HomeMy WebLinkAboutMOUNTAINSIDE VILLAGE #1 BLK 3 LT 11
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 4
ON-SITE WASTEWATER INSPECTION REPORT
OS P211183 v 112-
Permit Number: PID Number: 020-$�52
Dwelling: ❑® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade
Name
STEVE RHODES ABSORPTION FIELD
Site Address
17500 MOUNTAINSIDE VILLAGE DRIVE *ANCHORAGE, AK El Deep Trench EJ Wide Trench El Bed ®❑ Mound
❑ Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
907-441-1247 4 *3.0 GPD/SF SEE DWG Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot SEE DWG. Ft. 0.52
MOUNTAINSIDE VILLAGE #1; BLOCK 3, LOT 11 Ft.
Fill added above original grade Gravel length
Township Range Section SEE DWG. Ft. 25
Ft.
Gravel width Beds: Number of Lines Distance between lines
SEPARATION DISTANCES 10 Ft. 2 5 Ft..
To Septic Absorption Lift Station Tank Field Holding Sewer Total absorption area Number of trenches Dist. between trenches
From Tank Line250 Ftz - Ft.
Well *50'+ *50r+ *50'+25'+ TANK ElSeptic ElS.T.E.P. ElHolding 9 Other
Manufacturer Capacity
Surface Water *50'+ *50r+ *50r+ ANCHORAGE TANK 1500 Gal.
fvlaterial C c _tNumber of compartments
Lot Line5'+ *51+ 51+ NA F -;-B I GLA�v'��— '2
Foundation 10'T 1 �'_} ' LIFT STATION
1 Manufacturer Capacity
Remarks *AWWTS ANCHORAGE TANK 500
Gal.
Alarm location Electrical installed by
L z REMOTE MONITORING RISING SON
Tank
Installer ; PIPE MATERIAL House to tank D3034 dra nfield D3034
A+ HOME SERVICES ! Drainfield D3034 CC/MT D3034
Inspector GEG AND MOA BENCH MARK (Assumed elevation) 100.00 ft
Inspection 15, 8/3/2021 2nd 8/3/2021 Location and description
dates:
3'd Bi4i202d 4118/4/202-6" TOP OF MH
ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp
oo6�O �
conditional Approval: dwy Date
Uon �Aan, rna t,�h d S; !o �o rwT �P/X d 1 p��* 49 I' O�0D
i
Septic System,
Approved / Date
v i L
Noteis approval does not include well permit requireV
(Rev 05/02/18)
#AECC884
PERMIT
OSP211183 RECORD DRAWING
OSP211183
SWING TIES DERIVED FROM
AS -BUILT SURVEY
MOUNTAINSIDE VILLAGE #1;
BLOCK 3, LOT 10
VACANT PER
ANCHORAGE LIVE
NEW DRAINFIELD
—NEW 4 BEDROOM
ADVANTEX "FAP" UNIT.
O�
EXISTING 4
BEDROOM HOUSE
t; DRIVEWAY
.. x
DESS E II EE u rg Lt
ENGINEERING SALES CONSULTING
3701 Ei TUDOR ROAD, SUITE 101 • ANCHORAGE. AK 99507 • PHONE (907) 337-6179 -FAX (9D7)335-3246 • WEBSITE-www.gamerseng. nnp.<om
PREPARED FOR: PHONE NUMBER: PAGE NUMBER
STEVEN RHODES 907-441-1247 2 OF 4
LEGAL DESCRIPTION: DRAWN BY:
MOUNTAINSIDE VILLAGE #1; BLOCK 3, LOT 11 D.J.G.
TYPE OF WORK: DATE:
ASEPTIC SYSTEM RECORD DRAWINGS 10/22/2021
PARCEL ID NUMBER:
020-172-52
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PERMIT NUMBER: PARCEL ID NUMBER:
OSP211183 RECORD DRAWING 020-172-52
TOP OF AX POD = 99.97
2" OUTLET
OUTLET BUNG ELEVATION = 97.1
NO GROUNDWATER ENCOUNTERED
DURING EXCAVATION OF TANK HOLE
PER CONTRACTOR
0
SIDE VIEW
TOP OF OF MH = 100.00
FINAL GRADE: 99.56
. 4" INLET
INLET BUNG ELEVATION = 96.13
TOP OF AX POD = 99.96
FINAL GRADE: 99.56
n I — THE TANK INSULATION IS NOT SHOWN FOR
CLARITY; DUE TO THE INSULATION, TOP OF TANK
FRONT VIEW ELEVATION CANNOT BE TAKEN. ELEVATION
SHOTS ON THE AX POD WERE TAKEN TO
DETERMINE THE LEVELNESS OF THE TANK.
.NES .�"�R�� BJP, t
ENGINEERING SALES CONSULTING
3701 E TUDOR ROAD, SUITE 101 'ANCHORAGE. AK 99507'PHONE (907)337-6179 - FAX (907) 33&3246' VVEBSITE: w garnessengi n.ng.mm
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
STEVEN RHODES 907-441-1247 3 OF 4
LEGAL DESCRIPTION: DRAWN BY:
MOUNTAINSIDE VILLATE #1; BLOCK 3, LOT 11 D.J.G.
TYPE OF WORK: DATE:
� SEPTIC TANK PROFILE 10/22/2021
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LICENSE®1®�e®SS\Clo ®®
#AECC884 /
PERMIT NUMBER: PARCEL ID NUMBER:
OSP211183 RECORD DRAWING 020-172-52
FINAL GRADE = 98.68-99.11
2" INSULATION PER CONTRACTOR
F FILTER FABRIC
co MT
WIDE
OTTP
'ARNESS EN(_'v'lNEERlNo"__l GNR u Ltd
ENGINEERING~ SALES,, CONSULTING
3701 E. TUDOR ROAD, SUITE 101 'ANCHORAGE. AK 99507 -PHONE (907) 337-6179 -FAX (907)33&3246'WEBSITE w .gam ,,4medngw.
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
STEVEN RHODES 907-441-1247 40F4
LEGAL DESCRIPTION: DRAWN BY:
MOUNTAINSIDE VILLATE #1; BLOCK 3, LOT 11 D.J.G.
TYPE OF WORK: DATE:
I%,_ DRAINFIELD PROFILE 10/1412021
TOP OF SAND/EXISTING FILL
GRADE AT HIGHEST POINT= 95.39
INVERT OF DISTRIBUTION
LINE = 95,91
M OF EXCAVATION
= 89.98-91.1
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Municipality of Anchorage
On -Site Water and Wastewater Program
P.O. Box 196550 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
httl2://www.muni.org/onsite
Review Comments
Engineer: GARNESS ENGINEERING GROUP LTD
Legal Description: MOUNTAINSIDE VILLAGE #1 BLK 3 LT 11
Parcel ID: 02017252000
Permit: OSP211183 Septic
Report Type: As Built Review
t.
1)ei���rtn�ent
12/10/2021
Completed By: R.Carroll
The application has been reviewed and the following comments have been generated. These are to be satisfactorily
addressed prior to MOA approval:
_<Please check lift station to foundation separation noted on inspection report.
The new AdvanTex FAP units area composite plastic, not fiberglass. Please correct on inspection report.
('i'Flease confirm mound side slopes do not exceed 3:1
David Garness
From: David Garness
Sent: Tuesday, January 4, 2022 3:02 PM
To: 'Carroll, Rebecca M.'
Cc: Jeff Garness
Subject: RE: Mountainside Village #1; Block 3, Lot 11
Becca,
We can shoot the slopes in next spring and confirm the 3:1. It will have to be on "hold" until the snow melts.
From: Carroll, Rebecca M. <rebecca.carroll@anchorageak.gov>
Sent: Tuesday, January 4, 2022 2:34 PM
To: David Garness <David@garnessengineering.com>
Cc: Jeff Garness <Jeff@garnessengineering.com>
Subject: RE: Mountainside Village #1; Block 3, Lot 11
David,
AMC 15.65.210E.9 states that the side slope of any backfill mounded above grade level shall not be steeper than 33%,
unless the engineer provides documentation that mitigation was taken to ensure slope stability and protection from
future erosion. This section is not specific to mounded systems.
Becca Carroll
Onsite Water and Wastewater
Municipality of Anchorage
343-7908
From: David Garness <David@garnessengineering.com>
Sent: Tuesday, January 4, 2022 9:43 AM
To: Carroll, Rebecca M. <rebecca.carroll@anchorageak.gov>
Cc: Jeff Garness <Jeff@garnessenginee ring. com>
Subject: RE: Mountainside Village #1; Block 3, Lot 11
[EXTERNAL EMAIL]
Becca,
I believe the slopes are not greater than 3:1, however, it has been some time since I was onsite. We can confirm if
needed, however, I do not believe soil cover over "non -mounds" must be 3:1. It is my understanding that the 3:1 slope
requirement is to prevent daylighting. If that requirement applied to non -mounds, any system that is less than 3 feet
below original grade (unless insulated) would have to have confirmation that the cover does not exceed 3:1 slope.
From: Carroll, Rebecca M. <rebecca.carroll(@anchorageak.gov>
Sent: Tuesday, December 14, 20219:16 AM
To: David Garness <David@garnessengineering.com>
Subject: RE: Mountainside Village #1; Block 3, Lot 11
1
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP211183
Work Type: Septic Upgrade
Effective Date:
Expiration Date:
Tax Code Number: 02017252000
Site Legal Address: MOUNTAINSIDE VILLAGE #1 BLK 3 LT 11 G:3439
Site Mailing Address: 17500 MOUNTAINSIDE VILLAGE DR, Anchorage
Owner: RHODES STEVEN D & AMY A
Design Engineer: GARNESS ENGINEERING GROUP LTD
This permit is for the construction of:
6/4/2021
6/4/2022
Lot Size in Sq Ft: 65438
Total Bedrooms: 4
Cf✓ Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Received By:
Issued By:
Date: Co (- Z
Date: 2—
P.O. Box 196650 ® 4700 Elmore Road
Anchorage, Alaska 99519-6650 m (907) 343-7904 ® Fax (907) 343-7997
http:/http://www.muni.orq/Onsite/Onsite
Development Services Division Services Division
On -Site Water and Wastewater Program
�Krnt S
1)r.parrment
* * * * VARIANCE/WAIVER REVIEW * * * *
Waiver#: OSV211032 COSA#: Permit#:OSP211183
PID#: 020-172-52
Legal Description: Mountainside Village #1 Blk 3 Lt 11
Engineer: GarnessGarness Engineering
Your request for a waiver of the required 6 feet horizontal separation from the absorption field to
the absorption field has been approved. The approved separation distance is 0.0 feet.
This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-
site wastewater disposal system will require all separation distances be met or another approval
from this department.
............................................... ■ ................ t .. t \ ..... t .. ■
Waiver is Granted: X Waiver is not Granted:
Date: Z 1 Approved by:
Name of Rey' er
........................ M t t ............ t. t ......... 0.■. . 0 Z x M M x ............. 1
**** VARIAN C E/WAIVER REVIEW ****
MUNICIPALITY OF ANCHORAGE
pDepartment Phone: 907-343-7904
Develo ment Services
On -Site Water e Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 020-172-52
Property owner(s) STEVEN RHODES Day phone 907-345-5172
Mailing address 17500 Mountainside Village Drive *Anchorage, AK
Site address
Legal description (Sub'd., Block & Lot) Mountainside Village #1; Block 3, Lot 11
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 El Initial ❑
Single Family (SF)
Septic Tank 0 Upgrade Q
(w/wo ADU)
Holding Tank El Renewal❑
(D) F-1Renewal
Multiple Dwellings ❑
Privy ❑
(SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
N/A
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: S S Waiver Fees: -* 22 j
Date of Payment:2_ �d020 2 1 Date of Payment:
Receipt Number: G6 5 b J (27 Receipt Number: �6R�s yG
Permit No. 1115 1 18_'�) Waiver No. Of-IV21103Z
G:\Development ServicesTuilding Safety\On Site Water and Wastewater\FormsUient Forms\Permit Application.doc
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP211183, Deb Wockenfuss, 06/04/21
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP211183, Deb Wockenfuss, 06/04/21
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP211183, Deb Wockenfuss, 06/04/21
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OWNER:
By: (signature) Date:
(print name)
STATE OF ALASKA )
SS.
THIRD JUDICIAL DISTRICT
The foregoing instrument was acknowledged before
NOTARY PUBLIC FOR ALASKA
My Commission expires: �, 2
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(signature)
(print name)
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Title:
(rev. 05/18/2013) Page 3 of 3
Municipality of Anchorage Page --I offS?
DFPARTMENT 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
~¢~ ~ ~ ~ ~. ~~.Wastewater System: ~New
Upgrade,
~dd,~s: ~ ABSORPTION FIELD
Phone: No of Bedrooms: ~ Deep Trench ~ Shallow Trench ~ Bed ound ~ Other
~ Total Depth from original grade: ,
Block: Subdivision: Deplh to pipe botlom from original grade:
--Township: R;nge: Section: :ill added above original grade:~, q I Ft Gravel__length:_ ~ / Fl.
~ Gravel width: Numb~ines: Distance between lines:
WELL: ~New [~ Upgrade [~1 Ft- Y _ ~.~ Ft,
-- ,~C,C): Total Depth: Cased To: Tolal absorption area: .. Pipe mat~rial:~ I O
C~sification (Private, A ~ .~ I ~ ~
Data rillod: Static Water Leve[: I~s~E~MO -~'%¢ ~~&O~stalled:
~ield: ~ rPump Set at: Casing Heighl Above Ground: TANK
SEPARATION
From 'lank Field Station Tans S ...... L, .... ~~~ '~ ~
Well ~ J~ ~ --~ ¢ ~ ~¢ Material:~¢~/ ..... Number of Comp~,'tments:
Surface ~O~t~- fO~ ~ ~ LIF'f S'rATION
Water
~ Size in gallons: Manufacturer:
Line
~ ~ ~ "Pump on' 18v~~~) ofl" 18vd at: High water 818rm at:
Foundation
BENCH ~ARK
' Localion and Description:
Assumed
Elevation:
~NGI~L
Department of Health ~dguman S~s approval ~, v~, ~..
72 013 (Rev 9191) MOA25
Permit No. ~ ¢'l'~::::r~ Page~ '~.----- _of ~
Municipality of Anchorage
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
Legal Description: ~ .1~ ~--------~tA~T"~. PID No.:_ (~ ~ I'~_~'~
72-013 A (Rev. 9191) MOA 25
by
DOC Co.
SULLIVAN WATER WELLS
P.O. BOX 670272, CHUGIAK, ALASKA 99567 * TELEPHONE 668.2759
ADDRESS l~e~7~l~'F~O~~.-~. ~3_.U."~ ,RjD~- ~ ~?~/~STATICLEVELOFWATERF'F.
LEGAL DESCRI~I~ II ~4M~ ~ad~T~l~ ~I~E DRAW DOWN FT.
DATE- Sta,ed ~/~ Ended GALS. PER HR ~ ] D, ,
PEI~IT NUMBER
KIND OF C^S~NG 6'°,g'O'~ -
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MUNICIPALITY OF ANCHORAGE -~
ENV~")~ONMEN'i'AL SERVICEs DIVISION
Ft
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: MISCL. INFORMATION:
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DR1LLER'S NAME
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW920053
DESIGN ENGINEER:DUMMY COMPANY
OWNER NAME:RHODES STEVEN D & AMY A
OWNER ADDRESS:2801 W. INTERNATIONAL #A302DR
ANCHORAGE, ALASKA 99502
DATE ISSUED: 4/13/92
EXPIRATION DATE: 4/13/93
PARCEL ID:02017252
LEGAL DESCRIPTION: MOUNTAINSIDE VILLAGE #1 BLK
3 LT 11
LOT SIZE: 65438 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD / WELL SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
THE ATTACHED APPROVED DESIGN.
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).
THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
THIS IS AN ~,:~D,~j'PERMIT WITH CONDITIONS:
1. INSTALL NO~'~-~MEABLE BARRIER ON DOWNSLOPE SIDE OF BED
TO ENSURE DOWNWARD MOVEMENT OF EFFLUENT.
2. ENGINEER MUST RE-CERTIFY SOILS DURING CONSTRUCTI~/OF
BED.
RECEIVED BY: ~/~ ~<z~,
ISSUED BY: /~~ ~]z~_~-~
DATE:
DATE:
RECEIVED
AU6 6 199~
~.4unicipalily of Anchora§e
L;.~pt, Health & Human Services
July 28, 1922
ROBERTSHAFER. P E
ROGER SHAFER. P.E
CIVIL ENGINEERS
(9071694-2979
FAX 694 !2~1
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SITE PLANS
SOIL TEST
PERCOLATION
TEST
STRUCTURAL
MECHANICAL
INSPECTIONS
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN
Ms. Su~an 0swa~
Municipa~ty of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
REFERENCE:
seo~n~e$ ueu~nH '~ q~'leeH '~deo
e'Be.~ot~ou¥ Jo
Lot II; Block 3; Mou~ide V~age Sub,vision ¢I
Pe~it ~SW 920053
This letter is to address the. Special Provisions of the referenced
permit.
Prior to construction of the septic system,-a test hole was dug near
the proposed bed. On June 12, 1992 we inspected the. test hole to
verify soil type and water monitoring. The soils were, generally as
depicted on the original log. (Actually, we visually estimated the
previously classified SP soil lay~ as an SW/GW with light si~t,
however, we Suspect the percolation rate to be close to 13 minutes per
inch.)
'~-The~g~ba~dw~t~ t~vel Was 0Und -
~_~?~;,~.,~ : ......... : .... f to be at 4 feet b~10'~ the gr~a~d
On July 21, ~992 we performed an inspection of the excavated bed with
Dan Roth of your office. The soils within the. bottom of the bed were
consistent (est 13 min/in) and the groundwater leveZ was still at
approximately 4 feet.
Due to the lot slope, the proposed bed needed to be approximately 4
feet deep on the uphill side to be beneath the organics on the downhill
side and level. At this time we propose, the installation of a 2 foot
thick sandy gravel layeA on top of which a 2 foot sand filt~ layer
wdll be installed. The material is to be instaZled with a front end
loader. Movement of the loader during the installation of the new
material should provide sufficient compaction to allow in-situ
conditions of the effluent filtering material. The 15 foot by 80 foot
proposed bed d~ension remains unchanged.
If you have any questions or comments, please contact us.
~¢~y~sJ. SHAF¢R, P.E. ~
17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE k~_~f~
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:SW920053
DESIGN ENGINEER:DUMMY COMPANY
OWNER NAME:RHODES STEVEN
OWNER ADDRESS:2801 W. INTERNATIONAL #A302
ANCHORAGE, ALASKA 99502
PARCEL ID:02017252
LEGAL DESCRIPTION: MOUNTAINSIDE VILLAGE #1 BLK
3 LT 11
DATE ISSUED: 4/13/92
EXPIRATION DATE: 4/13/93
LOT SIZE: 65438 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS ]FOR THE: CONTRUCTION OF:
DISPOSAL FIELD / 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 (iSAACS0).
3. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED BY: ~' ~('~--~':/
DNHS MUST BE PRESENT FOR 1ST INSPECTION (PRIOR TO BACK-
FII, L. ~
ENGINEER MUST RE-CERTIFY SOILS THROUGHOUT BED DURING
ACTUAL CONSTRUCTION.
ENGINEER MUST PROVIDE: CURRENT WATER MONITORING READING.
DATE::
ISSUED By:.,~$~-~
DATE::
II
~ MJ*?~c~l:al~y of Anchor:~ge/
uepL I~[~Nh & Human Services,/
SEPTIC SYSTEM DESIGN
DATE PREPARED FOR:
SCALE. . PREPARED BY: ~'~,.~::,:.~ :~
~ I~'~ ~0 D _ . Kniefel Engineering Mo~ cE~o~o=o
SYSTEH DESIGN GUIDELINES AND NARRATIVE
Lot 11 Block 3, Hountainside Village Subdivision
System Design = 4 bedrooms x 300 sf/bed. = 1,200 sf
Absorption Bed = 15' x 80' = 1,200 sf
All materials, construction methods and required inspections
to follow MOA rules and regulations. The contractor is
responsible 'For notifying the Engineer and the MOA at least
four hours in advance of all inspection needs.
Contractor will insure no additions or changes have been
made to the location of wells and septic systems on the
adjacent lots prior to the time of construction of this
system. If any changes to those systems have occurred, the
engineer should be immediately contacted for review and
possible changes will be made as necessary.
The lot slopes (8 -12%) in a downward direction from the
street level to the west lot line, The installation of the
system wilt have little or no effect on the surface
drainage, ground water, or the adjacent systems in the area·
The septic system should be properly maintained to include
septic tank inspection and pumping as necessary on an annual
basis and no use of a garbage disposal. If a garbage
disposal is used the tank size should be increased to a
minimum 1,500 gal tank and the tank pumped on an annual
basis.
The tank shall be a two compartment steel tank as approved
by the MOA. If the design and final grading of the house
results in the house sewer service line unable to maintain a
minimum 2% grade through the tank to the field, an MOA
approved lift station shall be installed to pump the
material to the bed site. For that option, the engineer
shall be consulted to provide the proper tank, pipe, and
pump sizing.
MOA CE 90-030
Municipality of Anchorage
DEPARTMENT OF HEAL'FH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG D PERCOLATION TEST
8
9
10
11
13
14
15
16
17
18
19,
2O
ERt ,£to~
WAS GROUND W,~
ENCOUNTERED?
geplh to Water A. fl~_r~
Monitoring? ~_~.~ Dale:
Reading
Date
Gross
Time
COMMENTS
PERFORMED ~:
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
Net
Time
l0
LO
I0
!o
Depth to
Water
Drop
CERTIFY THAT THIS TEST WAS PERFORMED IN
· '[- 3 o .- ,~,t
MUHMP� UTYOFHCHORZAGE
Al
.
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 020-172-52-000
Expiration Date:
11/17/2023
Legal description MOUNTAINSIDE VILLAGE #1 BLK 3 LT 11
Site address 17500 MOUNTAINSIDE VILLAGE DR Anchorage AK 99516
Current property owner(s) RHODES STEVEN & AMY A
X The On-site system(s) is/are approved for 4 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
Original Certificate Date: 7/17/2023
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of
Anchorage, Development Services Department (DSD) issues COSAs based upon
representations provided by an independent professional engineer. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory x
Tank Age Advisory Arsenic Advisory
Other
COSA Approval_June 2022
MUNICPAUrf OF AmCH RAGE
Development Services Department ( Phone 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 020-172-52
Complete legal description MOUNTAINSIDE VILLAGE #1; BLOCK 3, LOT 11
Location (site address) 17500 Mountainside Village Drive *Anchorage, AK
Current property owner(s) Steven Rhodes
2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS
Day phone 441-1247
3. TYPE OF WATER SUPPLY: Q Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ❑ Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: 0 Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ❑ Steel 0 Plastic ❑ Concrete ❑ Fiberglass
Age 2 - See advisory if steel older than 20 years
6. ABSORPTION FIELD: 0 AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: ❑
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee $ Waiver Fee $
Date of Payment 7 Z % Z Date of Payment
COSA # 05C2 3 J 27 _3 Waiver #
COSA ApplicaVon_June 2022
COSA Checklist
Legal Description: MOUNTAINSIDE VILLAGE #1; BLOCK 3, LOT 11
Parcel ID: 020-172-52
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system
A. WELL DATA
R Well log is filed with Onsite (or attached)
Date drilled 5192 Total depth 160 ft
Cased to 51 ft
0 Sanitary seal is functioning correctly
❑■ Wires are properly protected
Casing height (above ground) 12+ in.
Date of flow test for COSA 7/13/23
Static water level at beginning of test 13.2 ft.
Comments
B. TANK DATA
Measured operating fluid level in septic tank
o Date of pumping NEW
R Required maintenance completed, if AWWTS
Comments:
I
D. ABSORPTION FIELD DATA
Which system tested (date installed) 8/4/21
ALL standpipes present per record drawing
Total measured depth from grade 3.58 ft (max)
Measured depth to pipe invert from grade weft (min)
❑ N/A — pressurized field.
0 Per record drawings, field is insulated.
R Monitor tubes go to bottom of effective.
If not, state depth into effective
❑ Presoaked required if
(Required if house vacant or field not us r more
than 30 days prior to date of test
Gallons introduced gallons date
Any rejuvena ' reatment (past 12 months)
enter date
Well production at time of test 1.6+ gpm
Water storage tank volume N/A gallons
Well disinfected for coliform test? ❑ Yes IN No
9 Coliform bacteria is Negative
Nitrate 7.96 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L X Arsenic less than MRL (ND)
Collected by GEG, Ltd.
Date 7/13/23
C. LIFT STATION
❑ Required maintenance completed
Age of lift station 2 years
Lift station material PLASTIC
Comments:
Adequacy test date N/A
Results Q Pass
Fluid depth prior to test in
Water added gal
New fluid depth in
Elapsed time min
Final fluid depth in
Absorption rate 600+ gpd
FIELD STATUS — POST RECOVERY
Effective depth (per record drawings)
Effective depth used 0 in
Effective depth remaining 6 in
Comments/Deficiencies: NEW INSTALL - NO TESTING PERFORMED
COSA Checklist June 2022
6 in
E
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100'
❑Yes if No *50+ ft ❑i Yes if No ft
Neighboring Tank > 100' ❑i Yes if No ft Private Sewer/Septic Line > 25' QYes if No ft
Absorption Field on Lot > 100' ❑ Yes if No *50+ ft Holding Tank > 100' g Yes if No ft
Neighboring Absorption Fields > 100' Animal Containment > 50' Q Yes if No ft
R Yes if No ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' Mu Yes if No ft Q Yes if No ft
❑ N/A — Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10' Q Yes if No ft Surface Water > 100' ❑ Yes if No *50+ ft
Tank to Property Line > 5' g Yes if No ft Wells on Adjacent Lots:
Field to Property Line > 10' 0 Yes if No ft Private Wells > 100' ❑ Yes if No *50+ ft
Water Main > 10'
Water Service Line > 10'
F. ENGINEER'S COMMENTS
*AWWTS
n Yes if No ft
0 Yes if No ft
Community Wells > 200' n Yes if No ft
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 Gamess Engineerinq Group, LTD. (GEG) Phone 907-337-6179
Engineer's Printed Name Jeffrey A. Gayness Date '7
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 industry
practices. The reported results describe the condition of the system/s on the date/s of the evaluation. 0 OF
F��0�4
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 o �� VN
upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate p /� •' �i
during the year), quality of construction (materials and workmanship), and the water usage of the family utilizingT
D* 4 , .
the systems. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not l �....:. .
guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regardin
the future performance of the well or septic system. GEG makes no representation whether an alternative well J /)
or septic system can be installed on the property in the event either of the current systems fail to Perform
�Jef CE- Gayness;
adequately in the future. The content of this report is for the sole 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 o� 9 ' U CE -79 oeO
(including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. �Q OIL,
LICENSEE VProfessi()`oQo
COSA Checklist June 2022 #A C8 DOO000��
T I o: Page: 08 of 10 2023-05-30 21:32:21 GMT 19073086608 From: Wes Anderson
452924
son'a 111.111 now
as 2 Bann Ron a on 5
I on .45 an a a 5.2 No
I Aavarffex� Field Maintenance Report
&nniinl lnqnprtinn
Romig � .9
5 X 'm 4
MIKE Im" z
AnchorageTank
907-272-3543
. -.I------- - I
Property Owner/P301M 9
Current
--
operator
A+ Home Services Tech
Steven & Amy Rhodes
Previous I
2nd Compartment
--7-s
Current
previous
Current
contact Phone
Site Address
17500 Mountainside Village Drive, Anchorage AK 99516
(907) 555-5555
AX Sita to 0Date
County 10 0
Pod 4
Float Cords .............
RTU ANL 0
of Last Inspection
0611612022
AX -153680
OSP21183
438139
RTU145251 -
Retrieve O&M Into
Daily flow—
Reciro ratio_
Timer settings:
Perform Field Sampling/Observations
NTU 0,5 A NTUs) PH 46-9) 0012-6)
Odor of sample
Typlcal �Au* L7 Earthy E] Moldy
Non -typical F_jSulfide E] Cabbage !--.'Decay
pity film in PVU F
Yes LNIpo
FqpM.In tank 0 yes E;VQ
Check Control Panel
Recirc Amps Diseharga Amps
I
AUthbIle and visual alarms C3PK
Dial wnejielerfttry-onty) yes ❑ No
Inspect/Cleaft PUMP System
Inspect Clean
Measure Sludge/Scum
Aeum
I st Compartment
Current
previous
Current
Previous I
2nd Compartment
--7-s
Current
previous
Current
Previous
Previous
inspect/Clean AdvanTeit Filter
Odor, &Normal E)Pungent
810mat: Ej Normal ❑ Excessive
aridging/Pording: [S;Aona/.M1nor Excessive
inspect/Clean Discharge PUMP System
inspect
Riser/Lid Sk
splice Box
Float cords
inspect/Service Other System C0171110ftents
inspect
Clean
Latera]VOrifices
Pod Bottom Lq
....
intake Vent Q,
Inspect Clean
Floats [a E�l
Pump rD-1. Eq
inspect Clean inspect Clean
Disinfection Equipment n E] Dispersal Laterals/".. E"
observations
Additional Services Rendered
�leanad textille sheets? Ll Replaced LN items?
iR cedJused other items?
Parts Use d W Warranty. I . 5 =: Billable .(v' appropriate selection
A lt� Number Descriotlon
IL R
E
Riser/Ud ..................
....
splice BOX ...................
Float Cords .............
Floats— - ...............
Final/Safety Inspection
ds bolted on
Pump ..................
RW rein.stalled.
Siotubev FHW .................
isManftld reconnected; flush valves closed
jacor*ol panel reactivated
Bloltube Pump vault ............
. Z�
SummarY/Recommentlations
Recirculating SpItter V*ve .......
iSSyst
emperforn%uW, no furtheravtion needed
-EDTank.needspumping
'7 Cali for service
[]Other?
Comments
Signature—
V4 1-3
Date
MU HMP U u V OF ANCHOR AI OCA
DEVELOPMENT SERVICES DEPARTMENT
On -Site Water and Wastewater Section
www.muni.org/onsite
Nitrate Advisory
Certificate of On -Site Systems Approval # OSC231273
Subdivision: Mountainside Village #1, Block: 3, Lot: 11
907-343-7904
Fax: 343-7997
A water sample revealed a nitrate concentration of 7.96 milligrams per liter (mg/L).
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. Since nitrates are known to slowly increase, we recommend
you monitor the water quality. 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.
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
Parcel I.D. # 02017252
CERTIFICATE OF HEAL'rH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
HAA# ~Y'~
GENERAL INFORMATION
Complete legal description Hountainside
Lot 11
Villaqe
Subdivision, Block
Location (site address or directions) Mountainside Drive
Property owner Steven D.
2801 W.
Mailing address
& Amy A. Rhodes Day phone
International #A302 Dr.
Lending agency
Mailing address
Day phone
Agent
Address
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
Community well
NOTE:
XX
Public water
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
NOTE:
xx
Individual on-site
Holding tank
Community on-site
Public sewer
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. ~/91) Fronl MOA#2~
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 flies and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm
Address
Engineer's signature
DHHS SIGNATURE
Approved for
Disapproved.
Conditional approval for
$ & S E.NG!.NEER!.NG
7034 Eagle EiYer Loop Eoad No. 2~
/~Z~/''~ ~/) bedrooms.
Phone
bedrooms, with the following stipulations:
Additional Comments
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-025 (Rev. 1/91} Back MOA #21
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: ~,.-~C~¢' ~ , !.~-0~- k\ Parcel I.D.
A. WELL DATA
Well type/~l;2~ t
Log prese t(~)
Total depth
Sanitary se~/N)
If A, B, or C, attach ADEC letter. ADEC water syste~ number
Date completed
Cased to ¢'~1'
FROM WELL LOG
Date of test
Static water level
Well flow '~ !/'~ ~--4 .'~. ~
Pump level hJ/-¢/% ·
Casing height
Wires properly protecte(~)'~'/
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot Iz:~'~) /
Absorption field on lot l g)'~~ -~
Public sewer main ~/'~ ·
Sewer service line ~O I-4-
AT INSPECTION
.3~,
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
Petroleum tank
WATER SAMPLE RESULTS:
Coliform ¢
Date of sample:
Nitrate
f~'L~O, I O~t~ /-'~ Other bacteria ¢
. Collected by: '~ ¢¢ ~ ,~d'~. ~--1¢- ·
B. SEPTIC/HOLDING TANK DATA
Date installed
Cleanout~_____~N~) "-L//
High water alarm (YI~
Date of pumping
Tank size I'?-~~::~) ~4~'C--- Compartments
Foundation cleanout (~N) ~ Depression (Y/¢
Alarm tested (Y/~) ¢~
Pumper I,..3-¢:..-L,~ -T~
SEPARATION DISTANCES FROM SEPTIC/HOt. DING TANK TO:
Well(s) on lot [ ~
To property line [/~
Surface water/drainage
On adjacent lots
Absorption field
Foundation I'~'l
Water main/service line_ /~:)f ~
72-026 (Rev 7/91) Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
Meets MOA electrical Codes (Y~'/
SEPARATION DIST. T.T.T.T.T.T.T.T~E FROM LIFT STATION TO:
Well on lot .,.-~ On adjacent lots
"Pump on" evel ~/t.,/'~ "Pump off" level at
Cycles tested
Surface water
D. ABSORPTION FIELD DATA
Date installed
Length ~;)L~t
Total absorption area
Depression over field,(Y~
Results (pass/fail)
I/J~:;~'"~'~ Soil rating ¢'~'~'~¢:~/~ System type
Width J'~----M i Gravel thickness ~'~--~ / Total depth
I ¢'4:~ ¢/~' Cleanouts present i~)
h'--J Date of adequacy test k._) /
~ ""/'~'~ for ~ bedrooms
Peroxide treatment ,es, giv, ,,ate
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Wellonlot J~'-P On adjacent lots /~:~-)~ ~ Propertyline J ~ I.gL-
To building foundation ,;~:~ / To existing or abandoned system on lot
On adjacent lots ';:~O/-t- Cutbank I'--J E) b---~ ~-.~ Water main/service line_
Surface water I ~:~ ~-/- Driveway, parking/vehicle storage area /
Curtain drain f,.J¢t--& ¢
E, ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in,
date of this inspection.
$ & S ENGINEERING
~7034 Eagle River Loop P, oad No. 204 ,';i',/,;';' ~ ':: ""
Eaqie i~iver, Aiasi(a 9~5~Y .?; '%: :J~)
Signature
Engineer's Name
Date ~'~'-
HAA Fee $ ! -') (~' Cf-~ Waiver Fee: $
Date of Payment I ~-- I -~'~ "'~ Date of Payment
Receipt Number ~ q ~'~ Receipt Number
72-026 (Rev. 3/91) Back MOA 21