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Home My WebLink AboutHILLSIDE PARK PUD LT 37 1........,, ,.1 -�ws}_ Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP261091 PID Number: 015-122-57 Dwelling: X Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ■❑ Upgrade Name GREENBAUM ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 7101 CROOKED TREE DR ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 15 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft, Gravel depth beneath pipe Ft. Subdivision Block Lot HILLSIDE PARK PUD LT 37 Fill added above original grade Gravel length Township Range Section Ft. Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES Ft. Ft, To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well NA* TANK ❑i Septic ❑ S.T.E.P. ❑ Holding []Other Manufacturer GREER/ANCH TANK, DEEP BURIAL Capacity 1500 Gal. Surface Water 1100'+ Material Number of compartments Lot Line 10'+ NA PLASTIC 2 Foundation 10'+ LIFT STATION Manufacturer Capacity Remarks * COMM .WATER Gal. Alarm location Electrical installed by Installer PIPE MATERIAL House to tank 3034 drainfleld Tank to 3034 MIKE ANDERSON Drainfield C0/MT3034 Inspector MIKE ANDERSON BENCH MARK (Assumed elevation) 100 ft Inspection1s, 5-29-26 2nd Location and description 3'd 4ih TANK MH LID ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp "' E 0.. At @�'? Conditional Approval: Date •— ,. • •• r' i *: 49TH •, Septic System' `/ > V. ... • • .• • s. I. 1 1 I f e b J•;5 : MICHAEL It ANDIRSCM Y ., Approved f __l_ Date CE -9 No'fe: this approval does not include well requirements. permit io,... ncinn�o: 1........,, ,.1 -�ws}_ Permit No. OSP261092 Page 2 of 2 Municipality of Anchorage DEVELOPMENT SERVICES DEPARTMENT ON—SITE WATER AND WASTEWATER SECTION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-7904 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: HILLSIDE PARK PUD LT 37 PID No.: 015-122-57 EXISTING FIELD BENCH, TOP OF MH I I NEW PLASTIC TANK I I CO1, CO2 I TCO1 MARK A B I I TING C I B TCO1 34.9 42.9 I TCO2 39.7 46.2 CO2 42.4 48.4 I CO3 43.6 49.3 I I EYBOX AS SCALE: 1"=50' - "=50' -EXISTING EXISTING FCO TC01, BENCH TCO2 CO2 CO3 OF �/� ♦♦♦ . ice. .•• •• AW "J.�. .� . Ar '�K: i 49TH 92.5 1,500 GALLON 92.2 i .......... • • •• • •'. PLASTIC TANK MICHAEL N. ANDERSON.—Ar No. CE 9469 ' i . ♦♦ '•.• 6-7-26 �.•.. i ♦♦111/ SEPTI SECTION E; :.�� 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: OSP261091 Work Type: SepticTank Upgrade Tax Code Number: 01512257000 Site Legal Address: HILLSIDE PARK PUD LT 37 G:2539 Site Mailing Address: 7101 CROOKED TREE DR, Anchorage Owner: GREENBAUM JETHRO 50% & Design Engineer: HUBER ENTERPRISE This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: t�eparttnent 5/13/2026 5/13/2027 23681 Non -Public ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Water 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. Coodinate with On -Site staff regarding preferred method. 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 Issued To: HUBER ENTERPRISE Issued By: Curtis Townsend Date: 5/13/2026 Date: 5/13/2026 MUNICIPALITY OF ANCHORAGE I Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section ON -SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 01512257000 Property owner(s) Greenbaum Jethro & Devaris Aimee Mailing address PO Box 230383, Anchorage AK, 99523 Day phone Site address 7101 Crooked Tree Drive, Anchorage AK, 99507 Legal description Hillside Park PUD, LT37 Number of Bedrooms 5 Engineering Firm Huber Enterprise AK Building Permit Number Not Applicable 0 APPLICATION IS FOR: APPLICATION IS AN: (® all that apply) Disposal Field ❑ Initial ❑ Septic Tank 0 Upgrade E Holding Tank ❑ Renewal ❑ Privy ❑ Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: No Waivers Requested Permit/Rush Fees: 2 Z- Waiver Fees: Date of Payment: 5 % ? J "Z Date of Payment: Permit No. C L, b �� Waiver No. Distance: May 2025 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP261091, Curtis Townsend, 05/13/26 Hillside Park PUD Lot 37 SepƟc Tank Design NarraƟve Project NarraƟve/DescripƟon: Hillside Park PUD Lot 37, beƩer known as 7101 Crooked Tree Drive, is an exisƟng 5-bedroom residenƟal property. Based on available as-built informaƟon, the residence has an exisƟng sepƟc system that was installed in 1993 and consists of a single 1500-gallon sepƟc tank connected to a Deep Trench AbsorpƟon Field. The exisƟng absorpƟon field has been inspected and is in operable condiƟon, however, the tank is failing and is in need of replacement. Design CalculaƟons Flow Rate: 5 Bedroom Main Residence at 150GPD/Bedroom - Design Flow = 5 bedroom X 150 GPD/bedroom = 750 GPD SepƟc Tank Size: Minimum Tank Size shall be 1000 gallons plus 250 gallons for each bedroom over 3 per - 1000 + (250 x 2) = 1500 gallons AbsorpƟon Field: - Based on available asbuilt informaƟon, the exisƟng deep trench absorpƟon field is 54 feet long with an effecƟve depth of 7 feet. This provides 756 SF of absorpƟon area. Soil condiƟons at the Ɵme indicated an applicaƟon rate of 1.2 GPD/SF. This exceeds current standards for required absorpƟon area. I am unaware of any adverse impacts this installaƟon would have on any wells or sepƟc systems constructed in the adjacent area. Should you have any quesƟons or require any addiƟonal informaƟon, please do not hesitate to contact me. Sincerely, Logan M. Huber P.E. (772) 528-6287 Lhuber87@gmail.com Feet 0 20 40 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP261091, Curtis Townsend, 05/13/26 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: 5tJ ~$OZ-97 LEGAL DESCRIPTION Lot: Block: Township: ,.~.~=~=.S u b d ivis i o n: IRange: I Section: PID Number: Wastewater System: l~ New [] Upgrade ABSORPTION FIELD [~Deep Trench [] Shallow Trench r-I Bed r'i Mound [] Other Soil Rating: /o Z- GPD/Sq. Ft Depth lo pipe bottom from original grade: ~ Ft. Fill added above original grade: -- Pt. Total Depth from origin~a~gtrade: Gravel depth beneath pipe "~ Ft WELL: [] New J~//A [] Upgrade Gravel width: Ft. Classification (Private, A,¢~,C): / Total Depth: Cased To: Total absorption area: Driller: ~ Date Drilled: Static Water Level: Inst~ller: ~ ~ D~te installed: Yield: ~ Pump Set at: ~ Casing Heigh~ Above Ground: ~u I ~-I ~'l TANK SEPARATION DISTANCES ~ ~s~mic TO Lift Holding Manufacturer: From Field Station Tenk Sewer Lines m~4 - Well Material: Surface Water Lot Size in gallons: I Manufacturer: I Line ,; ~ I "Pump on" level al: Foundation Curtain Drain Gravel length: ~'/'~ Ft. Number of lines: I ~istancs h~.~een lines: Pipe material: ,,O~"~'f/'~ ~0~ ~- ~10 []S.T.E.P. Capacity in gallons: /, ~'OO Number of Compartments: LIFT STATION High water alarm at: Electrical Inspections performed by: BENCH MARK Location and Description: .__/,~ P ~ ~' ~--~Ot,~/~ ~ A-,'T11 0/~J Assumed Elevation: I00. Inspections performed by: //~. /--//1¢¢1/..4 Dates: Department of He.i~/~ ,___~.,/~and H~ uman...Services approval 438 ~ - E · 013 (Rev. 9191) MOA 25 Permit No.. q307..97 Page 7- Municipality of AnChorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION of P.O. Box 196650 e'Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: 37 ~/u..-S/b-c Phd'~.A4. PIDNo.: "1 5'-r.I ~7 "- 50' l- CFCOOK£D Z~£ - '- ---~IV£ 72-013 A (?Jgl) MOA 25 Perm~ No. ', ~ ~J ~ SO Z..~'~ Page ~ of ~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 e: Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: LdT" $7, /-//L.~. ~'/~)~' 'PAI'~ PID No.: 72-013 A (2/91) MOA 25 qO ~0 Rick Mystrom. Mayor Mtmicipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 November 15, 1994 Mr. John Colliander 8920 Greenbelt Drive Anchorage, AK 99502 Subject: Lt 37 Hillside Park Subdivision Permit #SW930297, Parcel LD g015-122-57 Dear Mr. Colliander: The subject permit, issued August 13, 1993 by this office for a single family well and/or on-site wastewater system, has expired as of August 13, 1994. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If the on-site wastewater system has been completed and a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. Sincerely, ames Cross, P.E. Program Manager On-Site Services JC/kb cc: Michael Anderson, P.E. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW930297 DESIGN ENGINEER:ANDERSON ENGINEERING OWNER NAME:COLLIANDER JOHN E & GWEN E OWNER ADDRESS:8920 GREENBELT DRIVE ANCHORAGE, AK 99502 DATE ISSUED: 8/13/93 EXPIRATION DATE: 8/13/94 PARCEL ID:01512257 LEGAL DESCRIPTION: HILLSIDE PARK PUD LT 37 LOT SIZE: 23681 (SQ. FT.) NUMBER OF BEDROOMS: 5 THIS PERMIT: 5 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK 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 (18AACS0). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ~. ~./~, ~'~/ / ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, ALASKA 99524 August 9, 1993 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: Lot 37, Hillside Park Subdivision Septic System Design Impacts to Adjacent Properties Dear On Site Services Engineer: The topography on the subject lot varies from a high point in the southwestern corner to gentle slopes where the proposed septic system will be located. No ponding will occur over the proposed area and natural drainage will prevent any surface water buildup on the lot. Testholes excavated on the lot revealed no ground water with soils suitable for a drainfield. We are proposing to construct a deep trench system with 7' of drainfield rock below the pipe. This type of system should provide adequate absorption of the septic effluent for the proposed five bedroom home. Testholes and percolation testing was completed in August of 1990. We verified the type of soils encountered and noted lack of water in the monitor tubes on August 7, 1993. If the system is constructed in accordance with the attached design the following statements can be made: The system, if constructed as designed, will have no adverse impact onYhe wells currently in use. The subdivision is now served by a community water system. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on reserved space, either surface or subsurface, on any lots located in the area. Sincerely, Michael E. Anderson, P.E. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. 312' Flat[op Technical Services 14530 Echo Streel: Anchoracre, Alaska 99516 Municlp~lity of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage. Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: /--.OF 3~ Hl((.,[t~:~e ('Po.r/,[" 2 Township. Range, Section: SLOPE ~',.. o o ,,,, ,, o ,, ,, ,, o o ..... .,.,. ~ o ¥ ,,THEODORe: F. MOORE ~,'.~¥'.. CE- 3589 .."_~ ':"." ,,, o^'r~: PE,~FOr~MED: O/?/?O /SITE PLAN 3 4 5 6 7 8 9 10 12 13 14 15 16 17, 18- 19 20 Po ¢ l.-.~ t-z E. Anderson 4381 - E WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT O DEPTH.;' p E Timo Time (i'..~5 Water Drop ~_.~') PERCOLATION RATE ..~ (minules/inch) PERc HOLE DIAMETER ,~ It ~~ TESTRUNI3ETWEEN ,~.~"' FTAND ~,0 FT ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIR ~ATF CERTIFY THAT THIS TEST WAS PERFORMED IN LEGAL DESCRIPTION: ~,,O'/~ 3 7 Pf Flattop Technical Services 14530 Echo Street .~nchoracm, Alaska 9951G Municil~hlily o! Anchorage DEPARTMENT OF H~ALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG '-~..~ERCOLATION TEST Coil 'tan oz¢ ~, Township, Range, Section: SLOPE __ DATE PERFOHMED: 8/'~)/~(::~ ~cec t% Tt:z/'4~ R 3% .;,/'v. ISITE PLAN 6 7 8 9 10, 11 12 13 14 15 17 18 19 20 WAS GROUND WATER ENCOUNTEREO? s L IF YES, AT WHAT O DEPTH? p E 0eplh 10 Waler AIl8r Reading DuU~ Gross I~'et O,!plh lo Net Time Time Waler Drop COMMENTS _ ~ t4. ~,~. ~, PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER __ TEST RUN ~ETWEEN FT AND FT ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: RECEIVED [vlunicipaii~Y ol Anchorage Dept. Health & Human Services MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC261182 Parcel ID 015 -122-57 Expiration Date: 5/21/2027 Legal description HILLSIDE PARK PUD LT 37 Site address 7101 CROOKED TREE DR Current property owner(s) GREENBAUM JETHRO 50% & X The On-site system(s) is/are approved for 5 bedrooms By: 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 Service Department (DSD) issues COSAs based upon representations provided by an t independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's submittal. Conditional approval for bedrooms, with the following stipulations: Comments or conditions: ATTACHMENTS: COSA Checklist Absorption Field Advisory Tank Age Advisory Other X Well Flow Advisory Nitrate Advisory Arsenic Advisory MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section t Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-122-57 Complete legal description Location (site address) HILLSIDE PARK PUD LT 37 7101 CROOKED TREE DR, Current property owner(s) GREENBAUM 2. ON-SITE SYSTEMS SIZED FOR 5 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: , Private Well serving # dwelling units ❑ Other Non-public well as regulated by MOA ❑ Water Storage ❑ Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: ❑■ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑■ Plastic ❑ Concrete ❑ Fiberglass Age NEW - See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed 0 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 $ �� C} L' Waiver Fee $ Date of Payment t %V V 0 o �O Date of Payment COSA # L� 2 Z Waiver # COSA Application_Apr2025.cloc COSA Checklist Legal Description: HILLSIDE PARK PUD LT 37 Parcel ID: 015-122-57 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 Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Static water level at beginning of test ft. Date Comments B. TANK DATA Measured operating fluid level in septic tank NEW Date of pumping NEW ❑ Required maintenance completed, if AWWTS Comments: D. DISPOSAL FIELD DATA Which system tested (date installed) 8/93 X ALL standpipes present per record drawing Total measured depth from grade 10.8 ft (max) Measured depth to pipe invert from grade 5.8 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) _ If yes, enter date Comments/Deficiencies: COSA Checklist_May2025.docx C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date 5/16/26 Results ❑✓ Pass Fluid depth prior to test 4 in Water added 750 gal New fluid depth 14 in Elapsed time 1440 min Final fluid depth 4 in Absorption rate 750+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 84 in Effective depth used 4 in Effective depth remaining 80 in E. SEPARATION DISTANCES From Well on Lot to: (Please enter distances if less than required) Septic Tank/Lift Station on Lot > 100' U Yes if No _ ft Neighboring Tank > 100' ❑ Yes if No ft Disposal Field on Lot > 100' ❑ Yes if No _ ft Neighboring Disposal Fields > 100' ❑ Yes if No _ ft Sewer Line/Main > 100' ❑ Yes if No _ ft Sewer Manhole/Cleanout > 100' ❑Yes ifNo_ft Sewer Service/Septic Line > 25'❑ Yes if No _ ft Holding Tank > 100' ❑ Yes if No _ it 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 Disposal Field(s) on Lot to: (Please enter distances if less than required) Tank to Foundation > 10' 0 Yes if No _ ft Surface Water > 100' ✓0 Yes if No _ ft Field to Foundation > 10' ❑✓ Yes if No _ ft Tank to Property Line > 5' 0 Yes if No _ ft Field to Property Line > 10' E Yes if No _ ft Water Main/Service Line > 10' ✓❑ Yes if No _ ft F. ENGINEER'S COMMENTS Wells on Adjacent Lots: Wells > 100' Community Wells > 200' ✓❑ Yes if No _ ft ✓❑ Yes if No _ It If tank or field is under driveway comment below 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 MIKE ANDERSON Engineer's Printed Name SAME COSA Checklist_May2025.docx Phone 727-8864 Date 6/13/26 L01 36 CR��, urcIVr- ANCHORAGE RECORDING DISTRICT, ALASKA AS–BUILT OF: HILLSIDE PARK P.U.D. SUBDIVISION LOT 37 PLAT 79-263 SURVEY CERTIFICATE: I, 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 shoulc 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: DATE: SCALE. E—MAIL: MAY 30, 2026 1 "=30' schullerak®gmail.com 26-055 DRAWN BY: CHECKED BY GRID NUMBER: BOOK AGE: JLS SW2539 260218 - ism .�404, - I Q F NIN,\ .......A.� 1 / .• 9TH '•'�' /....... ... .. ........... , r / r ;Orlo" A.� ....... ....... ....... :.., • .JOHN L. S CHULLER.• / LS -10408 ' elf Ar p� ..i O f e s n o� slo � 'V?z4 ' _ 5 x U\V N'0 4 L � 'P� G z� n n 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 fax Municipality of Anchorage On -Site Water and Wastewater Program = (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 015-122-57 Expiration Date: _ �oZ o '2 0 Z" 1. GENERAL INFORMATION: PUD Complete legal description HILLSIDE PARKS/D; LOT 37 Location (site address) 7101 CROOKED TREE DRIVE ANCHORAGE AK 99507 Current Property owner(s) MICHAEL ROUNDS Day phone 229-6670 Mailing address 7101 CROOKED TREE DRIVE, ANCHORAGE AK 99507 Real Estate Agent YVAN CORBIN Day phone 865-6591 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class A Well ® Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee (co V) )j- 19 >lniaiwAr goo Q Date of Payment _ I I a y 02 02 C7 Date of Payment Receipt Number O Q 5 3 j r Receipt Number. COSA # O S C a 01 ( 5 ) Waiver # %< 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below. I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineering Group Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: (I 2�� 2r, In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industreported industry practices. The results describe the condition of the systemis on the date/s of the G��••' ''•r�+ l.;• evaluation. Separation distances were measured to readily identifiable features. Hidden defects or � encroachments may exist that were not Identified during the evaluation. The operational life of all wells ") and septic systems depend upon a variety of variables, Including but not limited to, soil conditions, ' groundwater levels (that may fluctuate during the year), /� y 9 Y ) quality of construction (materials and r� / l �� % workmanship), and the water usage of the family utilizing the system /s. These conditions can vary, and ti].. are outside the control of GEG. Satisfactory test results do not uarantee future perform ��. '� !" 9 p ormance of the ;f 1 ..., . , �..; system/s; therefore, GEG makes no warranty (express or implied) regarding the future erformance of �� ? the well or septic system. GEG makes no representation whether an alternative well or septic system '11� - CF adequately In can be installed on the property in the event either of the current systems fail to perform ' the future. The content of this report is for the sale benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or ��;•� ` �• party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE r _2!� System #1 Approved for J bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the _9y OF CCssa ON-SITE 'Orn WATER AND WASTE=v"ATER z m w+r�PROVsF q� o ipulation Original Certificate Date: q ` Zy The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered In the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's wbrk. 7. ATTACHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory COSA blue sheet 10.10-12.doc Nitrate Advisory Arsenic Advisory Other See—T isior`I /A Legal Description: HILLSIDE PARK SID; LOT 37 If more than 1 septic system on lot: COSA Checklist # of ELL DATA COMMUNITY WATER SYSTEM ❑ Well to led with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for C Static wate_rlearsf at beginning of test ft. ents Parcel ID: 015-122-57 Structure served by this system Well production at time of test Water storage tank voium gallons Well disinfecte coliform test? ❑ Yes ❑ No ❑ rm bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) c ug/L ❑ Arsenic less than MRL (ND) Collected by EG, LTD. Date of Sample B. TANK DATA IFT STATION Age of tank(s) 27 years ❑ Requl aintenance completed Tank type/material STEEL Age of lift station _ ye Measured operating fluid level in septic tank 49 Lift station material ❑ Standpipes/foundation cleanout per record drawing Comment Date of pumping 11/12/20 NOTE: FOUNDATION CLEANOUT WAS FOUND UNDER SKIRTED DECK. NOT ABLE TO ACCESS TO CHECK FUNCTIONALITY. FCO APPEARED TO BE CAST IRON. D. ABSORPTION FIELD DATA DEEP TRENCH Which system tested (date installed) 8/93 Adequacy test date "'20120 ❑ ALL standpipes present per record drawing Results QPass For 5 bedrooms Total measured depth from grade 10.8 ft (max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade 5.3 ft (min) Water added -952 gal ❑ N/A — pressurized field 1225 . New depth In * ❑ Monitor tubes go to bottom of effective. If not, state '--5.0' Elapsed time 175 min depth into effective ❑ Code -required sail cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 750+d (Required if vacant for greater than 30 days prior to ND Any rejuvenation treatment (past 12 months) date of test) N/A Gallons introduced gallons If yes, enter date Comments/Deficiencies: `BASED UPON MEASUREMENT ON CLOSEST DOUBLE CLEANOUT, MT EXTENDS —5 FEET INTO EFFECTIVE. `"WATER BEGAN TO APPEAR IN MT AFTER INTRODUCTION OF FIRST 120 GALLONS OF WATER. COSA Checklist yellow sheet E. SEPARATION DISTANCES COMMUNITY WATER SYSTEM Fr*FA rivate Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift St Lot > 100' Community Sewer Manhole/ut 100' es if No ft Neighboring Tank > 100' F1 Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No^' -fit Neighboring Absorption Fiela�"r'' ❑ Yes if No ft Sewer Main > 75' ❑ Yes if No ft ❑ Yes if No ft Pau ewer/Septic Line > 25'M Yes if No ft i`iMdi Tank > 100' ❑ Yes if No ft Animal Containmen _ E01 Yes if No ft Manure/Animal Excreta Storage > 10 ❑ Yes if No``"`�..1� From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑✓ Yes if No ft Surface Water > 100' ❑✓ Yes . if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Q Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' Yes if No ft Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Q Yes if No ft If absorption field is under driveway comment below Property Line > 10' Yes if No ft Wells on Adjacent Lots; Water Main > 10' Q Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' Yes if No ft Community Wells > 200'[j✓ Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that / 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 �.. OF A �:� %�� ig IJ ff Y1A,.tiGorn ' Q �CE 7951— ' dpyo f es sio�o uaeccsaa Septic Tank Advisory Certificate of On -Site Systems Approval #OSC 201652 Subdivision: Hillside Park PUD lot 37 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 27 years old. Typical replacement costs range from $8,000 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 20 -year-old steel tank MAY look like. 3 3 � MaiUng Address P O Box 196650 *Anchorage, glaska 99519 6650 *www muni org LOT 36 LOT 15 TTE CROOKED TREE DRIV E 30 . 0 R. O . W . PAVED DRIVEWAY EDGE OF PAVEMENT N1 0 ° 1 6 ' 4 0 " E 2 0 0 . 9 4 S69 ° 0 3 ' 4 0 " E 1 5 0 . 0 0 S2 3 ° 5 0 ' 0 0 " W 1 8 0 . 4 7 L=88.75R=230.00 S87° 45' 00"E 17.20 TRACT A G E 26. 0 36 . 7 36.8 RETAIN. WALL(TYP.) STAIRS 2ND STORY DECK 32.2 24 . 3 10.0 28 . 1 31.44. 0 10.9 32 . 3 13.0 6. 0 7.0 10 . 0 Lot 37 Hillside Park P.U.D. Subdivision 23,681 Sq. Ft. +/- 7101 Crooked Tree Drive 3 Story Wood Frame House With Attached 3 Car Garage S SS S S S S S PROFESSIONAL SEAL Date:Frontier Surveys, LLC Project No: 650 W. 58th Ave. Suite E Anchorage, Alaska 99518 As-Built Survey of: www.frontiersurveys.com Frontier Surveys, LLC I, Pierre Stragier, hereby certify that this Mortgage Inspection Survey was performed by me, or under my direct supervision on Plat:Grid:Ordered By: 907.460.1686 - info@frontiersurveys.com This survey complies with the ASPLS Mortgage Location Standards. The survey represents visible improvements and conditions at the time of the survey. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may reveal. It is the responsibility of the Owner to determine the existence of any easements, covenants, or restriction which do no appear on the record plat. Under no circumstances should this document be used for construction or for establishing a boundary or fence line. October 20th, 2020. Legend: Scale 1" = 30' Gas Meter Electric Meter/Outside Power Deck Lot 37, Hillside Park P.U.D. Subdivision General Notes: 1. This document is created for the purpose of a single property transaction and is subject to Federal Copyright Laws. 2. Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey. 3. All measurements/setbacks are to the visual/apparent building footprint. 4. All dimensions to property lines are plus/minus 0.1ft. Yvan Corbin 20-552 10/23/2020 79-263 2539 E T Elec. Pedestal Tel. Pedestal ConcreteWater Valve S T A T E O F ALA S K A 49 TH ROYEVRUSDNALLANOISSEFORP DER E T S I G E R Pierre M. Stragier NO. LS-9812 10/26/2020 G E S Septic