HomeMy WebLinkAboutMOUNTAIN TERRACE ESTATES #2 LT 5 Onsite File
Mountain Terrace
Estates # 2
Lot 5
#020 - 121 - 21
Municipality of Anchorage
On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP191030 PID Number: 020-121-21
Dwelling: Al Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑■ New ❑ Upgrade
Name
MGJ
ABSORPTION FIELD
❑E Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound
Site Address
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
3
1.2 GPD/SF
9.5 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
3.5 Ft.
Gravel depth beneath pipe
6.0 Ft.
Subdivision Block Lot
MOUNTAIN TERRACE EST. #2, LOT 5
Fill added above original grade
1 + Ft.
Gravel length
36 Ft.
Township Range Section
Gravel width
2.0 Ft.
Beds: Number of Lines
0
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
432 FF
1
Ft.
Well
1001+
1001+
501+
TANK X Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer Capacity
ANCH TANK 1000 Gal.
Surface Water
1001+
100,+
Material
STEEL
Number of compartments
2
Lot Line
10'+
10'+
NA
Foundation
10'+
10'+
LIFT STATION
Manufacturer
Capacity
Remarks
Gal.
Alarm location
Electrical installed by
PIPE MATERIAL House to tank 3034Tank to 3034
drainfield
Installer
MIKE N ANDERSON, P.E.
Drainfield 3034 CO/MT 3034
Inspector MIKE N ANDERSON, P.E.
BENCH MARK (Assumed elevation) 101.4 ft
Inspdection 15' 12-16-19 12-16-19
Location and description
2nd
GARAGE SLAB
3`d 4"'
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
Conditional Approval: Date
�� `; ° ° • °' ° °1;
4971�
�'
o• o o e a o0
• ° o°O e.............-`3
=� • MICHAEL N. AI.DERSON
Septic System �-
Approv ..._.�'� Datef'
° CE[ 9 b�
•° °°:..
Note: this approval does not include well permit requirements.
(Kev Ub/02/18)
Permit No. OSP191030
Page 2 of 2
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744
On—Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: MOUNTAIN TERRACE ESTATES #2 LT 5 PID No.: 020-121-21
0
MARK
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TC01
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FINISH GRAD!
ILTER FABRIC
1,000 RO K
GALLON 9 7 96.5
STEEL
TANK
SEPTIC SECTION
N.T.S.
1250 GALLON STEEL TANK
fIT`C05 .*10LUS 1
D DD ��••WE OF
.0 ORD � r :' #
Air
96.5 SP/SW /
... ..... ..••. ••
\':,MICHAEL N. ANDERSON.- i
�1�! ' No. CE 9469 C�
DRY. DEC 2019 ,��1, =�. •
I
fIT`C05 .*10LUS 1
D DD ��••WE OF
.0 ORD � r :' #
Air
96.5 SP/SW /
... ..... ..••. ••
\':,MICHAEL N. ANDERSON.- i
�1�! ' No. CE 9469 C�
DRY. DEC 2019 ,��1, =�. •
LO __4Z
Municipality of Anchorage IREERS,�EAL)
Development Services Department
On -Site Water and Wastewater Section
• .a„�e 4700 Elmore St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite ;` ......
(907)343-7904 ° � a
i
Performed For:
Legal Description:
Depth
(Feet)
Soils Log - Percolation Test
(A C7 Date Performed_.' t'xl 2/� 9 /
M0."L Kq,r-�vvgz o`, .SZ-Township, Range, Section:
4%4. L-0� �— Slope Site Plan
1- /
2-
3-
4-
5-
6-
7-
8-
9-
10-
11-
12-
13-
14-
15-
16-
�o� o-
17-
18-
19-
20 -
WAS GROUND WATER
Date
ENCOUNTERED?
Net Time
Depth to Water
s
IF YES, AT WHAT DEPTH?
i tp L
Depth to Water After
o
P
Monitoring?
E
Date:
Reading
Date
Gross Time
Net Time
Depth to Water
Net Drop
r i, z I
! d r►, � �,
(o �
S
PERCOLATION RATE (minules/inch) PERC HOLE DIAMETER Lp
TEST RUN BETWEENY FT AND FT
COMMENTS (( {!'Pp p1nc � 0 (/f 0
PERFORMED BY: r --N :4 • I CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: t
z %x
T�, r k„
r�
OWNER OF LAND: BDMG Ventures
ADDRESS: 16921 Kenai Terrace Rd
LEGAL DESCRIPTION Mountain Terrace Estates #2 Lot S
DATE: 3-6-19
PERMIT NUMBER: OSP191030 DATE OF ISSUE: 3-1-19
TAX IDENTIFICATION NUMBER 0212121000
Is well located at approved permit location: ®Yes [—]No
Method of Drilling: ®air rotary Elcable tool
Depth of Well: 182'
Casing Type: Steel Wall thickness .250 inches
Diameter: 6 inches, depth 44 feet
Liner type
Static Water Level: 37 feet
Recovery Rate 8 ® gpm gph
Method of Testing Air
Well Intake Opening Type: 1-1open end ®open hole
Screened Start feet Stopped
El Perforations Start feet Stopped
Grout Type: Bentonite Volume: 350 lbs
Depth: from 2 feet, to 42 feet
Well Disinfected Upon Completion: ®yes 1-1 no
Method of Disinfection: Chlorine 50 PPM
Comments:
WUER, MU UY TESTING
tag MUA
Bore Hole Data
Depth
From To
0 2
2 4
4 8
8 23
23 89
89 98
98 140
140 149
149 162
162 170
170 177
177 1 182
Casing Stickup
Overburden
Silty Sand & Gravel
Broken Bedrock
Bedrock Gray
Bedrock Gray w/ Quartz
Bedrock Gray
Bedrock Brown 3 GPM
Bedrock Gray
Bedrock Brown Broken 6 GPM
Bedrock Gray
Bedrock Brown
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.
Well Drilling Permit Number: SW OSP191030 Date of Issue 3/01/2019
Parcel Identification Number: 0212121000
Legal Description
Mountain Terrace Estates #2 Lot 5
Pump Installation Date: 10/21/2019
Pump Intake Depth Below Top of Well Casing: 150'
Pump manufacturer's Name: F & W
Pump Model: 4F11P07301S
Pump Size: 3/4
Pitless Adapter Burial Depth: 10
Pitless Adapter Installer: Mike Anderson
Disinfected Upon Completion? ® yes ❑ no
Method of Disinfection: Chlorine 50 PPM
II Comments: Pitless Manufacturer: Martinson
11 Pump Installers Name: Sullivan Water Wells
Property Owner Name & Address
BDMG Ventures
16921 Kenai Terrace Rd
feet
hp
feet
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Water & Wastewater System Permit
Permit Number: OSP191030
Work Type: WellSeptic Initial
Tax Code Number: 02012121000
Site Legal Address: MOUNTAIN TERRACE ESTATES #2 LT 5 G:3342
Site Mailing Address: 16921 KENAI TERRACE RD, Anchorage
Owner: BDMG VENTURES
Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING
This permit is for the construction of:
Effective Date:
Expiration Date
,�i1�Ltlj
s
y.
G C�
D pa Ctinent
Lot Size in Sq Ft:
Total Bedrooms:
3/1/2019
2/29/2020
40154
Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Q Private Well ❑ 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
Special Provisions:
r 7 day groundwater monitoring is required. Construction may proceed at your own risk before the 7 day water
monitoring is complete. Please submit stamped and signed results with the As -built Inspection Report. If the
results require a design change, construction of the system will stop pending On -Site review and approval.
G0
17�srq ►�
Gr ri ►1
C Z
'Peek
/
Received By:
Issued By:
Date:
Date: 2- / 2
3
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. 020-121-21
Property owner(s) PERKINS JAMES Day phone
Mailing address
Site address
Legal description (Sub'd., Block & Lot) MOUNTAIN TERRACE ESTATES #2 LT 5
Legal description (Township, Range & Section)
Lot Size 40,154 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR:
APPLICATION IS AN:
(® all that apply)
Absorption Field
0
Initial 0
Septic Tank
®
Upgrade ❑
Holding Tank
❑
Renewal ❑
Privy
❑
Private Well
�]
Water Storage
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
TYPE OF DWELLING:
Single Family (SF) El
(w/wo ADU)
Duplex
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: 12Z
Date of Payment: �2 / l d lq
Receipt Number: # /0 goo
Permit No. 05piq low
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
Go -lot-z.
Dec. 12, 2019
Municipalities of Anchorage
Departments of Health and Human Services
P.O. Box 196650
Anchorage, Alaska 99519-6650
Fax 249-7847
Re: MOA Septic pen -nit # 191030 Change Order #2
Legal: MOUNTAIN TERRACE ESTATES #2 LT 5
To Whom it may concern:
This is a request for a septic/well permit on the above referenced lot. Two test holes were done by Garness
Engineering Inc. in 2006, see attached. The lot has been cleared after the test hole excavation therefore the
overburden has been removed but the soils appear to match below the OG. After the recent rain storm we
have water running out of the cut bank along the east side of the property which has flooded test hole
(MNA #1), therefore another test hole was done on the west side of the house, see the plan. The new test
hole had water at 16 feet and the perc rate was 2 minutes per inch. The elevated water level in test hole
(MNA #1) was due to temporary grading which sloped all of the surface water to the test hole area. This
new flooding is only surface run-off and will dissipate soon, but we can't have the septic system flooding
therefore the need to relocate to the west side. Using the steep slope provisions of the code we have
designed a deep trench on the west side which is 50 feet away from the slope area which is over 46 percent.
All of the remaining areas near the septic system are less than 36 percent.
Due to the winter conditions we are requesting a permit to install at our own risk without the 7 day
monitoring period. Proper grading has been installed to keep the surface water away from the new test hole.
The new test hole monitoring tube will remain throughout the installation period to verify the water level.
The house and well have been completed which makes the septic tight to install therefore this change order
is required.
This permit will not impact any of the neighboring lots due to the size and good soils.
Sincerely 0—
Michael N. Anderson, P.E.
4661 Natrona
Anch, Ak 99516
Ph 727-8864
3t1z
CO 13t17-
DESIGN
DESIGN CRITERIA:
MOUND OVER
(MNA TH#2) (MNA TH#1) (TH#1) (TH#2)
in GRADE
3 BDRM X 150 = 450 GPD 2 ORG 2
ORG '
SOILS = 450/1.2 = 375 GPD
FILTER FABRIC
375 GA/12 = 32'
4"0 PIPE
SP/SW SP/SW SP/SW
SP/SW -3.0
(1) TRENCH
SEWER ROCK
9.0' DEEP
6.0' EFFECTIVE 10 10
9 0
2.0' WIDE SM/GM
SM/GM I 2.0'
32' LONG 16 15 14 14
CO
/? 2 SEPTIC FIELD SECTION
�\I
-------- —: ,l\ — —
�\—
—•\\
\
\ V
A A \" 7-A
\ ��Oy
EXISTING 100' \
WELL RADIUS
PROPERTY LINE
PROPOSED \
DRAINAGE FIELD \ \
EXISTING HOUSE \> 7-
v v
\ i
XX
Septic Design Prepared for
OF
JAMES & WINDY PERKINS
.•.`P..•••
MOUNTAIN TERRACE ESTATES #2, LOT 5
•:' ��
Anchorage, Alaska
49TH
;.....::.....................................
.......................::.
00
.....7)wl.
0.0':MICHNEoLCN.
Michael N. Anderson, P.E.
DATE:
12/12/2019
9N6E9RSON.=
4601 NATRONA AVE
DRAWN:
DJR
♦1� .'!. Z (2
ANCHORAGE, ALASKA 99516
SCALE:
1 "=200'
,�_:
(907) 727-8864 / FAX: (907) 345-1391
\ 1
\ I
\MOUNTAII
\ \0, \
\ 0\
\ 1 �
/
A \
MOUNTAIN TERRACE ESTATESk \
\
LOT 3/ 1
VACANT\\� \
MOUNTAIN TERRACE ESTATES #2 \ \
LOT 4 I \ \
I \\\� I
d TERRACE�,ESTATES #2 I 1 \
LOT 5 \ 1
EXISTING 100' \�
WELL RADIUS
PROPERTY LINE
i ONDQIIE?.
CD Z
SLOPE AREA
\ OVER 46% -
\
\ PROPERTY LINE
./I
52.4'
xz-
MT
MNA
SECONDARY
\
SITE'�><
\ SHOULDER OF
SLOPE OVER
25%
Irl
/
i I
• I
VACANT
VACANT \
MOUNTAIN TERRACE ESTATES #2 MOUNTAIN TERRACE ESTATES #2
LOT 7 LOT 6 \
Septic Design Prepared for
JAMES & WINDY PERKINS
MOUNTAIN TERRACE ESTATES #2, LOT 5
Anchorage, Alaska
NEW 1000 GALLON SEPTIC
TANK, 5' FROM ALL DECK
SUPPORTS
10-15 % SLOPE
1
I T11N R2W, SECTION 6
MNA TH#1 NE4SW4N2SE4SW4
\ VACANT
\
Michael N. Anderson, P.E. DATE: 12/12/2019
4601 NATRONA AVE DRAWN: DJR
ANCHORAGE, ALASKA 99516
(907) 727-8864 / FAX: (907) 345-1391 SCALE: 1 "=50'
Performed For:
Legal Description
1-
2-
3-
4-
5-
6-
7-
8-
9-
10-
11-
12-
13-
14-
15-
16------
17-
18-
19-
20-
WAS
-3-
4-
5-
6-
7-
8-
9-
10-
11-
12-
13-
14-
15-16-
17-
18-
19-
20-
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Section
4700 Elmore St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
Soils Log - Percolation Test
L0 __*Z
(�E NGrt�t�lt�5,�� EAL)
(-A C7T Date Performedse_;Y .Z 211 9 ,
l�ouK l�q�� `r-CtivgZ`o, �� 0 --Township, Range, Section:
w� s— Slope Site Plan
WAS GROUND WATER
Date
ENCOUNTERED?
Net Time
Depth to Water
_yam S
IF YES, AT WHAT DEPTH?
L
Depth to Water After
o
P
Monitoring?
E
Date:
Reading
Date
Gross Time
Net Time
Depth to Water
Net Drop
r2 r z l
169
(o t
S
(P
PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN Y FT AND FT
COMMENTS /�. I( {/�Pq �1Y1s p 1
PERFORMED BY: r-,fN A , I CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: t
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Section
4700 Elmore St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
Soils Log - Percolation Test
, EEWGWEET:;�S SEAL) = n
�1
AqTH
a MICHAEL N. ANDERSON
CE 969 +
-Z i < .
� rs ee. e•°` �.`'.�
Performed For: j �(S C- 7 �ju t d c t1 S Date Performed:
s
Legal Description: M [914-111ai V7 I v C 4 Township, Range, Section:
( tp Slope 2:4.
Lj I i i E
1-
2-
3-
4-
5-
6-
7-
8-
-
2-
3-
4-
5-6-7-8- 'C!—
WAS GROUNDWATER
9- k �,� LT' ENCOUNTERED? (% S
10- IF YES, AT WHAT DEPTH? L
Depth to Water After o
11- Monitoring? J E E
12- Date: 1
13-
14-
15
16-
17-
18-
19-
20-
I
Site Plan
q' -
Reading
Date
Gross Time
Net Time
Depth to Water
Net Drop
/J t
/c9 M
Cv
S
�t
J,
Cr ,r
'5
PERCOLATION RATE Z_ (minutes/inch) PERC HOLE DIAMETER U,
TEST RUN B TWEEN I FT` AND 14,S FT
COMMENTS �^e(� �t _tom- t �i (err Le.,
PERFORMED BY: t&S,4, I CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
AuB , IU. lUUb I UONM carnes$ Cnalneel III UI UUP , Lit/ . OV . MVJ!
t ,:, ,• . :�. 1.•._ OF a\ .�Q
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GARNESS ENGINEERING GROUP, Ltd. %� , . Al-/. - OA
. ,.,.___ •-•----,.— --CONaULTANYS a rainertAL CONTRACTORS * . o , ,
t. „ ,r" .1 "v".• . MOW ,".• ft? 7-SI n •nuc: r -3244• ^,r.•••••• ...#v v.n
[SOIL LOG — PERCOLATION TEST
LEGAL 0E3C1 !PTIOCI: MOUKTNN TERRACE CST. it, LOT r. VI' E-7953 n~R�
PERFORMED FOR: SHANNON w/ PRUDENTIAL DATE: 8/9/2006 I ' • • •' •d
DEPTHS 1 \ �prc f�sF.
(feet) ;:����s TEST HOLE #2 `N'
1 —<r57=�= ORGANICS
LA `r `" SOIL CLASSIFICATIONS \``� 't 1
2 S* ait, , \�i
)0°0•••1° WW2 GW _.7- 5 ORG
°o.% `
>N N mairI)GM CI_
a- goo. :; 671�•�.el.y� GC OL
�� ` I
eI•:i=,i .rta NW MH
5 tJ
o vo •I Q� SP CH / TESTHOLE
>•o°•o.•i i I;}�7 N SM .' .// OH \` / LOCATIONS
6__':%°.:V4 SW/SF' `y�i,�:i SC 1` i APPROXIMATE
> • •••t,
••o•or•• ��.
7
.�oo sets DEPTH TO
'o•We•• GROUNDWATER DATE 'N',,....\,/ TH 1 +
D •0••1;
8____/e0.„' DRY 8/9/2006
>•OIU.1 i TH#2
9_1'0401
>••o ♦ 1 . 100'
10 C:Cl - •
1isCLOCK NET TIME WATER LEVEL NET DROP
11 i:• M DATE READING TIME (MINUTES) READING (INCHES)
` '♦ '" 611/ZOO6 1 10:15 — 6" -
12 -� m SM/GM
2 _ 10:20 <1 _ 0" a•
•� • r 10:20 - 5"
roli•
14---4"- ---6.0 H. ! 5 10:25 - 6" -
a 1n•tn �1 0" c"
15--
16
16-
--
PFRrni a1 ir1N AATF et (MIN /IN(N) PR(W(\L,t N.A.. 8 (INCN6T)
Tlr3T rcurg OCTWCCIV D.O CT. ANN 0.0 r 1 .
20 A H)UR HOUR PRESOAK WAS PERFORMED: ❑ YES •NO
SOILS LOGGED DY:.__,. SUSAN OSWALT PERCOLATION I EST PERFORMED BY; BENNY MADS
COMMENTS:
PERFORMED BY GEG, Ltd. J. JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE:
nVo • I0 • f:VVU V•UVI11f1 . . .
„,,....,„< *,.VS ,Th
GA►RNESS ENGINEERINGG OUP, Ltd. ^./): `� �06
Y'..CC,,.... T.- ...--R-:. ..man CONSULTANTS a GENERAL CONTRACTORS a_,..,......t._.z..,..,,.:..___.,�• 4 A 1.• I • 'yy D
• C. • . un., • r•1 • en-m- Mc. • i11d►t 00713y7-4TR+VM.iter tW' { • %:.. -4..4-.0
SOIL LOG - PERCOLATION FEST ,.., I
L.CO k. oc„,,rTfpn. UOVNTNN 7G+7tvAC GCT. �OI LOT C y v '.I • Rrlr cs {Q
PERFORMED FOR; SHANNON w/ PRUDENTIAL DATE: 8/9/2006 F-7�• ,a#� G�
Dory!I
1%,e,..,.... ••'......••J �4
fool =a
oI•potn
(tool)
"~¢'�' !TEST HOLE #1 I ���'d
2 D;.;./•1 .f�• 4 GW 17 ,
N ORG \ \ s
,• •o••. t
3---,pioove•; l."t•NW GP I ML
ike
rate o••SI ;111'1 GM / CL \
j•°g'o. i 7/e, GC OL 1 '`i
4 >�o°oo• •i i` if �•I SW 111111 MH ``, i i N
5 —A.,00:4.4:1 ? / TESTHOLE
O'0°p�40I )ifill1 SM ,., ,/ OH \ / LOCATIONS
6•._jo'oe.:1 SW/SP 4 *,'r SC >, / APPROXIMATE
>.4):1:161 rk
7--!'.0 �; GROUNDWATEA TIATF \‘`,. -i THN14
8 P:•°:::::11 DRY 8/9/2008
0•0•0.•••• TH#2 ♦
9—'•°.A4
104,_,; �"
DATE READING CLOCK NET TIME WATER LEVEL NET DROP
11 G, 1. TIME (MINUTES) READING (INCHES)
124!1 y SM/GM 8/11/2006 1 10:15 — 6" �, —
i ' ` Y 1V.LV J 0" 6"
6' 3 10:20 _ _ 6" W
13—I:I .
' 4 10:25 3 0" 6"
•• "
14 B.O.11. _ 5 - 10:25 ^� 6" -
I
6 10:30 5 0" 6"
15_ —
16I .__ -.,-•-+ - - _,
17--•
16
PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
19—
TEST RUN BETWEEN 5.0 FT. AND 5.6 Fl.
20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES I.NO
SOILS LOGGED BY; SUSAN OSWALT PERCOLATION TEST PERFORMED BY: BENNY MAUS
COMMENTS:
•
��,1:4 Q. CONSTRUCT1O\ 1800 W. 48TH AVE. STE. 1C'
-• -n :�.t ANCHORAGE, ALASKA 99503
'.-,•.
TEST LAB
248-1333
RFORMED FOR: H.V. Lounsbury & Associates DATE PERFORMED: 6/26-6/27/80
EGAL DESCRIPTION: Lot__ 5 Block Subdivision Mountain Terrace Estates #2
-IIS FORM REPORTS: 0 Visual Soils Examination Xfkl Percolation Test
-IPTH SOIL NOTES _
:ET DESCRIPTION -- - I, • : _ T ��; • '
F — Z- — i
4" TOPSOIL :-_1-- - a: L� , _. - �, .
•
BROWN SILTY GRAVELLY SAND � jv_ ' ; •. --> • .
SP-SM MOIST w ,— --- - � •• , .1 1._.......:_..i...... _...i_...:_,
SEEPAGE ON UPHILL SIDE ` ' -- - - w- ---- •---
NOTED @ APPROXIMATELY 10' j ' -,
I
SEASONAL FROST MELT. - - � i' . ' - : . -•-- • . _.
• -__._-! R- ---t --Vif,--..:__.. ... ---
y = _07 - X7 } -{ _
- t.-_ __ _G ,a _1.CP
r.-E .
1.3. 5 °V. , i ._ - -- I �- _.__ �� I
BOTTOM OF HOLE •
S GROUND WATER ENCOUNTERED YES °._�__..F._._-.__:
YES WHAT DEPTH 13. 5 ' ! '
------H-•---M- ------1- . '
:GEND . _. __ -{ T--_.._ _ •__-1
- Perc zone _. - : : --: • (f : . __:. �_:_: _ -=
5 - Sample taken , _^
- Frozen zone GENERAL SITE SLOPE
- Water table • —_
:ADING DATE GROSS TIME NET TIME DEPTH TO H2O NET DRAINAGE
6/26/80 SATURATION PERIOD
---, 6/27/80 8 :05 0-.._...� � 6: 25 -----•��7 �-
-_ _9 :00 o;_a5 — L5_ - 7 . 25,
10 :00 1 :55 8. 0 . . 50"
11 : 30 _ __2.1.25_____.___ 31,0_ 1- 0,0"
12 :00 __ 3 :55 __9. 75 . 75"
RCOLATION RATE• 40 , in/inch _DRAINAGE REQUIREMENTS: 275 SF/B d,rp9�_,. _-_
•
:OPOSED INSTALLAT N : SEEPAGE PIT XJ DRAIN FIELD \o OTHER
)MMENTS : FROST N ED IN HOLE - NOT SUSPECTED TO BE--P.ER YA-FROST AS SITE AND OTHER
ESTS DO NOT EXHIBIT CHARACTERISTICS TO INDICATE SAME.ST PERFORMED BY: Liza DATA CERTIFIED BY: JamesR. Ringlet_T_____.
DATE: 6/3p/80 1i
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 020-121-21 Expiration Date:
1. GENERAL INFORMATION
Complete legal description MOUNTAIN TERRACE ESTATES #2 LT 5
Location (site address) 16921 KENAI TERRACE RD, ANCH, AK
Current property owner(s) MGJ
Day phone
Mailing address
Real estate agent Day phone
$678
2. TYPE OF DWELLING: 3
❑ Single Family (w/wo ADU) ,R[�
❑ Duplex Q
F]Multiple Dwellings (Single Family and/or Duplex) FES
a l
3. NUMBER OF BEDROOMS: 3 0z 6
r �'
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Private Well 0 Private Septic 0
Water Storage ❑ Holding Tank ❑
Community Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
Waiver request for:
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ Waiver Fee $
Date of Payment �to f ogoOL Date of Payment
Receipt Number 7� % 1�� Receipt Number
COSA # 6 5 C:2 d i UL(S Waiver #
Distan
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 MIKE N ANDERSON, P.E. Phone 727-8864
Address 4661 NATRONA AVE ANCH AK
Engineer's Printed Name MIKE N ANDERSON, P.E. Date 2-15-20
49TH
6. DSD SIGNATURE
�I System #1 Approved for 3 bedrooms 69° ° :° ° �b'�✓ ° ° . ° >. ° ° ° .
MICHAEL N. ANE)ERSCi! ;F a•�
System #2 Approved for bedrooms �'} � ° CE 459
Disapproved
Conditional approval for bedrooms, with the following stipulation
By: Original Certificate Date:
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 vhecklist
Legal Description: MOUNTAIN TERRACE ESTATES #2 LT 5 Parcel ID: 020-121-21
If more than 1 septic system on lot: COSA Checklist # of Structure served by this system
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled
Total depth J3_'Zft
Cased to 4(Y+ ft
❑ Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ground) 30"+ in.
Date of flow test for COSA NEW
Static water level at beginning of test 80 ft.
Comments
B. TANK DATA
Age of tank(s) NEW years
Tank type/material STEEL
Measured operating fluid level in septic tank NEW
❑ Standpipes/foundation cleanout per record drawing
Date of pumping NEW
D. ABSORPTION FIELD DATA NEW SYSTEM
Which system tested (date installed) NEW
❑ ALL standpipes present per record drawing
Total measured depth from grade 9.5 ft (max)
Measured depth to pipe invert from grade 3.5 ft (min)
❑ N/A — pressurized field
ON Monitor tubes go to bottom of effective. If not, state
depth into effective
X Code -required soil cover over field
❑ System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced 0 gallons
Comments/Deficiencies: NEW HOUSE AND ON -SITE SYSTEMS
COSA Checklist yellow sheet
Well production at time of test 2+ gpm
Water storage tank volume 0 gallons
Well disinfected for coliform test? ❑ Yes ❑ No
FO -1 Coliform bacteria is Negative
Nitrate 4.04 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ❑ Arsenic less than MRL (ND)
Collected by MNA
Date of Sample 1/28/20
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments:
Adequacy test date NEW
Results ❑✓ Pass For 3 bedrooms
Fluid depth prior to test 0 in
Water added NEW gal
New depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
Any rejuvenation treatment (past 12 months)
If yes, enter date
4
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'
✓Q
Yes
Community Sewer Manhole/Cleanout > 100'
Q✓ Yes
if No
ft
ED Yes
if No ft
Neighboring Tank > 100' Yes
if No
ft
Private Sewer/Septic Line > 25' F, Yes
if No ft
Absorption Field on Lot > 100' Yes
if No
ft
Holding Tank > 100' Q✓ Yes
if No ft
Neighboring Absorption Fields > 100'
Yes if No
Water Main > 10'
Animal Containment :50' Q✓ Yes
if No ft
Q✓ Yes
if No
ft
Yes if No
Water Service Line > 10'
F/
Yes
if No
Manure/Animal Excreta Storage > 100'
If septic tank is under driveway
Community Sewer Main > 75' ✓Q Yes
if No
ft
El 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'
Q✓ Yes if No
Property Line > 5'
✓Q
Yes
if No
ft
Wells on Adjacent Lots:
Q✓
Absorption Field > 5'
P/
Yes
if No
ft
Private Wells > 100'✓Q
Yes if No
Water Main > 10'
✓Q
Yes
if No
ft
Community Wells > 200'✓Q
Yes if No
Water Service Line > 10'
F/
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'
21
Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
Q✓
Yes
if No
ft
Wells on Adjacent Lots:
Water Main > 10'
Q✓
Yes
if No
ft
Private Wells > 100' Yes if No
Water Service Line > 10'
M
Yes
if No
ft
Community Wells > 200' Yes if No
Surface Water > 100'
0
Yes
if No
ft
F. ENGINEER'S 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.
COSA Checklist yellow sheet
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