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HomeMy WebLinkAboutCROSS VIEW ESTATES BLK 2 LT 21Cross View Estates Block 2 Lot 2! #015-$01-67  Municipality or'Anchorage :?'->' %. Development Services Department ~' ~."' ~ Building Safety Division '~ ~ On-Site Water and Wastewater Program, 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 Page of w~v.ct.anchorage ak.us (gO7) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. Sw070251 PID Number. 015-301-67 ~ Chadie and Angela McAIlen Wastewater System: (~ New [] Upgrade ~ 5316 Herffage Heights Ddve Anchorage, AK 99516 ABSORPTION FIELD ~ 2424)546 ,u,~=o~,~ 4 [~Dee~TmnO'~ D$~,~Tmm;n i'lBed Qi~,x~¢l LEGAL DESCRIPTION .9 ~.:~ 10-11 ~,. ~ 2 ~'a 21 suee,,~t Cross View Estates 3-4 n. 7 Ft 1-2 F~. 76 Well: (7] New I--~ Upgrade c.,~,~,,~= 3 F~. ""~"1'1°~:* ~-'~' Private 184 F~. 184 FI 1,064 ~ ASTM D3034 PVC Sullivan Water Wells 10/8/07 139 Ft Red Dog Excavating 11/7-12/07 10 GPU Ft 2 SEPARATION DISTANCES IZ]sep~¢ nHolding I-IS.T.E.P. l-IOther; Tank Field Station Tank S~r Line Anchorage Tank 1,250 w~ >100' >100' N/A N/A >25' Steel Two (2) s~=w,. ,lO0' >1oo' N/A N/^ ~ / LIFT STATION faLSe >5' >10' N/A N/A ~.~,o~ >5' >10' N/A N/A ~ ~ ~ ~ None Noted """'"' BENCH MARK Garage Slab "3'~'' ., ~. O!=~ ~,. 100.0 Er'~l[le~'~,.s Stamp Inspections performed by: A. Harala Dates: 1a 11/~r2o07 _~..'~. 2'~ 11112J2007 ~ ~:,,~_o-'%-° ~ o.~,o,~.~.e Development Services Department Approval~ .... .,~ '""" ' Condttional Approval Date:. Reviewed and approved by: f,~_/) ~/ Date: -S ! 1 / / l / I I I I I I E Z I I Pen'nit Number:. SW070251 Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904 On-Site Wastewater Disposal System or Well Inspection Report Page 3 of 3 PID No. 015-301-67 99.5 98.0 87.1~ ~80.0 87.1 Drainfleld Rock 76' (Trench Leng~) PROFILE AS-BUILT Sc, ate _ee-C,~*~:''' i -'"-.'~--~'e,~ ,,.'-'".-' .,i~-'...Y '. =...../:....4.~.~..,.....~D~..,~.~...,~, ;..~-. -.~./E# · ",-~.'... No. m-4:~.... _,~'-, -'-'~'~ DEVELOPMENT SERVICES DEPARTMENT ~'Lq,~.. [ SOILS LOG- PERCOL^T ON TEST [ PAR~LIDa: TEC~C~: ~. H~RALA ,~m~ [ TEST HOLE 4 (f~) '~ OB/OG SLOPE ~ITE PLaN 4~ · · " SEE SITE P~ 6~ 4' 7~ .' SILTY S~ND WITH GRAVEL 9 ~ 'd SH II .~. 3ROSS TIHE NET TIHEI DEPIH TO WATER N~T DRQF 13~..~ Co~a~s TO 12' D~TE ~E~D~NG (.~.UTES)(.tUUTES) ~ 0UC.ES) UUC.eS) 14~ ~ .' lEST HOLE PRESOAKED PRIOR TO TESTING: 11/07 1 1:41 5.50" 15~ ' a 2 2:11 30 7.75" 2.25" 3 2:12 5.62" 17~ 4 2:42 30 7.75" 2.13" 18-- 5 2:43 5.37" 19~ 6 3:13 30 7.50" 2.13" 20~ PERCOLATION~i 14 (M~C}~ PERC. HOLED~, 6" ~CHES) TEST R~ BE~EN: 6.5 .~. ~d 7.5 ~. COMME~S: T[Sl HOL~ P~ $O~E~ PRIOR ~0 ltST. TEST PE~O~MED BY ANDERSON ENGINEE~NG. I, MICt~EL E. A~E~ON CERTIFY ~AT THIS WAS PE~O~ED IN ACCO~ANCE WITH ALL STATE A~ M~ICIPLE G~DELI~S ~ EFFE~ ON ~IIS DATE: 10/I/~00~ ertifiel rilL1Ling by DOC CO. dba SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 ,TELEPHONE 688-2759 DATE: PERMIT NUMBER:"~ Is well I~at~ at app~v~ pe~it I~ation? ~.Yes ~ No Meth~ of Drilling: ~air mta~ Q cable t~i ~=~ ,~.~w~,, ~,~e~ D~v .,~c~e~ Di=eter ~" inches, depth / ~4feet Dn~ Type: Oasing Stickup Above Ground: ~ , feet Static Wat~ L~el: 13~ feet Meth~ of Testing: Well Intake Opting Type: ~n end O open hole O Scr~n~; S~d f~t Stop~d _ feet O Perforati~s Sta~, feet Stop~d feet ~pth: from ~ feet, to [~) . feet Well Disinf~t~ Upon Co~l~ti~n? ~Yes Q No ~eth~ of Disinf~tion: .~omments: Driller's Name C~,),~ ff~l{!//I]'~l/x A'I-rENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmeritual Conservation. MatSu Borough: Department of Environmentat Conservation. Mat~ Begich Mayor Well Drilling Permit Number: SW Parcel Identification Number:. Development Services Depa~l'ment Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, Al( 995[9-6650 www muni orq/on$ite (907) 343-7904 Pump Installation Log Date of Issue: Replacement Only: YES NO Legal Description Lot 21, Block 2 Crossview Estates Pump Installation Date: 1-5-08 --~[Prope7 Owner Name & Address: ICharhe MaAIlen Pump Intake Depth Below Top of Well Casing: 175 feet Pump Manufacturer's Name: Grundfos ?ump Model: 15SQE07-180 ?ump Size 3/4 hp Pitless Adapter Burial Depth: 13 feet Pitless Adapter blanufacturer's Name: Campbell itless Adapter Installer: Unknown Veil Disinfected Upon Completion? [] Yes [] No ~,lethod of Disinfection: l~ecirc. Pump Installer Name: Aarow Pump & tVell Service LLC 907-346-9355 Anchorage, AK 99516 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. MUNICIPALITY OF ANCHO~GE Development Se~ices Depadment On-Site Water & Waste~ter Pr~ram 47~ South Bragaw Street P.O. Box 1966~, Anch~age, AK 99519~6~ (907) 343-7~4 ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Date Issued: Sap 17, 2007 Expiration Date: Sep 16, 2008 Permit Number: SW070251 Legal Description: CROSS VIEW ESTATES BLOCK 2 LOT 21 Design Engineer: 0014 ANDERSON ENGINEERING Owner Name: CHARILE & ANGELA MCALLEN Owner Address: 5021 E. 98TH AVE ANCHORAGE, AK 99516- Parcel ID: 015-301-67 Site Address: 5316 HERITIAGE HEIGHTS DRIVE Lot Size: 43289 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] DisposalField [] Septicmank [] 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 inspect[on. 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. Issued By:. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Prcgram 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 www. muni.org/onsite (907) 343-7904 ON-SITE SEWERJVVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-301-67 Property owner(s) Charfie & Angela McAIlen Mailing address 5021 E. 98th Avenue Anchorage. AK Site address 5316 Heritage Heights Drive Anchorage. AK Day phone 242-0546 Zip Code 99516 Zip Code 99516 Legal description (Sub'd., Block & Lot) Lot 21, Block 2. Cross View Estates Subdivision Legal description (Township, Range & Section) Lot Size 43,289 .Sq. Ft. Number of Bedrooms Four (4) THIS APPLICATION IS FOR (~;;~ all that apply): THIS APPLICATION IS AN: Absorption Field [] Initial Septic Tank [] Upgrade Holding Tank [] Renewal Privy [] Private Well [] Water Storage [] [] [] [] I certify that the above information is correct. I further cer~fy that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Waiver Fees: Date of Payment; Receipt Number:. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) September 10, 2007 Municipality of Anchorage Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Su~e~: Lot 21, Block 2, Cross View Estates Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 21, Block 2, Cross View Estates Subdivision intends to construct a new four-bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new well and septic system to accommodate the home. The attached Site Plan and backup documentation identify the location and configuration of the proposed well and septic system along with the alternate site. Also identified on the plans are the existing wells and septic systems on surrounding lots. No conflicts exist between the proposed septic system and well or septic systems and wells on adjacent lots. Drainage arrows are shown on the site plan showing the grade and direction of flow on the lot. The drainage pattern will not be changed as a result of this project. The test holes placed on the lot in the area of the absorption trench and alternate site indicate silty sand with gravel (SM). The percolation rate of the soil was determined to be 6-15 minutes per inch. No groundwater was found during the placement of the test holes and none was noted during the monitoring period. An application rate of .8 gallons per day per square foot was used in the design of the absorption system. We are proposing to place a new 1,250-gallon septic tank and a 54' long by 3' wide by 7' effective depth absorption trench to treat and dispose of the effluent generated in the house. The elevation of the distribution line in the absorption trench will be 4' below the surface and the total depth will be 11'. A minimum of 3' of fill or 2" of insulation and 2' of fill will be placed over the absorption trench and 4' over the septic tank. The ground surface on the lot in the area of the septic system slopes to the north. The new trench will be constructed parallel with the slope as much as possible in conformance with Municipal requirements. The new septic system will be constructed a minimum of 100' from all wells and any surface water and 10' the proposed and existing Lot 2t, Block 2, Cross Point Estates Subdivision September 10, 2007 Page Two water services in the area. If the system is constructed in accordance with our design the following statements apply: The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. The system, if constructed as designed, will have no adverse impact on drainage pattems in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments 7 N 00'08'17~E~ 1~0.00' I I I I I I N O0'O~'Sg'w (Dm © LOT 21, BLOCK 2, CROSS VIEW ESTATES SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home Deep Trench System Pert. Rate: 6-15 Min./Inch 1,250 Gallon Septic Tank Application Rate: .8 GPD/SF 7' Drainfield Rook 4 Bedrooms X 150 GPD/.8 GPD/SF (Application Rate) = 750 SF Absorption Area 750 SFI14 SF/LF = 53.57 LF Trench Length THEREFORE: Construct a 54' Long x 3' Wide x 7' Effective Depth Absorption Trench at the Location Shown. Flow Line Elevation in Trench to be 4' Below Odginal Ground Surface. Total Depth to be 11' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption Trench. Maintain 100' Separation from Wells in the Area. Natural Backfill GeotextJle -- Fabdc 4" Perforated PVC (Holes Down) Drainfield Rock TYPICAL DEEP TRENCH SECTION (NO SCALE) NOTE: G~de Area Over Trench to D~in A~v. Mn'mum 6' Sepamt on From B~k M,nlmum 4 Sepamt,on From Gmun~ter. Minimum 100' Sepa~fion From Wells in ~e Area ~~~'~'~ Minimum 100' Sepam~on From Su,a~ Water o/SEeams.~ **;~.....? -, / ~..,'~ MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT Z+700 BRAGAW STREET ANCHORAGE, AK c)9519-6650 SOILS LOG - PERCOLATION TEST [ LEGAL DESCRIPTION: LOT 21, BLOCK 2, CROSS VIEW ESTATES SUBDIVISI PERFORMED FOI~ CHARLIE MCALLEN DATE: 8 / 15 / 20O? PROJECT No.: PARCEL ID#: TECI-INICIAN: DEPTI I If cci) 1 2 3 4-- 5-- 6-- 7 8-- 9 11 OB/OG SILTY SAND WITH GRAVEL SM TEST tlOLE 1 ] A. HARALA SLOPE WAS GROUND WATER ENCO~N'I'ER ED~ No COBBLES TO 12' BOH @ 18' SITE PI~AN SEE SITE Pm 5% -- (MINUTES) ](MINUTES) I (iNCHES) [ (INCHES) [ TEST HOLE PRESOAKED PRIOR TO TESTING: 9/09 [ I 6:10 3.63" I 2 6:40 30 5.81" 2.18" ] 3 6:41 3.75" I 4 7:11 30 5.88" 2.13" I 5 7:12 3.25" 6 7:42 30 5.38" 2.13" PERCOLATION RATE; 14 (MIN/INCII) PERC. IIOLE DIA, 6" (INCHES TEST RUN BETWEEN: 4.5 FT. and 5.5 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY ANDERSON ENGINEERING. l, MICHAEL E. ANDERSON CERTIFY TilAT Tills WAS PERFORMED IN ACCORDANCE WITtl ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE.'. 9/10/2007 ~700 DEPTII 1 2-- 3-- 4-- 6 7 8-- 9 11 20- MUNICIPALITY OF ~,NCHORAGE DEVELOPMENT SERVICES DEPARTMENT BRAGAW STREET ANCHORAGE, AK, 99519-6050 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: PERFORMED FOR: DATE: 8/15/2007 PARCEL ID#: LOT :::)1, BLOCK 2, CROSS VIEW ESTATES SUB. CHARLIE MCALLEN PROJECT No.: TECHNICIAN: OB/O(] SILTY SAND WITH GRAVEL SH COBBLES TO 12' B0H @ 18' A. HARALA SLOPE SITI~ PLAN SEE SITE PLAN WA~ GROUND WATER ENCOUNTT~ED? NO DATE READING GR. OSS T,,EI NET ~[~go JN T DRO. P [MINUTES) J(MINUTES) J (iNCHES) J (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 9/09 I 6:15 2.25" I I 2 6:45 30 4.75" 2.50" 3 6:46 2.38" 4 7:16 30 4.75" 2.37" 5 7:17 2.00" , I6 7:47 30 4.37" 2.37' PERCOLATION RATE; 14 (MIN/INCtl) PERC. HOLEDIA, 6" (INCIIE$ TESTRUN BETWEEN: 6.5 FT. and 7.5 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY ANDERSON ENGINEERING. !, MICIIAEL E. ANDERSON CERTIFY THAT TillS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON Tills DATE: 9/10/g007 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 21, BLOCK 2, CROSS VIEW ESTATES SUBDIVISION GENERAL: The scope of this project includes the procurement and placement of a new 1,250-gallon septic tank at the location shown on the Site Plan. Work also includes the construction of a new 54' long X 3' wide X 7' effective depth absorption trench at the location also shown on the Site Plan. The distribution line in the trench will be placed at 4' below the existing ground surface. Total depth of the trench will be 11' below the existing ground surface. The new absorption trench and septic tank must be placed a minimum of 100' from all private wells and any surface water in the area and 10' from the water service line proposed for the lot. A minimum of 3' of cover is required over the absorption trench and 4' of cover over the septic tank. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. The Contractor must also verify the location of wells in the area and assure that the separation distances are met. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. Contractors installing wastewater disposal systems must be certified by the Municipal Building Safety Division On-Site Water and Wastewater Program for system installations. Owners installing their own systems must receive prior approval from the On-Site Water and Wastewater Program. before beginning system installation. SEPTIC TANK INSTALLATION 1. A new 1,250-gallon septic tank must be procured from an approved source and installed at the location shown. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. Lot 21, Block 2, Cross View Estates September 10, 2007 Page 2 of 3 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct budal insulation. 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield reck and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. Contractor shall vedfy the septic tank and drainfleld are a minimum 100' away from any pdvate water wells in the area, 150' from a Class "C" Well or 200' from any community well. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trench to drain away. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. All pockets of unacceptable materials must be removed and replaced. Lot 21, Block 2, Cross View Estates September 10, 2007 Page 3 of 3 MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality' of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as-built of the completed system. 114 • 6 •, /l Municipality of Anchorage .!'�1' , On-Site Water and Wastewater Program N (907) 343-7904 a ' +q,ji$ Certificate of On-Site Systems Approval 4- �� Parcel I.D. 015-301-67 Expiration Date: C r 0, ~1 /c 6 8 9 1. GENERAL INFORMATION Complete legal description Cross View Estates Block 2 Lot 21 Location (site address) 5316 Heritage Heights Dr. Current Property owner(s) Cooper Family Trust Day phone Mailing address 5316 Heritage Heights Dr. Anchorage, AK 99516 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: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well El Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by40,0" Date: 62 /211 COSA to be released to the engineer,unless otherwise reques by the engineer. COSA Fee $ 521, Waiver Fee $ Date of Payment 6/4N Date of Payment Receipt Number O757767 Receipt Number COSA# 65C/ill2504 Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are)in compliance with all applicable Municipal and State codes, ordinances,and regulations in effect at the time of installation. 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) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 5/31/2018 OF A•••.61 kk } * • hi �\ *�l 6. DSD SIGNATURE � " ' •1• ` 1 System #1 Approved for Yf bedrooms ven R. Pannone: System #2 Approved for bedrooms91°.`0; q�• CE Disapproved �1k ?�OFESS1.0 -4.1 Conditional approval for bedrooms, with the following stipulations: OA pND z 5 SIJ FSS\N o ff✓ pnoGRPM /0,04/70%/i C� r. c %By: Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. • ,e-7.3. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory••-•:\ t Septic System Advisory Arsenic Advisory' ,-; --• Well Flow Advisory Other COSA blue sheet 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: Cross View Estates Block 2 Lot 21 Parcel ID:015-301-67 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 10/8/2007 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 184 ft. Cased to 184 ft. Casing height(above ground) 24+ in. FROM WELL LOG AT INSPECTION Date of test 10/8/2007 5/18/2018 Static water level 139 ft. 140.3 ft. Well production 10 g.p.m. 3.4 g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 0.638 mg/L Arsenic ND ug/L Date of sample: 5/18/2018 Collected by: PES B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 11/7/2007 Tank size 1250 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 b - L1 .I g Pumper A+ Home Services C. ABSORPTION FIELD DATA Date installed 11/7/2007 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.8 GPD/SF System type Deep Trench Length 76 ft. Width 3 ft. Gravel below pipe 7 ft. Total depth 1 1 ft. Eff. absorption area 1064 ft2 Monitoring tube _ Depression over field N Date of adequacy test 5/18/2018 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test in. Water added 600 gal. New depth �l in. Elapsed Time: ,0 min. Final fluid depth aL1 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) N 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 100+ On adjacent lots 100+ Absorption field on lot 100+ On adjacent lots 100+ Public sewer main 75+ Public sewer manhole/cleanout 100+ Sewer/septic service line 25+ Holding tank 100+ Animal containment areas 50+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10+ Property line 5+ Absorption field 5+ Water main 10+ Water service line 10+ Surface water 100+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water main 10+ Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS Survey on file. G. ENGINEER'S CERTIFICATION 414 OF A(,•,Q�lk! I certify that I have determined through field inspections and ,,f p,,`.- �1�� y;� review of Municipal records that the above systems are in 0*: 49 IN /\ •.*T�` conformance with MOA COSA guidelines in effect on this date. ���',.•. Engineer's Printed Name Steven Pannone # . }e '. Po none• p 5/31/2018 6�fig• CE-8149 .•x01 Date ,i�l • s ••42 COSA canary sheet_2-6-15.doc 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. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-301-67 1. GENERAL INFORMATION COSA# ~)~// Expiration Date:. Complete legal description Lot 21, Block 2, Cross View Estates Subdivision Location (site address) 5316 Hedtage Heights Drive Anchorage, AK 99516 Current Property owner(s) Chadie and Angela McAllen Day phone 242-0546 Mailing address 5316 Heritage Heights Ddve Anchorage, AK 99516 Lending agency Mailing address Day phone Real Estate Agent Mailing~ddress .... Un/ess othezwise requested, COSA will be held by DSD for pickup. NUMBER OF. BEDROOMS: Four (4) Day phone 3.-~ ~PE OF WAYER SUPPLY: Individual Well [] Individual Water Storage [] Community Class ~ Well [] Public Water System [] TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding Tank [] Community On-site [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems 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 COSAs upon request to homeowners. Certificates of On-Site Systems 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 sample results. (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, I vedfy that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Pdnted Name Michael E. Anderson, P.E. DSD SIGNATURE ~ Approved for J7L bedrooms. Disapproved. Date 2/14/2011 ¢, Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: ~ -17 "'// (rev. 11/o5) Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastawater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: A. WELL DATA Well type Pdvate Date comPleted 10/8/07 Total depth 184 Cross View Estates Subdivision, Lot 21, Block 2 Parcel ID: 015-301-67 If A, B, or C provide PWSID # Sanitary seal (Y/N) Y Cased to 184 ft. FROM WELL LOG Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) __ AT INSPECTION Y Y >24 in. Date of test 10/8/07 1/25/11 Static water level 139 Well production 10 WATER SAMPLE RESULTS: g.p.m. 142 ft. 4.3 g.p.m. Coliform 0 colonies/100 mL Arsenic: N/D mg/I SEPTIC/HOLDING TANK DATA Nitrate N/D mg/L Date of sample: 1/24/11 Other bacteria Collected by: 0 colonies/100 mL A. Harala Tank Type/Material Septic/Steel Tank size 1,250 gal. Foundation cleanout (Y/N) Date of pumping 2/8/11 ABSORPTION FIELD DATA Date installed 11/7/07 Length 76 ft. Total depth 11 ft. Number of Compartments Two Y. ~ Depression over tank (Y/N) Pumper A Plus Home Services Date installed 11/7/07 Cleanouts (Y/N) High water alarm (Y/N) Soil rating (g.p.d./ft2 or ~/bdrm) .8 GPD/SF Width 3 ft. Eft. absorption area 1,064 ft2 Monitoring tube Y Date of adequacy test 1/25/11 Results (Pass/Fail) Pass Flui'.d. depth in absorption field before test 29 Elapsed Time: 1,268 min. Final fluid depth 29 Any rejuvenation treatment (past 12 mo.) (Y/N & type) N System type Deep Trench Gravel below pipe 7 Y Depression over field For 4 bedrooms in. Water added 646 gal. New depth in. Absorption rate >= 600 N If yes, give date N in. g.p.d. LIFT STATION Date installed "Pump on" level at__ Datum in. E. SEPARATION DISTANCES Size in gallons "Pump off' level at__ Cycles tested in. SEPARATION DISTANCES FROM VVELL ON LOT TO: Septic tank/lift station on lot >100' Absorption field on lot >100' Public sewer main N/A Sewer/septic service line >25' Animal containment areas >50' Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? in. On adjacent lots >1oo' On adjacent lots >1oo' Public sewer manhole/cleanout Holding tank N/A Manure/animal excrete storage areas N/A > 100' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Water main N/A Water service line >1o' Wells on adjacent lots >1oo' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Absorption field >5' Surface water >1oo' Property line >1o' Building foundation >1o' Water Service line >1o' Surface water >1oo' Curtain drain None Noted Wells on adjacent lots >lOO' COMMENTS: Water main >1o' Driveway, parking/vehicle storage **** G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Pdnted Name Michael E. Anderson, P.E. Date 2/1412011 COSA Fee $ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number (Rev. 11/05) II o ~ o~, >~ I IX) Z - re.mc '-<~ CE} i-- ~ o ~>~.-oz --I to o C.n 0 cn Fq Z -0 0 Fq Z ];0T 3:0 3> Z 0 ~ (_hZ z ~ ~o~8~ ~ ~- rq ~ _~ ;;uz z o©rqT _~ ~ ~~o-~ > ~ ~ ~_F~o-< c 0 ~q- 0 ~>~ z 3> _q~ --{ ®e · 30.41' N 00'05'59"W 0 N 00'08'17"E 50.00' © C/go 0