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Home My WebLink AboutCROSS VIEW ESTATES BLK 1 LT 4Cross View Estates Block i Lot 4 #015-221-47 Municipality of Anchorage Development Services Department Building Safety Division On Site Water and Wastewater Program, 4700 Elmore Road P.O. Box 196650 Anchorage. AK 99507 Page of www.d anchorage.sk.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SWO60385 PID Number: 015-221-47 N.ma Crown Pointe, Inc. Wastewater System: Q New, ❑ Upgrade IWaax P.O. Box 112313 Anchorage. AK 99511 ABSORPTION FIELD prI 229-1886 wmonaswman. Four Q DeaD TraW, I7 $n4uw Tra,cn D BeJ O 4ounp Ode+I LEGAL DESCRIPTION SoeN.e a .8 GPnn:e 10 F1. Bpu1 btq Supaxeun Cross View Estates ao Dmroppelurncanp+u roa, p.ee Gr.u, pepm earoamppe q F,. 6 FI TamWD Rupe $acppn Fu.eplp.ppl enpry, Q,pp G•.vn lmpin 2.3 F, 70 FI. Well: ©New rade ❑ Upg r Gn a nan N moa arae Qwnp oaaen rue g F,. 1 - F, cu.4 on lPmv,e. A. s. C1 TMI uean aero To IW.p.". Pw 4ar•w Private 198 F1. 178 F, 840 Ft' ASTM D3034 PVC u^"+ D.4 D• SM. W.I. LHM a Iwl uew,ns,ueJ Alpine Drilling 5/2/07 141 F, Sanders 8 Sanders 8/28/07 ♦up Pump yn p C.e.p I .rt bow Giu 5o GP4 F,.2 F, TANK SEPARATION DISTANCES Aseptic ❑Holding ❑S.T.E.P. ❑Other: To I Septic Absorption I Lift Holding ub„HPnw,te .anew^. .P.cxy From Tank Field Station Tank sewer um Anchorage Tank 1,250 Gr wee >100' >100, N/A N/A >25' U.'" Steel om Nw a CprDnems Two (2) sw.pewn.r >too' >107 N/A N/A LIFT STATION ue .aaa• Lo, Vu >5' >IV N/A N/A G4 Fop^e"'0^ >5' >70' N/A N/A 'VunD pn'uw,n n 'Wmp ort',ea ., n Non w.,er.um,4 n CwnOnn None Noted Pump 4..e & Mope, Erpmu, ,nape * pM D, Remer.e BENCH MARK Lou,an w Geeu,pbn Back Deck. Northwest Comer. AewnieJ +v.uon F, Engineers Stamp Inspections performed by: A. Harala Dates: 14 8/28/07 ''��••••��••• 2nd W8107 Development Services Department Approval ' ."'�•. . Conditionalroval P Date: t�•J� . ................ •••f ,',�'� ^ ; Reviewed and approved by: e a Date:L1 .��•' BAINBRIDGE ROAD v w m � 3 N W18'43'N 178.37' z c o lA H R i n A w O 46 O w m Zimywo4' i o m 3 -0 0 N o D U)o < Z =_ N n 0 N D r < D rn 0 fTl m c_ sm . 000f m o z a t d Cn _ L�' RI �omw a rd 'm Ln A ma O7 —1 D <0 r D ?c n g$ ^O m �m C m Le) I C m�m OJ � x C Z 0 � s z I � ---- SRM DRNN 1SMr. U N N \\ \\ 1.118.72' R •. *\8�•• ��70.00' N OP73'191Y 60.39' v O w HE'RITAG r n EJ ?C�;_—GHTS DRIVE W S f � •,'�"R' I'• •• �� Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage, AK. 99519655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number. SWO60385 PID No. 015-221-47 94.8 U in r"'n UU F`..r.a fawe o.a a xmraem 1,250 Gallon Septic Tank 90.1 9.9 N U n � U 94.8 91.8 F.nmE Gin E.aWnY.i+tl! Geotextile Fabric ' 88.8 Drainfield Rock 88.9 82.8 00 76.0 70' (Trench Length) No Groundwater •i r}�� y�'{'•49th PROFILE AS—BUILT '.!f/"-``°"/h"Awf�/�A so, ��•'� o �•'•O "�� No Scale n�rtaa�0 ANDERSON ENGINEERING P.O. BOX 24aM ANCHORAGE,, AK 99524 522-7773 677-7766 (FAX) MEMORANDUM DATE: May 18, 2008 TO: Jeff Poet FROM: Mike Anderson, P.E. SUBJECT: Lot 4, Block 1, Cross View Estates Subdivision As -Built and COSA We reviewed the field data and have determined an error was made in the drafting of the previously submitted septic system as built drawing for Lot 4, Block 1, Cross View Estates Subdivision. The attached drawing is correct and should replace the drawing previously submitted. All other information previously submitted is correct. We apologize for the problem. Please call if you have any questions. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522.7773 677-7766 FAX MEMORANDUM DATE: March 21, 2008 TO: Deb Wockenfuss FROM: Mike Anderson, P.E. SUBJECT: Lot 4, Block 1, Cross View Estates Subdivision Septic System Absorption Trench Orientation COSA The surface of Lot 4, Block I, Cross View Estates Subdivision in the area of the new absorption trench is virtually flat with a very slight slope to the west. The owner of the lot requested that as many large trees as possible be saved during the construction of the septic system. The contractor determined the absorption trench could be placed In an east west orientation to the depths shown on the design and still remain in the silty gravel (GM) percolation zone. The distribution pipe was placed level at 4' below the surface at the east end of the trench and 3' below the surface at the slightly lower west end. Additional fill was placed over the entire trench and surrounding area to provide sufficient cover over the trench. Placement of the trench in the east -west orientation met the original design cross section for the trench and is in conformance with all requirements of the Municipal ordinance governing septic systems. ALPINE DRILLING & ENTERPRISES Permit Number: #SW060385 Date of Issue: 12-18-06 Parcel Identification Number: 015-221-47 Date Started: ¢1-07 Date completed: 5-2-07 Is well located at approved permit location? ® Yes ❑ No Legal Description: Cross View Estates Blk 1 Lot 4 Property Owner Name & Address: Crown Pointe, Inc. PO Box 113313 AS, e Alaska 99511 Borehole Data: nc ora Depth (ft) Method of Drilling ® air rotary ❑ cable tool Casing type: steel Soil Type, Thickness & Water Strata From To stick-up silt gravelly silt silty gravel 0 2 19 35 2 19. 35 92 Wall Thickness:. 025 inches Diameter: 6 inches Depth: feet Liner Type: Diameter: inches Depth feet Casing stickup above ground: 2 feet silt 92 107 Static water level (from ground level): 141 feet sandy silt 107 118 Pumping level: 198 feet after silty gravel 118 147 .2 hours pumping 50+ gpm cobbly silty gravel 147 154 Recovery Rate: 50+ gpm silly gravel 154 164 Method of Testing: air lift Well Intake Opening Type: silty water sand &gravel 164 194 water sand & gravel 194 198 ® Open End ❑ Open Hole ❑ Screened Startfeet Stopped feet ❑ Perforations Start feet Stopped feet Grout Type: bentonite gmules Volume: j Depth: Start 0 feet Stopped 7 feet Pump: Intake Depth feet Pump size hp Brand Name Well Disinfected Upon Completion? ® Yes ❑ No Method of Disinfection: chlorine tablets Comments: Well Driller. Alpine Drilling & Enterprises P.O. Box 110496 Anchorage, AK 99511-0496 Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property owner or the well driller shall provide a well log to the Development Services Department within §0 days of completion. MAR -21-2008 02:33A FROM: 70:3437997 P.1 D"gagAf ftmw bw Mawt wift ale" OKWO ON-8ft W40W a Waaf wetar Nrw " 4700 b aaw fuss P.Q. k" 141190 tAivAbiwaftanwahaftAmkwga. AK 4lnfl8ESO f Pump Installation Log Nit - Wap names Na9att Numban !areal 14"racw nNaaebart^;,�; Dsfs ar Iltaat Lopi prstpAa. Cro5511 sha -2 sat y Pv"ly cw.4rNaau i Aftranr �roco K Po ; � haph WanDoI - •� *+ter tabow 006 tdew Top of W40 t 5*21 r �o Mt ttMq Malubdanil; me pai('ic N 0 7"o'f TampMaetis � 7�SQ.�-ia-2� MMA *pUr lutea! Danit.. La hat TtAaoAQaptarida>rtaetena'.N.uat C'4 ��rr PldMAdaytaslnftDan u►n kHo w (� WaD Dlddimm Dpfn GtaSGtloa! N Yat 0 Na Caaaataart CALL FOR SERVICE - Complete wmar Syatam Bawka - AARoW PUMP & WER SERVICE, LLC `— BRIAN VALLE ANCHORAGE- EAGLE RIVER (007) 349-0365 (907) GM -OM AUMM%t Tho ami welter a1+tU fagNaa a pump teiatla:bs laf to DiD riddo 30 dada of peep {teailatfsa MUNICIPALITY OF ANCHORAGE hQ Development Services Department On -Site Water 8 Wastewater Program \ Q 4700 South Bragaw Street 1� P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Permit Number: SW060385 Date Issued: Dec 18, 2006 Expiration Date: Dec 18, 2007 Parcel ID: 015-221-47 Legal Description: CROSS VIEW ESTATES BLOCK 1 LOT 4 Design Engineer: 0014 ANDERSON ENGINEERING Site Address: NHN HERITAGE HEIGHTS DRIVE Owner Name: CROWN POINTE, INC. Lot Size: 43629 SO. FT. Owner Address: PO BOX 112313 Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE. AK 99511 - This permit is for the construction of: ❑✓ Disposal Field E 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. Received A_�_v JO iDate: Issued By. .f ->t^' Date: Municipality of Anchorage Development Services Department Building Safety Division _ On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 015421-47 Property owner(s) Crown Pointe, Inc. Day phone 345.6277 Mailing address P.O. Box 112313 Anchorage, AK 99511 Zip Code Site address Heritage Heights Drive Zip Code Legal description (Sub'd., Block & Lot) Lot 4, Block 1, Cross View Estates Subdivision Legal description (township, Range & Section) Lot Size 43,629 Sq. Ft. THIS APPLICATION IS FOR (® all that apply): Absorption Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well Water Storage ❑ Number of Bedrooms Four (4) THIS APPLICATION IS AN: Initial 0 Upgrade ❑ Renewal ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Date of Payment: Receipt Number. 89�f4 Ll Receipt Number. (Rev. 11/05) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 FAX December 14, 2006 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 4, Block 1, Cross View Estates Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 4, Block 1, Cross View 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 hole was placed on the lot in the area of the absorption trench and alternate site during the subdivision phase. The log indicates silty sand (SM). The percolation rate of the soil was determined to be between 1 and 5 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 .8 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 a 63' long by 3' wide by 6' effective depth absorption trench to treat and dispose of the effluent generated in the house. The elevation of the distribution line in the absorption trench will be 4' below the surface and the total depth will be 10'. 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. The ground surface on the lot in the area of the septic system slopes to the west. The new trench will be constructed parallel with the slope as much as possible in conformance with Municipal requirements. The new septic system will be constructed a Lot 4, Block 1, Cross Point Estates Subdivision December 14, 2006 Page Two 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: 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 'I 49:. VfiU--L E. AWE25CH ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 FAX MEMORANDUM DATE: April 30, 2007 TO: Joe Goodall FROM: Mike Anderson, P.E. SUBJECT: Lot 4, Block 1, Cross View Estates Subdivision Septic System Permit No. SW060385 The builder on the subject lot has requested the well be moved to the southeast corner as shown on the attached Site Plan. Placement at this location will not adversely affect the adjoining lot to the south. The same builder, Crown Pointe, Inc. owns the lot to the south and intends to place the septic system outside the well radii on both lots. He is aware of the requirements for septic system placement. Please review the attached data and advise if you have any questions concerning the relocations. LOT 6 VACANT � g 0 LAT 9 a.oua A. BLOCK 1 c� LAC PARK r. C7 O ix C E+W^1 ry K Z LOT S y BLOCK 1 •�'� t POINT ESTATES t +. �. Ed.urp IM a RIVE ••�� LOT 4 K:C EA"w a t Lor II 1 BLOCK z LILAC PARK haowa Yw aLD, V rea S.pea As ........... CSP "'..... �i i....49th ..:i•�t • .... ._.... AREA MAP K� 1� ;MICHAEL E ANDERSON f�� SCALE V= 100' 1�h��ffESSt_ w��• Z O C) m V U (/7 i w O O f— —J vi <mc, N b V, LLJ w '• w_ 0 \ U) U) 0 U ,69'09 M,6l,91D0 N o I I I I I \ . 1 _J 3 I x I o I , m 3Na� GlH� 3H 0 M I I 4 o; I •S o K� = �py N y�r �l ,ff'BLI -------------- -------------- M,fY,9ld0 N O M OVON 30016eNWO a 0 b YI LOT 4, BLOCK 1, CROSS VIEW ESTATES SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home Deep Trench System Perc. Rate: 1 to 5 Min./Inch 1,250 Gallon Septic Tank Application Rate: .8 GPD/SF 6' Drainfield Rock 4 Bedrooms X 150 GPD/.8 GPD/SF (Application Rate) = 750 SF Absorption Area 750 SF/12 SF/LF = 62.5 LF Trench Length THEREFORE: Construct a 63' Long x 3' Wide x 6' Effective Depth Absorption Trench at the Location Shown. Flow Line Elevation in Trench to be 4' Below Original Ground Surface. Total Depth to be 10' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption Trench. Maintain 100' Separation from Wells in the Area. Natural Backfill i_ Geotextile 3'6" Fabric 6" 1 N U I4" Perforated PVC (Holes Down) M 3' Drainfield Rock TYPICAL DEEP TRENCH SECTION (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. 04 : tL Minimum 6' Separation From Bedrock. %...., Minimum 4' Separation From Groundwater. %1 ' Minimum 100' Separation From Wells in the Area. Minimum 100' Separation From Surface Water or Streams.- 0i MILIMEL E MDER No. cEa i Lq MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 ELMORE ROAD ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: Lot 4, Block 1, Cross View Estates PERFORMED FOR: (rnwn Pninte Ine-. DATE: 8/28/07 PROJECTNo.: PARCEL ID#: TECIMCIAN: A. Harala DE:PT]I TEST BOLE # A (It -a) 1 3 4 5 6 7 8 9 Organics SILTY—SANDY—GRAVELS GM SLOPE loTrench n of WAS ES@WlGROUND WATER ENCOUNTERED' N�• Trench HFYFS (O WATER 11 DEpnl OF WATGR AFIE0. MONn ORINC DATE Or MDNrrORING. 12 13 14 15 16 17 18 19 OF ,• i 49th L ANDERSON SITE PAN SEE SITE PLAN �0 DATE READING G OSS TIME MINUTES) NET TIME (MINUTES) DEPTH To WATER (INCHES) NET DROP (INCHES) 8/28 TEST HOLE PRESOAKED PRIOR TO TESTING: 1 2:12 6.38" CHARGE 2 2:42 30 9.75" 3.37" 3 2:43 7.5" RECHARGE 4 3:13 30 10.75" 3.25" 5 3:14 7.25" RECHARGE 6 1 3:44 1 30 1 10.50"13.25" PERCOLATION RATE 9.2 (MIN/INCI I) FERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN.--L5-FT. and £i.5 FT. COMMENTS: Test hole Presoaked Prior to Percolation Test. TEST PERFORMED BY ANDERSON ENGINEERING. 1, MICHAEL E. ANDERSON CERTIFY THATTHE TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON TI ITS DATE: 3118108 pp0 -�`lp!l ....... CgSp� GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS # # O MI L 11A00 MYA. WK 101 • NK40RA C. K "W7 • N101K: 90) ]-{1)♦ • r4: YO) -3tN • •CBYIL p.rewq.rw�gmw /� SOIL LOG - PERCOLATION TEST ... .... .... (ou LEGAL DESCRIPTION: HERITAGE HILLS SUSDMSION 1; TRACT C&D PROPOSED LOT 4 a '.Je y Gar ess; PERFORMED FOR: PROFESSIONAL TECHNICAL SERVICES DATE: 8/30/200 E-7953 `4Q iii%JI/o, God DEPTH PetORGANICS p (roless%o^o TH 4 PTS 511 �00000�p 1 LOAM SOIL CLASSIFICATIONS 2 JGC GW ---- ORG 3GP ML GM CL4 OL SW MH SP CH SEE ATTACHED 5 SM OH �. 6 SC SITE PLAN 7 DEPTH TO DATE B 9 SM/ML 10 tt 12 13 14 15 B.O.H. 16 17 18 19 PERCOLATION RATE 8.6 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 5.5 FT. AND 6.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ® YES ❑ NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: CALEB GALL COMMENTS: PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WASP FORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: ) . ! GROUNDWATER READING DRY 8/30/2005 DRY 9/19/2005 8/31 OS 1 2:13 — DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 8/31 OS 1 2:13 — 6" — 2 2:43 30 2" 4" 3 2:43 — 6" — 4 3:13 30 2 1 /2" 3 1 2" 5 3:13 — 6" — 6 3:43 30 2 1 2" 3 1 2" 1 ii 9 S • Municipality of Anchor e ,R On -Site Water and Wastewater Progra JUN f 4 c� U f g: (907) 343-7904 �6 n: s ,, F E , I � A /Z 5. Ol68/�9 Certificate of On -Site Systems Approva Parcel I.D. 015-221-47 Expiration Date: 1. GENERAL INFORMATION Complete legal description Cross View Est. Block 1, Lot 4 Location (site address) 5085 Heritage Heights Dr. Current Property owners) Sean 8c Shelly Cochrane Day phone Mailing address Real Estate Agent 5085 Heritage Heights Dr. Anchorage, AK 99516 Relocation Company 2. TYPE OF DWELLING: Fx� 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 El Individual Fx� Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for:, COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ / Waiver Fee $ Date of Payment l Is Date of Payment Receipt Number /a 01 i A4 Receipt Number COSA# 65C I& (a3( 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the -local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 1 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE System #1 Approved for q bedrooms System #2 Approved for bedrooms Disapproved Date 6/12/2016 'ren, R.*15am6rie CE -8149 .-� Conditional approval for bedrooms, with the following stipulations: By: Original 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. ATTACHMENTS: COSA Checklist X Septic System Advisory Well Flow Advisory COSAbluesheer t ..i ,. Nitrate Advisory Arsenic Advisory Other If more than 1 septic system is on the lot; COSA Checklist # of Structure served by this system Certificate of On -Site Systems Approval Checklist_ Legal Description: Gross View Est. Block 1, Lot 4 A. WELL DATA Well type Private IfA,:B,orCprovide PWSID#— Date completed 5/2/2007 Sanitary,seal (YIN) Y Total depth 198 ft.. Cased to 198 ft. FROM WELL LOG Date of test 5/2/2007 Static water level 141 ft Well production 50+ g.p.m. WATER SAMPLE RESULTS: Coliform Ne9 - colonies/100 mL Nitrate 2.21 mg/L Arsenic ND ug/L Date of sample: 5/16/2016 Parcel ID: 015-22-1-47 Well Log (Y/N) Y Wires properly -protected (Y/N) Y Casing height (above ground) 18+ in. AT INSPECTION 5/16/2016 142 ft. 5.0+ 9•p:m- Collected by: PES B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 8/28/2007 Tank size 1,250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y " Depression over tank (YIN)- Nr High water alarm(Y/N) N Date of pumping �6 �� Pumper / I f Mei ! CC 'V ICCS , INC - C. ABSORPTION Fl p_R7 T/# Date installed 8/28/2007 Soil rating (g.p.d./fe or ftZ/bdrm) 0.8 GPD/SF System type Deep Trench Length 70 ft. Width 3 ft. Gravel below pipe 6 _ ft. Total depth 12.2 ft. Efr, absorption area 840 ft2 Monitoring tube Y Depression over field N Dateof adequacy test 5/1612016 Results (Pass/Fail) Pass For4_ bedrooms Fluid depth in absorption field before test 7 in. Water added 64'8 gal. New depth 13 in. Elapsed Time: 190 min. Final fluid depth 7 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 Size in gall Manhole/Access (Y/N "Pump on" level at in. . mp off" level at in. High wa arm level at in. Datum Cycles tested Meets Slami &circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot. 100+ On adjacentlots 100+ Absorptionfield 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 pN LOT TO: Property line 10+ Building foundation 10+ Water main-' 0+ Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 1,0+ Curtain drain 50+ Wells on adjacent -lots 100+ "F. COMMENTS Survey On Tile G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems areb conformance with MOA'COSA guidelines in effect on this date. Engineer's Printed Name Steven Pannone . Date 6/12/2016 CMA cadary sheet 2-6-15.doc 1'1 AhLY 8U • Municipality of Anchorage r On -Site Water and Wastewater Program (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 015-221-47 1. GENERAL INFORMATION Complete legal description Expiration Date: 8 ' / -6-- Cross View Estates BIk1 Lt4 Location (site address) 5085 Heritage Heights Dr., Anchorage Ak. 99516 Current Property owner(s) Dennis & Kay Pittman Day phone Mailing address 5085 Heritage Heights Dr., Anchorage Ak. 99516 Real Estate Agent 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 0 Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Received byF--''��' — Date: t f COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Waiver Fee $ Date of Payment Date of Payment Receipt Number Receipt Number COSA # / 2 I 't :% 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 Certif icate of On -Site System s 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 Phone 272-8218 Address P.O. Box 100217, Anchorage AK 99510 Engineer's Printed Name Steven R. Pannone Date /3C�?J E 6. DSD SIGNATURE 1 System #1 Approved for. bedrooms. System #2 Approved for. bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: By: f�& _/2,21 Original Certificate Date: The me li of orage Development Sery ices Division (DSD) issues Certificates of On -Site Sy stems 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 9-0-02.doc If more than 1 septic system is on the lot: COSA Checklist # + of I Structure served by this system f Certificate of On -Site Systems Approval Checklist Legal Description: Cross View Estates Blk1 U4 A. WELL DATA Well type� �f Date completed 5/2/07 Total depth 198 ft. Date of test If A, B, or C provide PWSID # Sanitary seal (Y/N) Y Cased to 198 ft. FROM WELL LOG 5/2/07 Static water level 141 Well production 50+ ft. Parcel ID: 015-222-47 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) IRI *I I/ in.� AT INSPECTION 10/8/12 147 ft. g.p.m. 5.2 g.p.m. WATER SAMPLE RESULTS: Coliform Absent colonies/100 mL Nitrate 1.17 mg/L Arsenic: _ ug/L date of sample: 4/3x13 Other bacteria Absent colonies/100 mL Collected by: PES B. SEPTIC/HOLDING TANK DATA Tank Type/Material Steel Date installed 8/28/07 Tank size 1250 gal. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (Y/N) Y Date of pumping 9/26/12 C. ABSORPTION FIELD DATA Date installed 8/28/07 Length 70 ft. _ Depression over tank (Y/N) N High water alarm (YIN) N/A Pumper McDonald's Pumping Service Soil rating (g.p.d./ft2 or ft2/bdrm) .s gpdfsf System type Deep Trench Width 3 ft. Gravel below pipe 6 ft. Total depth 112+ ft. Eff. absorption area 840 ft2 Monitoring tube Y Depression over field N Date of adequacy test 10/8/12 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test in. 120 1 Water added 624 gal. New depth in. Elapsed Time: _ min. Final fluid depth _ in. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N Absorption rate , 600+ g.p.d. If yes, give date D. LIFT STATION Date installed `Pump on" level at in. Datum Size in gallons "Pump off' level at _in. Cycles tested Manhole/Access (Y/N) _ High water alarm level at Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100+ On adjacent lots 100+ Absorption field on lot 100+ On adjacent lots 100+ Public sewer main 75+ Public sewer manhole/cleanout 100+ Sewer /septic service line 25+ Holding tank 100+ Animal containment areas 100+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: 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 COSA brown sheet 9-t-12.doc Absorption field 5+ Surface water 100+ Water main 10+ Driveway, parking/vehicle storage 110+ in. 4S. Municipality of AnchorageOn-Site Water and Wastewater Program(907)343-7904 f", CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel 1. D. 015-221-47 1. GENERAL INFORMATION Expiration Date: 1-,26--13 Complete legal description Cross View Estates BIk1 U4 Location (site address) 5085 Heritage Heights Dr., Anchorage Ak. 99516 Current Property owner(s) Dennis & Kay Pittman Day phone Mailing address 5085 Heritage Heights Dr., Anchorage Ak. 99516 Real Estate Agent 2. TYPE OF DWELLING: El 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 Q Individual iX Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Date: 10-d�5- /a COSA Fee $ �-a O Date of Payment 10 \ 5 I I a Receipt Number a COSA# OSCIa-ly_y 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 Certif icate of On -Site System s 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 Phone 272-8218 Address P.O. Box 100217, Anchorage AK 99510 Engineer's Printed Name Steven R. Pannone Date 6. DSD SIGNATURE _1--il" System #1 Approved for, bedrooms. System #2 Approved for. bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: By: Original Certificate Date: f 0 - :2 h — ) Z Til unicj li horage Development Sery ices Division (DSD) issues Certificates of On -Site Sy stems Approval (COSA) based only upon the rep sentations 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 Septic System Advisory Well Flow Advisory COSA blue sheet DA-12.doc Nitrate Advisory Arsenic Advisory Other If more than 1 septic system is on the lot: COSA Checklist # _of _ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Cross View Estates Blk1 U4 A. WELL DATA Well type Privata Date completed 512/07 Total depth 198 ft. If A, B, or C provide PWSID # Sanitary seal (Y/N) Y Cased to 198 ft. Parcel ID: 015-222-47 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 9 in. FROM WELL LOG AT INSPECTION Date of test 5/2/07 10/8/12 Static water level 141 ft 147 ft Well production 50+ 9.p -m. 5.2 9.p -m. WATER SAMPLE RESULTS: ColiformEJcolonies/100 mL Nitrate i .�� mg/L Other bacteria colonies/100 mL Arsenic: "t ug/L date of sample: j0=10 12 Collected by: _P E B. SEPTIC/HOLDING TANK DATA Tank Type/Material Steel Date installed 8/28/07 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N/A Date of pumping 9/26/12 Pumper McDonald's Pumping Service C. ABSORPTION FIELD DATA Date installed 8/28/07 Soil rating (g.p.d./ft2 or fe/bdrm) .s gpd/sf Length 70 ft. Width 3 ft. Total depth12+ ft. Eff. absorption area 840 ft2 Monitoring tube System type Deep Trench Gravel below pipe 6 ft. Y Depression over field N Date of adequacy test 10/8/12 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 1 in. Elapsed Time: 120 min. Final fluid depth in. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N Water added 624 gal. New depth in. Absorption rate , 600+ g.p.d. If yes, give date D. LIFT STATION Date installed "Pump on" level at _ in. Datum E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot_ Absorption field on lot 100, Public sewer main 75+ Size in gallons "Pump off" level at _ in. Cycles tested 100+ Sewer /septic service line 25+ Animal containment areas 100+ 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+ SEPTIC/HOLDING TANK ON LOT TO: 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 / 2101 Z COSA brown sheet 9-1-12.doc Absorption field 5+ surface water 100+ Water main 10+ Driveway, parking/vehicle storage 110+ 11 Municipality of Anchorage :-�- Development Services Department Building Safety Division r.. On -Site ate et &Wastewater Program T470z:;nr• 7 trvc;gq. z^ r,: r; .Rr. P.O. Pox 196650 -�'�Anohora9c AK 99519-6650 twww.nlunl.orglonsite % r;, '.q''1tmsnci;c; ^a is ;r•,' (907)$43-7904 lyj 91f, CERTIFICATE OF'ON—SITE SYSTEMS APPROVAL - -£=- FOR .A SINGLE FAMILY DWELLING - ll Parcel I.D. n l S =2;2 L W ' COSA# V 0(0 C? 1. GENERAL INFORMATION Expiration Date: — 0 Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address CROSS VIEW ESTATES: BLOCK 1. LOT 4 5085 HERITAGE HEIGHTS DRtVE • ANCHORAGE, AK • 99516 JOHN PLENGER Day phone 787-8407 5085 HERfTAGE HEIGHTS DRIVE • ANCHORAGE, AK * 99516 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well , Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSb also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ►Jl',41_ ..,1.,'IETf1L�0i9V5U •' `�P:" 4. STATEMENT OF INSPECTION BY ENGINEER t. 1 : 5 0,•. I V.' e1" -0C1 As certified by my seal affixed hereto and as of the vi' on date shown below, f verily that my investigation, based on procedures outlined in the Certilieate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater dispWj system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicat eroi.n. f further verify that based on the information obtained from the Municipality of Anchorage IJes,and from my investigation and inspection, the on-site water supply and/or wastewater disposal system-is(ere) in compliance with all applicable Munkjoal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. i ' ,O -Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date Engineer's Comments: In conducting this evaluation, GEG, VD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time ofthe test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide_ anywarranty or future estimate of how long the system will continue to meet the J operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any otherperson or party is not authorized, nor will it confer any legal right whatsoever. S. DSD SIGNATURE tlIGApproved for _hl— bedrooms. Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: Attachments: COSA Checklist V Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other ON-SITE WATER AND WASTEWATER PROGRAM By:&/5�(� Original Certificate Date: O taw 11/05) Iwo Municipality of Apchorage r • ==—iltY) a-V6VdI"Ment se Department it Isv31 mills 1wrw r � W I watery Program _.__Szn3m:uups^t{r3cer>Srma:Gw»i! 47W Street 96650 : Anchorage,99519-6650 www, rglonsite 3-7904 -C41=�AT-0P�1 YSTEMS APPROVAL CHECKLIST -7 £y�� --"-' TES• BLOCK 1 LOT 4 Parcel ID: (9 16- 2 2 I — =% A. WE Well type 'ORA, B, or C provide PWSID# N A Well Log (Y/N) YES Date completed 5/2/2007 Sanitary seal (Y/N) YES Wires properly protected (YIN) YES Total depth 198 ft. Cased to 198 ft. Casing height (above ground) 18+ in. FROM WELL LOG AT INSPECTION Date of test 5/2/2007 7/27/2009 Static water level 141 ft• 143 ft. Well production 50+ g.p.m. 6.6+ — 9 -p.m -WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate 1, mg./L. Other bacteria colonies/100 ml. Arsenic: L IJ ug./L. Date of sample: 7/27/2009 Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 8/28/2007 Tank size 1250 gal. Number of Compartments E Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (YIN) N/A Date of pumping 7/24/2009 Pumper MCDONALDS PUMPING C. ABSORPTION FIELD DATA Low EXISTING GRADE Date installed 8/28/2007 Soil rating (g.p.ddit'o /bd 0_8 System type DEEP TRENCH Length 70 ft. Width 3 ft. Gravel below pipe 6 ft. Total depth *12.1 ft. Eff. absorption area 840 ft' Monitoring tube YES Depression over field NO Date of adequacy test NEW SYSTEM Results (Pass/Fail) For_bedroo Fluid depth in absorption field before test_ in. Water added New depth _in. Elapsed Time: _ min. a d dt _ in. Absorption rate >= g.p.d. bay rej nation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed Size in gallon ti4(V0r1"6Qsss MINI) "Pum on" level at in. "Pum off' leve r_�s water alarm level at P P c DatumCycles tested Meets alarm 6 drwit requirements? E. SEPARATION DISTANCES rr SEPARATION DISTANCES FROM WELL ON LOT Septic tankfift station on lot 100'+ „ a - -T A � 71'+, i• Absorption field on lot 100'+ p 1 p' Public sewer main N/A Public s �Ilout Sewer /septic service line 25'+ Holding tank 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 N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN 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. Engineers Printed Name JEFFREY A. GARNESS Date (3/5/O q COSA Fee $ Y 9 V Date of Payment 11610,7, Receipt Number o (Rev. 11/05) Waiver Fee $ Date of Receipt Number M N = ` �y D o CCU z�< Z �� x.�- ♦� N mC ?a0 r- r. f0 �. Co O � N v C r�r�**S s (27 r) ri zmo0L��^z � (o m mN%�;UmvH N O OO�0ox;t cc o� : C� � 0 to m� mo � Zgg�sz D: • •�••;9>♦ tea. •c�� (: •u N 4 `�� .• I� . r 10 rc : _ . A' G7 :n •Yor x BAINBRIDGE ROAD w 0 N 00.16'43'W 178.33' f f — --- — — --- --- — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — —I N 37.4' rn ff Jam_ 20 srORIU pq�N ESAlT L�1 • N 22.0' R DECK DO 24.0• W Q 6� CANWT m Z � N 66.9' v ro I I -`--—---- - -- - I - -{ HERITAGE HEIGHTS DRIVE N 00.15'19"W "60.59' O Om 0 � cooCo>0 Sn I r0 m� co 0 O Z I Municipality of Anchorage • -�. Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. _015-22147 1. GENERAL INFORMATION COSA# M oo(pp Expiration Date: �i fZ1T S Complete legal description Lot 4, Block 1, Cross View Estates Subdivision Location (site address) 5db 5 Heritage Heights Drive Current Property owner(s) Crown Pointe, Inc. Day phone 229-1886 Mailing address P.O. Box 112313 Anchorage, AK 99511 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Ok fD Four r I }ol;kT .3. TYPE OF WATER SUPPLY: Individual Well El Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site El Individual Holding Tank ElCommunity On-site ElPublic Sewer f-1 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, 1 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. 1 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 3118f2007 I s 5. DSD SIGNATUREu'`nrLh i .hr• - _ # Approved for �_ bedrooms. ♦ •• » . Disapproved. Conditional approval for bedrooms, with the following stipulations: ........... Jam: ON-SITE i Attachments: COSA Checklist X t;nntir. SvatPm Arivicnry Arsenic Advisory Maintnnanrp Anrw rnpnta 3/z�/o 0 Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot 4. Block 1, cross view Estates Subdivision Parcel ID: 015-22147 A. WELL DATA Well type Private If A. B, or C provide PWSID # _ Well Log (Y/N) Y Date completed 52/07 Sanitary seal (YIN) Y Wires properly protected (Y/N) Y Total depth 198 ft. Cased to 198 ft. Casing height (above ground) >24 in. FROM WELL LOG AT INSPECTION Date of test 5/2/07 Static water level 141 Well production 50• g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform o colonies/100 mL Nitrate . $ mg/L Other bacteria 0 colonies/100 mL Arsenic: _/__ ugA Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material SepticJSteei Date installed 8/28/07 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 8128107 Soil rating (g p.d./ft2 or ftZ/bdrm) A CPC/SF System type Deep Trench Length .70 ft. Width 3 ft. Gravel below pipe 6 ft. Total depth 12 ft. Eff. absorption area goo ft2 Monitoring tube Y Depression over field N Date of adequacy test New Const. Results (Pass/Fail) For _ bedrooms Fluid depth in absorption field before test In. Water added_ gat. 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 (Y/N) 'Pump on' level at _ in. 'Pump off level at _ in. Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot >100, Absorption field on lot >100, Public sewer main NIA Sewer /septic service line >25' High water alarm level at in. Meets alarm 8 circuit requirements? On adjacent lots >100' On adjacent lots >100, Public sewer manhole/cleanout N/A Holding tank N/A Animal containment areas None Manure/animal excrete storage areas None SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >s: 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 >25' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS: G. ENGINEER'S CERTIFICATION I certify that l have determined through field inspections and ;._r _..:...... review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. 0 ...........;... . l Engineer's Printed Name Michael E. Anderson, P.E. ♦♦� %• '"' "'�''•'� Date 3/18/2008 ♦♦♦ '- r i -`: •.• COSA Fee $ 3 O j— / % tiv J2— Waiver Fee $ Date of Payment 3 _ .Z 0-09 Date of Payment Receipt Number 1042— 59 Receipt Number (Rev. 11105) UNMMAUTY of AP4CHORAGE a Development Services Department ��rl ` Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-221-47 1. GENERAL INFORMATION Expiration Date: !0~30 z02d Complete legal description CROSS VIEW ESTATES BLOCK 1, LOT 4 Location (site address) 5085 HERITAGE HEIGHTS DRIVE, ANCHORAGE, AK 99516 Current property owner(s) DAVID & LESLIE KNAPP Mailing address Real estate agent Day phone 5085 HERITAGE HEIGHTS DRIVE. ANCHORAGE. AK 99516 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 . 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ f 1 �� So( C0\1 I IJ 1 Waiver Fee $ Date of Payment -7-2-3 —a0 Date of Payment Receipt Number. 763 L OY Receipt Number COSA # 0 S C- 0 0 1'3 5 Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 7/17/2020 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & FWCS 6. DSD SIGNATURE System #1 Approved for _Y_ bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for of ��lil� e*: 49 7- ....•:* �j • ' • Curtis Huffman CE 128991 , \��`�AMP' � PROFESSIOW bedrooms, with the following stipul�t�R��t(((�� WATER AND n' - MW Original Certificate Date: 7--3cn `ZC;?) 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 Legal Description: CROSS VIEW ESTATES BLOCK 1 LOT 4 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 5/2/2007 Total depth 198 ft Cased to 198 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 7/10/2020 Static water level at beginning of test 155 ft. Well production at time of test 4.6+ gpm Comments B. TANK DATA Age of tank(s) 13 years Tank type/material SEPTIC / STEEL Measured operating fluid level in septic tank 49" ® Standpipes/foundation cleanout per record drawing Date of pumping 7/10/2020 D. ABSORPTION FIELD DATA Which system tested (date installed) 8/28/2007 ® ALL standpipes present per record drawing Total measured depth from grade 12.1 ft (max) Measured depth to pipe invert from grade 6.1 ft (min) ❑ N/A — pressurized field ® Monitor tubes no to bottom of effective If not state Parcel ID: 015-221-47 Structure served by this system Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® Nc ® Coliform bacteria is Negative Nitrate 1.74 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by FFWCS Date of Sample 7/10/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date 7/10/2020 Results M Pass For 4 bedrooms Fluid depth prior to test 2 in Water added 650 gal New depth 9 in depth into effective Elapsed time 1380 min ® Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 600+ and (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: US 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 Wells on Adjacent Lots: Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' Surface Water > 100' ® Yes Animal Containment > 50' ® Yes if No ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ft ft ft ft ft ® Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No. Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No. Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No _ ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. - tl— - �®�� Pee . TM Curtis Huffman 9`• CE 128991 •� �'� c�`��9••,7/17/2029•��' � �k�-`A? PROFIiWONP--.� ft ft