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HomeMy WebLinkAboutPOTTER HIGHLANDS PH 1 BLK 1 LT 5Potter Highlands Ph 1 Block 1 Lot 5 #020-281-57 Inspection Report7l-11117$6e 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.orq/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP141435 PID Number: 020-281-57 ❑✓ New ❑ Upgrade Name: John Fiagmeier Homes, LLC ABSORPTION FIELD ❑ Deep Trench ❑✓ Shallow Trench El Bed El Mound Address 6173 Greece Circle ❑ Other - Phone Number of Bedrooms - Soil Rating Total depth from original grade 4 4 GPD/S F 7.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 5.0 Ft. Gravel depth beneath pipe 2,9 FL Subdivision Block Lot Potter Highlands Phase 1 1 5 Fill added above original grade - 0 Ft. Gravel length 30.0 Ft. Township Range Section Gravel width SFt. Beds: Number of Lines N/A Distance between lines NIA Ft, SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line 214.0 Fr` 1 - N/AFt, well 161.5 180.1 172.0 N/A 127.0 TANK ❑ Septic ❑p S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank/ Orenco Capacity I 1,50OGal. Surface water 100+ 100+ 100+ NIA Material Number of compartments Lot Line 45.7 15.2 45.7 N/A Fiberglass 2 NA Foundation 33.7 52.2 44.0 N/A LIFT STATION Manufacturer Capacity - Curtain Drain N/A N/A NIA N/A Orenco 500 Gal. Pump on level at Pump off level at High water alarm at Remarks 43 in. 40 in. 45 in. Pump make and model Electrical Inspections performed by - P2005 De Pe et�htr Se�v_fc PIPE MATERIAL Housetotank Tanktc 3034 drainfield 3034 Installer John Hagmeier Homes, LLC Drainfeld 3034 CO/MT 3034 Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 100ft Inspection1s� $/10/2015 a 8/10/2015 Location and description dates: 3" 8/10/2015 2^ 4'" Top of Deck COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp .. !�Or- A int Conditional Approval: Date•! .. ..:* even A.'. an•riorae C 8149 Approved j Date=/_/ •: Inspection Report7l-11117$6e I "VcpOq�wpE �� i —, ti rNTo sip rHERS / WELL (P) \ NIC WELL (P) NIC zi r yv i Sy x kNEWIWELIL 70' ESM /_ \ D NEW LOT'S ' ! / 4BR HOUSE 1A / I� LOT VACANT p B '� / x NO WELLS OR SEPTICS A '; Wim_ W_�;W/' , PC i/ DC2 / =L DC1 / Ti NEW DRAIN FIELD NEW PRE -ASSEMBLED j ) 30LF x 5.0'W x 2.0'ED x 7.0'TD M1 15008 ADVANTEX TANK A n LS1, W/ AX20 POD \CI I C2, I RESERVE DRAIN FIELD (P) M2 �/ % 3OLF x 5.O'W x 2.O'ED x 7.O'TD / 700 O 1 TH 1 NOTES: PANNONE ENG SVC, LLC A klk Date RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 J C� CA kkt 8/18/2015 PHONE (907) 272-8218 FAX (907) 272-8211�y#) Scale 49 Tom+ .... ... .. :.. P.I.D. NO POTTER HIGHLANDS PHASE I, BLOCK 1, LOT 020-281-57 JOHN HAGMEIER / HAGMEIER HOMES Steven R. • Pannone j PERMIT NO. GREECE CIR. % �., CE 8749 .���/ OSP141435 � c� •. .��r PLAN ANCHORAGE, AK 99516 +'i11�� A B C D FC 7.5 - - - DCI 22.8 34.6 - - TI 35.2 45.0 - - - LS 45.5 54.0 - - DC2 46.3 52.5 - Cl 52.7 58.3 - Ml 54.4 58.9 - - C2 82.1 86.1- - - M2 82.0 1 87.4 - WELL NOTES: PANNONE ENG SVC, LLC A klk Date RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 J C� CA kkt 8/18/2015 PHONE (907) 272-8218 FAX (907) 272-8211�y#) Scale 49 Tom+ .... ... .. :.. P.I.D. NO POTTER HIGHLANDS PHASE I, BLOCK 1, LOT 020-281-57 JOHN HAGMEIER / HAGMEIER HOMES Steven R. • Pannone j PERMIT NO. GREECE CIR. % �., CE 8749 .���/ OSP141435 � c� •. .��r PLAN ANCHORAGE, AK 99516 +'i11�� SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON–SITE WASTEWATER DISPOSAL SYSTEMS AND ATTACHED SPECIAL PROVISIONS. 2. SCOPE OF WORK: INSTALLED NEW 1500g ADVANTEX TANK WITH AX20 POD AND DOUBLE CLEAN OUT AND SOIL ABSORPTION SYSTEM. INSTALLED NEW WELL 3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 145 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE WAS NOT OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 145 f-EET BELOW EXISTING GRADE. -2A TH-1 OR B42 FILTER FABRIC _ 4. 0 DRAIN PIPE E DUCTILE IRON PIPE TH TEST HOLE 5 G DRAIN ROCK 6' ABOVE PIPE FOUNDATION CLEAN OUT T# L C# CLEAN OUT NO -892 20I MONITOR TUBE NO. R, J. —87.2 DCO GM/ DRAIN ROCK DIVERTER-VALVE SM FLOW SPLITTER - BFG BELOW FINISH GRADE 7.5 ORIGINAL GRADE FG FINISH GRADE -14.5 TOPSOIL AND VEGETATE -7971 SECTION DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) _ TANK SIZE: 1500 ADVANTEX W/ AX20 POD AND DCO PERC RATE: 27 MPI SOIL RATING: 4 GPD/SF AREA ROD: 150 SF SYS. TYPE: WIDE TRENCH 2.0'ED RF 0.70 MIN LENGTH: 21.0 LF USE: 30 LFx5.0'Wx2.0' E.D., 7.0' TD TOTAL AREA: 214 SF PROFILE TRENCH SEE DESIGN LEGEND W WATER LINE/ WELL RADIUS — SS — NEW SEPTIC NOTES: PANNONE ENG SVC, LLC RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 POTTER HIGHLANDS PHASE I, BLOCK 1, LOT 5 JOHN HAGMEIER / HAGMEIER HOMES GREECE CIR. DESIGN DETAILS ANCHORAGE, AK 99516 ABBREVIATIONS CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT N0, C# CLEAN OUT NO M# MONITOR TUBE NO. R, J. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER-VALVE FS FLOW SPLITTER - BFG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL AND VEGETATE NIC NOT IN COhJRACT .OF. gC,gSl8/18/2015 Scale *:49TH NTS P.I.D. NO Steven F2� Panno'Re PERMIT N0. 0PFC, CE 8149 OSP141435 fl s� r PFD•- -'•' — Sheet ll� %'ROFEssn%P z '\����"��- 3 OF 3 All.,ne Drilling & Enterprisids Permit Number: #SW 141435 Date of Issue: 10-17-2014 Parcel Identification Number: 02028157000 Date Started: 2-1-15 Date Completed: 2-02-15 Is well located at approved permit location? x Yes ❑ No Legal Description: Potter Highlands Phase 1 Block 1 Lot 5 Property Owner Name & Address: Potter Creek Development LLC 3230 C Street First Floor Anchorage, Alaska 99503 Borehole Data: Depth (ft)r-MIlethodof Drilling x air rotary ❑ cable tool Soil Type, Thickness &. Wate- Strata From Toe: steel PStick-up 0 2ckness:.250 inches C)ragar�ics &silt 2 3: 6 inches Depth: 7 0 feet pe:Silty gravel 3 7: inches Depth: feet gravelly silt 7 15tickup above ground: 2 feet. silty cobbly gravel 15 23 Static water level (from ground level): 68 feet . gravelly silt 23 65 Pumping level: 200 feet after bedrock 65 ,206 2 hours pumping 40 gpm Recovery Rate:.40 gpm Method of Testing: ulr It d KZO 198 204 Well Intake Opening Type: ❑ Open End x Open Hole ❑ Screened Start feet Stopped feet ❑ Perforations Start , feet Stopped feet Grout Type: Bentonite eranules Volume: 2 bei De the Start 0 feet Stogped ? feet Pump* Intake Depth feet , Pump size hp Brand Name Well Disinfected Upon Completion? x Yes ❑ No Method of Disinfection: chlorine tablets Comments: Well Driller: Alpine Drilling & Enterprises PO Box 110496 Anchorage AK99511 i. , t} Pump Installation Date: 7/21n5 Pump Intake Depth Below Top of Well Casing: 175 feet Pump Manufacturer's Name: Goulds Pump Model: Meyers Pump Size 1 hp Adapter Burial Depth: 12 feet Pitless Adapter Manufacturer's Name: Martinson Pitless Adapter Installer: Aarow Pump & Well Service, LLC Well Disinfected Upon Completion? 7 Yes ❑ No Method of Disinfection: chlorine tablets Comments: Pump Installer Name- Aarow Pump & Well Service, LLC P.O. Box 114496 Anchorage, AK 99511-0496 Please save for your engineer. This is needed for your COSA. Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. Development Services Department Building Safety Division t On-Site Water & Wastewater Program i4 J 4700 Elmore Road P.0. Sox 196650 Mark Begich Anchorage, AK 99507 Mayor - www.muni.ora/onsi#e (907)343-7904 Pump Installation Log Well Drilling Permit Number: SW 141436 Date of Issue: 10-17-2014 Parcel Identification Number: 02028157000 Legal Description Property Owner Name & Address: Potter Highlands. Phase 1 Block 1 Lot 5 Potter Creek Development LLC 3230 C Street First Floor v Anchorage, Alaska 99503 Pump Installation Date: 7/21n5 Pump Intake Depth Below Top of Well Casing: 175 feet Pump Manufacturer's Name: Goulds Pump Model: Meyers Pump Size 1 hp Adapter Burial Depth: 12 feet Pitless Adapter Manufacturer's Name: Martinson Pitless Adapter Installer: Aarow Pump & Well Service, LLC Well Disinfected Upon Completion? 7 Yes ❑ No Method of Disinfection: chlorine tablets Comments: Pump Installer Name- Aarow Pump & Well Service, LLC P.O. Box 114496 Anchorage, AK 99511-0496 Please save for your engineer. This is needed for your COSA. Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. Aug 251503:21p Dependable Services 907-677-1372 P. DEPENDABLE SERVICES ELECTRICAL PO SOX 4357 Palmer, AK 99645 Aug 25, 2015 \\ ^�4) To Whom it May Concern, i L nn5� x his letter is to confirm that the lift station at 5/1 Potter Highlands, has been wired according.to N.E.C. standards by Dependable Services with the license No.34142. Sincerely, Andrew Wessel (907)317-9954 office (907)677-1372 fox okdependobleser ices@gmadxom 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: OSP141435 Tax Code Number: 02028157000 Work Type: WellSeptic Initial Permit Effective Dates: October 07, 2014 to October 07, 2015 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: POTTER HIGHLANDS PH 1 Site Legal Address: POTTER HIGHLANDS PH 1 BLK 1 LT 5 G:3638 Owner/Address: POTTER CREEK DEVELOPMENT LLC 3230 C ST FIRST FLOOR ANCHORAGE AK 995030000 Site Mailing Address: 6173 GREECE DR, Anchorage Lot Size in Sq Ft: 64381 Total Bedrooms: 4 This permit is for the construction of: Y Disposal Field N .Septic Tank N Holding Tank N Privy N 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. Received Issued By: hx- ,v Date: �a 7 MUNICIPALITY OF ANCHORAGE Community Development Department 16 Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWERNVELL PERMIT APPLICATION Parcel I.D. 020-281-57 Property owner(s) JOHN HAGMEIER t V Day phone Mailing address 3320 C ST. FIRST FLOOR, ANCHORAGII, AK 99577 Site address GREECE Legal description (Sub'd., Block & Lot) POTTER HM!10- LANDS PH 1 BILK 1 LOT 5 Legal description (Township, Range & Section) Lot Size 64,381 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field Initial 0 Single Family (SF) 0 (w/wo ADU) Septic Tank Upgrade F-1Duplex (D) Duplex ❑ Holding Tank ❑ Renew DwellingsPrivy e 4�1TTAIF ❑ ®Vand/or D) Private Well � � V Water Storage ❑ / OCT 0 1 2014 THISAPP T IKQt)UDES A VARIANCE hNAIVER REQUEST.FOR: �- I Dis tance: 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) p Permit/Rush Fees: 50 ,-J--24S 'f" L1110 qb Waiver Fees: Date of Payment: Lo 1111"4 Date of Payment: Receipt Number: 8547-7 Receipt Number: Permit No. (YJP N M35 Waiver No. Permit App_" Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve(cDoanengak.com September 30, 2014 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road P. O. Box 196650 Anchorage, Alaska 99519 Subject: Potter Highlands PH 1 Block 1 Lot 5 Septic System & Well Permit Request Ladies and Gentlemen: I am writing to request a permit to install a new septic system and well to be issued for this property. The proposed systems will serve a proposed four (4) bedroom house. The proposed system will utilize a 1500g S.T.E.P tank with an ax 20 treatment pod and a conventional wide trench. The surrounding developed lots are currently undeveloped. 1. Soils. We performed one test hole on this lot, and groundwater was monitored on 9/30/2014 and ground water was not observed below the ground elevation in the test hole monitor tube. From 0.0' to 1.0' was organics, from 1.0-14.5 ' was a silty sandy gravel. It is my opinion, based on the results of the soils tests, the use of a category III system and overall soils appearance; an application rate of 4 gallons/day/square feet should be used. 2. Soil Absorption System Design. a. See Sheet 2 of the design package. 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The existing topography slopes from the east to west at approximately 17% in the area of the proposed drain field with a flat area for the drain field location. There are no steep slopes located in the area of the proposed drain field. S. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On -Site Department, the note will be removed and "Issued for Construction" drawings will be issued. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 The proposed installation will not affect the future development of the surrounding or existing lots. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 ' — | /� ` \ '/// / // WELL GREECE CIR (p) DRIVEWAY (P) 10' T&E POTTER HIGHLANDS PHI i HOUSE FC cc W/ AN AX 20 PODOP) if MT MT DO PROPOSED DRAIN FIELD TH I ES AIN FIELD j I' NOTES PAMONE ENG SVC, LLC OF A.i�,qkk� D1O /1 /2013 FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 ..... .. 0, PHONE (907) 272-8218 FAX (907) 272-8211 0e NO 1 50 P, 11. D �NO JOHN HAGMEIER Steven R. Ponno.ne , PERMIT NO. CE 8149 OSP1 41435 GREECE CIR Sheet SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS AND ATTACHED SPECIAL PROVISIONS. 2. SCOPE OF WORK: INSTALL NEW 1500g S.T.E.P. TANK WITH AX20 POO, SOIL ABSORPTION SYSTEM, AND WELL. 3. GROUNDWATER NOT OBSERVED BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 13 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. /- FILTER FABRIC -14,5 TH_1 oo C) s o 4" 0 PERF PIPE OR ORGANICS ( MI 4" y PERF PIPE HOUSE (P) 4.� DRAIN ROCK 6' ABOVE PIPE INV ON BUILDING PAD MONITOR TUBE NO. R. 1. RIGID INSULATION D RAIN ROCK DOUBLE CLEAN OUT DV 0.5'T_ ri 12.0 FLOW SPLITTER M/ SILtt SANDY'S-.' OG ORIGINAL GRADE FG SM GRAVEL BOH SECTION NEW 1500 9 RIGID INsuurroN S.T.E.P. TANK W/AX20 POD DESIGN PARAMETERS PRIMARY/RESERVE SEPTIC SYSTEM NO. BEDROOM: 4(600gpd) TANK SIZE: 15008 STEP(P) PERC RATE — 27 MPI SOIL RATING: 4 GPD/SF CAT III AREA ROD: 150 SF SYS, TYPE: 5 WIDE TRENCH 2' E.D. RF: 0.7 MIN LENGTH: 21.0 LF USE: 30 LF X 5' WIDE, 2.0 TOTAL AREA: 150 SF E.D.. 7.0' TD W00y= LEGEND W WATER LINE/ WELL RADIUS SS — NEW SEPTIC oo C) s o �a <o oQ o z RAIN ROCK 6" ABOVE PIPE INV s 4" y PERF PIPE HOUSE (P) o� CLEAN OUT NO. ON BUILDING PAD MONITOR TUBE NO. R. 1. NEW 1500 9 RIGID INsuurroN S.T.E.P. TANK W/AX20 POD DESIGN PARAMETERS PRIMARY/RESERVE SEPTIC SYSTEM NO. BEDROOM: 4(600gpd) TANK SIZE: 15008 STEP(P) PERC RATE — 27 MPI SOIL RATING: 4 GPD/SF CAT III AREA ROD: 150 SF SYS, TYPE: 5 WIDE TRENCH 2' E.D. RF: 0.7 MIN LENGTH: 21.0 LF USE: 30 LF X 5' WIDE, 2.0 TOTAL AREA: 150 SF E.D.. 7.0' TD W00y= LEGEND W WATER LINE/ WELL RADIUS SS — NEW SEPTIC ABBREVIATIONS Cu COPPER DIP �a TER fggRlC � [ RAIN ROCK 6" ABOVE PIPE INV s 4" y PERF PIPE zd ��� ABBREVIATIONS Cu COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M$ MONITOR TUBE NO. R. 1. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BFG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE NOTES: PANNONE ENG SVC, LLC- of a V� Date FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 ^'c� • �gslk, 10/1/2013 PHONE (907) 272-8218 FAX (907) 272-8211 %q�p �yfj Scale NTS ... ... .:... ..:.. / P.I.D. NO POTTER HIGHLANDS PH 1 BLOCK 1 LOT 5020-281-57 JOHN HAGIVEIER Steven R Pannone j PERMIT NO. GREECE CIR ��+PS, CE 8149 OSP141435 DESIGN DETAILS ANCHORAGE, AK 99516 ��F� ass' ' Sheet 2 OF 3 READING SOILS LOG - PERCOLATION TEST CLOCK TIME TEST HOLE 2 WATER LEVEL READING NET DROP OR ORGANICS SLOPE .GREECE CR / 1 E A 1 3 1 I I DRNEwAr(P) --- 2 2 30 MIN 6.33 1.12 a 12:29 l A 10' T&E R07ER HIGHUNDG PHI 4 EPS.Vn / y, J i 1 BLK I, LOT5 HOUSE 12:59 _ _ w (P) 5� s i GM SILTY GRAVEL -, x r 6 1 TH 1:32 30 MIN 6.08 1.11 8 9 10 7 I� - 12 f 1 13 WAS GROUND WATER SLOPE is ENCOUNTERED? NO 15 BON IF YES, AT WHAT TH DEPTH? -NO WATER'- x 16 17 DEPTH TO WATER AFTER MONITORING? -NO WATER'- 18 DATE: 9130/2014 DATE PERFORMED: 9123/13 _ PEROLATION RATE 27 (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 3 FT AND 4 FT COMMENTS: Test hole excavated by JOHN HAGMEIER HOMES LLC. Perc hole was presoaked. Test run for one hour. Last 3 readings reported PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. P�O0NE7 ENGRASVCK 9LLo PHONE (907) 272-8218 FAX (907) 272-8211 ;��OF.q�gs\'1 %6j�P �91)I Dote 10/1/2013 FOR CONSTRUCTION Scale NTS POTTER HIGHLANDS PH 1 BLOCK 1 LOT 5 .... .... .... ..... P.I.D. NO - 6_261_57 JOHN HAGMEIER / Steven R. Pannone PERMIT NO. GREECE CIR +h�r CE 8149 \��/ OSP141435 Sheet SOILS LOG ANCHORAGE, AK 99516 (li P� ......... lz= �,�\ 3 of 3 READING DATE CLOCK TIME NET TIME WATER LEVEL READING NET DROP 1 9/23!14 11:57 -- 5.21 --- 2 12:27 30 MIN 6.33 1.12 a 12:29 --- 5.08 ___ a 12:59 30 MIN 6.16 - 1.08 s 1:02 --- 4.97 -- s 1:32 30 MIN 6.08 1.11 t Parcel I.D. 020-281-57 Municipality of Anchorage ' On -Site Water and Wastewater Program (907) 343-7904 p Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Expiration Date: I �2 ", — / -7 Complete legal description Potter Highlands Phase 1, Block 1, Lot 5 Location (site address) 6173 Greece Dr. Current Property owner(s) John Hagmeief Homes LLC Mailing address Real Estate Agent Day phone_ 2204 Cleveland Ave. Suite 201 Anchorage, Ak 99517 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well I] Individual El Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance Received by: 1 ! IV " Date: COSA to be released to the n weer, unless otherwise requested by the engineer. COSA Fee $ 111-1049 Date of Payment V22115 Receipt Number 6qCnH3 COSA # 15C (5t cf (0C2 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, r ordinances, and regulations in effect at the time of installation. Name of Firm Pannone Engineering Services LLC Phone (907) 27278218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SI ATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Date 8/2712015 LIK,L. 111M Steven R. •Paririorie . • CE -8149 ..�; Conditional approval for bedrooms, with the following stipulations: BY: /Z ` /f. Original Certificate Date:" —1.- Theunci alit chorage Development Services Division (DSO) issues Certificates of Onsite 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. - ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet t '- %, c If more than 1 septic system is on the lot: COSA Checklist # I of 1 Structure served by this system Certificate of On -Site Systems Approval Checklist. Legal Description: Potter Highlands Phase 1, Block 1, Lot 5 Parcel ID: 020-281-57 A. WELL DATA Well type Private If A, B, or C provide PWSID # Well Log (Y/N) Y Date completed 2/2/2015 Sanitary seal (Y/N) Y Total depth 204 ft. Cased to 70 ft. FROM WELL LOG Date of test 272/2015 Static water level 68 fL Well production 40 g.p.m. WATER SAMPLE RESULTS: Coliform Neg colonies/100 mL Nitrate 2.08 mg/L Arsenic ND ug/L Date of sample: 8/17/2015 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Advantex/Flberg lass Tank size 1,500 gal Foundation cleanout (YIN) Y Date of pumping New Number of Compartments 2 Depression over tank (YIN) N Pumper NIA Wires properly protected (Y/N) Y Casing height (above ground) 18+ in. AT INSPECTION New New ft New g.p.m. Collected by: PES Date installed 8/10/2015 Cleanouts(Y/N) Y High water alarm (Y/N) Y C. ABSORPTION FIELD DATA Date installed 81IQ42015 Soil rating (g.p.d./ft2 or ft2/bdrm) 4 GPD/SF System type Shallow Trench Length 30 ft. Width 5 ft. Gravel below pipe 2 ft. Total depth 7 ft. Eff. absorption area 214 ft2 Monitoring tube Y Depression over field N Date of adequacy test New Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test New in. Water added New gal. New depthNeW in. Elapsed Time: New min: Final fluid depth New 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 8/10/2015 Size in gallons 500 Manhole/Access (Y/N) Y "Pump on" level at 43 in. "Pump off'" level at 40 in." High water'alarm level at 4$ in. Datum Bottom of Tank Cycles tested New Meets alar & circuit requirements? Yes E. MOMRATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100+ On adjacent lots 100+ Absorption field on lot 100+ On adjacent lots 100+ Public sewer main 75+ Public sewer manhole/cleanout- 100+ Sewer /septic service line 25+ Holding tank . 100+ Animal containment areas 50+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Absorption field 5+ Water main 10+ Water service line 10+ Surface water 100+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: - Property line 10+ Building foundation 10+ Water main 10+ Water Service line 10± Surface water 100+ Driveway, parkingtvehicle storage _10+ Curtain drain 50+ 1 Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that t have determined through field Inspections and review of Municipal records. that the 4ove systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone Date 8/27/2015 COSA canary sheet_2-6-15.doc - PLAT NO. 2013-113 POTTER HIGHLANDS SUBD., PHASE 1 LOT 5, BLOCK 1 1.478 ACRES GREECE C 10' T. & E. ESI N GASTALDI LAND SURVEYING, LLC JEFF A. GASTALDI, R.L.S. 2000 E. DOWLING RD., SUITE 8 ANCHORAGE, ALASKA 99507 PHONE 248-5454 GRID I DATE SW3638 8/20/2015 F.B. I JOB NO. 14-06 PH151 1 "=50' BUILDING DETAIL SCALE: 1 "=20' 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 A +.® PSE;.......,, qs�. A ; •. �; 49TH *•. Jeffery A. Gostaldi i ®� ••. L$ 6091 ' o� AV VA, ap rofessionat 0 0111L ADVANCED WASTEWATER TREATMENT SYSTEM. MAINTENANCE AND REPAIR AGREEMENT BETWEEt[INI N M,CgIjPALITY OF ANCHORAGE AND t t tj2AJ 1 t N M(Y P t i i a 11.UA VVI. THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this �Day of{of20byand between lAui/arAmtteis # %pYVt k",Yn�7 herein the "OWNER,", and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as cyoanTa, 11560 located at (legal description). 2. Definitions. Alteration. Any change to the design or function of an AW WTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Certificate of On -Site Systems Approval (COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code (hereinafter, "AMC") 15.55, These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. Permit. An On Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA, and shall continue while the AWWTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations Installation and Removal of Additional Equipment, Prior to performing any alterations to an AWWTS, the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall maintain their AWWTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (3) maintenance, (3) adjustment(s), (4) replacement costs, and (5); inspection costs. B_ Owner agrees to comply with all applicable: ordinance, laws, regulations, rules and orders for the AWWTS. C. Upon request by the Municipality, the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor, the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. H. 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. 6. Nonwaiver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of provisions, nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality that this Maintenance and Repair Agreement was executed with, and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement, the only authorized representatives of the parties are: a. Owner: aLA � s 3'1 P Y'WCi IQ ci 1011403 S&rll i b. Municipality: Director, Community Development or designated authority C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 8. .jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair 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 Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. OWNER: gy.(signature) (.a.�•zc S�rnnesf C FTC* ,MMtI'M0.� (print. name) STATE OF ALASKA THIRD JUDICIAL DISTRICT The foregoing instrument was 24 5 p by I 6( C 0 k Wk41v: My Commission expires: MUNICIPALITY: By: (signature) Date: ©9 a! tS day of ,P'ey Notary Public MADISON WHYMW-MARSHALL State of Alaska My Commission Expires April 08.2018 Date: name) Title: