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HomeMy WebLinkAboutMOUNTAINSIDE VILLAGE BLK 4 LT 2 Municipality of Anchorage Community Development Department Page 1 of 2 On-Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage,AK 99519-6650• http://www.muni.org/onsite•(907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP171355 PID Number: 020-172-07 ❑ New ❑✓ Upgrade Name: JOSEPH DAMIANI ABSORPTION FIELD Address ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound 17803 MOUNTAINSIDE VILLAGE DRIVE ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot Ft. Ft. MOUNTAINSIDE VILLAGE 4 2 Fill added above original grade Gravel length Township Range Section Ft. Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES Ft. Ft. To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist.between trenches From Tank Field Tank Line Ft2 Ft. Well 108.0 N/A N/A N/A 90.9 TANK p Septic ❑S.T.E.P. ❑Holding ❑Other Manufacturer Capacity Surface Water 100+ N/A N/A N/A Anchorage Tank 1000Gal. Material Number of compartments Lot Line 67.4 N/A N/A N/A Steel 2 NA Foundation 25.5 N/A N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain 50+ N/A N/A N/A Gal. Remarks Pump on level at Pump off level at High water alarm at TANK REPLACE ONLY in. in. in. Pump make and model Electrical Inspections performed by to PIPE MATERIAL House to tank 3034 Tank drainfield 3034 Installer FLINESTONE ENERPRISES Drainfield CO/MT Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 1320ft Inspections, Location and description dates: 1 8/2/18 2' 8/7/18 3rd 4m AT HOUSE POINT A COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date ..c Pt el4A;Akk � ... `. .., t" df, t'teven'F "hannOR.e' 4%i 4k,64.#1 Approve t_.--- .1--/ Date g2.2 .7- kkussio .� Inspection Report_1-1-1 2.doc / • C! /11/1 ,/ // / / / / /' // / / /\ ,. \� ' ' / / / / / / / / / / / / / O- - / / �� / / / / / I / / / / < *'/ L : '! / / / / I / / •-I * ** 4/ / I / / / / / / �// ////' /^ i I I / / / // / . / ; �. / 4./ /// / / / II I 11 l /l / // //TRUE N SCA_E 1.'=150' / / Irl I WELL �/ / / /�. /. / / 111 /l 1 / / / / / / / / / ' I • % ,.. %' j / I I / / I / / / / I) / / . 1380 / 1 / I � I / I 1 / / / I /. /--..,./ / l / � / 1 I 1 1 / / / ri / \/ / 1 INSTALLED 1000g SEPTIC TANK --\ / / 1 I / ° 1 S..0 / W/DCO BEFORE & AFTER 1�7s / / /, / I / I 1 CONNECTED TO END OF EXISTING / / ► 1 1 TRENCH, BOULDERS PLACED AROUND TANK, / /• / / DCO VI + I •\ I I / / / / 1370 / / / / O� / �'T 1 (\ DECOMMISSIONED'✓EEXISTING/ // / // // // 6'9 / 614 • `��� :�� TANK PER MOA CODE / / / 1 / 1 / lll T2 1 3 / r I Jr I / ,3I / I / / / // • / / / 1 1 / Sr D l 1 1 1 / / l / I 1 / l 1 /-...., • II i + _ 111 J /1 1 11 , 1355 // /I /l /r 1/ /l 71 • /l I / r I ` ACK 1 /1 / r /l /' / / / / / / / l \„9 / 1 12 11 /l// I /1 / I 1350 / / / / I / / / Il I / / 1 1 1 / / / / / / l 1 1 l 1\� / / l / I I / / r A B /C . I / Q / 1 1 y I / 1345 / 1 I I I ! I DCO1 29.7 32.9 I / / /l I 1 r ! l 1 / I I I / I Ti 32.8 34.1 / Ni. // / 0 1 r I 1340 / 1 / I / ) I 1 T2 35.9 34.2 E ' oe/ I I 1 1 1 I I I 1 / 1 I 1 DCO2 37.3 34.6 ' / ,, r / .,1 r I I / / I I / 1/ I I I- 1- t- D > F D O 0 I- Lu 0 w 0 ca z z m z Dw W w �W OO U J J O U o 0 OG./FG. - - - - - 1317.0 4.0± 1 1312.4 / 1000 g SEPTIC \ TANK 1312,2 PROFILE SCALE: NTS NOTES: PANNONE L'N!'! SVC, LLC -", Date RECORD DRAWING P.O. ty BOX 102954 ANCHORAGE, AK 99510 P4. •••.• 8/13/2018 PHONE (907) 272-8218 FAX (907) 272-8211 1:••• I Scale _" 1" = 50' •••• •• ikliii. • ••• P.I.D. NO MOUNTAINSIDE VILLAGE B4 L2 • __ - 020-172-07 JOSEPH DAMIANI leVen lk•_ -an^orie PERMIT NO. DRAWN ACP • '• • CE 8149 OSP171355 17803 MOUNTAINSIDE VILLAGE DRIVE SITE PLAN ANCHORAGE, AK °�,.;' , Sheet 1 2 OF 2 � v.';'""`r, MUNICIPALITY OF ANCHORAGE t,�tenr On-Site Water&Wastewater Program - sr;, PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 - r. http://ww.muni.org/onsite ; , k` v w chartmrnt On-Site Wastewater Disposal System Permit Permit Number: OSP171355 Effective Date: 11/20/2017 Work Type: SepticTank Upgrade Expiration Date: 11/20/2018 Tax Code Number: 02017207000 Site Legal Address: MOUNTAINSIDE VILLAGE BLK 4 LT 2 G:3439 Site Mailing Address: 17803 MOUNTAINSIDE VILLAGE DR, Anchorage Owner: DAMIANI JOSEPH C Lot Size in Sq Ft: 101039 Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field El Septic Tank ❑ Holding Tank 0 Privy ❑ 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 ( ciaipeProvisions: A double cleanout is required downstream the septic tank, if not currently present. Ii, /... Y Received By: �' [a �' Date: ii �/P/ ,Issued By: atex G . ) 0 ( } Date: I a0 -20 I MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division -_ Fax: •S7.343.799774 \ A� , a , On-Site Water& Wastewater Program did1d 2011 ON-SITE SEWER/WELL PERMIT APPLICATION 4, Parcel I.O. 020-172-07 of s s L Property owner(s) Joseph Damiani Day phone Mailing address 25 Twin Elms Lane New City, NY 10956 Site address 17803 Mountainside Village Dr. Legal description (Sub'd., Block & Lot) Mountainside Village B4 L2 Legal description (Township, Range & Section) Lot Size 101,039 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank 0 Upgrade 0 Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE I 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) g .1.511 Permit/Rush Fees: at5-1" i?41 = 3�f y Waiver Fees: Date of Payment: I I—ZD—l 7 Date of Payment: Receipt Number: 0$11 rs1 Receipt Number: Permit No. 05Y171 J Waiver No. Permit App_.•:• ._.,c Pannone Engineering Services ac Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panengak.com November 17, 2017 Subject: Mountainside Village B4 L2 Tank Replace Permit Request Design Narrative This is a design narrative for a permit to install an upgrade 1,000g Septic Tank to replace an existing 1,000g Septic tank to be issued for this property. The existing tank has completely failed. It will be decommissioned per code. Currently the lot is developed. The proposed system will utilize a replacement 1,000g septic tank that will be connected to the existing drain field. The existing tank is located approximately 95' from the well. The proposed tank will be placed outside the existing well radius. All required separation distances will be met. 1. Upgrade Tank Design. A foundation clean out installed if needed. The tank will be located: 5'+ from any property line, building foundation or drain field 10'+ from any water line 100'+ from any surface water 100'+ from any private wells 200'+ from any public wells The proposed installation will not affect the future development of the surrounding or existing lots. If you have any questions or concerns, please contact me at 907.272.8218. Sincerely, sssss S . •• , 1 : StevenR Pannone Sp LLL��, � DRi t,. CE 8149 • Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage. AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 BOX 1~{~/];/), STAR ROUTE A ANCHORAGE, ALASKA 90502 SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF _ :~21.00 DRILLED AT THE RATE OF PEr FOOT. &~. ~J ~ 274-0870 PROPERTY OWNER - 2~0 7~t. LOCATION Of WELL SITE WELL LOG: 0-r--73' Cor~g,6o~ea~z,te. 13---250' Oex/.zoc,g. ,i .~edd~e~f.a.u;. rock.. Ro t~w. te;~. ,a.zodu. otd. or~ ~ko~g ~t 240 to 245 ~zat. I/2 ,-~o 7/2 ~P& :d~ .f~zo~ 2~7 .to 270 ~te~t. ,'~ ?~z .%egg .zoc,k. 27,4 go 277 ~e~t ~ko~ o~e ~2,~. 4 ~,zo~ ,zoc,k. ,~ c~q.. 1.6 ?_~ ~z fiooZ ~t, 200 -fiz~: ~_0 ~ ~ Ogwz 2500 9~ ,=wz 24 ;ko~ ,~e .~7000o00 ,oz~'Z tzp. ~,zor~ bt~ [}hz. ~ ,;~o$0o00 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROI'ECTION JUL. 2 3 1981 RECEIVED COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF THANK YOU VER.Y MUCH. DATE. BERNIE CLAUS OF RAMPART DRILLING WORKS SE:RVICE: CHARgE:OF I~% PE:R MONTM WILL BE: A~SESSE:D ON PAST D~OCOUNTS. F'ERH :[ T I'.,IEI. FIF:'F'L :[ CFINT FtI'.,IN C. I.,.I :[ L.I'::: :[ N%ON :t.,:1.139 P.I. X:;;:'.I'.4D FIVE. L. OCFIT :1:01'.,1 HT '.i!; I C,E ',,,' I L. LFIGE L.E:GFIL L2 B,:I. HT. :F::[[::,E ',,,'ILLFIGE LOT I"I]:NIHL.IH [)I%'I"F:It'..E:E: E:ETI.,IEEN I:::1 HELL.. FINE:, F:ll",!"r' Ed",I-:SITE SEI.,.tF:IGE D;[:SF'O'.E;FtL '.E;'¢'.'-?I'IEI'I ITL:; ::LEI(!) FEET FOR FI F:'f;i~:[',,,'F:t"FE: [,.IIELL. OR :LSEI "ro 2Eil;[~ FEET FF.:OH FI F'UBL. ]: C:: FIEL. L [:,E:F'Ei'.,I[::,ING UF'OI'.,I THE ?"¢F:'E OF F'IJE:L I C I,.IIELL. r,1]: 1'.41 I',IUH [::, :[ :~;TFd'.,IE:E: FF:OH FI F'R :[ ',,,'FITE I.,.IELL TO Ft F'F;: I Vi:YI"E '.SEI.,.IEI;? L. I NE I E; 25 FEET FIND 'T'O i::1 COHHLIN :[ T'¢ :E;EI.,.IEF~: L :1: NE :[ S 7!3 FEET. I.,.IELL L. OG~!E; FIF:'.E F:EC!LI!F;'.ED FIND I"IU:!TT' E.:E F4'.ETLIF..:NE:[:, TO THE DE:F'FII:~:'['HEHT !.,.!:l:'l'l.-IIi'.,I :2:El DFI'.¢':5 01:::' THE [,IEL. L. CEIHF'L.E'T:I:ON. o-r'l...llEl:',i: F;:E.'..:i:i:!I...I :[ F:%hlE'ZN'[':'5 HFt"r' RF'F'L."r'. SPEC ]~ FI CFIT I OI"4'.E~ FIN[:, CONS"FF4:LICT I ON [:.:, :[ I::IGI:~:FII'"I.'.'5 FII'~'.E FI',,,'FI i LFIE:LE: 'T'EI :[ I'-,I:E;UFi:E F'Fi:OPEF: ]: NSTRLLFITI ON. I E:IEF;:T :i: F"¢ THI::I"I" :1..: I FIH F'FIH]:L. IFIFi: klITH 'T'HE RE(;:!UIF?EI"tF'I",I"t"S FOR OI",I'""E;ITE ~;EHEI:~'.2; FIN[::' !,.IEI....I....2!; I:11~:; f:;ET FOfii:TH I:W THE HUN I C I F'FIL I T'T' OF FII",ICHOF?.F:IGE. ;2: ]: H:I:LL :I:I",I~i5"I"~!L:.L. THE: :5'¢E;TE;H Ii",l FICE:OFi:DFINL":E: HIT'H THIE :: '.3 E:, E ~q FIF:'F:'!... I C.:I::~f.,IT Ri'.,II'.,t I::L kl :[ L.I<: I ]: 2;:SUIED E',"r' , ............... [;:'RTE .... -~,- - MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL. SYSTEM AND/OR WEI L INSPECTION REPORT rPM°NE ~i ~w NAME LEGAL DESCRIPTION LOCATION ~ .... ] Well Absorpt~ ~z~area O~ DISTANCE TO: ~ f&n,~%~:.-~ I ~ Z Manufacture. ~ ~ - ~ ~ Lc GaDac ty ]ga OhS[ I Inside length ' ~ I ,~ .OM~m~. i ---- ~ ~ISTAN~E ~ell ~ ~ Dwelling t2 tmDwelling INO. OF B~OOMS No, o.~_~partmants OISTANCE TO: I ¢f1~ ['~:b~*.) ¢ No. qf line /~n~h ~ ea4~(line Top of tile to finish grade Length DISTANCE TO: DISTANCE TO: Width Depth Building foundation Total length of li~l~ ~ Material beneath tile Depth Driller , Sewer line Nearest lot lin~, 0 ' ITrench widths20 inches Liquid depth PERMIT NO. PERM__IZ O e 0 Distance be.tweon lines Total effective absorption araa PERMIT NO. Distance to lot line Septic tank OTHER PIPE MATERIALS SOIL TEST RATING / Absorption area(s) APPROV ED,:~ DATE LEGAL CONSTRUCTION TEST L~B "One Test is worth a Thousand Opinions" 2204 Cleveland Anchorage, Alaska 99503 277-0231 erfomned for Ann Wilkinson egal Description: Lot 2 'Block his Fomn reports: SOILS TEST yes Date Performed 11/3/79 Subdivision Mountain Side Village PERCOLATION 'PEST Depth Feet Soil Characteristics 20" 6" Peat Reddish Silt (ML) Brown Sandy Gravel Occasional Cobbles Slight Trace of Silt 11.5' Bedrock - Bottom of Test Hole s Ground Water Encountered No YES, What depth? ~ding Date Gross Tune Net TLme Depth to H20 Net Drainage ~colation Rate Minute Proposed Installation: SEEPAGE PIT DRAIN FIELD Depth of Inlet Depth to Bottom of Pit or Trench ~4ENTS: Bedrock was encountered at 11.5'. 125 square feet drainage area req3~ired Der bedroom from 20" to 11.5'. ~t Performed by. //~,~/~ Data Certified By: Construction Test Lab ~ D. Paul Date : 11/5/79 Time Date Time Date Inspector Inspector Inspector Comments Conditional Approval Date Sewer Installed Soils Rating Permit No, Well To Absorption Area Well to Tank Septic Tank Size ~. g ~) ~ Holding Tank Size Well Log Received P(operty Owner Mailing Address APPLICANT FILLS OUT LOWER HALF'ONLY Buyer ~ Address ,. ;_ Lending Institution -, ~ Address Realty Co. & Agent Address Legal Description Street Location Phone Phone Type,~o f Residence '3- Single Family Multipm Family Other No. of Bedrooms_ Wate, r,.Supply ,--~ Individual E Community Public Utilit~ Sewage Disposal :'El Individual E Public Utility · Holding_ Tank ATTACH WELL LOG, A well log is required for all wells drilled since June 1975, For wells drilled nrior [o that date. give wel depth (attach Icg If available.) Year Individual qstalled: ~ ' ' When Connected to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION Environmental Health Division CASE REVIEW WORKSHEET CASE NUMBER: DATE RECEIVED: COMMENTS DUE BY: S-7995 January 29, 19~,5 February 15, 1985 SUBDIVISION OR PROJECT TITLE: Lots 2A, 2b Block 4 Mountainside Village Subdivision ( ) PUBLIC WATER AVAILABLE ( ) PUBLIC SEWER AVAILABLE ( ) COMMUNITY WATER AVAILABLE bAun~cipal~y ~ Anchorage MEMORANDUM -,-o. ~~ ,~-~, ~/-~/~ SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEAl. TH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264~4720 SOILS LOG - PERCOLATIQN TEST PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19~ 20- SLOPE SITE PLAN~ WAS GROUND WATER I I S ENCOUNTERED? J~[,~ L ' O P E IF YES, AT WFIAT DEPTH? Reading Date Gross Net Del)th to Net Time Time Water Drop PERCOLATION RATE (minutes/inch) RUN BETWEEN ~ F~N D FT TEST SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST [] PERCOLATION TEST DATE PEREORMED: ¢i/W~ SLOPE SITE PL~CN 1 1 ENCOUNTERED? ~ O P. 12 IF YES, AT WHAT E DEPTH? 13 Gross Net Depth to Net Reading Date Time Time Water Drop 14 15- 16 17 18 ,.~ 19 - 20 PERCOLATION RATE (minutes/inch) · TEST RUN BETWEEN ~ E/I-~ AND "'i-- FT . ,,, Ih.,.>'.. 72-008 (6~79) 61891Q 77 •_ . -� Municipality of Anchorage AU ' 018 On-Site Water and Wastewater Program (907) 343-7904 r �<V 01 6 8 Certificate of On-Site Systems Approval Parcel I.D. 020-172-07 Expiration Date: PO 62 1. GENERAL INFORMATION Complete legal description Mountainside Village Block 4 Lot 2 Location (site address) 17803 Mountainside Village Dr. Current Property owner(s) Joseph Damiani Day phone Mailing address 25 Twin Elms Lane New City, NY 10956 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 request for: Distance: Received b : ! Date: opto _..."MP""." A - COSA to be released to the engineer,unless otherwise req st by the engineer. COSA Fee $ U"� Waiver Fee $ Date of Payment ( 7//7 Date of Payment Receipt Number yS"S 6 Receipt Number COSA# Z / 5-6;6) Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances,and regulations in effect at the time of installation. In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations.The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition,ground water levels that may fluctuate during the year,and the water usage of the family being served by the system.These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 8/15/2018 1110010 kkk Aur OF A�•ASV 6. DSD SIGNATURE %* TM`s`• *�4 System #1 Approved for -. 13 bedrooms .Seven R. Pannone: System #2 Approved for bedrooms � � CE-8149 Disapproved ���POFES510NA�' '• Conditional approval for bedrooms, with the following stipulations: WATT S1TE "5- WAS rEWAND PR©cRAm R G r r� 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet c c If more than 1 septic system is on the lot: COSA Checklist# 1 of 1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: Mountainside Village Block 4 Lot 2 Parcel ID:020-172-07 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 7/10/1981 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 280 ft. Cased to 280 ft. Casing height(above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 7/10/1981 10/6/2017 Static water level 80 ft. 89.3 ft. Well production 2 g.p.m. 1'2+ g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 2.41 mg/L Arsenic NDug/L Date of sample: 10/6/2017 Collected by: GARNESS B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 8/2/2018 Tank size 1000gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N/A Date of pumping NEW Pumper N/A C. ABSORPTION FIELD DATA Date installed 6/10/1980 Soil rating (g.p.d./ft2 or ft2/bdrm) 125 sf/bdrm System type 5-Wide Length 41 ft. Width 5 ft. Gravel below pipe 3.5 ft. Total depth 7.75 ft. Eff. absorption area 380 ft2 Monitoring tube Y Depression over field N Date of adequacy test 10/6/2017 Results(Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 455 gal. New depth 0 in. Elapsed Time: 1055 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. N Any rejuvenation treatment(past 12 mo.) (Y/N &type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100+ On adjacent lots 100+ Absorption field on lot 100+ On adjacent lots 100+ Public sewer main 75+ Public sewer manhole/cleanout 100+ Sewer/septic service line 25+ Holding tank 100+ Animal containment areas 50+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Absorption field 5+ Water main 10+ Water service line 10+ Surface water 100+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water main 10+ Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION �� OFALq , ki I certify that I have determined through field inspections and j p'�.•• `� Iyt#� review of Municipal records that the above systems are in 7*; - •/ \ ••* 6 conformance with MOA COSA guidelines in effect on this date. %.". A• `.Se r Engineer's Printed Name Steven Pannone r ..•Sleveri it•NrIririe:• 8/15/2018 ���lg •. CE-8149 I Date :? t� COSA canary sheet_2-6-15.doc 4 , / J ›. / .,:t. ,,, � moo. ,. ,,,, i, / I s01, / 00 4- / eco' �� / v QS'• / � / /2-• c3j 9 C,/ •••••/ / / / / / DWELL / / / / / / / / 4/4/ j// `'/ 22 4 / 2 S. ,Wr, TL p el, Co 3,m / m➢ - / '. o; / ti� r ,> En uo z _' / Z m . ir o- / 0 2.0 o /• / m O0.G m no ... F 'o .0. 3e L 0 o= O y T N y o, 4/ • Ni 4/S SO 6 00 AS—BUILT SURVEY 1" = 40 ' oO0�4pOO 'NO CORNERS SET THIS DATE QodcVOF AL�S4 /I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY O OF THE FOLLOWING DESCRIBED PROPERTY � 0 . �� TH %1\ vOO LOT 2, BLOCK 4, MOUNTAINSIDE VILLAGE SUB. 0* : 49 — . *,D v �/ ����v ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN Q'„ . .,i THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS O m ' :v CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND I$ EXIST OTHER THAN NOTED. O s SHANE A.HOLT • �1 NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. 0o B % LS-6914 ..,‘,,:/ EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT', ARE NOT SHOWN DATED AT ANCHORAGE,ALASKA THIS _13 TH DAY OF 04 ea '-..,, HEREON ( UNLESS INDICATED) _AUGUST , 2018. �4AIAIessiORaIC, NOTE: FENCELINES LINES OR POSITION ADDITIONALR ON THIS DRAWING IMPROVEMENTSARE NOT TO BE USED TO DETERMNE �'DOOo�� ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. HOLT LAND SURVEYING 9309 GROVER DRIVE ANCHORAGE,AK 99507 13731, FB 184-66,189-62 345-5513 . Municipality of Anc orage ",Gf et'�o On-Site Water and Wastewater Program Z l I (907) 343-7904 �' i n SAFETY Certificate of On-Site Systems Approval Parcel I.D. 020-172-07 Expiration Date: 1. GENERAL INFORMATION Complete legal description Mountainside Village Block 4 Lot 2 Location (site address) 17803 Mountainside Village Dr. Current Property owner(s) Joseph Damani Day phone Mailing address 25 Twin Elms Lane New City, NY 10956 Real Estate Agent Day phone 2. TYPE OF DWELLING: 0 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 request for: Distance: Received 131: r�1 (� % i •_ Date: 121121(Iv COSA to be released to the engineer,unless otherwise re. ested : the engineer. COSA Fee $ 4.'gO6 Waiver Fee $ Date of Payment /a((pl(? Date of Payment Receipt Number ( o5566 Receipt Number COSA# 06 C1W5Z,00 Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are)in compliance with all applicable Municipal and State codes, ordinances,and regulations in effect at the time of installation. In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations.The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition,ground water levels that may fluctuate during the year,and the water usage of the family being served by the system.These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system.The content of this report is for the sole benefit of the owner listed above. (907) 272-8218 Name of Firm Pannone Engineering Services LLC Phone Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 12/5/2017 FC kk r i\ •:v TA 6. DSD SIGNATURE / Pi System#1 Approved for bedrooms Steven f2.•�anrione• faIc6).x%. •. CE-8149 %i/ System#2 Approved for bedrooms �l s •. 4, , Disapproved ,i\�OFESS10 -er Conditional approval for _.- bedrooms, with the following stipulations: r. � tit S`t- K 007� otA tAie-{/Q Sep-f-tsc -4-- -)-Alc l 4-vt_ -�— t� r MA. v-0 U i G(Q N S t%V st ( ( G� --� t Zo f R _ \�\QP���Y OFgNC �O Y ON-SITE ��, WATERANu ,t, . 2 WASTEWATER O� •Q PROGRAM �`� gy, l tn• -C 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet r , c If more than 1 septic system is on the lot: COSA Checklist# 1 of 1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: Mountainside Village Block 4 Lot 2 Parcel ID: 020-172-07 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 7/10/1981 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 280 ft. Cased to 280 ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 7/10/1981 10/6/2017 Static water level 80 ft. 89.3 ft. Well production 2 g.p.m. 1.2+ g.p.m. WATER SAMPLE RESULTS: Coliform NEC' colonies/100 mL Nitrate 2.41 mg/L Arsenic ND ug/L Date of sample: 10/6/2017 Collected by: GARNESS B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 6/10/1980 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N/A Date of pumping Pumper C. ABSORPTION FIELD DATA Date installed 6/10/1980 Soil ratingz i 125 sf/bdrm 5-Wide (g.p.d./ft or ft /bdrm) System type Length 41 ft. Width 5 ft. Gravel below pipe 3.5 ft. Total depth 7.75 ft. Eff. absorption area 380 ft2 Monitoring tube Y Depression over field N Date of adequacy test 10/6/2017 Results (Pass/Fail) PASS 3 For bedrooms Fluid depth in absorption field before test 0 in. Water added 455 gal. New depth 0 in. Elapsed Time: 1055 min. Final fluid depth 0 in. Absorption rate >= 450+ d. 9.P. N Any rejuvenation treatment(past 12 mo.) (Y/N &type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: 100+ On ad scent lots 100+ Septic tank/lift station on lot J 100+ On ad scent lots 100+ Absorption field on lot 1 75+ + Public sewer main Public sewer manhole/cleanout 25+ Holdingtank 100+ Sewer/septic service line 50+ 100+ Animal containment areas Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Absorption field Water main 10+ Water service line 10+ Surface water 100+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: 10+ Property line 10+ Building foundation 10+ Water main 10+ Water Service line 10+ Surface water 100+ Driveway,parking/vehicle storage Curtain drain 50+ Wells on adjacent lots 10 F. COMMENTS G. ENGINEER'S CERTIFICATION 0' OF AL,QS��! I certify that I have determined through field inspections and Arrb.- �� 9�r review of Municipal records that the above systems are in 0*: a • •v /\ :.*T h conformance with MOA COSA guidelines in effect on this date. I _ r Engineer's Printed Name Steven Pannone r ':Sleveri fit. Pannone• 4 Date 12/5/2017 l+�'' • CE-8149•.0�� kkj��os'si COSA canary sheet_2-6-15.doc GARNESS ENGINEERING GROUP, Ltd � '°'o e CIVIL&ENVIRONMENTAL ENGINEERS November 30,2017 Joseph Damiani 5301 East 98th Ave. Anchorage, AK 99507 Subject: Private Well and Septic System Adequacy Tests for a Single-Family Residence within the Municipality of Anchorage(MOA) - Mountainside Village, Block 4, Lot 2. To whom it may concern: Per your request,adequacy tests were performed on the well and septic system serving the subject property. Our findings are summarized as follows: WELL: Prior to the start of the test on 10/6/2017, the static water level was 89.3.feet below the top of the casing (BTC). Five-hundred & forty-three (543) gallons were pumped from the well over a 240 minute period causing a liquid level drawdown of approximately 170 feet in the casing (259.3 BTC). Based upon this data, it was concluded that the well will continuously produce at least 1.2+ gallons per minute, which exceeds the MOA requirement for a 3 bedroom residence (0.31 gallons per minute). SEPTIC: The septic system serving the subject property(installed 6/10/1980)consists of a 1,000 gallon steel septic tank and a 5 foot wide,41 foot long trench type drainfield with an effective depth of 3.5 feet. It should be noted that per MOA records, there is a sump type monitoring tube(MT) located at the end of the drainfield, however,upon GEG inspection on 10/6/2017, no invert was located in the sump, therefore we were unable to confirm how far the sump extends into the effective depth of the drainrock. The sump extends 7.5 feet below grade, which is consistent with the Toben Spurkland,P.E. evaluation on 1/12/2004. Prior to the start of the test on 10/6/2017,the drainfield was found to bey, Five-hundred&Forty-three(543) gallons of water were introduced into the drainfield over a 240 minute period,causing a liquid level rise of approximately 3 inches in the sump. The drainfield was then allowed to recover for approximately 1,055 minutes resulting in a liquid level drop of 3 inches in the sump. Based upon this data, it appears that the drainfield currently meets the MOA (Municipality of Anchorage)minimum absorption rate required for a 3 bedroom residence(450+gallons per day). The accuracy of this assessment is limited by the accuracy of the sump depth. 3701 East Tudor Road,Suite 101 *Anchorage,Alaska 99507-1259 Phone: (907)337-6179*Fax: (907)338-3246*Website: www.gamessengineering.com Page 2 of 2 WATER QUALITY: Per your request, water samples were pulled on 10/6/2017 for Arsenic, Nitrates, &Coliform See water sample results below: • Arsenic: <5 ug./L. • Total Nitrate/Nitrite-N: 2.41 mg./L • E.Coli: Negative If you have any questions,please contact us at 337-6179. Sincerel , \ Jeffre Garness\P.E., M.S. Pre4ideht 3701 East Tudor Road,Suite 101 'Anchorage,Alaska 99507-1259 Phone:(907)337-6179 Fax:(907)338-3246*Website:www.garnessengineering.com Municipality of Anchorage · Development Services Department. .. . Building Safety Division ': On-Site Water and Wastewater. Program " ." ', ' · 4700 South Brag'aw. St. "- 'i ' · ' '" , www. ci.anchorage.ak.us . (907) 343-7904 " CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE. FAMILY DWELLING " Parcel I.D. ~O~,O- 1'7~- o '7 'l. GENERAL INFORMATION ComPlete legal description Location (site address of directions) Current Property owner(s). ~_-,~ Mailing address Lending agency Mailing address Real Estate Agent Ad,¢r~ss Day phone Day phone_ · "UtS~l~ss Othen/vise requested, HAA will be held by DSD forpickup. ,,.~.- . . ..¥.,., · 2..:):NuMI~ER 0~.. BEDI~O0,MS: ,-~ .: . . . . :; ',..;'. ~'~ 3, TYPE. OF, WATER SUPPLY: · '.. Individual Well .Jndivi~u:?l~W. ater. Storage [] Community Class Well D Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates 'of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Appro~/al ar~ required for the transfer of title (except beb. veen spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ~i ~ ?. ,, Mumc~pallty of Ancnorage , ~ . i :: .DeveloPmen~$erv~ces Department . ,.~ : ' ! i ' : : : ~i~ ~'=i~ BdiidingSafetyDMsio6' "i: :. . :' :,.![ ' ' : : On-Site Water.&WastewaterProgram; i . ii; i :i i ~ ! ~ : ; '.~.~.;i;~.[!; 4700 South Bragaw St:" I.; . · , -; i, : p O 'BOx' 196650 Ani:h0rage, AK i99519-6650 ; ; !i . ' . .ii.; ~: WW~.ci.anchorage.ak.us ' . i :. ; ~.' .... i : i ' : ;::': ii i i.!(g07):343'7g04 i : , ,,, .. , CHECKLIST i ,, " '" :HEALTH AUTHORI'EY. APPROVAL ':: !' "; i ~ ;!. ~ : i,' ' .. Legal DescriptiOn':".. '~'&'~ ~, ~"LI! ~;'(.: bO~4 ~-¢x, ,~'de.. !i'~li~.ee.. Parcel ID:: ~,2..O I i" i ..ii i,: : '":':'!I , ~ ,. Well:'t~ ~ IfA,;B,ii Provide =WSID# tq///k- Well Log iY/N)' !!',!;ii'+ pe '1 "i'iii~i!;:~ N'" I: Datecom~31et'edll ~ :san ~Se'al!(Y! )_~_ ! Wires properly protected (Y/N) fI ~. 't ! :":' i ' , : ' :, ',, 'i : Totaldep!h ~$~ ft. ' ~';'~;uas,~ o'J)~/¢,:~. Casing height (above ground) ,'. i : FRoMW~L *: AT INSPECTION : ': '· - ~'1' '/I~'!I i Dateoftest .I -/Jolb~ I~' 't../o ~ Static water;level . ' ' !; 'r~r D ft. ' I D '~, ' ft. i~ Well pro iD .p.m. I '~' ;: -i:. g.p.m." .... " ' ' ' ,' :i:i.; ',':~ .;! WATER SAMPLE RESULTS: ii l [. i '~ i '.. ':r :: Coliform !~colonies/100 mi.', ;NitJ'ate [~ mg./i. Other bacteria I~ .:i~ colOnie~/.i00 ., Arsen,c: ' ~/'l mD./1. : ;.i ::)aie of :sample: J/t'z./ot{ Collected by: .~p B, SEPTIC/HOLDING TANK DATA i!l ; .:; : r. ""'Tank Typ~elMa'e~r,;l' ~c )! "~'(--- '! Date installed '("~b/" Tank size i'."JabO gal. Number of Compadments ~ Cleanouts (Y/N) ;'~ '~: :. ' :! , .~ , I , ) i'~, [~' ' ' Sion ~3ver tank YIN Hi h water alarm (Y/N) ~:il~ ,:ir : Foundatloncleanout(Y/N) ~ ~.Depres ( ) ~ g . .. , i ' - ' , i I ' ' ' ' i ,, ' ~'i " ' ' ~ , i' I' : : :: Dateofp,ump,ng: (~/17--/0-5 ;'.,! :.purnpe, X : c, ABSORPTION FIELD DATA i : . : ' : ::i ': Dateinstaled ,/~/E'o Solrating ..(g.p.d./ft orfl/bdrm) I~p Systemtype ~'~ .. I.~ ' Length [ ::' /'~1 fl. i'! W,,idth : ..~ fl. · . Gravel belowp,pe . 1~ ~ -..' : ti!!~_~ ~ ~ 2 . . ~ · ' i ' Total depth '7, 7~ fl Eft absorption area 3(, Oft Mort tor ng tube "'/ Depression over.field, · ' . ~ :;I: , ' --7--- , ! " ~;' ' : I!l ,:,ii ', , ' , ' .i: Date of a~lequaLytest I/~z-/oql;!l !I:, Results(Pass/Fail) "~ For ~ bed. ro,o~s Fluid de 'th in absor tion field befdre' test '~ in. Water added ~Pgal. New depth P~ . P ' i'~ .1; . . Elapsed Time L~O min. ,.Final fluid depth ~ in. Absorpbon rate >= .' '~ Z~.':, Any rejuv, enat o'n treatment (past 12 mo'.) (YIN '& type) C,~ Il' yes, give o.ate . i ' t, it ~' : , ,,!;1' : i~ ' i~i : ' EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HEREON. ' "ASBUILT" No Cbrn~r$ set THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BE%VEEN EXISTING STRUCTURES AND PLA'I'rED LOT LINES OR EASEMENTS AND tS NOT TO BE USED FOR POSITIONING ADDITiONAl. STRUCTURES OR FEHCELIN.ES. I herelW ce.,'tify rna= I I~ave =un~eyed the Io;Iowlng delcd~e~ ~toperly. Lot ~ Blcc~ ~ .//~/~,~4/~/ 5't~h' ~l~fi~E Anchorage fe~ing aistrlcl Alaska, and t~at the Improvements slt~ated Ihere~ ara witch the prope~ lines ~ do not o~rlap Or encraa~ on