HomeMy WebLinkAboutPOTTER HEIGHTS BLK 2 LT 10Onsite File
Potter Heights
Block 2
Lot 10
#020-281-43
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On-Site Water & Wastewater Section Fax: 907-343-7997
Pump Installation Log
Well Drilling Permit Number: _______________ Date of Issue: ____-____-____
Parcel Identification Number: ____-____-____
Legal Description Block Lot Property Owner Name & Address:
Pump Installation Date: _____-_____-_____
Pump Intake Depth Below Top of Well Casing: __________ feet
Pump Manufacturer’s Name: ___________________________ Pump
Model: _____________________________________
Pump Size: ____________hp
Pitless Adapter Burial Depth: _________ feet
Pitless Adapter Manufacturer’s Name: _________________________
Pitless Adapter Installer: ____________________________
Well Disinfected Upon Completion? XX Yes No
Method of Disinfection: _____________________________
Comments:
Pump Installer Name: __________________________________
Company: ___________________________________________
Mailing Address: ______________________________________
City: ___________________ State: __________Zip: _________
Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation.
5
6
.
3
'
24.2'
5
6
.
3
'12.8'12.8'
W
SEPTIC
STANDPIPE TYP.
(10) TOTAL
N00° 09' 00"E 240.86'N78° 46' 1
0
"
E
2
4
1
.
2
6
'R=250.00'L=59.28'R=330.00'L=27.33'N45° 38' 30"E 271.46'
S89° 51' 15"E
34.99
L=25.82
R=20.00
20' UTILITY EASEMENTGRASS TRAIL
POTTE
R
HEI
G
HTS
D
RIVE POTTERCIRCLE3
0
'
3
0
'
25'
25'
LOT 9
LOT 10
5
1
.
2
'
52.8'71.6'86.9'25' SCREE
NI
N
G EASE
ME
NT
EXISTING
HOUSE
10.0'
4
8
.
2
'
LOT 10, BLOCK 2,
POTTER HEIGHTS SUBDIVISION
SEPTIC STANDPIPE
WATER WELL
FENCE
Gravel
Concrete
Overhang
Wood Deck
LEGEND:
NOTES:
1.THIS DRAWING SHALL NOT BE MODIFIED FOR USE AS A
PLOT PLAN WITHOUT THE EXPRESSED WRITTEN CONSENT
OF LCG LANTECH.
2.THE 25 FOOT SCREENING EASEMENT ALONG POTTER
HEIGHTS DRIVE WAS A 50 FOOT SCREENING EASEMENT
PER PLAT 81-224. MOA PLATTING AUTHORITY
RESOLUTION NO. 2019-010 REDUCED THIS TO A 25 FOOT
WIDE SCREENING EASEMENT. THIS DOCUMENT IS
RECORDED IN THE ANCHORAGE RECORDING DISTRICT
DOCUMENT NO. 2019-037878-0.
DRAWN DATE:
DRAWN BY:
SCALE:
CHECKED BY:
10/20/2019
SC
ADS
1" = 40'
PLAT:
WORK ORDER:19037
81-224
FB/PG: 814/46-47
GRID:SW3639
LEGAL DESCRIPTION:
ORDERED BY:JOHN DECARLO
250 H Street
Anchorage, Alaska 99501
Survey Department
Phone 562-5291
Mainline
Phone 243-8985
AECC 668
PARCEL #: 020-281-43-000
XW
SURVEY CERTIFICATION: LCG LANTECH, INC HAS CONDUCTED A PHYSICAL SURVEY OF
THE PROPERTY AS SHOWN ON THIS DRAWING AND CERTIFIES THAT THE
IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO
VISIBLE OR APPARENT ENCROACHMENTS EXIST OTHER THAN NOTED OR SHOWN.
EXCLUSIONARY NOTE: IT IS THE OWNERS' RESPONSIBILITY TO DETERMINE THE
EXISTENCE OF ANY EASEMENTS, COVENANTS, RESTRICTIONS OR RIGHT-OF-WAY
TAKINGS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO
CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION, FOR
ESTABLISHING PROPERTY LINES, OR FOR PLOT-PLAN PURPOSES.
AS-BUILTADDRESS: 6721 POTTER
HEIGHTS DRIVE
201e-037878-0
L Recording Dist: 301 - Anchorage
S 10/10/2019 08:05 AM Pages: 1 of 3
THIS COVER SHEET HAS BEEN ADDED TO THIS
DOCUMENT
•. • PROVIDE
.• Pj FOR
RECORDING
:.OR DDATA. • • SHEET
APPEARS AS THE FIRST PAGE OF THE
DOCUMENT IN THE OFFICIAL PUBLIC RECORD
After recording return to:
Municipality of Anchorage, Planning Department
Attn: Sonnet Calhoun, Land Use Plan Reviewer
P.O. Box 196650
Anchorage, AK 99519-6650
eRecorded Document
MUNICIPALITY OF ANCHORAGE.
PLATTING -AUTHORITY RESOLUTION NO. 2019-010
ANCHORAGE RECORDING DISTRICT
A RESOLUTION. APPROVING THE VACATION OF THE NORTHERN 25 FEET
OF A 50 -FOOT SCREENING EASEMENT LOCATED ALONG THE SOUTHERN
PROPERTY BOUNDARY OF LOT 10, BLOCK 2, POTTER HEIGHTS
SUBDIVISION, AS SHOWN ON PLAT 81-224.
(CASE S12508)
WHEREAS, a petition has been received from John DeCarlo (owner), to vacate
the northern 25 feet of a 50 -foot screening easement located along the
southern property boundary of Lot 10, Block 2, Potter Heights Subdivision, as
shown on plat 81-224; and,
WHEREAS, a public hearing was held on October 2, 2019.
NOW, THEREFORE, BE IT RESOLVED by the Platting Board that:
1. The Platting Board makes the following findings of fact:
a. The easement is surplus to current and future needs.
b. The standards set back in 1981, when this easement was
originally established, did not require screening of this
nature because there are no conflicting uses in the area.
C. The reduction to 25 feet will remove the slight
encroachment of the existing house.
d. It will reduce fire hazard by giving the ability to clear trees
farther from the structure than is presently allowed.
2. The Platting Board APPROVES the vacation of the northern 25
feet of a 50 -foot screening easement located along the southern
property boundary of Lot 10, Block 2, Potter Heights Subdivision.
PASSED AND APPROVED by the Anchorage Platting Board this 9th day of
October, 2019 subject to the following conditions:
1. The remaining 25 feet of the screening easement shall abut Potter
Heights Drive.
I II III�IIIIIIIIIIII
2of3
eRecorded Document 2019-037878-0
Platting Board
Resolution No. 2019-010
Page 2
2. Record the resolution approving the vacation with the district
recorder's office and provide the Planning Department with proof
of recording.
David R. W rtfield
Secretary
Case S 12508
Return to: Municipality of Anchorage
Dept. Community Planning & Development
P.O. Box 196650
Anchorage, AK 99519-6650
Attn: Dave Whitfield
IIIIIIIIIIIIIIIIIIIIIIIIIIII
3of3
eRecorded Document 2019-037878-0
Municipality of Anchorage Page __of
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
PermJtNumber: ,.5'%V' ~(oC)~-.. 45 PIDNumber: 02.02,8 14
Name:
Wastewater System: [] New [] Upgrade
Addrese: ABSORPTION FIELD
Phone: No. of B,~drooms:
,.~(~,~ - ~1 ~ ~ ~Z--~7~ ~ Deep Trench ~ Shallow Trench DBed ~Mound ~Other
LEGAL DESCRIPTION so,, Rating: Total Depth from original grade:
Lot: Block: Subdivision: Depth to pipe bottom from origina~ grade: Gravel depth beneath pipe
Township: II I~ Range: ~ ~ Section:~¢ I/~) ~ [4 Filladded above original~,~grade: Ft. Gravellength: ~ Ft.
WELL:~ New D Upgrade Gravel depth: Number of lines: Distance between lines:
Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material:
Driller: Date Drilled: StaticWater Level: installer: Date installed:
Yield: ~ Pump Set at: Casing Height Above Ground:
3 eVM, 3/5 ~. ~. S ~. TANK
SEPARATION DISTANCES ~Septic B Holding O S.T.E.P.
TO Septic Absorption Lift Holding Publi~ Manufacturer: Capacity in gallons:
From Tank Field Station Tank Sewer Lines ~
Well JZ~' I~0 ~ ~ N ~ ~7, ~ Material: Number of Compadments:
Surface
Water ~ ~ ~ ~ N ~ ~ A N A LIFT STATION
Lot Size in gallons: J Manufacturer:
Line ~,~ J~' ~ /~ l~ 7 ~ I~ ~I ~ ~
Foundation 40, ~ ~ I ~ ~ N ~ o' "Pump on" level at:IJ"Pump off" level at: , [ High water a~arm at:
I
CuKain
Drain J~ ~ J~ ~ l~ ~ j~ ~ j~ ~ PumpMake&Moder Electrical Inspections pedormed by:
Remarks: 5g& ~c~ ~c~ BENCH MARK
Location and Description:
I Assumed Elevation:
ENGINEER'S'SEAL
Inspections performed by: ~.~ ~. N~ ~ Dates: 1st ~' 14-~ .?~~.7~C.~..~...~ :~.~-t ""': ~ ~ ·
Department of Health a~d Huma~ Services approval
72-013 (1/91) MOA 25
~C.~M[I mO:~W~OUZ'+O VlU mO:~
SCALE: '
~'::3o'
i ' LO'T 9 , ~ ,
~5
IJ~
, ~-~.~ , ~ / %~;....~:. c~ ~,,. ~.;~
X~"' V/2/ X / ASSUAED RELAqVE.
- ~ ~/ ~ / POINT,TAKEOUT TABLE
~ ~ ~ ' PNT ANOLE L~T DIST. DESCRIP~ON
~ ~/ - ~/ 3 5'52'4~/ 241.3' CRNR. FIELD
'
~ ~/ ~/ ~, ~.~,o~- ,~,:~. ,c.... ~,~
/
o[s~s*:D*~ LOT 10, BLOCK ~ '
oR~ s~: ~ .o. POT~R HEIGHTS SUBDIVISION
"~'"="" ~AN WASTEWATER DISPOSAL SYSTEM,
' ~~,f~ AS-BUILT
PLOT SCALE:
PERMIT No: SW960245 PID No: 02028143
4" EXPANDEO 0
EXTRUDED POLYSTYRENE
Rf~ID IN~JLA110N
18,0'
FINISH GRADE-
ELEV.=167,7'
37,5'
MONITORING TUBE
TYP. EACH TRENCH
II
INLET INV. £LEV.-164.1~
12509 SEPaC
0~11~T INV. ELEV.=163,8'+
4" FLOW SPUTTI~
INVERT ELEV.- 163,7~
ORNN REM) 'IRENO'I
~1 INV. ELEV. mlS3.5'+
f2 ~NV. ELEV.-I$0.7"~
159'
NOTE: INVERTS S~MILAR EIOIH ' 153'
ENDS OF DRAIN FIELD
II
GRAVEL
2' SAND FILIRAllON LAYER
146.5[
FIELD BOOK RLE
,N/A I §4991C01,OWG J
LOT 10, BLOCK 2
POTTER HEIGHTS SUBDIVISION
WASTEWATER DISPOSAL SYSTEM
AS-BUILT
ANCHORAGE, ALASKA
PLOT SCALE: 1:1
1201 ~amona St. 99515 ANCHORA~I~ ALASKA
844-7714
SIX INCH WATER WELL DRILLED-
DRILLED AT THE RATE OF
OUT TO THE DEPTH OF 32.5 feet.
PER FOOT. Steel casing seated out to ]2_4 ft.
PROPERTY OWNER Dr, John DeCarlo 563-9913 762-6375 42~1 Laurel St. 99508
LOCATION Of WELL SITE I,t. 10 B!k. 2 Fatter Heights Sub.
DRILLER Bernie Claus of ~ampart Drilling Works.
WELL LOg:
0- i8' Coarse gravel, 30% silty material. Slightly wet.
18 - ~5' A dry coarse gravel,
~5 - 9~' Silty coarse & finer gravel. 20% clay material'.
q4-1~' Conglomerate. A broken/fractured/weathered bedrock. Casing was
d'riven to 124 ft. thru hard bedrock & broken beSrock.
12~ - 32~' Bedrock. A sedimentary bedrock with no water ~roduction showing
until 195 to 204 ft. Fissures in that area showing a yield of as much as 1/2
gpm. By 2_78 to 286 ft. new water increase was showing as much as 1 g~m total.
From 310 to 315' yielded 2 g~m. The total water ~roduction is how is a full
180 gallons var hour~ With water yield for short duration, after full draw-
down showing ~ gpm, but for only about 30 minutes'. Then production goes back
to ,~ full three gallons ~er minute on a steady basis. Water recovery is back u,~
to 35 to /4-5 feet off surface in four hours r~st time. One horsepower sub-
mersible pump should be install ten feet off bottom to get the full use of
Well. (10- to 15 ft.)
Cost of drilling.: ~25.00, eer ft. x 325 ft. $8,125.00
No charge for mobilization up or mobilization back out. No charge for set-up.
No charge for Muni approved Well Cap.
COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING.
~m~,art's cost of ~.rilling:
WRIThe CHECK PAYABLE TO RAMPART DRILLINg WORKS FOR THE SUM OF If8, 125. O0
The _i~_t_e~_r._i_t~ of this I.,Vell is ~uaranteed by Ramoart Drilling Works.
THANK YOU VERY MUCH.
P.S. The water is clear'!
DATE AU~USt 2.0_. 1996
~ERVICE CHARGE O F' 1~% PER MONTH WILL BE A~E~ED ON PA~T DUE ACCOUNTS.
Mr. 'DeCarlo. this is one Well T WoNrrT [n~maf. fnr ~ lnnm ~im~
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW960245
DESIGN ENGINEER:TRYCK, NYMAN & HAYES
OWNER NAME:DECARLO JOHN
OWNER ADDRESS:911 WEST 8TH AVENUE
ANCHORAGE, ALASKA 99501
PARCEL ID:02028143
PAGE 1 OF
DATE ISSUED: 8/12/96
EXPIRATION DATE: 8/12/97
LEGAL DESCRIPTION:
POTTER HEIGHTS BLK
2 LT 10
LOT SIZE: 43561 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT:
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM
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 DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
THE SAND USED IN THE FILTER LAYER MUST BE A CLEAN COARSE
SAND WITH 4% OR LESS PASSING THE #100 SIEVE AND 2% OR LESS
PASSING THE #200 SIEVE. A SIEVE ANALYSIS MUST'BE PROVIDED ON
THE SAND USED OR OBTAINED FROM AAI APPROVED SOURCE.
RECEIVED BY:
ISSUED BY'~~ f ~
DATE: ~13 ~ ~
TRYCK
NYMAN
HAY6$, INC.
ENGINEERS/SURVEYORS/LANDSCAPE ARCHITECTS
TRANSPORTATION and COMMUNITY PLANNING
5499.0
i EC£1vEb
AUC 81996
Munici
De Palit~
lat. Health '~Y~,f AnChora,~,,
August 7, 1996
Department of Health and Human Services
On-Site Services Division
825 "L" Street, Suite 502
Anchorage, Ak 99501
SUBJECT:
Lot 10, Block 2
Potter Heights Subdivision
Well and Septic System Permit Application
Dear Dan:
Thank you for your review comments on the above referenced system. We have redesigned the
plans for your review. This is a new subdivision and this will be one of the first houses and there
are no improvements within 200 feet to get measurements from.
Proposed System Design
The proposed system has been designed as a shallow trench system. This system was chosen due
to the high ground water in the area. The initial soils investigation occurred on 9/13/96. Ground
water was encountered at approximately 4.5 feet and 6 feet at the time of the investigation. A
subsequent site visit on 7/08/96 revealed no ground water present. The material encountered in
the test holes ranged from a poorly graded sand to a poorly graded gravel. Percolation rates
exceeded the minimum of 1 inch per minute. Percolation test results are attached for your review.
A two foot sand layer will be installed under the drain field where native sand is not present in
order to provide the necessary filtration layer.
The system was designed for three bedrooms, giving a design flow of 450 gallons per day. An
application rate of 1.2 gpd/ft2 was used in the design. The area required was calculated to be 375
ft2. Yielding a two 5 foot wide by 37.5 long drainfield.
The proposed septic tank is 1250 gallons and is to have two feet minimum cover with four inches
of expanded or extruded polystyrene insulation above it. The connecting piping is also shallow
and will require 4 inches of board insulation. The existing ground has a slope of 14% to 16%.
Over 40 Years Serving Alaska
911 West Eighth Avenue · Anchorage, Alaska 99501-3497 o (907) 279-0543/FAX (907) 276-7679
TRYCK
NYMAN
HAYES, INC.
On-Site Services
August 7th, 1996
Page 2
Lot information:
The subject lot is approximately 1 acre; the lot is constrained on the South by a Potter Heights
Drive and a 50 foot screening easement and slopes away to the NoRhWest at approximately a 15 %
slope. The proposed house is to be located in the middle of the lot on the side slope. The
proposed septic system has been set parallel to the slope and inset slightly. In any event, the width
of the proposed system and the relative fast percolation rates make it unlikely that there would be
any effluent seeping out the toe of the slope.
The designated replacement system is located 10' to the North-West and downhill of the primary
system.
Possible Points of Contamination:
It is unlikely that there would be any contamination of the future wells on the surrounding lots.
The lot immediately to the north is undeveloped at this time. Any lots to the east are separated
by Potters circle and in any event are up-slope. The lots to the North-West, while down slope,
are more then 100 feet from the proposed septic system and are also undeveloped.
The proposed well for this lot is located along the slope and slightly above the proposed septic
systems. I do not foresee any problems with contamination of the proposed well.
If you have any questions or concerns, please do not hesitate to call.
Sincerely,
INC:
Project Engineer
Permit, No.
P.O.
Page of
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
Box 19665 Anchorage, Alasko 99516-6650 Telephone: 545-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
LOT 10, BLOCK 2
Legal Description: POTTER HEIGHTS SUBD,
PID No.:
GENERAL NOTES:
1. ALL CONSTRUCTION SHALL BE IN ACCORDANCE WITH THE DEPARTMENT OF
HEALTH AND HUMAN SERVICES STANDARD SPECIFICATIONS FOR SEPTIC
SYSTEMS, MUNICIPALITY OF ANCHORAGE ORDNANCE 90-48 (S-1), AND
THESE PLANS.
2. THE PROPOSED WELL SHALL BE LOCATED APPROXIMATELY AS SHOWN, IN
ACCORDANCE WITH THE ARCHITECTS INSTRUCTIONS IN THE FIELD. A
MINIMUM OF 100' SEPARATION DISTANCE SHALL BE MAINTAINED FROM
ALL PROPOSED AND EXISTING SEPTIC SYSTEMS.
5. THE CONTRACTOR IS RESPONSIBLE FOR DETERMINING THE HORIZONTAL
AND VERTICAL LOCATIONS OF ALL UTILITIES PRIOR TO BEGINNING
CONSTRUCTION.
4. THE CONTRACTOR SHALL COORDINATE WITH THE ENGINEER AT LEAST
24 HOURS IN ADVANCE OF ALL REQUIRED INSPECTIONS. THESE
INSPECTIONS SHALL BE AS FOLLOWS: AFTER THE TRENCH SYSTEM IS DUG,
AND THE SEPTIC TANK IS SET IN PLACE, BUT BEFORE ANY GRAVEL OR
BACKFILL IS INSTALLED AND AFTER PLACEMENT OF DISTRIBUTION
PIPING, CLEANOUTS, STANDPIPES, FILTER FABRIC AND INSULATION,
BUT BEFORE ANY ADDITIONAL BACKFILL IS PLACED. THE CONTRACTOR
SHALL BE RESPONSIBLE FOR ANY ADDITIONAL INSPECTIONS SHOULD THE
WORK NOT BE READY DURING A SCHEDULED INSPECTION.
5. THE CONTRACTOR SHALL PROVIDE THE ENGINEER WITH AN AS-BUILT SET
OF PLANS WITH THE HORIZONTAL AND VERTICAL LOCATIONS OF ALL
IMPROVEMENTS CLEARLY MARKED WITHIN 5 DAYS OF COMPLETION OF THE
SEPTIC SYSTEM.
6. THE BOTTOM AND EDGES OF THE TRENCH SHALL BE SCARIFIED BEFORE FILLING
WITH GRAVEL, IF EITHER IS SMEARED DURING EXCAVATION.
7. THE SEPTIC TANK SHALL BE BACKFILLED WITH EXCAVATED GRANULAR MATERIAL;
NO SHARP ROCKS, ROCKS LARGER THEN 2" OR ANY OTHER MATERIAL WHICH
MAY DAMAGE THE SEPTIC TANK OR THE PROTECTIVE COATING, SHALL BE USED
WITHIN 6" OF THE SEPTIC TANK. ALL SEPTIC TANK BACKFILL SHALL BE
COMPACTED TO 95% MAX DRY DENSITY.
8. THE CONTRACTOR SHALL REPAIR ANY DAMAGED AREAS OF SEPTIC TANK
COATING PRIOR TO BACKFILL OPERATIONS.
9. THE CONTRACTOR SHALL PROMPTLY NOTIFY THE ENGINEER SHOULD FIELD
CONDITIONS VARY SIGNIFICANTLY FROM THOSE SHOWN ON THE PLANS.
O. BOARD INSULATION OVER DISTRBUTION PIPING SHALL BE A
MINIMUM OF FOUR INCHES THICK AND FOUR FEET WIDE, CENTERED
OVER THE PIPE.
JOB NO.: 5499 0 DATE: 8 06 96
Permit No.
P.O.
Page of
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
Box 19665 Anchorage, Alaska 99516-6650 Telephone: 545-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
LOT 10, BLOCK 2
Legal Description: POTTER HEIGHTS SUBD.
PlO No.:
SCALE:
1 "=50'
hOl 9
ADD BACKFILL AS REQUIRED TO
PROVIDE A 10% MAX SLOPE 10'
IN ALL DIRECTIONS OF PROPOSED
SEPTIC SYSTEM.
100' PROTECTIVE
RADIUS (TYP.)
TEST #2
/ ?
0
CULVERT
ELEVATIONS ARE ASSUMED
RELATIVE.
34.99'
.,{!i.
/ /////
TI LI TY .
.lOB NO.: 5499-1 DATE: 8-06-96
Shawn P. Snisarenko
No. CE 8817
Permit .No.
Page of
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 19665 Anchorage, Masko 99516-6650 Telephone: 545-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
LOT 10, BLOCK 2
Legal Description: POTTER HEIGHTS SUBD.
PID No.:
SCALE:
1"=50' SET UP POINT
5/8" REBAR
hOl 9
BAC,,KSITE POINT h CON '/
)h /5/8 REBAR ,,~¢\ZONI/k~. ~ } ./ / ..' // / // ..' /' ,."'/
~/ 's~S u~ ~ ~ ' ' " '
/ ~/ i i / /
/ ~ .~' ;" i / z / {
'~ /' / / / ,' / FER'C TEST
. ~ /' ~ , , / / i /
/.¥~ / / / i I / / I /
/ / / / / / / / ~0~ ~0
[/ / /' / . ;. , ,.
. / ,'
POINT STAKEOUT TA'BLE
PNT ANGLE RIGHT DIST. DESCRIPTION
5 548-24-01 120.32' CRNR. FIELD
4 5¢2-40-$0 110.72' CRNR. FIELD
5 558-59-59 150.09' !CRNR. FIELD
6 555-55-57 142.51' CRNR. FIELD
7 352-51-09 149.08' FLOW SPLITTER
8 551-12-50 158.05' TANK (OUT)
9 550-21-56 165.16' TANK (IN)
10 528-58-11 185.30' GSS @ HOUSE
11 54-0-45-15 188.69' HOUSE CRNR.
12 325-16-27 185.57' HOUSE CRNR.
15 525-17-56 274.65' WELL
/ /" ,I /' /
/' / / !
// / ..'/ / // /
I / i / /
/ / / / ?} / // / /// / ·
/ // / c/¢ ./ ./ .. ">',/ '":~
.X
., ,/ ~5 I / ASSUMED _ATIVE. "<,,
'~ // i.,;
/ ! i i I / / i /' / /
i i / / / / ;' i /
JOB NO.: 5499 .1 DATE: 8-12-96
/ / i /
> / / / i / /
/,. ::,<.,..".,'.,..'
. , / I /' /
Shewn P. Snisorenko
No. CE 8817
Permit No.
Page of
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O, Box 19665 Anchorage, Alaska 99516-6650 Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
LOT 10, BLOCK 2
Legal Description: POTTER HEIGHTS SUBD.
PtD No.:
"JIM" CAP (TYP.) -- 4" EXPANDED
EXTRUDED POLYSTYRENE
RIGID ]NSULA'RON W~
SEPTIC OVERLAPPING JOINTS
PUMP OUT
GROUND 18.0'
19'
2~ M7 2~
CONNECT TO j
INTERIOR PLUMBING /
SYSTEM ~DOUBLE C.O.
INSTALL NEW 4" FLOW SPLITTER--
1250g SEPTIC TANK INVERT ELEV.= 164.0'+
18" MIN.
MONITORING TUBE
W\ PERFORATIONS FULL
DEPTH OF DRAIN FIELD
57.5'
FINISH -
GRADE
4" PERFORATED
OR PVC PIPE POINT
PERFORA~ONS DOWN
INSTALL LEVEL
GRAVEL
2' SAND FILTRATION LAYER
JOB NO.: 5499-0 DATE: 8/07/96
Permit No.
Page of
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 19665 Anchorage, Alaska 99516-6650 Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
LOT 10, BLOCK 2
Legel Description: POTTER HEIGHTS SUBD.
PID No.:
NOTE: EXISTING SAND SHALL BE USED FOR THE REQUIRED
SAND FILTRATION LAYER WHERE POSSIBLE.
2.5' 5'
(TYP.)
10' 5'
GRADE
(NO COMPACTION)
SEASONALLY HIGH STATIC
WATER LEVEL
--I I I~1 I~1 ~-I I I~1 I~1
OR IMPERMIABLE LAYER
TYPICAL DRAIN FIELD SECTION
N.T.S.
4" RIGID INSULATION (TYP.)
GRAVEL
4" PERFORATED HDPE PIPE TYP.
INV, ELEV. = 162.0'::1:
SAND FILTRATION LAYER
I~ ~ ~9TH ~
.....
[~Shown P. Snisorenko/~1
~2~ ' ' .............. :L~ .%&
lOB NO.: 5~,99-1 DATE: 8-06-96
I_
PERCENT COARSER BY WEIGHT
PERCENT FINER BY WEIGHT
Job~ 5499.0
LU
,,>, ~,
fl.
LU
Anchorage, Alaska
GRAIN SIZE CLASSIFICATION
September, 1995 A-1004-56
~111 SHANNON&WILSON, INC. J Fig. 1
Geotechnical & Environmental Consultants
l'n t..It
SOILS LOG -- PERCOLATION TEST
1
2
3
4
s
fig/Zoo z,.^"//O,,4 ?'e:5
ENCOUNTERED?
DEPTH?
6
7
8
g
11
~2
A
R~dtng Oatl Gro~ Net DWfft to Net
Time Ti~l Wlt~ Drop
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14
15
16
17,
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19
20
PERCOLATION RATE ~-')' ,'~ (m,flums. flch) PERC HOLE DIAMETER ~'" * '
TEST RUN 8ETWEEN ~//2. FT AnO ~ FT
PE~FORMEDBY: ~~ ~ ~~1 ~O~',NA~N ~. GERTIFY THAT THIs T~T WAS p~FORMED IN
'~CCORD~NCE WiTH A~ STATE AND MUNICIPAL GUID~iNES IN EFFECT ON THIS DATE. DAT~
'~*~~'~ 8OIL~ LOG -- PERCOLATION TEST
-- O~AM I~ s~oPE
I
2
3
4
6
7
8
9
10-
11
12
13
14
16,
16-
17.
18
19
20
Township, Range, Section:
WAS=.OUNOW^~E. yf.~
ENCOUNTERED? .,,
SITE PI.AN
PERCOLATION RATE ~* /' ~) (m,nut~,',ncnI PERC HOLE DIAMETER , ~" ' '
TEST RUN BETWEEN ~-- I//Z FT AND ~ FT
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIOELINES IN EFFECT ON THIS DATE. DAT~
Reading Date Gro~ Net Del=~h to Net
- Time Time Water Drop
C~//.~/?~ ~3 ~c ~ ~-~ ~" /,'
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MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 020-281-43
1. GENERAL INFORMATION
Expiration Date: _ / U ' 3) — / 9
Complete legal description POTTER HEIGHTS BLOCK 2 LOT 10
Location (site address) 6721 POTTER HEIGHTS DRIVE, ANCHORAGE, AK 99516
Current property owner(s) JOHN DECARLO Day phone
Mailing address
Real estate agent
6721 POTTER HEIGHTS DRIVE, ANCHORAGE, AK 99516
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
Day phone
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 $ 56b
Date of Payment _LZo( ig
Receipt Number 03Q73-6
COSA# 650q[325'
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the
on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater
disposal system is (are) in compliance with all applicable Municipal and State codes, 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 ANDERSON CONSTRUCTION & ENGINEERING Phone 345-3377
Address 4661 NATRONA DRIVE, ANCHORAGE, AK 99516
Engineer's Printed Name MICHAEL N. ANDERSON, PE Date 6/19/2019
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 Mrs and Anderson Construction & Engineering.
6. DSD SIGNATURE
System #1 Approved for bedrooms
System #2 Approved for bedrooms
Disapproved
AIIIWR�OFA ,4
*:49
0
IaCMEL N. ANDERSON,
�1 No. CE 9469 A
AV
'/
Conditional approval for bedrooms, with the following stipulati9,gg(((((((((,,,
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.
7. ATTACHMENTS:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
COSA Checklist blue sheet
Nitrate Advisory
Arsenic Advisory
Other SGI ` ,' C- k�el
Legal Description: POTTER HEIGHTS BLOCK 2, LOT 10
If more than 1 septic system on lot: COSA Checklist #
A. WELL DATA
® Well log is filed with Onsite (or attached)
Date drilled 8/20/1996
Total depth 325 ft
Cased to 124 ft
® Sanitary seal is functioning correctly
® Wires are properly protected
Casing height (above ground) 24+ in.
Date of flow test for COSA 5/1/2019
Static water level at beginning of test 117 ft.
Well production at time of test 2.94 gpm
Comments
B. TANK DATA — 6/4/1998 - 1250 -gal
Age of tank(s) 23 years
Tank type/material STEEL
Measured operating fluid level in septic tank 49"
® Standpipes/foundation cleanout per record drawing
Date of pumping 5/1/2019
of
Parcel ID: 020-281-43
Structure served by this system
Water storage tank volume NA gallons
Well disinfected for coliform test? ❑ Yes ® Nc
® Coliform bacteria is Negative
Nitrate 3.27 mg/L E]Nitrate less than MRL (ND)
Arsenic ug/L ® Arsenic less than MRL (ND)
Collected by F�
Date of Sample 7/3/2019
C. LIFT STATION - NA
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. ABSORPTION FIELD DATA — 2 @ 38'L x 5'W x 0.5'ED —1.2 GPD/SF = 380 SF
Which system tested (date installed) 8/15/1996
Adequacy test date 5/1/2019
® "ALL standpipes present per record drawing
Results E Pass For 3 bedrooms
Total measured depth from grade 5.38 ft (max)
Fluid depth prior to test 0 in
Measured depth to pipe invert from grade 4.88 ft (min)
Water added 500 gal
❑ N/A — pressurized field
New depth 4 in
® Monitor tubes go to bottom of effective. If not, state
depth into effective
Elapsed time 10 min
® Code -required soil cover over field
Final fluid depth 0 in
❑ System presoaked
Absorption rate 450 gpd
(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: Tested upper trench — bottom trench had 2" of fluid. Q�Z.
COSA Checklist.docx
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
Community Sewer Manhole/Cleanout > 100'
® Yes
if No
ft
® Yes
if No ft
Neighboring Tank > 100' ® Yes
if No
ft
Private Sewer/Septic Line > 25' ® Yes
if No ft
Absorption Field on Lot > 100' ® Yes
if No
ft
Holding Tank > 100' ® Yes
if No ft
Neighboring Absorption Fields > 100'
Surface Water > 100'
® Yes
Animal Containment > 50' ® Yes
if No ft
® Yes
if No
ft
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ® 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
ft
Wells on Adjacent Lots:
Property Line > 5'
® Yes
if No
ft
Private Wells
Water Main > 10'
® Yes
if No
ft
> 100' Yes if No ft
®
Absorption Field > 5'
® Yes
if No
ft
Community Wells > 200' ® Yes if No
Surface Water > 100'
® Yes
if No
ft
Community Wells > 200' ® Yes if No ft
Water Main > 10'
® Yes
if No
ft
If septic tank is under driveway comment below
Water Service Line > 10'
®Yes
if No
ft
Surface Water > 100'
® Yes
if No
ft
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
I 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.
COSA Checklist.docx
OF AZ'4
4 J Tx
MICHAEL N. ANDERSON.'
N. CE 9469
.7/22/ 19 ..o~�
AftFESSIO-0
DEVELOPMENT SERVICES DEPARTMENT
On -Site Water and Wastewater Section
www.muni.org/onsite �--
Septic Tank Advisory
Certificate of On -Site Systems Approval #OSC191325
Subdivision: Potter Heights Block 2 Lot 10
ROME.� �#4
Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for
this property is 23 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.
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· ~ MUNICIPALITY OF ANCHORAGE
::.' (,~,~ DEPARTMENT OF HEALTH & HUMAN SERVICES
. '. ~ . .' ' Division of Environmental Services ·
· :. ' ~- i' ' .' Omsit~ServcesSection . .',
'P.O. B°X 196650 Anchorage, Alaska 99519-6650
...... "- . ' 343-4744 -' ''
' .' .... .. '. -.' .-' ' ' - - . '::
CERT F CATE OF HEALTH AUTHOR TY
. APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # 020.2 ~//-Y3' "'"'-': .... FiAA # ~f;'~o~-~"~,_,.,~,~
1. GENERAL INFORMATION
- Complete legal deScription :
Location (site address or directions)" /~?'~4-~ H£/~/~;~'5 Z?,~/vz:'/ 3,~/~.E3 F~
;Mailing adSress
':Len'ding ~ig'encY' ..........
'~:ai{ing address :,- ....
A~';,nt?:'~.'.!u~ _ -, :, ,.
Day phone
Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: ~
3. TYPE OF WATER SUPPLY:
Individual well
Community well ' · '
Public water
NOTE: If communitY well system, Provide written confirmation from State ADEC attest- ing to the legality and status of system. ·
4. TYPE OF,WASTEWATER DISPOSAL: .... -'~','
Individual on-site Y~' -' ' -~"' ' ~':. ,, -
;-.Iolding ·tank ·
- ' Community on-si '-
Public SeWer : .... ,-,' '-
NOTE~. if'cOm'~dbitY'~v~SteWater §YSt~'-'~,~.pr°.vide'written confirmation from State ADEC · attesting iO'the le~alit~and Stat~Si°f System.' '. ' ; -
72-025 (Rev. 1/91) Front MOA #21
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 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 structu re 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 in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm 7'~Y'~:/-r/~/Y/~A~' ~ Y'£~ //Vt
Engineer's signature (~¢¢¢~"~ .-
Phone
Date
DHHS SIGNATURE
Approved for
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
· ' ' Date ~' - / -~ -'~"7
By! -~... .... [ ." _./. .
'l:he Muni~ip.ality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
ApCt6val Certificates based only upon the representations giVen in paragraph 5 above by an independent
prof~esional engi,~'i;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. Em ~loyees 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.
72-025 [Rev. 1/91) Back MOACY21
"~ Municipality of Anchorage
l~% ~;J DEPARTMENT OF HEALTH & HUMAN SERVl~::r~c
~ 825 L Street, R~°e~i~%it~hn~iiilr~~~~ii~~~i~iiii~~-~
Legal Description' /-O~'/O ,~Oc~ ~, ~O~Z~ H~'I~¢~ Parcel ID'
A. WELL DATA
Well type
Log present (Y/N) Y
Total depth
Sanitary seal (Y/N)
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed
Cased to l ~. ~/t Casing height (above ground)
Wires properly protected (Y/N)
FROM WELL LOG
~ g.p.m.
AT INSPECTION
Date of test
Static water level
Well production
g.p.m.
WATER SAMPLE RESULTS:
7::'.~'.~. ~oc~ ~e~ ~
Coliform ~ ~/o C~ci /¢o~ Nitrate o.~1~/¢0
Date of sample: ~/¢~ [o4/o~/¢~) Collected by:
Other bacteria
B. SEPTIC/HOLDING TANK DATA
Date installed O~///,-5~-¢~ Tanksize
Number of Compartments
~-- Cleanouts (Y/N)_)/-E.5
Foundation cleanout (Y/N) Y'~'5
Depression (WN) /¥O High water alarm (Y/N)
Date of Pumping ~//,~ - A/£V,/ Pumper
C. ABSORPTION FIELD DATA¢lL~
Date installed ('~//~ ~ Soil rating (g.p.d./fF orft~/bdrm) /' 2~O/~f~System type ~/-/~/..r. cz~
Length .2.~' Width ~' Gravel thickness below pipe ~" Totaldepth ~'f
Effective absorption area ~O f'-/z Monitoring Tube present (Y/N). ~ Depression over field (Y/N)
Date of adequacy test IV/A* -/V£~' Results (Pass/Fail)
For bedrooms
Fluid depth in absorption field before test (in.);
Immediately after gal. water added (in.):
Fluid depth (ins) Minutes later: Absorption rate = g.p.d.
Peroxide treatment (past 12 months) (Y/N)
If yes, give date
72-026 (Rev. 3/96)*
Date installed
Manhole/Access (Y/N)
High water alarm level at*
Cycles tested
E, SEPARATION DISTANCES
Size in gallons
"Pump on" level at*
*Datum
On adjacent lots
On adjacent lots
Public sewer manhole/cleanout
Lift station k//,A-
"Pump off" level at*
Absorption field /'7'2- '
Wells on adjacent lots
Water main/service line
Driveway. parking/vehicle storage area --~O
Wells on adjacent lots /k/oNd I,',' ,5~r.~
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
Absorption field on lot !
Public sewer main f,J/,A
Sewer/septic service line
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation /'-/¢)' °¢ f Propertyline ~. ,~J
Water main/service line
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line /2./ Building foundation
Surfacewater NO/,I~ I~ A£~'/~
Curtain drain Not, I 'E. hV ~ ~.~
ENGINEER'S CERTIFICATION
I certify that I have. term/ned thru field inspections and review of Municipal
,n conf~~lines in effect on this date.
Engi~'s Name ~//~
HAA Fee $
Date of Payment
Waiver Fee $
Date of Payment
Receipt Number
72-026 (Rev. 3/96)*