HomeMy WebLinkAboutCROSS VIEW ESTATES BLK 2 LT 6ACross Vi*ew
Estates
Block 2
Lot 6A
#015�221�89
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program, 4700 Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number SWO90235 PID Number. 015-221 —410 2-9—
Name: COLONY BUILDERS
Wastewater System: X New 0 Upgrode
Address:
9420 VANGAURD DR * ANCHORAGE. AK * 99507
ABSORPTION FIELD��
Phone: No. of Bedrooms:
(907) 345-0371 5
0 Deep Trench 0 Shallow Trench 0 Bed 0 Mound 0 Other
LEGAL DESCRIPTION
$a Itatkq:
0.6
Total Depth trant 6donal grade:
10.92 MAX
WO/Sq. FL
FL
Block: Lot: Subdivision:
D-Pth 10 Pl" b0ttant ftWM "� QMX1a;
GMW dapth b..*ath p1pa:
2 6 CROSS VIEW ESTATES
SEE DWG. FL
7.11-7.03 FL
Township: Range: Section:
n1l odd.4 oNwa orlTnal qnxle;
SEE DWG.
Gl" langth:
45 & 46 (91 TOTAL)
In.
Ft.
WELL: 0 New 0 Upgrcde
GMel w1d9u.
2.5
� & Arwe:
2
JDM_
1477
In.
Cla.fic� (Pfi�k A.B.C):
rata Dpft-
I To:
Toltal obmVtWn G'SCI;
P'" tnateftl:
PRIVATE
1 265 J'255
,
1280 so. mi
D 3034/ F-810
DrW�.
ALPINE DRILLING
Dats Drillad:
24-27/091
lstat4 Water Lsoi:
227
sat~
RED DOG MASONRY
We "~
1 12/2-4-2009
ywd:
5
I P� sat 152
"I"t � &�:
24+
TANK
cft
Ljc
rL
SEPARATION
DISTANCES
0 Septic 0 Holding 0 S.T.E.P. 0 Others
Septic
Tank
Absorption
Field
Lift
Station
Holding
Tank
P=Pir.1-14
kla�vloct�.
ANCHORAGE TANK
capacity in "lorw.
1500
I
Well
100'+
100'+
—
25'+
"*na': STEEL
kwnta, of cvn,p�ts: 2
Surface Water
100'+
too'+
-
-
LIFT STATION
Lot Une
5'+
10'+
—
I
Foundation
5'+
10.+ 1
—
I —
I —
�P—� an" iavai at = at:
I F4h wat. olomt at:
Curtain Drain
NONE KNOW'N
777�=
Remarks:
BENCH MARK
THRESHOLD OF WEST DOOR NEAR POINT "A"
E� 100.00 r,
Inspections performed by: GEG, Ltd. Dates: 1st 12/2/2009
ENGINEEWS SEAL
2nd_12/3/2009
3rd 12/4/2009
.'b
Development Services Department Approval
C9 T
.. ............
Conditional approval: DatE
... . . .... .............
.. f y . orness.-
1P
E-7953
...
Reviewed and approved by: Date:.57. 1-10
00, P* at
rofeSSIot'
(R.. 4/06) e5;1"
L,
PERMIT NUMBER: PARCEL ID NUMBER:
SWO90235 AS -BUILT DRAWING 015-221-68
A
FCO
36.12
18.13
ST1
4D.95
21.17
ST2
46.19
28.18
DBLI
5D.DO
33.31
DBL2
51.38
35.31
SPL
56.28
39.66
COI
59.51
37.96
MT 1
59.84
38.77
CO2
=105. 67 - 14
-
_iF2
105.84
CO3
54.34
3.94
WT3
54.98
d6856
54.81
C04
96.48
70.19
WT4
96.06
6884
NEW
DRAJNFIELDS
100' WELL RADIUS
NEW 5 BEDROOM
HOUSE , . ..' /
NEW 1500 GALLON
SEPTIC TANK
n ALTERNATE SITE
1]111A WILL REOUIRE
ADV
ANCED TREATMENT
UPPER
HERITAGE
CIRCLE
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
3"1 L 101 - MCHOWL M �? - � - F" - �'
PREPARED FDR; PHONE NUMBER: PAGE NUMBER: A
f ey A.
COLONY BUILDERS 907-345-0371 2 OF 3 CE 7
LEGAL DESCRIPTION: DRAWN BY:
CROSS VIEW ESTATES S/D; BLOCK 2, LOT 6 A.J.G.
TYPE OF WORK: DATE: Qptofel
AS—BUILT DRAWING OF NEW SEPTIC SYSTEM 5 6 2010
PERMIT NUMBER: PARCEL ID NUMBER:
SWO90235 AS -BUILT DRAWlNG 015-221-68
FINAL GRADE - 100.83—IDO.91
INSULATION (PER CONTRACTOR)
ST2
IT1
TOP OF TANK AT
INLET - 97.22--\ /—TOP OF TANK AT
I I I I OUTLET - 97.18
171 r—
L4 L
NEW 1500 CALLON
INVERT OF SUNG SEPTIC TANK INVERT OF BUNG AT
AT INLET - 96.22 1 1 OUTLET - 96.01
IWEST DRAINFIEL
ORIGINAL GRADE - 99.33
rUS—TDRAINFIELD
0 HIGHEST POINT FOR
FINAL GRADE -
1 DO.34-100.56
BOTH TRENCHES
FINAL GRADE -
8-100.74
TH#1&2 ��FIOER
FABRIC
7
r-1 - ,
_A�FILTER
FABRIC
RELATIVE ELEVATION OF BOTTOM
OF TESTHOLE - 80.33 (DRY)
_� �lzllsw
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS ........
SMI L 101 - ANCHOWAL M FM (WfO�"
PREPARED FOR: PHONE NUMBER: PACE NUMBER: .... .... .......
f Gar ss:
COLONY BUILDERS 907-345-0371 3 OF 3
LEGAL DESCRIPTION: 0 CE -
1P
CROSS VIEW ESTATES; BLOCK 2. LOT 6 A.J.G.
TYPE OF WORK: DATE: Is slol'o�
PROFILE AS—BUILT OF NEW SEPTIC SYSTEM —1 12/7/2009
(Re� 01*5)
Alpine Drilling
C41V
FAX NO. :907 345 0202 May.07 2010 09:3SAM P1
Alpine Drilling & Enterprises
Well Log
Permit Number.SW 090235 Date of Issue: 11-24-09 Parcel Identification Number: 015-221-6
Date Startedt 11-24-09 Date Completeds lf-27-09 Ts well located at approved permit location? x Yes [3 No
Legal Description: Cross View Estates Blk 2 Lot 6
Property Owner Name & Address: ColonyBuilders
9420 Van Guard Drtve
Anchorace. Alaska 99507
Borehole Data:
Soil Type, Thickness & Water Strata
Depth (ft)
From TO
Method of Drilling x air rotary [:]cabletool
Casing typel steel
Stick-up
0
2
Wall Thickness: al inches
silt
gravellysilt
2
7
7
190
Diameter: L5 inches Depth: W feet
Liner Type:
Diameter: — inches Depth: _ fee
silt
190
215
Casing stickup above ground: 2 fbet
Static water level (from ground level): 227 feet
gravelly silt 215 247
silty water sand& gravel
249
253
Pumping level.,,210 feet after
bedrock
253
265
2 hours pumping I gpm
RecovM Rate: I gpm
Method of Testing: gLa
Well Intake Opening Type:
0 Open End C3 Open Hole
0 Screened Start — feet Stopped feet
x Perforations Start2afbet Stopped=fect
Grout Type: benntonlie granules Volume: 2-t=
Depth: Start 0 feet Stopped ? feet
Pump: Intake Depth _ feet
Pump size _ hp Brand Name
Well Disinfected Upon Completion? x Yes [:] No
Method of Disinfection:
Comments:
Well Driller. Alpine Drilling &Enterprises
PO Eax 110496
Anchorage AK 99511
Well Drilling Permit Number: SW Date of Issue:
Parcel Identification Number: Replacement Only: YES NO
Legal Description
Lot 6, Block 2, Crossview Estates
Development Services Department
Building Safety Division
CrN
"<Z'
ILI I d_�
On -Site Water & Wastewater Program
4700 Elmore Street
Pump Manufacturer's Name: Fairbanks Aforse
P.O. Box 196650
Mark Begich
mayor
Anchorage, AK 99519-6650
w� muni.org/onsite
(907) 343-7904
Piticss Adapter Manufacturer's Name: Afaas
Pump Installation Log
Well Drilling Permit Number: SW Date of Issue:
Parcel Identification Number: Replacement Only: YES NO
Legal Description
Lot 6, Block 2, Crossview Estates
Property Owner Name & Address:
Colony Builders
Pump Installation Date: 0111112010
Pump Intake Depth Below Top of Well Casing: 252 feet
Pump Manufacturer's Name: Fairbanks Aforse
Pump Model: 5BO7212
Pump Size 314 hp
Pitless Adapter Burial Depth: 12 feet
Piticss Adapter Manufacturer's Name: Afaas
Pitless Adapter Installer: RedDog
Well Disinfected Upon Completion? 0 Yes [__1 No
Method of Disinfection: Recirc
Comments:
Pump Installer Name: Aarow Pump & Mell Service LLC
PO Box 11 0496,Anchorage, AK. 99511
(907) 346- 9355
Attention: Ile pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
MUNICIPALffY OF ANCHORAGE
Development Services Department
On -Site Water& Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT
Initial
Permit Number: SW090235
Date Issued: Nov 24, 2009
Expiration Date: Nov 24, 2010
Parcel ID: 015-221-68
Legal Description: CROSS VIEW ESTATES BLK 2 LOT 6
Design Engineer: 0855 GARNESS ENGINEERING GROUF Site Address: NHN
Owner Name: COLONY BUILDERS (BILL TAYLOR) Lot Size: 0 SO. FT.
Owner Address: 9420 VANGUARD DR Total Bedrooms: 5 Permit Bedrooms: 5
ANCHORAGE, A 99507 -
This permit is for the construction of:
n-1 Disposal Field [?] Septic Tank E] Holding Tank [:) Privy Private Well E] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. AJI 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 engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
k
Received By:
Date: o C7
Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Bragaw St.
P.O. Box 196650
Anchorage. AK 9951M650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 01";'-g9 7 - 06V
Property owner(s) COLONY BUILDERS (BILL TAYLOR) Day phone 345-0371
Mailing address 9420 VANGUARD DR. *ANCHORAGF. AK
Site address
Zip Code 99507
Legal description (Sub'd, Block & Lot ) CROSS VIEW ESTATES BLOCK 2. LOT 6
Legal description (Township, Section & Range) N/A
Lot Size 6 ?; 0a -) — Sq. Ft.
THIS APPLICATION IS FOR (Z all that apply):
Absorption Field
Z
Septic Tank
Holding Tank
El
Privy
El
Private Well
E
Water Storage
El
Number of Bedrooms 5
THIS APPLICATION IS AN:
Initial
Upgrade
Renewal
El
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal codes.
GARNESS ENGINEERING GROUP, Ltd.
(Signature ef ffepeft ewneF er euiheFired agen!)
off
Permit/Rush Fees: .5 -; 0 -zoo
Date of Payment: I I'Z�/"u ijz_-�_
Waiver Fees:
Date of Payment:
ReceiptNumber: 051-2-30 0q2qr_5 ReceiptNumber:
(Rev. 11/05)
GARNESS ENGINEERING GROUP,, Ltd.
CONSULTANTS & GENERAL CONTRACTORS � - - - --
November 12,2009
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Elmore Rd.
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907) 343-7904
Ref. Proposed NVell and Septic System for Cross View Estates; Block 2, Lot 6,
To whom it may concern:
The subject property is currently vacant and is not currently served by any sewer or water service. We are
proposing drill a private well, and install a 1500 gallon septic tank and a deep trench type drainfield. Two
new test holes were excavated on the property. The drainfield will be designed around the 30 foot radii of
both test holes. Comments regarding the design are summarized as follows:
1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the
percolation test results.
2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications.
3. SURFACE AVATERS: There are no surface waters within 100 feet of the proposed septic system.
4. TOPOGRAPHY: As can be seen on the attached design drawing the average topography below the
drainfield is a 20-25 percent slope running approximately northeast to southwest.
We are unaware of any 'Vverse impacts this installation would have on adjacent wells or septic systems.
If you have any questio0l please contact us at 337-6179. Thank you for your assistance.
P.E.,
NOMPit -
ached is a siteplan draming, a design drawing, one soil log, which are allpart of the designpackagefor
this septic systent. (Contact G.E G. Ltd. for 7 page constniction specification letter.)
3701 E. Tudor Road, Suitc 101 * Anchorage, AK 99507-1259
Ph: (907) 337-6179 0 Fax: (907) 338-3246 * Websitc: www.gamessengincering.com
CROSS VIEW ESTATES
BLOCK 2. LOT I I
v
/HERITAGE HILLS;
BLOCK 2. LOT 3
I \ \ I
HERITAGE MIU.�,
BLOCK 1. LOT
CROSS VIEW ESTATES
BLOCK 2. LOT 10
- — — — — — — — — - -
- - — - - - - - - t-1
1c)
THI
06
JLLJ
0
CROSS VIEW ESTATES
<
BLOCK 2. LOT 9
Lli
m
HERITAGE HILLS,
—J
BLOCK 1. LOT
HERITAGE HILLS;
BLOCK 1. LOT I
CROSS VIEW ESTATES
BLOCK 2. LOT 10
- — — — — — — — — - -
- - — - - - - - - t-1
1c)
THI
JLLJ
0
CROSS VIEW ESTATES
<
BLOCK 2. LOT 9
/ I \ I I � , vl� -t
CROSS MEW ESTATES
BLOCK 2. LOT 8 LnLI
CROSS VIEW ESTATES
BLOCK 2, LOT 7
61-c�
PROPOSED
5 BEDROOM H(
.e
BLOCK 2. LOT 4
R"OSED/ CROSS VIEW ESTATES
WELL
CROSS VIEW ESTATES
SED BLOCK 2, LOT 5 S E:
YSTEM
64 100'
NO ENCROACHMENTS
WITH IN 200 FEET SOUTH HUFFMAN ROAD
OF THE PROPERTY
OF
GARNESS ENGINEERING GROUP, l'td* fL"):-*14 . *. I
I . CONSULTANTS & GENERAL CONTRACTORS . . . ..... ........
101 - � W �7 FO (NYW�N"
PREPARED FOR: COLONY BUILD5RS IPHONE NUMBER: PACE NUMBER:
1 OF efr A.. or ss:
(BILL TAYLO 345-0371 2 op .. I
DRAWN 8 7
LEGAL DESCRIPTION: Y; cp
CROSS VIEW ESTATES BLOCK 2 LOT 6 pNB
qi- .
TYPE OF WORK: DATE: ofe 510
SITE PLAN 11/24/09
TH
THI
.e
BLOCK 2. LOT 4
R"OSED/ CROSS VIEW ESTATES
WELL
CROSS VIEW ESTATES
SED BLOCK 2, LOT 5 S E:
YSTEM
64 100'
NO ENCROACHMENTS
WITH IN 200 FEET SOUTH HUFFMAN ROAD
OF THE PROPERTY
OF
GARNESS ENGINEERING GROUP, l'td* fL"):-*14 . *. I
I . CONSULTANTS & GENERAL CONTRACTORS . . . ..... ........
101 - � W �7 FO (NYW�N"
PREPARED FOR: COLONY BUILD5RS IPHONE NUMBER: PACE NUMBER:
1 OF efr A.. or ss:
(BILL TAYLO 345-0371 2 op .. I
DRAWN 8 7
LEGAL DESCRIPTION: Y; cp
CROSS VIEW ESTATES BLOCK 2 LOT 6 pNB
qi- .
TYPE OF WORK: DATE: ofe 510
SITE PLAN 11/24/09
OF BEDROOMS: 5
PER DAY (GPD): 750
nON RATE/S: 20 MIN./INCH
D APPLICATION RATE: 0.6
DRAJNFIELD SO.FT.: 1250
IM DEPTH: 12 FEET MAX
2.5 FEET
1: 90 (2 0 45) FEET
APPROVED SAND FILTER: N/A
TVE: 7 FEET
nON FACTOR: N/A
. SO.FT.: 1260
LETTER THAT PERTAINS TO THIS DESIGN.
TO OBTAIN A COPY OF THE LETTER
CONTACT DEG. IFY PROCEEDING FORWARD
WITH THIS INSTALLATION, THE ENGINEER,
WELL DRILLER, CONTRACTOR AND
PROPERTY OWNER AGREE THAT THEY
HAVE READ THESE SPECIFICATIONS AND
AGREE TO ACCEPT THE TERMS AND
NOTE: THE CONTRACTOR
SHALL HAVE THE EAST LOT
LINE, AND ALL WELL RADII
FLACCED BY A REGISTERED
LAND SURVEYOR PRIOR TO
CONSTRUCTION.
CROSS MEW ESTATES
BLOCK 2. LOT 7
6 c-ol
,oioe- 7 \2
PROPOSED
DRAINFIELD
ALTERNATE SITE WILL REQUIRE
AN ADVANCED TREATMENT
UPPER HERITAGE
CIRCLE
rLL
PROPOSED WE
CROSS VIEW ESTATES
BLOCK 2. LOT 5
GARNL-SS LNGINLL'RING GROUP, l,td
CONSULTANTS & GENE RAL CONTRACTORS -- --, p ......
M* L MA ll� 101 �7 - P� (90?)W�ln - rM (907)�-U" - WEEM'
PREPARED FOR:COLONY BUILDERS IPHONE NUMBER: PACE NUMBER:
(BILL TAYLOR) 1 345-0371 1 2 OF 2
LEGAL DESCRIPTION: U"WN UT:
CROSS VIEW ESTATES BLOCK 2. LOT 6 PNB
TYPE OF WORK: DAIL:
SEPTIC DESIGN 11/5/09
IR.. olm)
A
N
S E:
M..Nw
40'
f.- w
le
_, Gor ess-'
—7
'Iff3
3
I . C, I orl
PROPOSED
5 BEDROOM
HOUSE
20-25%
TH12
THJ37
PROPOSED
1500 CALLON
SEPTIC TANK
2D-25%
INSTALL DOUBLE
CLEANOUTS
2D-25%
INSTALL FLOW
THII
A%
SPLrrrER
PROPOSED
DRAINFIELD
ALTERNATE SITE WILL REQUIRE
AN ADVANCED TREATMENT
UPPER HERITAGE
CIRCLE
rLL
PROPOSED WE
CROSS VIEW ESTATES
BLOCK 2. LOT 5
GARNL-SS LNGINLL'RING GROUP, l,td
CONSULTANTS & GENE RAL CONTRACTORS -- --, p ......
M* L MA ll� 101 �7 - P� (90?)W�ln - rM (907)�-U" - WEEM'
PREPARED FOR:COLONY BUILDERS IPHONE NUMBER: PACE NUMBER:
(BILL TAYLOR) 1 345-0371 1 2 OF 2
LEGAL DESCRIPTION: U"WN UT:
CROSS VIEW ESTATES BLOCK 2. LOT 6 PNB
TYPE OF WORK: DAIL:
SEPTIC DESIGN 11/5/09
IR.. olm)
A
N
S E:
M..Nw
40'
f.- w
le
_, Gor ess-'
—7
'Iff3
3
I . C, I orl
VIEW
( 2.
HILLS;
LOT 3
HERITAGE
BLOCK 1,
HILLS;
LOT 2
E HILLS;
1. LOT I
I
CROSS V
BLOCK
u
I
IV,
I rEj
(:;ACANT
=D
I
V ESTATES
2. LOT 0
qACA�LTD
CROSS VIEW
BLOCK 21'
CROSS VIEW
BLOCK 2.
GARNESS ENGINEERING GROUP, Ltd.
— , CONSULTANTS& GENERAL CONTRACTORS
Im, E � �. � 101 - � m � - � IWYIW�ln - ru (90m��
PREPARED FOR: CQLONY BUILD5RS IPHONE NUMBER: PAGE NUMBER:
(BILL TAYLOR 345-0371 1 OF 2
LEGAL DESCRIPTION: DRAWN BY:
CROSS VIEW ESTATES BLOCK 2 LOT 6 PN8
TYPE OF WORK: DATE,
TOPO 11 /2/0!
41 Copj—, OkArtl
. ....... .. *..-T*.,
..... . . .. ... ... .......
1p r y A. Gorness.:
h,p. CE -7 51
N
fro f 0 9 slo�d\
GARNESS ENGINEERING GROUP, Ltd.
. . 1. 1. 1 -CONSULTANTS& GENERAL CONTRACTORS
ISOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: CROSS VIEW ESTATES, BLOCK 2, LOT 6
PERFORMED FOR: COLONY BUILDERS (BILL TAYLOR) D)
DEPTH
(fe e ORGANICS TEST HOLE fl]
LOAM SOIL
CLAS III A 11
DRY
GW
zzzz-
11/12/2009
0
—
GP
—
M
3:30
GM
4.5"
CL
3
GC
—
OL
00000
SW
4:00
M,
0.,
SP
5
C
—
sm
—
Ol
4:30
30
SC
1.5"
SM/ML
DEPTH TO
GROUNDWATER
DATE
DRY
11/5/2009
DRY
11/12/2009
3:00
—
6.
—
I
SEE ATTACHED
SITE PLAN
DATE READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
11/6/09 1
3:00
—
6.
—
1 2
3:30
30
4.5"
1.5,
3
3:30
—
6'
—
4
4:00
30
4.5"
1.5*
5
4:00
—
6'
—
6
4:30
30
4.5"
1.5"
9 PERCOLATION RATE 20 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 6.5 FT. AND 7.5 FT.
:0 A FOUR HOUR PRESOAK WAS PERFORMED: 2 YES [:1 NO
SOILS LOGGED BY: KYLE MAUS PERCOLATION TEST PERFORMED BY: ANDREW CRAY
COMMENTS:
PERFORMED BY GEG. Ltd. 1. JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: "It 7-ILic;
GARNESS ENGINEERING GROUP,�,j!j�..
-CONSULTANTS& GENERAL CONTRACTORS—
ISOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: CHU55 VILW LblA[L5, MULA Z' LUI t,
PERFORMED FOR: COLONY BUILDERS (BILL TAYLOR)
DEPT
(fee ORGANICS
TEST HOLE
7T� I
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
LOAM
SOIL QLAS I ATII
DRY
11/5/2009
GW
:zzzz:
3:00
0
6.
GP
1 2
M
w
4.5*
1.5'
GM
3:30
CL
6.
—
GC
4:00
CIL
1 4.5"
1.5*
SW
4:00
M
6'
—
SID
4:30
C
4.50
1.5*
SM
01
SC
SM/ML
DEPTH TO
GROUNDWATER
DATE
DRY
11/5/2009
DRY
11/12/2009
3:00
—
6.
—
. . . . . .........
A. ness.-
E-79?31
SEE ATTACHED
SITE PLAN
DATE READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
1
3:00
—
6.
—
1 2
3:30
30
4.5*
1.5'
3
3:30
—
6.
—
4
4:00
30
1 4.5"
1.5*
5
4:00
—
6'
—
6
4:30
30
4.50
1.5*
9 PERCOLATION RATE 20 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 6.5 FT. AND 7.5 FT.
:0 A FOUR HOUR PRESOAK WAS PERFORMED: E YES 0 NO
SOILS LOGGED BY: KYLE MAUS PERCOLATION TEST PERFORMED BY: ANDREW CRAY
COMMENTS:
PERFORMED BY GEG. Ltd. 1. JEFFREY A. GARNESS, CERTIFY THAT THIS WAS P !FLRMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: �M 1p 1 6
CYARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS& GENERAL CONTRACTORS------
..... ... . .. .....
Fs-oi-L-LOG - PERCO ....... ..
LEGAL DESCRIPTION: HERITAGE HILLS SUBDIVISION #1; TRACT C&D (PROPOSED LOT 7 A ss:
CE -7 53 ..*
PERFORMED FOR: PROFESSIONAL TECHNICAL SERVICES DATE: NO,
A! .. 0 cld
DEPT M 0 P,
(feetY
wz:!!! ORGANICS ITH#37/PTS#580
LOAM SOIL CLASSIFICATIONS
2—
GW :=z==: ORG
3- GP ML
GM CL
4— GC OL
SW
MH
5— SP CH
SM OH SEE ATTACHED
6— SC SITE PLAN
7— DEPTH TO DATE
GROUNDWATER
8— DRY 9/2/2005
- :---- .. 1, '1'"
DRY 9/19/2005
9— DRY 10/23/200!
10— SM/ML
11 DATE READING CLOCK NET TIME WATER LEVEL NET DROP
TIME (MINUTES) READING (INCHES)
12— 9/7/05 1 2:10 - 6. -
1 2 2:40 30 0. 6'
13— 3 2:40 - 6. -
4 3:10 30 0. 6-
14— 5 3:10 6. -
6 3:40 30" 0. 6'
15-
16-
17—
B.O.11.
18 L
19 PERCOLATION RATE 05 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 5 FT.AND 6 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: E YES 0 NO
SOILS LOGGED BY: JODY MAUS _ PERCOLATION TEST PERFORMED BY: CALEB CALL
COMMENTS: *RECOMMEND USING A 0.6 APPLICATION RATE
PERFORMED BY CEG, Ltd. 1. JEFFREY A. GARNESS, CERTIFY THAT THIS WAS, PffORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 11.17,10%
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
Parcel I.D. 015-221-89-000
Expiration Date: 9/28/2023
Legal description CROSS VIEW ESTATES BLK 2 LT 6A
Site address 12179 UPPER HERITAGE CIR Anchorage AK 99516
Current property owner(s) MCKENZIE CHARLES LEE &PAULETTE G
X The On-site system(s) is/are approved for 5 bedrooms
Conditional approval for
Comments or advisories:
bedrooms, with the following stipulations:
Original Certificate Date: 6/28/2023
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
Tank Age Advisory Arsenic Advisory
Other
COSA Approval_June 2022
I
Development Services Department p P Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
_ � ,m
Certificate of On Systems Approval Application4
1. GENERAL INFORMATION
Parcel I.D. 015-221-89
Complete legal description CROSS VIEW ESTATES; BLOCK 2, LOT 6A
Location (site address) 12719 UPPER HERITAGE HEIGHTS *ANCHORAGE, AK
Current property owner(s) CHARLES MCKENZIE Day phone 907-440-8785
2. ON-SITE SYSTEMS SIZED FOR 5 BEDROOMS
3. TYPE OF WATER SUPPLY: O 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: 0 Steel ❑ Plastic ❑ Concrete ❑ Fiberglass
Age 13 - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑® Deep Trench ❑ Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: Q
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 $
Date of Payment
COSA# 6)'Sc2,S %Z/ -:�_
Waiver Fee $
Date of Payment
Waiver #
COSA Application—June 2022
COSA Checklist
Legal Description: CROSS VIEW ESTATES; BLOCK 2, LOT 6A Parcel ID: 015-221-89
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system
A. WELL DATA
❑� Well log is filed with Onsite (or attached) Well production at time of test ** � -J gpm
Date drilled 11/27/09 Total depth 265 ft Water storage tank volume *500 gallons
Cased to 255 ft Well disinfected for coliform test? ❑ Yes ❑N No
��nitary seal is functioning correctly 0 Coliform bacteria is Negative
E Wires are properly protected Nitrate 3.34 mg/L ❑ Nitrate less than MRL (ND)
Casing height (above ground) in. Arsenic ug/L 0 Arsenic less than MRL (ND)
Date of flow test for COSA ** l 3 1 )- 3 Collected by GEG
Static water level at beginning of test ** 22 '?ft*. Date 6/6/2023
Comments *PER HOMEOWNER **WELL TEST PERFORMED BY ANCHORAGE WELL AND PUMP SERVICE
B. TANK DATA C. LIFT STATION
Measured operating fluid level in septic tank 48 ❑ Required maintenance compl
Date of pumping I (0 2? Age of lift station ears
❑ Required maintenance completed, if AWWTS Lift station nal
Comments: ents:
D. ABSORPTION FIELD DATA
Which system tested (date installed) 2009
❑■ ALL standpipes present per record drawing
Total measured depth from grade 12.06 ft (max)
Measured depth to pipe invert from grade 4.4 ft (min)
❑ N/A — pressurized field.
❑ Per record drawings, field is insulated.
❑ Monitor tubes go to bottom of effective.
If not, state depth into effective 6.81
❑ Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced 2000 gallons 6/8/2023 date
Any rejuvenation treatment (past 12 months) NO
If yes, enter date N/A
Adequacy test date 6/9/2023
Results Q Pass
Fluid depth prior to test 13.75 in
Water added 1000 gal
New fluid depth 33.75 in
Elapsed time 192 min
Final fluid depth 26.75 in
Absorption rate 750+ gpd
FIELD STATUS — POST RECOVERY
Effective depth (per record drawings) 84 in
Effective depth used 26.75 in
Effective depth remaining 57.25 in
Comments/Deficiencies: ALL MEASUREMENTS SHOWN ARE FOR THE WEST TRENCH. ALL WATER FOR PRESOAK AND ADEQUACY
TEST WERE INPUT IN TO THE WEST TRENCH. THE LIQUID LEVEL IN THE EAST TRENCH WAS 24" AND REMAINED AT THAT DEPTH THROUGHOUT THE PRESOAK AND ADEQUACY TEST
COSA Checklist June 2022
E
1 , %Al C:7,9 L/4012?
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Building Foundations > 10'
0 Yes
Septic Tank/Lift Station on Lot > 100'
Community Sewer Manhole/Cleanout > 100'
Tank to Property Line > 5'
N
0 Yes if No ft
[E Yes
if No
ft
if No ft Private Wells > 100' Z Yes if No
Neighboring Tank > 100' 0 Yes if No ft
Private Sewer/Septic Line > 25' ■❑ Yes
if No
ft
4�
Absorption Field on Lot > 100' Yes if No ft
Holding Tank > 100' ❑■ Yes
if No
ft
adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG
Neighboring Absorption Fields > 100'
Animal Containment > 50' Q■ Yes
if No
ft
Z
p■ Yes if No ft
LICE SE �o f e s s10 0�
#AECC884
ST1 IS APPROXIMATELY 55"
INCHES FROM DECK PILE (SEE ATTACHED PHOTO)
Community Sewer Main > 75' ❑■ Yes if No ft
Manure/Animal Excreta Storage > 100'
Q■ Yes
if No
ft
Z
❑ 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'
0 Yes
if No ft Surface Water > 100' ❑■ Yes if No
ft ?
Tank to Property Line > 5'
Yes
if No ft Wells on Adjacent Lots:
�o ��
Field to Property Line > 10'■❑
Yes
if No ft Private Wells > 100' Z Yes if No
ft
Water Main > 10'
0 Yes
if No ft Community Wells > 200' ■❑ Yes if No
ft
Water Service Line > 10'
Q Yes
if No ft If tank or field is under driveway comment below
Q f A. a Hess•
adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG
y
QQ
to perform the evaluation. Reliance upon the information provided in this report by any other person or party
9 CE 795 �
0 (p �2 (p 2
F. ENGINEER'S COMMENTS
Q�rP e . 3Ao
COSA Checklist _June 2022
LICE SE �o f e s s10 0�
#AECC884
ST1 IS APPROXIMATELY 55"
INCHES FROM DECK PILE (SEE ATTACHED PHOTO)
CO2 IS PINCHED BUT STILL FUNCTIONAL; C04 IS FILLED WITH GRAVEL AND NON-FUNCTIONAL
HOWEVER, THE CLEANOUT AT THE BEGINING OF THE TRENCH (CO3) COULyE USED TO SERVICE THE DISTRIBUTION LINE IF NEEDED.
PCC f19L7
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) Phone 907-337-6179
Engineer's Printed Name Jeffrey A. Garness Date
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
oQoO
distances were measured to readily identifiable features. Hidden defects or encroachments may
exist that were not identified during the
. . 9SQ0
evaluation. The operational life of all wells and septic systems depend
upon a variety of variables, including (but not limited to) soil conditions, levels
�o ��
groundwater (that may fluctuate
during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing
* :' 4. T
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
0....:. .. ...... ........ ..
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
Q f A. a Hess•
adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG
y
QQ
to perform the evaluation. Reliance upon the information provided in this report by any other person or party
9 CE 795 �
0 (p �2 (p 2
(including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever.
Q�rP e . 3Ao
COSA Checklist _June 2022
LICE SE �o f e s s10 0�
#AECC884
OR
ANCHORAGE WELL & PUMP SERVICE, INC.
7640 KING STREET
ANCHORAGE, AK 99518
PH. 907-243-0740
Bill To:
Lee and Paulette McKenzie
12179 Upper Heritage Cir
Anchorage, AK 99516
Invoice
Invoice #: 20235153
Ship To:
Lee and Paulette McKenzie
12179 Upper Heritage Cir
Anchorage, AK 99516
SALESPERSON
YOUR NO.
SHIP VIA
COL
PPD
SHIP DATE
TERMS
DATE
PG.
Mark VanWingerden
37328
Net 30
6/26/2023
1
TY.
ITEM NO.
DESCRIPTION
PRICE
DISC %
EXTENDED
TX.
PRICE
1
Service Call
FLOW TEST AND CHECK WELL SEAL,
CONDUIT
1
Field Service
06/23/23 - Locate well - found behind a locked
$800.00
$800.00
gate. Called Tami. She authorized us to cut
lock - no combination available. Cut lock and
back up to well. Pull pump off pitless adapter -
set pump back down to where pump is
normally set. Install flow meter and start test.
Pump well dry. Allow for recovery. Throttle
back pump to maintain static at 245'. Run for
1 hour at 4.2 GPM. Install gravel around well
head to slope away from well head. Straighten
up well seal and conduit. Well head 18" above
grade.
2
ST2-Mark
Service Tech
1
RIG
Pump Rig/Boom Truck
2
PARTS:
BAGS OF GRAVEL
$17.00
$34.00
SALE AMT.
$834.00FREIGHT
We appreciate your business. Thank you!
$0.00
SALES TAX
$0.00
TOTAL AMT.
$834.00
PAID TODAY
$0.00
BALANCE DUE
$834.00
�Lo O R
Q
SMP 5£�
WELL FLOW TEST REPORT
Conducted by Anchorage Well & Pump Service
7640 King Street, Anchorage AK 99598
Ph: (907) 243-0740 Fax: (907) 243-0742
OWNER INFORMATION
Owner: Charles & Paulette McKenzie
Address: 12179 Upper Heritage Cir
Anchorage, AK 99516
PUMP ON Time: 12:45PM Date:
PUMP OFF Time: 1:45PM Date:
PUMP INFORMATION
Intake Depth:
Static Water Level:
Depth of Casing
Max Drawdown:
06/23/23 Well Production:
06/23/23
252'
227'
255'
4.2 gpm
(at time of test)
Elapsed
Time
Water Level
Flowmeter
Gallons
Comments
Feet
Reading
Pumped
Stabilize well at 245'
6/23/23 12:45pm
245
30198
Start test
6/23/23 1:00pm
245
30261
6/23/23 1:15pm
245
30323
6/23/23 1:30pm
245
30387
6/23/23 1:45pm
245
30450
End test
Total gallons pumped - 252
Time pumped - 60 minutes
Well production at time
of test = 4.2 gpm
* Well chlorinated and flushed prior to test. Test performed at wellhead
McDonalds Pumping Sewer & Drain LLC
17933 Old Glenn Highway I Chugiak, Alaska 99567
907-830-1421 1 mcdonalds.pumping@outlook.com
RECIPIENT:
Tami Taylor
12179 Upper Heritage Circle
Anchorage, Alaska 99516
For Services Rendered
1500 Gallon Septic Tank
Pumping
Fuel Surcharge
1 Hour/1 Technician
Issued
Due
Account Balame
$0.29 cent per gallon times to total capacity of the
tank.
1 HR for attempting to pump rocks out of drain field
clean out.
- after pumping a few rocks out, it appears that the
clean out pipe is first jacked and disconnected
from the clean out fitting. Allowing rocks and dirt
and fall into the clean out. We recommend that the
clean out be dug up and repaired to code.
1 $435.00
1 $30.00
1 $175.00
Jun 16, 2023
Jul 16, 2023
,364U0
0
$435.00
$30.00
$175.00
Thank you for your business. Please contact us with any questions regarding this Total $640.00
invoice. Account balance $640.00
McDonalds Pumping Sewer and Drain LLC 87-2828052
Municipality of Anchorage
Development Services Department
Building Safety Division
4700 Bragaw Street
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGL'ETAMILY DWELLING
Parcel I.D. 015-2zi=ii� COSA
.L��
1. GENERAL INFORMATION Expiration Date: R <2
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
CROSS MEW ESTATES S/D; BLOCK 2 LOT 6
NHN UPPER HERITAGE CIRCLE * ANCHORAGE, AK * 99516
COLONY BUILDER2-(BILL TAYLOR) — Dayphone 345-0371
9420 VANGAURD DRIVE * ANCHORAGE, AK * 99507
Unless otherwise requested, COSA will be held by DSD forpickup.
2. NUMBER OF BEDROOMS: 5
Day phone
Day phone
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
E
Individual Water Storage
El
Individual Holding tank
El
Community Class—Well
El
Community On-site
El
Public Water System
13
Public Sewer
E]
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site Wastewater disposal and/or
water Supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. 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 andlor wastewater disposalsyStem Is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the
Municipality of Anchorage rites and from my investigation and inspection, the
information obtained from the tern Is(are) in compliance with all applicable Municipal
on-site water supply andlor wastewater disposal sys
and State codes, ordinances, and regulations in effect at the time of Installation.
Name of Firm GARNESS ENGINEERING GROUP. Ltd.
Address 3701 E. TUDOR ROAD. SUITE 101 * ANCHORAGE. AK 99507
Engineers Printed Name JEFFR Y A. GARNESS. P.E.
Engineers Comments:
in conducting this evaluation, GEG, LtD. attempted to provide 8 thorough,
conscientious engineering analysis of the system In accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily Identiliable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate- during the year. and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator Of the System- Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report Is for
the sole benerit of the owner listed above. Any reliance upon or use of this report by any
other person or party Is not authorized, nor will If confer any legal fight whatsoever.
5. DSD SIGNATURE
�� Approved for bedrooms.
Disapproved.
Phone 337-6179
Date
Conditional approval for _ bedrooms, with the filowing stipulations:
Attachments:
COSA Checklist
septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
ON-SfTE
WATERAND
WASTEWATER -F
PROGRAM
Ilk, IN
I
By: le Uj J—,-064— original Certificate Date: / �ID
(R". 111051
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 995IM650
www.muni.arglonsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL� CHECKLIST
Legal Description: CR03S MEW ESTATES S/D; BLDCK 2, LOT 6 Parcel ID: Q 1,5�- 2.2
A. WELL DATA
Well type PRIVATE If A. B. or C provide PWSID# N/A Well Log (Y/N)_____�LES
Date completed lIZ221-20-09 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth 265 ft. Casedto 255 ft. Casing heigh t (above ground) 24+ In.
FROM WELL LOG AT INSPECTION
Date of test __LZZZZ2009
Static water level
Well production 5
WATER SAMPLE RESULTS:
Colifor : m 0 colonies/100 mi. Nitratq._Z3�rng./L. Other ba cteria. 0 colonies/100 mi.
Arsenic: ug./L. Date of sample: iZIL-2-010 Collectedby: GEG Ltd.
B. SEPTICIHOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL
Tanksize 1500 gal. Number of Compartments 2
Foundation cleanout(Y/N) YES Depression over tank (Y/N) NO
Date of pumping NEW Pumper.
I
C. ABSORPTION FIELD DATA
Date Installed 11ZIZ4Z2009 Soil rating
(45 & 46) OHyor ft/bdrm) 0.6
Length__11 TOTAL' ft. Width 2.5/2.5
ym I A 'k * 12.07/
Date Installed — 12/2-4/2009
Cleanouts (Y/N) YES
High water alarm (Y/N)----YA
System type DUAL TRENCH
7.11/
Gravel below pipe 7.03 ft.
. ep - J i J1.2 it. Eff. absorption area 1280 ft Monitoring tube YES Depression over field NO
Date of adequacy test NEW Results (Pass/Fail) - For -7, 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 me.) (Y/N & type) NONEKNOWN If yes, give date--_=_
D. LIFT STATION
Date installed� Size in gallons� Manhole/Access (YI -
"Pump on* level at—in. wpumpoff"level �High �water a�larm evel at in.
Cycles lested� Meets alarm & circuit requlrements?�
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+
Absorption field on lot-- �101y+
Public sewer main -!!�
Sewer /septic service line 25'+
Animal containment areas 5 �O+
on adjacent lots 100'+�
On adjacent lots 100'+
Public sewer manholelcleanout ___±V�A
Holding tank
Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO:
Absorption field 5+
Water main �A Water service line____Lo�+ 100'+
Surface water
Building foundation ___5:_+ Property line----5L+—
Wells on adjacent lots ---i —00'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
ndation--iO-L+— Water main______YA
Property line 1 �0+ Building fou
Water service line ___Lo�+ 00'+ hicle storage 10'+ i
— Surface water lDriveway, parkinglve
Curtaindrain NONE KNOWN Wells on adjacent lots 100'+
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
contorniance with MOA COSA guidelines in effect on this
date. JEFFREY A. GARNESS
Engineer's Printed Name
Date
COSA Fee
Date of Payment
Receipt Number -7 7
(Rev. I V05)
Waiver Fee $
Date of Payment
Receipt Number
-S-Gsr-
SGS ReEN
1101805001
Client Name
Gamess Engineering Group, Ltd
Project Namem
Cross View B2 L6
Client Sample I D
Cross View B2 L6
AlAtrix
Drinking Water
Sample
pasunciff
Results LOQ
Metals by XCP/mg
Arsenic
5.00 U 5.00
Waterst Department
ToW Nitrate/Nitrite-N
2.33 0.100
Printed Dateflime
Collected Daterrime
Received DAtefrime
Technical Director
05106)2010 11:17
04/30/2010 10:30
04/30/2010 11:05
Stephen C. Ede
Allowable Prep Analysis
Units Nlcdwd Container ID Limits Date Date
ug/L EP200.8 C (<10) 05104110 05105110 NRB
mg/L Sh,120 450ONO3-F B (<10)
Microbiology Laboratory
Colony Count 0 col/100mL SM20922213
Fecal Coliform 0 colIlOOmL SM209222B
Total Coliform 0 col/lOOmL SM209222D
A (<200)
A (<I)
A (< 1)
04130110 AYC
04/30/10 DLC
04/30/10 DLC
04/30/10 DLC
PLAT NO. 2010-13
FENCE (APX) CROSS VIEW ESTATES SUBDIVISION
LOT 6A, BLOCK 2
97.546 S.F.
Oil
zo
WELL
HERITAGE CIRCI E
0
UPPER -40'
10' GAS ESWT.
200 T. & E. ESMT.
z
SEPTIC SYSTEM
IN 89047'17"E 1192.23'
REVISED 5/11/2010 ADDED MISSING SEPTIC VENTS.
AS -BU I LT
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
PROPERTY DEPICTED A13OVE AND THAT NO
GASTALDI LAND
ENCROACHMENTS EXIST EXCEPT AS INDICATED.
SURVEYING, LLC
IT IS THE RESPONSIBILITY OF THE OWNER TO
JEFF A. GASTALDI. R.L.S.
D=MINE THE EXISTENCE OF ANY EASEMENTS,
2000 E. DOWLING RD.. SUITE 8
COVENANTS OR RESTRICTIONS WHICH DO NOT
ANCHORAGE. ALASKA 99507
APPEAR ON THE RECORDED SUBDIVISION PLAT.
PHONE 2 —5454
UNDER NO CIRCUMSTANCES SHOULD ANY DATA
GRID
DATE
HEREON BE USED FOR CONSTRUCTION OR FOR
I
ESTABLISHING BOUNDARY OR FENCE LINES.
2737
4/17/2010
ANCHORAGE RECORDING DISTRICT. ALASKA
F.S. JOB NO. NOTE: NO CORNERS SET THIS DATE.
10-02 1 CVE62 I
4p
AV #
&
07.
Iw ' 9IH
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