HomeMy WebLinkAboutMOUNTAIN PARK ESTATES BLK 12 LT 9
Municipality of Anchorage Page 1 o! 3
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: SW980272 PIDNumber: 017-391-48
Name: Spinell Homes Wastewater System: ~ New [] Upgrade
Address: ABSORPTION FIELD
9210 Vanguard Drive Anch., AK
No. of Bedrooms:
Phone: 344--5678 ~[-~Deep Trench [] Shallow Trench [] Bed [] Mound [] Other
Tolal Depth from original grade:
LEGAL DESCRIPTION Soil Rating: 45
· GPD/Sq. Ft. 1 2 i _
Block: Subdivisio,n: 0eplh Io pipe bottom from original grade: Gravel depth beneath pipe
Lot: 9 12 Mtn. ParJ~ Est. 6 Ft. 6 Ft.
Township: I Range: ISectiOn: Fill added above original grade: Gravel length: 84
2 Ft. Ft.
Number of lines: Distaece between lines:
WELL: [~ New [] Upgrade Gravel depth: 6 Ft. 2 1 2 Ft.
Classification (Private, A,B.C): Total Depth: Cased To: Total absorption area: Pipe material:
Private 256'Ft. 256' Ft. 1 ,008 SQ. Ft. ASTM D3034 PVC _
)riller; Date Drilled: Static Water Level:Installer: Date installed;
Alpine 10/16/~8 218' Ft. Spinell Homes 10/9/98
IPump Set at: ICasing Height Ab°ye Gr°und: TANK
Yield: 30 GPM Ft. 2 I Ft.
SEPARATION DISTANCES ~Septic [] Holding [] S.T.E.P.
TO Septic Absorption Lilt Holding Public/Private Manufacturer: Capacity in gallons:
From Tank Field Station Tanl~ ;eworLines Anchorage Tank 1 r 000
Number of Compartments:
weu > 100 > 1 00 N/A N/A N/A Material: Steel Two
Surf'ace >100 >100 N/A N/A ~/A LIFT STATION- N/A
Water
Lot > 5 ' > 10 ' N/A N/A N/A Size in gallons: I Manufacturer:
Line
:oundation >5' >10 ' N/A N/A N/A "Pump °n' level at: I''Pump °ff'' level at:
High water alarm at:
Curtain Non( on L¢)t Pump Make & Model Electrical Inspections performed by:
Drain ,,
BENCH MARK
Remarks:
Location and Description: Top of Front Deck
Assumed Elevation:
100.0 F~,
, , A Harala
Inspections performed by, ... __ Dates. 1st
Department of Hea&h a~d Human Services approval
72~013 (1/91) MOA 25
2 3
Permit No. SW980272 Page of
MunicipaLity of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 e Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
/ega~Description: Lot 9, Block 12, Mountain Park EstatespiDNo.:
017-391-48
_______~C7
C6.~ - o
M2
c4 ~ c2
S2 ~ 1,000 Gallon
Sl ~ Septic Tank
Driveway F~Dom I% /
Well
Utility Easement
PLAN AS-BUILT
SCALE 1" = 30'
S2
C4
M1
C5
C6
A
13
24
27
32
39
IB
5 23.0
2146.1
0~46.5
5/20.8
5! 53.5
Permit No. SW980272 Page ~ of '~
Municipality of Anchorage
DEPARTMENT OF HEALTH .AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: Lot 9, Block 12¢ Mountain Park EstatespIDNo.:
Sep. Tank
3' 12' .3'
~. .: ;
017-391 -48
94.5
Geotex, t i____l:e Fabric
Drainfield Rock
.,86.6
42'
75.0
42 ' '1
PROF]:LE, AS-BUT-LT
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Pose-it' Fax Note 7671 Dat, "-.,~1%~ ,Jp~"# o~ · j
l~t
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 995~9-6650
(907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT
Initial
Date Issued: Jul 30, 1998
Expiration Date: Jul 30, 1999
Permit Number: 8W980272
Legal Description: MOUNTAIN PARK ESTATES BLK 12 LT 9
Design Engineer: 14.~c~-,~_~J'~-'~, ~'~L.¢',~ (L~_~-~
Owner Name: Spinell Homes
Owner Address: 9210 Vanguard Drive Total Bedrooms: 3
Anchorage , AK 99507-
Parcel ID: 017-391-48
Site Address:
Lot Size: 22356 SQ. FT.
Permit Bedrooms: 3
This permit is for the construction of:
¢~ Disposal Field ~J Septic Tank I~ 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 ( 18AACS0 ).
3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 (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 By: '~.~/~i~.. ~..~, '~ Date:
July 21, 1998
Municipality of Anchorage
Department of Heath & Human Services
825 "L" Street
Anchorage, AK 99502-0650
Subject:
Lot 9, Block 12, Mountain Park Estates Subdivision
Septic System Design
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 9, Block 12, Mountain Park Estates Subdivision intends to
construct a three bedroom home on the lot. We are therefore applying for
a permit to construct a well and septic system on the lot to serve the
house. The attached site plan and backup documentation identify the size
and location of the new septic tank and absorption trenches designed to
serve the house. It also shows the proposed location of the well and the
100' protective radius.
Two testholes were placed on the lot at the locations shown. Poorly
graded silty sand was encountered. Percolation tests completed indicated
rates in excess of 40 minutes per inch. No groundwater was encountered
nor was any measured during the monitoring period. We are therefore
proposing to construct a deep trench system with 6' effective depth.
Total length will be 84' with the distribution piping at 6' below the
existing ground surface. The total depth of the system will be 12' below
the existing ground surface.
The surface of the lot is fairly flat with only a minor slope from east to
west. The lot to the north is currently vacant with development on all
remaining sides. No conflicts will exist between the new system and
wells in the area.
Lot 9, Block 12, Mountain Park Estates
July 21, 1998
Page Two
If the system is constructed as designed 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.
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 reserved space, either surface or subsurface, on any lots
located in the area.
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
Lot 1 (
Lo% 12
well
sepl
Lot 11
well
not ? I
well
Lot 8 [
vacant
septic
ate&
1~ = 100'
Lot 1 --I
area
AREA MAP
SCALE 1" = 100'
septic
area
Lot 1, Blk. 5
well
'/
ALPINE DRIVE
'Alternate site
......
-'T~=~e ..... ~ ~,'~o0 ~,l'.
B~droom.. ~..' septic Tank
Nome-..
'H1
2-42' 'Long--X---3-::'-~ide X
'6' Effec,tive Depth
Absorpti0~) Trenches
k
\
Proposed Well ............
10' Utility Easement
. LOT 9 ....
SITE PLAN
SCALE 1" = 20'
LOT 9, BLOCK 12, MOUNTAIN PARK
ESTATES
DESIGN FACTORS:
SYSTEM REQUIREMENTS:
Three Bedroom Home
Perc. Rate: 31 - 60 Min./Inch
Application Rate: .45 GPD/SF
Deep Trench System
1,000 Gallon Septic Tank
6' Drainfield Rock
3 Bedrooms X 150 GPD / .45 GPD/SF = 1,000 SF of Absorption Area
1,000 SF/12 SF/ LF of Trench = 84 LF Trench Length
Therefore: Construct a Deep Absorption Trench System With Two Laterals
Each 42' in Length with 6' of Drainfield Rock Beneath the Lateral.
Distribution Pipe in Trench Placed at 6' Below the Original Ground
Surface.
Natural ~/I ~-~ ' '
Backfill~
310'1
TYPICAL DEEP TRENCH SECT]ON
(NO SCALE)
NOTE:
Grade Area Over Trench to Drain Away.
Minimum 3' of Cover over Septic System.
Maintain 10' Separation From Lot Line.
PERFORMED FOR:
Munici!~atity of A~chomge
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alasl(a 99502-0650
SOILS LOG -- PERCOLATION TEST
Spinell Homes
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Block 12. Mtn.
Park Estates
TESTHOLE NO.
Bottom of Hole
Townsl~ip. Range. Sec~on:
SLOPE
L
WAS GROUND WATER
ENCOUNTERED;'
SITE PLAN
I I
IF YES. AT WHAT
DEPTH;'
M~umrmg? /
PERCOLATION RATE ~'~'"' {m,nute~/mcn) PERC HOLE DIAMETER ~ II
PERFORMED FOR:
Municipality o! Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alasi(a 99502.0650
SOILS LOG -- PERCOLATION TEST
Spinell Homes
Lot 9, Block 12r
LEGAL DESCRIPTION:
Township, Range, SectJon:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20-
COMMENTS
~Mtn. Park
TESTHOLE NO. 2
Bottom of
Hole
Estates
SLOPE
WAS GROUND WATER
SITE PLAN
ENCOUNTERED;' /~/
$
IF YES, At WHAT J 0E
DEPTH? ~ P
E
_~_~ m W~ 14~ / ~"' ?/~.wl/~._ , ..-
&
Gro~ Net OeOtn to I Net
Reading Oa~e Time Time WaterI
PERCOLATION RATE ~:~ (m,n~e~,ncn) PERC HOLE DIAMETER
TEST RUN BETWEEN 7 FT AND <~ FI'
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 9, BLOCK 12, MTN. PARK EST. SUBDIVISION
GENERAL:
1. The scope of this project includes the procurement and
placement of a new 1,000 gallon septic tank. It also
includes the construction of 2 new 42' long by 3' wide by 6'
effective depth absorption trenches at the location shown
on the site plan. The distribution piping must be placed at
6' below the original ground surface. Total depth of the
trenches will be 12' from the original ground surface.
Grade finished surface to drain away from trenches.
2. Construction shall be in accordance with the approved site
plan, design drawings, Municipal Permit with any special
provisions or conditions, and all applicable State and
Municipal Wastewater Disposal Regulations.
3.-i"he Contractor shall be responsible for obtaining all
underground utility locates and for the layout of the septic
system and verification of the location of all lot lines.
4. Unless specifically agreed otherwise, the contractor shall
be responsible for final grading areas subsequently
depressed from soil settling. Property owner shall be
responsible for revegetation of affected areas unless
specifically agreed otherwise.
5. Contractors installing wastewater disposal systems must
be certified by the Municipal Department of Health and
Human Services for system installations. Owners installing
their own systems must receive prior approval from D.H.H.S.
before beginning system installation.
SEPTIC TANK INSTALLATION
A new 1,000 gallon septic tank must be procured from an
approved source and installed at the location shown on the
plans.
Lot 9, Block 12, Mtn. Park Est.
July 21, 1998
Page Two
2. A septic tank is to be constructed by a certified septic tank
manufacturer. Construction shall include two 4" cleanouts
for pumping access.
3. The septic tank shall be sufficiently bedded to prevent
settling or shifting of the tank.
4. All standpipes on the septic tank shall extend a minimum of
12 inches above final grade.
5. Tanks installed without 4' of cover shall have a minimum of
2" of direct burial insulation.
6. A foundation cleanout shall be installed one to four feet
from the building foundation. Two cleanouts are required
between the tank and the drainfield.
7. Final grading over the tank shall be such that a positive
slope exists away from the septic tank.
DRAINFIELD CONSTRUCTION:
1. The drainfield shall be constructed to the dimensions shown
on the design. The bottom of the trench shall be within 2"
of level.
2. Distribution piping must be placed level with perforations
down atop alevel bed of drainfield rock. Rock should then
be placed over the pipe to provide a minimum of 2" of cover.
3. A silt barrier or geotextile fabric must be placed between
the drainfield rock and the natural soil backfill.
4. Monitor tubes must be 4" in diameter and installed at the
locations shown on the design. The portion below ground
must be perforated.
Lot 9, Block 12, Mtn. Park Est.
July 21, 1998
Page Four
5. A permeable geotextile fabric (Typar, Mirafi or equal) must
be installed between the final drain rock layer and the
native soil layer.
6. All drain rock shall be .5" to 2.5" in diameter with less than
3% passing the #200 sieve.
INSPECTIONS:
A minimum of two inspections are required by Municipal
Ordinance. These inspections must be conducted under the
supervision of a professional engineer registered in the State
of Alaska. The first inspection must be conducted after the
excavation of trenches, beds or pits and before the installation
of any gravel. A septic tank may be set in place, but may not
be backfilled.
The second inspection must be conducted after the placement
of the geotextile fabric, gravel, distribution piping,
standpipes, cleanouts and insulation. No backfill should be in
place at the time of inspection.
Contractor shall provide a copy of all field survey layout and
construction notes for use in preparing the certified as-built
of the completed system.
Lot 9, Block 12, Mtn. Park Est.
July 21, 1998
Page Three
5. Contractor shall verify the septic tank and drainfield are a
minimum 100' away from any private water wells in the
area, 150' from a Class "C" Well or 200' from any community
well.
6. Direct bury insulation must be placed over the distribution
system if less than 3' of backfill depth is available. Finish
grade over the trench must be mounded to prevent
settlement or depressions.
7. Grade area surrounding the absorption trenches to drain
away.
8. A minimum 2' of accepting soil is required below the
drainfield rock for a 5' wide trench. Contractor shall verify
this condition prior to placement of the rock. All pockets of
unacceptable materials must be removed and replaced.
MATERIAL SPECIFICATIONS:
1. Septic tanks must be constructed by a Municipally approved
septic tank manufacturer.
2. The following pipe materials are approved for use in septic
system installations in the Municipality of Anchorage:
Cast Iron (perforated and solid), ASTM D3034 or P.V.C.
(perforated and solid), ASTM F810 or H.D.P.E. (perforated,
but not solid) and ASTM D2662 or A.B.S. (perforated and
solid).
3. Insulation shall be at least 2" thick extruded direct burial
polystyrene (Dow Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with
watertight couplings (Caulder, Fernco, or equal).
1. GENERAL INFORMATION:
Complete legal description Mountain Park Estates; Block 12 Lot 9
Location (site address) 12801 Mountain Place*Anchorage, AK 99516
Current Property owner(s) Lorraine Kastner Day phone 440-9813
Mailing address 12801 Mountain Place *Anchorage, AK 99516
Real Estate Agent Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ® Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community_ ❑
Public Water System ❑ Public Sewer
. WaiverNariance requestlor: Distance:
Received'by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee Waiver Fee $
Date of Payment V-2 Date of Payment
Receipt Number Q� 7� �� ' Receipt Number
COSA# 105c%q % 369 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: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179
Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507
Engineer's Printed Name: Jeffrey A. Garness Date: u fEr
In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system
in accordance with the guidelines and regulations established by the Municipality of Anchorage and
industry practices. The reported results describe the condition of the system/s on the date/s of the
evaluation. Separation distances were measured to readily identifiable features. Hidden defects or
encroachments may exist that were not identified during the evaluation. The operational life of all wells
and septic systems depend upon a variety of variables, including but not limited to, soil conditions,
groundwater levels (that may fluctuate during the year), quality of construction (materials and
workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and
are outside the control of GEG. Satisfactory test results do not guarantee future performance of the
system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of
the well or septic system. GEG makes no representation whether an alternative well or septic system
can be installed on the property in the event either of the current systems fail to perforin adequately in
the future. The content of this report is for the sole benefit of the person/party that retained GEG to
perform the evaluation. Reliance upon the information provided in this report by any other person or
party (including subsequent property purchasers) is not authorized, nor will it confer any legal right
whatsoever.
6. DSD SIGNATURE
WN
System #1 Approved for 3 bedrooms
System #2 Approved for bedrooms
Disapproved
Conditional approval for
'\'PtALITY6 �6f
bedrooms, with the following stjs: -fie ri,
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1
Original Certificate
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
Septic System Advisory
Well Flow Advisory
COSA blue sheet 10-10-12.doc
Nitrate Advisory
Arse.isory
Other
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'\'PtALITY6 �6f
bedrooms, with the following stjs: -fie ri,
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1
Original Certificate
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
Septic System Advisory
Well Flow Advisory
COSA blue sheet 10-10-12.doc
Nitrate Advisory
Arse.isory
Other
Legal Description: Mountain Park Estates; Block 12, Lot 9
If more than 1 septic system on lot: COSA Checklist # of
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled ""619e
Total depth 256 ft
Cased to 256 ft
❑ Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ground) 18+ in.
Date of flow test for COSA 7/12/19
Static water level at beginning of test 220.6 ft.
Comments
B. TANK DATA
Age of tank(s) 21 years
Tank type/material seplidsteel
Measured operating fluid level in septic tank 52
❑ Standpipes/foundation cleanout per record drawing
Date of pumping 5/24/19
D. ABSORPTION FIELD DATA
Parcel ID: 017-391-48
Structure served by this system
Well production at time of test 5.0+ gpm
Water storage tank volume n/a gallons
Well disinfected for coliform test? ❑ Yes ❑ No
❑ Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L (Arsenic less than MRL (ND)
Collected by GEG, Ltd. _
Date of Sample. 7 ci
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Which system tested (date installed) 1998
Adequacy test date 7/12119
❑ ALL stand pipes.present per record drawing
Results ❑✓ Pass For 3 bedrooms
Total measured depth from grade "13.25 ft (max)
Fluid depth prior to test 31 in
Measured depth to pipe invert from grade 6.5+ ft (min)
Water added 635 gal
❑ N/A — pressurized field
50
New depth in
❑ Monitor tubes go to bottom of effective. If not, stateElapsed
150
depth into effective "'
time min
Q Code -required soil cover over'field
Final fluid depth 42 in
❑ System presoaked
Absorption rate 450+ gpd
(Required if vacant for greater than 30 days prior to
Any rejuvenation treatment (past 12 months) no
date of test)
Gallons introduced n/a gallons
If yes, enter date -
Comm ents/Deficiencies: Tested west trench only, East trench had 5 inches of liquid in it. "To bottom of MT in West trench. —East trench MT 4.75'& West trench MT 5.66'
COSA Checklist yellow sheet
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100'
❑ Yes
if No *5+
Community Sewer Manhole/Cleanout > 100'
Q Yes
if No
ft
2] Yes
if No ft
Neighboring Tank > 100' Yes
if No
ft
Private Sewer/Septic Line > 25' 0 Yes
if No ft
Absorption Field on Lot > 100' Q Yes
if No
ft
Holding Tank > 100' 0 Yes
if No ft
Neighboring Absorption Fields > 100'
Water Service Line > 10'
El Yes
Animal Containment > 50' 0 Yes
if No ft
❑r Yes
if No
ft
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' Z Yes
if No
ft
❑✓ Yes
if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
❑ Yes
if No *5+
ft Surface Water > 100'
Q Yes if No ft
Property Line > 5'
v Yes
if No
ft Wells on Adjacent Lots:
if No
Absorption Field > 5'
❑� Yes
if No
ft Private Wells > 100'
0✓ Yes if No ft
Water Main > 10'
❑r Yes
if No
ft Community Wells > 200'
❑✓ Yes if No ft
Water Service Line > 10'
El 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'
Q
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' Q Yes if No ft
Water Service Line > 10'
Yes
if No
ft
Community Wells > 200' El Yes if No ft
Surface Water > 100'❑
Yes
if No
ft
F. ENGINEER'S COMMENTS
*Met code at time of installation (6.7' from ST1 to foundation)
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.
COSA Checklist yellow sheet
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Septic Tank Advisory
Certificate of On -Site Systems Approval #OSC191369
Subdivision: Mountain Park Estates B12 lot 9
Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for
this property is 21 years old. Typical replacement costs range from $6,000 to $9,000.
This advisory must be attached to all copies of the subject Certificate of On -Site Systems
Approval.
This is an example of what the metal of a 20 year old steel tank MAY look like.
P-501
MOUNTAIN PARK ESTATES SUBD.
LOT 9, BLOCK 12
22,353 S.F.
SEt 5�g' X $0" R6!LSA 2
C- '-RP
51
egcc e -°v -t05 Og 10\51A°I N 89059'00"E 196.08'
gE�ttSEp l0rl°`4a 4�4Vf:9 lPt i-°P`'rF'Q'S' ��
FINAL STRUCTURE AS -BUILT
.AS -BU I L T I hereby certify that I have surveyed the
property depicted above and that no
GASTALDI LAND SURVEYING encroachments exist except as Indicated.
Jeff A. Gastaldl, R.L.S. It Is the responsibility of the owner to
4726 West 88th Ave. - determine the existence of any easements,
Anchorage, Alaska 99302 covenants or restrictions which do not
PHONE 248-5454 appear on the recorded subdivision plot.
Under no circumstances should any data
GRID DATE hereon be used for construction or for
2838 11/30/98 °stablishing boundary or fence lines.
F. B. J08 N0. ANCHORAGE RECORDING DISTRICT, ALASKA
98-20 MPES12
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FINAL STRUCTURE AS -BUILT
.AS -BU I L T I hereby certify that I have surveyed the
property depicted above and that no
GASTALDI LAND SURVEYING encroachments exist except as Indicated.
Jeff A. Gastaldl, R.L.S. It Is the responsibility of the owner to
4726 West 88th Ave. - determine the existence of any easements,
Anchorage, Alaska 99302 covenants or restrictions which do not
PHONE 248-5454 appear on the recorded subdivision plot.
Under no circumstances should any data
GRID DATE hereon be used for construction or for
2838 11/30/98 °stablishing boundary or fence lines.
F. B. J08 N0. ANCHORAGE RECORDING DISTRICT, ALASKA
98-20 MPES12
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Parcel I.D. #
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AOTHORITY
APPROVAL FOR A SINGLE FAMII.:Y DWELLING
017-391-48 HAA# I
GENERAL INFORMATION
Complete legal description
Lot 9, Block 12~~ Mountain Park Estates
Location (site address or directions) Alpine Drive at Mountain Place
Property owner
Mailing address
Lending agency
Mailing address
Spinell Homes
9210 Vanguard Drive
Day phone 344-5678
Anchorage¢ AK 99507
Day phone
Agent
Address
Day phone
Unless otherwise requested, HAA will be held for pickup.
Three ( 3 )
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
individual well
Community well
NOTE:
XXX
Public water
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
NOTE:
XXX
Individual on-site
Holding tank
Community on-site
Public sewer
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA ~21
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 of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verifythat based on the information obtained from
the Municipality of Anchorage flies and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm ~nd~rson Engineering Phone 522-7773
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's signature ¢t~ ~_~
Date 3/10/99
DHHS SIGNATURE
~ Approved for ,.~
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-02~ (Rev. 1/91) ~ck MOA
RECEIVED
Municipality of Anchorage MAR 1 I 1999
DEPARTMENT OF HEALTH & HUMAN SERVIC~{~NIClPALiTY OF ANCHO
Environmental Services Division ENVIRONMENTALSERVICES [;
825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744
Health Authority Approval Checklist
Legal Description:
A. WELL DATA
Lot: 9~ Block 12, Mountain ParcelhD.: 01 7-391 -48
Park Estates
Well type. Private
Log present (Y/N)
Total depth 256 '
SanitaW seal (Y/N)
If A, B, or C, attach ADEC letter. ADEC water system number
Y Date completed 10/16/98
Cased to 256 ' Casing height (above ground)
y Wires properly protected (Y/N)
2I
FROM WELL LOG
Date of test
10/16/98
218'
30
Static water level
Well production
g.p.m.
WATEP, SAMPLE RESULTS:
Coliform 0
Nitrate
ATINSPEOTION
Date of sample: 3 / 4 / 9 9
B. SEPTIC/HOLDING TANK DATA
Date installed 1 0 / 9 / 9 8 'lank size _ 1 , 0 0 0
Foundation cleanout (y/N)
Date of Pumping New. ~ .*-.!.
"~:~ /...~:.
C. ABSORPTION FIELD DATA
[:)ate installed 1 0 / 9 / 9 8
.178 mq/L Other bacteria 0
ColleCted by: ~ MEA
g.p.m,
High water alarm (Y/N)
Length 8 4 ' Width 3 '
Effective absorption area. 1 ~ 0 0 8
Number of Compartments __.2 . Cleanouts (Y/N)
N
Depression (Y/N) N
Pumper Construction
Soil rating (g.p.d./ft2 or ft2/bdrm)
.45
Gravel thickness below pipe
S]~onitoringTube present (y/N) Y
Date of adequacy test New ¢'.ons'h. Results (Pass/Fail).
Fluid depth in absorption field before test (in.);
System type Deep Trench
6 ' Total depth 1 ¢" ..
· Depression over field (Y/N) ~
For
Immediately after gal, water added (in,):
Absorption rate = .g.p.d.
If yes, give date
N
bedrooms
Fluid depth
(ins) Minutes ater:
Peroxide treatment (past '12 months) (Y/N)
72-026 (Rev. 3/96)*
D, LIFT STATION None on Lot
Date installed
Manhole/Access (Y/N)
High water alarm level at*
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Size in gallons
"Pump on" level at*
*Datum
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer/septic service line
On adjacent lots > 100 '
On adjacent lots > 100 '
Public sewer manhole/cleanout
Lift station N / A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation > 5 ' Property line > 5 '
Water main/service line
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line > 1 0 ' Building foundation > 1 D '
Surface water > 1 0 0 '
Curtain drain None on Lot
ENGINEER'S CERTIFICATION
I certify that I have determined thru field inspections and ravia
in conformance with MOA HAA guidelines in effect on this date,
Signature ~t~, ~'~..~ ~.~
Engineer',s Name Michael F,. Anc]~r.~nn: p: ~..
Date
Absorption field > 5
Wells on adjacent lots
"Pump off" level at*
>100'
Water main/service line > 25 '
Driveway, parking/vehicle storage area > 2 5 '
Wells on adjacent lots > 1 (~D '
HAA Fee $. ~ ~D
Date of Payment
Receipt Number z74
72-026 (Rev, 3/96)*
Waiver Fee $
Date of Payment
Receipt Number
N Sd BD
CERTIFICATE OF OWNERSHI~P AND DEDICATION
}
23,570 ~E
SURVEYOR'S CERTIFICATE ~5.
I, MAURICE R OSWALD , PROFESS[0N~~
AND.CORRECT REPRESENTATION OF LANDS ACTUALLY
~OTARY h< ACKnOWLEDGMENt
SUBSCRIBED AND SWORN TO BEFORE ME THI~
~Y COMMISSION EXPIRES: ~y ~w~/_, /¢~
SIGNATURE
ACCEPTANCE OF DEDICATION
ANCHORAGE HEREBY ACCEPTS FOR PUBLIC USES AND
FOR PUBLIC PURPOSES THE REAL PROPERTY DEDICATED
ON THIS PLAT. INCLUDING BUI NO1 LIMITED TO
THE EASEMENTS. RIGHTS-OF-WAY. ALLEYS. ROAD~AYS.
THORODGH~E~RES AND PARKS SHOW) HEREO~,
DATED~rA~HORAGE. ALASKA. THIS ~&~"lDAY OF
.a.~,~ ,~,~: -
MOUNTA N PARK
ESTATES SUBDIVISION
LOTS IA&2A BLOCK 12
· -/t~-~ DICtdlNCXDDI' C~U~LD.WkLCH LCC
DRAWN SLH R-BIER E 18-04
SNO 5218 FIELDBOdK BBB-B? 105-68