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Municipality of Anchorage
Development Services Department
Building Safety Division
i' 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. SW030155 PID Number. 011-262-37
Name: FREE LAND BUILDERS
Wastewater System: ■ New ❑ Upgrade
Address:
3501 HIGHLAND DRIVE ' ANCHORAGE, AK, 99504
ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 727-3878 3
CID«p Trench ■ Shallow Trench O Bed O Mound O Other
LEGAL DESCRIPTION
sok Ratko:
1.2
Told Depen sem rgbd goer
8.0 (MAX)
CM/S% R
R
Block. Lot. Subdivision:
SKYHILLS #11
e.N AW bo". fmmWW-01rnal peas
Dpm
4.0 (MAX)
Gaeneaer rd Oeper bpipe:
4.0
w1'J •d'
. R
R
Township: Range: Section: —
— —
re oeaea aoerw "r Pear
cro'd Nnettn
40
SEE DWG. R
R
Gerd akefc
of srr:
Dbtanae between ewe:
WELL: ❑ New ❑ Upgrade
5.0 R
1
— R
cbwlemtbn Prtrete, A.9.0. ToW
tore T.
Told aorrytko ens:
400+
Pipe nx twit:
D 3034/ F-810
R
R
so. mi
Drela: Date DrWW:
Stade water lard:
kwbsn
LITTLE DIPPER
Date Yate
7/24-25/2003
R
reels:
Pura ad AD
`°dn° Nigm abs„ crwa '
TANK
aPY
R
R
SEPARATION
DISTANCES
■Septic oHolding 0S.T.E.P. Oether
To
Septic
Abandt on
NTanIk9
k�f wba .GREEK
~ 9b 1000
From
Station
Sewr U1ine
Well
>200'+
>200'+
—
—
—
Yolertd:
STEEL
/Aaribv Of oampa4nrb:
2
Surface water
100'+
1000+
—
—
—
LIFT STATION
Lot Une
5'+
10'+
—
—
—
sin In Ddan:
t/awlaatu r.
on lord OL
d:
faeh .aw .lam at:
Foundation
5'+
10'+
—
—
—
►unV Yoke
aecbw kwpeedwo far oY:
Curtain Drain
NONE
KNOW
BENCH MARK
Remarks:
taadbn and Deealptbn:
TOP OF FIRE HYDRANT
ararwd a..etbr.
0.00 R
ENGINEER'! e
v • S 00
performed by: AKWWC, INC. Dates: 1st 7/24/2003
. . ....Inspections ....�
2nd 7/25/2003
3rd 7/25/2003QO
., of A. Game S.
Development Se 'ces Department Approval
p ` OD
Q� °r�' .. 79 �e
c
Reviewed and approved by: Date: L
'Orofassto^°o��
00400��0
X&
PERMIT NUMBER: AS—BUILT DRAWING PARCEL ro NUMBER:
SW030155 011-262-37
ALTERNATE SITE WILL
REQUIRE THE USE OF
AN ADVANTEX
TREATMENT SYSTEM
PING KEY
LOCATION
tt•t�l
,
N GALLON
SEPTICPTIC TAh K
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-DBL2
11
ALASKA «'ATER & NVASTENVATER SCALE: A.J.G.
CONSULTANTS, INC... = 40 Q . . ............••••
RF.
701 F TUDOR ROAD, SU101 • ANf HORAGF. AK 99507 • MONF (90)1731-0179 • FAX (90)1338-0)<8 0 -
2EPARED FOR: PHONE NUMBER: PAGE NUMBER:
FREE LAND BUILDERS (907) 562-6464 2 OF 3 000 p e r Gar ess:'
:GAL DESCRIPTION: Q �. - 953
SKYHILLS #1; LOT 1, BLOCK 3
PE AS -BUILT DRAWING OF NEW SEPTIC SYSTEM 4����40000�00000
10.6
53.2
15.7
54.6
22.5
52.0
PDBL2
23.9
49.4
7.2
0.80
33.4
37.3
34.0
35.3
CO2
69.6
18.4
MT2
68.6
19.4
,
N GALLON
SEPTICPTIC TAh K
I
-DBL2
11
ALASKA «'ATER & NVASTENVATER SCALE: A.J.G.
CONSULTANTS, INC... = 40 Q . . ............••••
RF.
701 F TUDOR ROAD, SU101 • ANf HORAGF. AK 99507 • MONF (90)1731-0179 • FAX (90)1338-0)<8 0 -
2EPARED FOR: PHONE NUMBER: PAGE NUMBER:
FREE LAND BUILDERS (907) 562-6464 2 OF 3 000 p e r Gar ess:'
:GAL DESCRIPTION: Q �. - 953
SKYHILLS #1; LOT 1, BLOCK 3
PE AS -BUILT DRAWING OF NEW SEPTIC SYSTEM 4����40000�00000
PERMrTNUMBER: A S -BUILT DRAWING PARCH -� NUMBER:
SWO
SW030155 011-262-37
TH#78
1
TOP OF
INLET -
-TOP OF TANK AT
OUTLET - 100.88
/ I I NEW 1000 GALLON I I
INVERT OF BUNG J SEPTIC TANK
INVERT OF BUNG AT
AT INLET - 100.43
OUTLET � 100.14
FILTER
FINAL GRADE
101.73-105.24
rt;•; ; 'i
if'fi' 'iii_•• _�•�••'i'i�i
ORIGINAL GRADE
103.80 O HIGHEST
POINT __�
BOTTOM OF TRENCH
95.80 (AVG)
Iorwjw;or`��� 1 DRAWN BY:
ALASKA «'ATER S «TASTI:«'ATER Ste: A.J.G.
CONSULTANTS. INC. 1 = 40
3701 F TUDOR ROAD. SUITF 101 • ANDHORAGF. AA 00507 • PH F (0071137.6170 • FAX (00713383]46
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
FREE LAND BUILDERS (907) 562-6464 3 OF 3
LEGAL DESCRIPTION:
SKYHILLS #1 SUBDIVISION; LOT 1, BLOCK 3
TYPE OF WORK:
PROFILE AS -BUILT OF NEW SEPTIC SYSTEM
4
.. ... ..... .......
p =, f A. am ss:
o C —79 �Fo
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
Date Issued: May 27, 2003
Expiration Date: May 26, 2004
Permit Number: SW030155 Parcel ID: 011-262-37
Legal Description: SKYHILLS PHASE 1 BLOCK 3 LOT 1
Design Engineer: 0041 AK Water & Wastewater Consultarr Site Address: NHN SKY HILLS DRIVE
Owner Name: KEN JACKSON Lot Size: 41612 SO. FT.
Owner Address: NHN SKY HILLS DRIVE Total Bedrooms: 3 Permit Bedrooms: 3
ANCHORAGE, AK 99502 -
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: 5 *28 -o3
Date:
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ALASKA WATER F� WASTEWATER
CONSULTANTS, INC.
May 9, 2003
Municipality of Anchorage
Development Service Department
Building Safety Division
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Proposed Well and Septic System for Lot 1, Block 3; Skyhills Subdivision #1
To whom it may concern:
The proposed 3 bedroom house is to be served by public water and a private septic system. The
proposed septic system will consist of a 1000 gallon septic tank and a 5 -wide type drainfield.
Two test holes were excavated on the property by Michael E. Anderson, P.E.. The primary and
alternate drainfields will be designed around the 30 foot radii of these test holes. Comments
regarding the design are summarized as follows:
1. SOILS: See the attached Michael Anderson soil logs which shows the soil classifications,
groundwater monitoring, and the percolation test results. The SP material should act as a sand
filter.
2. TRENCH DESIGN:
a.
Percolation Rate: <1 minutes/inch
b.
Proposed Application Rate: 1.2 gallons/day/ft2
c.
Number of Bedrooms: 3
d.
Design Flow: 450 gallons per day
e.
Minimum Absorption Area: 375 112
f.
Total Depth: 8 feet (max.)
g.
Effective Depth: 4
h.
Width: 5 feet
i.
Reduction Factor: 0.50
j.
Minimum Length: 40 feet long
k
Effective absorption area = 400 R2
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic
system.
6901 Debarr Road, Suite 2B • Anchorage, AK 99504
Ph: (907) 337-6179' Fax: (907) 338-3246 0 Website: akwwc.com
4. TOPOGRAPHY: The average topography around the area for the proposed drainfields is a
20%+/- slope running approximately east to west; in short, there are no slope concerns.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you have any questions, please contact us at 337-6179. Thank you for your
M.S.
NOTE: A site plan drawing, a design drawing, two soil logs, and a 7 page construction
specification letter which are all part of the design package for this septic system.
6901 Debarr Road, Suite 2B * Anchorage, AK 99504
Ph: (907) 337-6179 • Fax: (907) 338-3246 • Website: akwwe.com
'ESTI
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SLOT 3. L KY HILLS CK ��I
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ALTERNATE SITE I
SKY HILLS S/D
LOT 1, BLOCK i,
1
1
1 SERVED BY
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OPOSED SEPTIC SYSTEM
(SEE DESIGN PACE 2 OF
2)
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BAR
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LOT 1. TRACY Ar---
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WESTDIAMOND I BARNHILL S/o:
-�•_�_ BLVD, ` LOT z. TRACT A
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CONSULTANTS, DRAWN BY: \.• .. (1\vM1
ALASKA WATER & WASTEWATER
SCALE:C.J.G.
INC..........°
M
6901 DFBAAR R0e0. SUTE iA • eNfNOAAGF. AK 99504 • PNONF (901)111-0179 • FAX (907)338-1T46 1 — 100,
•,
Y'
PREPARED FOR PHONE NUMBER: PACE NUMBER: �
KEN JACKSON 727-3878 1 OF 2 Je A Cam ss:
LEGAL DESCRIPTION: ('(�� o C -7 F r?
SKYHILLS SUBDIVISION #1; LOT 1. BLOCK 3 �V�;ee' •• .....••''�p4�?'
TYPE OF WORK: yvV^3av3fesslov%
SITE PLAN FOR PROPOSED WELL LOCATION AND SEPTIC SYSTEM 4nv ,y ; ; �'
1
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/ PROP;ED
/ WATER UNE
EXISTING KEY
BOX LOCATION
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INSTALL FOUND
CLEANOUT
-ALTERNATE SITE WILL
REQUIRE THE USE OF
AND ADVANTEX
TREATMENT SYSTEM
LON �—INSTALL DOUBLE
CLEANOUTS
NOTE: THE CONTRACTOR SHALL
HAVE THE NORTH PROPERTY LIN
FLAGGED BY A REGISTERED LAND
SURVEYOR PRIOR TO ANY
CONSTRUCTION.
•on1 neoeoo sono mri m . eur�i.no� r.F eF o� DRAWN BY: ��! •• sl�o
.... a C.J.G. //��.' ••' 0
O J: yA
ALASKA WATER & �'VASTKV�'ATER � r
CONSULTANTS, INC. " — tt •• •• ••• ••••••• •• •••
OM1@. • Mnui famm?A1]0 • FG[ f0011SSR V6/. 1 40 'I1
PREPARED FOR: PHONE NUMBER: PAUL NUMtltK: ��
KEN JACKSON 727-3878 2 OF 2 QQ p ff ae s
LEGAL DESCRIPTION: QO of tEZ
SKYHILLS SUBDIVISION #1; LOT 1, BLOCK 3 4,
DESIGN OF PROPOSED WELL LOCATION AND SEPTIC SYSTEM
1 /
PROPOSED DRAINFlELD. EXCAVATE
A TRENCH THAT IS B FEET DEEP
MAXIMUM BY S FEET WIDE BY 40
FEET LONG. ADD 4 FEET OF
CLEAN. WASHED SEWER DRAINROCK.
LON �—INSTALL DOUBLE
CLEANOUTS
NOTE: THE CONTRACTOR SHALL
HAVE THE NORTH PROPERTY LIN
FLAGGED BY A REGISTERED LAND
SURVEYOR PRIOR TO ANY
CONSTRUCTION.
•on1 neoeoo sono mri m . eur�i.no� r.F eF o� DRAWN BY: ��! •• sl�o
.... a C.J.G. //��.' ••' 0
O J: yA
ALASKA WATER & �'VASTKV�'ATER � r
CONSULTANTS, INC. " — tt •• •• ••• ••••••• •• •••
OM1@. • Mnui famm?A1]0 • FG[ f0011SSR V6/. 1 40 'I1
PREPARED FOR: PHONE NUMBER: PAUL NUMtltK: ��
KEN JACKSON 727-3878 2 OF 2 QQ p ff ae s
LEGAL DESCRIPTION: QO of tEZ
SKYHILLS SUBDIVISION #1; LOT 1, BLOCK 3 4,
DESIGN OF PROPOSED WELL LOCATION AND SEPTIC SYSTEM
Mar 25 03 11:02a Palmer/Voliva 907-273-7372 P.2
(ENGINEERS SEAL)
• „ Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825'L' Street. Anchorage, Alaska 99502.0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: L H Construction DATE PERFORMED:
LEGAL DESCRIPTION: LTi • BLE 31 Sky Hills Subdivision
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
f�- /.-
rr
f5M06,-
5N
SM
tG �7LJ �� irr
■■■■■■■R■■
Net
Time
Deoth to
Water
Net
Drop
No
2:�I:ob
TI C2
2:3Lt`I
1-4.c,6
G.o
A..o
■■
EEO
■E
-
J WAS GROUND WATER
ENCOUNTERED? '
S s �
IF YES. AT WHAT �d� C e
DEPTH? p
E
is WWdwAAer 0T.OBa� 8'zc'�b
Reading Date Gross
Time
Net
Time
Deoth to
Water
Net
Drop
2:�I:ob
TI C2
2:3Lt`I
1-4.c,6
G.o
A..o
20 -{ I q Q w
IL_j PERCOLATION RATE —G,G_ Iftunuteymcnl PERC MOLE DIAMETER
TEST RUN BETWEEN FT AND -1 FT
COMMENTS Perc cavity WaS Dresoaked
PERFORMED BY: —.S—p74 1CERTIFY THAT THIS TEST WAS PERFORMED IN
Michael n eraoo
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE.
Mar 25 03 11:02a Palmer/Voliva 907-273-7372 P.1
(ENGINEER'S SEAL)
.r Municipality of Anchorage .
DEPARTMENT OF HEALTH b HUMAN SERVICES
825 -L' Street. Anchorage. Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: L H Construction DATE PERFORMED:
LEGAL DESCRIPTION: LT it BLE3, Sky Hills Subdivision
�. SLOPE SITE PLAN -
1 ��{E1F• i-rG•i
3
• n �}
5 r • �' ,40.9 It 1t s
8 t
9
t0 WAS GROUND WATER —�
ENCOUNTERED?
11 S
IF YES. AT WHAT ,�A� L
O
DEPTH?
12 P
E
tk'ph to Water llaCf Q
13 Mmanilg7 � yr�o"i$
14 Reading Date Gross Net Depth to Net
Time Time MIIJ. Water II Drop
15 80
%V L%�io •'11. 3
16 7 : ►7 13
17
2 4: .j 13. 1*. 01.
16
19
20 { 1 t
IL_ JI PERCOLATION RATE 0'2 Immotesimcnl PERC MOLE DIAMETER
TEST RUN BETWEEN---4—FT AND l 5 FT
COMMENTS Pere Cavity was presoaked
PERFORMED BY: Q7 /1 1 CERTIFY THAT THIS TEST WAS PERFORMED IN
Michael Anderson
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE 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.cf.enchorage.ak.us
(907)343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 011-262-37 Permit Number 5w03 0/35 -
Mailing address (1) 3501 HIGLAND DRIVE • ANCHORAGE. AK
SAAB g-address(2) NNA/ SkYRILL T DRIVE Zip Code 99504
PN
Legal description (Lot, Block & Sub'd.) LOT 11- RLOCK 3- SKYHILLS SURDIVISION V1
Legal description (Section, Township & Range) N/A
Lot Size �, 6 ZAcre q.Ft. Number of Bedrooms 3
THIS APPLICATION IS FOR:
Sewer Only ❑ Well Only ❑
Sewer and Well Water Storage ❑
Sewer Upgrade ❑
THIS PROPERTY CONTAINS:
Hot Tub
❑
Jacuzzi ❑
Swimming Pool
❑
Water Softening Unit ❑
Therapy Pool
❑
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 do WASTEWATER CONSULTANTS, INC.
-{Signature-of-property-owneror-euthodzed-agent) -
Permit Fees: 4 �00 -
Date of Payment: 5.19.05
Receipt Number: 15 6) 157
Waiver Fees*
Date of Payment:
Receipt Number:
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COSA Checklist.docx
COSA Checklist
Legal Description: SKYHILLS PHASE 1 BLOCK 3 L0T 1 Parcel ID: 011-262-37
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____
A. WELL DATA - PUBLIC &/OR CLASS “A” WATER
Well log is filed with Onsite (or attached)
Date drilled Total depth ft
Cased to ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) in.
Date of flow test for COSA
Static water level at beginning of test ft.
Well production at time of test gpm
Water storage tank volume NA gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by
Date
Comments __________________________________________________________________________________
B. TANK DATA
Measured operating fluid level in septic tank 49”
Date of pumping 7/11/2024
Required maintenance completed, if AWWTS
Comments:
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed) 7/25/2003
ALL standpipes present per record drawing
Total measured depth from grade 9.8 ft (max)
Measured depth to pipe invert from grade 4 ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
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) N
If yes, enter date
Adequacy test date 5/30/2023
Results Pass
Fluid depth prior to test 11 in
Water added 600 gal
New fluid depth 11 in
Elapsed time < 5 min
Final fluid depth 11 in
Absorption rate 450 gpd (Absorbed 600 GPD)
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) 48 in
Effective depth used 11 in
Effective depth remaining 37 in
Comments/Deficiencies: Field fluid levels on 7/11/24 were 8”.
COSA Checklist.docx
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) - NA
Septic Tank/Lift Station on Lot > 100’
Yes if No ft
Neighboring Tank > 100’ Yes if No ft
Absorption Field on Lot > 100’ Yes if No ft
Neighboring Absorption Fields > 100’
Yes if No ft
Community Sewer Main > 75’ Yes if No ft
Community Sewer Manhole/Cleanout > 100’
Yes if No ft
Private Sewer/Septic Line > 25’ Yes if No ft
Holding Tank > 100’ Yes if No ft
Animal Containment > 50’ Yes if No ft
Manure/Animal Excreta Storage > 100’
Yes if No ft
N/A – Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10’ Yes if No *5’+ ft
Tank to Property Line > 5’ Yes if No ft
Field to Property Line > 10’ Yes if No ft
Water Main > 10’ Yes if No ft
Water Service Line > 10’ Yes if No ft
Surface Water > 100’ Yes if No ft
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No ft
Community Wells > 200’ Yes if No ft
If tank or field is under driveway comment below
F. ENGINEER’S COMMENTS
*Septic tank to foundation 5’+ per code at install.
G. CERTIFICATION & 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, 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.
Name of Firm FIRST WATER CONSULTING Phone 907-350-9566
Engineer’s Printed Name CURTIS HUFFMAN, PE Date 7/20/24
Comments: This investigation was completed in compliance with MOA guidelines, regulations,
and best industry practices / methods. The assessment of the condition of the well and septic
applies only to the conditions as of the day tested. The flow and absorption rates may change
due to subsurface conditions that may not be observed from the surface, changes in land use,
local soil characteristics, groundwater levels that may fluctuate during the year, quality of
construction (workmanship & materials), the water usage of the family being served by the
system and maintenance. The operational life of all well and septic systems are subject to
these various and dynamic characteristics and are outside the control of the evaluator of the
well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory
for current or future occupants or guarantee that no unseen encroachments, deficiencies or
discrepancies exist can be given by First Water Consulting &
7/20/24
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1�V�11UH C LI TY OF "HCF� 0RR A GE
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. 011-262-37-000
Expiration Date:
Legal description SKYHILLS PH 1 BLK 3 LT 1
Site address 8505 SKYHILLS DR Anchorage AK 99502
Current property owner(s) FENDERSON LAURIE E & GEORGE W
9/13/2023
X The On-site system(s) is/are approved for 3 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories: Per MOA tax records this is a 4 bedroom house.
system is only designed for a 3 bedroom house. Any future upgrades to the septic
system will require a permitted redesign for the existing 4 bedroom house.
The septic
Original Certificate Date: 6/1312023
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 Services 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 work.
ATTACHMENTS:
COSA Checklist
Absorption Field Advisory
Tank Age Advisory
Other
X Well Flow Advisory
Nitrate Advisory
X Arsenic Advisory
COSA Approvdjune 2022
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 Application
1. GENERAL INFORMATION
Parcel I.D. 011-262-37
Complete legal description SKYHILLS PHASE 1 BLOCK 3, LOT 1
Location (site address) 8505 SKYHILLS DRIVE, ANCHORAGE, AK 99502
Current property owner(s) LAURIE & GEORGE FENDERSON Day phone
2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS
3. TYPE OF WATER SUPPLY: ❑ Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ® Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ® Steel ❑ Plastic ❑ Concrete ❑ Fiberglass
Age 20 - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ® Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: ❑
Distance:
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 $ _�3 50
Date of Payment 6d/ -z'3
COSA # CSC 23117 5
Waiver Fee $
Date of Payment
Waiver #
COSA Application.doc
COSA Checklist.docx
COSA Checklist
Legal Description: SKYHILLS PHASE 1 BOLCK 3 L0T 1 Parcel ID: 011-262-37
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____
A. WELL DATA - PUBLIC &/OR CLASS “A” WATER
Well log is filed with Onsite (or attached)
Date drilled Total depth ft
Cased to ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) in.
Date of flow test for COSA
Static water level at beginning of test ft.
Well production at time of test gpm
Water storage tank volume NA gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by
Date
Comments __________________________________________________________________________________
B. TANK DATA
Measured operating fluid level in septic tank 49”
Date of pumping 5/30/23
Required maintenance completed, if AWWTS
Comments:
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed) 7/25/2003
ALL standpipes present per record drawing
Total measured depth from grade 9.8 ft (max)
Measured depth to pipe invert from grade 4 ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
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) N
If yes, enter date
Adequacy test date 5/30/2023
Results Pass
Fluid depth prior to test 11 in
Water added 600 gal
New fluid depth 11 in
Elapsed time < 5 min
Final fluid depth 11 in
Absorption rate 450 gpd (Absorbed 600 GPD)
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) 48 in
Effective depth used 11 in
Effective depth remaining 37 in
Comments/Deficiencies:
COSA Checklist.docx
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) - NA
Septic Tank/Lift Station on Lot > 100’
Yes if No ft
Neighboring Tank > 100’ Yes if No ft
Absorption Field on Lot > 100’ Yes if No ft
Neighboring Absorption Fields > 100’
Yes if No ft
Community Sewer Main > 75’ Yes if No ft
Community Sewer Manhole/Cleanout > 100’
Yes if No ft
Private Sewer/Septic Line > 25’ Yes if No ft
Holding Tank > 100’ Yes if No ft
Animal Containment > 50’ Yes if No ft
Manure/Animal Excreta Storage > 100’
Yes if No ft
N/A – Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10’ Yes if No ft
Tank to Property Line > 5’ Yes if No ft
Field to Property Line > 10’ Yes if No ft
Water Main > 10’ Yes if No ft
Water Service Line > 10’ Yes if No ft
Surface Water > 100’ Yes if No ft
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No ft
Community Wells > 200’ Yes if No ft
If tank or field is under driveway comment below
F. ENGINEER’S COMMENTS
G. CERTIFICATION & 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, 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.
Name of Firm FIRST WATER CONSULTING Phone 907-350-9566
Engineer’s Printed Name CURTIS HUFFMAN, PE Date 6/2/23
Comments: This investigation was completed in compliance with MOA guidelines, regulations,
and best industry practices / methods. The assessment of the condition of the well and septic
applies only to the conditions as of the day tested. The flow and absorption rates may change
due to subsurface conditions that may not be observed from the surface, changes in land use,
local soil characteristics, groundwater levels that may fluctuate during the year, quality of
construction (workmanship & materials), the water usage of the family being served by the
system and maintenance. The operational life of all well and septic systems are subject to
these various and dynamic characteristics and are outside the control of the evaluator of the
well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory
for current or future occupants or guarantee that no unseen encroachments, deficiencies or
discrepancies exist can be given by First Water Consulting &
6/2/23
MUNI MP UTY OF ANCHORAGE
OCA
DEVELOPMENT SERVICES DEPARTMENT ntt
On-Site Water and Wastewater Section
www.muni.org/onsite
Septic Tank Advisory
Certificate of On -Site Systems Approval # OSC231175
Subdivision: Skyhills Phase 1 Block:3, Lot: 1
907-343-7904
Fax: 343-7997
The septic tank for this property is 20 years old. The average life of an asphalt
coated steel septic tank is 20 years. Typical replacement costs are $10,000 or more,
not including engineering, surveying or MOA permitting fees.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
This is an example of what the metal of a 30 year old steel tank MAY look like.
Ellin&LS
•
•, ;_� Municipality of Anchorage °°'
On-Site Water and Wastewater Program
(907)343-7904
Certificate of On-Site Systems Approval
Parcel I.D. 011-262-37 Expiration Date: 41
1. GENERAL INFORMATION
Complete legal description Skyhills #1 B3 L1
Location (site address) 8505 Skyhills Drive
Current Property owner(s) Gerry & Tina Suellentrop Day phone
Mailing address 8505 Skyhills Drive Anchorage, AK 99502
Real Estate Agent Day phone
2. TYPE OF DWELLING:
• Single Family(w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ❑ Individual
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.
COSA Fee $ 5556 Waiver Fee $
Date of Payment l 12-1 16) Date of Payment
Receipt Number 0246,7-D Receipt Number
COSA# OS C 01000 Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,based on procedures outlined
in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater
disposal system is(are)safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that
based on the information obtained from the Municipality of Anchorage files and from my investigation and Inspection, the on-site water supply
and/or wastewater disposal system is(are)in compliance with all applicable Municipal and State codes,ordinances,and regulations in effect at
the lime of installation.
In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA
guidelines and regulations.The reported results describe the performance of the system under the conditions encountered at the time of the test,
and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil
condition,ground water levels that may fluctuate during the year,and the water usage of the family being served by the system.These conditions
are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future
performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty
for future performance, nor can we estimate remaining life of the system.The content of this report is for the sole benefit of the owner listed
above.
Name of Firm Pannone Engineering Services LLC Phone (907) 745-8200
Address P.O. Box 1807 Palmer, AK 99645
Engineer's Printed Name Steven R_Pannone`-,t3 a' Date e12?4______—
i ' ;: 9 +I* , , TH :*
6. DSD SIGNATURE "'=s��S• �;' V
System#1 Approved for __ bedrooms •S{even l onnone,
6 -0.•. CE-8149 .
System#2 Approved for bedrooms ��! ..:z1.1
,�•4 r
''
Disapproved t (0„4.�"
kk\\\�'
Conditional approval for bedrooms, with the following stipulations:
Ie✓' F_vwJ I(Vt e'ei - I S a L'i 13e4 L- o-m ,`tie
, of c .3 s i& c,Q"a ►tea( -�par►� f el ►� 3 �3 ,c.
�"'Ky -?-0•, c)vre Jr � -/-0 Z 4f S�fitvt LA)i i I
kava 4o b.c pv v ►M k f t-4 d r Li f.,d volyvt r .
4.
ON-SITE
WATER AND c ,
WASTEWATER
A '
PROGMLj
By - y--
,_-_ d,,& Original Certificate Date: {^-�-j' e�`
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval(CO'SPQp6AlQd only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet f .
If more than 1 septic system is on the lot:
COSA Checklist# 1 of 1
Structure served by this system 1
Certificate of On-Site Systems Approval Checklist
Legal Description: Skyhills #1 B3 L1 Parcel ID:011-262-37
A. WELL DATA
Well type Public If A, B,or C provide PWSID# Well Log(YIN)
Date completed Sanitary seal (Y/N) Wires properly protected(Y/N)
Total depth ft. Cased to ft. Casing height(above ground) in.
FROM WELL LOG AT INSPECTION
Date of test N/A N/A
Static water level ft. ft.
Well production g.p.m. g.p.m.
WATER SAMPLE RESULTS:
Coliform N/A colonies/100 mL Nitrate N/A mg/L
Arsenic N/A ug/L Date of sample: N/A Collected by: N/A
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic! Steel Date installed 7/24/2003
Tank size 1000 gal. Number of Compartments 2 Cleanouts(Y/N) Y
Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N/A
Date of pumping 9/18/18 Pumper Isaacs
C. ABSORPTION FIELD DATA
Date installed 7/25/2003 Soil rating z
(g.p.d./ft2or ft2/bdrm) System type Trench
Length 40 ft. Width 5.0 ft. Gravel below pipe 4.0 ft.
Total depth 8.0 ft. Eff. absorption area 400 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 12/26/18 Results(Pass/Fail) Pass For 3 bedrooms
Fluid depth in absorption field before test 0 in. Water added 600 gal. New depth 12 in.
Elapsed Time: 100 min. Final fluid depth 0 in. Absorption rate >= 600 g p d
None Known
Any rejuvenation treatment(past 12 mo.)(Y/N&type) If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access(Y/N)
"Pump on"level at in. "Pump off' level at in. High water alarm level at in.
Datum Cycles tested Meets alarm&circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot N/A On adjacent lots N/A
Absorption field on lot N/A On adjacent lots N/A
Public sewer main N/A Public sewer manhole/cleanout N/A
Sewer/septic service line N/A Holding tank N/A
Animal containment areas N/A Manure/animal excrete storage areas N/A
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 101+ Property line 101+ Absorption field 101+
Water main 25 + Water service line 25+ Surface water +
Wells on adjacent lots 1001+
ABSORPTION FIELD ON LOT TO:
Property line 101+ Building foundation 101+ Water main 101+
Water Service line 25'+ Surface water 1 001+ Driveway,parking/vehicle storage 1 01+
Curtain drain 50't Wells on adjacent lots 1001+
F. COMMENTS
G. ENGINEERS CERTIFICATION
' ��.....,,z,..-....N..\‘‘‘,
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I certify that I have determined through field inspections and - ��� .i'
review of Municipal records that the above systems are in *: /\ •.*
conformance with MOA COSA guidelines in effect on this date. 0•• • 9
Engineer's Printed Name Steven Pannone i7' 0 . ":Seven �. annone
Date /5 f z 3 r 4� c�•, CE8149 1
COSA canary sheet_2-6-15.doc
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•
PLOT PLAN _ AS BUILT X SCALE 1" = 50' GRID _ SW 2322— Project No. 18-647/A1 _
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & Associates, •Inc. (907) 522-6476 Phone Qov��p%
Professional Land Surveyors
(907) s92urveycomax OFA \''
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y jonothanOlangsurvey.com 4,F,% !•'' "'•�SN
I hereby certify that I hove surveyed the following described property: O�• O
LOT 1, BLOCK 3. SKYHILLS — PHASE 1 (PLAT No. 99-54) ,� 4.9TH •.,��0
Anchorage Recording District, Alaska, and that the Improvements situated thereon are L
within the property lines and do not encroach onto the property adjacent thereto, that
no improvements on the property lying adjacent thereto encroach on the surveyed O / ��: :
premises and that there are no roadways, transmission lines or other visible 0 73 '••• KENNETH ( a
easements on sold property except as Indicated hereon. d�P•. ik.'2.tt� .•• l
Dated this the —_ Day of _____— —__, --, at Anchorage, Alaska 40��,eR.L•S-5202' oyo
z :: .v � 44‘OFFSSIoNAL thcS�'
It Is the responsibility of the owner to determine the existence of any easements, �OOOpo��
covenants, or restrictions which do not appear on the recorded subdivision plot. AECC963
•
Pannone Engineering Services ac
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail:steve@panengak.com
3 January 2019
Municipality of Anchorage
Development Services Department
On-Site Water& Wastewater Program
4700 Elmore Road
P 0 Box 196650
Anchorage,Alaska 99519-6650
Subject: Skyhills#1 B3 L1
COSA Approval
Ladies and Gentlemen:
We request a COSA approval on the above mentioned property.The Onsite system was designed for a three
bedroom house.The house was built as a three bedroom house and then expanded to four bedrooms.The Onsite
system has been in operation for 15 years without any documented issues and is currently about 10 percent used.
PES conducted an adequacy investigation this month and added over 600 gallons into the system.The water levels
rose 12 inches,and then immediately returned to a dry state when the water was turned off(most likely the 12 inch
rise was caused by hydraulic head from water being introduced into the system.) On average a 4 bedroom house will
have 5 people living in it, with an average waste water production of 50 gallons per day per person for a total of 250
gallons per day. We request a COSA approval for 3 bedroom/600 gallons per day. When the current system fails it
will be replaced with an onsite system designed for 4 bedrooms.
The septic tank was also found to be missing± 1.0' of cover.There is documentation showing two inches of rigid
insulation present, and at the time of inspection 12/26/2018 the water in the both compartments of the septic tank
was not found to be frozen.The septic tank has also been in operation for the past 15 years and has had no
documented issues such as freezing.
Granting this approval will not affect the health and safety of this lot or the surrounding lots now or in the future.
If you have any questions or concerns, please contact me at 907.745.8200.
Sincerely,
•
.
e. Steven R.Pannone ;/�/!
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Steven R. Pannone, P.E.
Owner/Civil Engineer