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Home My WebLink AboutKASILOF HILLS BLK 5 LT 2A Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: 0SP261100 PID Number: 015-133-28 Dwelling: ❑■ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New FW Upgrade Name VIRGINIA ROSSORPTION FIELD ❑ D Trench XWide Trench El ound Site Address 10300 KASILOF BLVD., ANCHORAGE, AK Other Phone Number of Bedrooms Soil RatingTotal depth f original grade 623-696-8137 3 ISF Ft. LEGAL DESCRIPTION Depth to pipe invert from origil EXISTING„ el depth beneath pipe Subdivision Block Lot KASILOF HILLS 5 2A Ft. Fill added above original gr Gr I length Ft. Ft. Township Range Section - - Gravel width Ft. Beds: Number of Lines - Dist a between lines - Ft. SEPARATION DISTANCES Tod Septic Absorption Lift I Holding Sewer Total orption area Number of trenches Dist. between t chis From Tank Field Station Tank Line Ft' - - Well 1100+ EXIST. j - - 25'+ TANK ❑ri Septic ❑ S.T.E.P. ❑ Holding ❑ Other p g Manufacturer INFILTRATOR SYSTEMS Capacity *IM -1530 Gal. Surface water 100'+ EXIST. - - Material Number of compartments I Lot Line 5'+ EXIST. ! - - I NA PLASTIC 2 ATION Foundation 1 p'+ EXIST. - i _ Manufacturer Capacity Remarks *TANK LARGER THAN REQUIRED. 4E Gal' 1,e tolled by Alarm location Installer PIPE MATERIAL House to tank D3034Tank to D3034 drainfield ARM SEPTIC SERVICES _ Drainfield EXIST. CO/MTD3034 Inspector GARNESS ENGINEERING GROUP, LTD. BENCH MARK (Assumed elevation) 95.05 ft Inspection151 6/15/2026 Location and description ectio2n aro 41h TOP OF MANHOLE LID (MH1) ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp QotSaO`�DO Conditional Approval: Date o •. 9s�OG Septic Syste U�� '.� Th CE A�9` �rness: Approved Dat 31 c�G Nate: this approval does not include well permit requtrem nts. �tAECC884 R��1 ess10 I -I (Kev ub/02/1,6) PERMIT NUMBER: RECORD DRAWING I N G PARCEL ID NUMBER: OSP261100 015-133-28 NOTE: SEE PAGE 3 OF 3 FOR ELEVATIONS OF DRAINFII DS AFTER REPAIRS WERE COMPLETED. �4�� / - v / J o ' CONTRACTOR INSTALLED NEW CO AND MT (2" STEEL MT DRIVEN TO BOTTOM OF EFFECTIVE DEPTH) - CONTRACTOR REPAIRED CLEANOUT-._ 1986 DRAINFIELD. PASSED SEPTIC ADEQUACY TEST ON 5/6/2026 - NEW INFILTRATOR IM -1530 PLASTIC SEPTIC TANK - CONTRACTOR REPAIRED MONITORING TUBE AND SUCKED OUT ALL DEBRIS FROM BOTTOM OF MT - X-1977 DRAINFIELD ----INSTALLED POLYLOK FLOW DIRECTOR (FD) INSTALLED DOUBLE CLEANOUTS (DBL3 & DBL4) NOTE: PER THE CONTRACTOR, THE OLD STEEL SEPTIC TANK WAS DECOMMISSIONED IN PLACE PER UPC INSTALLED DOUBLE CLEANOUTS (DBL1 & DBL2) 4 C 3 BEdG 4" yOuse M . ••� :.yam.. O. AA 4 .J 0 L5 � r 4 .. ....s•.... .. .i... ENGINEERING SALES $CONSULTING 3701 E. TUDOR ROAD, SUITE 101 -ANCHORAGE, ALASKA- PHONE (907)337-6179 * WEBSITE: www.gamessengineedng.00m r ■•• • .....■..■.•uu• ■..... ■ PREPARED FOR: PHONE NUMBER: PAGE NUMBER: +/ C^ ey A. Gar s 4 VIRGINIA ROSS 623-696-8137 2 OF 3 �j� C -79 3 PROJECT/LEGAL DESCRIPTION: DRAWN BY: •� F�+•+.+ �,jx ��..•�••�� KASWDLOIDATE: HILLS; BLOCK 5, LOT 2A L M TMPE OF ♦�!� pROFESS��Pi�� RECORD DRAWING OF SEPTIC TANK/SYSTEM UPGRADES 6/22/2026 #AECC884 ,`�� / SCALE: 1"=30' A I B C j DBL1 19.5 18.6 45.1 / DBL2 19.8 19.2 45.4 % MH 52.2 69.8 92.9 / STI 58.0 72.0 93.6 / DBL3 60.7 73.4 94.3 / DBL4 61.4 73.7 94.4 / FD 65.0 76.3 96.3 j C01 74.6 83.5 101.9 CO2 112.9 108.4 116.7 / MTI 112.0 108.0 116.6 / CO3 55.5 82.2 107.8 / MT2 56.5 83.1 108.7 i 100' WELL RgDIOS C04 113.6 115.4 127.6 NOTE: PIPE LOCATIONS ARE SHOWN PER GEG SHOTS TAKEN WITH LEICA DISTO S910 LASER DISTANCE METER. SWING -TIES TO I HOUSE CORNERS WERE I `-\GENERATED IN AUTOCAD. ; 10. T/ S4f, X-1977 DRAINFIELD ----INSTALLED POLYLOK FLOW DIRECTOR (FD) INSTALLED DOUBLE CLEANOUTS (DBL3 & DBL4) NOTE: PER THE CONTRACTOR, THE OLD STEEL SEPTIC TANK WAS DECOMMISSIONED IN PLACE PER UPC INSTALLED DOUBLE CLEANOUTS (DBL1 & DBL2) 4 C 3 BEdG 4" yOuse M . ••� :.yam.. O. AA 4 .J 0 L5 � r 4 .. ....s•.... .. .i... ENGINEERING SALES $CONSULTING 3701 E. TUDOR ROAD, SUITE 101 -ANCHORAGE, ALASKA- PHONE (907)337-6179 * WEBSITE: www.gamessengineedng.00m r ■•• • .....■..■.•uu• ■..... ■ PREPARED FOR: PHONE NUMBER: PAGE NUMBER: +/ C^ ey A. Gar s 4 VIRGINIA ROSS 623-696-8137 2 OF 3 �j� C -79 3 PROJECT/LEGAL DESCRIPTION: DRAWN BY: •� F�+•+.+ �,jx ��..•�••�� KASWDLOIDATE: HILLS; BLOCK 5, LOT 2A L M TMPE OF ♦�!� pROFESS��Pi�� RECORD DRAWING OF SEPTIC TANK/SYSTEM UPGRADES 6/22/2026 #AECC884 ,`�� PERMIT NUMBER: PARCEL ID NUMBER: OSP261100 RECORD D RAW I N G 015-133-28 TOP OF TANK @ INLET = 91.12 - INVERT OF PIPE @ INLET= 90.52 — ' OF MANHOLE FINAL GRADE LID = 95.05 r = 94.01-94.50 ST1 PER THE CONTRACTOR, THE TANK WAS INSULATED WITH 4" OF RIGID INSULATION aFFLE WALL 1530 2 -COMPARTMENT INFILTRATOR SEPTIC TANK EXISTING DRAINFIELD ELEVATIONS ON 6/22/26 BENCHMARK FOR PROJECT IS TOP OF MANHOLE (MH1) = 95.05 NOTE: DURING TANK INSTALLATION, ARM SEPTIC SERVICE PERFORMED REPAIRS ON SEVERAL DRAINFIELD SEPTIC PIPES. *SEE ATTACHED LETTER REGARDING 1977 DRAINFIELD. TOP OF TANK @ OUTLET = 91.15 VERT OF PIPE @ OUTLET = 90.31 in 4 �} ..... ......................a.., ENGINEERING - SALES - CONSULTING _ 3701 E. TUDOR ROAD, SUITE 101 'ANCHORAGE, ALASKA' PHONE (907) 337-6179' WEBSITE www.0emenengineedng.mm PREPARED FOR: T623-696-8137 ONE NUMBER: PAGE NUMBER: VIRGINIA ROSS 3 OF 3 PROJECTILEGAL DESCRIPTION: DRAWN BY: KASILOFF HILLS; BLOCK 5, LOT 2A J.L.M. TYPE OF WORK: DATE: RECORD DRAWING OF SEPTIC TANK/SYSTEM UPGRADES 6/23/2026 CE -79 3 LICENSE t, AUI'ESS�� #AECC884 �,"�~ TOTAL DEPTH LIQUID LEVEL GRADE 1977 DRAINFIELD C01 *89.86 DRY 93.59 CO2 *91.07 DRY 94.61 MT1 *88.58 DRY 94.62 1986 DRAINFIELD CO3 84.86 DRY 89.65 MT2 83.70 DRY 89.57 C04 84.71 DRY 89.78 NOTE: DURING TANK INSTALLATION, ARM SEPTIC SERVICE PERFORMED REPAIRS ON SEVERAL DRAINFIELD SEPTIC PIPES. *SEE ATTACHED LETTER REGARDING 1977 DRAINFIELD. TOP OF TANK @ OUTLET = 91.15 VERT OF PIPE @ OUTLET = 90.31 in 4 �} ..... ......................a.., ENGINEERING - SALES - CONSULTING _ 3701 E. TUDOR ROAD, SUITE 101 'ANCHORAGE, ALASKA' PHONE (907) 337-6179' WEBSITE www.0emenengineedng.mm PREPARED FOR: T623-696-8137 ONE NUMBER: PAGE NUMBER: VIRGINIA ROSS 3 OF 3 PROJECTILEGAL DESCRIPTION: DRAWN BY: KASILOFF HILLS; BLOCK 5, LOT 2A J.L.M. TYPE OF WORK: DATE: RECORD DRAWING OF SEPTIC TANK/SYSTEM UPGRADES 6/23/2026 CE -79 3 LICENSE t, AUI'ESS�� #AECC884 �,"�~ 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: OSP261100 Work Type: SepticTank Upgrade Tax Code Number: 01513328000 Site Legal Address: KASILOF HILLS BLK 5 LT 2A G:2541 Site Mailing Address: 10300 KASILOF BLVD, Anchorage Owner: ROSS WAYNE A & VIRGINIA L Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: l7epartnient 5/14/2026 5/14/2027 Non -Public ❑ Disposal Field 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 Special Provisions: Make repairs to the existing fields as described in the project documents. Issued To: GARNESS ENGINEERING GROUP LTD Issued By: Curtis Townsend Date: 5/14/2026 Date: 5/14/2026 3 Development Set -vices Department , Phone: 907-343 /904 On -Site Water & Wastewater Section ON -SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 015-133-28 Property owner(s) VIRGINIA ROSS Day phone 623-696-8137 Mailing address 10300 KASILOF BLVD., ANCHORAGE, AK Site address 10300 KASILOF BLVD., ANCHORAGE, AK Legal description KASILOF HILLS; BLOCK 5, LOT 2A Number of Bedrooms 3 Engineering Firm GARNESS ENGINEERING GROUP, LTD. Building Permit Number Not Applicable 0 APPLICATION IS FOR: (® all that apply) Absorption Field ❑ Septic Tank Holding Tank ❑ Privy ❑ Well ❑ APPLICATION IS AN: Initial ❑ Upgrade Renewal ❑ TH10 ADDI ICATICIAI INICI I MCC A IA/AI WEER DCQI 'EST FOR: � �.w ram.. .• n� r.vvw � •�r-� .� � .�� v v. FOR: Permit/Rush Fees: Waiver Fees: Date of Payment: Permit No. c S( Z b t I Date of Payment: Waiver No. Distance: Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP261100, Curtis Townsend, 05/14/26 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP261100, Curtis Townsend, 05/14/26 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP261100, Curtis Townsend, 05/14/26 MUNICIPALITY OF ANCHORAGE DE -iTMENT OF HEALTH AND HUMAN SER ES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION RIEpORT LEGAL DESCRIPTION Block SubdlvfsIoR Lo, .2-/- ~" /Cas;'/° I¢'l~-- Township, Barlgs. ~ TANKS ELL T LINE UNOATION DISTANCES WELL SEPTIC ADSORPTION TANK FIELD AS-BUILT DIAGRAM (Show Iocahon of web, septic system property lines, Ioundaboo, duvoway, wmer bodies, etc) E] SEPTIC ~ HOLDING ,--~'~ ~C~p,Cc,%,n ga,o/%~- TYPE OF SYSTEM [] TRENCH [] RED '~ W. DRAIN [] OTHER oog~nal grade '~'~/ I FT ~ FT 0¢'~ FT / FT FT $0 Fl'J --.~' FT 0 Numbel elhnos . Soil rating ~-Jt Pipe material ~ ~ 16~"' S~F 7230"5 j¢~lo WELLS PRIVATE [] OTHER (Identify) 1 FT REMARKS: Inspeclions Pealer med by ~_~'/~_~~~__~ cerhly th al this inspection was pad otto ed according to ail htunJcJpal and Slate g~ ellecl on this date: ENGINEERS SEAL 12!; 4 (:~ .,. i/.~ ~"/i J:> ~.i! ,,__-~,, GRE., ER ANCHORAGE AREA BOk JGH ~,-~, , . ,,~-,~ ,~, Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION LOCATION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM WELL /'~ INSIDE WIDTH LIQUID DEPTH NUMBER OF COMPARTMENTS' ~ __ LIQUID CAPACITY/~C) GALLONS. TILE DRAIN FIELD: D,STANCEFROMWEL,/~]d)/ / g /0 / TOTAL LENGTH _FOUNDATION _0 NEAREST LOT LINE OF LINES I NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTH IN. TOTAL EFFECTIVE ABSORPTION AREA ~ ~2 ~¢~__~g4.~<~t~¢z¢Q. FT. LENGTH OF EACI4 LINE DEPTH OF FILTER DEPTH: TOP OF TILE TO F:INISH GRADE 'i~/ I MATERIAL BENEATH TILE '-~O IN. ABOVE TILE "~"-~ IN. WELL: TYP~/,-,~-~'~' /~ __CONSTRUCTION _DEPTH BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION_____ LOT LINE____ SEWER LINE , TANK SYSTEM CESSPOOl O-rHER SOURCES APPROVED _~ DISAPPROVED__ REMARKS DISTANCE FROM: DISTANCES: INSTALLED BY: ¢ SEWER LINE DEPTH: LOT SLOPE: REMARKS: DIAGRAM OF SYSTEM THE: I_..E:I'.,IG'TH I::, :[ I"'lE:l'.,l:ii; ]: CIl'.,I :[ :!i; THE: LI:I'~G"rH ,:: ]: f.,I FEET ::, O1::' Tl...llii~ 'f'I:;i:E:I'.~CH i::)l:;i: E:,I:;i:I:::t :[ I'.,11:::' :[ liE[.[). "I'HliE E:,Ii:F:'TH i:::ll:::' I::1 'T'Fi:I!i!:I",IC:H (:)1:;i: F:']ZT :1::!~:: THE: I) ]: :ii;TFil'.,]Cl!~:: E',E:I"I,.II!EI!::I'.,I THE (:!il:;i:l:ll...IHl::, Fff.,IE:, 'I"I.IE: [3(:lTT(:ll','l (:il:::' 'TT.II~i: li-i:;:.:;C:I::I',/I::IT]ZCHq ,::]:1'.,I I:::'[!~E:'T). 'T'HI~: 'T'E:Ii::I'.,ICH I.,.I :[ I::,'I"H I=l:)R: DI:;:I:::I ]: lqF:' ]: I:~I...D:~:; ]: :~; :~: F:E:IiET. THE: C:iI:;;'.I::'I',,,'tF:I... [::,liiiZF"T'l.J ]:'.!~:; 'I"HI!!: I','l:[l'.,l:l:l','ll...ll','l IE:,E:I::,TI4 OF:' (3f:~:l:::i'v'E:l.. E',[:~:"l'l,.ll!!i:lii:l,,I THE: O1.1'11:::'1:::1t..I. F::' ]: F:'i:i: I:::ff.,t[) "l"H[i~ E!H:)]'I'OI¥1 Ot':: 'THI=: EZX(::FI'v'I::FI"]:(:i!'.,I ,::~t",1 Municipality of Anchorage ~,~_~ ~, DEPARTMENT OF HEALTH & HUMAN SERVICES '~I~-~ ~['~","~* 825 "L" Street, Anchorage, Alaska 99502-0650 ~1~- ~ SOILS LOG ~ PERCOLATION TEST ~1, .o ~ SLOPE SITE PLAN WASENCOUNTERED? GROUND WATER 11 S , L IF YES, AT WHAT 15 Op 12 DEPTH? d~l lJ.°~ .- f~,t~ ,d~J ke~( E, Deplh t0 Waler After ~) uP4.. I O 1 3 Monitoring? Dale: Reading Date Gross Net Depth to Net Time Time Water Drop 2. J~,~ 5/o '330 ,~¢ - 3 Vo lo , q3 .. t qoO 14 15 16 17 18 19 20 - 5'00 ' - ~ O PERCOLATION RATE ¢ Y V/(~rr~,nutes/,noh//P~RC HOLE DIAMETER ~'~" TEST RUN BETWEEN FT AND % FT PERFORMED BY: ~ ~c~- /~. S~¢ O I ER~IFY IHA~ THIS TEST WAS PERFORMED iN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES iN EFFECTON THIS DATE. DA~E: 72-008 (Rev. 4/85) SOILS LOG PERFORMED FOR: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-650, Anchorage, Alaska 9950:2. 276-2221' SOILS LOG - PERCOLATION TEST DATE PERFORMED: [] PERCOLATION TEST SLOPE SITE PLAN 1 3 7 8 10 11 %¢~¢ ~;/ /~'~ '~ WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? 12 13 14 15 16 17 '18 19 20 Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) COMMENTS PERFORMED BY: TEST RUN BETWEEN FT AND ---- FT CERTIFIEDBY: ~O~'NI/t.,i~-~-~I~Z[~Y b¢~ DATE: ~0~, 72-008 (7/76) ALASKA ENVIRONMENTAL CONTROL SERVICE" INC. 1200 West 33rd Avenue, ouite B ANCHORAGE, ALASKA 99503 (907) 561-5040 JOB /~ .~/ SHEET NO _ CALCULATED CHECKED BY OF DATE /I J~''~ /??;~ DATE /// / / / / / / ? / / / / / \ / / / / / / ~A [:,IEI::'I::II:;~:TI"IENT OF' FIEFIL.'TI4 FtI'.,I[:, IEI'.,Ik,'I~:?X;]$.!h'iI:E]'.,FI"FII... F'F?X;)TEiE:T]]EIN E":;[?,.~!!~ '"1.,.'" '."STIE~EE[T., t::ff'~E:HCd~I:::IGE,, I:::lt{. t!])~i!!!!il~:.l:'J.. iL,.fl EE IL... I~ ..... F" lEE ~:;E.~ li'"11 LE "Ir" ,:: 7'?':':1."L E: ::, FI F' F' L. I C FI N "[' L. 0 C R T 1' 0 N L,.IEGf:IL I..IH T NE Id R ...~,~,~ I,.JE~Ft E~ I<Fr.[~ .T I...X.]F 14 Z L.L. fE; L2FI E:5 I<:F:It:E:II...OF I'..I ]: L I_. E; LO'T :iii: ]: M I t'.,i ]: t"1LIi"1 [:, ] .::. FHN ..E:. E:E':'I"t.,-IEIEI'.,! F:I NI.'.ELI._ I::11'.,11:::, ~ I'.':ll',l-..f::; :1: "FIE E;E:t.,.II:;:IEiE: I':, ;~.r..-}E~ FE:ET EOF..: la F'F4::[',,,'I~']TE' I-,.IEI...I... Cfi';.'. ;.T..: Ct E,] FEET F:OF.". Fl F'LII.:.i',t._]:C I.,.IEI..I .... !-,.IIEL. L. L..O(:~itL:; FIF..'E I~;?.E:QUT[I,?.I.:.]::, FII'4[::, FtL.IE;T E~E: I;.'.E:TI...IF?.NE:.'E:, TEl THE: [)IEf':'F:II~:'.Tt"IENT I.,.1:["1"1..'1]:1'-,I ElF THE klE:LL. C:CIIh'IF'LET I E',F'I:EIZ: ]: F ]: Cf-"I'T'.'I[ OI"~E; FIN[:, C:ON'..};TI:;.:I..II]:T ]: CIN [:, :[ Fll][~:FIi"I'.E: I::II:;.'.E: I::I',,,'F:I ]: L. FIE$1....IE 'T'I]I I IqE;T FILI...I::IT :1: ON. I C:IEF?.T :[ f"r' THFI"I" d.: 3: FII'I i::'FII"I.I:I.....TFII;~: !.,.1:1:'1"1'"1 THE RE6!I...I]:I;;?.EHEI',IT'.:i; FOR Efl",t"-:'~!;]:'I"E: :E;IE!41EI:;;::!5 FIN[::, I.,.ll!ii:L..I....:i5 1::I:5 E;E:'T F'CtR"I"I4 E:"r' "['1"11:~: i'"lUl",1:1: C I PI:rtL..T T"r' Eft:' FIl",lE:lqCIl~F:l[:'i[i:.'. ;;.i'.: :[ I.,.l:[kk ZNE;TFII....L. THE %"r".:i;TEl"l II",t FiC:E:OR[:'FINC:E Iq]:'T'H THE: CODE:E;. 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 OSC261216 Parcel ID 015 -133-28 Expiration Date: Legal description KASILOF HILLS BLK 5 LT 2A site address 10300 KASILOF BLVD Current property owner(s) ROSS WAYN E A &VIRGINIA L X The On-site system(s) is/are approved for 3 bedrooms By: 5/1/2027 Conditional approval for bedrooms, with the following stipulations: Comments or conditions: No comments Original Certificate Date: 6/29/2026 This C tificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject sys/tem(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Dtevelopment Service Department (DSD) issues COSAs based upon representations provided by an i independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other MUNICIPALITYPIF Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application I. GENERAL INFORMATION Parcel I.D. 015-133-28 Complete legal description KASILOF HILLS; BLOCK 5, LOT 2A Location (site address) 10300 KASILOF BLVD., ANCHORAGE, AK Current property owner(s) VIRGINIA ROSS Day phone 623-696-8137 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: X Private Well serving # 1 dwelling units ❑ Other Non-public well as regulated by MOA ❑ Water Storage ❑ Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: I Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel X Plastic ❑ Concrete ❑ Fiberglass Age NEW - See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench X 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 / �—S U �''� Date of Payment COSA # L C Waiver # COSA Applicalion_Apr2025.doc COSA Checklist Legal Description: KASILOF HILLS; BLOCK 5, LOT 2A Parcel ID: 015-133-28 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system 1 A. WELL DATA n Well log is filed with Onsite (or attached) Date drilled 4/20/1977 Total depth 434 ft Cased to 30 ft M Sanitary seal is functioning correctly X Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 5/1/2026 Static water level at beginning of test 34.1 ft 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) 1986 ❑Q ALL standpipes present per record drawing Total measured depth from grade **5.9 ft (max) Measured depth to pipe invert from grade **4.8 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. Well production at time of test 1.1 gpm Water storage tank volume NONE gallons Well disinfected for coliform test? ❑ Yes Al No K Coliform bacteria is Negative Nitrate mg/LNitrate less than MRL (ND) Arsenic ug/L ❑■ Arsenic less than MRL (ND) Collected by GARNESS ENGINEERING Date 5/1/2026 T STATION ❑ Require tenance co Age of lift station Lift station nal ents: Adequacy test date ***5/6/2026 Results Q Pass Fluid depth prior to test ***6 in Water added 473 gal New fluid depth *"7.25 in Elapsed time 110 min Monitor tubes go to bottom of effective. AT TIME {7F TEST. ', Final fluid depth *** in 8.75° TAT NOW HAS 12"+ 450+ If not, state depth into effective OF EFFECTIVE Absorption rate gpd A Presoaked required if , FIELD STATUS — POST RECOVERY (Required if house vacant or field not used for more *** than 30 days prior to date of test) Effective depth (per record drawings) 12 in Gallons introduced 2000 gallons 5/6/2026 date Effective depth used ***0 in Any rejuvenation treatment (past 12 months) NONE Effective depth remaining ***12 in If yes, enter date Comments/Deficiencies: *INITIAL TRENCH INSTALLED IN 1977, 2ND TRENCH INSTALLED IN 1986. **MEASUREMENT AFTER 1986 DRAINFIELD REPAIRS ***TESTED 1986 DRAINFIELD. AT TIME OF TEST, 8.75" (0.73') OF EFFECTIVE MEASURED. AFTER TEST ON 5/6/2026, THE MT FOR 1986 TRENCH WAS CLEANED OUT OF DEBRIS AND NOW MEASURES 12+ INCHES OF EFFECTIVE (MT DRY). SEE ELEVATIONS FOR DRAINFIELDS�OyBN RECORD DRAWING, PAGE 3 OF 3. COSA Checklist_May2025.docx env - r n� 2L¢�Z 1 1�' 1�'- }� V�=��i,—rye E. SEPARATION DISTANCES From Well on Lot to: (Please enter distances if less than required) Septic Tank/Lift Station on Lot > 100' Sewer Service/Septic Line > 25'F✓ Yes if No ft 0 Yes if No ft Neighboring Tank > 100' Q✓ Yes if No ft Disposal Field on Lot > 100' 0 Yes if No ft Neighboring Disposal Fields > 100' if No ft Yes if No ft Sewer Line/Main > 100' QYes if No ft Sewer Manhole/Cleanout > 100' 0 Yes if No ft Sewer Service/Septic Line > 25'F✓ Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Animal Containment > 50' 0 Yes if No ft Manure/Animal Excreta Storage > 100' ft Q 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' M Yes if No ft Surface Water > 100' Yes if No ft Field to Foundation > 10' 0 Yes if No ft Wells on Adjacent Lots: Tank to Property Line > 5' M Yes if No ft Wells > 100' Yes if No ft Field to Property Line > 10' MYes if No ft Community Wells > 200' ✓( Yes if No ft Water Main/Service Line > 10' [/✓ Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS SEE ATTACHED LETTER REGARDING 1977 TRENCH. 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 Garness Engineering Group, LTD. (GEG) Engineer's Printed Name Jeffrey A. Gayness, P.E. 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. 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), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform 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 (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. COSA Checklist_May2025.docx Phone 907-337-6179 Date .4. t.. ............:. �........... IfJe ey arness: O C —79 3 0 LICENSEE P ofessiO AECC884 �D�OOOd� GARNESS ENGINEERING GROUP, Ltd AeroCell ENGINEERING SALES CONSULTING Alaska Authorized Dealer June 23, 2026 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Status of 1977 trench for Kasilof Hills; Block 5, Lot 2A To whom it may concern: On 6/15/2026 a new septic tank was installed on the property. The cleanout (CO1) at the beginning of the 1977 trench was exposed and the new tank elevation was installed to ensure gravity flow could be achieved to both the 1977 and 1986 drainfields. After the installation of the tank the contractor proceeded to expose the far end of the 1977 trench to replace the non- functional sump with a clean-out and monitoring tube. The sump was replaced with a new cleanout (CO2) and 2" steel monitoring tube (MT1). GEG performed elevation shots after the tank installation and repairs were completed and found that the CO2 (end of 1977 trench) invert elevation was 1.21 feet higher than the cleanout (CO1) at the beginning of the trench, and 9 inches higher than the invert of the new tank outlet. In order to confirm functionality of the 1977 trench, we added 456 gallons (in 64 minutes) to C01 to see if water would back-up in the flow splitter or the double cleanouts after the new septic tank. At no point did we observe water flowing into either the flow splitter or double cleanouts. Based upon this testing, it appears the 1977 is functional; however, the levelness of the distribution line is compromised.. If you have any questions, please contact us at 337-6179. Thank you for your assistance. Jb%e, IG"n e s, P. E., M.S. Presi ent 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Website: www.garnessengineering.com 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. # CERTIFICATE OF HEAl_TH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING HAA # 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address _ Lending agency Mailing address Agent Address Day phone Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~' TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site 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 on the date of this inspection. NameofFirm '~;/-"/"-~1 ..~,,~./,..~.~,_,~,_~.(.2 i.\= Phone Address ~)'(:::~ ~ ~' / ~ ~' f~- ~'> (~, Engineer's signature ¢ - ,~-~( L-¢~-~ ~'~ DHHS SIGNATURE Approved for ~'~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date -~' - ~7/- 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~)25 (Rev. 1/91) Back MOA #21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. Well Data Well type ~'-- Log present (Y/N) Total depth Sanitary seal (Y/N) , Parcel I.D. / If A, B, or C, attach ADEC letter. ADEC water system numbe~r Date completed C/~ 4,/~ ,-~ Driller ~ ¢> ~;/ Cased to ~.*r / Casing height %/' Wires properly protected (Y/N) FROM WELL LOG AT, I,N~PECTION Date of test L/ . ¢, /.? --/ Static water level - ~- Well flow (") g.p.m. Pump levell t-"~t'.. /'-.:,,-,/.--'i - SEPARATION DISTANCES FROM WELL TO: O [ t~';~' P ; On adjacent lots ; On adjacent lots Public sewer manhole/cieanout Petroleum tank Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts (Y/N) / High water alarm (Y/N) Date of pumping Tank size ,//~/t~ d-- Compartments ,~- Foundation cleanout (Y/N) _ H Depression (Y/N) Alarm tested (Y/N) h? ' ¢~ '~ Pumper / .~ ~:~ d~. ,~' / ? SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot // To properly line Surface water/drainage On adjacent lots Absorption field ') ,/(..'a ('-: Foundation ~//:~ , /"¥ Water main/service line /, ,, LJ 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date,nsta,,ed Length ~-¢Z/~ ¢-~-7 Width Total absorption area Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) Soil rating (GPD/FF) /~(¢: _~ System type ~ Gravel thickness ~... ~ '~ I Total depth Cleanout present (Y/N) x/ Depression over field (Y/N) / Results (pass/fail) ~ for '~ ~.~/ After test ~ r-%~ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots Surface water ',~. Curtain drain Bedrooms If yes, give date % /.~?~:~3 Property line On adjacent lots ~ To existing or abandoned system on lot Cutbank ~ ~' ~ Water main/service line Driveway, parking/vehicle storage area . r-'%~ ~% E. ENGINEER'S CERTIFICATION I certify that I have checked, var~fled, or conformed to afl MOA and HAA guidefines in effect on the date of this inspection. HAAFee$ / 7 Date of Payment Receipt Number 72-026 (3/93)' Back Waiver Fee $ Date of Payment Receipt Number