HomeMy WebLinkAboutMOUNTAINSIDE VILLAGE #1 BLK 3 LT 16Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP231273 PID Number: 020-172-44 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name LARA MABRY & JULIE JORDAN ABSORPTION FIELD ❑ Deep Trench ® Wide Trench ❑ Bed ❑ Mound Site Address 17400 MOUNT MC KINLEY DR., ANCHORAGE ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 1.2 GPD/SF 5.5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 2.5 Ft. Gravel depth beneath pipe 3 Ft. Subdivision Block Lot MOUNTAINSIDE VILLAGE #1 3 16 Fill added above original grade VARIES 1.07 — 3.06 Ft. Gravel length 50 Ft. Township Range Section Gravel width 5 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 431 Ft2 1 -- Ft. Well 100'+ 100'+ 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Surface Water 100'+ 100'+ GREER 1000 Gal. Material Number of compartments Lot Line 51+ 10'+ NA HDPE 2 Foundation 10'+ 10'+ LIFT STATION Manufacturer Capacity Remarks Gal. Alarm location Electrical installed by Installer JRS PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield Drainfield 3034 CO/MT 3034 Inspector FWC BENCH MARK (Assumed elevation) 100 ft Inspection15, g/18/23 dates: 2�d 9/19/23 Location and description 31d 9/19/23 41h 9/20/23 TOP OF MH RISER ON-SITE WATER AND WASTEWATER SECTION APPROVAL Conditional Approval: Date law 'Wq*: 49 Z-. ..:* •• •v•% Septic System A roved - Pp �� Curtis Huffman �`�is'•. CE 128991 Date • •.�`�A/W 9/28/202. lll��pROFESSIONP .� Note: this approval does not include well permit requirements. io,... nein�ie o� PID:020-172-44 PERMIT:OSP231273 FIRST WATER CONSULTING MOUNTAINSIDE VILLAGE #1 B3, L16 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP231273 Work Type: Septic Upgrade Tax Code Number: 02017244000 Site Legal Address: MOUNTAINSIDE VILLAGE #1 BLK 3 LT 16 G:3439 Site Mailing Address: 17400 MOUNT MC KINLEY DR, Anchorage Owner: MABRY LARA MARIE DDS 50% & Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date: Expiration Date cnr O CIA J Department Lot Size in Sq Ft: Total Bedrooms: 9/7/2023 9/6/2024 66895 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ 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 Received By: S i �'?-� F wC Date: Issued By: Date: 20 L 3 Development Services Department �` Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 020-172-44 Property owner(s) MABRY LARA MARIE Day phone _ Mailing address 2601 BONIFACE PARKWAY ANCHORAGE, AK 99504 Site address 17400 MOUNT MCKINLEY DRIVE ANCHORAGE, AK 99516 Legal description (Sub'd., Block & Lot) MOUNTAINSIDE VILLAGE #1 BLOCK 3 LOT 16 Legal description (Township, Range & Section) Lot Size 66,895 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ® Initial ❑ Single Family (SF) X❑ (w/wo ADU) Septic Tank ® Upgrade X❑ (D) El Holding Tank ❑ RenewalDuplex ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Sig nature,-of.property- owner or authorized agent) Permit/Rush Fees: 5% S Waiver Fees: Date of Payment: �� / �� 202 3 Date of Payment: Receipt Number: ( 0 ) 5 Receipt Number: Permit No. / 5)02? l27? Waiver No. GADevelopment Services\Building Safety\On.Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com ! !! August 21, 2023 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT LEGAL: MOUNTAINSIDE VILLAGE #1 BLOCK 3, LOT 16 The property owner has requested we obtain a permit to upgrade the failed septic system of the above referenced lot. We propose to install the reserve field of one shallow trench and upgrade the aged steel tank with a 1000-gallon HDPE tank to serve the existing 3-bedroom residence. We would recommend a 1500-gallon HDPE tank be installed for future consideration or flexibility. No groundwater was noted in the MOA on-site file, but if groundwater is encountered during installation an epoxy coated steel septic tank may be required. The design is based on the S&S test hole conducted in 1997 per the MOA file. No groundwater was observed at test hole excavation or monitoring. The slopes are 15-20% at the proposed upgrade location. The lot and area are served by private water. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231273, Curtis Townsend, 09/07/23 FIRST WATER CONSULTING MOUNTAINSIDE VILLAGE #1 B3, L16 DESIGN CALCS: INSTALL RESERVE FIELD PARALLEL TO SLOPES. NO SLOPES >25% WITHIN 50' OF PROPOSED FIELD. NO WELLS WITHIN 100' OF PROPOSED SEPTIC SYSTEM. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231273, Curtis Townsend, 09/07/23 FIRST WATER CONSULTING DESIGN DETAILS: MOUNTAINSIDE VILLAGE #1 B3, L16 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231273, Curtis Townsend, 09/07/23 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 Permit Number: .~'~,~,1 ¢'~L¢)/~ c/ RiD Number: ~0 ~' /7~ ~ Name: ~/2/~ ~W5'>%ud>~o~ WastewaterSystem: ~New_ D Upgrade /~ot ~ , ~~ , ~ ABSORPTION FIELD Phone: _~ ~¢~:./~/6- NO. of Bedrooms:  ~ Deep Trench ~ShaHowTrench Q Bed ~ Mound ~ Other ' Total Depth from o~n~l grade: LEGAL DESCRIPTION Sol[Rating: j, 2 GPD/Sq.F,. /~ ~ Subdiv~ion: ~/ Depth to pipe bosom from originsI grade: Gravel depth beneath pipe~/ Township: ._~" Range: ~ Section: Fill added above/~origioal/grade: Ft. Gravel length: 4~~ / Ft~ WELL: D Upgrade Gravel width: ~/ Number of lines: Distance b¢~een Ik,0~: Classification (Private, A,B,C): Total Depth: Cased To: Total absorptio . )tiller: Date Orilie~: StaticWater Level: Installer: , / ¢ ~ /~-/~ - ¢ 7 sud~c~ /~ /¢o~w ~ LIFT STATION Water . Lot Line FX / ~ / / size in gallons: Manu~ Cu~ainDrain /~/0 ~¢~0~ ~O~W~¢~/~' / / Pump Make & Model, .. .-- Electrical Inspections pedormed by: Remarks: BENCH MARK Location and Description: ~ - Assum~ Elevation: Depadment of Health and Human Se~ices approval , ~--. %...... ..... "?... _.. Reviewed ndapproved . 72-013 (Rev. 9/91) MOA 95 PERMIT NO. SW970169 PAGE 2 OF 2 Municipatilv of Anchoraae DEPARTMENT OF HEALTH AND HUM'AN SERVICES ENVIRONMENTAL SERVICES DIVISION P.D. Box 196650 eAnchorage, ALasI<~ 99519-6650·Tetephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 16, BLOCK 3, MOUNTAINSIDE VILLAGE #IP, I,D. NO. 020-172-44 LOT 1 5 NEW 1000 GAL,-  SEPTIC TANK NEW TRENCH C01 A B FCO 39.0' 18.5' ST1 66,0' 41.0' ST2 66.5' 45.0' DBL1 68.0' 51.0' DBL2 72.0' 56.0' C01 99,0' 91,5' MT1 121.5' 115.0' C02 141.0' 1,32.0' LOT 16 DBLi -INSULATION UNDER DRIVEWAY FINAL GRADE~ COl ST1 / ST2 , ~ MT1 C02 97.9'~ I / /96.6 MT,:._____.___9~.6'~k~ __ZC02C01 =__ 97.3'94.3,_  NEW :- -- ~COI = 90.6' tO00 GAL ~'- , ~'~m C02 90.8' SEPTIC '~ 92.0 TAN~ 87.8' -/ 80.3' B.O.H. M-W DRILLING, Inc. P,O. ~x 11~70 · 1~ Old 8award Highway ANCHO~E, A~S~ ~B11 S AND S ENG[NEERTNG PAGE DRILLING, LOG APR 2 2 3998 MunicCpality of Anchorage Oept. Health & Human Services Location (addreas of: Towr, ship, R~mile, Section, it known; or distance ma~ Ske el c~tng _6" ._Depth o~ Hole. ~4 8_ ..=.=, ~eet C~ to 2 6.2 5 .__~eet St~l~ wamr lev~J22 .~t, [q~, low) lind surfak. F~ish et well (~k one) o~n end ( ~oun~a~ ~.~ 6t~O~matio~ ~netrat~. size of msterlal, ~1o~ and hardne~. _ - -~,.~ ~].~. :f-* ....... -. _ x ); ft, HEALTH AUI HOR[TY APPROVALS SE~/ER & WATER MAIN EXTENSIONS SEWER & WAiER INSPECTION neee n ROBERT C, cOWAN, RE. ROBERT A. SHAFER, RE. CIVIL ENGINEERS Date: Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 9~519-6650 REFERENCE: (907) 694-P979 FAX (907) 694-1211 RECEIVED OCT 16 1997 MiJn~Cll)ality of Anchorage Dept. Health & Human Services ENGINEERING STUDIES AND REPORTS WELt INSPECTION & FLOWTEST ROAD DESIGN ' , ' ections for the referenced property were The septic ~nsp ~ .... ,~Lo /~ . Prior to submitting performed on ]0 D0 I~! .. ~na ,u~ - ,_ ' n water D~sDosal System and/~r Well Inspectlo the On-site Waste , ~ ~.~o,~3 ~J'~¢~"- to be Report we are waiting ~or un~ completed. If we may be of further service please contac% us. Sincerely~ / . Robert C. Cowan, P.E. SOILTEST PERCOLATION TEST STRUCTURAL & MECHANICAL iNSPECT~ONS ONSITE W/~TEWATER D~SPOSAL SYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP ' SUITE 204 ' EAGLE RIVER, ALASKA 99577 PAGE 1 OF 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:SW970169 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:ROGERS HELEN J OWNER ADDRESS:17901 MOUNTAINSIDE VILLAGE DRIVE ANCHORAGE, ALASKA 99516-5735 DATE ISSUED: 7/03/97 EXPIRATION DATE: 7/03/98 PARCEL ID:02017244 LEGAL DESCRIPTION: MOUNTAINSIDE VILLAGE #1 BLK 3 LT 16 LOT SIZE: 66895 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 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 AMD HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISI~_. ? - 77 ROBERT C. COWAN, RE. ROBERT A. SHAFER, RE. CIVIL ENGINEERS HEALTH AUT HORLEY APPROVALS SEWER&WATER MAIN E~TENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTESE PERCOLATION TEST STRUCTURAL & MECHANICAL. iNSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN June 26, 1997 (907) 694-2979 FAX (907) 694-1211 MUNICZPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 · ~ Block 3, Mountainside Village S/D No. 1 REFERLNCE: Lot 16, Request you issue a permit ko drill a well and install a septic system to serve the proposed three bedroom house on the referenced property. A test hole was excavated and a percolation test performed. the approximate location of the test hole is located on the attached site plan. The monitoring tube within the test hole has been checked and found to be dry. This property has enough area for a future septic upgrade which can be seen on the attached site plan. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. If you require additional information, please contact us. Sincerely, RCC/mg Enclosure P.E0 ~UN~NTA. at. SERvi ~ _ CEo o/ViSiON dUN 2 7 1997 RECEIVED 17034 NORTH EAGLE RIVER LOOP ° SUITE 204 · EAGLE RIVER, ALASKA 99577 DEF!GN SITF-PI AN - mm · -rI .--t 0 7t3 ~'m~ © C) LARGE /~MONITORING WELL f _.Redraft 7/L1/9~ FOR: Frank ]~ethara Date Sc~e-' _. Legal D?crl~tion 343g g7307 MOUNTAINSIDE 563~ Silv~rado Way, Suite H-201 DraWn by Field"Book SUBDIVISION ~chorage, ala*ka 99518 I hereby oerUfy that ~e property d~eribed h~reon has been ~u~eyed by me, or st my dir~ction, and ~a[ the ~9~ovemen~ ]ituat~d ~er~ou ~., .... ,..~ are ~thin ~e prop.rty l~e~ and do not overlap or ~ucroach on ~. property l~ng adjacent ~ereto unle~z o~e~se shown. ~at no i~prowmen~ on ~h~ property l~ug adjae~txt ~er~o ~ncroaeh on ~h~ line. or o~er eaeem.u~ ~ .aid prop.rty .xcept as ,ho~. to verify proposed build~g grad. relative ~ finish grade ~d uUII~ conn~o~on~ and to det.rmine ~e e~st.nve of aay easemsn~, eo~.aan~, '~.~'. LS-7326 or restric~on~ which do not appe~ on the ~.corded ~ubdi~sion plat. Rcproduc~on ~uy cause dl~torUon. PERFORMED FOR: LEGAL DESCRIPTION: 2 3 7 8 10 12 ]4 ~8 2O Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST ~ ~.~ ,O~RT c, COW~ /,~, ~.~..~ .,' . ," ~- ~ Township, Range, Section: WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? P E to Water Alter $~/,./~1,~,~1~ Depth MonitorinD? I~ ~"7' Date: 7 SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE TEST RUN BETWEEN ~ , '7 tmmutesimch) PERC HOLE DIAMETER -- '~'- FT AND ~ FT COMMENTS $ & S ENGINEERING ~ ~ . . ~ CERTIFY THAT THIS TEST WAS PERFORMED IN PERFORMED BY: .-1-t0~~C~ ?.~LN~041 /t~¢ (,/,/'/ ~/ ~O/ ~ 7 ACCORDANCE Wl~Lt ~E~I~7~AL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) ROBERT C. COWAN, RE. ROBERT A. SHAFER, RI--. REALTH AUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING S [UDIES AND REPORTS WELL INSPECTION & FEOWTEST SITE pLANS ROAD DESIGN SOiL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 REFERENCE: Lot 16, Block 3, Mountainside Village S/D No. 1 June 26, 1997 GENERAL: 1. The scope of this project includes the installation of a 1000 gallon septic tank and a five foot wide drainfield to serve the proposed three bedroom residence for 'the referenced property. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applJ_cable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. e Ail standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 1703,!. NORTH EAGLE RIVER LOOP ' SUITE 204 ' EAGLE RIVER, ALASKA 99577 Page Two Lot 16, Block 3, Mountainside Village S/D No. 1 June 26, 1997 Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanont, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/D~INFIELD INSTALLATION: 1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level· If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed-up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and[ the native soil backfill. Ensure the silt barrier covers 'the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench 'to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is ].ess 'than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page Three Lot 16, Block 3, Mountainside Village S/D No. 1 June 26, 1997 MINIMUM ~ATERIAL SPECIF~CATIONS: 1. 4 o Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Cast Iron ASTM D3034 (PVC) ASTM F810 (HDPE) ASTM D2662 (ABS) Perf orated Solid Yes Yes Yes Yes Yes No Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the tt200 sieve. When sand is being used as a filter material, its gradation specifications must conform to current M~O.A. or D.E.C. requirements, which ever applies° Page Four Lot 16, Block 3, Mountainside Village S/D No. 1 June 26, 1997 INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, 'the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/OWNER MUNICIPALITY OF ANCHORAGE Development Services Department 7 Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 020-172-44 Certificate of On -Site Systems Approval Expiration Date: Legal description MOUNTAINSIDE VILLAGE #1 BLK 3 LT 16 Site address 17400 MOUNT MC KINLEY DR Anchorage AK Current property owner(s) MABRY X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: M Original Certificate Date: 29 z_3 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 l�U�f UHMP A L QTY oC� • C� Q��.9 C C� ®I�I�CC�E rqll�l �� Development Services Department _ Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 020-1 Complete legal description MOUNTAINSIDE VILLAGE #1 BLOCK 3 LOT 16 Location (site address) 17400 MOUNT MCKINLEY DRIVE ANCHORAGE, AK 99516 Current property owner(s) LARA MABRY & JULIE JORDAN Day phone 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: ® Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: Z Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel Z Plastic ❑ Concrete ❑ Fiberglass Age 0 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ® Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ 9 q C6 Waiver Fee $ Date of Payment Date of Payment COSA # 0�3 c Z2 1 - 75 Waiver # COSA Application 2022.doc COSA Checklist.docx COSA Checklist Legal Description: MOUNTAINSIDE VILLAGE #1 BLOCK 3 LOT 16 Parcel ID: 020-172-44 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 7/31/1997 Total depth 240 ft Cased to 26.25 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 40 in. Date of flow test for COSA 8/8/2023 Static water level at beginning of test 10 ft. Well production at time of test 5+ gpm Water storage tank volume NA gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 2.88 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 8/8/2023 Comments B. TANK DATA Measured operating fluid level in septic tank NA Date of pumping NEW TANK Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) NEW SYSTEM ALL standpipes present per record drawing Total measured depth from grade 8.6 ft (max) Measured depth to pipe invert from grade 3.6 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes go to bottom of effective. If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date NEW SYSTEM Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) in Effective depth used in Effective depth remaining in Comments/Deficiencies: COSA Checklist.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 9/20/2023 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 or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 9/28/23 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & I--IUivtAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-.4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 02017244 HAA # ¥-1 1. GENERAL INFORMATION Complete legal description Lot 16[ Block 3; Mountainsid~ Vi. ll~g~= ~1 Location (site address or directions) Property owner Mailing address Lending agency Mailing address McKinney Drive Anchorage, AK Bethard Construction 12801Reata Aneh~r~g~ AK Day phone_345-1615 q~]~ Day phone Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. 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: Individual on-site Xxx 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/orwastewaterdisposal system is safe, functional and adequate for the number of bedrooms and type ofstructure indicated herein. I furtherverifythatbased 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. S & S ENGINEERING Name of Firm ,~,,,~A =.~,, ~; .... ~ ,,^,,, ~,,,a kJo: 704 Address Eagle River, Alaska 9957'7 Engineer's signature '~-~///-~./-~---- 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 engineers work. 72-025 (Rev. 1/91 ) Back MOA I¢21 RECEIVED Municipality of Anchorage APR 2 2 3998 DEPARTMENT OF HEALTH & HUMAN SERVICES -- . . MUNICIPALITY OF ANCHORAGE Environmental' Services L)ivtsl~vmo. E T V IVI$ION 825 L Street, Room 502, Anchorage, Alaska g9501 · Legal Description: LO T'- t k, A. WELL DATA Health Authority Approval Checklist Log present (_¢¢N) 'Total depth ,-':), k~ 0 Sanitary seal (~/N) Date completed Cased to If A, B, or C, attach ADEC letter. ADEC water system number Casing height (above ground) Wires properly protected (~/N) FROM WELL LOG AT INSPECTION Date of test Static water level Well production WATER SAMPLE g.p.m, g.p.m. 0, '7 -~ G Other bacteria O $ & $ ENGINEERING Collected by: ~er Le,:l: ~,,~:! Ne. 2-r~. -- Eagle River, Alaska 99577 Coliform ~ Nitrate Date of sample: / F B. SEPTIC/HOLDING TANK DATA Date installed /~/~o/~17 Tanksize /coo Number of Compartments_ ~Z Cleanouts ~/N). Y~J' High water alarm (Y/~ ,-, o Foundation cleanout ~N) ¥~J' Depression (YA~ /'' Date of Pumping /'//4 ~ '~¢"~ Pumper C. ABSORPTION FIELD DATA Date installed /0 /10//¢/ ? Length S' 0 Width J. ~L System type '3' ~ ~.~, Gravel thickness below pipe ,~ Total depth Monitoring Tube present ~/N). YtJ Depression over field 0 Results (Pass/Fail) For _~-- bedrooms Soil rating (g.p.d./fF or fF/bdrm) Effective absorption area ~ 3/ Fr Date of adequacy test/,//f -/,~ rb ~ Fluid depth in absorption field before test (in.); Immed~atel~L~er~ gal. water added (in.): Fluid depth. (ins) Minutes~A~lat .'er/~' Absorption rate = g.p.d. Per_o~eatrrr~ (past 12 months) (Y/N) If yes. give date 72-026 (Rev. 3/96)* LIFT STATION Date installed S~ Manhole/Access (Y/N) "P~" level at* ."Pump off" level at* High water alarm level at* .~'~'~ *Datum Cycle~ E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: ! Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line On adjacent lots On adjacent lots Public sewer manhote/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation 0% (' Property line "~ Water main/service line /o -t- Surface water/drainage SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line 3 f Building foundation 6 IOO Absorption figld Wells on adjacent lots /0 O /0 ¥ Water main/service line Surface water ) o e 4- Driveway, parking/vehicle storage area / Curtain drain ~,¢ 0 ,-,/~.. ~c/¢ o ~.u ,¢ Wells on adjacent lots ENGINEER'S CERTIFICATION I ceRify that l have determined thru field inspections and review of Municipal re~{~e a~ ~V~ms in conformance wi¢ ~0~ H~ guid~nes in effect on this date. .~"~--'-- S gnature ~~ ~ ~~- ~,~,,~ ~..,~ Engineer's Name ]c'8~, C ~ (0 ~4~ HAAFee $. ~-~0~)-0~) Date of Payment Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* I I ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: MOUNTAIN VILLAGE SUBD ADD Nol LOT 16 BLOCK 3 PLAT 83-348 SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance shoul4 any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER:— DAVE- SCALE; E-MAIL: SEPT 27, 2023 1 =50' schuller0ok.net 23-091-1 DRAWN BY, ICHECKED BY; GRID NUMBER: BOOK AC* JLS SW3439 230321 * = FND 5/8" REBAR ;Lqwq%qb%',4. SO? A'1W OF I A ily Aw I lk, AQTH -t 0 _� 0, ....... ........... .. .... 'A i I •004F ...... .. ..................... J? •,J • 0 N L. SCHULLER. LS -10408 1831 Talkeetna, Street IN T 0 --Z 7 Anchorage, Alaska 99508 0 f(907) 227-1455 office ession& '"W (907) 274-4992 fax A )'I MAE 0 b 0 I ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: MOUNTAIN VILLAGE SUBD ADD Nol LOT 16 BLOCK 3 PLAT 83-348 SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance shoul( any information on this drawing be used for construction of fences-, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any casements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK- ORDER NUMBER: DATE* SCALE: E-MAIL, AUG 19, 2023 =50' schuller0ok.net 23-091 DRAWN BY. CHECKED BY; GRID NUMBER: BOOK/PAFX JLS SW3439 230265 * = FND 5/8" REBAR SLJI?V L A �N,'o 0 C#0 A T V.191 Ou 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 fax