "1-)1 Site address AJ/4 " t75LoAES Legal description (Sub'd., Block & Lot) 7 E iz L 412. GOT i 0 Legal description (Township, Range & Section) Lot Size DZ 514 Sq. Ft. Number of Bedrooms APPLICATION IS FOR: APPLICATION IS AN: OF DWELLING:N, t®all that apply) �� Absorption Field ® Initial Single Family(SF) ', (w/wo ADU) Septic Tank El Upgrade 0 Duplex(D) ❑ Holding Tank ❑ Renz i al IN Ntulti Wellings ❑ Privy 111 ( and/or D) e.., _ Private Well I/ 1) llA \ Water Storage 0 `i THIS APPLICATION INCLUDES A VARI . CE/WAI QWEST FOR: 2/ I`l I g Distance: I certify that the above information is correc I furth rtify that this is in accordance applicable Municipal Codes. Z1 (___CSiga of of Ty owner or authorized agent) Permit/Rush Fees: 9 - 5o Waiver Fees: Date of Payment: (O 57(5 Date of Payment: Receipt Number: 3 9'i5f' Receipt Number: Permit No. Qs Waiver No. Permit App_9-1-12.doc \ „iii..-4671•31316..W.‘ l TERI #2 i �:••'•.. x,1111 APPROX. NEIGHBOR'S LOT 6Ai_ ••;9OA 100'WELL RADIUS TERI #2 0 */ -•.! 11'I �\ 9 LOT 6B � •• •••� •••• / (NO WELL OR SEPTIC) TERI #2 N 0 tHARLESGBALZARINt ,ck- Al LOT 09 10'x25'ANCHOR + c�c�.•• CE-13854 •• •`c,/ (UNDEVELOPED) EASEMENT �1 ��c�•. / 0/15.•�� 1 kV/PROFEssP"�.� 0,<„ l�\\\-��~ 10'UTILITY EASEMENT <0 TERI #2 LOT 5 5'x75'SHALLOW I SFS ("BIO-SHELTER" NO WELL TRENCH WITH O 3'EFFECTIVE 'Q/L OR SEPTIC) SEWER ROCK 15°I0 PROPOSED OU NATION F TH-1 1500 GAL .EAN• T — • '1° PES3 SEPTIC TANK • 5'x75' RESERVE \ TH-2 ..• / AREA \\ ® PROPOSED \ - \ 56R. HOME 0o \v 01 \ / I \ 3 PROPOSED TOE OF WELL SLOPE \ TOE I \\\ \ \ '4/, BUILDING PAD yy \ \ NEIGHBOR'S TERI #2 / \ 100'WELL RADIUS LOT 10 \ / / iT F NEIGHBOR'S / \ �\ 100'WELL RADIUS \ \ N / \ \ LEGEND NOTES. \ TERI #2 0 CLEANOUT LOT 11 1.THE PROPOSED SEPTIC SYSTEM IS GREATER THAN: / 100'FROM ANY PRIVATE WELLS • MONITOR TUBE 200'FROM ANY PUBLIC WELLS I 100'FROM ANY SURFACE WATER ® TEST HOLE 50'FROM ANY STEEP SLOPES SEC 0.5% \SLOPE INDICATOR 10'TO ANY PROPERTY LINE OR FOUNDATION AR A 5'TO ANY TEST HOLES \ SCALE: 1”=50' LEGAL DESCRIPTION:TERI#2 LOT10 C&M ENGINEERING SERVICES OWNER:LANCE KRONBERGER DATE: 05/10/15 REV: 0 DRAWN:CB REF: 907-854-5558 SITE PLAN a Municipality of Anchorage =�'`(.eNGINEE$„T§kAL},9 �, Development Services Department * 49 T" / - :*4 Building Safety Division ✓ ••• .......... f'�r�. On-Site Water and Wastewater Program I ,,,,,••... / 1— 4700 Elmore Road /1' Charles G.Balzarini ;W P.O. Box 196650 Anchorage.AK 99507 4. www.ci.anchorage.ak.us ,' 6" '• CE-13854 ,_ (907)343-7904 c, ,.•. � %✓*., �` Soils Log - Percolation Test ,11-tIv 5��- Performed For: (,+4A,GE 1-1 .A/(3 ZPZ 6 E(_ Date Performed: ),/(S Legal Description: 7 ERZ j 1401-- Lor to Township,Range,Section: Slope Site Plan Depth 0 e t) 7.0p5 ,2L �� R r5 1- j © ��E 2- HilV 51 rE:- 3- >jY R_A,,/ 4- ', U iN\ 5- 6- I,` F4/ 7- 1 (. 8- WAS GROUND WATER )5 9- ENCOUNTERED? S 10- . IF YES.AT WHAT DEPTH? lir L Depth to Water After I 11- t to 3 ' P Monitoring? 12-_I--- ''7,(- 0 Date: L /l�h,� E A S 13- z 14- Reading �` Date Gross Time Net Time Depth te+ Ner Net Drop 15605/5 *65'07 o-:Cb' 5 °di? 16- 3,1 / 7 O'to ° n 17- 2, : IT Of 00 5 4)46- 18- cf I 0 LI/b 19- tc : 27 0,00 5 044 20- for V� 3', 39 0,./0 o 'x/16 PERCOLATION RATE6- (minuteslnch) PERC HOLE DIAMETER TEST RUN BETWEEN -;_ 5 FT AND '-t FT COMMENTS- (4957- A 42,65 57&c.-(4) PERFORMED BY: 1 /•i4G2/4R I - CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 14/7J0��5 t. Municipality of Anchorage 1 Cr).to A NGINEER's .EAL•}..�- • Development Services Department •• 49 T.H �, *.� Building Safety Division /r � .... - .. '� 0 �. On-Site Water and Wastewater Program • 4700 Elmore Road j �� ,.. i >' • Chart Baltarini �� P.O. Box 196650 Anchorage.AK 99507 .F •� www.ci.anchorage.ak.us �.4.*: (907)343 7904 ,.��c�` �• -z1 ' V• 1 9 .5!Y/� (�• Soils Log - Percolation Test ,+f��iOra S°:`••. Performed For: ' 4CCttz /,b112 . Date Performed: q/220) Legal Description: -TER-J-412-- (�I (0 Township, Range,Section: Slope Site Plan Depth O (Feet) q_.;,,, jOOTL 2- ,,.''r) S 1 I SGiG+rtyS�?� ii 3- , �,,, Y 6 t/h FL r.^/ 4- 3P51/1/ 5- 6- 7-c 8 WAS GROUND WATER �/� 9- ENCOUNTERED? /LS V S 10- r IF YES.AT WHAT DEPTH? 1/ o 1 Depth to Water After P 11- • Monitoring? �1Lao E -- 3,k!,. 12- ti Date: -1 ,/i> 13- 441141,-- 14- 3- W/t t4Yt14- Reading Date Gross Time Net Time Depth to-Water Net Drop 15 t 14/25/fS I D'U� 0. Qo S p�16 0 16- 1) 5-i, , ..(el o $i16 9 - //lb 17- 3 0' S� o. - o/1 0 18- y ':03 0 0D in 11 - %fib 19- S 3 r'o 500 Sc 0o 20 6 3; !5 0Lo 19/It� y-n 7Q ' : /b q co 5 -0,7b1 0 PERCOLATION RATE /2, 5 Lon t"3u- CpQt-E-t�IAMErER /v/61,4'-i-... .,::046 TEST RUN BETWEEN �L FT AND S FT COMMENTS se 4195-i— 7 ./Z w,✓GS ./.. �(,,r/t 'l PERFORMED BY: G� t -AL:2 .-2,)v'12 I CERTIFY THAT THIS TEST WAS '< PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: c-{/3o/ Ri(;k Myslrom, Mayor Mmficipality of Anchorage Department of Health and Human Services 825"L"Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 November 15, 1994 Mt'. Terry Danisoo 1721 Kodiak Street Anchorage, AK 99504 Subject: Lt. 10, Teri Subdivisiou//:2 Permit #SW930465, Parcel ID #050-75 l- 16 Dear Mr. Danison: ri'be subject perlnit, issued November 3, 1993 by this office for a single falnily well al]d/or on-site wastewater system, has expired as of Novelnber 3, 1994. A new permit must be obtained fi'om this office for a well and/or on-site wastewater system NOT installed by the expil'atioli (late. if you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the perlnit. If the on-site wastewater system has been completed aud it licensed Professional Engineer has inspected the installation of the ou-site wastewater systeln, the original as-built il]spectiol] report must be sent to this office for review, approval and documentation. All inspectiou reports must be submitted within 30 clays of construction colnpletion. When applying fol' a i]ew permit, the fees are: $320.00 for all on-site wastewater perlnit; $120.00 for a well pelmit and $440.00 for it combined on-site wastewater and well permit. If you have any qaestions, please call this office at 34%4744. Sincerely, Program Manager On-Site Services JC/kb cc: Robert C. Cowan, P.E. PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW930465 DESIGN ENGINEER:S ~ S ENGINEERING OWNER NAME:DANISON TERRY I ~ OWNER ADDRESS:1721 KLONDIKE ST. ANCHORAGE, AK 99504 DATE ISSUED:il/03/93 EXPIRATION DATE:il/03/94 PARCEL ID:05075116 LEGAL DESCRIPTION: TERI #2 LT 10 LOT SIZE: 88514 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM 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 (iSAAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECEIVED ISSUED ROBERT SHAFER. P.E. ROGER SHAFER, P.E. October 18, 1993 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 H F~,LTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES ANO REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 'L' Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: 7'eri Subdivision Addition #2, Lot 10 Request you issue a permit to drill a well and install a septic system to serve the proposed four bedroom house on the referenced property. Test holes were excavated and percolation tests performed. The approximate location of the test holes are located on the attached site plan. At the time of excavation water was encountered at 7 feet and after seven day water monitoring water was found at 7 feet in test hole #1 and 8 feet in test hole #2. This property has enough area for a future septic upgrade which can be seen on the attached site plan. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic system. If you have any questions, or require additional information for your review, please contact us. . Shafer, P. ti/ RAS/LSU/isu ~. ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 NORTH EAGLF RIVER LOOP ° SUITE 204 · EAGLE RIVER, ALASKA 99577 1" = 50' SITE PLAN SCALE 'N %. / / / Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: L. EBA' DESOR,PT,ONd. "r 2 3 4 5 6 7 8 9 10 11 12 13- 14- 15- 16- 18- 20- BATE Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT ~-- ?'~ pO DEPTH? E Depth to Waler Alter ,~" Monitoring? . Date: SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~ ~ (m~nutee/mch) PERC HOLE DIAMI--TER ~ TEST RUN BETWEEN ~.__~,//FFT~AND '~> FT~ $ &S ENGINEE. EING 17034 Eagle Rwer Loop Road No. 204 ~N PERFORMED BY: ~.~.~-~,,--~,- ~-~,, .... 5'"" I ,,"/~~_ CERTIFY THAT THiS TEST WAS PERFORMED ACCORDANCEWITH'a~L'~L':';A;'E'~DTU~IO:;AL GUIDELIN.~FF~T ON THIS DATE. DATE: 72-008 (Rev. 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: /~/0~1~ fl(Z.J~ZOO/C. DATE PE LEGAL DESCRmTION:.L..O-t' tO '--¢~'-T~_ ~//D ;1=~'2- Township, Range, Section: 4- 5- 6- 7- 8 9 10 11 12 SLOPE 13 15 16 17 18 19 20- WAS GROUND WATER /~--~ ENCOUNTERED? ~4'~, t s IF YES, A'r WHAT ~' DEPTH? p E Depthl0 Water After ~ ¢ ~oniterinD? Bate: · '(ENG SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop : 2.S ~o ~ ~/~ Y~" TEST RUN BETWEEN/./~£ AND COMMENTS"O-'" PERFORMED e[~gie River, Alaska ACCORDANCE WIYH ALL STATE AND MUNICIPAL GUIDE~C~'~I~/~FFECT ON THIS DATE. 72-008 (Rev. 4/85) PERCOLATION RATE /;~"~ (m~nutesnnch) PERC HOLE DIAMETER CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: £Pc/IMS MUNICIPALITY OF ANCHORAGE 7. . ir Development Services Department \ l 7Phone: 907-343-7904 On-Site Water & Wastewater Section _._. _r Fax: 907-343-7997 Certificate of On-Site Systems Approval C% Parcel I.D. 05075116 Expiration Date: 1. GENERAL INFORMATION Complete legal description Teri #2 Lot 10 Location (site address) 3912 delores Current property owner(s) CMM General Day phone 862-8758 Mailing address 3912 delores Real estate agent Day phone 2. TYPE OF DWELLING: rj Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer.unless otherwise requested by the engineer. ,74 COSA Fee $ r Waiver Fee $ Date of Payment a. I Date of Payment Receipt Number 0320616 Receipt Number COSA# O$viM IauC Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On-Site staff may visit the site to verify the information submitted. Name of Firm C&M Engineering Services Phone 8545558 Address 20182 Tulwar Engineer's Printed Name Charles Balzarin Date 2/17/19 j9!.A�gslil 1,0,.. �� .3, To *:4s ni ilk •.* 6. DSD SIGNATURE % 1 . .-. :.4.......... 0,01 System #1 Approved for J bedrooms CHARLES G BALZARINI 1 •� / System #2 Approved for bedrooms rTo;�,lFq, CE-13854 ti• ,..•., Disapproved ,�\\fix...--�+" Conditional approval for bedrooms, with the following stipulations: �\ k ,...i; X11. �z ON—SITE C11-‘ 'Z WATER AND o, WASTE R Q . ‘ PROGRAM o cs B . �— Original Certificate Date: 3 -1 —1 7 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 Checklist blue sheet COSA Checklist Legal Description: Teri#2 Lot 10 Parcel ID: 05075116 If more than 1 septic system on lot: COSA Checklist# 1 of 1 Structure served by this system 1 A. WELL DATA ■❑Well log is filed with Onsite (or attached) Well production at time of test +15 gpm Date drilled 7-6-18 Water storage tank volume na gallons Total depth 320 ft Well disinfected for coliform test? ❑ Yes ❑■ No Cased to 225 ft ❑■ Coliform bacteria is Negative ❑� Sanitary seal is functioning correctly Nitrate mg/L 0 Nitrate less than MRL (ND) ❑■ Wires are properly protected Arsenic ug/L I Arsenic less than MRL(ND) Casing height(above ground) 24 in. Collected by C&M Engineering Date of flow test for COSA 7/6/18 Date of Sample 2/12/19 Static water level at beginning of test 104 ft Comments flow test data from well log B. TANK DATA C. LIFT STATION Age of tank(s) 1 years ❑ Required maintenance completed Tank type/material plastic Age of lift station - years Measured operating fluid level in septic tank na Lift station material - M Standpipes/foundation cleanout per record drawing Comments: no lift Date of pumping na D. ABSORPTION FIELD DATA shallow trench Which system tested (date installed)9/25/18 Adequacy test date na ALL standpipes present per record drawing Results Q✓ Pass For 5 bedrooms Total measured depth from grade 6.5 ft(max) Fluid depth prior to test na in Measured depth to pipe invert from grade 3.3 ft(min) Water added na gal ❑ N/A—pressurized field New depth na in ❑ Monitor tubes go to bottom of effective. If not, state Elapsed time na min depth into effective ■❑ Code-required soil cover over field Final fluid depth na in ❑ System presoaked Absorption rate na gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) na date of test) Gallons introduced na gallons If yes, enter date na Comments/Deficiencies:new system COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot> 100' Community Sewer Manhole/Cleanout> 100' ✓❑Yes if No ft E Yes if No ft Neighboring Tank > 100' ✓❑Yes if No ft Private Sewer/Septic Line >25' ✓❑Yes if No ft Absorption Field on Lot> 100' ❑✓ Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' Animal Containment> 50' r Yes if No ft —0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' p Yes if No ft —❑✓ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' Q✓ Yes if No ft Surface Water> 100' ElYes if No ft Property Line > 5' p Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' p Yes if No ft Private Wells > 100' ✓0 Yes if No ft Water Main > 10' ✓❑ Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Water Service Line > 10' p✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Q✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' El Yes if No ft Wells on Adjacent Lots: Water Main > 10' ✓0 Yes if No ft Private Wells > 100' ❑✓ Yes if No ft Water Service Line > 10' Q✓ Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Surface Water> 100' ❑ Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION +4 OF l • I certify that I have determined through field inspections and review �O •.� • of Municipal records that the above systems are in conformance with /*: �"ThiI *Cf:P#/ MOA COSA guidelines in effect on this date. I / CHARLES G BALZARIK( 10 � , • � < •. •CE•13854 • ` /� �1i, leo ROFESS,ONt� �•� COSA Checklist yellow sheet ``1\�i�� 1'. r \. :::,, \ \Z.,..,„ %. 3, • • • •9 o zoo \ • S 'o ,/ \ \: 'il.`\?' i\ • a . a ‘,\ ,0 ASBUILT SEWARD & ASSOCIATES LAND SURVEYING 694-0829 I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE` FOLLOWING DESCRIBED PROPERTY: ....-=-.—......--. + OF !I( �a .7 s'/_r-;id, -- eZ.4 - zoT/o DATE. y '.. e AND THAT NO ENCROACHMENTS EXIST EXCEPT AS /��-'9 �P S,�w1 INDICATED. IT 1S THE RESPONSIBILITY OF THE :4' )M s .,'. OWNER TO DETERMINE THE EXISTENCE OF ANY GRID= p EASEMENTS, COVENANTS, OR RESTRICTIONS _I-e-.. 4:?,' ;' . �� !j�}-✓/ WHICH DO NOT APPEAR ON THE RECORDED SUBDI- ---- q . D,an•Me? ' ` VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD Fa' 6°�'. LS-5 74 l..) .' ANY DATA HEREON BE USED FOR CONSTRUCTION + ��+-../I OF FENCE LINES, OR FOR ESTABLISHING BOUND- Di2AWN: �'•+k�°i't'sikXV). 4'` ARY LINES. �/yf aIVO s� ._ _-__1