HomeMy WebLinkAboutSHANGRI-LA ESTATES EAST BLK 4 LT 1hangri -La
Estates East
Block 4
Lot 1
#020-043-71
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP201316 PID Number: 020-043-71
Dwelling: Single Family (SF) with ADU Duplex (D) Two Single Family Project: New Upgrade
Name
JOSEPH & DARLENE MARUSHACK
ABSORPTION FIELD
Deep Trench Wide Trench Bed Mound
Site Address
16610 SANDPIPER DRIVE, ANCHORAGE
Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
5
4 GPD/SF
5 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
3.5 Ft.
Gravel depth beneath pipe
1.5 Ft.
Subdivision Block Lot
SHANGRI-LA EST. EAST 4 1
Fill added above original grade
VARIES 3.7 — 5.6 +/- Ft.
Gravel length
33+ Ft.
Township Range Section
Gravel width
5 Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Lift Station
Tank
Line
212+ Ft'
1
Ft.
Well
--
50'+
25'+
TANK Septic S.T.E.P. Holding Other ADVANTEX
Manufacturer
EXISTING
Capacity
2500 Gal.
Surface Water
--
50'+
Material
Number of compartments
Lot Line
--
10'+
NA
Foundation
--
10'+
LIFT STATION
Manufacturer
Capacity
Gal.
Remarks: Installed reserve field per MOA record docs. Field elevated
& absorption area enlarged in size compared to original field.
Alarm location
Electrical installed by
PIPE MATERIAL House to tank --- Tank to 3034
Installer NORTHERN EXCAVATION
drainfield
Drainfield 3034 CO/MT 3034
Inspector FWC
BENCH MARK (Assumed elevation) 100 ft
Inspection 1" 8/25/20 8/25/2020
Location and description
2nd
31d 8/28/20 41h
DOOR SILL
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
�e f�
Conditional Approval: Date
• ='°-
AM
' ''
Septic System
Approve f%
�li/�
1•, Curtis Huffman •��
�
`G, . CE X28991 •���
�{%4
Date (� G
.��'�� ° • . 9/7/2020, . • r�
Note: this a roval does not include well permit requirements.
(Nev Ub/U1/16)
PERMIT: OSP201316
R--12�
- MT
DIV
EXISTING /
2500- AL TANK
& TWO 20 PODS
B
A -C=31 2'
B -C=39.8'
A -D=38.6'
B -D=36.7'
A -E=47.0'
B -E=31.5'
A -F=24.2'
B -F=19.1'
MEA 2015 TH
PID: 020-043-71
N 89058'45"E
50' TEMPO
TURN-AROW
INSTALLED 33'L x 5'W x 1.5'ED
TRENCH - 5' FROM OG
�CO
0
LEXIS ING
ORIG AL FIELD
JA
H MH
FCO
5BR HOUSE
DIVERTER CO MT CO
FCO
MH MH 99.17 99.50 A
1 11 2 AX20s
I 1 11 11 1 FILTER FABRIC
EXISTING
ADVANTEX
2500—GAL
TANK
SEWER ROCK
50' WELL RADIUS
SCALE: 1" = 20
FINAL GRADE
1.0' OG/OL.
GW/GM
NO
GRND.WTR.
16' 8/23/15
79.50 BOH
MEA TH
8/4/2015
SHANGRI-LA ESTATES EAST B4, L1 SUPPORT$SERVICES: ' OF A\
PREPARED FOR: �� 1
JOSEPH & DARLENE MARUSHACK
16610 SANDPIPER DRIVE* 9 TH
ANCHORAGE, AK 99516
FIRST WATER CONSULTING / rtis Huffman
13030 Sues Way DATE: 09/07/2020 SURVEY: KGL 2020 1 r� CE 128991Aw
Anchorage, Alaska 99516 DRAWN: FWCS 19/7/2020
(907)350-9566 SCALE: 1" = 20' \ '`%FESS1014 ' ,w
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/ R,120.00
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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: OSP201316
Work Type: Septic Upgrade
Effective Date
Expiration Date
Tax Code Number: 02004371000
Site Legal Address: SHANGRI-LA ESTATES EAST BLK 4 LT 1 G:3239
Site Mailing Address: 16610 SANDPIPER DR, Anchorage
Owner: MARUSHACK JOSEPH P & DARLENE J
Design Engineer: FIRST WATER CONSULTING
This permit is for the construction of:
Q Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy
s
66 d
DeI)artrnent
8/19/2020
8/19/2021
Lot Size in Sq Ft: 40302
Total Bedrooms: 5
❑ 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
Received By:
Issued By: _)2w
Date:
Date:
y i A,- � L
!w
ilyl10 nzTim
Development Services Department fes'
On -Site Water &Wastewater Section
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 020-043-71
Phone: 907-343-7904
Fax: 907-343-7997
Property owner(s) JOSEPH & DARLENE MARUSHACK Day phone 3072482593
Mailina address 16610 SANDPIPER DRIVE, ANCHORAGE, AK 99516
Site address 16610 SANDPIPER DRIVE, ANCHORAGE, AK 99516
Legal description (Sub'd., Block & Lot) SHANGRI-LA ESTATES EAST 134, L1
Legal description (Township, Range & Section)
Lot Size 40,302 Sq. Ft. Number of Bedrooms 5
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
0
Initial ❑
Single Family (SF)
0
(w/wo ADU)
Septic Tank
ElUpgrade
El
Duplex
ElHolding
(D)
Tank
ElRenewal
❑
Multiple Dwellings
❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION
INCLUDES
A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: ��6.2 5 CoU ID -1
Date of Payment: - S�l'L�ZOZa
Receipt Number: d(2 i ZZ
Permit No. Q S P1201 ?d (o
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
13030 Sues Way, Anchorage, AK 99516
907-350 -9566 / firstwaterAK@gmail.com
August 11 , 2020
Municipalities of Anchorage
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: ABSORPTION FIELD UPGRADE PERMIT
LEGAL: SHANGRI-LA ESTATES EAST BLOCK 4, LOT 1
The property owner has requested we obtain a permit to upgrade the failed leach field of the
above referenced lot. We propose to install one shallow gravity-fed trench with diverter to the
original field and connected to the existing 2500-gallon Advantex tank / system. The proposed
5-bedroom design is based on MOA record documents (soils, groundwater and slope
calculations...). The slopes are approximately 12-17% at the proposed upgrade location. The lot
and area are served by private water. The design will not impact any of the neighboring
properties. Please contact us if you have any questions.
Sincerely,
Curtis Huffman, P.E.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201316, Deb Wockenfuss, 08/19/20
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201316, Deb Wockenfuss, 08/19/20
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201316, Deb Wockenfuss, 08/19/20
Municipality of Anchorage
On -Site Water and Wastewater Program • (907) 343-7904 Page ( of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP151219 PID Number: 020-043-71
Dwelling:❑ Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: X New ❑ Upgrade
Name:
Crown Pointe, Inc.
ABSORPTION FIELD
E] Deep Trench NShallow Trench E] Bed E] Mound
Address
P.O. Box 112313 Anchorage, AK 99511
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
229-1886
Five
6.0 GPD/SF
7 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
6 Ft.
Gravel depth beneath pipe
1 Ft.
Subdivision Block Lot
Shangri La Estates East 4 1
Fill added above original grade
2.9 Ft.
I Gravel length
22 Ft.
Township Range Section
Gravel widthBeds:
5 Ft.
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
126.4 Fiz
One
Ft.
Well
>100'
>100'
>100'
>75'
>25'
TANK ❑ Septic ❑ S.T.E.P. ❑ Holding 0 Other
Manufacturer
Advantex/Anchorage Tank
Capacity
2,500 Gal.
Surface Water
>100'
>100'
NA
NA
Material
Number of compartments
Lot Line
>5'
>10'
NA
NA
Steel
Two
NA
Foundation
>5'
>10'
NANA
LIFT STATION
Manufacturer
Capacity
Curtain Drain
None
Noted
Gal.
Remarks
Pump on level at
in.
Pump off level at
in.
High water alarm at
in.
Pump make and model
Electrical Inspections performed by
Dependable Services
Installer
PIPE MATERIAL House to tank D3034 dralnfieid D3034
Sanders & Sanders
Drainfield F810 caMr
Inspector MEA
BENCH MARK (Assumed elevation) 100.0 ft
Inspectiont9' 5/11/16 5/12/16
Location and description
dates: 2m
3" 6/4/16 a
Lower Level Door Stoop SE Corner.
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
♦
0...
4Ggs�1
Conditional Approval: Datew
(,j • ��0,
49TH
...•.
rq„ MICHAEL E. ANDERSON . O
���f•, GE -4381
Approved I ( Datej�
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-------------------� < A
33' UTILITY ESMT. I O (�
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Permit Number: OSP151219
83.4
No Gm
5-15-15
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
SHANGRI LA
011141 0
ESTATES EAST
4, LOT 1
99.7
Page 3 of 3
PID No. 020-043-71
22' (Trench Length)
PROFILE AS -BUILT
Scale: NONE
90.8
LOT 1 BLOCK 4, SHANGRI-LA EST. EAST SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Five Bedroom Home 5' Wide Trench System
Perc. Rate: 3.3 Min./Inch Five Bedroom Advantex Treatment System
Application Rate: 6 GPD/SF with AX -20 Pod - Add On Lift Station
1' Effective Depth
5 Bedrooms * 150 GPD/Bedroom = 750 GPD Design Flow
750 GPD/6 GPD/SF/5 SF/LF (Width)*.87 (Red. Factor) = 21.75 LF Trench Length
THEREFORE: Construct a 22' Long x 5' Wide x 1' Effective Depth Absorption Trench.
Flow Line Elevation in Trench to be 6' Below Original Ground Surface. Total Depth to be
7' Below Existing Ground. Provide 3' Cover Over Absorption Trench and 4' Cover Over
Septic Tank.
5'
TYPICAL 5' WIDE TRENCH SECTIO"'
(NO SCALE)
NOTE: Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock.
Minimum 4' Separation From Groundwater.
Minimum 100' Separation From Private Wells in the Area.
Minimum 100' Separation From Surface Water or Streams.
01/30/2016 22:31 907-345-0202 ALPINE DRILLING PAGE 01/02
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
MarkBeglch Anchorage, AK 99507
Mayor w"uhl ora/onsite
(907)348-7904 -
PumP Installation Log
Well Drilling Permit Number: SW 161219 bate of Issue: 711412015
Parcel Identiflcadon Number: 02004371000
shangri La East, Block 4, Lot 1
Pump Intake Depth Below Top of Well Casing- Zs.S feet
Pump Manufacturer's Name: Grundfos
Property Owner Name &c
Joseph Llanlshack/Crown Polrna
700 G Street, ATO 2100
Anchorage, AK 99601
Pump Model. 10SWE15.330
Pump Size 11/2 hp
Pitless Adapter Burial Depth: CK feet
Pitless Adapter Manufacturer's Name: go UN �t
Pitless Adapter Installer: NIA
Well Disinfected Upon Completion? W) Yes ❑ No
Method of Disinfection.
Comments:
Pump Installer Neme: Aarow Pump & Well Service, LLC
P,O. Box 110498
Anchoraga,AK 99511-0406
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
�L->.. X F
IlrlC�l�Ir]19 1
pl�IiRA
st.
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
�L->.. X F
IlrlC�l�Ir]19 1
01/30/2016 22:31 907-345-0202 ALPINE DRILLING PAGE 02/02
Alpine Drilling & Enterprises
Well Log
Permit Number: #SVV 151219 Date of Issue: 7-14-15 Parcel Identification Number: 02004371000
Date Started: 9-15-15 Date Completed: 9-16-15 Is well located at approved permit location? x Yes ❑ No
Legal Description: Shangr-La Estates East Block 4 Lot 1
Property Owner Name & Address: Marushack Joseph and Darlene J - Crown Point
700 G St A TO 2100
Anchorage, Alaska 99501
Borehole Data: Depth (ft)
Method of Drilling x air rotary F1 cable tool
Soil Type, Thickness & Water Strata From
To
Casing type: steel
Stick-up 0
2
Wall Thickness: .250 inches
Gravelly silt 2
765
Diameter: 6 inches Depth: 201 feet
Liner Type:
silt 165
181
Diameter: _ inches Depth: feet
gravelly silt 181
196
Casing stickup above ground. 2 feet
bedrock 196
287
Static water level (from ground level): 135 feet
Pumping level: 285 feet after
— hours pumping 5 gpm
Recovery Rate: 5 gpm
Method of Testing: air lift
Well Intake Opening Type:
❑ Open End x Open Hole
❑ Screened Start —feet Stopped_ feet
ElPerforations Start feet Stopped _ feet
Grout Type: bentonite granules 'Volume: 2 -bus
e the Stad 0 feet Stopped ? feet
Pump: Intake Depth _,,, feet
WATER QUALITY TESTING
Colltol'rri _ �1 _ COU100ML
Pump size hp Brand Name
Nitralm nV&
Well Disinfected Upon Completion? a Yes ❑ No
Arsenic l D uug/L
Method of Disinfection: chlorine tablers
Comments:
Wel] Driller: Alpine Drilling & Enterprises
�,�•.�, >.`•�:
P0Box 110496
Anchorage AK 99511
No
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: OSP151219
Tax Code Number: 02004371000
Work Type: WellSeptic Initial
Permit Effective Dates: July 14, 2015 to July 13, 2016
Design Engineer: ANDERSON ENGINEERING
Subdivision: SHANGRI-LA ESTATES EAST
Site Legal Address: SHANGRI-LA ESTATES EAST BILK 4 LT 1 G:3239
Owner/Address: MARUSHACK JOSEPH P & DARLENE J
700 G STREET ATO 2100 ANCHORAGE AK 995010000
Site Mailing Address: 16610 SANDPIPER DR, Anchorage Lot Size in Sq Ft:
Total Bedrooms:
This permit is for the construction of:
q-11-/_�_
40302
4
Y Disposal Field Y Septic Tank N Holding Tank N Privy Y Private Well N Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater
Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80).
3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received
Issued By
Co
COI
Chanye5
sy.fem
�-o
If
RUSHY j MUNICIPALITY OF
Community Development Department
Development Services Division
On -Site Water & Wastewater Program
ANCHORAGE
3�)5rm
RUSH!
10 2015
Phone:907t-779904 �0h
Fax: 907- 97 : /
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 020-043-71
Property owner(s) .Joseph & Darlene Marushack
Day phone
Mailing address 700 G Street Ato 2100 Anchorage, AK 99501
Site address 16610 Sandpiper Drive Anchorage, AK 99516
Legal description (Sub'd., Block & Lot) Shangri-La Estates East, Block 4, Lot 1
Legal description (Township, Range & Section)
Lot Size 40,302 Sq. Ft. Number of Bedrooms Four (4)
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑x
Initial ❑X Single Family (SF) ❑X
Septic Tank
❑X
Upgrade ❑ (w/wo ADU)
Duplex (D) ❑
Holding Tank
ElRenewal
F]Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑X
Water Storage
❑
THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR:
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)
Permit/Rush Fees: Waiver Fees: J
Date of Payment:!I IS Date of Payment: o? f $—
Receipt Number:%�Jt�i� Receipt Number:
Permit No. 105P15101l9 Waiver No.
Permit App_":. :La-
July 10, 2015
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 1, Block 4, Shangri La Estates East Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 1, Block 4, Shangri La Estates East 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. No conflicts exist
between the proposed septic system and well or septic systems on adjacent lots as no
development has occurred in the near proximity of the lot. Drainage arrows are shown
on the site plan showing the grade and direction of flow on the lot. The drainage
pattern will not be changed as a result of this project.
The test holes placed on the lot in the area of the absorption trench and alternate site
indicate gravelly sand with silt (SM) in the zone specified for the absorption trench. The
percolation rate of the soil was determined to be 3.3 minutes per inch. No groundwater
was found during the placement of the test hole but was noted at 7.4' below the surface
during the monitoring period. Plat notes require the use of nitrate reducing septic
systems on the lot. We have therefore specified an Advantex Treatment System to
accommodate four bedrooms. An application rate of 6.0 gallons per day per square
foot was used in the design of the absorption system. We are proposing to place a new
1,500 gallon Advantex Tank and AX -20 Pod and a 20' long by 5' wide by .5' 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 2' below the surface
and the total depth will be 3'. The bottom of the trench will be entirely in the percolation
zone. 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. An add on lift station will be required to
pump the effluent to the absorption trench.
Lot 1, Block 4, Shangri La East Subdivision
July 10, 2015
Page Two
The ground surface on the lot in the area of the septic system slopes to the northeast.
The new trench will be constructed parallel with the contours of the slope as much as
possible in conformance with Municipal requirements. The new septic system will be
constructed a minimum of 100' from all wells and any surface water and 10' the
proposed and existing water services in the area.
If the system is constructed in accordance with our design the following statements
apply:
1. The system, if constructed as designed, will have no adverse impact on the wells
in the area or those to be constructed in the future.
2. The system, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
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,
,4 e, a--�
Michael E. Anderson, P.E.
Attachments
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LOT 1 BLOCK 4, SHANGRI-LA EST. EAST SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS
Four Bedroom Home 5' Wide Trench System
Perc. Rate: 3.3 Min./Inch Four Bedroom Advantex Treatment System
Application Rate: 6 GPD/SF with AX -20 Pod - Add On Lift Station
1' Effective Depth
4 Bedrooms * 150 GPD/Bedroom = 600 GPD Design Flow
600 GPD/6 GPD/SF/5 SF/LF (Width) = 20 LF Trench Length
THEREFORE: Construct a 20' Long x 5' Wide x .5' Effective Depth Absorption Trench.
Flow Line Elevation in Trench to be 6' Below Original Ground Surface, Total Depth to be
7' Below Existing Ground. Provide 3' Cover Over Absorption Trench and 4' Cover Over
Septic Tank.
5'6"
6" 1 1 . O
1'
5'
Fabric
1" Perforated
PVC (Holes Down)
3/16" Diameter Holes
30 @ .83'
Drainfield Rock
TYPICAL 5' WIDE TRENCH SECTION
(NO SCALE) 14
0.i
NOTE: Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock. ....:
Minimum 4' Separation From Groundwater. A W
Minimum 100' Separation From Private Wells in the Area. 0�
Minimum 100' Separation From Surface Water or Streams: �j.�,,
49th
MICHAEL E. ANDERSON
No. CE -4301
Coi
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT/ON-SITE WATER AND WASTEWATER PROGRAM
4700 ELMORE ROAD, ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
PROJECT #:
PERFORMED FOR: Crown Pointe Homes DATE PERFORMED: 8/4/2015
LEGAL DESCRIPTION: Lot 1 Block 4 Shangri La Estates East
TEST HOLE # 2 SLOPE SITE PLAN
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WAS GROUNDWATER
ENCOUNTERED? No S
L
IF YES, WHAT DEPTH? 0
DEPTH OF WATER None P
AFTER MONITORING: E
DATE: 8/23/15
:• MICHAEL E. ANDERSON
f No. CE -4381
BOH �i f '•.. . _.
See Site Plan
READINGDATE
GROSS
TIME
NET
TIME
DEPTH TO
WATER
NET
DROP
1
8/9
11:03/11:13
10
1.25"/4.13"
2.88"
2
11:14/11:24
10
1.1311/4.00"
2.87"
3
11:25/11:35
10
1.00"/3.88"
2.88"
4
11:36/11:46
10
1.13"/4.00"
2.88"
5
11:47/11:57
10
1.00"/3.88"
2.88"
6
11:58/12:08
10
1.00"/3.88"
2.88"
FERC RATE: 35 MIN./INCH FERC. HOLE DIAMETER: 6"
TEST RUN BETWEEN 4 5 FT. AND 5.5 T.
COMMENTS: Test Hole Pre Soaked Prior To Percolation Test.
TEST PERFORMED BY: MEA I, MICHAEL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 8/26/15
C a2i
August 26, 2015
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 1, Block 4, Shangri La Estates East Subdivision
Absorption Trench to Slope Waiver
Dear Onsite Services Engineer:
The large house, driveway and well location planned for the subject lot reduce the
amount of area available for the septic system. We have located an area with
acceptable soils for the absorption trench, but it is located 30' from a break in grade
greater than 25%. The alternate site is 10' from the 25% break. We are therefore
applying for a waiver allowing placement of the absorption trench and the alternate site
at the designated locations.
The attached drawing shows the absorption trenches in relation to the slope. The
imaginary 25% slope when extended downward from 2.5' above the flow line does not
daylight for neither the primary nor the alternate trench. We therefore recommend a
waiver be issued allowing placement of the new absorption trench within 40' and 25' of
a slope greater than 25%.
Sincerely,
Michael E. Anderson, P.E.
.�,.-
49th
MICHAEL E. ANDERSON
.. No. CE -4381 ,
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W.O.# 05716
DHI CONSULTING ENGINEERS
800 E. DIMOND BLVD. SUITE 3-545
ANCHORAGE, ALASKA 99515
SOILS LOG—PERCOLATION TEST
TEST HOLE LOG # L1B4
PERFORMED FOR: ANCHORAGE DEVELOP. & CONST. DATE PERFORMED: 2/14/06
LEGAL DESCRIPTION: LOT 1, BLOCK 4 SHANGRA-LA EAST SUBO.
�vjV FROZEN ORGANIC MAT
1
'�_� REDDISH BROWN SILTY SAND
2 m:: 21.
SM
3
I DATE
MM IME
I Na IME 1
0w�mW
NET DROP
4
1
2/14/06
11:" 206
e
6'
5
P
2
231:00-- 06
//
1131:00-
11: 57:21
BROWN GRAVELLY SAND W/ SILT
6
fi"
ROCK 4"-8"
3
2/14/06
OCCA. BOULDER 16"
23:58 MIN.
6"
SM
7
4
7
12:35:00-
12:5&00
24:00 MIN.
6"
8
�9
10
11
12
13
14
15
16
SLOPE
0
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vaq
CE 5807 V i
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SITE PLAN
>� WAS GROUND WATER S
ENCOUNTERED ? NO L
IF YES, AT WHAT P
DEPTH ? E
DEPTH OF WATER
/n AFTER MONITORING ? 7.4 DATE: MAY 16, 2011
r
17 1 - "B.O.H.
REAMNG
I DATE
MM IME
I Na IME 1
0w�mW
NET DROP
PMRAW
1
2/14/06
11:" 206
29:26 MIN.
6'
6"
4.90
2
231:00-- 06
//
1131:00-
11: 57:21
26:21 MIN.
6-
fi"
4.39
3
2/14/06
12:22:558
23:58 MIN.
6"
6"
3.99
4
2/14/06
12:35:00-
12:5&00
24:00 MIN.
6"
5.
4.00
5
2/14/06
1:2&of
21:07 MIN.
6"
6'
3.62
6
2/14/08
11:Xle
20:16 MIN.
6"
6'
3.38
7
2/14/66
1`49'5-
2:09:05
20:05 MIN.
6"
6"
3.
8
2/14/06
2:12:00-
2:31:37
19:37 MIN.
6'
8"
3.271
PERCOLATION RATE: 3.3 (MINUTES/INCH.) PERCHOLE DIAMETER: 6"
TEST RUN BETWEEN: 4.0 FT. AND 4.5 FT.
COMMENTS: THIS TEST HOLE INFORMATION IS PROVIDED TO COMPLY WITH THE SUBDIVISION APPROVAL PROCESS AS
OUTLINED IN AMC 15.6.180.B.1. ANY USE OF THIS DATA FOR ANY OTHER PURPOSE, INCLUDING THE
DESIGN OF AN INDIVIDUAL SEPTIC SYSTEM IS STRICTLY PROHIBITED, WITHOUT THE WRITTEN CONSENT
OF THE ENGINEER OF RECORD.
ALL SOILS WERE PRE—SOAKED PRIOR TO STARTING THE PERCOLATION TEST.
PERFORMED BY: DHI CONSULTING ENGINEERS. I DEE HIGH CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 2/07/06 716CSSUD
If -
MUNICRPALITY oF ANCHORAGE
Development Services Department 4 Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 020-043-71 Expiration Date: 12A30/-z-0?0
1. GENERAL INFORMATION
Complete legal description SHANGRI-LA ESTATES EAST BLOCK 4, LOT 1
Location (site address) 16610 SANDPIPER DRIVE, ANCHORAGE, AK 99516
Current property owner(s) JOSEPH & DARLENE MARUSHACK Day phone
Mailing address
Real estate agent
16610 SANDPIPER 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:
5
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:
Received by:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 2-10 COU1U
Date of Payment 9�1 ZG 2 0
Receipt Number 5716, a 2 3
COSA# ()SG2 199.3
Date:
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
Distance:
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 8/25/2020
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
5���
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 ��Q�. • • • • �-
well and septic system. Therefore, any estimate of how long a system will function satisfactory //Oj • •;9 �r
for current or future occupants or guarantee that no unseen encroachments, deficiencies or * TH •,* ,
discrepancies exist can be given by First Water Consulting & FWCS • • • • • • ' • • • • • • •
6. DSD SIGNATURE �% • :• Curtis Huffman
V" System #1 Approved for 5 bedrooms ��Fcisj'•, CE 128991 • ,�����r
ROFESSEW0ION��^�
System #2 Approved for bedrooms 1\��
Disapproved
Conditional approval for bedrooms, with the following stipulations:
V oNoo
Z
WP �.��,P�ER o
PRBC'
PS5 31
By: Original Certificate Date: O Z!>
The Municipality of Anchorag evelopment 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 Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA Checklist
Legal Description: SHANGRI-LA ESTATES EAST BLOCK 4, LOT 1 Parcel ID: 020-043-71
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 9/16/2015
Total depth 287 ft
Cased to 201 ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) 18+ in.
Date of flow test for COSA 12/18/2019
Static water level at beginning of test 126 ft.
Well production at time of test 3.5+ gpm
Water storage tank volume gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate 2.45 mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by
Date of Sample 8/6/2020
Comments __________________________________________________________________________________
B. TANK DATA
Age of tank(s) 4 years
Tank type/material ADVANTEX / STEEL
Measured operating fluid level in septic tank *SEE
Standpipes/foundation cleanout per record drawing
Date of pumping *8/6/20
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
*ADVANTEX MAINTENANCE REPORT
D. ABSORPTION FIELD DATA – NEW FIELD
Which system tested (date installed) 8/25/2020 - NEW
ALL standpipes present per record drawing
Total measured depth from grade 9 ft (max)
Measured depth to pipe invert from grade 7.5 ft (min)
N/A – pressurized field
Monitor tubes go to bottom of effective. If not, state
depth into effective
Code-required soil cover over field
System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced gallons
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) N
If yes, enter date
Comments/Deficiencies:
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 50’+ 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 50’+ 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
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.
8/29/2020
08/10/2020 09:12 8686770
0810412020 10:36 And orage Tank
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PAGE 04
P.0011001
r-.-IIvanTe x& Field MARWanee Rep>OMt Anchorageiank
Annual Ins; ection 907-272-3543
----- — -- olio --olio--- ---lionolio-- -
olio ---•olio- • --
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Prernmr cwcorrtrn=xma+ I Larry Betts
Joseph & Darien[ Marushack -------olio---
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vmnc
sor Haar=o� (907) 868.252?_
16610 Sandpipel Drive, Anchorage AK 99516 onnor.n aaPo trr
nx 9nn ion f-ounly for Foon e'P_aru�n
AX -137644
OSP 151219 423604 423603 FZTU121954 06/12/2019
Retrieve O&M Infr
CJIy fl. --
Fleck. n4o—__....
Timor 101MQs.
This is a COS . Inspection.
Perform Field 51l Ipling/Observations
NTUU (l5 ./NT/Ua) i PM (e�
CO
T/ `•' ---_j-------------------------------------
Inspect
Clean
_
Odor al Sample
sown
------
Typical :fr l urory (_Eertn
Y - 'MoltlY
Noll- Afltle CCnbhPq.e
7-Dorny
Oily film ill PVU '`I YCs
/Nn
Foam in tank 71 Yr
No
Check Control P nel
AmAUCibL;
FRol,rc
Pnvious
Ccrront
Patl visa alnmta
CK
r]lal lnn^ (relerr.. "only)
Yez 7—No
Inepect/Clean Pimp System
Ina `ct
In=pect Clean F2
Clcnn
Inspect
Clean
_-_--__.-__—_—_...-___.
sown
------
----------
RiserA➢tl ..... ... ..... .....
_ _ _ _ ______.•
-__—_------------------
Atvinus
splice Box. ..
Pmvinu;
P6rts Used: W = Warranty, 9 = Billable (✓ appropriate gnlnc:tion)
Flool, Osrda -
W e Ram Number Description
2rd Compartment Current
Pnvious
Ccrront
Fmeioo?.
Pune.
y
1...-__--•..
niowbcr Rltar.
be Papt ,::h .... .. ..
BioWn
Ifhy
Recirn;tating rl ilter VAN•r......
.
y-/.
/
Measure Sludge/Scum
Ina `ct
In=pect Clean F2
Clcnn
Oi^.infecrinn Fq�imm�nt llroO' / / nIzperenf I nmrN1/M1Tcca/
sladaa
_-_--__.-__—_—_...-___.
sown
------
----------
_ _ _ _ ______.•
-__—_------------------
Atvinus
CorrcN
Pmvinu;
P6rts Used: W = Warranty, 9 = Billable (✓ appropriate gnlnc:tion)
lotCnmpnrtmcrIt Curn]nt
W e Ram Number Description
2rd Compartment Current
Pnvious
Ccrront
Fmeioo?.
•,
1...-__--•..
—
-
— -_____________
Inspeet/CIean AdvanTAX FiitPr
Inspe[r.
Clean
Odor.,- Nortral
_.]Pungent
LatorelvOritces
alomah Nnrmal
] Exrnnslve
Pad Bnticm
Bridging/Ponorag'/-NonvMlnor
). _'Exccsslve
Inteko Vent
I�
Inspect/Clean Discharge Pump System
Inspect
clean
n aped
r
r
Riser/Lid I—
Flnala
Splice Bull
Pomp
F_
Float cords —
Inspect/SelvicA Other System Components
Ina `ct
In=pect Clean F2
Clcnn
Oi^.infecrinn Fq�imm�nt llroO' / / nIzperenf I nmrN1/M1Tcca/
_-_--__.-__—_—_...-___.
Additional Services Rendered
F7 Cleoned textils sheets? [_. Rcplacetl UV items^.
[] Replaced/Used other it[rna^
P6rts Used: W = Warranty, 9 = Billable (✓ appropriate gnlnc:tion)
W e Ram Number Description
Final/Safety Inspection
RSV rain5talled tls bolted on
Manifold mconncrtetli duan valves ciceiatl .. Control panel renctioaterl
?
Suum m ary/Recommendat ion s
n Sya[c'rn pederrnfig; no lunrier a[[ian nactlCtl Tank ne¢e`. pumprlg
r[
Call for Smnce
Comments __ L
signature.__ _ date—•�
Fax complleted form to 1.866-384-7404
MUNICIPALITY OF ANCHORAGE
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of this u 11 , 4 µ Day of 1111.k11,1 of 20 by and between
o herein the "OWNER," and the Municipality of
Anchorage, herein the 'TAUNICIPALIIY', 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:
1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as AN ADVANTEX SYSTEM
located at (legal description)
SHANGRI-LA ESTATES EAST BLOCK 4, LOT 1
- -------------
2. Malntenance, Repairs and Alterations.
(Owner is required to read, understand and initial each section)
Throughout 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.
ri It shall be the responsibility of the Owner during the term of this Agreement to pay for all
fJ repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $600).
Owner agrees that only maintenance and repair personnel approved by the Municipality
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. 05/18/2018) Page I of 3
Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
r'4
"<< Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
'd 4
Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. 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 AWVVTS.
Owner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Tema. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. 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) rage 2 of 3
OWNER
By:%i SK fes.• -(signature) Date:, 7. 2!o2 c�
SuLt -;0,72-0 (print name)
STATE OF ALASKA }
ss.
THIRD JUDICIAL DISTRICT ) }
�vJ
The foregoinI. ins° J rent , � `ac : owledged before me thi day o `� >�
2, by
<a NARY PUBLIC FOR ALASKA �� J
My Commission expires: Afo k -VV
r�r
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MUNICIPALI'I X:
By: _ (signature)
--_(print name)
Date: �a U
Title:
im
(rev. 05/18/2018) Page 3 of 3
Parcel I.D. 020-043-71
Municipality of Anchorage
p�F Bli
On -Site Water and Wastewater Program
(907)343-7904 A e.r
Certificate of On -Site Systems Approval
1. GENERAL INFORMATION
Complete legal description
Expiration Date: q' 21- I
Shangri La Estates East, Block 4, Lot 1
Location (site address) 16610 Sandpiper Drive Anchorage, AK 99516
Current Property owner(s) Crown Pointe Inc. Day phone
Mailing address
Real Estate Agent
P.O. Box 112313 Anchorage, AK 99511
2. TYPE OF DWELLING:
0 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
4. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class
Public Water System
WaiverNariance request for:
Five
Day phone
TYPE OF WASTEWATER DISPOSAL:
0
Individual
0
❑
Holding Tank
❑
e"1 /
Community
❑
❑ 4&
Public Sewer
❑
Received by: (�IVII A,,Vl Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
0
COSA Fee $ Gglr Y/ �� Waiver Fee $
Date of Payment '512- % / I'L Date of Payment
Receipt Number (9'71 C9 19 6 Receipt Number
COSA# 6S%1(0I( oil Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm Anderson Engineering
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E.
6. DSD SIGNATURE
4L System #1 Approved for
System #2 Approved for
Disapproved
Conditional approval for
Phone 522-7773
Date 5/21/2016
-- -, _ • 14
ZL 9 7H"y1 _ �. `gin
-�QU0 '.c.a tµ✓��n
bedrooms ' MICHAEL E ANDERSON = r'
sf • ._CE -4381
_ bedrooms
4oplitTS%E mm0®
bedrooms, with the following stipulations:
By: Original Certificate Date: 23 _
The Municipality of Anchorage Development Services Division (DSD) issues Certifcates 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
CASA bluesheet r '- :. c
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: Shangii La Estates East, Block 4, Lot 1
A. WELL DATA
Parcel ID: 020-043-71
Well type Private If A, B, or C provide PWSID # Well Log (Y/N) Y
Date completed 9-16-15 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y
Total depth 287 ft. Cased to 201 ft. Casing height (above ground) >1811 in.
FROM WELL LOG AT INSPECTION
Date of test 9-16-15
Static water level 135 ft
Well production 5 g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mL Nitrate 2.29 mg/L
Arsenic ND ug/L Date of sample: 4j
B. SEPTIC/HOLDING TANK DATA
ft.
Collected by: Anderson Engineering
Tank Type/Material Septic/Steel/Advantex Date installed 6/4/16
Tank size 2,500 gal. Number of Compartments 2 G"leanouts (Y/N)
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) _
Date of pumping New Pumper Construction
C. ABSORPTION FIELD DATA
Y
Y
Date installed 5/2/16 Soil rating (g.p.d./ft2 or HZ/bdrm) 6 GPD/SF System type 5' Wide
Length 22 ft. Width 5 ft. Gravel below pipe 2 ft.
Total depth 9.9 ft. Eff. absorption area 105 ft2 Monitoring tube Y Depression over field N
Date of adequacy test New Const. Results (Pass/Fail) For 2 bedrooms
Fluid depth in absorption field before test in. Water added gal. New depth in.
Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date
D. LIFT STATION
Date installed
"Pump on" level at in.
Datum
Size in gallons Manhole/Access (Y/N)
"Pump off" level at in. High water alarm level at
Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot >100,
Absorption field on lot >100'
Public sewer main >75'
Sewer /septic service line >25'
Animal containment areas >50'
SEPTIC/HOLDING TANK ON LOT TO:
On adjacent lots > 100'
On adjacent lots >100'
Public sewer manhole/cleanout >100'
Holding tank >75'
Manure/animal excrete storage areas
Building foundation >51 Property line >51
Water main >100 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 None Noted Wells on adjacent lots >100,
F. COMMENTS
G. ENGINEER'S CERTIFICATION
l certify that I have determined through field inspections and
review of Municipal" records that the above systems are in
conformance with MOA COSA guidelines /n effect on this date.
Engineer's Printed Name Michael E. Anderson, P.E.
Date 5/21/2016
COSA brown sheet 10-10-12.doc
>100,
Absorption field >51
Surface water >100,
Water main >10'
Driveway, parking/vehicle storage >10'
OF.q
'.MICHAEL E. ANDERSON ."Q- Y
Imo'^ f -ItCi
bill
PLAT NO. 2011-62
SHANGRI-LA ESTATES -EAST SUBDIVISION
LOT 1, BLOCK 4
40,302 S.F.
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GASTALDI LAND
SURVEYING, LLC
JEFF A. GASTALDI, R.L.S.
2000 E. DOWLING RD., SUITE
ANCHORAGE, ALASKA 9950
PHONE 248-5454
GRID
SW3239
zo
15-04
DATE
6/15/2016
JOB NO.
SLE14
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 !�
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Jeffery A. Gaslaldi : i AW
•- LS -6091 J m'� AN
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111-40'
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
BETWEEN MUNICIPALITY OF ANCHORAGE
AND 7hrlene
THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this
Day of JUhE of 2014 by and betweenQ7�
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
Advantex Treatment System
located at (legal description).
Lot 1, Block 4, Shangri La Estates East Subdivision
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') 15.65. 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 AW WTS for the entire term of the AW WTS. 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), (2) 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 AW WTS.
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 AW WTS
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
AW WTS 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 the
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: �Ie CIIJC% 1'%PJ? e / % rz4S/7Lt t
b. Municipality: Director, Commun4 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.
OW
NE
By: signature) Date:
(print name)
STATE OF ALASKA )
) ss.
THIRD JUDICIAL DISTRICT )
The fore m trument wa�Sckno led d efore me this day of lug,
20� by [V lUl r W .
A,,pNEY 0,9,
' a�4
NOTARY PUBLIC F ALAS = �Ta9 ° y
My Commission exp res q z ;s
N :� u�
i�,>qT by FxaiF „5'�''•�P�
MUNICIPALITY:
By: (signature)
(print name)
Date: (CP -30
Title: