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Home My WebLink AboutPARK HILLS #1 BLK 1 LT 9Pork Hills lock I Lot 9 017-142 -13 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of I ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP241191 PID Number: 017-142-13 Dwelling: 9 Single Family (SF) n with ADU F-1 Duplex (D) n Two Single Family Project: F1 New [0[, Upgrade Name ARMSTRONG ABSORPTION FIELD n Deep Trench A Wide Trench 1-1 Bed El Mound Q Other Site Address 14642 PARK HILLS DR Phone Number of Bedrooms Soil Rating Tota', depth from original grade 13 1.0 GPDISF, 3.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 2.0 Ft. Gravel depth beneath pipe 1,0 Ft. Subdivision Block Lot PARK HILLS# I BLK 1 LT 9 Fill added above original grade 1.5 Ft. Gravel length 90 Ft. Township Range Sedion Gravel width 5,0 Ft. Beds: Number of lines Distance between lines Ff. SEPARATION DISTANCES Tot Septfc From Tank Absorption 1 Holding Sewer Lift Station Field I Tank Line i Totai absorption area 450 F112 Number of trencnes Dist. between twn--(7hes FU well i 100'+l 150'+ TANK r —1 Septic 0 S,T.E.P. 0 Holq!a 0 Other Manu'acturer Capacity Surface Water 1001+ Gal. Material Number of wrripartments Lot Line + 10, NA 101+ Foundation LIFT STATION Manufacturer Capacity Remarks Gal� Alarm location Electricai installed by Installer MIKE N ANDERSON PE PIPEMATERIAL Housetotank Tankto 3034 drainfield Drainfield 3034 C01MT 3034 Inspector MIKE N ANDERSON PE BENCH MARK (Assumed eievation,, 97.4 ft Inspection 1% 7/12124 dates: 2nd 3td 4" Location and description TOP OF MH LID ON-SrrE WATER AND WASTEWATER SECTION APPROVAL Englneet's Stamp Conditional Approval: Date OF 414'kk� 49TH* 0 a WOO r� vf� * 6 MIC L N. ANDRSCIS! :mc 00 cir, - 9 7ill '9 P V'0 X" , Septic Systemr� Approved Date azrl n Note: this approv ot include well permit requirements, knuv vulV41 101 -a- - Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: PARK HILLS# 1 BLK 1 LT 9 PID No.: 017-142-1 WELL WELL MARK A B MT 40 95 MT2 68 101 MT3 101 92 / / i ELEVATED DECK MT1 \ \ 1 SEPTIC MT2\ / \ RE—BUILD 5—W [)y/SYSTEM i ASBUILAO' SCALE: 1 "=\ TOP OF MH I` I\ \ I I \ I \ � / I I / / / I I I / I i / i ELEVATED DECK MT1 \ \ 1 SEPTIC MT2\ / \ RE—BUILD 5—W [)y/SYSTEM i ASBUILAO' SCALE: 1 "=\ TOP OF MH OG ��•�p�� i= 49TH '. ,w.■...,.,l ... 0. .... w.■..r..,r...r....:... :M SEP71C SMON WATER ® 89 JUNE 2018 N.T.S. '\ :MICHAEL N. ANDERSONe� No. CE 9469 &%.7-116-24•� � I / I I OG ��•�p�� i= 49TH '. ,w.■...,.,l ... 0. .... w.■..r..,r...r....:... :M SEP71C SMON WATER ® 89 JUNE 2018 N.T.S. '\ :MICHAEL N. ANDERSONe� No. CE 9469 &%.7-116-24•� S INSTITUTIONS SPECIFICALLY TO SHOD/ ANY rD LOT LINES AND/OR EASEMENTS; AND IS TURES, IMPROVEMENTS, OR FENCELINES- ON THE RECORD PLA T , ARE NOT SHOYN VG ARE NOT TO BE USED TO DETERMNE VTS. TO EXCESSIVE SNON AND/OR ICE. AS-BUILTSURVEY I" =30' NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT BLOCK PARK HILLSADD'N. 1 (PLAT 82-196) ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLEIMPROVEMENIS SITUATED THEREON ARE WITHIN THE PROPERTYLINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATEDATANCHORAGE,ALASKA THIS 16 TH DAYOF JUL Y 2024 16097 237-75238-8 HOLT LAND SURVEYING 9309 GROVER DRIVE ANCHORAGE,AK 99507 223-8615 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 hftp://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP241191 Work Type: Septic Upgrade Tax Code Number: 01714213000 Site Legal Address: PARK HILLS#1 BLK 1 LT 9 G:3037 Site Mailing Address: 14421 Riverton CT, Anchorage Owner: WHITLOCK CALEB W & NAOMI E Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft Total Bedrooms: De I7artrraent 7/10/2024 7/10/2025 41200 0 Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: t '` �i��f� (;n/ Date: Issued By: Date: �" _? 3 MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section Parcel I.D. 017-142-13 ANCHORAGE 1?()5H ON -SITE SEPTIC/WELL PERMIT APPLICATION Property owner(s) ARMSTRONG Mailing address 14642 PARK HILLS Site address SAME Day phone Legal description (Sub'd., Block & Lot) PARK HILLS#1 BILK 1 LT 9 Legal description (Township, Range & Section) Lot Size 41200 Sq. Ft. Number of Bedrooms 3 Phone: 907-343-7904 Fax: 907-343-7997 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field 0 Initial R Single Family (SF) R. (w/wo ADU) Septic Tank ❑ Upgrade � Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: R ' Z Waiver Fees: Date of Payment: ' U�2- ' Date of Payment: Receipt Number: Receipt Number: Permit No. D_S P ZW I LC I Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc July 8, 2024 Municipalities of Anchorage On-Site Water and Waste Water Section 4700 Elmore Rd Anchorage, Alaska Phone 343-7904 Re: New leach field replacement Legal:PARK HILLS #1 BLK 1, LOT 9 To whom it may concern: This is a request for a septic permit on the existing 5-wide trench, see the attached site plan. The system was rebuilt in 2018 and has failed. We are proposing to raise the existing field 12 inches with MOA filter sand after removing all of the organics. None of this proposed design will impact the surrounding neighbors. The slopes are to the west at about 10 to 12 percent. Sincerely Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241191, Curtis Townsend, 07/10/24 SEPTIC FIELD SECTION DESIGN CRITERIA: 0.5' EFFECTIVE 3 BDRM X 150 = 450 GPD SOILS = 450/1.0 = 450 GPD 450 GA/5 = 90' 5.0' WIDE 90' LONG (1) TRENCH 4.0' DEEP 1. 0 ' 5.0' -4.0 -2.0 MOUND OVER FILTER FABRIC SEWER ROCK 3,3( GRADE 1"=200' PROPERTY LINE PROPOSED NEW REPLACEMENT DRAINAGE FIELD EXISTING HOUSE EXISTING WELL 100' RADIUS - R I V E R T O N C T - SCALE: DJRDRAWN: DATE: PARK HILLS#1 BLK 1 LT 9 Anchorage, Alaska ARMSTRONG 7/8/2024 PAR K S H I L L S & INSULATION -3.0 MOA FILTER SAND SEP T I C SEP T I C Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241191, Curtis Townsend, 07/10/24 1"=50' ALL ORGANIC MATERIAL TO BE REMOVED FROM THE BOTTOM OF THE SYSTEM EXISTING HOUSE DRIVEWAY SCALE: DJRDRAWN: DATE: PARK HILLS#1 BLK 1 LT 9 Anchorage, Alaska ARMSTRONG 7/8/2024 SHE D SEPTIC EXISTING 5-WIDE TRENCH TO BE REBUILT AND RAISED 12 INCHES TYP. WELL WELL MAX 10 - 1 2 % SEPTIC MT MT MT WELL Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241191, Curtis Townsend, 07/10/24 f INSTITUTIONS SPECIFICALLY TO SHOD/ ANY rD LOT LINES AND/OR EASEMENTS; AND IS TURES, IMPROVEMENTS, OR FENCELINES- ON THE RECORD PLA T , ARE NOT SHOYN VG ARE NOT TO BE USED TO DETERMNE VTS. TO EXCESSIVE SNON AND/OR ICE. AS-BUILTSURVEY I " = 30' NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT BLOCK PARK HILLSADD'N. 1 (PLAT82-196) ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLEIMPROVEMENIS SITUATED THEREON ARE WITHIN THE PROPERTYLINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED ATANCHORAGE,ALASKA THIS 5 TH DAYOF JUL Y 2024 HOLT LAND SURVEYING 9309 GROVER DRIVE ANCHORAGE,AK 99507 223-8615 16097 237-75 Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181140 PID Number: 017-142-13 Dwelling: ■❑ Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ❑■ Upgrade Name: Kenneth & Stephanie Moll ABSORPTION FIELD ❑ Deep Trench ❑■ Shallow Trench ❑ Bed ❑ Mound Address 14642 Park Hills Drive Anchorage, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade Three (3) 1.2 GPD/SF 5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 4.5 Ft. Gravel depth beneath pipe •5 Ft. Subdivision Block Lot Park Hills #1 1 9 Fill added above original grade .5 Ft. Gravel length 90 Ft. Township Range Section Gravel width 5 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 450 Ft z 1 Ft. Well N/A >100' N/A N/A >25' TANK ❑ Septic 9 S.T.E.P. ❑ Holding ❑ Other Manufacturer Existing Capacity I Gal. Surface Water N/A >100' N/A N/A Material Number of compartments Lot Line N/A >10' N/A N/A NA Foundation N/A >10' N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain None Noted Gal. RemarksAbsorption trench only replaced under Pump on level at in. Pump off level at in. High water alarm at in. this permit. Pump make and model Electrical Inspections performed by Installer PIPE MATERIAL House to tank Tank to drainfield A Plus Home Services Drainfield D3034 CO/MT Inspector MEA BENCHMARK (Assumed elevation) 100 ft Inspection 1" 6/18/18 6/19/18 Location and description dates: 2nd 3rd 4th Garage Slab. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp pF A(N, >< Conditional Approval: Date ��Q"t . A01*: 49 TH •.* . Michael E. Anderson �� • 4381-E • -0 AW Aw Approve �_ _ Date {C AW li>>�RpFESSIli.."" tt�11 Inspection Report_9-1-12.doc PARK HILLS #1 131 L9 - 14642 PARK HILLS DR PERMIT # OSP181140 LOT 10 \ EXISTING WELL 1 LC � \ EXISTING WELL •�I� te,.._ •. Michael E. Anderson \ E kit 1 PID # 017-142-13 I 1 10' T&E EASEMISNT LOT Ev \ 90' LONG X 5' WIDE X .5' EFF. DEPTH ABSORPTION TRENCH. NOTE: EXISTING STEP TANK VERIFIED SUITABLE FOR CONTINUED USE. NOTE: NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. 0 50 100 FEET 111=50' LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT- MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE PROPERTY LEGAL DESCRIPTION PERMIT # OSP181140 PID #017-142-13 ABSORPTION TRENCH ONLY REPLACED UNDER THIS PERMIT. EXISITNG TANK DETERMINED SUITABLE FOR CONTINUED USE. 103.6 2 f 108.6 FINISH GRADE /- 108.1 ORIGINAL GRADE 2i GEOTEXTILE FABRIC r 11 11 DRAINFIELD ROCK HOLES @ 3' 06C. 1 �- 103.1 �= 90' GROUNDWATER @ 97.1 - 6/11/18 95.1 GE PROFILE AS -BUILT E H G I NEE lI (NO SCALE) 103.1 103.6 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 470Elmore Road Anchorage, Alaska 88519O8aO Po 804 Fax: (3O7)343'799r Permit Number: O8P181140 Work Type: Septic Upgrade Tax Code Number: 01714213000 Site Legal Address: PARK HILLS #1 BLK 1LT 9 G:3037 Site Mailing Address: 14421 Riverton CT, Anchorage Owner: MOLL KENNETH R&STEPHANIE B Design Engineer: FORGE ENGINEERING This permit iefor the construction of: Effective Date: 6/15/2018 6/15/2019 P Disposal Field 1-71 Septic Tank El Holding Tank 0 Privy F -I Private Well El Water Storage All construction shall beinaccordance 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 (18AAC8U) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.G5. Provide notification bycalling (Q07)343-7SO4(24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall beeither: e. Opened and Closed onthe same day, or b. Covered, sealed, and heated toprevent freezing Received By: Date: Issued By: Date: 3 MUNICIPALITY OF A Community Development Department al Development Services Division On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT Parcel I.D. 017-142-13 GE JUN 12 Z0t8 �Ilne: 907-343-7904 ax: 907-343-7997 Property owner(s) Kenneth & Stephanie Moll Mailing address 14642 Park Hills Drive Anchorage, AK 99516 Site address Same h w� Day phone Legal description (Sub'd., Block & Lot) Park Hills #1, Block 1, Lot 9 Legal description (Township, Range & Section) Lot Size 41,200 Sq. Ft. Number of Bedrooms 3 (Three) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field ❑x Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank ElUpgrade ❑X Duplex (D) ElHolding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. 1n,Q,/_ ?-� a,,s., (Signature of property owner or authorized agent) Permit/Rush Fees: .516) Date of Payment: ea 113/19 Receipt Number: n"3aa-1J Permit No. CSS p l??I d 46 Permit App_-'- : :-..:c Waiver Fees: Date of Payment: Receipt Number: Waiver No. R E j E N G I N E E R I N G PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) June 12, 2018 Municipality of Anchorage Development Services Dept- On -Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Park Hills #1, Block 1, Lot 9 — Park Hills Drive Septic System Design and Permit Application Dear On -Site Services Engineer: The existing absorption trench on the subject lot has failed after nearly 22 years of continuous use. We are submitting this permit application for the construction of a new absorption trench. The existing STEP tank will be inspected and verified suitable for continued use. The attached site plan identifies the location of the home as well as the existing well, septic system and the wells on adjacent lots. Due to limited available surface area the absorption trench will be constructed in the same location as the existing trench. No conflicts exist between this proposed system and any other wells or septic systems, whether on this or adjacent lots. The ground surface on the lot slopes to the west at shallow grades in the area of the new and existing absorption trench. No slopes greater than 25% are within 50 feet downslope of the absorption trench. Drainage arrows are shown on the site plan showing the grade and direction of flow. Storm water drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. Wells on this and adjacent lots are shown. The new system will be a minimum of 100' from all wells and surface water, and more than 5' away from the septic tank. Please refer to the attached test hole logs, plan and profile pages for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, _7 - Michael E. Anderson, PE OF A t`sk *:'49 TH •.* ...................... '. Michael E. Anderson : �� ••,4381-E .`�i 6/12/18 PARK HILLS #1 131 L9 - 14642 PARK HILLS DR / NOTE: \ \ \ EXISTING ABSORPTION TRENCH WILL BE -PUMPED TO NEAR DRY CONDITION. ALL CONTAMINATED SEPTIC ROCK AND SURROUNDING SOIL STRATA WILL BE REMOVED \ / AND BURIED IN -THE -DISPOSAL AREA MORE THAN 1 00'FROM ALL WELLS IN THE AREA. \ / UNGONTAAMINATED MATERIAL WILL-BE—USED FOR�BACKFILL OVER THE GEOTEXTILE 10' T&E EASEMENT -FABRIC IN THE NEW ABSORPTION TRENCH: \ \ \VISPOSAL AREA LOT E ` / LOT 10 / \ REMOVE EXISTING ABSORPTION / 1 EXISTING WELL 7 l \ TRENCH AND ALL CONTAMINATION IN 1 ® I \ \ ENTIRETY.ITS LONG XS' DE XO5S90 E F. DEPTH ABSORPTION TRENCH AT THE SAME LOCATION. END OF / I TRENCH EXISTING ® LOT 9 MT I I M EXISTING WELL \ / TH1 .� I \ / ✓ _i EXISTING1,250 \ \ GALLON STEP.. _ / -BDRM HOM — \ / MT NOTE: �O QP VERIFY INTEGRITY OF EXISTING STEP G TANK FOR CONTINUED USE. GE LNGINELLING NOTE: NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE LEGEND i4C_4!k,� PROPOSED SEPTIC SYSTEM CO - CLEANOUT !* *49 •�}� *+I ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS 2C0 -DOUBLE CLEANOUT ,4k:• •• • • /� PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC FCO -FOUNDATION CLEAN( FS - FLOW SPLITTER VALVE ... SYSTEMS. Michael E. Anderson. / MH - MANHOLE �+ �F•• 4831-E ��/� 0 50 100 MT -MONITORING TUBE FEET SV - SEPTIC VENT l : 1 =50' TH -TEST HOLE PARK HILLS SUBDIVISION ##1 BLOCK 1, LOT 9 DESIGN FACTORS: SYSTEM REQUIREMENTS: 450 GPD PEAK FLOW 5' WIDE DEEP TRENCH SYSTEM PERK RATE: .4 MIN/IN VERIFY EXISTING 1,250 -GAL STEP TANK APPLICATION RATE: 1 GPD/SF FOR CONTINUED USE 450 GPD / 1.0 GPD/SF / 5' WIDE " 1 (RED. FACTOR) = 90 LF TRENCH REQUIRED (90 LF SPECIFIED) BOTTOM OF TRENCH: 4' BELOW GRADE FLOW LINE ELEVATION: 3.5' BELOW GRADE TOP OF TRENCH:.5' ABOVE GRADE 31 GEOTEXTILE FABRIC DRAINFIELD ROCK PERFORATEDPVC HOLES. • 16 REMOVE EXISTING ABSORPTION TRENCH IN ITS ENTIRETY INCLUDING CONTAMINATED SOIL AROUND THE PERIMETER OF NEW TRENCH. DISPOSE IN AREA SHOWN. REMOVE ALL CONTAMINATED SOIL FROM UNDER PROPOSED TRENCH AND REPLACE WITH MOA APPROVED SAND. TYPICAL WIDE TRENCH SECTION (NO SCALE) NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY ENGINEEPING *; 49 TH •,* .. ... ..................... '. Michael E. Anderson 6, 4831-E ��il®;�PROFESSI�NP � DEPTH (feet) 1- 2 3 4 5 6 7 8 9 10 11 12 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 ELMORE ROAD ANCHORAGE, AK 99519-6650 SOILS LOG AND PERCOLATION TEST LEGAL DESCRIPTION: PARK HILLS #1 131 L9 PERFORMED FOR: KEN MOLL DATE: 5/31/18 PROJECT No.: PARCELID#: 017-142-13 TECHNICIAN: J. MILLETTE TEST HOLE 1 1 N. SHAPER SANDY SILTY GRAVEL SM/GM WAS GROUND WATER ENCOUNTERED? NO SLOPE Engineers Stamp: SITE PLAN SEE SITE PLAN IF YES « WHAT DEPTH? - L GROSS TIME (MINUTES) 1' OB 0 GRAVEL DATE OF MONITORING: 6 -II -18 P SAND 1 SP/SW SANDY SILTY GRAVEL SM/GM WAS GROUND WATER ENCOUNTERED? NO SLOPE Engineers Stamp: SITE PLAN SEE SITE PLAN IF YES « WHAT DEPTH? - L GROSS TIME (MINUTES) DEPTH OF WATER AFTER MONITORING: 11' 0 NET DROP (INCHES) DATE OF MONITORING: 6 -II -18 P 1 13:31/13:33 13 *PERKED IN SAND LAYER 14 15 16 17 18 19 2 COMMENTS: REPLACE DRAIN FIELD IN PLACE DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH To WATER (INCHES) NET DROP (INCHES) 6/02 TEST HOLE PRESOAKED PRIOR TO TESTING: 1 13:31/13:33 2:06 416 / 1016 6" 2 13:34/13:36 2:21 416 / 1016 6" 3 13:38/13:40 2:27 416 / 1016 6" 4 13:41/13:43 2:29 416 / 1016 6" 5 13:44/13:46 2:28 416 / 1016 6" 6 13:47/13:49 2:27 416 / 1016 6" PERCOLATION RATE: 0.4 (MINANCH) PERC. HOLE DIA_9�INCHES) TEST RUN BETWEEN: 3 FT. and 4 FT. DEPTH (feet) 1- 2 3 4 5 6 7 10 11 12 13 14 15 16 17 18 19 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 ELMORE ROAD ANCHORAGE, AK 99519-6650 SOILS LOG AND PERCOLATION TEST LEGAL DESCRIPTION: PARK HILLS # 1 131 L9 PERFORMED FOR: KEN MOLL DATE: 5/31/18 PROJECT No.: PARCELID#: 017-142-13 TECHNICIAN: J. MILLETTE TEST HO�IA N. SHAPER 1' OB GRAVEL SAND SP/SW SANDY SILTY GRAVEL SM/GM SLOPE SI I E FLAN SEE SITE PLAN WAS GROUND WATER ENCOUNTERED? NO READING IF YES @ WHAT DEPTH? - L DEPTH To WATER (INCHES) DEPTH OF WATER AFTER MONITORING: 111 0 TEST HOLE PRESOAKED PRIOR TO TESTING: DATE OF MONITORING: 6 -II -18 P 14:11 *PERKED IN SILTY LAYER COMMENTS: REPLACE DRAIN FIELD IN PLACE DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH To WATER (INCHES) NET DROP (INCHES) 6/02 TEST HOLE PRESOAKED PRIOR TO TESTING: 1 14:11 416 2 14:41 30 916 416 3 14:43 416 4 15:13 30 916 5 5 15:14 416 6 15:44 30 9 16 415- 16 PERCOLATION RATE: 6.1 (MIN/INCH) PERC. HOLE DIA.--.g--(INCHES) TEST RUN BETWEEN: 7. FT. and 8 FT. WOTM V1.152 313 0 Well LOT 9 2. (D 2.0 0 CL (P 0 CD 24.3 I .-Ret. wall /r8eptic ven "Tank dY 09;, & Z emSZ R=20.00 kpin n \ 0, L=31.42 aF AAW V,>, Jz AV e .. ..... •. W**• r M . 1. lizab th L. Walatko oo 8036 - LS SCALE: V= 50' IL I EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON REJ, FB 18-2, pg 58 UNLESS OTHERWISE NOTED. AS -BUILT NO CORNERS SET THIS DATE I hereby certify that I have performed a Mortgagee's inspection of the following described property: LOT 9. BLOCK 1. PARK HILLS SUBDIVISION ADDITION No, I — 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 the 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 16th day of MAY 2018. FRED WALATKA & ASSOCIATES, L.L.C. Engineers and Surveyors BE 1 907-248-1666 ":" ' ~' Municipality of Anchorage Page ~_._.~of :::': ' DEPARTMENT OF HEALTH AND HUMAN SERVICES · .' . · ENVIRONMENTAL SERVICES DIVISION . p~o. BOX ,196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater .Disposal System and/or Well Inspection Report Permit Number: ,-,~, ~ ~ ~--,,. ,.., PID Number: Name:~..~,~,,~ ~ ~ ~"~"T~, Wastewater System: ~ New [] Upgrade ^d~ess: t4-4'~) p_t~"m~J ~'r. ~,~ ABSORPTION FIELD Phone: ~_~ INo. of~drooms: ~ Deep Trench ~ Shallow Trench ~Bed C Mound Q Other LEGAL D ES C R I PTI O N so, Rating:l · ~ GPD/Sq. Ft. Totali.Depth~/~fromw, ooriginal, grade: Lot: ~ Block:~ ~Subdiv~i°n:~' ~ I Depth, to, pipe/~b°tt°m ~,fr°m ~°rigjnal~ grade: Ft. Gravel depth, ebeneath~ pipe Ft. Township: ~ ~ Range: ~/~ I Section: /~ Fill added a~ove original gra~e: Gravel length~ ~ / ~ ' ~ ~ ~' ~ ~ Ft. Ft. WELL: ~ New D Upgrade Gravel width: ~ Number of lines: Distance ~etweenlines: Classification (Private, A,B,C): Total Depth: ~ Cased To: Total absorption area: Pipe material: SEPARATION DISTANCES a Septic ~ Holding ~ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From' Tank 'Field Station Tank Sewer Lines ~' ~ ~ : Water Lot ~ Cu,aJn ~A .~ .~ ~ . (~ Pump Make & Model IElectricaltnspectionspefformedbY: Drain ~ ~ ? BENCH MARK' ~ Location and Description: ~:lnSpections performed bYj ~~ ~ Dates: 1st ~¢~ ~ ~~,, Department of Heal~ a~d~ ,,~ Humann ~~ervices approval ~{;~'~' ?~0~s~;'~'"' ...... Reviewed and approved by: Z~ ~. '~~ Date: ~'-~'-~? 72-013 (Rev, 9/91) MOA 25 AS-BU1-LT D AWIN6 -- WELL RADIUS ALASKA WATER & WASTEWATER TH MONITORING, TUBE,~ TRENCH, 88 FEET LONG. HOUSE CENTER LID. L~~DCATI~NOF S&S TH MONITORING TUBE, AD=88,5 BD=lT.G AF=44,5 BE=54,6 CG=71,9 DG=BG,8 SEPTIC AS-BUILT, LOT 9, BK 1~ PREPARED FOR: LYNN ROBERTS PREPARED BY~ ALASKA WATER DATE: 9/19/96 PARK HILLS S/D, WASTEWATER SERVICES · DRAWN: GARNESS SCALE: 1' = 30' CE-7953 AS-BUILT ]3RA ING ' ,TOP DF LII) IS )~ENCHMARK, GRDUNI) ELEV, AT TANK : 99,6 (APPROX.> /' ASSUMED ELEV, 100.00 COVER = 6 FEET (~PPROX.) NEW 1~50 ~ALLDN ~TEP TANK, 1,25 INCH PRESSURE ANCHORAGE TANK. INLET INV. 4 INCH DIA, PVC LINE FROM LINE TO NEV TRENCH. ~ = 93.12 ' HOUSE. INVERT AT FDUN~ATIDN = 93,2B, ~RDP FROM HDU~E TANK SET LEVEL WITHIN ,03 FEET. TD T~NK 1.g INCHES, ORIGINAL OR~E DN HIOH SIDE DF TRENCH VARIE~ FROM 10~,2 TD 104.2, LOW SI~E OF TRENCH VARIE~ FROM IO1.B TD 108,B~ ~DTTDN OF TRENCH IS 100.3. MAXIMUM DEPTH = 4 FEE% OROUN~WATER ENCOUNTERED AT ~EPTH OF B FEET IN S&S ENO. TE~T HOLE ON 5/16/96. NO GROUNDWATER ~FDR LOCATION OF M.T's ~EE PLAN ~RAWING TO lO FEET IN ALASKA ~ATER & WA~TE- ~ATER TEST HOLE DN 5/~3/96, ~ ~I.5 INCH PVC, ~ITH 3/16 INCH ~IA, HOLES EVERY ~ / 5 FEET, AND AT EACH EN~, ALL HOLES ~DVN. NDA ~EPTHBEDROCKDF 0R6 FEETIMPERMEA~LEBELDV ]DTTDHSOILS TDOF "~ // ~ FILTER FABRIC DYER 2RAINRDCK ~RAINROCK, ~ ~ORIOINAL ORA~E ~ ~~ ~GROUN~ ELEVATION OVER TRENCH = 104.3+, MINIMUM '~ ~~/~ ], INVERT DF ~RAINPIPE = 101,0 C. TRENCH LENGTH : B~ FEET ~. TOTAL ~D~ORPTIDN AREA = 400 ~Q, FT,+ DEN~HMARK I~ TOP DF LIFT ~TATIDN LI~, A~UME~ ELEVATION = I00,00 ..... PREPARE~ FBR, LYNN ROBERTS ALASKA WATER & ~ASTE~ATER · ...'. DATE~ 9/19/96 DWN: GARNESS SCALE: NTS - AUG'-22-1996 1~:30 AURORA ENG SYS P.O2/L ~rATE OF ALA~4(A OEPARTMENT OF NATURAL RESOURCF~ DIVISION OF MINING & WATER MGMT LOCATION. OF WElL WATER WELL RECORD -- ~.,.~ DE~NSM~URED P~M:~8,1ng top ~gr0unO surfa~ W~L DEPTH: "-*' -" * '~TE D~H TO ~ATIC WATER L~EL: " .......... M~HOD OF DNLLING; ir mt~ ~ c,~le USE OF ~LL: ~'~ome~tic ~ i-ig.tion ~: monitor , CASING $TIC~_~ ft. Diem , . ~ pe~orated ~ o~n hole SCR~ TY~ Dbm: D~ELO~ M~O: ~MPING L~ ~D Y~D: PWP INTAKE D~H: ft H~Jl~we.. ? J INFORMATION= REMARKS; ./I . ~~>.-/~*-,~- MAIL WHITE COPY OF LOG TO: PLEASE ~-m~z.a ~esorese~tve ---- ~ DN~IG~ OF MIN~G & WAT~',MGMT A 3e010 G~ S~m~ NGH~OE AK 09G03-693B ."=~one 4907)259-8639, Nx (907)562-1394 RUG~20-lcJg~ 18:55 89~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PERMIT NUMBER:SW960007 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:ROBERTS LYNN P & LINDA L OWNER ADDRESS:14421 RIVERTON CT ANCHORAGE, ALASKA 99516-4230 PAGE 1 OF ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT DATE ISSUED: 1/16/96 EXPIRATION DATE: 1/16/97 PARCEL ID:01714213 LEGAL DESCRIPTION: PARK HILLS #1 BLK 1 LT 9 LOT SIZE: 41100 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM 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 DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECEIVED BY: ISSUED BY: DATE: ) /( ':ir / ~'~ Adaska Water & Wastcwatcr May 28, 1996 8471 Brookridge Drive ~ Anchorage ~ Alaska 99504 (907) 337-6179 ~ Fail,[907) 338-3246 C o n,.s ~11~114~ ~ n eers Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Seetion P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref.' Septic System Installation for Lot 9, Bk l, Park Hills S/D #1. To whom it may concern: A sewer permit (SW960007) was issued for the subject installation on 1/18/96. The original soils test and design were prepared by S&S F. ngineexing. Ihave been retained by the property owner, Lynn Roberts to inspect the installation, and prepare the as-built drawings. I inspected the site on 5/16/96, and monitored for groundwater. Water was encountered at 7 feet below the ground surface, dictating that the design be modified. Comments regarding the proposed changes are summarized as follows: 1. Soils: An additional soils test was done approximately 55 feet north of the test hole done by S&S Engineering. Below the organic layer the soil transitionedfi'om a coarse gravel to a sandy soil. Between these two layers, at the south end of the test pit, a 6 inch layer of SP-SM soil was encountered. Since the coarse gravel was frozen, I could not nm a percolation test init; consequently, I ran a test in the sandy soil below the frozen SP-SM layer. This soil layer perked faster than i minute per inck Due to the presence of the insitu sand layer we didnot intend to use a sand filter. No groundwater or seeps were encountered. The intent is to limit the total depth of the system to 3 feet, or shallowen In addition, tithe SP-SM soils are encountered during the installation, it is our intent to excavate through it and replace it with coarse sand that is stock piled on the site. A sample of the sand was submitted with this letter. Another change I am proposing is to alter the spacing of the holes in the pressure distribution line. I am planning to use 3/16 inch diameter holes at 5 feet on center. This will put more head on the pump, which is designed to operate at a high total dynamic head (TDH). 2. Trench Design: a. Percolation Rate: <1 minutes/inch b. Application Rate: 1.2 gallons/day/ft2 c. Number of Bedrooms: 3 d Design Flow: 450 gallons per day e. Minimum Absorption Area: 375 t'r2 f. System Type: Wide Trench g. Effective Depth: .5 feet h. Width: 5 feet i. Reduction Factor = N/A i. Length: 80 j. Effective absorption area = 400 fi2 3. Surface Waters: There are no surface waters within 100 feet of the proposed septic system. I am unaware of any adverse impacts this installation wouldhave on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179, or on my digital pager at 1-800-481-1162. Thank you. Sincerely, O~n~ :/{2-o~'s~ltan[ '" Lynn Robertsl.wps THE TRENCH SHALL HAVE A MINIMUM LENGTH OF 80 FEET, AND A TOTAL EFFECTIVE ABSORPTION AREA OF 400 SQUARE FEET. WITH .NATIVE SOIL. AND MOUND. MONITORING TUBE (TYP.) PERFORA TED IN DRAINROCK. NOTE: BOTTOM OF TRENCH, EXCAVATION SHALL BE LEVEL. VARIATION OF 2 INCHES BETWEEN HIGH & LOW SPOTS, __ PROVIDE 2 INCHES OF BOARD INSULATION IF SOIL COVER IS LESS THAN ;3 FEET. INSULATION SHALL COVER THE ENTIRE WIDTH OF THE TRENCH. FABRIC SILT BARRIER DRAINROCK SHALL BE SCREENED PER M.O.A SPECIFICA TOTAL TRENCH DEPTH SHALL NOT EXCEED 3 FEET AT THE DEEPEST POINT. 5 FEET WIDE NO TE: 1. FOR LOCATION OF MONITORING TUBES, SEE THE SITE PLAN. CONSTUCTION PRACTICES, AND MA TERIAL SPECIFICATIONS SHALL COMPLY WITH ANCHORAGE MUNICIPAL CODE 15.65, "WASTEWA TER DISPOSAL REGULATIONS". INCH DIAMETER "PVC. 3/16 INCH DIAMETER HOLE~ ON BOTTOM AT $ FEET CENTER TO CENTER. HOLES SHALL FACE DOWN. DETAIL FOR 5 FOOT WIDE SHALLOW TRENCH: PREPARED FOR: LYNN ROBERTS ALASKA WATER & WASTEWA TER SERVICES DA TE: 5/27/96 DWN: GARNESS SCALE: NTS PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: "~. ,/¥¢?--~-- ~'"~11...,~,,,~ %/~ :Ct-- I 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O DEPTH (FEET) ..... ,...,ri DATE PERFORMED: Township, Range, Section: SLOPE SITE PLAN ~k WAS GROUND WATER ENCOUNTERED? s . IF YES, AT WHAT /,,j pO DEPTH7 , , 'E ! Depth to Water After I",] I A-- - Bonitoring? [}ate: Gross Net ' Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ''~ (minutes/inch) PERC HOLE DIAMETER KC n T~STRUN~ETWEEN 4',O ~TAND E'O ~ PERFORMEDBY:,~.~.~_.~::::~.- O~'~._q~ I~.~ ~z~'%:?-d~-'-'q'~ OERTIFYTHATTH)STES',~WASPERFORMEDIN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON T~IS DATE. DATE: 72-008 (Rev. 4/85) PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH& HUMAN SERVICES 825 "L" Street. Anchorage. Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST DATE PERFORMED: LEGAL DESCRIPTION;/..OT C~ /~4./< / /O~/~C ~J~,L.~ ~/Township. Range. Section: 1 2 3 4 5 6 7 8 10 11 12 13 ~? COMMENTS B.o,/,./. SLOPE $,~,v D WAS GROUND WATER ENCOUNTERED? S L IF YES. AT WHAT ""- O DEPTH7 p E Depth t0 Walar All,', 'j/~ / O~ ~ Moflilorino? '~'Y Oate' SITE PLAN Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 3 ~/:Z.. FT AND PERFORMED BY: ....... ,- -, .... , --- ...... ...~: s/~a'e'=-.4,- ,~,--, ,-M~,p~,,~,~--i ..... - . CERTIFY THAT/THIS TEST WAS PERFORMED IN ACCORDANCE WI~I~tLI~I~I[~I~'t~AL GUIDELINES IN EFFECT ON THIS DATE. DATE. Certificate of On -Site Systems Approval Parcel I.D. 017-142-13 Legal description PARK HILLS#1 BLK 1 LT 9 Site address 14642 PARK HILLS DR Expiration Date: Current property owner(s) ARMSTRONG SEAN P & ANDREA J 6/19/2025 X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: By: vv Original Certificate Date: 7/19/2024 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 X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory X Arsenic Advisory Other COSA Approval—June 2022 MUNICIPALITY OF ANCHORAGE ROSH 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. 017-142-13 Complete legal description PARK H (ILLS# 1 BLK 1 LT 9 Location (site address) 14642 PARK H ILLS DR Current property owner(s) ARMSTRONG Day phone 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: A-1 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: X Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑E Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 28 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ❑N Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: FN 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 $ 1 c{ 2 Date of Payment Z//7/z moi' COSA# SG2�-1 1252 Waiver Fee $ Date of Payment Waiver # COSA Application—June 2022 COSA Checklist Legal Description: PARK HILLS#1 BLK 1 LT 9 Parcel ID: 017-142-13 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA fi❑ Well log is filed with Onsite (or attached) Date drilled 8/17/96 Total depth 326 ft Cased to 98 ft ❑ti Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA 6/19/24 Static water level at beginning of test 66 ft. Comments Measured operating fluid level in septic tank '30 Date of pumping 6/19/24 ❑ Required maintenance completed, if AWWTS Comments: " STEP TANK D. ABSORPTION FIELD DATA Which system tested (date installed) NEW 0 ALL standpipes present per record drawing Total measured depth from grade 4.5 ft (max) Measured depth to pipe invert from grade ft (min) ❑� N/A — pressurized field. ❑ Per record drawings, field is insulated. 0 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) If yes, enter date COSA Checklist June 2022 Well production at time of test 2+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes 01 No H Coliform bacteria is Negative Nitrate 0.452 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L H Arsenic less than MRL (ND) Collected by Date 6/19/24 MNA C. LIFT STATION H Required maintenance completed Age of lift station 28 years Lift station material STEEL Comments: Adequacy test date NEW Results Q Pass Fluid depth prior to test _ in Water added _gal New fluid depth _ in Elapsed time _ min Final fluid depth _in Absorption rate 450 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) t2 in Effective depth used 2 in Effective depth remaining 12 in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Qi Yes if No _ ft Neighboring Tank > 100' Q Yes if No _ ft Absorption Field on Lot > 100'❑ Yes if No _ ft Community Sewer Manhole/Cleanout > 100' ❑� Yes if No _ ft Private Sewer/Septic Line > 25' Q Yes if No ft Holding Tank > 100' FEI Yes if No _ ft Neighboring Absorption Fields > 100' Animal Containment > 50' Q Yes if No _ ft no Yes if No _ ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75'❑ Yes if No _ ft Qi 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 Surface Water > 100' R Yes if No _ It Tank to Property Line > 5' ❑i Yes if No _ ft Field to Property Line > 10' ❑1 Yes if No _ ft Water Main > 10' 0 Yes if No _ It Water Service Line > 10' R1 Yes if No _ ft F. ENGINEER'S COMMENTS Wells on Adjacent Lots: Private Wells > 100' Community Wells > 200' CE Yes if No _ ft 0 Yes if No _ ft If tank or field is under driveway comment below 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 t-111A'rN Ad 0,�3. Engineer's Printed Name COSA Checklist June 2022 Phone V.7a"? Date ( 5% v` 0 i- AlT'^ Y. w i 00.1 •.r• A1ICHAE. N. AKGAkFrl CE -94 9 o MUNICIPALITY OF ANCHORAGE s � Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Lift Station/Pump Vault Maintenance Log Owner Street Address - Septic Tank: -Sludge level LKinches -Pumping: requiredes no -Pumping completed yes no Lift station: •Pump basket cleaned es no *Effluent filter cleaned Q no -Control floats cleanedfe no *Proper float settings confirmed es no -Operation satisfactoryno Alarm System: -Dedicated electrical alarm circuites no -Audible and visual alarm inside dwelling es no -Alarm system operationatisfacto not satisfactory Manhole Riser *Ground water intrusion at riser to tank connectiongesno •Ground water intrusion around pipe penetrations •Weep hole functional a no es•Manhole lid: Functional no Insulated Properly Secured a no Other -All manufacturer required inspections and maintenance completed fyes J no Comments: Qualified Maintenance Provider: Technician L.a-rry W BQ �k� fir-- Date of maintenance J Company ey-J4t_ i� Signature DateQD 3tj(1ek MUNICIPALITY OF ANCHORAGE DEVELOPMEi T SERVICES DEPAERTNIENT � � '�`` 907-343-7904 On -Site Water and Wastewater Section � i Eax: 34.3-7997 www.muni.org/onsite Septic Tank Advisory Certificate of On -Site Systems Approval # OSC241252 Subdivision: Park Hills #1 Block:1, Lot: 9 The septic tank for this property is 28 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. - - - - - -1- -. -�- -LIT - -F Development Services Department On -Site Water & Wastewater Section ANCHORAGE. Certificate of On -Site Systems Approval Phone: 907-343-7904 Fax: 907-343-7997 Parcel I.D. 017-142-13 Expiration Date: 7-q— 2 r Complete legal description PARK HILLS #1 BLOCK 1, LOT 9 Location (site address) 14642 PARK HILLS DRIVE, ANCHORAGE, AK 99516 Current property owner(s) JENAYA ROHLFING & JAMES HAYES Day phone Mailing address 14642 PARK HILLS DRIVE, 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: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $�5� ff Date of Payment 2 Receipt Number. l S Waiver Fee $ Date of Payment Receipt Number COSA # Waiver # 5 ST-A-TEMEN-T--OF-INSPECTION-B-Y-ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY. ANCHORAGE. AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 3/29/2021 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 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 & fWCs 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved r 49 TM, / • • ' Curtis Huffman. • • ' . • %/ rr� �F6" , CE 128991 .•��`�� PROF S 2 0P4-�.. Conditional approval for _ bedrooms, with the following stipulations: J ON-SITE VVA1 ER AN �0— WACT':i, fAT Jct PROGRAM By: \ Wti Original Certificate Date: _ Z The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other�C �G�Ji Si U Legal Description: PARK HILLS #1 BLOCK 1 LOT 9 Parcel ID: 017-142-13 If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 8/17/1996 Total depth 326 ft Cased to 98 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA 3/29/2021 Static water level at beginning of test 65 ft. Well production at time of test 2.5 gpm Comments B. TANK DATA Age of tank(s) 25 years Tank type/material STEP / STEEL Measured operating fluid level in septic tank *FLOAT ® Standpipes/foundation cleanout per record drawing Date of pumping 3/29/21 D. ABSORPTION FIELD DATA Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate 0.561 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) FIGS Collected by �- Date of Sample 3/29/2021 C. LIFT STATION ® Required maintenance completed Age of lift station _ years Lift station material STEEL Comments: *FLOAT LEVELS Which system tested (date installed) 6/18/2018 Adequacy test date 3/29/21 ® ALL standpipes present per record drawing Results I. Pass For 3 bedrooms Total measured depth from grade 5 ft (max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade ft (min) ® N/A — pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective ASSUMED Water added 450 gal New depth 2 in Elapsed time 25 min ® Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 450 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) If yes, enter date Gallons introduced gallons FW'H Comments/Deficiencies: ALL STANDPIPES PRESENT. .. 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' ❑ Yes if No Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No ft Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No ft Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ® Yes if No ft ® Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No *7+ ft Surface Water > 100' ® Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: ® Yes Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No 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 _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ®Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS *PER CODE AT TIME OF INSTALLATION. G. ENGINEER'S CERTIFICATION I certify that l 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. ��q��►�0 @� ® ' �� '.. .... ....•.. Curtis Huffman CE 128991 •.• i�`�i MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT On -Site Water and Wastewater Section Septic Tank Advisory Certificate of On -Site Systems Approval #OSC 211142 Subdivision: Park Hills #1 B l lot 907-343-7904 Fan 343-7997 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 25 years old. Typical replacement costs range from $8,000 to $11,000 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 20 -year-old steel tank MAY look like. Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Owner Septic Tank: -Sludge level rzinches iff ctafiinn- Lift Station/Pump Vault Street Address -Pumping: required es no -Pump basket cleaned no -Control floats cleaned ves` no -Operation satisfactory ves no Alarm System: -Pumping completed esu no -Effluent filter cleaned ves, no -Proper float settings confirmed ea' no -Dedicated electrical alarm circuit esi no •Audible and visual alarm inside dwelling es , no -Alarm system operation sa isf 1 not satisfactory Manhole Riser -Ground water intrusion at riser to tank connection yes no-, -Ground water intrusion around pipe penetrations es o -Weep hole functional es no -Manhole lid: Functional es, no Insulated est no Properly Securedesu no Other -All manufacturer required inspections and maintenance completed es no Comments: Qualified Maintenance Provider: Technician M'4s- Company �---a,— C2,C 6\(: 25 Signature Date of maintenance., 0&- 'L) Date a X56 789 ♦ ro ti L. ; • r� L !_t � Municipality of Anchorage Q o .- (�y On-Site Water and Wastewater Program `� Ie-:,4• 1;t,`: (907) 343-79040_ . . ..,, T a x3 cJ Certificate of On-Site Systems Approval o 6 a • . Parcel I.D. 017-142-13 Expiration Date: ��Z2-1 S7 1. GENERAL INFORMATION Complete legal description Park Hills #1 Block 1 Lot 9 Location (site address) 14642 Park Hills Drive Anchorage, AK 99516 Current Property owner(s) Kenneth & Stephanie Moll Day phone Mailing address 14642 Park Hills Drive Anchorage, AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: n Single Family (w/wo ADU) n Duplex n Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well H Individual x Individual Water Storage Holding Tank n Community Class Well Li Community Public Water System n Public Sewer n WaiverNariance request • . Distance: MEM 1 Received by . . -%. .. ;- ��_ Date: ios az-- COSA to be relea ed ttoo e •-eer • l ss otherwise re uested by the engineer. - -4/-iL (//d`9//r (Zus COSA Fee $ 2�� '1- 1(,)1 .lo Waiver Fee $ Date of Payment (a "2-o—1 0 Date of Payment Receipt Number b LA-'q co Receipt Number COSA# O5C 1.2 Z /q 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. Name of Firm Forge Engineering Phone (907) 522-7773 Address PO Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson,_PE Date _ 6/20/2018 "a—OF A\�, % If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: Park Hills #1 Block 1 Lot 9 Parcel ID: 017-142-13 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 8/17/96 Sanitary seal (Y/N) Wires properly protected (Y/N) Y Total depth 326 ft. Cased to 98 ft. Casing height (above ground) '12 in. FROM WELL LOG AT INSPECTION Date of test 8/17/96 5/22/18 Static water level 96 ft. 66 ft. Well production 1 5 g.p.m. 2.4 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate .323 mg/L Arsenic ND ug/L Date of sample: 5/21/18 Collected by: Forge Engineering B. SEPTIC/HOLDING TANK DATA Tank Type/Material S.T.E.P•/SteelDate installed 8/17/96 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) Y Date of pumping 8/30/17 Pumper A Plus Home Services C. ABSORPTION FIELD DATA Date installed 6/18/18 Soil rating (g.p.d./ft2 or ft2/bdrm) 1 .2 System type Shallow Trench Length 90 ft. Width 5 ft. Gravel below pipe •5 ft. Total depth 5 ft. Eff. absorption area 450 ft2 Monitoring tube Y Depression over field N Date of adequacy test New Const. Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed 8/15/96 Size in gallons 1 ,250 Manhole/Access (Y/N) Y "Pump on" level at 43 in. "Pump off' level at 39 in. High water alarm level at 45 in. Datum Bottom of Tank Cycles tested 3 Meets alarm&circuit requirements? Y 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 >75' Animal containment areas >50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line >5 Absorption field >5 100' Water main >10 Water service line >10 Surface water > Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: >10' >10 >10' Property line Building foundation Water main 10' Water Service line >10Surface water >100 Driveway, parking/vehicle storage > Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS G. ENGINEER'S CERTIFICATION 3.OF A�gsll) ��?. 4* x-11 I certify that I have determined through field inspections and j*'49 TH .A :17 I review of Municipal records that the above systems are in .42.-;11:.L.(2 ) . �..p ../� .../'�...(.)�� , conformance with MOA COSA guidelines in effect on this date. >�``u'-•1-. L.(2 Michael E. Anderson, P.E. rI / . Michael E.Anderson : / Engineer's Printed Name 11 PF•. .4381-E •ms i Date 6/20/2018 11 1`\PR•OFF S O�-s A, \\\NN� COSA brown sheet 10-10-12.doc MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT +• }Il"�) 907-343-7904 On-Site Water and Wastewater Section �, / Fax: 343-7997 www.muni.org/onsite �/T. Septic Tank Advisory Certificate of On-Site Systems Approval # OSC181279 Subdivision: Park Hills #1 Block:1, Lot: 9 The septic tank for this property is 22 years old. The average life for a steel septic tank is 20 years. Typical replacement costs range from $6,000 to $9,000. 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 20 year old steel tank MAY look like. rt 0:'".1.: ;,. NV.:310 % 1 . ' ,, .fi'd` „ •. - q,fir tt x ..,P"" • y° 010¢. ` `y - 0. .'•. $'i' '' • r -. ., - .. ,y-- • y y .nf - � i�: 4 as k„ .. o tx � l yy �iw ` Ail. , :� , }y • Mailing Address: P. O. Box 196650 * Anchorage,Alaska 99519-6650 * www.muni.org MUNICIPALITY. OF ,i1�E,,t-tEJKHk,= sum (/. L,J.� Phone: 907-343.7904 Nelopment Services Department _ •_ Fax: 907-3431997 i-Site Water & Wastewater Section Lift Station/Pump Vault Maintenance Log K:eca_±—S- an-Le--tZl*d- Street Address�'� a. . `"��11 _�. .-— NnerPED___ �— - - lone_`*tin-ZoLA t Legal Desc. _ up lank: Mudge level .inches -Pumping. required y �;l Pumping completed Y_- �.►- 9 S 30 17eft _ lump basket cleaned y es tolee t -Effluent filtc r cleaned =49 - nate- , . t ;ontrol floats cleaned ..moi •Proper float settings confirmed 6 . regi )peration satisfactory c Jaren $ystem: 69 _Dm Dodicated Rlectrical alarm circuit no -Audible and visual alarm inside dwelling .--- Alarm system operation not satiSiargtgl /{aatta n B r Ground water intrusion at riser to tank connection 0s QTJ_ penetrations y+ S •u ep hole functional 6 n Ground water intrusion around pipoe� Properly Secured (*...till lid: Functional insulated r �rta_ •A{l manufacturer required inspections and maintenance completed y no C0.5‘.4._�.4/le ." sK.p 1-- fin. mkooste. ... Maintenance Provider: �.r, e / Date of rnain�tenanceZ2 / Tacltinlcian _ C , .-- Carnpac►Y ___ _ _.= f SErlatUlR%. - - Date .-.'-3' •jjC Pit Allinsi Address: P. 0. Box 196660'Arnct►orapsi Alaska 99519.66SO ' ,hww.muni.orp Is Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4'~00 Brag.a~.Stre. et P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 OF ON-SITE SYSTEHS APPROVAL SINGLE FAHILY DWELLING CERTIFICATE FOR A Parcel I.D. 017-14-21,3 1. GENERAL INFORMATION Expiration Date: Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address PARK HILLS #1; BLOCK 1, LOT 9 14642 PARK HILL DRIVE *ANCHORAGE, AK 99516 LYNN ROBERTS Day phone 14642 PARK HILL DRIVE *ANCHORAGE, AK 99516 545-5680 Day phone TIM RI'FI'AL W/ REMAX Day phone 110 W. 38TH. SUITE 100 *ANCHORAGE, AK 9950,3 248-2249 ¸2. Unless otherwise requested, COSA will be held by DSD for pickup. NUMBER OF BEDROOMS: 3. 'TYPE OF WATER sUpPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well · 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 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 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 ¢hown 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 an.d 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 557-6179 Address .3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 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 .~J Approved for 'r o f e s sio~x:~%%~<~°~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Arsenic Advisory. Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: ~ - C:~ __// Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & 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 Legal Description: WELL DATA Well type PRIVATE Date completed Total depth ;326. ft. Date of test Static water level Well production CHECKLIST PARK HILLS #1; BLOCK 1, LOT 9 Parcel ID: 017-14-213 8/17/96 If A, B, or C provide PWSID# N/A Sanitary seal (Y/N} YES Cased to 98 .ft. FROM WELL LOG 8/17/96 96 ft. WATER SAMPLE RESULTS: Coliform (-~ colonies/100 mi. Arsenic: ~,~ ug./L. SEPTIC/HOLDING TANK DATA 1.5 g.p.m. Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION 11/18/2OLO 68 ff. 6.8 g.p.m. Nitrate0o"~5Omg./L. Other bacteria __ Date of sample: 11/18/10 Collected by: Tank Type/Material SEPTIC/STEP Tank size 1250 gal. Number of Compartments 2 Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO Date of pumping ~~ Pumper. / / ABSORPTION FIELD DATA I'BELOW EXISTING GRADEI Date inst~alted'~/,t'5~- 1:7/1996Soil rating (g.p.d./ft2o~ 1.2 Length 82 ft. Width 5 ft. Total depth *4.5 ft. Eft. absorption area 400 ft2 Monitoring tube YES Date of adequacy test 11/18/2010 Results (Pass/Fail) PASS ',Fluid depth in absorption field before test DRY in. Water added 450 gal. Elapsed Time: 145 min. Final fluid depth DRY in. AbsorptiOn rate >= Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN YES colonies/100 mi. GEG Ltd. System type _SHALLOW TRENCH Gravel below pipe 0.7 ft. Depression over field NO For 3 bedrooms New depth 1 in. 450+ g.p.d. If yes, give date - YES 12+ in. Date installed 8/15-17/1996 Cleanouts (Y/N) YES High water alarm (Y/N) YES ISAACS PUMPING LIFT STATION Date installed 8/15-17/96 Size in gallons 1250 "Pump on" level at 41 in. "Pump off" level at 4;I in. Datum BOTTOM OF TANK Cycles tested 3 E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot 100'+ Public sewer main N/A Sewer/septic service line 25'+ Animal containment areas 50'+ 100'+ Manhole/Access (Y/N) YES High water alarm level at 45. Meets alarm & circuit requirements? YES ¸in. On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout Holding tank N/A Manure/animal excrete storage areas N/A 100'+ Building foundation Water main Wells on adjacent lots SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: 5'+ Property line 5'+ Absorption field N/A Water service line. 10'+ Surface water. 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: 5'+ 100'+ Property line 10'+ Building foundation, 10'+ Water service line 10'-I- Surface water 100'+ Curtain drain NONE KNOWN Wells on adjacent lots ;100'+ COMMENTS Water main N/A Driveway, parking/vehicle storage 1'+ 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 Printed Name JEFFREY A. GARNESS Date COSA Fee $ Date of Payment Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number FROI4 : FLEHING SURUEYING SUC. PHONE NO. : 9~Z17 243 4,q'~'_~ Au~. '-27 1996 %o