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HomeMy WebLinkAboutMOUNTAIN PARK ESTATES BLK 1 LT 4Mountain Park states lock I Lot 4 017-061 -38 N`opA!!Ty 0 MUNICIPALITY OF ANCHORAGE \ On-Site Water&Wastewater Program `e c;, \ PO Box 196650 4700 Elmore Roadlear Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 f http:l/www.muni.orglonsite Uchartnlynt NCM ORaJE. On-Site Wastewater Disposal System Permit Permit Number: OSP191329 Effective Date: 8/19/2019 Work Type: SepticTank Upgrade Expiration Date: 8/18/2020 Tax Code Number: 01706138000 Site Legal Address: MOUNTAIN PARK ESTATES BLK 1 LT 4 G:2938 Site Mailing Address: 13240 CRESTVIEW DR, Anchorage Owner: HESTER JOHN T 50% & Lot Size in Sq Ft: 62400 Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING Total Bedrooms: 4 This permit is for the construction of: ❑ Disposal Field Q Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 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: Date: V 2 a Issued By: ' i Date: • MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 017-061-38 Property owner(s) John Hester Day phone Mailing address 13240 CRESTVIEW DR Anch, AK Site address SAME Legal description (Sub'd., Block & Lot) MOUNTAIN PARK ESTATES BLK 1 LT 4 Legal description (Township, Range & Section) Lot Size 62,400 Sq. Ft. Number of Bedrooms 4 cD APPLICATION IS FOR: APPLICATION IS AN: '� Y E OF'DWELLING: (® all that apply) Absorption Field El Initial fF Ingle FarT ily (SF) ❑ s(w/wo ADU) Septic Tank ❑ Upgrade 11 Duplex (D) ❑ Holding Tank ❑ Renewal Fa 100 Multiple,Dwellings ❑ Privy ❑ 01 6 g L 9 SFfand/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: �o�I o�`J Waiver Fees: 71 Date of Payment: 3019 Date of Payment: Receipt Number: /oCM Receipt Number: Permit No. d3I019132.9 Waiver No. G:1Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc J July 31, 2019 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: Septic Tank Permit Legal: MOUNTAIN PARK ESTATES BLK 1 LT 4 To Whom it may concern: This is a request for a septic tank permit to move the tank away from the house where a new garage will be built. All of the required off-set distances from the new garage and the existing trenches will be done, see the attached drawing. The surrounding properties will not be impacted by this new septic tank permit. Please call me if you have any questions. Sincerely /-44' 1 Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 CinGc. VIRE t L ( (/Lc vC..,p(a G r 4, jl ',I `~`�CC���/� 28.2' of �`4.0' x 9.4' COVERED PORCH _+ OF A`,� `k20.0• 1?:•• '•••,• sib•;E me •• r 2 STORY pe ' ..• jç ••.� N WOOD FRAME N e* :49TH A ••- "' RESIDENCE N . .•..• 13.0' o o 13.0' N • rj�••MICHAEL N. ANDERSON .,,_, ' 22.2' r ' r - i •: '*\ 1 C•, CE- 4 9 ,.'.' _-iBDALWN113.o' Et ��1�®� F�ss����` HOUSE DETAIL XX\x-",..-' SCALE: 1" = 30' ILot 5A < /�l v i-G°o I L/ i (\ ^t 0l(. 4.0 �p� ritPtG ?c Ut Lot 8 L / Lot 584;1-4( 7 �"°' S lid�r 10' UTILITY EASEMENTS Z u / 11 / rl Lot SCorI't,. r. S 7g 42, e 36 / l 2 co ��iy�vnS, /{ion It 00" 8 8' / ac9 C 0\0v c 1,�c✓ ti e, cv 1�� � ! _ Lot 4 `�x'`y''' , , ,.—big , / / roc 4' S 65,436 s.f. `1 ./c) e /•:-..✓'v„x f=0M (tftI`te,,, Q 1=- ,. N ' y /A- W ��; p SEPTIC CLEANOUT' O0 ��,ow 4` O O SEE HOUSE DETAIL 0 / )\\ Lot 7 0 \ ,� vi ir9 z 133.2' ' .•. G••VEL . DRIVtiy . • AY. V \ 133.2' , f WELL / • ' 1.• PROTE' WELL RADIUS j 149,3 w N S 8619'00"W 320.58' i i / i / Lot 6 I Lot 3 \ I 7' / 30' UTILITY EASEMENT PLOT PLAN AS BUILT X SCALE 1" = 60' GRID SW 2938 Project No. 10-126 Lang & Associates, Inc. 11500 Daryl Avenue, Anchorage, Alaska 99 -3049 Registered Land Surveyors (907) 522-4625 Fax 522-6476 X4000 A i p kglanglsOalaska.net / jclanglsOalaska.net •• 4 o" �.�FA� 9s44 I hereby certify that I have surveyed the following described property: OO/� • �4, '••'�'0O LOT 4, BLOCK 1, MOUNTAIN PARK ESTATES SUBD. (Plat No. P-461) 0 4• ..-ii;),..-- '•.7 00 Anchorage Recording District, Alaska, and that the improvements situated thereon are 0 �` .ti 0 within the property lines and do not encroach onto the property adjacent thereto, that Q no improvements on the property lying adjacent thereto encroach on the surveyed 0 � premises and that there are no roadways, transmission lines or other visible OQ. NETH ; 0 0 easements on said property except as indicated hereon. Q Dated this the 1,Tth Dayof v Za kir) LS 5202 i 1, . at Anchorage, Alaska Q4FaA' v74G1.!•••• 50 It is the responsibility of the owner to determine the existence of any easements, 40QRO SSIOtJM- covenants, or restrictions which do not appear on the recorded subdivision plat. v_ lo Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program, 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 Page of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: 05P101205 PID Number: 017-061-38 Name: Jayand Jean Schultz Wastewater System: [] New [] Upgrade Address: 13240 Crestview Drive Anchorage, AK 99516 ABSORPTION FIELD Phone: Number of Bedrooms: 727-5259 4 [~ Deep Trench [] Shallow Trench [] Bed [] Mound [] Other: LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: .6 GPD/Ft2 11-12.3 Ft. Block: 1 Lot: 4 Subdivision: Depth to pipe bottom from odginal grade: Gravel depth beneath pipe: Mountain Park Est. 4-5 Ft. 8 Ft. Township: Range: Section: Fill added above odginal grade: Gravel Length: .5-2 Ft. 84 Ft. Well: [] New [] Upgrade Grave~ width: Numberof lines: Distance between lines: 3 Ft. 2 >16 Ft. Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material: Private 301 Ft. 301 Ft. 1,344 Ft2 ASTM D3034 PVC Driller: Date Drilled: Static Water Levek Installer: Date Installed: Alpine Drilling 11/22/10 234 Ft. Sanders & Sanders 9/29-30/2010 Yield: Pump Set at: Ft. Casing Height Above Greund: 8 GPM 275 2 Ft. TANK SEPARATION DISTANCES [] Septic [] Holding [] S.T.E.P. [] Other: T~To Septic Absorption Lift Holding 'ublic/Pdvate Manufacturer: Capacity: From~ Tank Field Station Tank Sewer Line Anchorage Tank 1,250 GaL Material: Number of Compartments: wall >100' >100' N/A N/A >25' Steel Three (3) Surface Water >100' >100' N/A N/A !~ / LIFT STATION Size: Manufacturer: Lot Line >5' >10' N/A N/A Gal. "Pump on" level at: "Pump off' level at: in. High water alarm at: Foundation >5' > 10' N/A N/A in. in. Curtain Drain None Noted Pump Make & Model Electrical Inspections performed by: Remarks: BENCH MARK Location and Descdptiom Garage Slab. Assumed Elevation: 100.0 Ft. Inspections performed by: A. Harala Dates: 1st 9/28/10 ~'~' Development Services Department Approval Conditional Approval Date: ~... ~' · '"~,;4381 .'~" 0 I II I I rq c 0 / / 0 N O0'O0'O0"E 235.00' 00' Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 EImore Road Anchorage, AK. 99519-6655 - 343-7904. On-Site Wastewater Disposal System or Well Inspection Report Permit Number: OSP101205 Page 3 of 3 PID No. 017-061-38 90.2 [- G · 00.8~ 99.4 ~1,250 Gallon 8.3J [SepticTank Finished Grade Odginal Ground 96.2 -t- 96.0 ./ Geotextile Fabdc Drainfleld Rock 83.1~ 52' (Trench Length) NORTH TRENCH 77.0 No Groundwater 9/28/10 Finished Grade Odginal Ground 99.0 ./97.0 Geotextile Fabdc 92.7 Drainfield Rock ~ 85.7---~ 52' (Trench Length) I SOUTH TRENCH 77.0 No Groundwater 9128/110 90.2 92.7 PROFILE AS-BUILT No Scale · i~? 49th ~"~'"';t'"'~""'~'"'f"/ ...... .~'""~ ,................................................, ~'~-.MICHAEL E. ANI1ERSBN ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) MEMORANDUM DATE: July 8, 2011 TO: Jeff Poet FROM: Mike Anderson, P.E. SUBJECT: Lot 4, Block 1, Mountain Park Estates Subdivision Certificate of On Site System Approval (COSA) We have reviewed your comments and offer the following comments: 1. Test Hole No. 2 was deepened to 19' prior to construction. A monitor tube was placed and you were on site to inspect the depth. A copy of the test hole showing the additional depth is attached. 2. The trench alignment was altered slightly to be more parallel with the contours of the slope. The absorption trench falls completely within the soils strata of the percolation test. 3. The total depth of Test Hole No. 2 is 19'. The profile view of the absorption trench is correct. Municipality of Anchorage I ~ ~_~,~.C~E¢~.'~-~.~; ~, I Development Services Department ~.~w...~ 49~'~¢ '..?, ¢¢I' Building Safety Division On-Site Water and Wastewater Program eeeeee .... 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www. ci.anchoraqe.ak, us (907) 343-7904 '~ -.-~'e I~, ~381 . _-~ Soils Log - Percolation Test/ rge jeff ' Date Pe,o~ed: ~J~ J~,~ Pe~ormedFor: . Lega~ption: Mountain Pk. Eats. Su~., ~, B~ T~ship, Range, Se~ion: //  " S~pe Site Plan WAS GROUNDWATER ENCOUNTERED? 2- 3- 4- 6- 7- 8- 9- 10- 11- 12- 13- 14- IF YES. AT WHAT DEPTH? Depth to Water After Monitoring? Date: Reading Date Gross Time Net Time Depth to Water Net Drop ~ I¢:l'z/ ~ Ft/~5, ~,~" ~.~,1" 51,4 TI ','1 ! 16- ~17- 18- 19- '~'Oi~ PERCOLATION RATE ~ (minutes/inch) PERC HOLE DIAMETER 1 X, . TEST RUN BETWEEN '~,~ FT AND ~',g~ ft PERFORMED BY: ?~J~ I ~Y/~..LJ_~ ~~-~lFY THAT THiS TEST WAS PERFORMED IN ACC~O~.bANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THiS DATE. DATE: Alpine Drilling & Enterprises Well Log permit Number: #SWOSPIO1205 Date of Issue: 9-28-10 Parcel Identification Number: 01706'138000 Date Started: 1%~9-10 Date Completed: ~ t-22-'/0 Is well located at approved p~rmit location? x Yes [] No Legal Description: Mountain Park Estates BIk 1 Lot 4 G:2938 Property Owner Name & Address: Schultz Jay A & Jean P 13240 Crestview Anchorage,. Alaska 99516 Borebole Data: Depth (fi) Method of Drilling x air rotary Soil Type, Thickness & Water Strata From To Stick-up 0 2 silt 2 7 Sandy silt 7 41 Mit 41 86 gravelly silt 86 ! 02 silt 102 129 gravelly Mit 129 231 silty sand~ gravel small amt I-F20 231 238 silt 238 261 gravelly silt 261 295 silty water sand & gravel 295 301 [] cable tool Casing type: steel Wall Thickness: .250 inches Diameter: 6 inches Depth: ~01 feet Liner Type: ~ Diameter: __ inches Depth: __ feet Casing stickup above ground: _2 feet Static water level (from ground level): Pumping level: 303 feet after 2 hours pumping ~ gpm Recovery Rate: 8 gpm Method of Testing: air lift Well Intake Opening Type: x Open End [] Open Hole [] Screened Start feet Stopped__ [] Pert'orations Start~ feet Stopped 'Grout Type: bentonite granule.; Start 0 feet Pump: Intake Depth ~ feet Pump size hp Brand Name feet feet Volume: g bgs Stopped ? feet Well Disinfected Upon Completion? x Yes [] No Method of Disinfection: Comments: Well Driller: ~4lpine Drilling & Enterprises PO Box 110496 /tnchorage/IK 99511. EOEO ~£ L06: 'ON X~3 Mark Beg,¢ch 4780 E!mer~ ;$'.O. Box ~.96650 Ar~cho, r~9¢,, AK 99:507 Pu:m;p Installation Log Well Drilling Permit N umber: SW Date Parcel Identification N.mber: O [~al l~scription LOT 4 BLOC~ 1 MOUNTAIN PARK Pt~:mp Installation Date: 3,~9¢~; Pump .Man~faemrer*s Name: G~UND¢OS Pump .M~ek 15$QE15.290 PitJt~s Adapter Manufacturer's Name: CAMdLE Pitless Adapter Installer: BR~ANW~LLE g~e[i DisinCeeted Upon Comptedoa? [~] Yes iii No Meth~ of Dis~nlqecfion: ~ECikCULATED U~NG CH:L, OR:INE P~LL~T$ Co:mmeuts: ProperS" Own:er Name & Addrt.~S: HOUC:dq~:ON C©NSYRUC3"IO:N Pump In,~talier Name: $~L~.N WlLLE Attention: Thc pump installer shatI Wov[dc ~ pump i~stallat:ion .fog ~o the D:SD within 30 days .of pump On-Site Water & Wastewater System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP101205 Tax Code Number: 01706138000 Work Type: WellSeptic Initial Permit Effective Dates: September 28, 2010 to September 28, 2011 Design Engineer: ANDERSON ENGINEERING Subdivision: MOUNTAIN PARK ESTATES Site Legal Address: MOUNTAIN PARK ESTATES BLK 1 LT 4 G:2938 Owner/Address: SCHULTZ JAY A & JEAN P 13240 CRESTVIEW DRIVE ANCHORAGE AK 995160000 Site Mailing Address: 13240 Crestview DR, Anchorage Lot Size in Sq Ft: Total Bedrooms: 62400 4 This permit is for the construction of: Y Disposal Field Y SepticTank N Holding Tank N Privy Y Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: The Engineer needs to do an additional test hole prior to the construction of the septic field to confirm no impermiable layer. Please submit stamped and signed results with the As-built Inspection Report. If the results require a design change, construction of the system will stop pending On-Site review and approval. Date: Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 . Anchorage, Alaska 99519-6650 www. muni.org/onsite . (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 017-061-38 Property owner(s) Jay and Jean Schultz Mailing address 13240 Crestview Ddve Anchorage, AK Site address 13240 Crestview Drive- Anchorage, AK Day phone Zip Code 99516 Zip Code 99516 Legal description (Sub'd., Block & Lot) Mountain Park Estates, Block 1, Lot 4 Legal description (Township, Range & Section) Lot Size 62,400 Sq. Ft. Number of Bedrooms Four (4) THIS APPLICATION IS FOR ([~ all that apply): Absorption Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage [] THIS APPLICATION IS AN: Initial [] Upgrade [] Renewal [] I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: "~ ~ ~:) Waiver Fees: Date of Payment: ~ - ~__ O - / O Date of Payment: Receipt Number: (~ / 7 ~ '~'~' Receipt Number: (Rev. 11/05) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) September 20, 2010 Municipality of Anchorage Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 4, Block 1, Mountain Park Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 4, Block 1, Mountain Park 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 well and septic system and wells or septic systems 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 indicates silt gravel with sand (GM). The percolation rate of the soil was determined to be between 31 and 60 minutes per inch. No groundwater was found during the placement of the test hole and none was noted during the monitoring period. An application rate of .45 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 2- 50' long by 3' wide by 8' effective depth absorption trenches to treat and dispose of the effluent generated in the house. The elevation of the distribution line in the absorption trenches will be 2' below the surface and the total depth will be 9'. 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. A flow splitter valve will be placed to insure even flow to each trench. The ground surface on the lot in the area of the septic system slopes to the northeast at a 5% grade. The new trenches will be constructed parallel with the slope as much as possible in conformance with Municipal requirements. The new septic system will be Lot 4, Block 1, Mountain Park Estates Subdivision September 20, 2010 Page Two constructed a minimum of 100' from all wells and any surface water and 10' the proposed and existing water services in the area. If the system is constructed in accordance with our design the following statements apply: o 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 patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments .,,tAb.'.; ................ E ~ 49th ~ ~ ~ ~.....~. ................. , ....... ~ ...~ II 235.00 0 C 0 B~ RID 0 N O0'O0'O0"E 235.00' 30' Utility. Easements / / / / / .J / / / / / / LOT 4, BLOCK 1, MOUNTAIN PARK ESTATES SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home f _ Deep Trench System Perc. Rate: 31-60 Min./Inch 1,250 Gallon Septic Tank Application Rate: .45 GPD/SF 7' Drainfield Rock 4 Bedrooms X 150 GPD/.45 GPD/SF (Application Rate) = 1,333.3 SF Absorption Area 1,333.3 SF/14 SF/LF = 95.23 LF Trench Length THEREFORE: Construct 2-50' Long x 3' Wide x 7' Effective Depth Absorption Trenches at the Location Shown. Flow Line Elevation in Trench to be 2' Below Original Ground Surface. Total Depth to be 9' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption Trench. In Lieu of Cover Place 2" of Insulation and 2' of Cover Over Trenches and Tank. Maintain 100' Separation from Private Wells in the Area. Natural Backfill Geotextile --Fabric 4" Perforated PVC (Holes Down) Drainfield Rock TYPICAL DEEP TRENCH SECTION NOTE: Grade Are.a, Over Trench to Drain Away. ~"~' ? 49th Minimum 6 Separation From Bedrock. ¢.:._.~.....! ...... ¢~'-'~'""/R":" Minimum 4' Separation From Groundwater. ~ ~ ~ MICHAEL E ANDERSON Minimum 100 Separation From Private Wells in the Area. &~¢\ . Minimum 100' Separation From Surface Water or Streams.' ~,;>¢;\ No. Performed For: Legal Description: 4- 5- 6- 7- 8- 10- 11- 12- 13- 15- 16- 17- 18- 19- 20- /  Municipality of Anchorage Development' SerVices Department Building Safe~ Division On-SEe Water and Waste~ter Program 4700 Elmore Road ' - P.O. Box 196650 ~omge, AK 99507 ~.d.anchoraqe.ak. us (907) 34~79~ Soils LOg - PercOlation Test George Jeff Date Peffo~ed: Mountain 'Pk. Ests. Subd., L4, B~ , o~ship, Range, WAS GROUND WATER ' /~ ENCOUNTERED? ' 0 Mon~Hng? ~ E COMMENTS~ i~/'~ Site Plan Date: Reading Date ' '. Gross Time Net Time Depth to Water Net Drop I I .. '1~':'t* ~o ~,,~ ~r,~1" PERCOLATION RATE ~'-~,,) (minutes/inch) TEST RUN BETWEEN PERC HOLE DIAMETER '-7 ts PERFORMED IN ACCOI~DANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Performed For:. Le~ption: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.ci.anchoraqe.ak, us (907) 343-7904 Soils Log - Percolation Test George Jett Mountain Pk. Ests. Subd., L4, BI Slope WAS GROUNDWATER ENCOUNTERED? L IF YES, AT VVHAT DEPTH? ~ O Depth to Water After p Monitoring? ~ ,,, E ,.: 4.9~ ' ~, ~'t"x) '_" · ..., ....',,~. "~ Date Performed: Township, Range, Section: Site Plan 3- 4- 5- 6- 7- 8- 9- 10- 11- 12- 13- Depth to Water Net Drop 14- Reading Date Gross Time Net -~me ',z- PEROO~TION'~TE ~ (minutes~n~) PERC HOLE DIAMETER ~EST RUN BE~EN ~~ AND PERFORMED BY: ~ J ERTIFY THAT THIS TEST WAS PERFORMED IN ACC~bANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: MUNICIPALITY OF ANCHORAGE (4:77. Development Services Department . `_. Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On-Site Systems Approval Parcel I.D. 017-061-38 Expiration Date: —( 1. GENERAL INFORMATION Complete legal description MOUNTAIN PARK ESTATES BLK 1 LT 4 Location (site address) 13240 CRESTVIEW DR, ANCH AK Current property owner(s) JAY & JEAN SCHULTZ Day phone Mailing address SAME Real estate agent Day phone 2. TYPE OF DWELLING: 9 10 77 El Single Family (w/wo ADU) 6 7d �4 ❑ Duplex El Multiple Dwellings (Single Fa a d/ortplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: << OL 6 YPE OF WASTEWATER DISPOSAL: Private Well � Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: !14 i4/'- Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ t5"6-0 Waiver Fee $ Date of Payment aWfq Date of Payment Receipt Number 4 /orb. Receipt Number COSA# d5C/9// 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. I acknowledge that On-Site staff may visit the site to verify the information submitted. Name of Firm MIKE N ANDERSON, P.E. Phone 727-8864 Address 4661 NATRONA AVE ANCH AK Engineer's Printed Name MIKE N ANDERSON, P.E. Date 5-2-19 4:°47 • '•� * 49TH •••-trl� 6. DSD SIGNATURE / lam t System#1 Approved for 4 bedrooms :•MICHAEL N. ANDERSCN :� System #2 Approved •' y for bedrooms ry%�f�.• cE 9469 � o1;10• • . ••••�� ' Disapproved `k PRQFEScZA. Conditional approval for bedrooms, with the following stipulations: 1.' ier-%00v OrAisi_q SITE NWATER WASTEWATF R o� ROGRAM /)))FtSERVECO N\. Originalrr Certificate Date: S- l b--(el 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 COSA Checklist blue sheet COSA Checklist Legal Description: MOUNTAIN PARK ESTATES BLK 1 LT 4 Parcel ID: 017-061-38 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA FE -1 Well log is filed with Onsite (or attached) Well production at time of test_gpm Date -drilled "'22'to Waterstorage-tank-volume-0 gallons Total depth 301 ft Well disinfected for coliform test? ❑ Yes X No Cased to 301 ft 0 Coliform bacteria is Negative FE -1 Sanitary seal is functioning correctly Nitrate 4.42 mg/L ❑ Nitrate less than MRL (ND) FO -1 Wires are properly protected Arsenic ug/L X Arsenic less than MRL (ND) Casing height (above ground) 18+ in. Date of flow test for COSA 4/18/19 Static water level at beginning of test 228 ft. Comments Pump was lowered by aarow pump and well. B. TANK DATA Age of tank(s) 2010 years Tank type/material steel Measured operating fluid level in septic tank '3 ■❑ Standpipes/foundation cleanout per record drawing Date of pumping 4/20/19 D. ABSORPTION FIELD DATA Which system tested (date installed) 9/30910 ❑E ALL standpipes present per record drawing Total measured depth from grade 12/13 ft (max) Measured depth to pipe invert from grade 4/5 ft (min) ❑ N/A — pressurized field ❑■ Monitor tubes go to bottom of effective. If not, state depth into effective ❑- Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: both trenches tested, south trench was dry prior to test. COSA Checklist yellow sheet Collected by mna Date of Sample 4/18/19 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 4/18/19 Results Q✓ Pass For 4 bedrooms Fluid depth prior to test 0/8 in Water added 600+ gal New depth 2/16 in Elapsed time 1440 min Final fluid depth 0/9 in Absorption rate 600+ gpd Any rejuvenation treatment (past 12 months) UN If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout> 100' ✓Q Yes if No ft E✓ 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' Animal Containment> 50' ❑✓ Yes if No ft ✓0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0✓ 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 ft Surface Water> 100' ❑✓ Yes if No ft Property Line > 5' El Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' ❑✓ Yes if No ft Water Main > 10' ✓❑ Yes if No ft Community Wells > 200' El 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' p Yes if No ft Wells on Adjacent Lots: Water Main > 10' p Yes if No ft Private Wells > 100' Q Yes if No ft Water Service Line > 10' 1:3 Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Surface Water> 100' ✓❑ Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION ...."::\cc, OF 4'�'��kZ It ii I certify that I have determined through field inspections and review y' •Yof Municipal records that the above systems are in conformance with ;I*; 49T N p--- ;lc 10 MOA COSA guidelines in effect on this date. %•••E •,>-• 6 . MICHAEL N. ANDERSQN ...Z: s: �r CE:194(69 Ei;ft�. 1•.,��.c�- 1k,\;`ESSlOV`�� COSA Checklist yellow sheet \fit 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. 017-061-38 GENERAL INFORMATION Complete legal description Location (site address) Lot 4, Block 1, Mountain Park Estates 13240 Crestview Drive Anchorage, AK 99516 Expiration Date: Current Property owner(s) Jay and Jean Schultz Mailing address 13240 Crestview Ddve Anchorage, AK 99516 Day phone Lending agency Day phone Mailing address Real Estate~Agent Mailing Add'resS;:. Unles~ b~biWise re'q.~ted, COSA will be held by DSD for pickup. NUMBEROF,BEDROOMS: Four (4) TYPE OF WATERSUPPLY: IndMdual Well [] Individual Water Storage [] Community Class Well [] Public Water System [] Day phone 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 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 nu,mber of bedrooms and type of structure indicated herein. I further vedfy that based on the information obtained :from the Municipality of Anchorage files and from my investigation and inspection, the on-Si~ei!Water sqpPlY and/or wastewater disposal system is(are) n compliance with all app cab e Municipa and State ~des, 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 J-/ bedrooms. Disapproved. Date 7/6/2011 Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory (Rev. 11/05) X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: 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 CHECKLIST Lot 4, Block 1, Mountain Park Estates Subdivision If A, B, or C provide PWSID # Sanitary seal (Y/N) Y Cased to 3Ol FROM WELL LOG 11/22/10 g.p.m. Nitrate N/D mg/L Date of sample: 6/16/11 Legal Description: A. WELL DATA Well type Private Date completed 11/22/10 Total depth 301 f. Date of test Static water level 234 Well production 8 WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Arsenic: N/D mg/I B, SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1,250 gal. Number of Compartments Two Foundation cleanout (Y/N) Y .... Depression over tank (Y/N) ~ Date of pumping New. Construction Pumper C, ABSORPTION FIELD DATA Date installed 9/30/2010 Soil rating (g.p.d./ft2 or ft2/bdrm) .6 GPD/SF Length 84 ft. Width 3 ft. Total depth 12-13 ft. Eft. absorption area 1,344 ft2 Monitoring tube Date of adequacy test New Const. Results (Pass/Fail) __ Fluid depth in absorption field before test in. Water added Elapsed Time: ~ min. Final fluid depth Any rejuvenation treatment (past 12 mo.) (Y/N & type) Parcel ID: 017-061-38 Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) __ AT INSPECTION .. g.p.m. Collected by: A. Harala Date installed 9/29/2010 Cleanouts (Y/N) Y High water alarm (Y/N) N System type Deep Trench Gravel below pipe 8 ft. Y Depression over field N For bedrooms gal. New depth in. in. Absorption rate >= g.p.d. If yes, give date Y >18 in. 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 WELL 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 >10' Wells on adjacent lots >lOO' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water Service line >10' Curtain drain None Noted >100' COMMENTS: Absorption field >5' Surface water ·1oo' Surface water ·1oo' Wells on adjacent lots Water main >1o' Driveway, parking/vehicle storage ·10' 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. ' M~ h IE An rson PE Engineer s Printed Name Michael E. Anderson, P.E. Date 7/6/2011 Date of Payment ~ ~ ~ ~ [ ~ Date of Payment Re i.t .u be Re i.t .umuer (Rev. 11/05) Lot 8 Lot 7 Lot 6 Lot 5A 13.0' 20.0' 2 STORY WOOD FRAME RESIDENCE h 15.0' 22.2' ~'~'~ x 9.4' COVERED PORCH ~10.0' x 13.0' BALCONY HOUSE DETAIL SCALE: 1' = 30' Lot 5B / EASEMENTS / Lot 5C / --~- _._/ Lot 4 65,436 s.f. sm-nc SEE .oust / \ 133.2' :" ':: :". '.'.' 133.2' / WELL~ / Lot 3 UTILrrY EASEMENT / I I \ / / P~T P~N AS BUILT X SCALE 1" = 60' GRID SW 2938 Project No. 10-126 Lo ng (907) 522-6476 Registered Land Surveyors (907) 522-4625 kglangls~alaska.nef / Jclangls~alaska.nef & Associofes, inc. 11500 Oaryl Avenue, Anchoroge, Alaska 99515-3049 Phone Fax I hereby certify that I have surveyed the following described properly: LOT 4, BLOCK 1, MOUNTAIN PARK ESTATES SUBD. (Plat No. P-461) Anchoroge Recording District, Alaska, and thaf the improvements $1fuafed thereon are wifhln fha properly lines and do not encroach onto the properly adjacent thereto, that no improvements on fha properly lying adjacent thereto encroach on the surveyed premises end fhaf there are no roadways, fronsmisslon lines or other visible easements on said properly except as indicated hereon. Dated this fha '?,,'Tth Dm/ of ~-~ , ~ ~\ , af Anchoroge, Alaska It is fha responsibillty of fha owner fo determine fha exlsfence of any easements, covenants, or restrictions which do not appear on fha recorded subdivision plat.