HomeMy WebLinkAboutHULTQUIST HEIGHTS LT 110 ID
Hultquist Heights
Lot 1
t:,q@vu@ mrAir-Amor.]
Municipality of Anchorage
On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 1
ON -SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP241300 PID Number: 020-044-03
Dwelling: RN Single Family (SF) EJ with ADU El Duplex (D) El Two Single Family Project: FE New n Upgrade
Name
Hultquist Homes, Inc.
ABSORPTION FIELD
W Deep Trench El Wide Trench [] Bed El Mound
Site Address
15744 Elizabeth Street
El Other
Phone
of Bedrooms
Soil Rating
Total depth from original grade
77��
4
1.2 GPD/SF
10.0 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
4.0 Ft.
Gravel depth beneath pipe
6.0 Ft.
Subdivision Block Lot
Hultquist Heights 1
Fill added above original grade
0 Ft.
Gravel length
42.0 Ft.
Township Range Section
Gravel width
2.5 Ft.
Beds: Number of Lines
N/A
Distance between lines
N/A Ft,
SEPARATION
DISTANCES
To
Septic
Absorption
Holding Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field Lift StationTank
Line
1504 Ft2
1
N/A Ft.
Well
100'+
100'+ 100'+
NA 25'+
ITANK El Septic Ma S.T.E.P. 0 Holding E] Other
IManufacturer
Greer
Capacity
1500 Gal,
Surface Water
100'+
100'+ 100'+
NA
Material
Number of compartments
Lot Line
5'+
10'+ 10'+
NA NA
HDPE (Deep Burial)
2
Foundation
10'+
*5.5' 10'+
NA
LIFT STATIONManufacturer
Capacity
Remarks * See attached waiver request
Orenco
250 Gal.
Alarm location
House
Electrical installed by
AKE Electrical Services
PIPE MATERIAL House to tank D2661 d Tank to D1785
Installer
rainfield
Red Dog Masonry, Inc.
Drainfield D1785 CO/MT D3034
Inspector PES
BENCH MARK (Assumed elevation) 100.0 ft
Inspdates:ection vt 07/08/25 nd 07/08/25
Location and description
2
3rd 07/09/25 4 1h 07/14/25
See Site Plan, Top Of Foundation Wall @'BM'
ON -SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
A N l
F. AL,
Conditional Approval: Date
AW
.
,ae C-) -
49TH
Septic System
Approved
...... . ... ........
i>teven R. Pan! gone
1QE 149
3
'4�0
Date
J
I f
Note: this approval does not include well permit requirements.
(Kev ubiuu its)
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WELL (E)
WELL (E)
INSTALLED DRAIN FIELD (N)
42LF x 2.5'W x 6.0'E.D. x 10.0'T.D.
INSTALLED MT AT EACH END
USED 1.25''Ø SCH 40 PVC LATERAL
W/ 1
8'' HOLES DRILLED 24'' O.C.
WELL (E)
TH-ANDERSON
APPROXIMATE LOCATION
PER MOA RECORDS
WELL (E)
UNNAMED STREAM
PER S4 SURVEY
25' STREAM PROTECTION
SETBACK
RESERVE AREA (NIC)
CAT III
INSTALLED 1500gal STEP TANK (N)
INSTALLED FC BEFORE TANK
INSTALLED W/PF2005HH EFFLUENT PUMP
WELL (E)
1.25"Ø SCHD 40 PVC
FROM LIFT STATION TO DRAIN FIELD
MINIMUM 4.0' OF GROUND COVER
& 4" OF RIGID INSULATION UNDER DRIVEWAY
MH1
MH2
MT2
MT1
A
B
C
DFC
BLDG OVERHANGBM
1500 GAL GREER
POLY STEP TANK
OG/FG:
90.8
FC
86.2
PROFILE
SCALE: NTS
1.25"Ø LATERAL W/ 1
8'' HOLES 24'' O.C.
DRAIN ROCK 6" ABOVE PIPE INV
FILTER FABRIC
MT2
6.0' DRAIN ROCK
MT1
TEST HOLE PERFORMED: 09/23/2024
DRY: 10/01/2024
95.195.1
GRAVELLY
SAND
TEST HOLE 3
(OG/FG: 98.6)
82.6
89.1
OG: 99.1
FG (S): 98.1FG (N): 99.0
89.1
MH1 MH2
11
4''Ø SCH 40 PVC
DISCHARGE TO DRAIN
FIELD
4.0 MIN.
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DESIGN PARAMETERS
PRIMARY SEPTIC SYSTEM
NO. BEDROOM: 4(600 gpd)
TANK SIZE: 1500gal STEP
MOA APPROVED SEPTIC TANK
PERC RATE: <1.0 MPI
SOIL RATING: 1.2 GPD/SF
AREA RQD: 500 SF
SYS. TYPE: DEEP TRENCH 6.0'ED
MIN LENGTH: 42 LF
USED:
42LF x 2.5'W x 6.0' E.D., 10.0'T.D.
TOTAL AREA: 504 SF
RESERVE SEPTIC SYSTEM
NO. BEDROOM: 4(600 gpd)
TANK SIZE: 1500gal ADVANTEX
W/ AX-20 POD
PERC RATE: <1.0 MPI
SOIL RATING: 6.0 GPD/SF
AREA RQD: 100 SF
SYS. TYPE: DEEP TRENCH 6.0'E.D.
MIN LENGTH: 8.33 LF
USE:
10LF x 2.5'W x 6.0' E.D., 10.0'T.D.
TOTAL AREA: 120 SF
A B
FC 9.8 7.9
MH1 62.2 46.2
MH2 66.6 50.7
RECORD DRAWING
THIS RECORD DRAWING REPRESENTS THE AS-BUILT CONDITION OF THE PROPERTY IMPROVEMENTS DESCRIBED ABOVE.
THE DRAWING AND ANY OTHER SUBSEQUENT ATTACHED OR INCLUDED INFORMATION IS BASED ON PERIODIC VISUAL OBSERVATION
BY A REPRESENTATIVE OF PES ALONG WITH NOTES, PHOTOS, AND OTHER INFORMATION PROVIDED BY THE INSTALLER OF THE SYSTEM.
THE INFORMATION PROVIDED IN THE RECORD DRAWING APPEARS REASONABLE AND REPRESENTS THAT THE PROJECT WAS DESIGNED AND CONSTRUCTED IN GENERAL
CONFORMANCE OF 18 AAC 72, THE ADEC ONSITE WASTEWATER SYSTEM INSTALLATION MANUAL, AND AMC 15.65 WHERE APPLICABLE. PES SHALL NOT BE HELD LIABLE FOR
SYSTEM DEFICIENCIES WHICH FALL OUTSIDE THE SCOPE OF THE REQUIRED VISUAL OBSERVATIONS OR SUBSEQUENT OBSERVATIONS IF REQUESTED BY THE INSTALLER. SEPTIC
SYSTEM INSTALLERS ARE TRAINED AND APPROVED BY THE MUNICIPALITY OF ANCHORAGE AND OR ADEC AS APPLICABLE. INSTALLERS ARE RESPONSIBLE FOR CONSTRUCTING
THE SEPTIC SYSTEM AS DESIGNED AND ENSURING THEIR WORK CONFORMS TO THE CODES AND POLICIES STATED ABOVE.
C D
MT1 16.3 41.3
MT2 27.8 17.2
ABBREVIATIONS
CO CLEAN OUT NO.
DCO DOUBLE CLEANOUT
DV DIVERTER VALVE
(E)EXISTING
FC FOUNDATION CLEANOUT
FS FLOW SPLITTER
MT MONITOR TUBE NO.
MH MANHOLE NO.
(N)NEW
NIC NOT IN CONTRACT
(P)PROPOSED
TH TEST HOLE
TYP TYPICAL
NEW SEPTIC
WATER LINE / WELL
RADIUS
ESMT/SETBACK
STREAM/DRAINAGE
WAY CENTERLINE
FLOW PATH
Lot 1, Hultquist Heights
Land Surveying
Land Development Consultants
Subdivision Specialists
Construction Surveying
124 E 7th Avenue
Anchorage, Alaska 99501
(907) 306-8104
mail@S4AK.com
AKCAN 173042
Group
S4 Asbuilt
0 40'
GRAPHIC SCALE 11/5/2025
Certified Drilling Log
OWNER OF LAND: Hultquist Homes
ADDRESS: 15744 Elizabeth St. Anchorage, AK 99516
LEGAL DESCRIPTION Hultquist Heights LT 1
DATE: 7/8/25
PERMIT NUMBER: OSP241300 DATE OF ISSUE: 10/7/24
TAX IDENTIFICATION NUMBER 02004403000
Is well located at approved permit location: Yes No
Method of Drilling: air rotary cable tool
Depth of Well: 300’
Casing Type: Steel Wall thickness .250 inches
Diameter: 6 inches, depth 68 feet
Liner type
Static Water Level: 6 feet
Recovery Rate 3 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 Volume: 50 Lbs.
Depth: from 2 feet, to 42 feet
Well Disinfected Upon Completion: yes no
Method of Disinfection: Chlorine 50 PPM
Comments:
Bore Hole Data
Depth
From To
0 2 Casing Stickup
2 4 Overburden
4 12 Fill
12 19 Silty sand and gravel
19 29 Silty sand and gravel, water
29 65 Tight silty sand and gravel
65 121 Bedrock gray
121 129 Bedrock gray with quartz
129 251 Bedrock gray
251 284 Bedrock broken
284 300 Bedrock gray
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.
www.sullivanwaterwells.com
Pump Installation Log
Well Drilling Permit Number: OSP OSP2413000 Date of Issue 10/7/24
Parcel Identification Number: 02004403000
Legal Description Property Owner Name & Address
Hultquist Heights Lot 1 Hultquist Homes
15744 Elizabeth St., Anchorage
Pump Installation Date:
7/22/25
Pump Intake Depth Below Top of Well Casing:
292 feet
Pump manufacturer’s Name:
Grundfos
Pump Model:
10SQE10-290
Pump Size:
1 hp
Pitless Adapter Burial Depth:
10 feet
Pitless Adapter Installer: unk
Pitless Manufacturer:
Disinfected Upon Completion?
yes no
Method of Disinfection:
Chlorine 50 PPM
Comments:
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.
Merrill
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: OSP241300
Work Type: WellSeptic Initial
Tax Code Number: 02004403000
Site Legal Address: HULTQUIST HEIGHTS LT 1 G:3238
Site Mailing Address: 15744 ELIZABETH ST, Anchorage
Owner: HULTQUIST HOMES INC
Design Engineer: PANNONE ENGINEERING SERVICES
This permit is for the construction of:
Effective Date
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
r
I)epartill ent
10/7/2024
10/7/2025
63465
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
-Reeeived-By: r 15,5v��a�
Issued By: (�l/
Date:
Date:
4
MUNICIPALITY OF ANCHORAGE
Y�
Community Development Department Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On -Site Water e Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 020-044-03
Property owner(s) Hultquist Homes Day phone
Mailing address 12570 Old Seward Hwy
Site address NHN Elizabeth Street
Legal description (Sub'd., Block & Lot) Hultquist Heights L1
Legal description (Township, Range & Section)
Lot Size 63,465 Sq. Ft. Number of Bedrooms
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(® all that apply)
Absorption Field x❑ Initial R Single Family (SF) x❑
(w/wo ADU)
Septic Tank RX Upgrade ❑ Duplex (D) ❑
Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well ❑x
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE / 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: 12
Date of Payment: y
Receipt Number: 12-K06
Permit No. a.,e 2 q ( - 00
Permit App_'-'- : • :'-.,'c
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
Pannone Engineering Services LLC
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: steve@panengak.com
Mailing: P.O.Box 1807, Palmer, AK 99645
Telephone: (907) 745-8200 FAX: (907) 745-8201
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, Alaska
Subject: Hultquist Heights L1
Well and Septic System Permit Request
This is a design narrative for a permit to install an initial well and septic system on the subject property. The
proposed installation will serve a proposed four (4) bedroom house. This lot and surrounding lots are served by
private wells. Currently there are no wells within 100 feet of the proposed wastewater treatment system.
1. Soils: A test hole was performed on this lot by Pannone Engineering Services on 09/23/2024. Groundwater was
not observed during the excavation of the test hole to a depth of 16 feet, and bedrock was not encountered.
Groundwater was not observed in the test hole monitor tube after 7-day. Based on the results of the percolation
test and attached sieve analysis an application rate of 1.2 gpd/SF was used for the design of a conventional
wastewater treatment system in the area of the test hole.
2. Soil Absorption System Design: See Sheet 1 of the design package.
3. Surface Water: There are unnamed streams on this property as mapped MOA ARC GIS. The proposed location
for the drain field and septic tank creates at least 100 feet of overland flow between the wastewater treatment
system and the stream.
4. Topography: See attached site plan for area topography.
5. Drawing Markings: The Drawings are marked “For MOA Review Only”. When written notification that the
review is complete and no further comments are received from MoA On-Site Department, the note will be removed
and “For Construction” drawings will be issued.
The proposed installation will not affect the future development of this or the surrounding lots.
If you have any questions or concerns, please contact me at (907) 745-8200.
Sincerely,
SRP
Steven R. Pannone, P.E. F. ASCE
Owner/Civil Engineer
4 October 2024
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241300, Deb Wockenfuss, 10/07/24
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NOTES:
PANNONE ENG SVC LLC (C.1. 1088)
P.O. BOX 1807 PALMER, AK 9645
PHONE 907 745-8200 FAX 907 745-8201
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REVISIONS
UAIL
9/3/2024
FOR CONSTRUCTION
REV 1: 2024.t0.02
CHANGE ORDER
HULTQUIST HEIGHTS L1
HULTQUIST HOMES
NHN ELIZABETH STREET
ANCHORAGE, AK
REV 2: 2025.05.19
SCALE
1" = 60'
DRAWN
acP
P.I.D. NO
020-044-03
CHECKED
sRP
SITE PLAN
PERMIT NO.
OSP241300
SHEET
1 OF 3
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A SCALE: 1"=5'
DRAIN FIELD SECTION
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241300, Deb Wockenfuss, 10/07/24
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2.2. SCOPE OF WORK: INSTALL SYSTEM IN ACCORDANCE WITH THE ATTACHED DESIGN AND SPECIFICATIONS.
16 FEET
16 FEET
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241300, Deb Wockenfuss, 10/07/24
PA
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COMMENTS: Test hole excavated by HULTQUIST HOMES.
PERFORMED BY: PANNONE ENGINEERING SERVICES, LLC. I CERTIFY THAT THIS TEST
WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN
EFFECT ON THE DATE OF THIS TEST.
·<1.0 (min/inch)
·6"
·4 FT AND 5 FT
SOILS LOG & PERCOLATION TEST
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241300, Deb Wockenfuss, 10/07/24
040.002 Crowther Associates
1632 Bellevue Circle / Anchorage, Alaska 99515
Telephone (907) 349-2198 / E mail: 907crowther@gmail.com
Date:September 27, 2024
Client:Pannone Engineering Services, Dan
Project:Hultquist Heights Lot 1
Anchorage, Alaska
Particle Size Distribution Table
(percent passing subject sieve size)
Sample Source Lot 1
Moisture
Content
4.8%
Sieve Size Percent Finer Percent Finer Percent Finer Percent Finer
3 inch 100
1-1/2 inch 100
¾ inch 82
#4 56
#10 41
#40 13
#100 6
#200 5
0.02 mm xx
Classification Gravelly Sand
(SP)
Invoice 226
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241300, Deb Wockenfuss, 10/07/24
.Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Elmore Road
P.O. Box 196650 Anchorage, AK 99507
www.ci.anchorage.ak.us
(907)343-7904
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Performed For: C06 �j 1 k a u is -j- Date Performed:
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COMMENTS
WAS GROUND WATER
ENCOUNTERED? 1� 7
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(Feet)
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COMMENTS
WAS GROUND WATER
ENCOUNTERED? 1� 7
IF YES, AT WHAT DEPTH?
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Depth to Water After / P
Monitoring? E
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Date: �a z Z r 3
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Site Plan
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PERCOLATION RATE?(minutesfinch) PERC HOLE DIAMETER 6_
TEST RUN BETWEEN FT AND FT
PERFORMED BY: (\11A( . 1 CERTIFY THAT THIS TEST WA
PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: A51 zz
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
OSC251540
Parcel ID 020-044-03 Expiration Date: z
Legal description HULTQUIST HEIGHTS LT 1
Site address 15744 ELIZABETH ST
Current property owner(s) HULTQUIST HOMES, INC.
X The On -site system(s) is/are approved for 4 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or conditions:
By: Curtis Townsend Original Certificate Date:
12/9/2025
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage,
Development Service Department (DSD) issues COSAs based upon representations provided by an
independent professional engineer. The Municipality of Anchorage is not responsible for errors or
omissions in the professional engineer's submittal.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
MUNICIPALITY
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 020-044-03
Complete legal description Hultquist Heights Lot 1
Location (site address) 15744 Elizabeth Street
Current property ownerHultuist Homes, Inc,
s) � Day phone
2. ON -SITE SYSTEMS SIZED FOR 4 BEDROOMS
3. TYPE OF WATER SUPPLY: R Private Well serving # 1 dwelling units
❑ Other Non-public well as regulated by MOA ❑ Water Storage
❑ Community Well or Public
4. TYPE OF WASTEWATER DISPOSAL: R Private Septic ❑ Private Septic serving 2 dwelling units
Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass
Age C 1 - See advisory if steel or fiberglass older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit
Waiver request for: Field to Foundation Distance: 5•5'
Expedited review requested: ❑
By applying for this entitlement, this property is subject to inspection by municipal On -site staff
to verify the accuracy of the information provided.
COSA Fee $ 7 5 Waiver Fee $
Date of Payment IIIX124 Date of Payment '
COSA # C 5� S�iU Waiver # Ofy2u55
COSA Application Apr2025,doc
COSA Checklist
Legal Description: Hultquist Heights Lot 1
Parcel ID: 020-044-03
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system 1
A. WELL DATA
0 Well log is filed with Onsite (or attached)
Date drilled 07/08/2021 Total depth 300 ft
Cased to 68 ft
rN-1 Sanitary seal is functioning correctly
A Wires are properly protected
Casing height (above ground) 24 in.
Date of flow test for COSA 07/08/2025
Static water level at beginning of test 6.0 ft.
Comments
B. TANK DATA
Measured operating fluid level in septic tank New
Date of pumping N/A
❑ Required maintenance completed, if AWWTS
Comments: New System
D. DISPOSAL FIELD DATA
Which system tested (date installed) 07/08/2025
0 ALL standpipes present per record drawing
Total measured depth from grade 9.0 ft (max)
Measured depth to pipe invert from grade ft (min)
M N/A — pressurized field.
❑ Per record drawings, field is insulated.
Q Monitor tubes go to bottom of effective.
If not, state depth into effective
❑ Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months) no
If yes, enter date
Comments/Deficiencies:
COSA Checklist_May2025.docx
Well production at time of test 3.0 gpm
Water storage tank volume none gallons
Well disinfected for coliform test? n Yes ❑ No
no Coliform bacteria is Negative
Nitrate mg/L n Nitrate less than MRL (ND)
Arsenic ug/L X Arsenic less than MRL (ND)
Collected by Sullivan Water Wells
Date 07/22/2025
C. LIFT STATION
❑ Required maintenance completed
Age of lift station <1 years
Lift station material HDPE
Comments:. New System
Adequacy test date New System
Results Q Pass
Fluid depth prior to test in
Water added gal
New fluid depth in
Elapsed time min
Final fluid depth in
Absorption rate 600 gpd
FIELD STATUS — POST RECOVERY
Effective depth (per record drawings) 72 in
Effective depth used 0 in
Effective depth remaining 72 in
E. SEPARATION DISTANCES
From Well on Lot to: (Please enter distances if less than required)
Septic Tank/Lift Station on Lot > 100'
Z Yes if No ft
Neighboring Tank > 100' M Yes if No ft
Disposal Field on Lot > 100' Q Yes if No ft
Neighboring Disposal Fields > 100'
Yes if No ft
Sewer Line/Main > 100' [71 Yes if No ft
Sewer Manhole/Cleanout > 100'
(Z✓ Yes
if No ft
Sewer Service/Septic Line > 25'M Yes
if No ft
Holding Tank > 100' Q✓ Yes
if No ft
Animal Containment > 50' Ql Yes
if No ft
Manure/Animal Excreta Storage > 100'
QYes if No
❑ N/A — Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Disposal Field(s) on Lot to: (Please enter distances if less than required)
Tank to Foundation > 10' F.71 Yes if No
ft
Surface Water > 100'
Q Yes if No
Field to Foundation > 10' ❑ Yes if No
*5.5 ft
Wells on Adjacent Lots:
Tank to Property Line > 5' ❑✓ Yes if No
ft
Wells > 100'
Yes if No
Field to Property Line > 10' Yes if No
ft
Community Wells > 200'
[?]Yes if No
Water Main/Service Line > 10' Yes if No
ft
If tank or field is under driveway comment below
F. ENGINEER'S COMMENTS
*See attached waiver request.
G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER
ft
ft
ft
ft
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, indicates that the on -site
water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
In conducting an adequacy test, I attempt to provide a thorough, conscientious �
engineering analysis of the system in accordance with ADEC & MOA guidelines and OF q 0
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regulations. The reported results describe the performance of the system under the �C,'t C �S,
conditions encountered at the time of the test, and separation distances measured to Gj _ •:9
readily identifiable features. The operational life of all wells and septic systems depend W 49 TH
on the local soil condition, ground water levels that may fluctuate during the years, and
the water usage of the people served by the system. These conditions are outside the ® - � • • . • • • .
Steven F annone a
control of the evaluator of this system. All systems eventually fail, and satisfactory test CE 8149 `>®
results do not guarantee future performance if the system, nor do they guarantee that
there are no hidden defects of encroachments. Therefore, we cannot provide anyvp�G
warranty of future performance, nor can we estimate the 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.
Engineer's Printed Name Steven R. Pannone
Phone (907)745-8200
Date 12/03/2025
COSA Checklist_May2025.docx
Pannone Engineering Services LLC
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: steve@panengak.com
Mailing: P.O. Box 1807, Palmer, AK 99645
Telephone: (907) 745-8200 FAX: (907) 745-8201
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK
Subject: Hultquist Heights Lot 1
Drain Field to Foundation Waiver Request
Ladies and Gentlemen:
We hereby request a separation distance waiver from the newly installed drain field to the existing foundation on the
subject property to a distance of five-point-five (5.5) feet. A deep trench absorption field was installed on the subject
property during the construction of the dwelling located on this lot. Due to space limitations between the proposed
dwelling and the eastern utility easement, the subject drain field was installed at a lesser distance than the prescriptive
ten (10) foot separation to maintain clearance from the existing utility easement and retain required setbacks.
The native receiving soil at the trench location consists predominantly of poorly graded sands (SP), with rapid infiltration
characteristics verified by sieve analysis and percolation testing (<1.0 min/in.). Based on an estimated worst-case
infiltration condition (46% infiltration from the drain field lateral), the vertical zone of influence from the drain field i s
projected to extend approximately just above the existing foundation foot ing. The dwelling is constructed on a CMU stem
wall and concrete footing. This foundation was waterproofed in accordance with standard constructi on practices.
Effluent bio-mat build-up is generally confined to within a limited distance from any drain field boundary . In an area with
confirmed well-draining soils; the anticipated soil infiltration of effluent is likely to occur at a steeper angle exhibiting
more of a vertical than horizontal infiltration gradient. The placement of the drain field is not likely to have any adverse
impacts on the native soils in which are supporting the foundation.
In accordance with the Alaska Department of Environmental Conservation (ADEC) regulations for On -site Wastewater
Treatment Systems (18 AAC 72 & most recent On-Site Wastewater Installation Manual) the horizontal separation from
foundation to absorption field of ten (10) feet –is not listed as a requirement but only as recommendation.
Given these conditions, we believe the installed separation provides adequate protection of the structure. Granting this
waiver is not likely to affect the health and safety of this lot or the surrounding lots now or in the future. Furthermore,
granting this waiver will not hinder the future development of this or surrounding lots.
If you have any questions, please contact me at (907)-745-8200.
Sincerely,
Steven R. Pannone, P.E., F. ASCE
Owner/Civil Engineer
3 December, 2025
Municipality
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P.O. Box 196650 0 4700 Elmore Road
Anchorage, Alaska 99519-6650 0 (907) 343-7904 0 Fax (907) 343-7997
http://www.muni.org/Onsite
Development Services Division
On -Site Water and Wastewater Program
* * * * VARIANCE/WAIVER REVIEW * * * *
Waiver#: OSV251540 COSA#:OSC251055 Permit#:
P I D#: 020-044-03
Legal Description: HULTQUIST HEIGHTS LT 1
Engineer: Pannone Engineering Services
Your request for a waiver of the required 10 feet horizontal separation from the disposal field to
the foundation has been approved. The approved separation distance is 5.5 feet.
This waiver approval applies to the existing disposal field only. Any future upgrade to the on -
site wastewater disposal system will require all separation distances be met or another approval
from this department.
Waiver is Granted: X Waiver is not Granted:
j )�::
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Date: 2 Approved by: /
Name of a fewer
**** VARIAN G EMAIVE R REVIEW ****