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HomeMy WebLinkAboutSOUTHPOINTE BLK 1 LT 2 Onsite File Southpointe Block 1 Lot 2 #020 - 311 - 47 Municipality of Anchorage 61OZ s :-.030 On-Site Water and Wastewater Section • (907) 343-4 Page , ' of 4 ON-SITE WASTEWATER INSPECTION REP t ®ivesmsen Permit Number: OSP191175 PID Number: 020-311-47 •L..�6� Dwelling: Q Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: K New ❑ Upgrade Name Crown Pointe, Inc. ABSORPTION FIELD ❑ Deep Trench 0 Wide Trench ❑ Bed ❑ Mound Site Address 6124 Southpointe Ridge Dr. Anch., AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 229-1886 5 4.0 GPD/SF 2.4 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 1.9 Ft. Gravel depth beneath pipe 0.5 Ft. Subdivision Block Lot Southpointe 1 2 Fill added above original grade 3.1 Ft. Gravel length 38 Ft. Township Range Section Gravel width 5.0 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 190 Ft2 1 Ft. Well >50' >50' N/A N/A >25 TANK ❑ Septic ❑ S.T.E.P. ❑ Holding X Other Manufacturer Capacity Anchorage Tank / Advantex 2,500 Gal. Surface water >50' >50' N/A N/A Material Number of compartments Lot Line >5' >10' N/A N/A NA Steel 2 Foundation >10' >10' N/A N/A LIFT STATION Manufacturer Capacity Remarks Gal. Alarm location Electrical installed by PIPE MATERIAL House to tank D3034Tank to D3034 drainfield Installer Northern Excavation Drainfield D3034 cO/MT D3034 Inspector J. Mlllette / L. Tidwell. BENCH MARK (Assumed elevation) 100 ft Inspection 151 10/21/19 10/29/19 Location and description 2�0 aro 4th Bottom of siding @ NW corner of home. ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp � OF q� Conditional Approval: Date ���P,.°•°""`"' '°•••:9� V. "• 49th W .................. nu u.eanwan..�uu.� �n °; MICHAEL E. ANDERSON g w NO. CE-4381 Septic System Approved �A'� Date i 3 �62D ••.,,p 12/6/19 ,.•`°'�C . ••.........°••° Note: this approval does not include well permit requirements. tKev uo/uziiu/ SOUTHPOINTE BLOCK 1 LOT 2 PERMIT # OSP191175 PID # 020-311-47 ! / / LOT / / VACANT I I J I � ——1 TH3 ( 10'AE EASEMENT( / / 15' T&E ASEf1�ENT I 38',(ONGx5'WIDEx.5 / EFFECTIV�DEtsTH \ I z /ABSORP16N TRENCH• 602 ALTERNATE SITE C01 i THB i ` _ � I ui I\ / z 2500- ALLON 2STETANK w/ I ' ( �'i 2_%0 PODS / W H2 ) I ` I I LOTS 2 `% o I A Q /_ z r 1 1 MH0 ° o� I , C ' ( i FCO NOTE: /\ NOISLOPJS >45 �WERE N�TED WITHIT 35o, OF THE INSTALL D ABSORPTION ON.TR S IN DIREC ® I \ \ I ( EXISTING\WELL \ w/50' RADtU.SS_ \ \ ISTINSEPTIC SYSTEM z \ J / EXISTING WELL \\ \ / J / w/100' RADIUS \ LOf 3 I ®� I LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE �v. SOUTHPOINTE BLOCK 1 LOT 2 UMMUMIX0160jamaw PID # 020-311-47 V I - 88.6 FINISH GRADE /- 85.5 ORIGINAL GRADE PROFILE AS -BUILT (NO SCALE) 83.6 83A SOILS LOG AND PERCOLATION TEST E N Gik� I N G LEGAL DESCRIPTION: SOUTHPO I NTE BI L2 PERFORMED FOR: CROWN POINTE DATE: 10/22/19 PROJECT No.: PARCELID#: 020-311-47 TECHNICIAN: J. MILLETTE DEPTI-f TEST HOLE B (feet) 1 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 COMMENTS: 1.60B / ORGANICS CLEAN FILL GM GRAVEL w/SILT & SAND GM IQ:to:1 01011 WAS GROUND WATER ENCOUNTERED'? IF YES Car WHAT DEPTH? DEPTH OF WATER AFTER MO DATE OF MO SLOPE NO SITE PLAN SEE SITE PLAN x v - L MONITORING: NONE 0 MONITORING: 10/29/19 P E DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH To WATER (INCHES) NET DROP (INCHES) 10/29 TEST HOLE PRESOAKED PRIOR TO TESTING: 1 9:15 <1 MIN 0 I� - e 6 b 2 9:16 <1 MIN O d- 6 6 °- 3 9:17 <1 MIN 0 i0 - 6 ib 4 9:18 <1 MIN 0°-6-6° 6° 5 9:19 <1 MIN 0 ,o - 6 6 9:20 <1 MIN 0 0- 6IT6 6 PERCOLATION RATE: <I (MIN/INCH) PERC. HOLE DIA.--L—(INCHES) TEST RUN BETWEEN: 3 FT. and 4 FT. MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7994 On -Site Water & Wastewater Section �� _ % l=ax: 907-343-7997 Pump Instailation Log Well Drilling Permit Number: 191175 Date of Issue: 5 _ 14 _ 19 Parcel Identification Number: 02(_3114700 Legal Description Southpoint Block 1 Lot 2 Property Owner Name & Address: Crown Pointe, Inc Po Box 112313 Anchorage, Alaska 99511 Pump Installation Date: 12 -18 -19 Pump Intake Depth Below Top of Well Casing: 275 feet Goulds Pump Manufacturer's Name: 7HS10 Pump Model: 1 Pump Size: hp 15 Pitless Adapter Burial Depth: feet Martinson B-10 Pitless Adapter Manufacturer's Name: Don't know Pitless Adapter Installer: Well Disinfected Upon Completion?Yes ❑ No Method of Disinfection: Chlorine tab] s Comments: David Harper Pump Installer Name: Aarow Pump & Well Svs, LLC Company: PO Box 110496 Mailing Address: Anchorage Ak Zip: 99511 City: State: Attention. The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. --'° lq **s ILYA VA rA 01 \DUOIsseyo 44 t 0% ozoz -V jw L609—SI IV• PIDISDO T Raaf E)• 0 poo 0 co a Ar 0 ,OZ=., I :71VOS Wi3C] ONICI-line §A UVa SIHI 13S S83NHOD OON t zss Olid3S ONISSIN (130CIV OZOZ/*/C eoIISr v)isyw amisiaDNION0038 3MOH3NV 'S3Nn30N3A 80 AWGNnoe0NIHSnEIV1,S31 80-4 80 NOLLmUSNOO 80-4 a3sn3EI N030W -3oL . Z4 vivo kw alnOHS Mwismnmo ON 83aNn' 3NOHd UVId NOiswoens m800m 3H.L NO 8UddV VXSYW '3f)VNOHDNV ION 00 HOIHM SNO=IHIS38 80 SMVN3AO3:Q !/-0966 uns -am ONnMOa *3 000-1 'SJLN3ri3SV3 AW AO 30N31SIX3 3Hl. Wmmai *S-1*8 'ICrIVISVO *V AA3P 01 83NMO 3HI 40 kLnl8lSNOdS38 3H.L Sl A 311 'DNIAMms *03.LV310NI SV JLd33X3 MX3 SiN3HH3VO83N3 ONVI iawisvo ON ivH.L aNv 3Aoev a3iold3aAJMdOHd:!--.- 3H.La3,k3mns3AvH I J-WU MU30 A83U3H IMMINCROWTVA -n3M YS L L t IFL I NoMe 'Z iM NOISIAlcionS 31NlOdHino L!—ZOOZ 'ON IVId I F4 Olid3S ONISSIN (130CIV OZOZ/*/C (33SIA3N -3oL . Z4 ,VZ- rz 6 0- -n3M Mui ONI(nine DNUsm00 U- :3 m w m w D rn a Zia 13AVaf) O z D .02 i i ul 11 MMS),S 0LLd3S I > �°v 4; -3 q. -oz 3.19t./O./q S .00 L YS L L t IFL I NoMe 'Z iM NOISIAlcionS 31NlOdHino L!—ZOOZ 'ON IVId I F4 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 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP191175 Work Type: Septic Initial Tax Code Number: 02031147000 Site Legal Address: SOUTHPOINTE BLK 1 LT 2 G:3738 Site Mailing Address: 6124 SOUTHPOINTE RIDGE DR, Anchorage Owner: SIRACUSA DEAN Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: io� g�y ��ent �c< r r • V Depai•tin ent 5/14/2019 5/13/2020 74117 Q Disposal Field Q 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 C-- 1 Special Provisions: l) 1. The Engineer is required to do an additional percolation test prior to construction of the septic field. 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. 2. Construction may proceed at your own risk before the 7 day water monitoring is complete. 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. 3. A MOA inspector is required to be at the bottom of trench inspection to observe the existing fill and surrounding slopes. CO*) �e�d locc.Ytbh �h���1 /04 -er/AT Co -V-- Z 2 ��' sunr� �i�te✓ re�u�%�vl Received By: Date: c/ Issued By: Date: dog 9PUNJIS RUS-) 9 L=am r? U/- jY/ I// MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 020-311-47 Property owner(s) Crown Pointe, Inc. Day phone 229-1886 Mailing address P.O. Box112313 Anchorage, AK 99511 Site address NHN Southpointe Ridge Drive Anchorage, AK 99516 Legal description (Sub'd., Block & Lot) Southpointe, Block 1, Lot 2 Legal description (Township, Range & Section) Lot Size 74,117 Sq. Ft. Number of Bedrooms APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial 0 Single Family (SF) Q (w/wo ADU) Septic Tank Q Upgrade ❑ Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Absorption Trench to Slope >25% Distance: 10' I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. wl'—J'k a ag-� (Signature of property owner or authorized agent) Permit/Rush Fees: 5-g Waiver Fees: ,3&6 Date of Payment: .6—1/6)Ll Date of Payment: �f!®ti9 Receipt Number: Permit No. 05JOl `?1 `-71's Permit App_.:- : . �. c Receipt Number: Waiver No. ®,5V19 16 �Vv CC'!�c1 October 24, 2019 MOA Development Services Dept, On -Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Southpointe, Block 1, Lot 2 — NHN Southpointe Ridge Septic System Design Dear On -Site Services Engineer: The owner of the above lot intends to build a 5 -bedroom home on the property. We are submitting this permit application for the construction of a septic system. The attached site plan identifies the location of the home and the existing well, proposed septic location and alternate site. No conflicts exist between this proposed system and any other well or septic system on this lot or adjacent lots. The ground surface on the lot in the area of the absorption trenches slope to the northwest. The absorption trench will be placed closer than 35' from slopes greater than 25%, but the trench section has been designed to meet the steep slope provision of the ordinance. No waiver is required. Contours are shown on the site plan indicating the grade and direction of flow. Storm water drainage will not impact this septic system. The new trenches will be constructed parallel to the slope as much as possible. The absorption trench will be constructed partially in fill material. The material is clean gravel with some silt and no organics or other debris. It is compacted to the same degree as the underlying in situ material. The fill was placed during construction of the road more than 10 years ago. The percolation rate of the fill may be slower than the underlying in situ material. We have use an application rate of 4 gallons per day per square foot which equates to a percolation rate of up to 30 minutes per inch which is much slower than the in situ material. Please refer to the attached test hole log and plan and profile sheets for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Michael E. Anderson, PE SOUTHPOINTE BLOCK 1 LOT 2 co / LOT 1 VACANT TH3 / / ( 10'AE EASEMENT / / 15' T&E EASEMENT w ,ry / J / ALTERN E SITE . 38' LCNG, x KWIDE x!5' I 0 / co EFFECTIVE DEHJ —_ABSORPTION TRENCH I ui 250NGAA �'� ` —+ate— _/ i \ (� STEE TANK w/( T THB 0 I J z� I 2- 20 PODS pp MH o 2C0 1 i / w LOTS 2!z- � Fco / /' \ r I 5 -BEDROOM H E m / NdTE: � I NOISLOP S >45° WERE N8TED WITH 5' 7) OF THE P OPOS D ABSO PTION I I 1 TR NCH S IN ANi DIRECTION. �-7�__, \ \ ( EXISTING\WELL w/50' RADIUS EXI TING SEPTI SYSTEM / \ --\� \ EXISTING WELL \\ \ w/100' RADIUS \\ \ I � LOT 3 NOTE: ®\ SLOPES >25% WITHIN 35' OF THE ABSORPTION TRENC ES. TRENCHES ARE DESIGNED FOR STEEP SLOPE PLACEMENT, NO SURFACE WATER WITHIN 50' OF THE PROPOSED SEPTIC SYSTEM LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE ' A ":' �� ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS rp...9th . ,,,, ,�,,,,,� PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC VpnpN [� -:7 r�CHAEL�Et�ANDER50N SYSTEMS. `vim No. cE—a3ai 0 50 100 11123/11 FEET jobpROFESS\�®®°���� 1.._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 SOUTHPOINTE, BLOCK 1, LOT 2 co #I DESIGN FACTORS: SYSTEM REQUIREMENTS: 750 GPD PEAK FLOW 5' WIDE TRENCH SYSTEM PERK RATE: 5.8 MIN/IN 2,500 -GAL STEEL ADVANTEX TANK APPLICATION RATE: 4 GPD/SF 2 -AX -20 TREATMENT PODS 750 GPD / 4 GPD/SF /5' WIDE * 1.0 RED. FACTOR = 37.5 LF TRENCH REQUIRED (38 LF SPECIFIED) BOTTOM OF TRENCH: 3.5' BELOW GRADE FLOW LINE ELEVATION: 3' BELOW GRADE TOP OF TRENCH: 1.0' ABOVE GRADE Gc) ? 2 1' —III II. 2'6" 6" 21011 - FROM LOW SIDE - FROM LOW SIDE - FROM LOW SIDE 2" INSULATION 4" PERFORATED PVC (HOLES DOWN) DRAINFIELD ROCK MOA APPROVED SAND EXISTING FILL MATERIAL IN SITU MATERIAL TYPICAL 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 f SOILS LOG AND PERCOLATION TEST LEGAL DESCRIPTION: SOUTHPOINTE BI L2 PERFORMED FOR: CROWN POINTE DATE: 10122119 PROJECT No.: PARCELID#: 020-3II-47 TECHNICIAN: J. MILLETTE DEPTH (feet) 1- 4 5 6 7 8 9 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20 - COMMENTS: TEST HOLE B 1.5' OB / ORGANICS CLEAN FILL GM GRAVEL w/SILT & SAND GM BEDROCK WAS GROUND WATER ENCOUNTERED? IF YES n WHAT DEPTH? DEPTH OF WATER AFTER MONITORING: DATE OF MONITORING: SLOPE SITE PLAN SEE SITE PLAN U a` NO _ L 0 GROSS TIME (MINUTES) - P DEPTH To WATER (INCHES) E DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH To WATER (INCHES) NET DROP (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 1 4:54 -ie 2 5:24 309 iZ 5-Z 3 5:25 4i6 4 5:55 30 9 i16 5-,b 5 5:56 4 -ib 6 6:26 30 9 ,b 5-16 PERCOLATION RATE: 5.8 (MIN/INCH) PERC. HOLE DIA.--L—(INCHES) TEST RUN BETWEEN: 7 FT. and 8 FT. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191175, Deb Wockenfuss, 05/14/19 M-W Drilling, 'mc. ,P.O. Box l10378·Anchorege, AK 99511* · 907-34§-4000 · 907-345-3287 Fax · Job No.: 03-170 Project No.: N/A Permit No. SW030213 Groundwater Well As-Built & log Well Owner: Potter Creek Land Company · Use of Well: Domestic Legal Description: Villages View Estates, Tract AlE ~. ~lla~c~ West S'abd'.".ds!_ .' ':' . - , Alaska Anchorage, AK *Hole Depth: 305' *Casing $1ze: 6" ·Cased To: 20.34'. *Material: A 53 Steel *Drill Method: Air Rotary Well Completion- Open end X Screen __ Perforated Method: *Screen/Perforation description: None * Grout Notes: 10" hol~ drilled to 21'.and 6" casing installed with 5 sacks of No. 8 bentonite granule grout. * WellDevelopment: Method: Air surge Notes: *Static water iavel (SWL) 40.55' (a~c:~) (below) top of casing (TOO. , WellyieJd test at 3.5 gallonsper minute (GPM)/~*~9 for __ with 83.76' of drawdown (DD) from sta(ie level ($WL). · Method: Submersible 24 hours · Date of completion: 05 September 2003 *Pump InstalL' Well Log Depth in feet from top of casing. Details of formations penetrated, size of material, color and hardness. 0 TO 2.5 Casing stiekup 2.5 TO 7.5 Topsoil 7.5 TO 305 Bedrock: black silt-stone argil~ite, with quartz seams in intermittent TO fractures with small water seaps TO TO TO TO TO TO · TO TO TO TO TO MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water B Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519.6650 (907) 343-7904 ON-SITE WATER SUPPLY PERMIT Initial Permit Number: SW030213 Legal Description: Villages View Estates Tr Al E Design Engineer: 0014 Anderson Engineering Date Issued: Jun 23, 2003 Expiration Date: Jun 22, 2004 Parcel ID: 020-311-39 Site Address: unknown Owner Name: Robert L. Ethal Miller Lot Size: 2197558 SO. FT. Owner Address: 16420 St. James Circle Total Bedrooms: 0 Permit Bedrooms: 0 Anchorage , AK 99516 - This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. WHEN THE WATER WELL HAS BEEN COMPLETED AND SATISFACTORY WATER PRODUCTION HAS BEEN DETERMINED, THE WELL DRILLER SHALL PLACE AN APPROVED SANITARY SEAL ON THE WELL HEAD AND NO PITLESS ADAPTER OR PUMP SHALL BE INSTALLED UNTIL AN APPROVED WASTEWATER DISPOSAL SYSTEM HAS BEEN CONSTRUCTED. STHIS PERMIT ISSUED FOR VILLAGES WEST SUBD.`BLOCK 1 'LOT 1 Received By Issued By. Date: tZ W le Date:J Municipality of Anchorage Development Services Department Building Safety Division / On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.sk.us (907) 343-7904 ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 0Z 0— 3//.39 Permit Number SW030213 Property owner(s) Potter Creek Land Company Mailing address (1)16420 St..tames FLace Anchorage_ Day phone -345-184? AK 99516 Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) lot J- Block i, Villages West Subdivi+lon (Fr000sed) Legal description (Section, Township & Range) Tract Al , Villager View Entateo 5 ,bdivlalon Lot Size Za./77 U8 Acre q.Ft. Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only ❑ Well Only Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 1 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 Fees: Date of Payment: Receipt Number. (Rev.12M 1 Waiver Fees: Date of Payment: Receipt Number. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) June 19, 2003 Municipality of Anchorage Building Safety Division On -Site Water and Wastewater Program 4700 S. Bragaw Street Anchorage, AK 99507 Attention: Jim Cross, P.E. Subject: Villages West Subdivision Case No. S10950 Tract A-1 E, Villages View Estates Dear Jim: We have identified the locations for the three wells we intend to use for the aquifer test for Villages West Subdivision. These locations are shown on the attached Site Plan. We are hereby applying for permits to construct the three wells so the required testing and documentation can be completed to satisfy the subdivision requirements. Please advise if additional information is required prior to issuance of the well construction permits. Sincerely, rOL___L . Michael E. Anderson, P.E. Attachments MINWIlLwi LIM I ITE PLAN SCALE 10 = 100' MUNICIPALITY OF AHCHU E 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. 020-311-47 1. GENERAL INFORMATION Expiration Date: JCAJ D� Complete legal description Southpointe, Block 1, Lot 2 Location (site address) 6124 Southpointe Ridge Drive Anchorage, AK Current property owner(s) Crown Pointe, Inc. Day phone (907) 346-3156 Mailing address Real estate agent P.O. Box 112313 Anchorage, AK 99511 2. TYPE OF DWELLING: g Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑■ Private Septic 9 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 $ a ? / - Date of Payment 3 �!0 / 26 X20 Receipt Number 0/1-'M p COSA # DS .*zG l U29 Waiver Fee $ Date of Payment Receipt Number Waiver # 6. 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 Forge Engineering Phone 907-522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 3/10/2020 6. DSD SIGNATURE System #1 Approved for 5 bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: .�`����� OF � r(" i� J� W -SITE \NATER AND NASA,;.v o ra ar�C�F�A� R� °>> T SE04 la�111 71 till)) - Id 3 /.?020B . On inal Certificate Date. The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSA Checklist yellow sheet COSA Checklist Legal Description: Parcel ID: 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 Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date of Sample Comments __________________________________________________________________________________ B. TANK DATA Age of tank(s) years Tank type/material Measured operating fluid level in septic tank Standpipes/foundation cleanout per record drawing Date of pumping C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA ______________________ Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade ft (max) 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 Code-required soil cover over field System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Adequacy test date Results Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: Southpointe, Block 1, Lot 2 020-311-47 4.1 9/5/03 N/A 305 20.34 7.58 56 Forge Engineering 3/04/2020 54.1 2/28/20 <1 FAP/Fiberglass New New Construction - 10/21/19 Wide Trench 10/29/19 New Construction 5.5 5.0 COSA Checklist yellow sheet 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 ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft From Septic/Holding Tank on Lot to:(Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Property Line > 5’ Yes if No ft Absorption Field > 5’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If 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 Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft If absorption field is under driveway comment below Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft F. ENGINEER’S 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. 3/23/20 >50 ✔ ✔ ✔ ✔ >50 ✔ ✔ ✔✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ >50 >50 ✔ ✔ MUNICIPALITY OF ANCHORAGE    DEVELOPMENT SERVICES DEPARTMENT    907‐343‐7904  On‐Site Water and Wastewater Section                                                                                           Fax: 343‐7997  www.muni.org/onsite         Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org      Nitrate Advisory   Certificate of On‐Site Systems Approval # OSC201079  Subdivision: Southpointe, Block: 1, Lot: 2  A water sample revealed a nitrate concentration of 7.58 milligrams per liter (mg/L).   The  Environmental  Protection  Agency  (EPA)  has  established  a  maximum  contaminant level (MCL) of 10.0 mg/L for public drinking water systems.  While  private wells are not subject to this regulation, EPA standards are based on existing  health information and can therefore be used to gauge the relative quality of water  from private wells.  Since nitrates are known to slowly increase, we recommend  you monitor the water quality.  Please see the attached “Nitrate Fact Sheet” for  important information regarding nitrate.  This advisory must be attached to all copies of the subject Certificate of On‐Site  Systems Approval.                                 Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org  Nitrate Fact Sheet  From Northern Testing Laboratories, Inc.  Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water.  Nitrate  is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.  SOURCE:  Nitrate is a major component of fertilizer and wastewater.  Often the nitrate is in the form of  ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the  oxidized form known as nitrate.  Sources of nitrate from wastewater include urea, ammonia cleaners,  food solids, and bacterial cells.  It may also result from the breakdown of organic matter buried in the soil.  TOXICITY:  Nitrate is generally not toxic to adults or children over the age of two or three years, but is  associated with a potentially fatal infant disease called methemoglobinemia.  In the digestive system of  young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood  stream.  There it combines with the hemoglobin and interferes with the ability of the blood to carry  oxygen.  For this reason, methemoglobinemia is referred to as “blue baby” disease.  The EPA limits the  concentration of nitrate in public drinking water supplies to 10 mg/L.  The standard has been lowered  from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.  TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home  water treatment systems such as softening or iron filtration does not readily remove nitrate.  The best  method for limiting nitrate in well water is source control.  This can include avoiding overdosing of  fertilizer near the well and maintaining good separation distances between septic tank leach fields and  the well.  A special anion exchange filter that contains a medi a with a strong affinity for negatively charged  ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.  TESTING:  Nitrate analysis is usually done by one of the several  “wet  chemical”  methods  using  a  spectrophotometer to read the final color endpoint.  Specific ion electrodes also can be used to detect  the activity of nitrate in water.  This laboratory uses several different wet chemical methods approved  under the public water supply laboratory certification program.  They also have test kits available, which  the laboratory uses to perform an inexpensive “screening test”, and with which the homeowner can  monitor the change in nitrate levels from their well.  They recommend comparing the test kit results  against a certified analysis from the lab occasionally to verify the accuracy of the kit.  We recommend  using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.          M13NICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this g Day of c of 20.,�3, by and between b-( pL,K i h cin the "WNNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as Advantex Waste Water Treatment Svstem located at (legal description) Southpointe Block 1 Lot 2 2, Maintenance. Repairs and Alterations. (Owner is required to read, understand and initial each section) :u Throw=pout the term of this Agreement, the Owner shall enter into a service agreement' with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing.treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically 5400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality jlc- or the manufacturer's representative will inspect and make any necessary maintenance, repairs or, permitted alterations to the system. Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/1.8/2018) Pagel of 3 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may he assessed in accordance with AIMC 14.60.030. Ownrer agrees to grant the Municipality reasonable access to test and inspect the AWNVTS. The Municipality will give at least 24-hour notice. Owner agrees that any sale or transfer of title of the property will not occur without a new } Certificate of On -Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and Approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the ,lunicipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. `onwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: i .. By: (signature) print name) Date: (-�'-% ZOZ-0 STATE OF ALASKA ) SS. THIRD JUDICIAL DISTRICT ) The foregomg foregoinstrumen was acknowledged before me this day of 20L -U by STATE Oh ALASKA NOTARY PUBLIC` i`IO ' PUBLIC ALA 1(22 C. Nugent My Commission e%pi S: JT9 My Commission Expires: July 19.2022 MUNICIPALITY: n A By: {� UV( -OV si nature) Date: /1 / ( $ /�eleeco. (�rno �C (printname) Title: (rev. 05/18/2018) Page 3. of 3