Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutPOLLOCK HOMESTEAD BLK B LT 10Pollock
Homestead
Block B
Lot 10
#017-112-38
907 Water Well Services
P.O Box 210249
AK 99521
(907)230-1868
johnnie.netherton1702@gmail.com
N V" D) 5 "ted''E__
BILL TO
Matt
15330 Pollock Dr
Anchorage, Ak 99516
ACTIVITY
Service Call
Flow test is not being charged due to insufficient water down hole. 7/28/17
Pump Rig
Removal of all down hole components in order for drill rig to set up over well
8/1/17
1 In Long Body Check Valve
1 check valve was placed 100 ft above the pump and the other one was placed a
1 00f below the pitless
Touque Arrestor
Placed directly above pump to keep wear and tear away from wires from pump
thrust when pump kicks on
Pump Rig
8/2/17 reinstallation of pump,pipe and wire after drilling well deeper pump directly
from well head to clear out sediment
10/2 AWG Super Blue Drop Wire
Additional wire down hole due to well being drilled deeper
1 in PVC Drop pipe
80ft added to pre-existing 140ft of 1" pvc drop pipe
Q,07
C
RESIDENTIAL 8 COMMERCIAL WATER AND WELL SERVICES
24HR EMERGENCY SERVICES AVAILABLE
FREE ESTIMATES
John Merherron
P.O 6ox 210249
Anchorvge, AK y� "y ? �"�.
99521 90 —.a ,3 0—
INVOICE # 1410
DATE 08/02/2017
DUE DATE 08/02/2017
TERMS Due on receipt
OTY
RALE
AMOUNT
1
145.00
145.00
1
165.00
165.00
2
56.00
112.00
1
36.00
36.00
4
165.00
660.00
70
2.35
164.50
80
2.25
180.00
BALANCE DUE $1,462.50
Erik Widger
From: Matthew McSorley <matthew_mcsorley@hotmail.com>
Sent: Thursday, April 16, 2020 12:25 PM
To: Erik Widger
Subject: holding tank
Good morning Erik,
Thank you for the call and update on the COSA. The water holding tank in the garage is 300 gallons. It was installed in
2014 by Anchorage Pure Water Products. Below is the receipt.
We look forward to seeing your report.
Sincerely,
Matthew & Christina McSorley
Sent from my iPhone
1
-
�. _,
pppp-f/-,�
(( tiw
i L
-
l
i 6•
St
G
7
-
.,:.
l
.q.
C CC f
43 111
:.
4�
.i
1
Municipality of Anchorage
• Development Services Department=_ s7
Building Safety Division
On-Site Water & Wastewater Program, 4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: SWO30483 PID Number: 017-112-38
Name:
RYAN MATHIAS
Wastewater System; ■New ❑Upgrade
Address:
13120 LUPINE ROAD * ANCHORAGE, AK 99516
ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 24.0-8430 4
O Dsep Trench ■ Shallow Trench ❑ Bed jiMound ❑ Other
LEGAL DESCRIPTION
Seg Rating:
6.0
Total Depth from original grade:
I
GPD/Sq.
Ft. SEE DWG. FL
Block: Lot: Subdivision:
B 10 POLLOCK HOMESTEAD
Depth to pipe bottom from original grade:
SEE DWG.
Growl depth beneath pipe:
0.7
Ft. FL
Township: _ Range: Section:
FlII added above orginel grade:
Grovel length:
_
SEE DWG.
Ft. 30 Ft
WELL: ■ New ❑ Upgrade
Gravel width:
5
Number of line•:
1
Distance between lines:
_
Ft
FL
Classification (Priv" A.B,C):
Total Depth:
Cased To:
Total obeorpNen area:
Pipe material:
PRIVATE
166 Ft.
72 FL
150 SO.
Ft. D 3034/ F-810/SCH 40 PVC
Dollar.
Data Drilled:
Islet. Water laud:
Installer.
Date installed:
ALPINE DRILLING
1 19/20031
40 FL
GEG, Ltd.
1/6-7/2004
1bld:Pump
Set A4
Casing Haight Above Ground:
3.0 CPM
UNKNOWN Fc
2 Ft.
TANK
SEPARATION
DISTANCES
0Septic ❑Holding ■S.T.E.P. ■Other**
Ta
Septic
Tank
Absorption
Field
Lift
Station
Holding
Tank
Public/Private
sewer unes
Manufacturer.
ORENCO
Capacity in gallons:
1500
From
Well
100'+
100'+
100'+
—
25'+
Material:
FIBERGLASS
Number of compartments:
2
Surface Water
**100'+
**100'+
**100'+
—
—
LIFT STATION
Lot Line
5'+
10'+
5'+
—
—
Size in gallons:
1500/76
Manufaahvvr.
ANCHORAGE TANK ORENCO SYSTEMS
Foundation
5'+
***5'
5'+
—
—
'Pump on' level ab
TIMER/13.5"
Pump level at.
TIMER/13.5"
High waler eleven ab
46"/24-
Curtain Drain
—
—
—
—
—
Pump Mab @ Model:
Dee Weal Inspections performed by.
#20 OSI 05 HHF
M.O.A.
Remarks:
BENCH MARK
Location and Description:
*THIS IS AN ADVANTEX TREATMENT SYSTEM
TOP OF FILTER POD
**CURTAIN DRAIN OUTFALLS TO DRAINAGE DITCH
ALONG ROAD FILLED WITH DRAINROCK TO COVER
Ascumed Elevation: 11)5.78
pt.
SURFACE WATER. ***WAIVER GRANTED.
ENGINEERS JEA.
a®6p
-NO F.C.O. BECAUSE GRINDER PUMP IN BASEMENT
Inspections performed by: GEG, Ltd. Dates: 1st 1/6/2004
* ....... .... ...' *Q�
2nd 1/6/2004
3rd 1/7/2004
y
p0
Development Services Department Approval
c zs G�0
do4
/, '
Reviewed and approved by4 kmA"l Date: 9 /S
e,,•, � a���'c���0
��e0'Pr D��a
(Rev. 12/01)
o f essio� o0
�ODDOq�d
-�` 91?-a1/S GAG has -FhoLf Mlle dr0.'riFi',W is hcavily Uegc.-werl.
PERMITSWO NUMBER: AS DRAWING PARCEL INUMBER:
SWO3O483 017-11 12-38
I
I
J
F
YI
U
O
J
J
O
\ n
vl
DRAINAGE DITCH
ALONG ROAD FILLED
WITH DRAINROCK�
ST1
POD
MH1
MH2
NEW WELL MT1
MT2
100'WELL
�. RADIUS t
OUTFALL
I
1. OWNER, IAS
- --•-i: -••e .-w NEW / /)
®- - 4 BEDROOM /
HOUSE
TH#2
THA
�
I� NEW DRAINFIELD-
I
TH#3 FOR
LOT 11-
-5' LOT LINE
WAIVER GRANTED
WITH PERMIT
NEW 1500
GALLON
ADVANTEX
TANK.
r---- )
L----_ J
A B
40.81 28.80
45.68 34.39
39.69 38.16
43.03 41.69
39.94 48.02
37.80 66.95
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS SCALE: 3D 'k . T
3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 ' PHONE (907)337-6179' FAX (907)336-3246 —
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
RYAN MATHIAS (907) 240-8430 2OF 3 .....
Q� J Gamess:
LEGAL DESCRIPTION: P Si 95 eG
POLLOCK HOMESTEAD SUBDIVISION; LOT 10, BLOCK B ppQrm '- :3�Z3�o+��g�o�
TYPE OF WORK:o E
AS -BUILT OF NEW WELL SEPTIC SYSTEM 4��p40oo�00�0
PERMITNUMBER:
SWO
SW030483
AS—BUILT
DRAWING PARCEL INUMBER:
7TOPOF
L
017-11 12-38
SAND
TOP OF ADVANTEX POD
TOP OF MANHOLE _
= 104.05 (AVG.)
= 105.78 (AVG.) 105.66 (AVG.)
>) INCH HOLES SPACED 10 INCHES ON
TOP OF MANHOLE _
FINAL GRADE =
BOTTOM OF TRENCH =
105.76 (AVG.)
103.8+
100.09-101.55 LIMITED TO
RELATIVE ELEVATION OF GROUNDWATER
THE REMOVAL OF ORGANICS
OATS
INSULATION
99.47 (EAST END OF TRENCH)
TOP TANK
RELATIVE ELEVATION OF BOTTOM
OF TEST HOLE = 92.09-93.55!
= 100.87
10
•I
TOP 10 TANK
I / = OF TANK
_..._,. .
1504 GALL(
AGVANIEX
TANK
INSTALLED BRACT
AND STAKING
ORIGINAL GRADE
= 101.09-102.55
INVERT OF
= 101.
BOTTOM OF
VAULT =
FINAL GRADE _
107.24 (AVG)
INSULATION
FILTER FABRIC
TO DRAIN I
FIELD
ORENCO PUMP
VAULT
TH#3
7•
' APPROVED `
:g lSA�D. FlLTER�s _
7TOPOF
L
INVERT OF PIPE = 104.75 (AVG.) THE
SAND
rj�l
DISTRIBUTION LINE IS 1.25 INCH PVC WITH
= 104.05 (AVG.)
>) INCH HOLES SPACED 10 INCHES ON
CENTER (30 HOLES TOTAL)
BOTTOM OF TRENCH =
100.09-101.55 LIMITED TO
RELATIVE ELEVATION OF GROUNDWATER
THE REMOVAL OF ORGANICS
98.01 (WEST END OF TRENCH)
99.47 (EAST END OF TRENCH)
RELATIVE ELEVATION OF BOTTOM
OF TEST HOLE = 92.09-93.55!
DRAWN BY: yl....... .... (� 1(
M.E.W./C.J.G.
GARNESS ENGINEERING GROUP, Ltd. SCALE: y
o
TE N1 - ANCHOR E GENERAL CONTRACTORS N.T.S a....... ... ,. • ... .......
3701 E. TUDOR ROAD, SUITE 101 •ANCHORAGE, AK 99507 •PHONE (907)337-6179 *FAX (907)338-3246 Q
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
RYAN MATHIAS (907) 240-8430 3 OF 3 o. a A. SS:
LEGAL DESCRIPTION: QO C - 95 of
POLLOCK HOMESTEAD; LOT 10, BLOCK 8 �9r coo
TYPE OF WORK: 4 Qe�-eyp $ .3 •bop
PROFILE AS -BUILT DRAWING OF NEW SEPTIC SYSTEM Opp tofesstoaq
40ooq
RightFax 1/19/2004 7:10 PAGE 1/1 RightFax
Inspection Report
Municipality of Anchorage, Building Safety Division
4700 South Bragew
INSPECTIONO VOICE 343-8300 INSPECTIONi FAX (9071248-7777 INFO: 343-7962
Name Dave Permit 04-7076
Address 19330 POLLOCK DR Phone 727-0972
i
622-6777
Legal BK B LT 10 Inspection Date 1/1912004 PM
Subdivision POLLOCK HOMESTEAD
Commends or Directions
Inspection Retro Electrical Reinspection N
NO NONCOMPLIANCE OBSERVED
❑ CORRECTIONS ESSENTIALAS EXPLAINED BELOW
❑ WILL RE-EXAMINE AT NEXT ❑ DO NOT CONCEAL UNTIL REINSPECTION
INSPECTION
{ COMMENTS: (for inspector use only)
SC-sn4 Lr fl
f;
i'
k
i
t
R
Data-/ ^ 01
Municipality of Anchorage
Department of Health and Human Services
825 °L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
Rick Mystrom httpJAv vw.d.anchorage.ak.us
Mayor /
Permit Number: #SW 03048 Date of Iss e: 11-19-03 Parcel Identification Number: 017-112-38
Date Started:16 1-04 Date Completed: 11 04 Is well located at approved permit location? ® Yes ❑ No
Legal Description: Pollock Homestead Block B Lot 10
Property Owner Name & Address: Ryan Mathias
13120 Lupine Road
Anchorsoe. Alaska 99516
Borehole Data:
Depth (R)
Method of Drilling ® air rotary ❑ cable tool
Soil Type, Thickness & Water Strata
From To
Casing type: steel
Stick-up
0 2
Wall Thickness: .250 inches
gravelly stat
Bedrock
2 70
70 166
Diameter: 6 inches Depth: 72 feet -
Liner Type:
Diameter: inches Depth: feet
Casing stickup above ground: 2 feet
Static water level (from ground level): 40 feet
Pumping level: 186 feet after
2 hours pumping 3 gpm
Recovery Rate: 3 gpm
Method of Testing: air Ar
Well Intake opening Type:
❑ Open End ❑ Open Hole
❑ Screened Start feet Stopped feet
❑ Perforations Startfeet Stopped feet
Grout Type: bentonite # 8 Volume: 1
Depth- Start 0 feet Stopped 1!2+ feet
Pump: intake feet
- — -
-Depth
Pump size - hp Brand Name
Well Disinfected Upon Completion? ® Yes ❑ No
Method of Disinfection: chlorine tablets
Comments:
Well Driller: Alpine Drilling & Enterprises
PO Box 110496
Anchorage Alaska 99511
Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT
Initial
Permit Number: SW030483
Legal Description: 9 ato A
Design Engineer: 0041 AK Water & Wastewater Consultant
Owner Name: Ryan Mathias
Owner Address: 13120 Lupine Road
Anchorage , AK 99516 -
Date Issued: Nov 19, 2003
Expiration Date: Nov 18, 2004
Parcel ID: 017-112-38
Site Address: 15330 Pollock Drive
Lot Size: 18958 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
Date:
Date:/ (/3
Municipality of Anchorage
o Park x:'i
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.cl.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D.—) I ! Z y 03 4i33
( � Permit Number S (.t/ �
Property owner(s) RYAN MATHIAS Day phone 240-8430
Mailing address (1) 13120 LUPINE ROAD * ANCHORAGE AK
Mailing address (2)
Zip Code 99516
Legal description (Lot, Block & Sub'd.) LOT 10. BLOCK B• POLLOCK HOMESTEAD IS'UBDDIVISION
-
Legal description (Section, Township & Range) ±U%�j � t F I I n C 1 I�J
Lot Size_ IS
t C4 Acres/E)
cres q.Ft. Number of Bedrooms 4
THIS APPLICATION IS FOR:
Sewer Only ❑ Well Only ❑
Sewer and Well 0 Water Storage ❑
Sewer Upgrade ❑
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit F9
Therapy Pool ❑
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal codes.
ALASKA WATER & WASTEWATER CONSULTANTS, INC.
Permit Fees: z
Date of Payment: I i� )
Receipt Number. LT L 1
Waiver Fees:
Date of Payment:
Receipt Number:
'--
ALASKA. WATER & WASTEWATER
CONSULTANTS, INC. -
November 10, 2003
Municipality of Anchorage
Development Service Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
Ref: Proposed Well and Septic System for Lot 10, Block B; Pollock Homestead Subdivision
ADVANTEXT"r TREATMENT SYSTEM
To whom it may concern:
1. GENERAL: The proposed 4 bedroom home will be served by a private well and septic
system. Three test holes were excavated on the property. We are proposing to design the septic
system around the 30 foot radius of test hole #3 for lot 11. Due to the limited amount of
receiving soils and high groundwater we are proposing to use an Advantex treatment system with
a pump vault and a pressurized 5 -wide trench type drainfield. The well is to be located in the
area shown on the site plan and design drawing.
2. SOILS: See the attached log, which shows the soil classifications, groundwater monitoring,
and the percolation test results.
3. DRAINFIELD APPLICATION RATE: The intent is to install an Advantex Treatment
System that will allow the use of a small drainfield in the area around the 30 foot radius of the
test hole. The Advantex system has received class III approval and we are going to assume an
application rate of 4.0 GPD/FT2.
4. PRESSURIZED 5 -WIDE DESIGN:
a. Percolation Rate: <1 & 6.7 minutes/inch
b. Proposed Application Rate: 4.0 gallons/day/ft2
c. Number of Bedrooms: 4
d. Design Flow: 600 gallons per day
e. Minimum Absorption Area: 150112
f. Total Depth: 1.0 feet (max. limited to the removal of organics)
g. M.O.A. Approved Sand Filter Depth: 2.5+ feet
h. Effective Depth: 0.5 feet
i. Width: 5 feet
j. Minimum Length: 30 feet long
k. Effective absorption area: 150112
3701 E. Tudor Road, Suite 101 *Anchorage, AK 99507
Ph: (907)337-6179 * Fax: (907)338-3246 * Website: akwwc.com
5.ORENCO PACKAGE SYSTEM: The STEP tank with the Advantex Treatment System will
be manufactured by Anchorage Tank & Welding to meet the latest design criteria established by
Orenco Systems, Inc. The point of contact at Anchorage Tank is Lowell McNutt. As with their
standard STEP tank, it is equipped with a high water alarm per M.O.A requirements.
6. SURFACE WATER: There are no surface waters within 100+ feet of the proposed septic
system.
7. TOPOGRAPHY: As can be seen on the attached topography site plan the area around the
proposed drainfield is relatively flat. In short, there are no slope concerns.
8. LOT LINE WAIVER REQUEST: We request that a 5 foot lot line waiver be granted from
the south lot line to the proposed primary and alternate drainfields. We are unaware of any
adverse effects on the adjacent property with the granting of this waiver.
9. CLOSING: I am open to any suggestions from your department that would be an
improvement to the proposed system. I am unaware of any negative impacts that this installation
would impose o adjacent wells, or septic systems. If you have any questions, please call us at
337-6179. 1 11
.E., M.S.
NOTE. Attached is a site plan drawing, a design drawing, an Advantex detail, a trench detail,
three soil logs, and a 7 page construction specification letter which are all part of the design
package for this septic system.
3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507
Ph: (907)337-6179 * Fax: (907)338-3246 * Website: akwwc.com
1 I ,'\ LOT 4, BLOCK A
;LOT 3, BLOCK A I , I� POLLOCK HOMESTEAp/t.>
POLLOCK HOMESTEAD
E�IIi�` j)
`MRIC
�1 I %
IC R
\ oI
LOT 2, BLOCK A 1 ( ! AA
POLLOCK HOMESTEAD I LOT 5, BLOCK A \V�
1 1 POLLOCK HOMESTEAD
I I 01
LOT 1, BLOCK A i
POLLOCK HOMESTEAD I i LOT 6, BLOCK A _ !
IPOLLOCK HOMESTEAD !
i (VACANT i!
€ I jf PROPO
! I �I WELL
Y I
I LOT 8, BLOCK B I
PPLLOCK HOMESTEAD S/D I
I
RABBIT CREEK _ROAD_
PROPOSED WELL -
LOT 1A, BLOCK 1
POLLOCK HOMESTEAD
Y�
i
CSEPTIC 1
\ARI
LOT 9, BLOCK B
POLLOCK HOMESTEAD,
I \ 11
LOT 1B, BLOCK 1
POLLOCK HOMESTEAD
ALTERNATE SITE
LOT 3, BLOCK 2 �\
POLLOCK HOMESTEAD �\
ABANDONED
WELL
-PROPOSED SEPTIC SYSTEM
(SEE DESIGN PAGE 2 OF 4)
CLASS "C"
WELL
SITE
PROPOSED i
i \ 4 BEDROOM
/ HOUSE
i
LOT 2, BLOCK 1
POLLOCK HOMESTEAD
ALASKA WATER & WASTEWATER
CONSULTANTS, INC. .
3701 E. TUDOR ROAD, SUITE 101 - ANCHORAGE, AK 99507 * PHONE (907)337-6179 " FAX (907)338-3246 1 = 1 DO' ✓ '
PREPARED FOR PHONE NUMBER: PAGE NUMBER: ��
RYAN MATHIAS 240-8430 1 OF 4 ". Af
LOTS 10 AND 11, BLOCK B; POLLOCK HOMESTEAD SUBDIVISION
OF WORK:
SITE PLAN FOR PROPOSED WELL AND SEPTIC SYSTEM LOCATION
' CELL 7953
Pio f P.s sioo
HOLADNIING
-PROPOSED
4 BEDROOM
HOUSE
ALTERNATE SITE
LOT 3, BLOCK 2 �\
POLLOCK HOMESTEAD �\
ABANDONED
WELL
-PROPOSED SEPTIC SYSTEM
(SEE DESIGN PAGE 2 OF 4)
CLASS "C"
WELL
SITE
PROPOSED i
i \ 4 BEDROOM
/ HOUSE
i
LOT 2, BLOCK 1
POLLOCK HOMESTEAD
ALASKA WATER & WASTEWATER
CONSULTANTS, INC. .
3701 E. TUDOR ROAD, SUITE 101 - ANCHORAGE, AK 99507 * PHONE (907)337-6179 " FAX (907)338-3246 1 = 1 DO' ✓ '
PREPARED FOR PHONE NUMBER: PAGE NUMBER: ��
RYAN MATHIAS 240-8430 1 OF 4 ". Af
LOTS 10 AND 11, BLOCK B; POLLOCK HOMESTEAD SUBDIVISION
OF WORK:
SITE PLAN FOR PROPOSED WELL AND SEPTIC SYSTEM LOCATION
' CELL 7953
Pio f P.s sioo
NOTE: THE CONTRACTOR SHALL HAVE THE SOUTH
LOT LINE, THE EAST LOT LINE, AND THE 100 1
FOOT WELL RADII FLAGGED BY A REGISTERED
LAND SURVEYOR PRIOR TO CONSTRUCTION.
WELL
—--' s PROPOSED
4 BEDROOM
HOUSE ,
•U•, CLEANOUT,
CO
TH#1 / TH#2�
H
PROPOSED 1500
GALLON ADVANTEX / �' MH
TREATMENT SYSTEM
(/S ^ f.�9S_ r,
SEE DETAIL DRAWING '%/// ry//
PAGE 3 OF 4.)� MT
— — —' MTL-___—__—J L_—____—J 1.
PROPOSED DRAINFIELD. EXCAVATE A
TRENCH THAT IS 1.0 FEET DEEP MAXIMUM
(REMOVE ALL ORGANICS) BY 5 FEET WIDE
BY 30 FEET LONG. ADD 2.5+ FEET OF
M.O.A. APPROVED SAND FILTER AND THEN
0.5 FEET OF CLEAN, WASHED SEWER
DRAINROCK. THE DISTRIBUTIOIN LINE IS
TO BE 1.25 INCH PVC PIPE WITH 1/4
INCH HOLES DRILLED EVERY 10 INCHES
ON CENTER, 30 HOLES TOTAL. (SEE
DETAIL DRAWING, PAGE 4 OF 4)
T FOR
LOT
LOT 11-
INCH
1-
\ PROPOSE
----`W'--- \ SEPTIC
ALASKA WATER & WASTCWATER J•L.M.
CONSULTANTS, INC. scALE:
01 E TUDOR ROAD SUITE 101 - ANCHORAGE, AK 99507 ' PHONE (907M37-6179 ' FAX (907)338-3246
PARED FOR: PHONE NUMBER: PAGE NUMBER:
RYAN MATHIAS 240-8430 2 OF 4
4L DESCRIPTION:
POLLOCK HOMESTEAD SUBDIVISION; LOT 10, BLOCK B
OF WORK:
DESIGN OF PROPOSED WELL LOCATION AND SEPTIC SYSTEM
—0F
SITE
•..*
jJf
A.
On.a es�s:
C 7953
;'
0
\
NOTE: THE CONTRACTOR SHALL HAVE THE SOUTH
LOT LINE, THE EAST LOT LINE, AND THE 100 1
FOOT WELL RADII FLAGGED BY A REGISTERED
LAND SURVEYOR PRIOR TO CONSTRUCTION.
WELL
—--' s PROPOSED
4 BEDROOM
HOUSE ,
•U•, CLEANOUT,
CO
TH#1 / TH#2�
H
PROPOSED 1500
GALLON ADVANTEX / �' MH
TREATMENT SYSTEM
(/S ^ f.�9S_ r,
SEE DETAIL DRAWING '%/// ry//
PAGE 3 OF 4.)� MT
— — —' MTL-___—__—J L_—____—J 1.
PROPOSED DRAINFIELD. EXCAVATE A
TRENCH THAT IS 1.0 FEET DEEP MAXIMUM
(REMOVE ALL ORGANICS) BY 5 FEET WIDE
BY 30 FEET LONG. ADD 2.5+ FEET OF
M.O.A. APPROVED SAND FILTER AND THEN
0.5 FEET OF CLEAN, WASHED SEWER
DRAINROCK. THE DISTRIBUTIOIN LINE IS
TO BE 1.25 INCH PVC PIPE WITH 1/4
INCH HOLES DRILLED EVERY 10 INCHES
ON CENTER, 30 HOLES TOTAL. (SEE
DETAIL DRAWING, PAGE 4 OF 4)
T FOR
LOT
LOT 11-
INCH
1-
\ PROPOSE
----`W'--- \ SEPTIC
ALASKA WATER & WASTCWATER J•L.M.
CONSULTANTS, INC. scALE:
01 E TUDOR ROAD SUITE 101 - ANCHORAGE, AK 99507 ' PHONE (907M37-6179 ' FAX (907)338-3246
PARED FOR: PHONE NUMBER: PAGE NUMBER:
RYAN MATHIAS 240-8430 2 OF 4
4L DESCRIPTION:
POLLOCK HOMESTEAD SUBDIVISION; LOT 10, BLOCK B
OF WORK:
DESIGN OF PROPOSED WELL LOCATION AND SEPTIC SYSTEM
—0F
SITE
•..*
jJf
A.
On.a es�s:
C 7953
;'
0
NOTE: JIM CROSS, Ad1lanTeVM Treatment System
P.E. HAS THE �1 ••G1�6 GGAA Treatment hv�{J System
�!
ADVANTEX MANUAL AX20 - Mode la
_ 40x94Pod
INLET7INSULATION
orsa�
KTR/,E
LIFT STATION
NOTE: THE B
TO PROPOSED DRAINFIELD
--
INSTALLED OVER THE SEPT
BEYOND ON ALL SIDES EX
THE ADVANTEX FILTER. THI
FOR HEAT TO ESCAPE FR
RISE TO THE FILTER ABOVE IT.
6" JIM CAP
FINAL GRADE (TYP.2)-
ADVANTEX
�AX20 POD
30 INCH
INSULATED
RISER-,
6" PJC PUMP-OUI
MP.2,
6" PVC COUPLING
GLUED TO TANK
(TYP.2)
SEWER
SWb4t.ROCK
INLET
ORENCO
-- --1 BIOTUBE
OPTIONAL SCREENED
SLIDE SECTION VAULT
OF 6' PIPE
OVER THIS CONNECTION
TO PROVIDE4 BEDROOM ORENCO
SHEER PROTECTION— EFFLUENT
EXTEND TO FIBERGLASS TANK PUMP
BRIDGE EXCAVATION
DATE: p06� 4
11/10/2003� OF;q �qa
ars I DRAWN BY:
ALASKA WATER & WASTEWATER I.L.M.oaf`.4 S��a0
CONSULTANTS, INC. SCALE: Q * :
3701 E. TUDOR ROAD, SUITE 101 ` ANCHORAGE, AK 99507 . PHONE (907)337-6179' FAX (907)338-3246 N.T.S. • • 4 D
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: }' Q
RYAN MATHIAS (907) 240-8430 3 OF 4 � •• • s
d �, f e G me s,- �
LEGAL DESCRIPTION: QA 9. E 7953 0O0
POLLOCK HOMESTEAD SUBDIVISION; LOT 10, BLOCK B
TYPE OF WORK: u�4e01P O�Eo
DETAIL DRAWING OF ADVANTEX TREATMENT UNIT �Opp�0000�
FEET LON
1
MTO I
5 FEET WIDE
I
INSTALL VISOU ND / �OM PUMP VAULT
BARRIER AROUND J
PERIMETER OF TRENCH.
THE DISTRIBUTION LINE IS TO BE 1.25 INCH SCH
40 PVC WITH 1/4 INCH HOLES FACING DOWN
EVERY 10 INCHES ON CENTER (30 HOLES TOTAL),
FINAL GRADE
INSULATION
FILTER FABRIC
0.5 FEET OF EFFECTIVE
INSTALL BRACING AND
STAKING AS NEEDED INSTALL BRACING AND
STAKING AS NEEDED
ORIGINAL GRADE \
ORIGINAL GRADE
2.5+ FEET OF M.D.A. ..'
/`/ ;' .� -APPROVED SAND FILTER:-"-`
\ THE DISTRIBUTION LINE IS TO BE 1.25
1.0 DEEP MAXIMUM �r\ r\�/i\\n\ \\n\�n\ INr\�/i\\n\ \\n\�n\ INCH Sum. 40 PVC WITH } INCH DIAMETER
(REMOVE ALL ORGANICS) FEET WIDE HOLES SPACED 10 INCHES ON CENTER.
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
3701 E. TUDOR ROAD, SUITE 101 ' ANCHORAGE, AK 99507 " PHONE (907)337-6179 • FAX (907)338-324
'REPARED FOR: PHONE NUMBER:
RYAN MATHIAS 240-8430
.EGAL DESCRIPTION:
POLLOCK HOMESTEAD SUBDIVISION; LOT 10, BLOCK B
YPE OF WORK:
DETAIL DRAWING OF PRESSURIZED TRENCH
11/10/2003
'••
DRAWN
J.L.M.
O��P
.+.
.S��p
SCALE:
N.T.S.
..........
. . ..........
PAGE NUMBER:
4 OF 4
Q ' .J
Q� s '•
fr GGrness
953
•' �O
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
3701 E TUDOR ROAD, SUITE 101 • ANCHORAGE. AK. 99504 " PHONE (9W)N7-5179 • FAX: (-9-07T338-32M " WEBSITE: okw ...
SOIL LOG — PERCOLATION TEST
LEGAL DESCRIPTION: POLLOCK HOMESTEAD SUBDIVISION: LOT 10, BLOCK B
PERFORMED FOR: CHARLES VANDERGAW DATE: 6/12/2002
DEPTH Z�---
(feet) = _ TEST HO -LE --#-l]
1 —? ORGANICS
8
9
10
11
12
13
14
15
16-
17-
is -
TO
GROUNDWATER
DATE
WEEP
WEEP 0 7'
SOIL CLASSIFICATIONS
2
6/21/2002
DRY
10/17/03
12:14
—
6"
_
us
GW
_ _
30
3 1/4"
ORG
3
3
12:44
OLi
6"
GP
H�3
/ H#
~THj
ML
0 a
L�
'VV���, mTH02
1 /
I
5
GMWOH
—
6"
CL4
6
1:44
30
!
GCOL
d
_2
—
n
ism
SWMH
/1
1"=100'
5
iSPCH
6
SC
7-1
LENSES OF
8
9
10
11
12
13
14
15
16-
17-
is -
TO
GROUNDWATER
DATE
WEEP
WEEP 0 7'
6/12/2002
10.5'
6/21/2002
DRY
10/17/03
12:14
—
oF
ASN
*�;
................
e f e A. G ss.:
o y C 7953 o
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
6/13/2002
1
12:14
—
6"
_
us
12:44
_ _
30
3 1/4"
2 3/4-
3
12:44
OLi
6"
—
H�3
/ H#
~THj
I /
0 a
L�
'VV���, mTH02
1 /
I
5
;
—
6"
—
6
1:44
30
!
3/4"
d
_2
—
n
SITE PLAN
/1
1"=100'
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
6/13/2002
1
12:14
—
6"
_
2
12:44
_ _
30
3 1/4"
2 3/4-
3
12:44
—
6"
—
4
1:14
30
3 1/4"
2 3/4-
5
1:14
—
6"
—
6
1:44
30
3 1/4"
3/4"
_2
19 PERCOLATION RATE 10.9 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 4.5 FT. AND 5.5 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: 0 YES ❑ NO
SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: ZACHARIAH GALL
PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WA4 PqRFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 11//0/0.3
DEPTH TO
GROUNDWATER
DATE
WEEP ® 4'
3'
OF
71/4/03
S�4
73:10
ALASKA
ATER �P �0
WATER &WASTEW
_
CONSULTANTS, INC. p DD
3701 E TUDOR
ROA.
SUITE 101 • ANCHORAGE, W. 99504 • PHONE (907)337-6179 • FAX: (907)338-3246 • WEBSITE: ok..mm ........ ... . ..... ....
0"
g"
SOIL LOG — PERCOLATION TEST Q
LEGAL
DESCRIPTION:
p
POLLOCK HOMESTEAD SUBDIVISION; LOT 10, BLOCK B OQ •. 'ff y ar ess:'
PERFORMED
FOR:
P pp
RYAN MATHIASOso• CE 79 1 p
DATE: 11/3/2003 QO s �.. • ,. •' c�0
DEPTH
_
4
(feet)
9
ORGANICSrofe 9710
TEST HOLE #2
6"
5
13:30
—
g"
_
SOIL CLASSIFICATIONS
6
13:39
9
0"
g"
4
°;>s•e'
GP/SP TO GC OL \— w I t
....
GM/SM °$ 0 0 n SWMH I ��w€�� I
I V
5
;°;:'..;?:c•a'
SP CH \ �\ I /
/✓
SC
.......a0•
TH#
`✓ 4TH#2
mai
B.O.H.
t
811/3/2003I
/ R
l� 4
9
/ \
— — SITE PLAN
/ 1 "=100'
10
71
12
13
14
15
61718 16-
17-
18
t9
PERCOLATION RATE *1.5 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 2.0 FT. AND 3.0 FT.
20
A FOUR HOUR PRESOAK WAS PERFORMED: E YES ❑ NO
SOILS LOGGED
BY: JODY MAUS PERCOLATION TEST PERFORMED BY: JODY MAUS
COMMENTS-
*PERCOLATION
TEST PERFORMED IN A BENCH BETWEEN TH#2 AND TH#3
PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WA PE FORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: it 110103
DEPTH TO
GROUNDWATER
DATE
WEEP ® 4'
3'
11/10/03
71/4/03
1
73:10
—_
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
71/4/03
1
73:10
—_
g"
_
2
—3
73:19
9
0"
g"
13:20
—
g"
_
_
4
13:29
9
0"
6"
5
13:30
—
g"
_
6
13:39
9
0"
g"
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, W. 99604 • PHONE: (907)33]-61]9 • IM (907)33a-3246 - WEBSITE: ok....
SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: POLLOCK HOMESTEAD SUBDIVISION; LOT 10, BLOCK B
PERFORMED FOR: RYAN MATHIAS DATE: 11/3/2003
DEPTH ��_...^
(feet)t " � ORGANICS TEST HOLE #3
1 a®.
L
3
5
6
7
8
9
10
11
12
13
14-
15-
16-
17-
18-
19-
20 -
GP/SP TO
GM/SM
SOIL CLASSIFICATIONS
DEPTH TO
GROUNDWATER
GW
GP
GM
GC
SWMH
SP
SM
SC
c
~I ~i
ORG
ML
CL
CH
OH
3'
11/10/03
I
°12
NOL
DEPTH TO
GROUNDWATER
DATE
WEEP ® 4'
11/3/2003
3'
11/10/03
DATE
READING CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
Na
P
jN#2
pp"(, P
KN#g.
fif
g�g1EN
\
o
J
i
'H#3
TH#2
�
6
—
SITE PLAN
1
1 I
1"=100'
DATE
READING CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
Na
P
jN#2
pp"(, P
KN#g.
g�g1EN
P ERpp��\pN SEE
PERCOLATION RATE — (MINANCH) PERC. HOLE DIA. — (INCHES)
TEST RUN BETWEEN — FT. AND — FT.
A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES ❑ NO
SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY:
COMMENTS:
PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE:
IN ACCORDANCE
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
01 E. TUDOR ROAD, SURE 101 • ANCHORAGE, AK. 99507 • PHONE: (907)337-6179 • FAX: (907)338-3246 • WEBSITE: akwwa.wr
SOIL LOG — PERCOLATION TEST
LEGAL DESCRIPTION: POLLOCK HOMESTEAD SUBDIVISION; LOT 11, BLOCK B.
PERFORMED FOR: MATT LEDERHOSS DATE: 4/29/2003
DEPTH _:::-
(feet) —_ ORGANICSTEST HOLE #3
®•••Qac SOIL CLASSIFICATIONS
2 wee®flao
"ww•Qao SP/SW GW ORG
wesoaaa ,,._
GP ML
3 we w.. o„a
5
6
7
9
10
11
12
13
14
15-
16-
17—
is—
GM
5161718
GM
DEPTH TO
GROUNDWATER
GM
5.0'
4/29/2003
CL
5/6/2003
GC
10/17/03
!,
OL
o°> o
SW
MH
—
SP
0"
6"
CH
msc
SM
_ —
'
OH
DEPTH TO
GROUNDWATER
DATE
5.0'
4/29/2003
37"
5/6/2003
5.0'
10/17/03
5.0'
10/31/03
A. arness: O
—7953 ' •"p0
p
' eA
1 LOT 10, BLOCK B /
), I POLLOCK HOMESTEAD I //
/
5
o
C)
O TF{ 3
o f
*TH#1
TH$ h
I�
3
, I
SITE PLAN
1 "-100'
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
4/29/03
2
—
4
0"
6"
3
_ —
—
6-
4
—
4
0"
6"
5
— --
—
61,
—
6
—
4
0„
6„
7
—
_
—
6"
—
8
—
4
0„
6„
--
9
—
—
6"
-
70
—
4
0"
61,
19 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 1.5 FT. AND 2.5 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES ENO
SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: SUSAN OSWALT
COMMENTS:
PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PE FORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: Ir�Iu 0
Municipality of Anchorage
Mark Begich, Mayor
Building Safety Division
P.O. Box 196650 • 4700 Bragaw Street
Anchorage, Alaska. 99519-6650 • (907) 343-8301 • Fax (907) 343-8200
http://m�,.mimi.org
November 20, 2003
Jeff Garness, PE
Alaska Water & Wastewater Consultants, Inc.
3701 E. Tudor Road, Suite 101
Anchorage, Alaska 99507
Subject: Waiver Request for Pollock Homestead Block B Lot 10
Waiver Request # WR030107
PID #017-112-38
Dear Mr. Garness:
Vaf N
} C
S A F F T
Your request for waiver of the required 10 feet horizontal separation from a property line to a
wastewater absorption field has been approved. The approved separation distance is 5 feet from
the South Lot Line to the proposed Primary and Alternate Drainfields.
This waiver approval applies to the existing on-site wastewater disposal system to property line
separation only. Any future upgrade to the on-site wastewater disposal system will required all
separation distances be met or another approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office at 343-
7904.
Sincerely,
17
Daniel Roth
Civil Engineer
On -Site Water & Wastewater Program
WR#: 030107 PID#:017-112-38
Date Received: 11/20/03
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
Waiver Review Worksheet
HA#: Permit#: SW030483
Legal Description: Pollock Homestead Block B Lot 10
Engineer: Alaska Water & Wastewater Consultants, Inc.
3701 E. Tudor Road, Suite 101
Applicant: Ryan Mathias
Waiver Requested: 5 foot Lot Line waiver from the South Lot Line to the Primary & Alternate Drainfields
Criteria:
Geology Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Tota I:
...............................................................................
Waiver is Granted:
Waiver is not Granted.
List Conditions or Reasons for above: LG t AL j,9 '; F lv) i_ Z_- TT {i' c L
ib57/i-i(1471LAL1 Vc L lL,7 " ,=) %/NC,vF /'�)
Date:J1211(,-5 By: f _W 6v
Name of Reviewer
...............................................................................
Rec#: 44786 Amount: $150.00 Date Paid: 11/2012003
EPLALS
® Municipality of Anchorage ° ?V
On -Site Water and Wastewater Program -
(907) 343-7904
Certificate of On -Site Systems Approval
Parcel I.D. 017-112-38 Expiration Date:
1. GENERAL INFORMATION:
Complete legal description POLLOCK HOMESTEAD; BLOCK 8, LOT 10
Location (site address) 15330 Pollock Drive 'Anchorage 99516
Current Property owner(s) Matthew McSorley Day phone 230-4124
Mailing address
Real Estate Agent
2. TYPE OF DWELLING:
© Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
4
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
©
Individual
0
Individual Water Storage
❑
Holding Tank
❑
Community Class_Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
WaiverNariance request for: Distance:
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
claW 12
COSA Fee $ 5661 Q 12.6b Waiver Fee $
Date of Payment L1 I7212®4 Date of Payment
Receipt Number csga2scg Receipt Number
COSA 4 Q a® l tS 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 wastewaterdisposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm: Garness Engineering' Group, Ltd (GEG) Phone: 907-337-6179
Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507
Engineer's Printed Name: Jeffrey A. Garness Date: t4 Ili
In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system
in accordance with the guidelines and regulations established by the Municipality of Anchorage and oocsdo� O
industry practices. The reported results describe the condition of the system/s on the date/s of the o ��
evaluation. Separation distances were measured to readily identifiable features. Hidden defects or
encroachments may exist that were not identified during the evaluation. The operational life of all wells �Q
and septic systems depend upon a variety of variables, including but not limited to, soil conditions,
groundwater levels (that may fluctuate during the year), quality of construction (materials and Q�
workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and
are outside the control of GEG. Satisfactory test results do not guarantee future performance of the Q
system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of..... • • . ... .
the well or septic system. GEG makes no representation whether an alternative well or septic system Q �, ''. fr Garness•
can be installed on the property in the event either of the current systems fail to perform adequately in Qn 9 CE -79 c�Op
the future. The content of this report is for the sole benefit of the person/party that retained GEG to v J Ut• o p
perform the evaluation. Reliance upon the information provided in this report by any other person or
' _ p
party (including subsequent property Purchasers)is not authorized, nor will it confer any legal right OO'o�lfeo�sst�o0�°6�
o
whatsoever.
#AECC884
6. DSD SIGNATURE OFA/���/
System #1 Approved for bedrooms
System#2 Approved for bedrooms _� ON-SITE �� r
`�JpTER A"TEP
R
c� v STEV'`'
Conditional approval for bedrooms, with the follg stgl���
rt
By: Original Certificate Dater y Q2 6
g
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 __ Nitrate Advisory
Septic System Advisory' Arsenic Advisory
Well Flow Advisory Other
COSA Checklist
Legal Description: POLLOCK HOMESTEAD; BLOCK B, LOT 10 Parcel ID: 017-112-38
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 2.1+ 9 p
Date drilled 1/11/04 Water storage tank volume 300 gallons
Total depth *245 ft Well disinfected for coliform test? ❑ Yes ❑■ No nCA
Cased to **70 ft EP<'Cliform bacteria is Negative'4j
0 Sanitary seal is functioning correctly Nitrate mg/L trate less than MRL (ND)
0 Wires are properly protected Arsenic ug/L rsenic less than MRL (ND) d
Casing height (above ground) 18+ in. Collected by GEG,LTD
Date of flow test for COSA 4/8/20 Date of Sample 4/10/20
Static water level at beginning of test 69.1 ft.
Comments *WELL DEEPEND 8/2/17 (SEE ATTACHED DOCUMENTS) "TO BEDROCK
B. TANK DATA
Age of tank(s) 16 years
Tank type/material FIBERGLASS
Measured operating fluid level in septic tank
❑■ Standpipes/foundation cleanout per record drawing
Date of pumping 6/14/19
D. ABSORPTION FIELD DATA
F1
-GEG DID NOT EVALUATE THE WATER STORAGE SYSTEM
P
C. LIFT STATION
❑■ Required maintenance completed'
Age of lift station 16 ears
9 Y
Lift station material FIBERGLASS
Comments:
*LIDS FROZEN SO MEASUREMENTS NOT TAKEN
Which system tested (date installed) 1/7/04
Adequacy test date 4/8/20
Al ALL standpipes present per record drawing
Results ❑✓ Pass For 4 bedrooms
Total measured depth from grade *3.25 ft (max)
Fluid depth prior to test 3 in
Measured depth to pipe invert from grade ft (min)
Water added 609 gal
❑■ N/A — pressurized field
New depth 4 in
❑■ Monitor tubes go to bottom of effective. If not, state
Elapsed time 10 min
depth into effective
3
❑1 Code -required soil cover over field
Final fluid depth in
❑ System presoaked
Absorption rate 600+ gpd
(Required if vacant for greater than 30 days prior to
Any rejuvenation treatment (past 12 months)
date of test)
N/A
Gallons introduced gallons
If yes, enter date N/A
Comments/Deficiencies: 'DRAINFIELD IS INSULATED .-PIPE LABLED ST1 ON RECORD DRAWING IS ACTUALLY A 24" MANHOLE
COSA Checklist yellow sheet
In
t
NONE
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
❑✓ Yes
50 +
Sewer Manhole/Cleanout > 100'
❑ Yes
if No
ft
✓❑ Yes
if No
Neighboring Tank > 100' ❑✓ Yes
if No
ft
Private Sewer/Septic Line > 25' ✓❑ Yes
if No
Absorption Field on Lot > 100' ❑ Yes
if No
50'+ ft
Holding Tank > 100' ❑✓ Yes
if No
Neighboring Absorption Fields > 100'
Surface Water > 100'
❑ Yes
Animal Containment > 50' ✓❑ Yes
if No
❑✓ Yes
if No
ft
Manure/Animal Excreta Storage > 100'
—✓❑
Community Sewer Main > 75' ✓❑ Yes
if No
ft
Yes
if No
ft
ft
ft
ft
ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10' ❑✓ Yes if No ft Surface Water > 100' ❑ Yes if No 50'+ ft
Property Line > 5'✓❑ Yes if No ft Wells on Adjacent Lots:
Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' ❑ Yes if No 50'+ ft
Water Main > 10'✓❑ Yes if No ft Community Wells > 200'✓❑ Yes if No ft
Water Service Line > 10' ❑✓ 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'
❑✓ Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
❑ Yes
if No
*5 ft
Wells on Adjacent Lots:
Water Main > 10'
✓❑ Yes
if No
ft
Private Wells > 100' ❑ Yes if No 50'+ ft
Water Service Line > 10'
❑✓ Yes
if No
ft
Community Wells > 200'✓❑ Yes if No ft
Surface Water > 100'
❑ Yes
if No
50'+ ft
F. ENGINEER'S COMMENTS
*WR#030107
G. ENGINEER'S CERTIFICATION
1 certify that 1 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
#AECC884
05/06/2019 13: 15 0l P6770
t� ■i iMi■1� M■■
■- ■ 'i ■ ■■M iii
0 1M■■ ■ 111111111
APLUS
3313 950
M■ )Mii�A >r
FA
�dvanmaxll Field Maintenance Report
Annual inspection
prep" thvr>wr/rmukh. F
Mathew MoSorley
SIM AComss
15330 Pollock Drive, Anchorage AK 99518
AX ako IDN �;03048�--
AX-105110
i?etrieve O&M info
Dally flow
Recirc ratio_
Timer settings;
Perform Field SarnplinglObservations
T•frLl (15;t MTUs)
p9)
Inspect
i` -s}
Riser/Lld ........ . ........... gr
Splice Box ....................
Float Cords .. ........ .......
4
Odor of Sample -
Typical .Igty ❑I Earthy ❑ Moldy
Non -typical ❑ Sulfide ❑ Cabbage ❑ flecaY
oily film in PVU ❑'Yes
�No
Foam in tank ❑Yes
Check Contra[ Panel
Retitc Amps
Comments ,
Pisch Amp$
1arcge
Audible and visual alarmsCK
Dial tone (telemetry only)Yas
❑ No
Inspect/Clean PumP System
clean
Inspect
Clcon
Riser/Lld ........ . ........... gr
Splice Box ....................
Float Cords .. ........ .......
4
Floats . . ........ ........ ....
Pump...................... .�
. • . • .
Biotub,e Filter... • • .. • • •
Blctuba Pump vault ....... • • • • .
Recirculating SPlitter ValVO........
!
�-Yd
Comments ,
Signature Z f
1A■■ ■ O
■ »
111111111111115
operator
Larry Betts
PAGE 01
Anchoracll,'Tank
907-2 :: '.-354:3
corttnct Pone
907-248-4199
Pod 8 m'll 81U6 N Data of Last lnapocilort
20-446 RTU10255.3 05/07!2015,
measure Sludge/SCUM
Sludge Scum --�
1 at com�aartmAnt Current previous Curmnt TrelvkollS
2nd Compartment Current Previous current PmVioU$
Inspect/Clean Advanitex Filter
Odor: fk—�Normnl ❑Pungent
aiamat; Normal ❑ F-Xcossive
BtldgingiPonding: �Nono/Mlnor I J Excessive
Inspoct/Clean Discharge PUMP system
Inspect
Riser/Lld
SPlide Box
Float cords
Inspect/Service Other System) Components
Insppefct Clean
I -y.
Olalnfectlon Equipment I.- claps
Observations
Im"Oect
clean
Laterals/prfficas p'S
En
pod Bottom
Inteka Vent
4
impect Clesn
Floats
Pump
Innpect clson
rfal Latet'aiS/orlticeio 2s— 4111
Additional Services Rendered
❑ Gleaned tox lie sheets? ❑ Replaced UV Items?
❑ ReplaceclMsed other items?
Parts Used: W = Warranty, B = Billable (vl appropriate selactlon)
Final/Safety inspection
IaSV reinstalled &'.ids bolted an
danlfeld reconnected; flush valves closed f Control pants reactivated
Summary/Recommendatlons
❑ System performing; na further action needed `.ink needs pumping
❑ Cail for service ❑ Other?
Date 5
pax completed form) to i-866-384-7404
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered
t into as of this Day of ��� (/ of 20 AAO, by and between
UI VIN 1��yN , herein the "OWNER," and the Municipality of
Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Svstems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater "Treatment System (AWWTS),
described as
located at (legal description)
2. Maintenance, Repairs and Alterations.
(Owner is required to read, understand and initial each section)
6`5 Throughout the term of this Agreement, the Owner shall enter into a service agreement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
accordance with the equipment's approval for operation in the Municipality.
It shall be the responsibility of the Owner during the term of this Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically 5400 to $600)_
�7 Owner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
Owner acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfleld
replacement.
(rev. 05/18/2018) Pagel of 3
Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
b$77 Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
&F2 Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
615 Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AWWTS.
Cf7 Owner agrees to maintain remote monitoring of the AWWTS as required by the
A W WTS approval.
3. Tcrm. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in' the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7. Severabilitv. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
(rev. 05/18/2018)
Page 2 of 3
OWNER:
By: G��!"�/ (signature) Date:
(print name)
STATE OF ALASKA )
ss.
THIRD JUDICIAL DISTRICT )
They ga`eg(ing in trument was acknowledaed before me this day of
i <l`RY PU LIC FOR ALASKA 7KATTHERINEA.HALVORSON
tary Public
bv
nexpires: € 1�(/ eoiAlaskan Expires Dec 7, 2021
MUNICIPALITY:
By: �1 Alii toy (signature)
i-0 (print name)
Date: i a ?i' 9017a
t
Title:
(rev. 05/18/2018) Page 3 of
Municipality of Anchorage
• �` Development Services Departm
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6
www.ci.anchorage.ak.us
(907)343-7904
CERTIFICATE OF HEALTH
FOR A SINGLE FAMILY
Parcel I.D. 017-1 12—X 3g
1. GENERAL INFORMATION
ITY
MM`
W
APPR6VAL
Expiration Date:
Complete legal description POLLOCK HOMESTEAD SUBDIVISION; LOT 10, BLOCK B,
Location (site address or directions) 15330 POLLOCK DRIVE * ANCHORAGE, AK. 99516
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
RYAN MATHIAS Day phone 240-8430
13120 LUPINE ROAD * ANCHORAGE. AK. 99516
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
Day phone
Day phone
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
0
Individual On-site
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid
water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water
system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's
work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, t verify that my
investigation, based on procedures outlined in the Health Authority 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.
Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone
337-6179
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 0
Engineer's Comments:
In conducting this evaluation, GEG, Ltd. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described 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 soils condition, groundwater 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 the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for bedrooms.
Septic System Advisory Supplemental Engineer's Reort
Well Flow Advisory
M
(Rev. 12101)
Other
Original Certificate Date:
Municipality of Anchorage
• "'� Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.cl.anchorage.ak.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
uE Bpi
O P
S. �O
sa ery
Legal Description:POLLOCK HOMESTEAD SUBDIVISION; LOT 10, BLOCK B, Parcel ID: 017-112- 1 `ib
A. WELL DATA *CASED TO BEDROCK
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (YIN) YES
Date completed 6/11/2004 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth 166 ft. Cased to *72 ft. Casing height (above ground) 18+ in.
FROM WELL LOG AT INSPECTION
Date of test 6/11/2004
L�
Static water level 40 ft. � ft.
Well production 3.0 g.p.m. 9—
p.m-WATER SAMPLE RESULTS:
Coliform 0 colonies/100 ml. Nitrate 0.1 mg./L. Other bacteria 2 colonies/100 ml.
8/2/2004 &
Arsenic: N/A mg./L. Date of sample: 8/5/2004 Collected by: GEG, Ltd.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material FIBERGLASS/ORENCO Date installed 1/6/2004
Tank size 1500 gal. Number of Compartments E Cleanouts (Y/N) YES
Foundation cleanout (Y/N) *NO Depression over tank (Y/N) NO High water alarm (Y/N) YES
Date of pumping NEW Pumper —
C. ABSORPTION FIELD DATA BELOW FINAL GRADE
Date installed 1/6-7/2004 Soil rating .p.d./ rft2/bdrm) 6_0 System type
Length 30 ft.
Width 5 ft.
Gravel below pipe
TRENCH
0.7 ft.
Total depth *3.19 ft. Eff. absorption area 1150 ft' Monitoring tube YES Depression over field NO
Date of adequacy test — Results (Pass/Fail)
Fluid depth in absorption field before test
Elapsed Time: = min.NEW—= in. Absorption rate >=
(past 12 mo.) (Y/N & type)
For 4 s
New depth =in.
g.p.d.
If yes, give date —
D. LIFT STATION
Date installed 1/6/2004
TIMER/
"Pump on" level at 13.5 in,
Datum B.O.T
E. SEPARATION DISTANCES
Size in gallons 1500
TIMER/
"Pump off' level at 13.5 in.
Manhole/Access (YIN)
YES
High water alarm level at 46/24 in.
Cycles tested NEW Meets alarm & circuit requirements? YES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+
Absorption Feld on lot 100'+
Public sewer main N/A
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Sewer /septic service line 25'+ Holding tank N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line **5' Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain 25+ Wells on adjacent lots 100'+
F. COMMENTS
*CURTAIN DRAIN OUTFALL AND DRAINAGE DITCH FITTED ALONG ROAD WITH
G. ENGINEER'S CERTIFICATION
i certify that I have determined through geld inspections and Y*
review of Municipal records that the above systems are in "" ""' "' ""
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name JEFFREY A. GARNESS aQ mY-7 5Y
Date �� 3010 tic �— ...........
HAA Fee $
Date of
Receipt Number
(Rev. 12101)
Waiver Fee $
Date of Payment
Receipt Number
08/13/2004 09:36
Y
ScA1-r
/"a 30`
9072432081
FRED WALATKA & ASSO
I
ZS //81''58'z 5'E 14•0,l� I
ftaben L. `crinrr �"a'
LS 7071
ASEMENTS OF RECORD, OTHER THAN F6 04- Al
HOSE SHOWN ON THE RECORDED
LAT ARE NOT SHOWN HEREON. %5' $-0
ON
C
REv15gD f CORREcT(rp 2 -11 -64 -
AS -BUILT
-II -6 --AS-BUILT NO CORNERS SET THIS DATE
ME
PAGE 01
SL" 3?,4
-3-
I hereby certify that I have performed a Mortgagee's inspection
of the following described property: /U
54 DlvrSloal
Anchorage Recording Precinct, Alaska, and that the
improvements situated thereon are within the property lines and
do not overlap or encroach on the property lying adjacent
thereto, that no improvements on property lying adjacent thereto
encroach on the premises in question and that there are no
roadways, transmission lines or other visible easements on said
Property except as indicated hereon.
Dated at Anchorage, Alaska
this /o 4 day of TLILY 20 0
FRED WALATKA & ASSOCIATES
(907) 248-1666 Engineers and Surveyors
Wr
I
0 WELL
1!
Ih
' N 2 STORY � ZB•-' N
I w
\
HOUSE
13
77AMa
.. ? 4
Cit
I
e
Q
I 7
ti
55P�1a*P�
Wr�I
1S
I/V
e9° 58 'zs "E
ftaben L. `crinrr �"a'
LS 7071
ASEMENTS OF RECORD, OTHER THAN F6 04- Al
HOSE SHOWN ON THE RECORDED
LAT ARE NOT SHOWN HEREON. %5' $-0
ON
C
REv15gD f CORREcT(rp 2 -11 -64 -
AS -BUILT
-II -6 --AS-BUILT NO CORNERS SET THIS DATE
ME
PAGE 01
SL" 3?,4
-3-
I hereby certify that I have performed a Mortgagee's inspection
of the following described property: /U
54 DlvrSloal
Anchorage Recording Precinct, Alaska, and that the
improvements situated thereon are within the property lines and
do not overlap or encroach on the property lying adjacent
thereto, that no improvements on property lying adjacent thereto
encroach on the premises in question and that there are no
roadways, transmission lines or other visible easements on said
Property except as indicated hereon.
Dated at Anchorage, Alaska
this /o 4 day of TLILY 20 0
FRED WALATKA & ASSOCIATES
(907) 248-1666 Engineers and Surveyors