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MOUNTAIN PARK ESTATES BLK 4 LT 2
Mountain Park Estates Block 4 Lot 2 #017-061-31 S USMITTAL Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ONSITE WASTEWATER INSPECTION REPORT Permit Number: OSP111155 PID Number: 017-061-13 ❑✓ New ❑ Upgrade Name: Crown Pointe, Inc. ABSORPTION FIELD ❑ Deep Trench ❑Shallow Trench E] Bed E] Mound Address 165 E. Parks Highway, Wasilla, AK 99654 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 357-9394 4 .45 GPD/SF 11.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3.0 Ft. Gravel depth beneath pipe 8.0FL Subdivision Block Lot Mountain Park Estates 4 2 Fill added above original grade 1-2 Ft. Gravel length 98.0 Ft. Township Range Section Gravel width 3.OFt. Beds: Number of Lines Distance between lines I Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line 1,568 Fe 2 > 16 Ft. Well >100' >100' N/A N/A >25' TANK O Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity I 1,25OGal. Surface water >100' >100' N/A N/A Material Number of compartments Lot Line >5' >10' N/A N/A Steel Two (2) NA Foundation >5' >10' NIA N/A LIFT STATION Manufacturer Capacity Curtain Drain None Noted Gal. Remarks— Final Grading to be Completed by 6/15/2012. Pump on level at in. Pump off level at in. High water alarm at in. Pump make and model Electrical Inspections performed by Installer PIPEMATERIAL Housetotank D3031 Tank to D3031 drainfield Sanders and Sanders Excavation Drainfield F810 CO/MT D3031 Inspector A. Harala BENCH MARK (Assumed elevation) 100.Ofl Inspection 8/9/11 8/10/11 Location and description dates: 2nd Garage Slab 3,d 4,h COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL En9ial ry?amp F-.OF"q A(,4f Conditional Approval: Date � S'F Ie -., 49 'aq \\NN•N! N. N•••NN•N :M1CHM E M�t3tSON� W p •off •.�,_rz ik ���.. Approved Date"l2 114W �Ei ®�q�FESS11 0Np� �"Ah♦ Inspection Report1-7-17.dol M I co N O O 6 Z >c �V d 0 a S 03'41.00"E 175.00' E ' ° '� , a� O Ot/)v 10' UTIL. ESMT. --------------- °m o _ UZ✓Z�IU. p V n 2 H H U 0 pq HO N W 'W dv> 7_O O FM LL0. mM: 00 �-' Lo N Q co O O C Tl ff w W O W I I N D aW pOj W W \ W O> Q a' O Q W Q Z /r U N N m cn tm aF `p a00 ~/� v% \ a n u x o�v \L �Wr Z Y W do ® �,00N W a o `m J d Q V 76 \ i�W mo Wm O Lf. in \ Za 3m o°•. wx m mxe� w N o vi ¢4 Mm Z M awi�mi?i�Ni� O mry ginN`am ma 0 ¢ N N 1 m m V (n0 J Z N U g E U U U O I S 03'41'00"E 175.00' r a O P: ' U) CRESNIEW DRIVE gos 00 z o1u>'• �,��,•'4i ♦tis S E� a * g ; R Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: OSP111155 PID No. 017-061-31 7.4 96.4 n UU N Finished Existing 3.37 11 250 Gallon Septic Tank 93.1 a ,n WE5 1 I KENGH ' U � U 97.0 / M 95.3 ! 957 = /c�TM Finished Grade .F 92.5 Drainfield Rock 92.5 54' (Trench Length) EAST TRENCH PROFILE AS -BUILT No Scale 84.5 � — 75.8 No Groundwater Boil :. 49th %MICHAEL E. ANDERSON n No. CE -4381 i PLAT NO. P-461 MOUNTAIN PARK ESTATES SUBDIVISION LOT 2FoB SOCK 4 111=30' GASTALDI LAND SURVEYING, LLC JEFF A. GASTALDI, R.L.S. 12000 E. DOWLING RD., SUITE 8 (ANCHORAGE, ALASKA 99507 PHONE 248-5454 GRID DATE 2838 7/10/2012 F.B. JOS NO. MPE24 I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. ANCHORAGE RECORDING DISTRICT, ALASKA NOTE: NO CORNERS SET THIS DATE. OF A4 �Q•�.,,.......q.,4s� 40 Jeffery A. Gasialdi ' AV 67991 AN AMP ......o* a ' e0'A �' 5 �' OUBMITTAI ,LIAR 5 2012 L Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP111155 PID Number: 017-061-31❑ New El Upgrade Name: Crown Pointe, Inc. ABSORPTION FIELD Dee ❑ p Trench [:1 Shallow Trench El Bed El Mound Address P.O. Box 112313 Anchorage, AK 99511 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 .45 GPD/SF 11.0 FL LEGAL DESCRIPTION Depth to pipe invert from original grade 3.0 Ft. Gravel depth beneath pipe 8.OFt. Subdivision Block Lot Mountain Park Estates 4 2 Fill added above original grade 1-2 Ft. Gravel length 94 Ft. Township Range Section Gravel width 3.0Ft. Beds: Number of Lines I 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 1,504 z Ft 2 16 Ft. Well >100' >100' NIA NIA >25' TANK ❑✓ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity I 1,25OGal. Surface water >100' >100' N/A N/A Material Number of compartments Lot Line >5' >10' N/A N/A Steel Two (2) NA Foundation >5' >10' NIA N/A LIFT STATION Manufacturer Capacity Curtain Drain None Noted Gal. Remarks Final Grading to be Completed by 6/15/12. Pump on level at n. Pump off level at in. High water alarm at in. Pump make and model Electrical Inspections performed by Installer PIPEMATERIAL Housetotank D3034 Tankto drainfield D3034 Sanders and Sanders Excavation Drainfield F810 CO/MT D3034 Inspector A. Harala BENCHMARK (Assumed elevation) 100.Oft Inspection .t dates: t 8/9/11 zea 8/10/11 Location and description p 3,d 4'h Garage Slab COMMUNITY DEVELOP"��NT DEPARTMENT APPROVAL E meer'A tamp ,/� r�E ®� Ag4su Conditional A rov pP � '° Date � S ��Q;.`. / +11.00-9010 plot Nb„ `_ lljji rs a vi1�i r%IS�JUIiI��1PGtF1/avYQ ltE1 n>r t1'SLgI^"f c% ••• ••,• • .................p, �' nnlctlArd a ANQFR$py : Jw SIYA she �—W Gt ah I "7A CE-_�t381 Approved Date ZIB�a��s inspection Kepon_i-i-iz.aoc M O OCl) 3 N O O N cm m Z Q U a S 03'41'00"E 175:00' '= ° 0 omaO o.o 3 i 10' UTIL. ESMT.— ------ zug�``LL — w a —_---_ ------ U JU�rWO N LL N x U U LL J E o 0 m O Iq Z O N M 7p�ry�J p N 0 O F Jd Li CO 2 O X m O2 LU C6 0 rcn LO N o ¢` 2°' W W ° w o>a �� c Z Tx Q T U _ W N Q Z V O) zom co UZ .0 Z Y W V' '= t wo _® woavosa g0N �6d� \ F aswvo a Q Lu O m� o \ m N� N 0- 3 c o w N Ln O Z o �F moa oN Q f0 O M K,,5.6. ( i tC r � � NNN� a7NMP � Q II— b�Fa NioF ina J Z N N h N y LL SQ i J 3 LO S 03'41'00"E 175.00' : X3241, a O > rjz rol��� fa, CRESTVIEW DRIVE`0 _ _-- -�;�a z 0.• f rt5a+� c`n • fp p a. Pf ��S � � •R�G�g®e Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: OSP111155 N �U7.496.4 N UU CO 1,250 Gallon Septic Tank Page 3 of 3 PID No. 017-061-31 U U 92.5 VVES I I KLNUH 89"' N 97.0 ro 95.3 95.7 = O.G. QTH Finished Grede F- re.ueaae CeHry Drainfield Rock II 84.5—/ 52' (Trench Length) __75.8 No Groundwater 8/9/11 EAST TRENCH PROFILE AS -BUILT - No Scale U �— 92.5 FROM :Alpine Drilling FRX NO. :907 345 0202 Feb.29 2012 10:09AM P2 Alpine Drilling & Enterprises Well Log Permit Number: #SWOSP111155 Date of Issue: 7-19-11 Parcel Identification Number: 01706131000 Date Started: 8-5-11 Date Completed: 8-7-11 Is well located at approved permit location? x Yes ❑ No Legal Description: Mountain Park Estates B/k 4 Lot 2 Property Owner Name & Address: Conn Robert & Kellie 7110 S Hudson Circle Centennial, Colorado 80122-2642 Borehole Data: Soil Type, Thickness & Water Strata Depth (ft) From To Method of Drilling x air rotary ❑ cable tool Casing type: steel Stick-up 0 2 Wall Thiclmess:.250 inches Silty gravel Sandy salt 2 25 25 78 Diameter:,¢ inches Depth: 294 feet Liner Type: Diameter —inches Depth: _feet gravelly silt 78 105 Casing stickup above ground: 2 feet Static water level (from ground level): 244 feet silty cobbly gravel 105 181 silt 181 231 Pumping level: 294 feet after gravelly silt silty sandy gravel H2O 231 290 290 294 2 hours pumping 5 gpm Recovery Rate: 5 Spin Method of Testing: air li Well Intake Opening Type: x Open End ❑ Open Hole ❑ Screened Start `feet Stopped^ fest ❑ Perforations Start feet Stopped y feet Grout Type: bentonite granules Volume: 2 bes Dath; Start 0 feet Sto Pump: Intake Depth _ feet Pump size hp Brand Name Well Disinfected Upon Completion? x Yes ❑ No Method of Disinfection: chlorine tablets Comments: WATER QUALITY TESTING Comorm ("� C0111001TIL Well Driller: Alpine Drilling & Enterprises PO Box 110496 Nitrates rnglL Anchorage AK 99511 Arsenic N_b uglL n- Development Services Department Building Safety Division • On -Site Water & Wastewater Program a'GE 8U'<o 4700 Elmore Road.. P.O. Box 196650 e, AK 99507 Anchors A E T Y Mark Begich 9 Mayor www.muni.oro/onsite (907) 343-7904 Pump Installation Log Well Drilling Permit Number: SW 111155 Date of Issue: 7-19-11 Parcel Identification Number: 01706131000 Cr0v",)(�� Legal Description Property Owner Name & Address: Mtn Park Estates Blk 4 Lt 2 Conn Robert & Kellie 7110 S Hudson Circle Centenlal, Colorado 00122 Pump Installation Date: 1-8-12 Pump Intake Depth Below Top of Well Casing: 280 feet Pump Manufacturer's Name: crundfos Pump Model: 5 SQE-07-320 Pump Size 3i4 hp Pitless Adapter Burial Depth: 10 feet Pitless Adapter Manufacturer's Name: ? Pitless Adapter Installer: Sanders Excavation Well Disinfected Upon Completion? V Yes ❑ No Method of Disinfection: Chlorine tablets Comments: Pump Installer Name: Aarow Pump & well Service, LLC John Netherton Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. On -Site Water & Wastewater System Permit MUNICIPALITY OF ANCHORAGE wr Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP111155 Tax Code Number: 01706131000 Work Type: WellSeptic Initial Permit Effective Dates: July 19, 2011 to July 18, 2012 Design Engineer: ANDERSON ENGINEERING Subdivision: MOUNTAIN PARK ESTATES Site Legal Address: MOUNTAIN PARK ESTATES BLK 4 LT 2 G:2938 Owner/Address: CONN ROBERT & KELLIE 7110 S HUDSON CIRCLE CENTENNIAL CO 801222542 Site Mailing Address: 13321 Crestview DR, Anchorage Lot Size in Sq Ft: 36000 Total Bedrooms: 4 This permit is for the construction of: Y Disposal Field Y Septic Tank 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: * Prior to construction, the permitted drainfield design shall be verified to be 6 feet minimum above bedrock or impermeable material. Results shall be submitted with the inspection report. ** Prior to construction, the permitted drainfield design shall be verified to be 4 feet minimum above the ground water elevation adjusted to the seasonal high (Note: To determine the seasonal high using July or August readings, add 2 feet to the actual groundwater reading) Results shall be submitted with the inspection report. C— 0 1 r e \AO'ej � � IQ � 0_%'%� ok V\ J A V-&-, 0 �� e I a ) � C'pt'4 �'V 0 - el-cl', 0 Received By: Issued B / "',;� % 7 Y/—� :.;�'1,;? r,� i!-' -. / �i- _ Date: P0� ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. DI ]- 061 Si Property owner(s) 9-013t"2r -4- Kt_-- L4j 0_,,o j .i Day phone Mailing address 7/1 D 5. /--uP_SorJ G it a Gtppj i C--:P.t" ik 1,0 230iLz. Site address / 3 3 z-li (_JZAZ-'&7- i`I ET j D R_(V i CA4 Legal description (Sub'd., Block & Lot) M 100 rJ"_M 1IJ PA -A*__ t�S; �1 T�-� �:-oc�t� ''� LOT � Legal description (Township, Range & Section) Lot Size 5 �, ® 6 C Sq. Ft. Number of Bedrooms F -o o `- THIS APPLICATION IS FOR: THIS APPLICATION IS AN: (® all that apply) ' Initial Absorption Field Septic Tank tK Upgrade ❑ Holding Tank ❑ Renewal ❑ Privy ❑ Private Well 0 Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: 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. t (Signature of property owner or authorized agent) Permit/Rush Fees: ?J`= Date of Payment: 1 l Receipt Number: Permit No. GABuilding\On Site\Forms\Client Forms\Permit App_01 041 1.doc Waiver Fees: Date of Payment: Receipt Number: Waiver No. (Rev. 1/11) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 FAX July 9, 2011 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 2, Block 4, Mountain Park Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 2, Block 4, 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- 42' 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 3' below the surface and the total depth will be 11'. A minimum of 3' of fill or 2" of insulation and 2' of fill will be placed over the absorption trench and 4' over the septic tank. 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 southwest 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 2, Block 4, Mountain Park Estates Subdivision July 9, 2011 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: 1. 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. 2. 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. 3. 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. 4. 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 � OF :•• 49th_.° �n' ; MICHAEL E. ANDERSON . ; No CE -4381 • 0 0 S 03.41'00"E 175.00' 10' UTIL. ESMT•-------- ;0 ° 0 -6 � o a S' 0 o= / V 0 Z a O �o J �vV N f Oc N Xvm o�c cn J� O O / O \ O deo° U O CV O O I a _ O c /C `\ mO a c C WO V) o a� N� C II '0 LLJ r� Q L° m = \ \ C �s 00 W Q \ z u co J Z Y LLJ \X0=cn VJ Wovm0� —J /y V' V) Q3 V Va O li \ / \ r,w`T °z O Mi � • vi \ // \ �Q0— 0 o, WHO Loom O O — / 'a 3 a0 p d c q Q� O 0 Nb :112 ", L cn_ a mmcno3 o my oa �N> J Z o� v):5° Dcs Z z 0 0 :5 (tnn con U�0341�OO-E 175.00 O �P Z ESNIEW DRIVE — = `'�-' �. : y '>♦� -- — --- —� — --- • R / ALL: ��¢ w `Cn 0O: w : � / ��- +' L ° Q, z : v �• � =N +' 3A4&, fA31A30018 •'��� ,\ LL 1 \ - 00 ZJ I Fn H I ��J ® I ® N 1\ xW W3 •♦ X3 ui N Y I U Ll % mp Q \ \\ < m A irm a / C / W Q O Ld Y �\ Z Z O j i. Q F- ZO / j V) Q H ZO It Z OJ 0 O ---'---__"- i Fn / W Y \ Q / J < LLI m � J n Ld _ ui OJ \\ O \ Lid z O / m 1 D= I x3 D- 1\ w • I - - -- zO \ i V A — LLJ -��, - Z v ZJ / zJw3 ® X3 / Ld Fn \ W \ j H W Y \ / W Y '---_ - O Y O ¢ mD Elf J N - - -- Z Z Q Z � J Z J Ci A W O �Of 0 D ¢ i WQ D W Y n () Q uJ (n of of Q w ¢ m cn D_ z 'O F¢- O ZOJ I --------__ —--------— -------------------- Q, z : v �• � =N +' w o CL O 0 II ti w J Q W ry LOT 4, BLOCK 2, MOUNTAIN PARK ESTATES SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home Deep Trench System Perc. Rate: 31-60 Min./Inch 1,250 Gallon Septic Tank Application Rate: .45 GPD/SF 8' Drainfield Rock 4 Bedrooms X 150 GPD/.45 GPD/SF (Application Rate) = 1,333.3 SF Absorption Area 1,333.3 SF/16 SF/LF = 83.3 LF Trench Length THEREFORE: Construct 2-42' Long x 3' Wide x 8' Effective Depth Absorption Trenches at the Location Shown. Flow Line Elevation in Trench to be 3' Below Original Ground Surface. Total Depth to be 11' 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 2'6" Geotextile Fabric 6" O 4" Perforated PVC (Holes Down) No 3' Drainfield Rock TYPICAL DEEP TRENCH SECTION•...., (NO SCALE) ••��7F......... NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. 49th Minimum 4' Separation From Groundwater. ih t •...... Minimum 100' Separation From Private Wells in the Area. J m MICWKE ANDERSON j �i Minimum 100' Separation From Surface Water or Streams. �'%', NO. CE -4381 •��� �FESS��i••• Municipality of Anchorage Development Services Department Building Safety Division r On -Site Water and Wastewater Program 4700 Elmore Road - P.O. Box 196650 Anchorage, AK 99507 www.ci. anchoraoe.a k. us (907) 343-7904 Soils Log - Percolation Test i^,/ ��j,',IV VIIVGCfC JCf1L��fc" "v W 49M •. : ! 0 M3COAR L /IFiDEUON �o' Ws G� • 4381 • 4� - . � Ar �1 it,p�OFESS��L,•�.� Performed For: Date Performed: Legal Description: iH . ��,,{c j L'21 rj+ Township, Range, Section: 990 9_ /s 10- 11- / 12- 13- 14- 15- 16- 17- 18- 19- 20- COMMENTS fe',�k MFS Site Plan WAS GROUND WATER Date ENCOUNTERED? Net Time Depth to Water Net Drop s IF YES, AT WHAT DEPTH? L Depth to Water After o P Monitoring? '#*fK E Date: ✓� Reading Date Gross Time Net Time Depth to Water Net Drop J : O + /farcy /� -7, 2`` PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER 4 " TEST ►.RUN ,BETWEEN � r.� y� FT - AND 5",. FT 4 � ,5vAVCgt;p ALke K► +-* 4 WW6,- PERFORMED BY: I CERTIFY THAT THIS TEST WAS PERFORMED IN AC60DANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: C01 Municipality of Anchorage Development Services Department Building Safety Division i On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www. ci.anchoraoe.a k. us (907) 343-7904 Soils Log - Percolation Test _.&V,&r.- Performed For: Date Performed: Legal Description:} �'�_ Cp �[ , � �� Township, Range, Section: Slope T & 2- - 4- 5- 6- 7- 4- 5 -6 -7- 9- 10- 11- 12- 13- 14- 15- 16- 17- 19- 20 - 9 -10 -11- 12- 13- 14 -15- 16- 17- 19 -20 - WAS WAS GROUND WATER l l ENCOUNTERED? Iy s IF YES, AT WHAT DEPTH? Depth to Water After h y P Monitoring? E Date: { I Reading Date` Gross Time Net Time Depth to Water Net Drop L 3M%44 (.P-9` 1p q '4`4 f; p ` n ! %geb 30-%�PwS `t �r. 1I l PERCOLATION RATE !tO_ (minutesfinch) / PERC HOLE DIAMETER (Q TEST RUN BETWEEN — o FT ANP FT COMMENTS PERFORMED BY. r'j `—)AAA (,,Q I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 'j 4—%/ Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and WactawrAw Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.ci.anc-+oraggj (907) 343-7904 Soils Log - Percolation Test G _._,4 _ e AW All • �Pi�INtt1i' ' SEAI.�� • 49181 Perfonned For. Date Performed' Legal Description: M YI~171,y [�t5L7! �' Township. Range, Section: 1N .00 Depth N 1- �L 2- 3- 1-1 - 31- j 9- - 1-5r '0tvj 15- 16- 17- 18- 19 - 21- 15 -16- 17- 18- 19 - COMMENTS COMMENTS *- MICOA L AMOMM CE , 4381 ! a� ,��pA'OFESSIa�p+�+ -az tzoL t Site Plan WAS GROUND WATER ENCOUNTERED? S IF YES. AT WHAT DEPTH. A -P< L Depth to Walw AftDro %�° W/ ' E Daft: Reading Date Gross Time Net Time Depth to Water Net Drop i1�1'f 3o P1 '31 M i.�t " 1'1 � 17 � 3 a � 1r.�' � /'•• Ez d 0. PERCOLATION RATE -7�- (a:wl..%Ch) PERC HOLE DUMETER 7' TWT OWN GC7WCCN "- "► PT ANO CO PT PERFORMED BY: f54^—cdCERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE: 1'15 '11 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 2, BLOCK 4, MOUNTAIN PARK ESTATES SUBDIVISION GENERAL: The scope of this project includes the procurement and placement of a new 1,250 -gallon septic tank at the location shown on the Site Plan. Work also includes the construction of 2 new 42' long X 3' wide X 8' effective depth absorption trenches at the location also shown on the Site Plan. The distribution line in the trench will be placed at 3' below the existing ground surface. Total depth of the trench will be 11' below the existing ground surface. The new absorption trenches and septic tank must be placed a minimum of 100' from all private wells and any surface water in the area and 10' from the water service line proposed for the lot. A minimum of 3' of cover is required over the absorption trench and 4' of cover over the septic tank. A flow splitter valve must be placed to assure even flow to each trench. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. The Contractor must also verify the location of wells in the area and assure that the separation distances are met. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Building Safety Division On -Site Water and Wastewater Program for system installations. Owners installing their own systems must receive prior approval from the On -Site Water and Wastewater Program. before beginning system installation. SEPTIC TANK INSTALLATION A new 1,250 -gallon septic tank must be procured from an approved source and installed at the location shown. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. Lot 2, Block 4, Mountain Park Estates July 9, 2011 Page 2 of 3 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. 5. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trench to drain away. 8. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. All pockets of unacceptable materials must be removed and replaced. Lot 2, Block 4, Mountain Park Estates July 9, 2011 Page 3 of 3 MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. Parcel I.D. 017-061-31 1 Ii_ - c t -- N,�S &y Municipality of Anchorage i On -Site Water and Wastewater Program K'` o (907)343-7904 �.FE',Y Certificate of On -Site Systems Approval Re- Z s s uea— 5-/3-/4 Expiration Date: GENERAL INFORMATION Complete legal description Mountain Park Est. Block 4, Lot 2 Location (site address) 13321 Crestview Dr. Current Property owner(s) Tommy & Elizabeth Pennington Day phone Mailing address 13321 Crestview Dr. Real Estate Agent Day phone 2. TYPE OF DWELLING: i] Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well El Individual FX71 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request I f't, n. \ Received by: eft4"- i_ � `/ `._ Date: COSA to be released to then ineer, unless otherwise requested by the engineer. COSA Fee Date of Payment Receipt Number COSA # I t I0 6 Z Waiver Fee $ Date of Payment Receipt Number 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 Pannone Engineering Services LLC Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Phone (907) 272-8218 Date 5/12/2014 *: 49 TH 6. DSD SIGNATURE 9/ System #1 Approved for bedrooms CE -81 System #2 Approved for bedrooms 4 Disapproved 'l,� DR�OFE55' Conditional approval for bedrooms, with the following stipulations: Uff ON-SITE By: Original Certificate Date: '! Th ic' 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 blue sheer r If more than 1 septic system is on the lot: COSA Checklist # 1 of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Mountain Park Est. Block 4, Lot 2 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 8/7/2011 Sanitary seal (YIN) Y Total depth 294 ft. Cased to 294 ft. FROM WELL LOG Date of test 8/7/2011 Static water level 244 Well production 5 F11 Parcel ID: 017-061-31 Well Log (YIN) Y Wires properly protected (Y/N) Y Casing height (above ground) 24 in. AT INSPECTION 2/18/2014 237 3.3 WATER SAMPLE RESULTS: Coliform Neg colonies/100 mL Nitrate 1.22 mg/L Arsenic ND ug/L Date of sample: 5/5/2014 Collected by: PES ft. g. p. m. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 8/10/2011 Tank size 1,250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YIN) Date of pumping 2/25/2014 Pumper A+ Home Services C. ABSORPTION FIELD DATA 7 Date installed 8/10/2011 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.45 GPD/BR System type Deep Trench Length 98 ft. Width 3 ft. Gravel below pipe 8 ft. Total depth 13.6 ft. Eff. absorption area 1,568 ft2 Monitoring tube Y Depression over field N Date of adequacy test 2/18/2014 ResultsPass/Fail ( )Pass For 4 bedrooms Fluid depth in absorption field before test 27 in. Water added -61 6 gal. New depth 27 in. Elapsed Time: 180 min. Final fluid depth 27 in. Absorption rate , 600+ g p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons in. "Pump off' level at in. E. SEPARATION DISTANCES WELL ON LOT TO: Cycles tested Septic tank/lift station on lot 100+ Absorption field on lot 100+ Public sewer main 75+ Sewer /septic service line 25+ Animal containment areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots 100+ On adjacent lots 100+ Public sewer manhole/cleanout 100+ Holding tank 100+ Manure/animal excrete storage areas 100+ Building foundation 5+ Property line 5+ Water main 10+ Water service line 10+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water Service line 10+ Surface water 100+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS 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 Steven R. Pannone Date 5/12/2014 COSA brown sheet -1 0-10-1 2.doo Absorption field 5+ Surface water 100+ Water main 10+ Driveway, parking/vehicle storage 110+ in. • '� Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval — Parcel I.D. 017-061-31 Expiration Date: 0 �i l 1. GENERAL INFORMATION Complete legal description Location (site address) Mountain Park Est. Block 4, Lot 2 13321 Crestview Dr. Current Property owner(s) Tommy & Elizabeth Pennington Day phone Mailing address 13321 Crestview Dr. Real Estate Agent Day phone 2. TYPE OF DWELLING: - I TTAL El Single Family (w/wo ADU) FEB 28 2014 ❑ Duplex Gmtahen Stuhair ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual Fx I Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public- Water System ul Puhllc Cewef n u Waiver/Variance request Received by:, J Date COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ �- J&. —Waiver Fee $ Date of Payment '31S114 Date of Payment Receipt Number Receipt Number COSA4 Qs64 (4 19 a 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 Pannone Engineering Services LLC Address P.O. Box 100217, Anchorage Alk. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE _ z System #1 Approved for bedrooms System #2 Approved for _ bedrooms Disapproved Phone (907) 272-8218 Date 2/18/2014 �-n, �r,�p'(� f*'.49 TM *I a .............. even �2.•�.annone CE -8149 Conditional approval for bedrooms, with the following stipulations: By: Original Certificate Date: The ni ipality 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 blue sheet r c If more than 1 septic system is on the lot: COSA Checklist # 1 of 1 Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Mountain Park Est. Block 4, Lot 2 Parcel ID: 017-061-31 A. WELL DATA Well type Private Date completed 8/7/2011 Total depth 294 ft. Date of test If A, B, or C provide PWSID # Sanitary seal (Y/N) Y Cased to 294 ft. FROM WELL LOG 8/7/2011 Well Log (Y/N) Y Wires properly protected (YIN) Y Casing height (above ground) 24 in. AT INSPECTION 2/18/2014 Static water level 244 ft. 237 ft. Well production 5 g.p.m. 3.3 9-P M. WATER SAMPLE RESULTS: Coliform A4_colonies/100 mL Nitrate / 55 mg/L Arsenic /Vj�! ug/L Date of sample: a �r �-O ty Collected by: t` g� B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1,250 gal. Number of Compartments 2 Y N Date installed 8/10/2011 Cleanouts (YIN) Y Foundation cleanout (Y/N) _ Depression over tank (YIN) _ High water alarm (Y/N) N Pumper Date of pumping �a5� �o l Y{ �o e S Pi ✓ (� 25 C. ABSORPTION FIELD DATA Date installed 8/10/2011 Soil rating (g.p.d./ft2 or ftZ/bdrm) 0.45 GPD/BR System type Deep Trench Length 98 A � ft. Width 3 / 3 ft. Gravel below pipe 8/ ,�q ft. Total depth 13.6rft. Eff. absorption area 1,568 ftZ Monitoring tube � Depression over field nJ/i`,1 Date of adequacy test 2/18/2014 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 27 in. Water added 616 gal. New depth 27 in. Elapsed Time: 180 min. Final fluid depth 27 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons in. "Pump off' level at Cycles tested _ E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100+ Absorption field on lot 100+ Public sewer main 75+ Sewer /septic service line 25+ Animal containment areas 100+ SEPTIC/HOLDING TANK ON LOT TO Manhole/Access (Y/N) _ in. High water alarm level at Meets alarm & circuit requirements? On adjacent lots 100+ On adjacent lots 100+ Public sewer manhole/cleanout 100+ Holding tank 100+ Manure/animal excrete storage areas 100+ Building foundation 5+ Property line 5+ Water main 10+ Water service line 10+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water Service line 10+ Surface water 100+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone Date 2/18/2014 COSA brown sheet 10.10-12.doc Absorption Feld 5+ Surface water 100+ Water main 10+ Driveway, parking/vehicle storage11 0+ 111 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. 017-061-31 COSA # © S C- 12– Expiration Date: O 1. GENERAL INFORMATION Complete legal description LoK Mountain Pa k Estates Subdivision Location (site address) 13321 Crestview Drive Anchorage, AK 99516 Current Property owner(s) Crown Pointe, Inc. Day phone 345-6277 Mailing address P.O. Box 112313 Anchorage, AK 99516 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Urdess otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Four (4) 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 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 number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date7/1�� 5. DSD SIGNATURE Approved for 4— Disapproved. Conditional approval for r r0 OF A4 eg ....:...0 .... .•...... .. HM L ANIMSON.� W /✓ CE=43811?�o ._ 7—fL—�7.�bQv •. bedrooms. bedrooms, with the following stipulations: COSA Checklist A Arsenic i-kowsory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other By: Original Certificate Date: (Rev. 11 NS) Municipality of Anchorage e ea • 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/onske (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lott' Block , Mountain Park Estates Subdivision 0 Parcel ID: 017-061-31 A. WELL DATA Well type Private If A. B, or C provide PWSID # _ Well Log (YIN) Y Date completed 817/11 Sanitary seal (YIN) Y Wires properly protected (Y/N) Y Total depth 294 ft. Cased to 294 ft. Casing height (above ground) >18 in. FROM WELL LOG AT INSPECTION Date of test &7/11 Static water level 244 ft• ft. Well production 5 9-P.M. 9 -p -m WATER SAMPLE RESULTS: Coliform o colonies/100 mL Nitrate .712 mg/L Other bacteria o colonies/100 mL Arsenic: N/D mgll Date of sample: 2/21/12 Collected by: B. Schiller B. SEPTIC/HOLDING TANK DATA Tank Type/Material SeptictSteei Date installed 6/9/2011 Tank size 1,250 gal. Number of Compartments Two Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping New. Construction Pumper C. ABSORPTION FIELD DATA Date installed 8/9-1012012 Soil rating (g.p.d.M2 or ftz/bdrm): 5 GPD/SF System type Deep Trench Length 98 ft. Width 3 ft. Gravel below pipe 8 ft. Total depth12-16 ft. Eff. absorption area 1,568 ft' Monitoring tube v 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 Size in gallons Manhole/Access (YIN) "Pump on" level at _ in. "Pump off" level at_ in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAi t station on lot >100' On adjacent lots >100' Absorption field on lot >100' On adjacent lots >100' Public sewer main NIA Public sewer manhole/cleanout NIA Sewer /septic service line >26 Holding tank NIA Animal containment areas >60' Manurelanimal excrete storage areas >100' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5_ Absorption field >5' Water main NIA Water service line >10' Surface water >100' Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation P >1a Water main >19 Water Service line >19 Surface water >100' Driveway, parking/vehide storage >10' Curtain drain None Noted Wells on adjacent lots >1017 F. COMMENTS: G. ENGINEER'S CERTIFICATION ���*''hr I certify that I have determined through field inspections and � *� review of Municipal records that the above systems are in 00 conformance with MOA COSA guidelines in effect on this date. y.n6-----wl" ♦ e . mic") Engineer's Printed Name Michael E. Anderson, P.E. ,����.• �* Date 3/6/2012 COSA Fee $_ Date of Payment Receipt Number (Rev. 11105) Waiver Fee $ _ Date of Payment Receipt Number U 30' PLAT NO. P-461 MOUNTAIN PARK ESTATES LOT 2, BLOCK 35,000 S.F. SUBDIVISION 4 1 "=30' GASTALDI LAND SURVEYING, LLC JEFF A. GASTALDI, R.L.S. 2000 E. DOWLING RD., SUITE 8 ANCHORAGE, ALASKA 99507 PHONE 248-5454 GRID ATE 2838 ! D 7/10/2012 I F.B.JOB NO. I MPE24 I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OP ANY EASEMENTS, COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. ANCHORAGE RECORDING DISTRICT, ALASKA NOTE: NO CORNERS SET THIS DATE. OF1� �. Q'<�........ . gs 0` • .....w..................*a100 W-0 :Jeffery A. Gasialdi . g LS -6091 m� i .� mr�F '. // .•' Jta P #� ea�'•.1j.1.�,r p5 �4%P �! �afessiort(l y�� 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 Parcell.D. 017-061-31 COSA# osCtatn(a�- Expiration Date: 1. GENERAL INFORMATION Complete legal description Location (site address) Lot)Block ', Mountain Park Estates Subdivision 13321 Crestview Drive Anchorage, AK 99516 Current Property owner(s) crown Pointe, Inc. Mailing address Lending agency Mailing address P.O. Box 112313 Anchorage, AK 99516 Day phone 345-6277 Day phone Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. ' 2. NUMBER OF BEDROOMS: Four (4) 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 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 number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 3/6/2012 OF MKHAMLAMXU0N; 'I 5.. DSD SIGNATURE IfI �• ' z p s •� CE94381 �•�`"� Approved for bedrooms. 0+gf6 �'C ;1.Z•' W Disapproved. +t E \8\0�����'' Conditional approval for r bedrooms, with the following stipulations: Attachments COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: �� Original Certificate Date: (Rev. 1IM5( Municipality of Anchorage Az • 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 Legal Description: _4 Block), Mountain Park Estates Subdivision Parcel ID: 017-061-31 A. WELL DATA Well type Private If A, B, or C provide PWSID # _ Well Log (Y/N) Y Date completed 6/7/11 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 294 ft. Cased to 294 ft. Casing height (above ground) >18 in. FROM WELL LOG AT INSPECTION Date of test 817111 Static water level 244 ft. Well production 5 a.o.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate .712 mg/L Arsenic: WD mg/I Date of sample: 2/21/12 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septir/Steel Tank size 1,250 gal. Number of Compartments Two Foundation cleanout (Y/N) Y Depression over tank (Y/N) N Date of pumping New. Construction Pumper C. ABSORPTION FIELD DATA ft. g.p.m. Collected by: B. Schiller Date installed 8/9/2011 Cleanouts(Y/N) High water alarm (Y/N) _ Y N Date installed 6/9-10/2012 Soil rating (g.p.d./ft2 or ft2/bdrm).45 GPD/SF System type Deep Trench Length 94 ft. Width 3 ft. Gravel below pipe 8 ft. Total depth 12-13 ft. Eff. absorption area 1,504 ft' 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 Size in gallons Manhole/Access (YIN) "Pump on" level at _ in. "Pump off" level at _ in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM 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 N/A Public sewer manhole/cleanout N/A Sewer /septic service line >25' Holding tank N/A Animal containment areas >50' Manure/animal excrete storage areas >100' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5'Absorption field >5' Water main N/A Water service line >10' Surface water >100' Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water main >10' Water Service line >10' Surface water >100' Driveway, parking/vehicle storage >10' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS: G. ENGINEER'S CERTIFICATION �P;•••• �S �� 1 certify that t have determined through field inspections and 49M] *Y_ review of Municipal records that the above systems are in ••• •• +•• ••• ••%�' conformance with MOA COSA guidelines in effect on this date. g7:j.!«Ye!/ .. 0 WDEM Engineer's Printed Name Michael E. Anderson, P.E. �� c' a F`N.' `moo ®%r . CE -4381 Date 3/6/2012®9fFpFp •3.;;7;;�`'�� '�0 � e?ROPESStOA®mss � )n F•R COSA Fee $ `['1U — Waiver Fee $ Date of Payment 3 IT 112 Date of Payment Receipt Number Receipt Number (Rev. 11/05)