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HomeMy WebLinkAboutMOUNTAINSIDE VILLAGE #1 BLK 4 LT 16Mountainside Village #1 Block 4 Lot 16 #020-172-59 11 b ', All -0 0 1 Municipality of Anchorage I On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT -22144°1 Permit Number: OSP2447219& PID Number: 020-172-59 Dwelling: nE Single Family (SF) n with ADU El Duplex (D) FI Two Single Family Project: n New ME Upgrade Name CHARLES & RENEE GARTLANDABSORPTION FIELD Site Address El Deep Trench 0 Wide Trench n Bed El Mound 7015 BIG MOUNTAIN DRIVIV E 'ANCHORAGE, AK El Other Phone Number of Bedrooms Soil Rating Total depth from original grade 940-613-28 - 73 4 0.8 GPD/SF1 SEE DWG. Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot SEE DWG. Ft. 0. 5 MOUNTAINSIDE VILLAGE #1; BLOCK 4, LOT 16 Ft. Fill added above original grade Gravel length Township Range Section N/A SEE DWG. Ft. 75 & 75 (150+) Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES 5 Ft. TO Ft. Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches T Lift Station From Tank Field Tank Line t2 2 750+ F 6'+ Ft. Wel 1 100'+ 100'+ 25'+ TANK N Septic El S.T.E.P. fn_1 Holding El Other Manufacturer Capacity Surface Water 100'+ 100'+ INFILTRATOR 1530 Gal, Material Number of compartments Lot Line 10'+ 10'+ NA PLASTIC 2 Foundation 10'+ 1 10'+ LIFT STATION Manufacturer Capacity Remarks PER CONTRACTOR, OLD TANK WAS HAULED OFFSITE Gal. Alarm location Electrical installed by Tank to Installer A.C.E.S. PIPE MATERIAL House to tank Tank D3034 Drainfield D3034 CO/MT D3034 Inspector GEG BENCH MARK (Assumed elevation) 97.11 ft Inspection dates: 1st 7/19/2023 2nd 7/25/23 Location and description - 3rd _7/26/23 4-7/27/23 TOP OF MANHOLE ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp OF A 1_% Conditional Approval: Date 9 H Septic Systemco E f .... 6o .. ......... P �Qp4 ess, Approved Date-Q/74t( P 0\ rofe �=7 Note: this approval es not include well permit requirements. SS',Of\ (Rev 05/02118) # CCSM -04-ZY PERMIT G&R2 n•tUMBne8& 0<P-17,1 41 q RECORD D RA W I N G cnn A B MOUNTAINSIDE VILLAGE; MH1 38.6 28.1 BLOCK 4, LOT 5 - VACANT ST1 32.3 36.6 PER MOA RECORDS DBL7 34.1 37.9 DBL2 34.7 38.2 ALTHOUGH NOT REQUIRED ON THE PERMIT, THREE FO 35.9 38.3 TEST PITS WERE EXCAVATED TO CONFIRM ADEQUATE FS 114.5 123.2 SEPARATION TO GROUNDWATER AND IMPERMEABLE C01 117.0 109.4 SOILS. - SEE PAGE 313 FOR TESTPIT INFORMATIONS. SOIL COVER OVER DRAINFIELD WAS TOPSOLED AND SEEDED WITH A TACKIFIER. MOA ONSITE DEPARTMENT MADE A SITE VISIT TO INSPECT FINAL GRADING. NOTE: PIPE LOCATIONS ARE SHOWN PER GEG SHOTS TAKEN WITH LEICA DISTO S910 LASER DISTANCE GENERAL LOCATION OF METER. SWING -TIES TO 2023 MIDDLE TEST PIT - HOUSE CORNERS WERE GENERATED IN AUTOCAD. 2023 WEST TEST PIT MSa Co H.4 /- NEW MOUNTAINSIDE VILLAGE #1; BLOCK 4, LOT 17 EXISTING Imo^'' GENERAL LOCATION OF 2023 EAST TEST PIT PARCEL ID NUMBER: 020-172-59 GENERAL LOCATION OF SEWER LINE NEW IM -1530 INFILTRATOR SEPTIC TANK (5'+ TO ALL DECK POSTS AND 104 TO FOUNDATION) DBL1 F 0 MHt / ST B / 7 EXISTING 4 / q BEDROOM HOUSE/ / it f •a DRIVEWAY "• •y r GARNE,SS ENGINEERING GROUP, Ltd - ENGINEERING - SALES'- CONSULTING 0701 E. TUDOR ROAD, SUITE 107 • ANCHORAGE, AK 99507' PHONE (907) 3373179' FAX (907) 338.3246' WEBSITE:nvw parnessen)pnn•nnp wm` PREPARED FOR: PHONE NUMBER: PAGE NUMBER: CHARLES GARTLAND 940-613-2873 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: MOUNTAINSIDE VILLAGE #1; BLOCK 4, LOT 16 D.J.G. TYPE OF WORK: DATE: \ SEPTIC TANK AND DRAINFIELD RECORD DRAWING 10111/2023 `•., ♦ %1' C # 7953 ... ,c��°mo i #AECC884 PERWT NUMBER: OSP221285• Lff -1 ORIGINAL GRADE AT HIGHEST POINT = 68.2 WEST 2023 T.H. y1"/ate TOP OF TANK AT OUTLET = 92.61 INVERT OF PIPE AT INLET = 91.99 OF MANHOLE = 97.11 PARCEL ID NUMBER: 020-172-59 FINSRbQE = 96.82-97.07,e�. {'f 'i Z (ABOUT 6" OF ESS.C.Q„VER) MH ST1 f Al S'. =7/s 7 (3 7 t+r f v 2" OF INSULATION PER THE CONTRACTOR NEW IM -1530 INFILTRATOR 2 -COMPARTMENT SEPTIC TANK 'ka fl.'.Z,1 V G" .' sj P.e . SOUTH A, L Co -1 1r 1 J �`r,d 1 41z7 14� FINAL GRADE=70,30.70.58 pr=/•'!�"1� 2" INSULATION FILTER FABRIC TOP OF SANDILOW O.G. = 66.79 AVG. TOP OF TANK AT INLET = 92.52 INVERT OF PIPE AT OUTLET = 91.61 THE CONTRACTOR DESTROYED THE INITIAL TEMPORARY BENCHMARK (NAIL IN TREE). ALL TRENCH ELEVATIONS ARE EITHER TAKEN AFTER THE INSTALLATION OR BACK -CALCULATED FROM THE INSTALLATION FIELD NOTES DOWNGRADIENT SLOPES OF MOUNDED SOIL ARE <50%. DRAINFIELD HYDROSEEDED AND SPRAYED WITH NORTH KIFIER TO PREVENT EROSION. MOUND DSCILWAS INSPECTED BY MOA AND GEG AAT i+l. ORIGINAL GRADE AT HIGHEST POINT = 65.6' MID - 2023 T.H. -INVERT OF PIPE = 67.36 AVG. ---- (LEVEL DURING CONSTRUCTION PER GEG INSPECTION) BOTTOM OF EXCAVATION = 63.79 (3'+ BELOW LOW O.G. PER FIELD NOTES) 11.5' BELOW GRADE. - T.H. DRY ON 726/2023 (EXCAVATED ON 711 912 02 3) 6+ 10' BELOW GRADE - T.H. DRY ON 712512023 (EXCAVATED ON 711 a/2023) FINAL GRADE = 66.6467.01 INSULATION -yt- FILTER FABRIC :OW O.G. = 63.82 EAST 2023 T.H. TOP OF SAND O.G, = 63.29 AVG, - INVERT OF PIPE = 63.73 AVG. (LEVEL DURING CONSTRUCTION PER GEG INSPECTION) BOTTOM OF EXCAVATION= 60.09 (3.2' BELOW TOP OF SAND PER FIELD NOTES) 1 P BELOW GRADE. - T.H. DRY ON 7/2612023 (EXCAVATED ON 7/1 W023) ENGINEERING SALES CONSULTING 3701 E. TUDOR ROAD, SUITE 101 . ANCHORAGE. AK 99507 *PHONE M7133M179 - Fax 1.1133n.37ae • wcn ..,..v, ,.,.., .......-a.._ ._- PREPARED FOR: I PHONE NUMBER: PAGE NUMBER: CHARLES AND RENEE GARTLAND 940-613-2873 3 OF 3 LEGAL DESCRIPTION: DRAWN BY: MOUNTAINSIDE VILLAGE #1; BLOCK 4, LOT 16 D.J.G. TYPE OF WORK: DATE: SEPTIC TANK AND DRAINFIELD PROFILE 9/27/2023 / 'c�•.• ,0 ................0 .. I I. rr..... :•' �')ff ey-ASa1'ness Z �r ��'•�� C -795 _xr` 2.31 NS♦FU•pii•"•SPL, *• E����1At\z�* ' cc ii / PLOT PLAN AS BUILT X SCALE 1" = 60' GRID SW 3439 Project No. 23-472/A1 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, inc. (907) 522-6476 Phone kenOlangsurvey.com ,��► `1� 1 Professional Land Surveyors jonothanOlongsurvey.com + OFAt, q yy trovisOiangsumay.com 1 hereby certify that I have surveyed the following described property: LOT 16, BLOCK 4, MOUNTAINSIDE VILLAGE SUED. — ADDN. No. 1 (PLAT No. 83-348) Anchorage Recording District, Alaska, and that the Improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on sold property except as indicated hereon. Dated this the 1 l Day of �� '= = at Anchorage, Alaska It Is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. c *:*49TH TH .ir KENNETH G. LANG •c� No. 202 OF6SDNA State of Alaska AECC963 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 hftp://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP221419 Work Type: Septic Renewal Tax Code Number: 02017259000 Site Legal Address: MOUNTAINSIDE VILLAGE #1 BLK 4 LT 16 G:3439 Site Mailing Address: 7015 BIG MOUNTAIN DR, Anchorage Owner: GARTLAND CHARLES JOSEPH & Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Effective Date: Expiration Date ent..S n r. ' � J llehartn�enr Lot Size in Sq Ft: Total Bedrooms: 11/4/2022 11/4/2023 62365 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 Special Provisions: 1. If contractor installs the new tank in the same location as the existing (or closer to the house than shown on site plan), minimum 5 ft separation to deck supports shall be confirmed. 2. A test hole is required prior to construction of the drainfields to confirm minimum separation to impermeables and seasonal high groundwater. Construction may proceed at your own risk prior to 7 -day groundwater monitoring. If results require a design change, construction shall stop pending Onsite review and approval of a change order. Please submit results with inspection report (or change order, if required). Beseived-Bqi S S� C-7 E C Date: Issued By: Date: Zo Z Z 4 MUNICIPALITYF ANCHORAGE 1, � Development Services Department `, r _ j Phone: 907-343-7904 On -Site Water & Wastewater Section - ' Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 020-172-59 Property owner(s) Charles & Renee Gartland Mailing address 7015 Big Mountain Drive *anchorage ak Site address same Day phone 940-613-2873 Legal description (Sub'd., Block & Lot) Mountain Village #1 B4 L16 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field 0 Initial ❑ Single Family (SF) ❑ (wlwo AD U) Septic Tank Q Upgrade ❑ Duplex (D) ❑ Holding Tank ❑ Renewal F Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: l i q Waiver Fees: Date of Payment: / U Z LZ' I- Date of Payment: Receipt Number://�� C� Receipt Number: Permit No. As P a/u % 1 Waiver No. GADevelopment Services\Building Safety\On Site Water and WastewaterTormsUient FormsTermit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221419, Curtis Townsend, 11104122 GARNESS ENGINEERING GROUPLtd -X-e-roCell ENGINEERING ° SALES - CONSULTING.,,..;. _ ,.g., :<,. _.. , October 5, 2022 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Re -issuance Letter for Mountainside Village #1; Block 4, Lot 16 To whom it may concern: A permit was issued for the subject property on 7/20/2021 and expired on 7/20/2022. Per the request of the homeowner, they would like to have the permit reissued. A site visit was made by GEG on 10/4/2022 with the contractor A+ Home services. During our site visit, there were no observations as to why the system could not be installed as initially designed. We are requesting the permit be re -issued "as is". We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Website: www.garnessengineering.com MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PoBox 1g00SO 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 Permit Number: OSP211285 Work Type: Septic Upgrade Effective Date Expiration Date: Tax Code Number. 0201725900 Site Legal Address: MOUNTAINSIDE VILLAGE #1BLK 4 L 16 G:3438 Site Mailing Address: 7015 BIG MOUNTAIN DR, Anchorage Owner: SARTLANDCHARLES JOSEPH & Design Engineer: GARNESSENGINEERING GROUP LTD This permit is for the construction of: 7C2O/2O21 7/28/2O22 Lot Size inSqFt: 62365 Total Bedrooms: 4 10 Disposal Field Z Septic Tank [lHolding Tank 0 Privy El Private Well MWater Storage All construction shall beinaccordance 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 (18AACOO) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Sen/ices Department per AMC 15.65. Provide notification by calling (907) 343-7984 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall beeither: a. Opened and Closed onthe same day, or b. Covered, sealed, and heated tuprevent freezing |Provisk/ns: itractor installs the new tank in the same location as the existing (or closer to the house than shown on i), minimum 5 ft separation to deck supports shall be confirmed. t hole is required prior to construction of the drainfields to confirm minimum separation to impermeables /sona(bigh groundwater. Construction may proceed at your own risk prior to7-dmygroundwater ing. If results require a design change, construction shall stop pending Onsite review and approval of a order. Please submit results with inspection report (or change order, if required). R000ivedBy:Oaba� Issued By: Date.- / :3 � 4, �u--n+': cc�A� .� .7' 6r"-'z,� ""teall `' �A 3 � n. I u 1 u--w'i a 5Y `r:..�✓ :1 r�'� �a .., � 3 '=cam F� �, 6 �'3 �i�s �a ii � 1�A � Development Services Department Phone: 907-343-7904 On -Site Water & �nlastewater Section - ax: 907-343-7997 ON-SITE SEPTICIWELL PERMIT APPLICATION Parcel I.D. 020-172-59 Property owner(s) CHARLES AND RENEE GARTLAND Day phone 940-613-2873 Mailing address 7015 BIG MOUNTAIN DRIVE *ANCHORAGE, AK Site address 7015 BIG MOUNTAIN DRIVE *ANCHORAGE, AK Legal description (Sub'd., Block & Lot) MOUNTAIN VILLAGE #1; BLOCK 4, LOT 16 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field 0 Initial ❑ Single Family (SF) ED (w/wo ADU) Septic Tank Fx_1 Upgrade 0 (D) El Holding Tank ❑ RenewalDuplex ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 5 Waiver Fees: Date of Payment: _ '7 JA ! Date of Payment: Receipt Number: 0 `� (19 Receipt Number: Permit No. 0,510-2-1 12Sq- Waiver No. GADevelopment Services\Building Safety\On Site Water and WastewaterTorms\Client FormsTermit Application.doc Municipality of Anchorage On-site Water and Wastewater oMnMMED FOR CODE COMPLIANCE U4 112t 1114=4 till Lez&lfll 1111=12K019111 W I I It July 8th, 2021 11285, Rebecca Carroll, 07/20/21 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic System Upgrade for Mountainside Village #1; Block 4, Lot 16 To whom it may concern: The existing 4 -bedroom house is served by a private well and septic system. The homeowner contacted us and requested us to prepare a design for a new tank & reserve drainfield. We are proposing to decommission the existing septic tank per UPC and install a new 1500 -gallon HDPE Greer tank (oversized) and a dual shallow trench type drainfield. Per MOA records, six (6) "testholes" were excavated on the lot and we are proposing to construct the drainfield adjacent to "teshtoles" #5 and #6. It should be noted that testholes #4, #5 and #6 appear to only be "benches" for the percolation tests. It appears the reserve site was initially approved from the data provided for Testholes #1, #2 and #3. We are proposing to do a confirmation test hole (to visually confirm soil conditions and vertical separation to bedrock & groundwater), at thelocation shown on the attached design drawing, prior to installing the new trenches. Comments regarding the design are summarized as follows: 1. SOILS: Per the soil logs in MOA records by Toben Spurkland, PE, testhole #5 and testhole #6 had percolation rates of 5 min/inch and 10 min/inch. We are proposing an application rate of 0.8 (6-15 min/inch), which is conservative. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: There are no surface water concerns. 4. TOPOGRAPHY: The drainfield is being installed on slopes that are greater than 25% but less than 45%. We are appealing to the "steep slope provision" in the onsite wastewater code which allows for a shallow trench to be installed on slopes greater than 25% but less than 45%, if sand is installed that extends 3 feet below original grade, on the downhill side of the trench. We are proposing three feet of sand to meet this provision. In short, although the trench is installed on a steeper slope (greater than 25%), it still meets MOA code requirements. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any q estions, please contact us at 337-6179. Thank you for your assistance. S cer y, Je rey aim P. E., M. S. Presid t,' 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com THE DEPICTION OF ALL STRUCTURES SHOWN ON ADJACENT PROPERTIES ARE APPROXIMATE IN REGARD TO CONFIGURATIONILOCATION AND MAY BE BASED SOLELY ON PUBLICLY AVAILABLE MOA GIS RECORDS. THE LOCATION OF ALL WELLS AND SEPTIC SYSTEMS SHOWN ARE APPROXIMATE AND MAY BE BASED SOLELY ON INFORMATION OBTAINED FROM PUBLICLY AVAILABLE MOA ONLINE RECORDS 0 MOUNTAINSIDE VILLAGE; BLOCK 4,LOT 4 MOUNTAINSIDE VILLAGE; BLOCK 4, LOT 5 -VACANT PER MOA RECORDS MOUNTAINSIDE VILLAGE #1; BLOCK 4, LOT 17 S Municipality of Anchorage On-site Water and Wastewater OST211285, Rebecca C MOUNTAINSIDE VILLAGE; BLOCK 4, LOT 6 MOUNTAINSIDE VILLAGE #1; BLOCK 4, LOT 15 MOUNTAINSIDE VILLAGE / #1; BLOCK 6, LOT 2 \ MOUNTAINSIDE VILLAGE #1; BLOCK 6, LOT 3 410 AllAW 1♦ �e ... • 4 . ......... .......... .. ........... ENGINEERING SALES CONSULTING w. -� .....Y' .. "..."... 3701 EAST TUDOR ROAD SUITE 101 'ANCHORAGE, ALASKA' PHONE (907) 337-6179' WEBSITE www.gamessengineenng.com �/ PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ♦♦ r arness .r CHARLES AND RENEE GARTLAND 940-613-2873 1 OF 2 ♦ �J, C 79 3 , °�Ar PAW PROJECT/LEGAL DESCRIPTION: DRAWN BY: ♦� �C� ' �� 4V MOUNTAINSIDE VILLAGE #1; BLOCK 4, LOT 16 D.J.G. ��j FO "�p��p(,.. '`ry'�,��p�- 4� TYPE OF WORK: DATE: LICENSE M,4AvAVpj �'• SEPTIC SYSTEM UPGRADE 6/29/2021 #AECC884 07/20121 DESIGN CRITERIA: NUMBER OF BEDROOMS: 4 GALLONS PER DAY (GPD): 600 PERCOLATION RATE/S: SEE NARRATIVE PROPOSED APPLICATION RATE: 0.8 MINIMUM DRAINFIELD SC.FT.: 750 FT, DRAINFIELD DESIGN: MINIMUM DEPTH OF EXCAVATION: 3 FEET MINIMUM ON THE DOWN GRADIENT SIDE OF EXCAVATION MAXIMUM DEPTH OF EXCAVATION: 8 FEET ON THE UPGRADIENT SIDE OF EXCAVATION OR SIX FEET FROM BEDROCK (IF ENCOUNTERED DURINGS CONFIRMATION TESTHOLE) SAND FILTER: 3 FEET LENGTH: 75 AND 75 (ISO FEET TOTAL) WIDTH: 5 FEET EFFECTIVE: 0.5 FEET ACTUAL SQ.FT.: 750 FT' 6 FEET PROPOSED DRAINFIELD GEG, Ltd. HAS AN 8 PAGE SPECIFICATION LETTER THAT PERTAINS TO THIS DESIGN. BY PROCEEDING FORWARD WITH THIS INSTALLATION, THE ENGINEER, WELL DRILLER, CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND CONDITIONS OUTLINED. \Nr APPROXIMATE LOCATION OF EXISTING DRAINFIELDS Municipality of Anchorage On-site Water and Wastewater OSP211285, RebeA I'll - IHOUSE, WELL, SEPTIC PIPES AND TESTHOLE LOCATION ARE APPROXIMATE AND TAKEN FROM MOA RECORDS CONTRACTOR TO HAVE THE APPROXIMATE TESTHOLE #5 AND #6 LOCATIONS AND WEST LOT LINE FLAGGED BY A PLS PRIOR TO CONSTRUCTION / EXCAVATE CONFIRMATION TEST HOLE TO DEPTH OF \S, 14 FEET TO CONFIRM SEPARATION TO BEDROCK T.H.#2 T.H.#1 EXISTING SEPTIC TANK TO BE DECOMMISSIONED PER UPC T.H.#4 PROPOSED 1500 GALLON (OVERSIZED) HDPE GREER; INSTALL DOUBLE CLEANOUTS BEFORE AND AFTER TANK EXISTING 4 BEDROOM HOUSE/ 01T Aw "ARNESS EN"'IN"ERING 'R U 9 t 0 `Lx %ff irld %ff 0 ENG[NEERING,,,, S%�� v Cq �n (ffl,,yLTINEq IL 3701 EAST TUDOR ROAD SUIT 101 'ANCHORAGE, ALAS - HONE( 3 6179' WE SITE: www.gamessenqlneerinq.com � fi PREPARED FOR: PHONE NUMBER: PAGE NUMBER: CHARLES & RENEE GARTLAND 940-613-2873 2 OF 2 PROJECT/LEGAL DESCRIPTION: DRAWN BY: MOUNTIANSIDE VILLAGE #1; BLOCK 4, LOT 16 D.J.G. TYPE OF WORK: DATE: SEPTIC TANK AND DRAINFIELD DESIGN 7/9/2021 ibe LICENSE #AECC884 Municipality of Anchorage Page i of -� DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 o Anchorage, Alaska 99519-6650 ® Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report 7 —6 �r Permit Number: S i, r' I crf PID Number: J 9-0 ' 17" Name: Wastewater System: ❑ New ❑ Upgrade Address: V -D _ 4/ U / `� tom- r. C't co ✓v �-(�C.,V'✓ r i U � ABSORPTION FIELD M �7 fl � V Phone: No. of Be rpoms: ❑ Deep Trench Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating Total Depth from of iginal grade t� GPD/Sq. Ft. Lot: Block. Subdivision: -4 Depth to pipe bottom from original grade. Gravel depth beneath pipe i / I 1o % r'Q I 'C' . 1--3 Ft Ft. Township. Range: Section: Fill added above original grade. Gravel length: _ — h FL Ft. WELL: New El Upgrade Gravel width: 15 Numberoflines: Distance between lines: Ft. Ft. Classification (Private, A.B,C): Total Depth: Cased To: Total absorption area: Pipe material: I 1 —rj Ft. J Ft. 75 C^' SO. Ft. Driller Dale Drilled: Static Vater Level: Installer: Date installed: Yield Pump Set at. Casing Height Above Ground: TANK h 3 GPM vo I—Icv Ft. Ft. SEPARATION DISTANCES ['.Septic 11 Holding ❑S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: A-NC4 Capacity in gallons: From Tank Field Station Tank Sewer Lines j /a- t f(.._ L) Material: //' Number of Compartments: �� Well I Lf v L� C� •� S ti—o�s— Surface Water I iFie. Home LIFT STATION Lot(� Size in gallons: Manufacturer: 1 Line `I U I 0 _ "Pump on" level at: 'Pump off' level at: High water alarm at: Foundation i y Curtain 1 Pump Make 8 Model Electrical Inspections performed by: Drain �, No ii f� BENCH MARK Remarks: Location and Description: Assumed Elevation: I (,LO Fl ENGINEER'S SEAL Inspections performed by: ,S Dates: 1st 2nd L- V -� '7 Department of Health'and Human Services app oval DateReviewed ) �tt and approved by/.-' 72-013 (Rev. 9,91) MOA 25 i AC \ 355 AD 58 BD 8 AE 75 BF 83,\5 \ AF 72 \ BF 102,5\ \ DIVERSION BOX Ar, 83 BG 108.5 \ \ E AH 94 \ \ BH \ 133,5 \ G D AJ 11010 J BJ 144,5 o \ \ H CP®c B \ \ A \ 25 0 25 .50 75 100 125 ISO SCAL C 1' = 50 FT, TOBBEN SPURKLANll P.E. pT 16, BLOCK 4 MOUNTAINSIDE VILLAGE SEPTIC SYSTEM AS BUILT 203 W 15TH. AVENUE DATE FFR.. 25, 1994 ANCH. AK. 99501 PAUL GR££N ,.,.. SEC 11 T11N R3W SHEET: V3 GRID: 3439 PSP -P — 75 -- - Monitor Clean Out - — Clean Out Standard Frenches+ 3 7 5' Wide 75' L ong P Deep 10 .5' Sewer rock 3' Cover DIVER TION BOX Monitor Clean Out / Clean Out 3 T U J14j 3 C CU NO SCALE 0 a 3 4 O Ea Q c� a Cleanou is (u 1250 gal Septic tank nitor '� 4" Top oil 3' C ver + &v _ - 92.2 81.6 Mira fi 140 721 ,5 f't of Septic Rock 77. C) 1- 1250 gal. septic tanl< 74 bedrock NO SLALE ldIU/NE TOBBEN SPURKLAND PE, LOT 16 BLOCK 4 MOUNTAINSIDE VILLAGE SEPTIC SYSTEM DESIGN 203 W 15TH, AVENUE GREEN DATE FEB. 25, 1994 ANCR AK. 99501 N07IUN 1 ?79-391f, SECTI[INPAU11 TIIN R3W SHEET, 3/3 GRID 3439 PlvY�IPPPP -�� - WE SERVE ResL!NG s®c P.O. BOX 670042 - A) ;IAK, ALASKA 99567 CHUGIAK, AK 688-3199 Paul Green OWNEROF LAND ....... .........................................-- ADDRESS.....7015 Big, r1t. _Drive Anchorage Ak......................... WELL - SITE . Blk. 4 dot 16 Mt... Side Subd. Anchorage. Ak. DATE- STARTED ..... 2..-•............................................................. DATE- ENDED......6-i7-92.................................................................... KIND OF FORMATION: FROM ...................�. FII. TO ..................2.. FT Stub. °S�'.................. FROM................ i2. FT. TO ..................4. FT. FiI1-.....................--. FROM .................. 4. FT. TO ................I I z: r Overburden......... FROM ................. FT. TO ................1 fi. FT... Sandy... Cla3!......... FROM ................. FT. TO ............... 21 FT... Brown Clad ......... FROM ................ 1. FT. TO ................22.. FT... Boulder................ FROM ................. FP. TO ............... 27.. FP...Brovn Sand.......... FROM ................ FT. TO ...... .......... 29. FT... Boulder................ FROM ................ 29. FT. TO ................ FT... Brown CIaY.......... FROM ................ 38. FT. TO ............... 43.. FT... Boulders.............. FROM .................43. FT. TO ................45.. r i ....Ssaf.► ..3�dx.vs ;a .... FROM ................ A?. FT. TO ...............4Z- FT... Bedrock................ ALL ALAbKA DEPTH OF WELL 115., f t-........, STATIC LEVEL OF WATER FT. 44 -f t ............. DRAW DOWN FT. AN .. f t ................................ WASILLA, AK 376-3199 GALS. PER HR. .1.380...QB-23...G..P.,,Ii................................................... KIND OF CASING `.e. A-5-3..A:S.T.,M.. 2�0 *All............ ...... ..................... MLSCL INFORMATION: No warranty or no warranties implied a From'64'=069 €t 3 G.P.M. from `di to 97 ft. 20 G.P.M. i tt DRILLER'S NAME 3 7 6 FROM .................47.. FT. TO ............... 2 FT Firm Bedrock FROM ................ 52.. FT. TO ............... 64 FT. Bedrock ................ FROM .................6.4.. FT. TO ...............6.9.... FT. > xctur�.d..Bos k FROM .................69.. FT. TO ................ U.... FT. Bock....................... FROM ................ 81.. FT. TO ...............97 FT, Fractured..Rock FROM ............... 97.. FT. TO ............. Al5.... FT. Bedrock................ FROM....................... FT. TO ........................ FT. FROM....................... FT. TO ........................ FT. FROM....................... FT. TO ........................ FT. FROM....................... FT - TO .......... FROM ....................... FT. TO FROM_ ..................... FT. TO Jay Williams FT. ....................... ................. 7...-,.. "rr, ami FT. ......5 ......... �o -- ti C.J �I y, PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE ��CwY1 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:SW920109 DATE ISSUED: 5/28/92 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. EXPIRATION DATE: 5/28/93 OWNER NAME:GREEN PAUL & KAREN OWNER ADDRESS:P.O. BOX 243493 ANCHORAGE, ALASKA 99524 PARCEL ID:02017259 LEGAL DESCRIPTION: MOUNTAINSIDE VILLAGE #1 BLK 4 LT 16 LOT SIZE: 62365 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ENGINEER SHALL DEEPEN TH # 5 & TH #6 TO A MINIMUM DEPTH OF EIGHT ( 8 ) FEET A�) THE TIME OF CONSTRUCTION. RECEIVED BY: DATE: L 'T~ "IB F:"" LJ F� rf-N 1"l 13 F�~ E...~ 2KJW15th.Avenue, Suite 206 ANCHORAGE, ALASKA 99501 (907) 279-3916 SEPTIC SYSTEM DESIGN L-0 T 16 13 L- 0 C K 4 14 0 U N T A IN S IDDE V I t- I -A 6 E PAUL GREEN Impervious Layer at 74:t" Bedrock Use Wide Trench Soil Ratirig. From test 11/12/91 4�13 min/in gal/min Required Area per Bedroom: 150/.8 = 187.5 sq. -Ft.. Foundation Clean Out Elevation 1476+� Ground Surface at Absorption Field 1470+� Number of Bedrooms 4 Length of Trench 187.5 x 4 / 5 = 150 l.f. SYSTEM CONVIGURATION WIDE TRENCH TOTAL LENGTH TOTAL WIDTH TOTAL DEPTH ROCK DEPTH COVER SEPTIC TANK 1250 GAL- The installation of this well and septic system will not impact adjacent lots. The well location conforms to the siting of the existing wells in the area, �And will not prevent the adjacent lot owners from developing these lots or replacing the existing septic systems. There are no developed or natural surface / suh surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. Septic System Design Lot 16 Block 4 Mouintainside Village pg.1 6 I I 5 i I B L \ I e e 16 17 \ m E \ � s e � S e r�" e 3 / 7r e / r \ BL 0 C K 6 \ e s P _�``^\` -10• :n sueec gooe a•aa eee ec cc {� 'E a9•l09G3, � \ � ��F�"ROFESSIO" fOBBEN SPURKLAND RE, �pT 16, BLOCK 4 MCIUNTAINSI�E VILLAGE SEPTIC SYSTEM DESIGN 203 W 15TH. AVENUE PAUL GREEN DATE, NOV, 14, 1991 ANCH. AK. 99501 SEC 11 T11N R3W SHEET, 1/4 GRID, 3439 rangy ala-lQlr ' s / mond r) � / - y n T4 o�e-�#4 Dlstrllyuio Box - / ,, s - N1 ocoJp' Sep tic �To nk Prmory Sys 'e - "GorT6' rd Shed T 3 k ell / 10, / i roc eeo n: .- 5 25 0 25 50 75 100 125 150 SCALE; 1' =- 50 FT, REVISED MAY 25, 1992 I UDDLIN Jr UKRLHIVIJ rX, (I LOT 16, PLUCK 4 MOUNTAINSIDE' VILLAGE' I I SEPTIC SYSTEM DESIGN 203 W 15TH. AVENUE PAUL GREEN DATE NOV 14, 1991 ANCA, AK, 99501 SEC 11 711N R3W rqn» ?79-3910. SHEET, P/¢ GRIDS 34 Mirafi 140 /'lnn nn. ii -c Distribution Box We Clean Outs 1250 gal Septic tank +f'A (Vann nij+ \ v., `v` - — I A. e 6 in of Septic Rock NO SCLAE 1250 gal, septic tank REVISED, May 25, 1992 Ground ver k TDBBEN SPURKLAND P.E,SEPTIC SYSTEM DESIGN 203 WtSth Ave LOT 16 BLOCK 4 MOUNTAINSIDE VILLAGE Anchorage A 99501 SECTION 11 T11N RAI DATE, MARCH 11, 1992 ., ., PAUL GREEN SHEET, 314 GRID, 3439 n Akin TYPICAL CR®SS SEC T10N 5' WIRE TRENCH SCALE+ 1' = 5 FT, RL 1-2 -T TOBBEN SPURKLAND P,E. SEPTIC SYSTEM DESIGN 203 W 15TH. AVENUE LOT X BLOCK 4 MOUNTAINSIDE VILLAGE ANCH, AK. 99501 SEC 11, MAI R3W ]LATE NOV, 14, 1991 __. ..,- --., I I AeIu rvrrni 11 SHEET, 314 GRID, 3439 u Municipality of Anchorage q DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG --- PERCOLATION TEST 7 PERFORMED FOR: cL-c,c�Y �i1, =-i� _ DATE PERFORMED: I I ._� Li LEGAL DESCRIPTION:yC`% ` 1 IG'� �a L"�,) / Township, Range, Section: C -W> e .j J-uJ0 2 0 Ca rte.. vL)t r vt 3 i>L:. W l Vt j"z- 5 D.�_l�lS�'- 6 7 81=��'�a 9 C. nDC 10 Gross Time Net Time WAS GROUND WATER Net Drop ENCOUNTERED? 11 IF YES, AT WHAT DEPTH? 12 13 Depth to Water After Monitoring? _`. 41516 14- 15- 16 17 18 19- 20- COMMENTS 920 COMMENTS S / L (u L E Dale: t I i zl l SITE PLAN Reading Date Gross Time Net Time Depth to Water Net Drop !Z�5' PERCOLAI ION RATE (minutesimch) PERC HOLE DIAMETERb 11 TEST RUN BETWEEN FT AND 3 —FT PERFORMED BY: ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFF 72-008 (Rev. 4785) L LGL - CERTIFY THAT THIS TEST WAS PERFORMED IN ON THIS DATE. DATE: o -,/I V 0 11.I Municipality of Anchorage u t DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG m PERCOLATION 'rEST PERFORMED FOR: "d --+t LEGAL DESCRIPTION: 00 A `i'6Wt Net Time Depth to Water Net Drop 1 i' l Sct <Ji -t3 2 � «0ww 3 _ 4 5 7 C) 6 8 9 DATE PERFORMEDW. - fi I` ski t Township, Range, Section: SLOPE 10 WAS GROUND WATER ENCOUNTERED? 11 S IF YES, AT WHAT L 0 12 DEPTH? — P E 13 Depth to Water Aller Monitoring? _ Date: 14 15 16 17 18 19 20 COMMENTS SITE PLAN Reading Date Gross Time Net Time Depth to Water Net Drop —Tr1 ai Ca e� i' l Sct iJ d iJ 7 C) PERCOLAT ION RATE 7� Immulesimch) PERC HOLE DIAMETER ,7 TEST RUN BETWEEN —�— FT AND �—? FT PERFORMED BY: ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFF 72-008 (Rev. 4185) CERTIFY THAT THIS TEST WAS PERFORMED IN l/C f ON THIS DATE. DATE: /\)e'// / ! ! Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST i (ENGINEER'S SEAL) PERFORMED FOR: C�•�-�-�� C -'Vi DATE.PERFORM.ED:_ I bj �t LEGAL DESCRIPTION:_ I j' '0� 14-ce.!94Q). cU=As- Township, Range, Section: V ���t_j SLOPE SITE PLAN 2 4 b U art"ti.ut_c Net Drop (1 JZSu- �!(�-i�Z_2 5 6 7 IUB' I 8' 9 10 11 12 W 13 14 15 16 17- 18 19- 20 COMMENTS WAS GROUND WATER ENCOUNTERED? t"Ib S _H I IF YES, AT WHAT I- O DEPTH? p E Depth to Water Aller Monitoring? Date: Reading Date Gross Time Net Time Depth to Water Net Drop (1 JZSu- �!(�-i�Z_2 � IUB' I yy zz W ,l PERCOLATION RATE 1 (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 02- FT AND - —FT a PERFORMED BY: ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN 72-008 (Rev. 4/85) Gc-V CERTIFY THAT THIS TEST WAS PERFORMED IN ON THIS DATE. DATE: —Noll Ht:q u Municipality of Anchorage a DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOC - PERCOLATION TEST PERFORMED FOR:�,[3Wl-�'� DATE PERFORMED' LEGAL DESCRIPTION: I � �,pX? �J LLa,.0 Township, Range, Section: _— SLOPE SITE PLAN T), L S F -T -I -I--" F-1 I I 1 1 2 3 V� 4 �� C � .�a� •e -e 5� 6 7 8 9 10 11 - 12 13 14 15- 16- 17 18 19 20 COMMENTS �; 4'ttd' S -e WAS GROUND WATER —�— ENCOUNTERED? S IF YES, AT WHAT /./ ? L DEPTH? �J' O P E Depth to Water Alter Monitoring? _ Date: Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE (minutesiinch) PERC HOLE DIAMETER TEST RUN B TWEEN /J FT AND FT / \t SCt 'v-ot. HeLf ( ate lJ 7` -j ) PERFORMED BY: T 1 —�r CERTIFY THAT THIS TEST WAS /PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: -/- IP ` 72-008 (Rev. 4/85) t-% u Municipality of Anchorage I r' DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L Street, Anchorage, Alaska 99502-0650 SOILS LOO — PERCOLATION TESD I PERFORMED FOR: ec,lal c [/L �/( DATE PERFORM EI7i- LEGAL DESCRIPTION: 1 944,4AaGl 'dk IL Township, Range, Section: U SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS Sa r r oly (I.L WAS GROUND WATER ENCOUNTERED? (] S IF YES, AT WHAT L O DEPTH? p E Depth to Water Aller Monitoring? Dale: Reading Date Gross Time Net Time Depth to Water Net Drop VC&C a. — g r r z. r — n s ,' 1'2 :.5 7 r d 1 L t7 � pp rl PERCOLATION RATE 5 (minutes/inch) PERC HOLE DIAMETER -f1- TEST RUN BETWEEN ':; Z FT AND t FT PERFORMED BY: p ' CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) 14,f _�Ik-'(ENINEER`S'SFAL) Net Time Depth to Water o Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 ao SO SOILS LOG a PERCOLATION TEST PERFORMED FOR:DATE PERFORMED: LEGAL DESCRIPTION: 114) 6rOCt township, Range, Section: 1-77e P� SLOPE F %l U2•G/4N)cS 2 Qe GewaLLLLe�!/ �urs� � Yay 3 4 5- 6 7 8 10 - WAS GROUND WATER ii II ENCOUNTERED? IV O 11 s IF YES, AT WHAT L 0 DEPTH? 12 P E Depth to Water Aller 13 - Moniloring? _ _ Date: 14- 15 16- 17 18 19- 20 - COMMENTS SITE PLAN Reading Date Gross Time Net Time Depth to Water Net Drop bR Z 1n•.31) T=r SO 1i 1-77e 1 C> r n 1 3 It3? 1 t' t 6 1 Its 3rL 1112- .� .5 10 110 b :D 7 10 19 2/9 n Q t) PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER v r TEST RUN BETWEEN FT AND —3 FT PERFORMED BY: r • l� I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: _ /L�!/!�a!/9 �b M2_ 72-008 (Rev. 4/85) MUNICIPALITY'Of ANCHORAG A, Development Services Department On -Site Water & Wastewater Section Certificate of On -Site Systems Approval Parcel I.D. 020-172-59 1. GENERAL INFORMATION one: 907-343-7904 Fax: 907-343-7997 Expiration Date: `1' AY - Complete Y - Complete legal description MOUNTAINSIDE VILLAGE #1 BLK 4 LT 6 Location (site address) 7015 BIG MOUNTAIN DRIVE, ANCH AK Current property owner(s) DONALD & SHELBY ISBELL ROSS Day phone Mailing address SAME 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: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER Private Well 0 Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distan Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ _ qSU Date of Payment Receipt Number ©� 5" 2 COSA# (JCC Z11()Jy Waiver Fee $ Date of Payment Receipt Number Waiver # DISPOSAL: 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify th on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this on-site water supply and/or wastewater disposal system is (are) safe, functional and ad bedrooms and type of structure indicated herein. I further verify that based on the infor Municipality of Anchorage files and from my investigation and inspection, the on-site water disposal system is (are) in compliance with all applicable Municipal and State codes, ordir effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify tt Name of Firm MIKE N ANDERSON, P.E. Address 4661 NATRONA AVE ANCH AK Engineer's Printed Name MIKE N ANDERSON, P.E. my investigation, based Plication, shows that the uate for the number of 3tion obtained from the Ipply and/or wastewater ices, and regulations in information submitted. Phone 727-8864 Date 1-14121 4 6. DSD SIGNATURE ...... r ,/ System #1 Approved for 4 bedrooms �' :: hI System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulatic kkkkk l BY Original Certificate Date: c,s ' CE - 9469 RoF JY OF I IV -SITE 1a °4,�---,-17^ "f '''ATE R -� th,AM The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Appro I (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. he 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 l oV,.(t f vy r COSA Checklist blue sheet COSA Checklist Legal Description: MOUNTAINSIDE VILLAGE #1 BLK 4 LT 16 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA X Well log is filed with Onsite (or attached) Date drilled 6117/92 Total depth 115 ft Cased to 52 ft 0 Sanitary seal is functioning correctly M Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 1/4/21 Static water level at beginning of test 85 ft. Comments B. TANK DATA Age of tank(s) 6/1992 years Tank type/material .51e-� G Measured operating fluid level in septic tank 48" 9 Standpipes/foundation gleagout per record drawing Date of pumping d" o2 D. ABSORPTION FIELD DATA Which system tested (date installed) 6/1992 Q ALL standpipes present per record drawing Total measured depth from grade 4 ft (max) Measured depth to pipe invert from grade 3.5 ft (min) ❑ N/A — pressurized field Monitor tubes go to bottom of effective_ If not, state depth into effective Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Structure served by this Parol ID: 020-172-59 Well production at time of test 6+ Water storage tank volume 0 Well disinfected for coliform t X Coliform bacteria is Negat Nitrate 5.09 mg/L ❑ Nit Arsenic ug/L *An Collected by MNA Date of Sample 1/4/2 C. LIFT STATION ❑ Required maintenance con - Age of lift station year; Lift station material Comments: Adequacy test date 1/4/21 Results ❑✓ Pass For 4 Fluid depth prior to test 1� Water added 600+ gals New depth 5 in Elapsed time 1440 min Final fluid depth 1 in Absorption rate 600+ gpd Any rejuvenation treatment (i Gallons introduced 0 gallons If yes, enter date Comments/Deficiencies: North trench absorbed entire 600 gallons, south trench surcharged. COSA Checklist yellow sheet gallons ❑ Yes No less than MRL (ND) c less than MRL (ND) bedrooms in : 12 months) 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/( ❑✓ Yes if No ft Yes Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line > 2 Absorption Field on Lot > 100' [,_J✓` Yes if No ft Holding Tank > 100' Neighboring Absorption Fields > 100' Water Main > 10' ✓[ 1 Animal Containment > 50' El Yes if No ft Water Service Line > 10' Community Sewer Main > 75' 2]Yes if No ft Manure/Animal Excreta Stora From Septic/Holding Tank on Lot to: (Please enter distances if less than required Building Foundations > 10' ❑✓ Yes if No ft Surface Water > 100' Property Line > 5'✓[ ]` Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Q Yes if No ft Private Wells > 100' Water Main > 10' ✓[ 1 Yes if No ft Community Wells > 200' Water Service Line > 10' Q Yes if No ft If septic tank is under drivel From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Rl Yes if No ft If absorption field is under c Property Line > 10' if No ft Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓Q Yes if No ft Private Wells > 100' Water Service Line > 10' Q Yes if No ft . Community Wells > 200' Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet eanout > 100' [_j✓ Yes if No ft (]Yes if No ft M Yes if No ft ❑✓ Yes if No ft > 100' ✓Q Yes if No ft EJ Yes if No ft ❑✓ Yes if No ft Yes if No ft :omment below sway comment below [D Yes if No ft ❑✓ Yes if No ft eA V. 0�� 49T f .. ... .......... +` N } : •fs 7a •'1Vftt N. AKDERSC;•J ; r` 4 Septic Tank Advisory Certificate of On -Site Systems Approval # OSC211016 Subdivision: Mountainside Village #1 Block:4, Lot: 16 The septic tank for this property is 29 years old. The average life for a steel septic tank is 20 years. Typical replacement costs range from $7,000 to $11,000. 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 30 year old steel tank MAY look like. gla � Mailing Address POBox 196650`*Anchorage, Alaska 99519 6650 *www muni or '" 'Titrate Advisory Certificate of On -Site Systems Approval # OSC 211016 Subdivision: Mountainside Village #1 B 4 lot 16 A water sample revealed a nitrate concentration of 5.09 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. lVla�ing Address P O Box 196650 *Anchorage, Alaska 99519 6650* www`mum org r • Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval Parcel I.D. 020-172-59 1. GENERAL INFORMATION Complete legal description Expiration Date: Mountainside Village #1, Block 4, Lot 16 Location (site address) 7015 Big Mountain Drive Anchorage, AK 99516 Current Property owner(s) David Hoffman Day phone Mailing address Real Estate Agent P.O. Box 111829 Anchorage, AK 99511 Chris Swires 2. TYPE OF DWELLING: E] Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Four Day phone 338-8292 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Fx I Individual El Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request Received by: l%� Date: - —� COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ o { Waiver Fee $ Date of Payment ar�� �J [ i a i Date of Payment Receipt Number ®1� �J J� Receipt Number COSA 4 ®5c 1 a 15j� Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below. I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, -- -ordinances, and -regulations in effect at the time of installation. - Name of Firm Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Phone 522-7773 Date 12/13/2012 49th MICHAEL E. ANDERSON Conditional approval for bedrooms, with the following stipulations: By: GLS Original Certificate Date: 1 ' %-2- The icipaAnchorage 5 loe pment 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 - . , If more than 1 septic system is on the lot: COSA Checklist # _of _ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Mountainside Village #1, Block 4, Lot 16 Parcel ID: 020-172-59 A. WELL DATA Well type Private If A. B, or C provide PWSID # Well Log (Y/N) Y Date completed 6/17/92 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 115 ft. Cased to 52 ft. Casing height (above ground) >18 in. FROM WELL LOG AT INSPECTION Date of test 6/17/92 12/10/12 Static water level 44 ft. 72 ft. Well production 20 g.p.m. 6.25 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate 6.52 mg/L Arsenic N/D ug/L Date of sample: 121/3/12 Collected by: B. Schiller B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 6/92 Tank size 1,250 gal. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) Date of pumping 6/11/12 Pumper A Plus Home Services C. ABSORPTION FIELD DATA N Date installed 6192 Soil ratingz z .8 GPD 5' Wide Trench (g.p.d./ft or ft /bdrm) System type Length 75 ft. Width 5 ft. Gravel below pipe .5 ft. Total depth 4 ft. Eff. absorption area 750 ft2 Monitoring tube Y Depression over field N Date of adequacy test 12/7/12 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 0** in. Water added 600 gal. New depth 3 in. Elapsed Time: 1,440 min. Final fluid depth 0 in. Absorption rate >= 600 g P d Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons in. "Pump oft' level at Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: >I r)r%. Manhole/Access (YIN) in. High water alarm level at Meets alarm & circuit requirements? Septic tank/lift station on lot On adjacent lots Absorption field on lot >100' On adjacent lots > 100' Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line >25' Holding tank N/A Animal containment areas >50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation >51 Property line >5r Water main >10' Water service line >10' Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line >10, Building foundation >10' Water Service line >10' Surfacewater >100' Curtain drain None Noted Wells on adjacent lots >100' Absorption field >5r Surface water >100' Water main >10' Driveway, parking/vehiclestorage >10' F. COMMENTS Absorption Trench to the South is Surcharged. Trench to the North Absorbed Entire 600 Gallons. G. ENGINEER'S CERTIFICATION l certify that t 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. Engineer's Printed Name Michael E. Anderson, P.E. Date 10/29/2012 COSA brown sheet 10-10-12.doc 49th _•�: E. ANDERSON Municipality of Anchorage � aG Community Development Department Development Services Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AIC 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 121566 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 4, Lot 16 of Mountainside Village #1 subdivision. This inspection revealed a nitrate concentration of 6.52 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. a �r.un :Twp ZeLp Op � w�alw IVNva ST2� UNDER NO ORCUMSTANCES SHOULD AN AS-BULT BE USED FOR CONSTRUCTION OR FOR ESTABL15HINO BOUNDARY OR FENCE LINES. THE SURVEYOR TAKES RESPONSIBIUTY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL LIABILITY ONLY FOR THE COST OF THE SURVEY, US= DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCALE. LOT �+W" SURVELTWETOPOGRAP�YT FOMOAIOR AS -"l SYMBO❑ rmW S1eLwKunE AS-BMLTSET REBAREl DRNNACE I ASPHALT O FWND REBAR PIAt PLµ ... AS-BULT .. LOi 9S—�9 WOW FENCE® ASSUMED ELEV, n—O—. METAL FENCE�.... WnrYl lu-ryr IT 15 THE RESPONSIBILITY OF THE CONSTRUCTION, TO VERIFY PROP( TO FINISHED GRADE AND UTILITY THE EXISTENCE OF ANY EASEMENT WHICH DO NOT APPEAR ON THE SURVEY CERTIFICATION PLOT " r Ill�lrr II I[ Yr M Mwt � , .MM MNMWYny / 1 M rM �1w1� M YM / x r T ATIOK AS -BUILT iYl M NIN N�i Y� •. N YN IIMXIIYN Y /M. Il�rp 1 STRUCTURE AS-BIALT �A c rrul r. nr.y �N'r WN i �a DER OR OWNER, PRIOR TO I ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE BUILDING GRADE RELATIVE SHOWN. FENCES, WELLS, SEPTIC CLEANOUTS, SIDEWALKS, DRIVEWAYS, CTIONS AND TO DETERMINE ETC., ARE SHOWN IN THEIR APPROXIMATE LOCATION, ONLY, SNOW VENANTS OR RESTRICTIONS MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED. DROED SUBDIVISION PLAT. ALL nmTaun<c .ems e.-...... _ gammIiIIIIIrreparea oy OF. '�+� Robert E. Johns, Jr. & Assoc. Professional Land Surveyors %•� ANCHORAGE00 �ALASKA 99904 h % Scala 111 _ 60 1 Rea Let S.F. Rec. Pfut Re No. . ...10 Dat. SVn.yed: 12/17/12 Or*- by' REJ Cneclyd e.�MK JOHNS. ' / J .o = Date Drdw: Grid: yr,C 12/18/12 121- /' 3439 12-556 PrLot 16 BLOCK 4 MOUNTAINSIDE VILLAGE #1 Parcel I.D. # MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 020-17259 J� in HAA # _ 1. GENERAL INFORMATION Complete legal description Lot 16; Block 4; Mountainside Village #1 Location (site address or directions) 7015 Big Mountain Drive Anchorage, AK Property owner Karen Green Day phone 345-7935 Mailing address _ 7015 Big Mtn. Drive Anchorage, AK 99516 Lending agency Day phone _ Mailing address— _ Agent Ron Denney/Fortune Properties Day phone_ 345-7935 Address e Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well XX 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 XX Holding tank Community on-site Public sewer NOTE: 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 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 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect ,#4VAj*" inspection. Name of Firm Address Engineer's signature Alaska Water & Wastewater Consultants, Inc. Shall be PAID $ 1006. ez) 4 Or prior to, closing for the Engineering Services Provided, 6. DHHS SIGNATURE Approved for Disapproved. FOU / bedrooms. Conditional approval for Additional Comments std 2B Phone ?37— 61_7J Date 5-12 Ori bedrooms, with the following stipulations: Date CP " / - 91 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 orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-M(Rm.1/91) Back MOAM21 KtLtivtu • Municipality of Anchorage MAY 26 199 I 1 DEPARTMENT OF HEALTH & HUMAN SERVICESMUNiCIPALtry of ANC Environmental Services Division ENVIRONMENTAL SERVIC 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist Legal Description: V llgKPa cel LD.:_ �c�a S G� A. WELL DATA Well type Qrl v , If A, B, or C, attach ADEC letter. ADEC water system number Log present (9�) `� Date completed Total depth / 1 6 Cased to _ 6'z Casing height (above ground) a "y Sanitary seal (Y/N) Date of test Static water level FROM WELL LOG Wires properly protected ON) y— AT INSPECTION /910117 a9' Well production 9.p -m. %i J 9 -10 -m - WATER SAMPLE RESULTS: Coliform Nitrate I + '� L Other bacteria_ Date of sample:a ��� % _ Collected by: Awwe,_ zo e= - 13. SEPTIC/HOLDING TANK DATA Date installed & _ Tank size ld,56 Number of /Compartments � Cleanouts `fi'N)—y Foundation cleanout ON) _ 1� Depression (Y/t9 /ll High water alarm (Y16—da- -1 Y/6 � /a _ Date of Pumping l %CJ _ Pumper /� f Hk fie) -u' �1 C. A13SORPTION FIELD DATA Date installed C/ Soil ratin (g.p�d./ft or ft2/bdrm) _ System type Length 75 —_Width _ _ Gravel thickness below pipe �j_ Total depth G� beloly c) r61 d9. Effective absorption area—'756 Monitoring Tube present/N)4 Depression over field (ye—do Date of adequacy test 3-122!Z y I Results<(Pas Fail) a S For bedrooms Fluid depth in absorption field before test (in.); Immediately after 000 gal. water added (in.): Fluid depth (ins) Minutes later: Absorption rate = ("OC�t� #- g.p.d, Peroxide treatmentast 12 months Y/N woa� mow (p ) ( ) — If yes, give date _— 72.-026 (Rev. 3/96)* �����Gl �cl��r�4rer,e% 6e,i1-clime/ •�r�nc�, scer��har�cl/�e�i/�ci D. LIFT STATION Date installed Manhole/Access (Y/N) High water alar el at* Cyc ested E. SEPARATION DISTANCES Size in gallons "Pump on" level at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO "Pump off" level at* r � Septic/holding tank on lot On adjacent lots ��G7 r � Absorption field on lot 4__ On adjacent lots CDU Public sewer main N114 Public sewer manhole/cleanout ( r Sewer /septic service line .t— Lift station %114 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: r � r Foundation 5 Property line %60 •- Absorption field Water main/service line %d Surface water/drainage _ Me') 4- Wells on adjacent lots 166 ' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line + r Building foundation Water main/service line ` t Surface water %00 /--Driveway, parking/vehicle storage area 'fo r i Curtain drain %%�%�1 � ��aoojpl Wells on adjacent lots 1 0U '7` F. ENGINEER'S CERTIFICATION l certify that I in conforman inspections and review of Municipal ,s in effect on this date. Signature I /� Engineer's Name Date 5/Z6/5 q HAA Fee $ 5-J-1' , �Z Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number of AL t o s are oY A �+�1 55( SNA ae M�•'v .. — I—.. iivwir � I � �1I r Ii n� Vu I UawI ME Environmanlal Services Inc. CM Ref,# 992295001 Client Name AK Water 8c WaSTEWaler COnSUItWS ?uc Prqject Name/# Mountainside Village L 16 34 Client Sample LV Mountainside Village 1, 16 34 .Matrix Dnnking Water Ordered By MID 000000 !-cII r.u4lua r-sua Client YO# Printed I1ptalTitne 05127/9914:15, Collet:ted a4telTime 03/24/99 15:30 .Received Date/Time 05/25/99 16:00 Technical Director: Stephen C. Ede Released By ALlowdbte PrCP Analysis Paramaeer__ _ ___ ResultsPO..,,L.�.,-._. UnitsMESaOd Limits..... haze nate-T lnit Total Coliform 0 col/100(,11. 54118 9222a 05/25/99 KAP Mitr&to-11 3.10 0.500 mg/E EPA 300.0 10 Max 05/26/59 05/25/99 SCI.