HomeMy WebLinkAboutSOUTH HILLS BLK 4 LT 401'/
'LoT
Municipality of Anchorage
On-Site Water and Wastewater Program • (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP181087 PID Number: 017-072-13
Dwelling: ® Single Family (SF) El Duplex(D) El Multiple (SF and/or D) Project: ❑ New ® Upgrade
Name: ABSORPTION FIELD
KEN & BAERBEL EPPERSON
Address ® Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound
7601 Old Hillside Way, Anchorage, AK 99516 ❑ Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
3 1.2 GPD/SF 11 Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot 3 Ft. 8 Ft.
SOUTH HILLS 4 4 Fill added above original grade Gravel length
Township Range Section Varies 1.4 — 1.8 Ft. 24 Ft.
Gravel width Beds:Number of Lines Distance between lines
SEPARATION DISTANCES 3 Ft. Ft.
To
Septic Absorption Holding Sewer Total absorption area Number of trenches Dist.between trenche-s
From
Tank Field Lift Station Tank Line 384 Ft2 1 Ft.
Well 100+ 100'+ NA NA NA TANK ® Septic 0 S.T.E.P. 0 Holding 0 Other
Manufacturer Capacity
Surface Water 100'+ 100'+ NA NA ANCHORAGE TANK 1000 Gal.
Material Number of compartments
Lot Line 5'+ 10'+ NA NA STEEL 2
NA
Foundation 10'+ 10'+ NA NA LIFT STATION
Manufacturer Capacity
Gal.
Curtain Drain NA *50'+ NA NA
Remarks Pump on level at Pump off level at High water alarm at
*None known. Existing tank
decommissioned in place per code. in. in. in.
S.T. & service lines insulated Pump make and model Electrical Inspections performed by
PIPE MATERIAL House to tank 3034dTarainnkfito eld 3034
Installer A+ Home Services _Drainfield 3034 CO/MT 3034
Inspector ARCTERRA BENCH MARK (Assumed elevation) 100 ft
Inspection 1"5/21/2018 2nd 5/21/18 Location and description
dates:
3f° 5/22/18 4th Bottom of siding
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engin
Otil AI
Conditional Approval: Date j r<`S�' `IA c\. ,
/ ,-A 9TH /�* #
/.WI_
l _ _ iti/�/
% KENNET M. D r /
,�� 18 � �
1LL &A 6.A. I Dateh . aApproved /� /!J sSAsr
eer's Stamp
Inspection Report_9-1-12.doc
AS-BUILT SYSTEM DETAILS/SITE PLAN Permit ❑SP181087
SOUTH HILLS SUBDIVISION LOT 4 BLOCK 4 PID# 017-072-13
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z H L=b3.a1�
-- B-C=62.25
A-D=67.50' 07.63 97.5T
y B-D=67.10' g
A-E=73.50' 11 1 1111 o
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— — _ FINAL GRADE
• B E-70.40 _ 96,3 95.9 1 �94.5ca
A-F=71.25' 0 I °IGTM"L \
o _ _ VARIES
FILTER FABRIC
B-F=68,50 A - 1000GAC. \
• A-G=84.80 H SEPTIC 91.52 917.52 T
8, B-G=75.80' 'v TANK SEWER ROCK
13 A-H=82.50' i' s-16-18 444
93,83 93,6 83.5 No cwm.
B-H=74.50' ��
U ( 77.5two
w ��`` I - - 24' I
SCALE' NTS
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PREPARED FOR; CTE D
�r��� `�� �� KEN & BAERBEL EPPERSON a°� �RtdrAlk{`�),-,,,,,,
° / vl TH J� + 7601 ❑LD HILLSIDE WAYa/• * : B cn
= * IANCH❑RAGE, AK 99516 / ��oI I FlELD BOOKS COMPUTED 5 I
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1\ F'ESSIDl• �' Db .FILE GID SW2940 '�! \ C �;�
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k `_� ACRD FILE ,a6 No.: 18-137 �R/f�RSUL.TING ,,,3g
FILE AK.99577
OLD AR BBIT — —
EK ROAD
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(S85'52'10"E 152.96' R)
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_ to BASIS OF BEARING )
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ANCHORAGE RECORDING DISTRICT,ALASKA _
ASBUILT OF:
SOUTH HILLS SUBDIVISION O =FND REBAR
LOT 4 BLOCK 4 PLAT P-636
SURVEY CERTIFICATE:I,John L.Schuller,Have conducted a .. ' 0 F 4 i�` tip LS R�•
�
physical survey of this property as shown on this drawing and that the // ��'• .••'•• •.-is,' ��.XN.() .-1' Sr„ •:j
improvements situated hereon are within the property lines and no c� `(� 11 N,ev 414,
s
enchroachments exist other than noted.Under no circumstance should % ▪ 49TH i\ *• ' a -(1
•
any information on this drawing be used for construction of fences, a. N., r
structures,improvements,or for establishing boundary lines. J1—
EXCLUSION NOTES:It is the owners responsibility to determine / to I"• �'••. C?
ty • IIN L. SCHULLER: °/ = , Olt
'•1
the existence of any easements,covenants,or restrictions which e.. �• ,�
s LS-10408 "t'•.,..,,......r'
do not appear on the recorded subdivision plat. ,' /
WORK ORDER NUMBER: DALE SCALE: E-YNL ` t' c,Jje 1831 Talkeetna Street
1%;0,7,..-s.4.7.3,1- a,r Anchorage, Alaska 99508
18-019-2 DRAM meq®B' MID"'"'�'O BOOK/PAM: ����°fessiono\ '� (907) 227-1455 office
JLS SW2940 180141 \�.`��' (907) 274-4992 fax
2t _l-
st.,, ,``°"li,r!, MUNICIPALITY OF ANCHORAGE ment
On-Site Water&Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997
httpalwww.muni.org/onsite L
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hCHORNO*
On-Site Wastewater Disposal System Permit
Permit Number: OSP181087 Effective Date: 5/17/2018
Work Type: Septic Upgrade Expiration Date: 5/17/2019
Tax Code Number: 01707213000
Site Legal Address: SOUTH HILLS BLK 4 LT 4 G:2940
Site Mailing Address: 7601 OLD HILLSIDE WAY, Anchorage
Owner: EPPERSON KEN & BAERBEL Lot Size in Sq Ft: 51200
Design Engineer: ARC TERRA CONSULTING INC Total Bedrooms: 3
This permit is for the construction of:
0 Disposal Field RI Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 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: �' Date: / 7'e•
Issued By: ,CA �n, Date: 5M
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On-Site Water& Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 017-072-13
KEN & BAERBEL EPPERSON... 441-0933
Property owner(s) Day phone
Mailing address
7601 OLD HILLSIDE WAY, ANCHORAGE, AK 99516
Site address 7601 OLD HILLSIDE WAY, ANCHORAGE, AK 99516
Legal description (Sub'd., Block & Lot) SOUTH HILLS B4, L4
Legal description (Township, Range & Section)
Lot Size 51 ,200 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(E)all that apply)
Absorption Field U Initial Single Family (SF) x
(w/wo ADU)
Septic Tank Upgrade Duplex (D) L J
Holding Tank Renewal I IMultiple Dwellings LJ
Privy (SF and/or D)
Private Well n
Water Storage
THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes._
(Signature • property owner or authorized agent)
Permit/Rush Fees: 541,9 Waiver Fees:
Date of Payment: `nl�d C3 Date of Payment:
Receipt Number: ( 41,07on Receipt Number:
Permit No. 66PIRl6 g? Waiver No.
Permit App_9-1-12.doc
01 �RCTERRq „
s ^\ ARC 1 m
ERRA
CONSULTING, INC
; 212 E. 51it Ave,Anchorage, AK.99503
� N�. Office(907)868-3791, Fax(907)868-3793
4'� St.TI NG•�jt'
AK.995Y1_•I
May 11, 2018
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Upgrade Sewer Permit— SOUTH HILLS B4, L4
It has been determined that the absorption field of the subject property is
saturated. Subsequently, the owner has requested we proceed forward to obtain
a septic permit to upgrade the septic system.
The general slope of this lot is from southeast to northwest at a grade of
approximately 7-12% over the proposed septic area, with steeper slopes down
gradient. On May 7, 2018 a testhole was performed to investigate soils and
groundwater. The results of this test are attached for your review. The proposed
upgrade will serve the existing 3-bedroom house. We propose to install one deep
trench with an Advantex System. Groundwater was not encountered or at
monitoring.
The property and adjacent lots are served by private water. There is no surface
water within 100' of the proposed system and there are no known curtain drains
within 50'. We do not expect there to be any adverse effect on adjacent lots by the
development of this system. If you have any questions, please contact me at 868-
3791 / FAX 868-3793.
Respectfully submitted,
ArcTerra Consulting, Inc.
Kenneth M. Duffu�
Attachments: On-Site Sewer Application
Wastewater Absorption System Details/Site Plan
Soils Log/Percolation Test
20441 PTARMIGAN BLVD • EAGLE RIVER,AK 99577-8736 • PH(907)868-3791 • FAX(907)868-3793
WELL & WASTEWATER DISPOSAL SYSTEM DETAILS/SITE PLAN
SOUTH HILLS SUBDIVISI❑N LOT 4 BLOCK 4
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___________
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FLAG PROPERTY LINES
WELL RADII & EASEMENTS
A PRI❑R TO CONSTRUCTION Scale: 1''= 1o0'
DESIGN DETAILS PAGE 1 OF 2
.t 3 BDRM X 150 GPD = 450 GPD
m 450 GPD/1.2 GPD PER SQ. FT. = 375 SQ. FT
Q (150 / 2 x (8' GRAVEL) = 24 FT. TRENCH
USE TRENCH - 24' (L) X 2' (W) X 8' <ED)
t Total depth of system is 11' max from original grade.
o Total depth of gravel below distribution pipe is 8' .
03
• NO PUBLIC WELLS WITHIN 200' OF
'70,'.
PROPOSED SYSTEM. NOTES:
NO PRIVATE WELLS WITHIN 200' OF
PROPOSED SYSTEM EXCEPT AS NOTED. 1. INSTALL 1000-GAL & INSULATE TANK IF <4' COVER.
8' RIAU JE.EEXCEPT AS NOTED. 2. INSULATE TRENCHE WITH 2' HD BURIAL FOAM IF < 3' OF FILL.
MIN. 2' FILL WITH INSULATION, >3' COVER NO INSUL REQ.
3. CONTRACTOR WILL ENSURE MINIMUM 2% SLOPE INT❑ SEPTIC TANK.
4. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT
N —_`` WELLS, SEPTICS EASEMENTS, PROPERTY LINES, ETC...
<s o•F • ,6 PREPARED FOR: gCTER D
1 KEN & BAERBEL EPPERSON A' lCq
�� ��.- `� 7601 ❑LD HILLSIDE WAY * 'M� �°��,
* . 4 9TH . * Y ANCHORAGE, AK 99516
03 / 907-441-0933 1 / \ I
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FESSI024
\ DWG. FILE GRID: SW2940 �� CO C �1
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'11166...%:416:11111P ACAD FLE FILE JOB No.: 18-137 Pe, K.SING
WASTEWATER DISP❑SAL SYSTEM DETAILS
SOUTH HILLS SUBDIVISI❑N LOT 4 BLOCK 4
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FLAG PROPERTY LINES
2 WELL RADII & EASEMENTS
PRI❑R TO C❑NSTRUCTI❑N scale; 1°= 30'
N 40:1111.7.6.11601, PAGE 2 OF 2
W
Ar,- � . . &_s. 1 PREPARED FOR: .�CTER
L' #A � ti'''
KEN & BAERBEL EPPERSONoti Q ...
�q ��/ 7601 OLD HILLSIDE WAY �
/ * :4• TH /\ -0* I ANCHORAGE, AK 99516 (!$\907-441-0933•
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I. FESSIOTZ
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DWG. FILE: GRID: SW2940 Ct` CG �G' �1
\��� ACRD FILE FILE No.: 4-' `s�TING •�36 l�
FILE 18-137 AK.99577'
�RCTER,i,_ ^ ��`\
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i ' CONSULTING, INC / 1 --"k" y
' 0 f 212 E. 515t Ave,Anchorage, AK.99503 * 4• TI1 i
---,1`f���S�ATING•�,,c... Office(907)868-3791, Fax(907)868-3793
9 KENNETH M. DI., er x /
SOILS PERCOLATION TEST ,%;,' 7116 44/
% zYiiks G
Performed for: KEN EPPERSON Date Performed:5/7/2018 li,\'�F�:sstoi
`a
Project: SOUTH HILLS BLOCK 4,LOT 4 TEST HOLE II TH 18-1
Depth
(Feet) . SEE ATTACHED SITE PLAN
iiiii1l � i Org/OL
FOR HOLE LOCATION
1'"-Ill g
4 y Was Ground water encountered? NO What depth? NA
2-4 1: .
14 :.�
1 Depth to water after monitoring? NO Date? 5/11/18 4 Sr/upv
3- '"r'71
it 4d�� "
4-
. �: SP/GP/gm-sm mod dense,trace of Reading Date Gross Net Depth to Net
5- 7 f
5 silt,w/cobbles to 1' Time Time Water Drop
. >
x<* ' 1 5/8/18 1:00
-2''`'C' '' 2 1:10 10 min 6/16" 5 10/16"
4,:;4'.?'''''
0e70'
8 "#1'4,441:! 3 * 1:11 - 6" _
,
K'
9- � ' ','
� .
, 4 1:21 10 min 8/16" 5 8/16"
'.4 5 * 1:22 6"
,4
1 1-f,y;;,;,‘,84-.A 6 1:32 10 min 8/16" 5 8/16"
PA ,A.}y
F S
12- 7 * 1:33 - 6" -
13- r` ' 8 1:43 10 min 10/16" 5 6/16"
14- "„.) ` 9 * 1:44 - 6" -
15-A';.74:-.0''• 10 1:54 10 min 9/16" 5 7/16"
16- 4, 11 * 1:55 - 6" -
17-'-v, 12 2:05 10 min 10/16" 5 6/16"
B.O.H.
18- * Water Added
19- Percolation Rate 1.8 (min/in) Perc Hole Diameter 6"
HOLE PRESOAKED
20- PRIOR TO TEST Test Run Between 4.5 feet and 5.5 feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State
and Municipal guidelines in effect on this date.
OLD AR BBIT -" ---- — —
ROAD
0
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885'47'29"E 153.01'
(885'52'10"E 152.95' R)
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S83.42 28.0. �,
Q OF 3.38' (153.50' R) 3a. ' :;
_ _ "� BASIS BEARING
— HILLSIDE WAY
-------, _ _
ANCHORAGE RECORDING DISTRICT,ALASKA — �-�........
ASBUILT OF:
SOUTH HILLS SUBDIVISION O =FND REBAR
LOT 4 BLOCK 4 PLAT P-636 ''_`"\`
SURVEY CERTIFICATE:I,John L.Schuller,Have conducted a _ T� OF 4z A` 'y ,LAND v.k
III physical survey of this property as shown on this drawing and that the /// .`�;.•'' •.:�Q��' �4•�10 S ��j.
improvements situated hereon are within the property lines and no c�..•• '�
enchroachments exist other than noted.Under no circumstance should 0 .' 49TE , -�
any information on this drawing be used for construction of fences, % A ry +,
structures,improvements,or for establishing boundary lines. / 5 U Cry
til �`' �..,
EXCLUSION NOTES:It is the owners responsibility to determine �D . \.
1 co • OHN L. SCHULLER.• 0/
the existence of any easements,covenants,or restrictions which , o. •�� •
do not appear on the recorded subdivision plat. ,'� LS-10408 .?' ...,�._,,,r
WORK ORDER NUMBER: DATE SCALE E-►�� s .4'2-T•i •• g°jam 1831 Talkeetna Street
It o i Anchorage, Alaska 99508
APR 25, 2018 M BY:CiEOCED B15 ORM �ae0' BOOK/PA : \��,°fessiono\ s'�� (907) 227-1455 office
18-019 JLS SW2940 180130 ‘\ (907) 274-4992 fax
MUNICIPALITY OF ANCHORAGE
DE[ ,TMENT OF HEALTH AND HUMAN SER~, ~S
Environmental Health Division
,., 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LEGAL DESCRIPTION
Township, Range, Section
TANKS
~PTIC ~ HOLDING
TYPE OF SYSTEM
NCH [] BED [] We DRAIN [~ OTHER
FiLl added above original grade
FT
Gravel width
FT
Distance between lines
P~pe material
Date Installed
WELLS
7otal absorption area,~,//~..O SO Et
Number of I~nes ~od rating
/ /5-cb SOFT
Installer
Gravel depth beneath pipe
~'"", O FT
~* ~ FT
FT
[~PRIVATE [] OTHER (Identifv)
Classdicahon (A,B,C) Total Depth ET Cased to F'JF
Installe~ Date InstaHed:
REMARKS:
DISTANCES
SEPTIC
TANK
WELL
LOT LINE
FOUNDATION ,,~ '"7 '
ABSORPTION WELL
FIELD
11'3'
I0'
AS-BUILT DIAGRAM (Show location of well, septic system, property hnes, foundation,
driveway, water bodies, etc,)
Scale:l~m'~)
Inspections Perfo~d by:
Health D epa.ment Approval; ~ . .... Date: :~h:h:
72-013 (3/85)
CIPRLiT¥ OF ~NCHOR~GE
9EPAR!MENI' OF HEALIH AND ENVIRONMENIAL PROTECTION
825 L SI'REET~ ANCHORAGE~ AK 99501
264-4720
ON-SITE SEWER PERMIT
APPLICAN'I: BARBARA EPPERSON
~DORESS: 7601 HILLSIDE NAY
RNCHORAGE, AK ~9516
CONTACT PHONE: 545-!0~4
LEGAL DESCRiP: SUBUIVISiON: SOUIHHiLLS
SECTION: 25 }OWNSHiP: !SM
LOT SIZE: 51135 iS~.FI~ OR ACRES)
~A× BEDROOMS: ~
BLOCK:
Listed beiom are the options available to you ia designing your smptic
~vstem~ Choose the option that best iits your site.
TRENCH BED W.DR~
DEPTH TO PiPE DOTTOM (FT.) 4~0 3.0 m, 4.0
GRAVEL BEPI'W (Fi'.) 3.0 0.5 2.0
TO~AL ~EPTH (FC) 7.0 .~5
GRAVEL LENGIH (Fl. } 75.0 36.0 65.0
GRAVEL VOLUNE (CU.YDS.) 24.4 25.4 29.2
TAN~ S~ZE (GARS) ~000.0 ~ I~000.0 *~ i~000.0
SOiL RATIN~ (SO.FT./DR} I50 i50 t50
DEPTH TO PIPE GOITOH < 2.5 Fl'. REQUIRES INSULATION
DEPTH TO PIPE BOTTOH < 4.0 FT. MAY REQUIRE A LiFT STATION
TANK MUST HAVE Al LEASi' lWO COMPARTMENTS
certi!y that:
! am Familiar with the requirements !or on-site sewers and wells as set
~orth by the Hunicipal~ty oF Anchorage (MOA) and the State o~ Alaska.
I wiii instmll the system in a~cord~nce with all MOA codes and regulmtions~
and in compiimmce mith the design criteria mi this permit.
! mit! adhere to ali HOA and State mi Alaska requiremeots for the set back
distances irom any existing me}i~ mastemater dzsposat system mr public
sewerage system on this or any ad&acemt o¢ oearby lot.
i understand that this permit ~s valid CDr m maximum mi ~ bedrooms and
any enlargement milt require an additional permit.
iF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES~
THEN (I) AN ELECTRICAL PERMIT AND iNSPECTION HUSl BE O8[AINED~ (2) AS-GUiLTS
WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT~ AND (S) THE
ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN.
APPLiCAWI: BARBARA EPPERSON
~ W~bL
SEWER SYSTEM LOCATION PLAN
e
NORTH
LOT
BLOCK ] ,~IUBDIVI$10N
NOTE,
FOR,
SHEET
PERFORMED FOR:
LEGAL DESCRIPTION:
4-'~ · ~
7
8
14-
15
16
17
18
19
20
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
-OF
Township, Range, Section:
SLOPE
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
SITE PLAN
/llll
E
Depth to Water ~ter
Mo. itori.0? ~a [t?~ ,ate: /~5~/i¢~
Gross Net Depth to ~Net~'~
Reading Date Time Time Water ~.~op
PERCOLATION RATE --
(minutes/inch) PERC HOLE DIAMETER __
TES,~T RUN BETWEEN FT AND ET
P ERFORMEDBY: ~ O,,~ , //~/5~ O ERTIFYTHATTHISTESTWASPERFORMEDIN
ACCORDANOE WITH ALL STATE AND MUNICIPAL GUIDELINE~IN EFFE//ON THIS DATE. DATE:
_OGREt
'R ANCHORAGE AREA BOR' GH
Department of Environmental Quality
3500 Tudor Road
Anchorage, Alaska 99507
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME/~. ,~'/'~--~'~'~/d2/ MAILING ADDRESS,~-P-'~'/ .~/~ .~
LOCATION ~%~:~ .X ~ LEGAL DESCRIPTION
SEPTIC TANK:
DISTANCE /_
FROM WELL :~,F~
INSIDE LENGTH
~,~:: NUMBER OF
MANUFACTURER ~- ~'~"~/--- MATERIAL % ~.~.2/-- COMPARTMENTS
INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY /~'~ GALLONS.
SEEPAGE PIT:
NUMBER OF PITS / DIAMETER _ OR WIDTH /~, LENGTH//~, DEPTH
LINING MATERIAL~Zf~2~~'' CRIB SIZE: DiAMETER~.~i~EPTH ~2 /DISTANCE FROM:
/~-/""~ .. TOTAL EFFECTIVE
BUILDING FOUNDATION~ , NEAREST LOT LINE
ABSORPTION AREA (WALL AREA) /~'L/¢~ SQ. FT.
ADDITIONAL ABSORPTION
WELL:
TYPE /¢/-;¢P/~'~?:¢ CONSTRUCTION ~ ~ ¢~//~:~/;JZ DEPTH
BUILDING NEAREST /¢2-~ ¢~¢¢~/~A REST SEPTIC
FOUNDATION/~;~ , LOT LINE/X;//4/ SEWER LINE '~- TANK
C ESS PO O L///'~- ~
OTHER SOURCES
DISTANCE FROM:
_6--:/2 ~ SEEPAGE ~.~".b- /
.. SYSTEM
APPROVED /i/g.' DISAPPROVED
DISTANCES:
· INSTALLED BY: ,~7-~/,./72'
PIPE MATERIAL:
L%:~~ %?"
LOT SLOPE: .x/ D/ .¢..>/ .
Form PW-026
DIAGRAM OF SYSTEM
DATE , ~; ' '' , --
~ >" '2 G.A.A.B.
m-~Af DRILLING, Inc.
P. O. Box 4-1728 e 2811 Dawson
H C 907-279-1741
ANCHORAGE, ALASKA 99509
DRILLING LOG
Well Owner. /fF~Ytt,'~T//
Use of Well Dom
Location (address of: Township, Range, Section, if known; or distance main road
_5c~ :~ 7-/z~, ,~3u .sm O~lO~-y~.4xu l¥~t~t/~.~
Size of casing
Depth of Hole ~' feet Cased to 7~ feet
Static water level
Screen (
~o ft. ( ~i~o~ )
); Perforated (
Describe screen or perforation
Well pumping test at 2~4
gallons per (tiff/f)
of drawdown from static level.
(below) land surface. Finish of well (check one)
).
(minute) for ~ hours with . !C.O?J.
Date of completion.. 23 June
open end ( X );
ft.
WELL LOG
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
0 TO 10 S~lty O ~-,,'
o~.,~..~,.e, Gravol,.
TO 71 Sil'- ~
TO_ 75
TO_.
TO
TO
.TO_
TO...
TO..
TO.
TO
TO
.TO..
TO.
TO...
10
71
.. Sondv ~rovel: wat?.tb~r~r~,.~,L
' ' GRE~-,, ,-'R ANCHORAGE AREA BOR,....~;~GH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD POUCH 6-6510
ANCHORAGE, ALASKA ~95102
TELEPHONE 279-8686
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
PHONE ~ 7~,-lZz 7
, OTHER
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
/i/
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
TO NEAREST LOT LINE.
DRAIN FIELD
, DRAIN FIELD
SEEPAGE PIT /& ~'*)
WATER MAIN TO SEPTIC TANK , SEEPAGE PIT
DRAIN FIELD
SEPTIC TANK, '~'~ i //0~ ~'
, SEEPAGE PiT , DRAIN FIELD
TO RIVER LAKE STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON_SEPTIC TA~K AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO E~oRo EGULATIONS REGARDING INSTALLATION.
DIAGRAM OF SYSTEM
HEALTH AUTHORITY
OR
LICENSED DESIGNER
I CERTIFY THAT ] AM FAMILIAR WITH THE REQUIREMENTS OF GREATEI
DATE ~C~' '7 '' ~:~ APPLICANTS SIGNATURET?N
ANCHORAGE I~EA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
ItEALTH DEPARTMENT
32? EAGLE STREET
ANCHORAGE, ALASKA gg501
Performed
For
Legal Descrip~'i~on: LOts~l~Log~- B'~'ock~]~ .S~d~vision. ~fon25'~'~'v~ ~)~
This Fopm Repo~s a; -- .
Depth
Feet Soil Characteristics__. __.
Was Ground Wa~em Encountered?
If ,Yes, A~ W~a~ Depth
I Reaclng
Location Sketch
Da~e i Gross Time Net Time I Deoth To H20 Ne'~ Drop
~nu-ce .....
Proposed Installation; Seepage Pi~ / Drain Field
,~e~n To Bottom Of Pit Or Trench '~'
Depth Of Inlet .... '
Tes~ Performed ~): ~'~ < ]
Da=a Certified By: ......
August 16, 1972
~,ir. & Mrs. Kenneth R. Epperson
4601 Garfield, Apartment 3
Anci'iorage, Alaska 99503
Subject: On-Site Sewer and Water System
Lot 4, Block 4, South Hills Subdivision
Dear Mr. & Nfs. Epperson,
On June 30, 1972, this Department inspected the on-site sewer
system and well at the above subject location. Th~ septic
'tank anu seepageppit is approved by this DepartmeFmt. We
cannot approve the well as it is located approximately 85 feet
from tae seepage pit and does not meet the 100' minimum
required distance. While we are not taking any legal action
in this matter, we can)'~ot, approve t~e well for ti)is reason.
The well is at an approved def)th of 74 feet and is of
approved construction.
If you nave any furti)er questions, please do not hesitate to
con,act us.
Sincerely,
C. S. McKechnie
Environmental Control Officer
bb
cc: Lee Struer, Design North
MUNICIPALITY F ANCHORAGE
0'
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. 017.072-13 Expiration Date: "' 0-2 021
1. GENERAL INFORMATION
Complete legal description SOUTH HILLS BLOCK 4, LOT 4
Location (site address) 7601 OLD HILLSIDE WAY, ANCHORAGE, AK 99516
Current property owner(s) ADAM E. HARTIG
Mailing address
Real estate agent
Day phone
7601 OLD HILLSIDE WAY, ANCHORAGE, AK 99516
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
3
4. TYPE -OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
®
Private Septic
Water Storage
❑
Holding Tank
❑
Community Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Waiver request for: Distance:
Received by:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSAFee$ gm5orcmD-I��
Date of Payment T I a �/ a o� -o
Receipt Number Rb6 21`7
cosA # OS C- a� l 5 33
Date:
Waiver Fee $
Date of Payment
Receipt Number
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. I acknowledge that On -Site staff may visit the site to verify the information submitted.
Name of Firm FIRST WATER CONSULTING Phone 907-350-9566
Address 13030 SUES WAY, ANCHORAGE, AK 99516
Engineer's Printed Name CURTIS HUFFMAN, PE Date 9/2512020
Comments: This investigation was completed in compliance with MOA guidelines, regulations,
and best industry practices / methods. The assessment of the condition of the well and septic
applies only to the conditions as of the day tested. The flow and absorption rates may change
due to subsurface conditions that may not be observed from the surface, -changes in land use,
local soil characteristics, groundwater levels that may fluctuate during the year, quality of
construction (workmanship & materials), the water usage of the family being served by the
system and maintenance. The operational life of all well and septic systems are subject to
these various and dynamic characteristics and are outside the control of the evaluator of the
well and septic system. Therefore, any estimate of how long a system will function satisfactory
�'•' l
• • • :1 �'
for current or future occupants or guarantee that no unseen encroachments, deficiencies or
discrepancies be by First Water
���Q:.
W g•
1%I
exist can given Consulting & fW[.5
-49
.. .. .. , , , , ;,
`
6. DSD SIGNATURE
Curtis Huffman '
System #1 Approved for bedrooms�F,q�s•,
CE 128991`��
}i
O .9125/ZOk �!
�l ROFESS10 a
System #2 Approved for bedrooms
tea����4�
Disapproved
Conditional approval for bedrooms, with the following stipulations:
''iM))limV,,-
Original Certificate Date: 2-02 d
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 work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
Legal Description: SOUTH HILLS BLOCK 4 LOT 4 Parcel ID: 017-072-13
If more than 1 septic system on lot: COSA Checklist # _of
A. WELL DATA
® Well log is filed with Onsite (or attached)
Date drilled 6/28/1972
Total depth 75 ft
Cased to 73 ft
® Sanitary seal is functioning correctly
® Wires are properly protected
Casing height (above ground) 12+ in.
Date of flow test for COSA 9/24/2020
Static water level at beginning of test 55 ft.
Well production at time of test 1.58 gpm
Comments
B. TANK DATA
Age of tank(s) 2 years
Tank type/material SEPTIC / STEEL
Measured operating fluid level in septic tank 48"
® Standpipes/foundation cleanout per record drawing
Date of pumping 9/24/2020
D. ABSORPTION FIELD DATA
Which system tested (date installed) 5/21/2018
® ALL standpipes present per record drawing
Total measured depth from grade 12.8 ft (max)
Measured depth to pipe invert from grade 4.8 ft (min)
❑ N/A — pressurized field
® Monitor tubes go to bottom of effective. If not, state
depth into effective
® Code -required soil cover over field
❑ System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced gallons
Com ments/Deficiencies:
Structure served by this system _
Water storage tank volume NA gallons
Well disinfected for coliform test? ® Yes ❑ N
® Coliform bacteria is Negative
Nitrate 2.63 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ® Arsenic less than MRL (ND)
Collected by
WE& SULLIVAN
Date of Sample 9/24/20 & 9/29/2020
C. LIFT STATION
❑ Required maintenance completed
Age of lift station _ years
Lift station material
Comments:
Adequacy test date 9/24/2020
Results M Pass For 3 bedrooms
Fluid depth prior to test 0 in
Water added 690 gal
New depth 22 in
Elapsed time 80 min
Final fluid depth 0 in
Absorption rate 450 gpd
Any rejuvenation treatment (past 12 months) N
If yes, enter date
0
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100'
® Yes
if No
Community Sewer Manhole/Cleanout > 100'
® Yes
if No
ft
® Yes
if No
Neighboring Tank > 100' ® Yes
if No
ft
Private Sewer/Septic Line > 25' ® Yes
if No
Absorption Field on Lot > 100' ® Yes
if No
ft
Holding Tank > 100' ® Yes
if No
Neighboring Absorption Fields > 100'
if No
ft
Animal Containment > 50' ® Yes
if No
® Yes
if No
ft
ft
If septic tank is under driveway comment below
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ® Yes
if No
ft
® Yes
if No
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 _
Property Line > 5'
® Yes
if No
ft
Wells on Adjacent Lots:
® Yes
Absorption Field > 5'
® Yes
if No
ft
Private Wells > 100'
® Yes if No _
Water Main > 10'
® Yes
if No
ft
Community Wells > 200'
® Yes if No _
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'
® 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'
® Yes
if No
ft
Private Wells > 100' ® Yes if No —ft
Water Service Line > 10'
® Yes
if No
ft
Community Wells > 200' ® Yes if No
Surface Water > 100'
® Yes
if No
ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION �►►i�����'`,N>k1
law
1 certify that 1 have determined through field inspections and reviewAW-
of Municipal records that the above systems are in conformance g • •:�
with MOA COSA guidelines in effect on this date. : • i '•
• Curtis Huffman
�� �'c j•. CE 128991 • •�`��
c�lF ' • .10/6/2Q29' &§ •�'
ft
ft
ft
ft
ft
ft
ft
ft
•
•F Municipality of Anchorage , 14,r, ;+ `e
On-Site Water and Wastewater Program <''
(907) 343-7904 A ErY
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 017-072-13 Expiration Date: al ..2 q, ;o 1
1. GENERAL INFORMATION
Complete legal description SOUTH HILLS BLOCK 4, LOT 4
Location (site address) 7601 OLD HILLSIDE WAY,ANCHORAGE,AK 99516
Current Property owner(s) KEN &BAERBEL ESPPERSON REV.TRUST Day phone
Mailing address 7601 OLD HILLSIDE WAY,ANCHORAGE,AK 99516
Real Estate Agent Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
O Duplex
O Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
TYPE OF WASTEWATER DISPOSAL:
4. TYPE OF WATER SUPPLY: Individual
Individual Well ® Holding Tank ❑
Individual Water Storage ❑ Community ❑
Community Class Well 0 Public Sewer ❑
Public Water System ❑
WaiverNariance request for: Distance:
Received by: /! / // / ��'` � Date:
COSA to be released to the engineer,unless otherwis e i ested by the engineer.
COSA Fee $ Waiver Fee $
Date of Payment 5--/ can Date of Payment
Receipt Number 09SCOOD Receipt Number
COSA# d5 U r .ZI 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 ARCTERRA CONSULTING,INC. Phone 868-3791
Address 20441 PTARMIGAN BLVD.,EAGLE RIVER,AK 99577
Engineer's Printed Name KENNETH M. DUFFUS Date 5/23/2018
THIS COSA DOCUMENT CANNOT BE USED TO TRANSFER TITLE UNLESS ALL VENDORS(ENGINEERING,SURVEYING,CONTRACTORS,ETC...ASSOCIATED
WITH THIS COSA ARE PAID IN FULL AT OR BEFORE CLOSING. Engineer's Comments: This investigation was completed in compliance with
ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested.
The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use,
local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the
system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the
control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function
satisfactory for current or future occupants or can ArcTerra guarantee that no unseen
encroachments,deficiencies or discrepancies exist. • � OFAL �
Aar
1 * 4• I * t
6. DSD SIGNATURE
System #1 Approved for 3 bedrooms. �!
KENNETH M. .
System #2 Approved for bedrooms. , � 7116
Disapproved. \ '°'OFEss o��`" Aley
Conditional approval for bedrooms, with the following stipulations:
o� ANCioR,
C.) DAARp.NOR •
o•.
o `NPScOC?R
PR ce•
n4hA�t,IT
By: -R 'aa Original Certificate Date: a.4• (21-1 201
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 work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet 10-10-12.doc
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system
Certificate of On-Site Systems Approval Checklist
Legal Description: SOUTH HILLS BLOCK 4, LOT 4 Parcel ID: 017-072-13
A. WELL DATA
Well type PRYT If A, B, or C provide PWSID# Well Log (Y/N) Y _
Date completed 612811972 Sanitary seal (Y/N)Y Wires properly protected (Y/N) Y
Total depth 75 ft. Cased to_73 ft. Casing height (above ground) 18 in.
FROM WELL LOG AT INSPECTION
Date of test 6/28/1972 4-18-2018
Static water level 50 ft. 57 ft.
Well production 2-4 g.p.m. 0.95 g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 mL Nitrate 1.64 mg/L
Arsenic: ND ug/L Date of sample: 518/2018 Collected by: ARCTERRA
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC I STEEL Date installed 5121/2018
Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N)Y _
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N
Date of pumping NA-NEW TANK Pumper
C. ABSORPTION FIELD DATA d
Vee-
Date
PPDate installed 5/21/2018 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.2 System type .SHAL TRENCH
Length 24 ft. Width 3 ft. Gravel below pipe 8 ft.
Total depth 11+ ft. Eff. absorption area 384 ft2 Monitoring tube Y Depression over field N
Date of adequacy test NA-NEW FIELD Results (Pass/Fail)_ For bedrooms
Fluid depth in absorption field before test_ in. Water added _gal. New depth in.
Elapsed Time: min. Final fluid depth in. Absorption rate >=_ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N &type)_ If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access(Y/N)
"Pump on" level at in. "Pump off' level at in. High water alarm level at in.
Datum Cycles tested Meets alarm&circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main 75'+ Public sewer manhole/cleanout 100'+
Sewer/septic service line 25'+ Holding tank 100'+ _
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 10'+ Property line 5'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main 10'+
Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain 50'+(NONE KNOWN) Wells on adjacent lots 1001+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in conformance
with MOA COSA guidelines in effect on this date. A! OF ALS
Engineer's Printed Name KENNETH M.DUFFUS /��� 1-11
Date 5123120184; Til ��
COSA canary sheet_2-6-15.doc
KENN
vtt:
g-is ador
ss►o
114'Nkh.` 110411°-
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT i o iktrT) 907-343-7904
On-Site Water and Wastewater Section ` Fax: 343-7997
www.muni.org/onsite
Well Water Advisory
Certificate of On-Site Systems Approval # OSC181228
Subdivision: South Hills, Block: 4, Lot: 4
This well's productivity was determined to be 0.95 gallons per minute. The
minimum well productivity required under (AMC 15.55) for a 3-bedroom residence
is 0.31 gallons per minute or 150 gallons per day per bedroom. Although the
subject well currently exceeds this minimum requirement, the production capacity
can fluctuate and may be insufficient to meet your needs.
This advisory must be attached to all copies of the subject Certificate of On-Site
Systems Approval.
Mailing Address: P.O. Box 196650 *Anchorage,Alaska 99519-6650 *www.muni.org
SGS Ref.# 1181993001
Client Name ArcTerra Engineering and Surveying Printed Date/Time 05/14/2018 16:24
Project Name/# South Hills B4,L4 Collected Date/Time 05/08/2018 9:15
Client Sample ID Spigot Received Date/Time 05/08/2018 9:35
Matrix Drinking Water Technical Director Stephen C.Ede
Sample Remarks:
Allowable Prep Analysis
Parameter Results LOQ Units Method Container ID Limits Date Date Init
Metals by ICP/MS
Arsenic ND 5.00 ug/L EP200.8 C (<10) 05/09/18 05/10/18 VDL
Waters Department
Total Nitrate/Nitrite-N 1.64 0.100 tng/L SM21 4500NO3-P B (<10) 05/08/18 AYC
Microbiology Laboratory
E.Coli Negative 1 100mL SM21 9223B A 05/08/18 K.W
Total Coliform Negative 1 100mL SM21 9223B A 05/08/18 K.W