HomeMy WebLinkAboutSOUTH HILLS BLK 4 LT 1South Hills
Block 4
Lot 1
#017-072-10
Inspection Report_9-1-12.doc
Municipality of Anchorage
On -Site Water and Wastewater Program • (907) 343-7904 Page of
ON-SITE
WASTEWATER INSPECTION REPORT
Permit Number: 0SP171277
PID Number: 017-072-10
Dwelling: ® Single Family (SF)
❑ Duplex (D) ❑ Multiple
(SF and/or D) Project: ❑ New ® Upgrade
Name:
DUSTIN SHANNON
ABSORPTION FIELD
❑ Deep Trench ® Shallow Trench ❑ Bed ❑ Mound
Address
7777 OLD HILLSIDE WAY,
ANCH., AK 99516
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
3
1 GPD/SF
10 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
6 Ft.
Gravel depth beneath pipe
4 9 Ft.
Subdivision Block Lot
SOUTH HILLS
4 1
Fill added above original grade
Varies -.67 to +1.92 Ft.
Gravel length
45 Ft.
Township Range Section
Gravel width
5 Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION
DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
450 Fe
1
Ft.
Well
100+
100'+
100'+
NA
25'+
TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
EXISTING — ANCH. TANK
Capacity
1500 Gal.
Surface Water
100'+
100'+
100'+
NA
Material
STEEL
Number of compartments
2
Lot Line
5'+
10'+
5'+
NA
NA
Foundation
5'+
10'+
5'+
NA
LIFT STATION
Manufacturer
Capacity
Gal.
Curtain Drain
NA
*50'+
NA
NA
Remarks *None known.
Pump on level at
in.
Pump off level at
in.
High water alarm at
in.
Pump make and model
Electrical Inspections performed by
PIPE MATERIAL House to tank 3034 drainfield Tank to
Installer A+3034
Drainfield 3034 CO/MT 3034
Inspector ARCTERRA
BENCH MARK (Assumed elevation) 100 ft
Inspeection 1519/29/2017
9/29/2017
Location and description
ction
Znd
3`d 10/03/17
4"'
Garage Slab
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
Engin
Off, Al
Conditional Approval:
Date
`�� \
loor
T H� -
10
r KENNE1 Dt llUYE' S rC /
Approve(
Approved
Date
%FSdI
eer's Stam
Inspection Report_9-1-12.doc
AS -BUILT SYSTEM DETAILS/SITE PLAN
S0.U-T-H—H.IL-.L-S- SU3-DIV-Ia— 0N--L-1]-T-1—BL-DGK-4 --
1
1
17.9' TEMP SHED
NO FNDN
1
TH DHI NEW FIELD
1
M T F�
L
10
N
DECK
27.0'
EXISTING
3—BR HOUSE 2.5'x14.5'
CANT
FCO a� B 28.5'
C
MTD
DIVERTER' GRAVEL
D/W
IL TI Y ESM
\2 00„w
53.15(R&M
BEARING
_ LLSIDE WAY
GEG
J
r
�o
W
f �
�
A—C-19.0'
ORIGINAL GRADE
VARIES
F-
m B—C=48,5'
—
T4.0'
<N
to
=A—D=21.5'
E3
U U « = q
US
o B—D=49.5'
ND GRIMVATER
SCALE: NTS
A—E=52.5'
A
EXISTING
GB—E=88.5
1500-GAL
m A—F=53.0'
'v
TANK
B—F=89.0'
I
OF ALl� 01�
*. 9TH *�
EO
ID
I� us
o ` CE— 1 w�
1 Nb
° \ p�OFESSIC A -dw
) FINAL GRADE
FILTER FABRIC \
SEWER ROCK
45' —
PREPARED FOR:
DUSTIN SHANNON
7777 OLD HILLSIDE WAY
ANCHORAGE, AK 99516
FIELD BOOKS
BOUNDARY: N/A
STAKING: N /A
ASBUILT: SLS
DWG. ME.
ACAD FILE: FILE
COMPUTED:
DRAWN: BMW
CHECKED: KMD
DATE: 10/3/17
GRID: SWO059
toe No.: 17-181
0
0
Permit OSP171277
PID# 017-072-10
50.0'
SCALEi 1' = 30'
W
7
r
�o
W
f �
99,70
ORIGINAL GRADE
VARIES
T4.0'
83,70 B-
ND GRIMVATER
SCALE: NTS
MUNICIPALITY OF ANCHORAGE
4„,,,,‘!-2e.."_":!-,,,,,. titin c n t
On-Site Water&Wastewater ProgramN�� `Y�
PO Box 196650 4700 Elmore Road L
} Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 ,�
rt j' httpalwww.muni.org/onsite f
--- epartmen t
UFP
On-Site Wastewater Disposal System Permit
Permit Number: OSP171277 Effective Date: 9/26/2017
Work Type: Septic Upgrade Expiration Date: 9/26/2018
Tax Code Number: 01707210000
Site Legal Address: SOUTH HILLS BLK 4 LT 1 G:2940
Site Mailing Address: 7777 OLD HILLSIDE WAY, Anchorage
Owner: SHANNON DUSTIN EDWARD & Lot Size in Sq Ft: 52967
Design Engineer: ARC TERRA CONSULTING INC Total Bedrooms: 3
This permit is for the construction of:
0 Disposal Field ❑ Septic Tank 0 Holding Tank ❑ Privy 0 Private Well ❑ Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (2417).
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
..------ 7/24/ �
Received By: Date: 9
Issued By: Date: '11,410/ 7
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. 017-072-10
Property owner(s) DUSTIN & ASHLEY SHANNON Day phone 360-6251
Mailing address 7777 OLD HILLSIDE WAY, ANCHORAGE, AK 99516
Site address 7777 OLD HILLSIDE WAY, ANCHORAGE, AK 99516
Legal description (Sub'd., Block & Lot) SOUTH HILLS BLOCK 4, LOT 1
Legal description (Township, Range & Section)
Lot Size 52967 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(Z all that apply)
Absorption Field P`l Initial ❑
Single Family (SF)
(w/wo ADU)
Septic Tank ❑ Upgrade Duplex (D) ❑
Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE I WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signatur- . p •perty owner or authorized agent)
Pe it/Rush Fees: Waiver Fees:
Date of Payment: gigw19 Date of Payment:
Receipt Number: o3--”10t) Receipt Number:
Permit No. 05P/1-/a.?-?- Waiver No.
Permit App_9-1-12.doc
? CTERR; Sf]itysia‘�
c
•
a_ /� /�
ARC 1 ERRA
•
CONSUL'T`ING, INC
F�S�LIING 212 E. 515'Ave, Anchorage,AK.99503
Office(907)868-3791, Fax(907)868-3793
September 21, 2017
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 Block 4, Lot 1
It has been determined that the absorption field of the subject property is
operating marginally. Subsequently, the owner has requested we proceed
forward to obtain a septic permit to upgrade the septic system by installing the
reserve field as shown in MOA record documents.
The general slope of this lot is from south to north at a grade of approximately 2-
5% over the septic area. We will be utilizing the existing testhole data in MOA
records. The proposed upgrade will serve the existing 3-bedroom single-family
residence. We propose to install a 45-foot shallow trench with a diverter to the
original field.
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.
1111
41p....„„,"„eriap
Kenneth M. D ffus, P
Attachments: On-Site Sewer Application
Wastewater Absorption System Details/Site Plan
Soils DHI & GEG Copies
20441 PTARMIGAN BLVD • EAGLE RIVER,AK 99577-8736 • PH(907)868-3791 • FAX(907)868-3793
WELL & WASTEWATER DISP❑SAL SYSTEM DETAILS/SITE PLAN
SOUTH HILL LOT 1 BLOCK 4
t I I
1 e
1 Ji I
I
I,a.,� X moo• 5090'
2 I
,.�. � § Lu
/puma
MUMS
•:ter
13
rS 1.2 In c21
1 Ac i 9
IF, s
IZ i SEPTIC AREA
1
rpo:1 ME
' SEPTIC AREA I i / aosipn.
"j I
J .41 ``t
1 t. —
153.15'
H/LLS/D — "
SEPTIC AREA
o FLAG PROPERTY LINES
WELL RADII & EASEMENTS
PRI❑R TO C❑NSTRUCTI❑N scale: 1'= 50'
DESIGN DETAILS PAGE 1 ❑F
3 BDRM X 150 GPD = 450 GPD
m 450 GPD/1 GPD PER SQ. FT. = 450 SQ. FT
�, (450 / 5 x 0.5 (4' GRAVEL) = 45 FT. TRENCH
1.
USE 1 TRENCH - 45' (L) X 5' (W) X 4' (ED)
✓ Total depth of system Is 10' max from original grade.
oo Total depth of gravel below distribution pipe Is 4' ,
NO PUBLIC WELLS WITHIN 200' OF
Z PROPOSED
En Fi0 PRIVATESYSTEM.
WELLS WITHIN 200' OF NOTES.
li PROPOSED SYSTEM EXCEPT AS NOTED. 1. CONNECT TO EXISTING 1500-GAL TANK W/ ADVANTEX SYSTEM.
m PROPOSED WELL EXCEPT"AS NOTED. 2. INSULATE TRENCH WITH 2' HD BURIAL FOAM IF < 3' OF FILL.
v MIN. 2' FILL WITH INSULATION, >3' COVER ND INSUL REQ.
IZ 3. CONTRACTOR WILL ENSURE MINIMUM 2% SLOPE INT❑ SEPTIC TANK.
I 4, CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT
0 WELLS, SEPTICS EASEMENTS, PROPERTY LINES, ETC...
a. -40.0111110%.tlik
41 oF At
flirt , '7� PREPARED FOR: R_CTER4 r
DUSTIN SHANNON
$, C7 �,0- 'r 7777 OLD HILLSIDE WAY ° �A err
E r* . 19TH 1\ * ANCHORAGE, AK 99516 ,:,40'(-1,P.-
�m
• / •APO / 907-360-6251 a 7;
t , �t
, FIELD BOOKS COMPUTED: ;
NIA n i
CE ��• BOUNDARY:N/A oRAwN: BMW 1F' III
,j
ta
1 4�LL(/ .. , STAIONL` NIA C�+EC�n: KMD �� \ P •1
1 10��' / AseuLT. SEN DATE 09/22/17 '� "lei; ` 41‘
u , '[CESS DM. FILE: crao: °t c G �1
E I 2940 F O N
��� ACAD Fl� Ioe No.: Rl sULTING .�6laP
FILE 17-181 4K, 99577
WASTEWATER DISP❑SAL SYSTEM DETAILS
A SOUTH HILL LOT 1 BLOCK 4
K'
0
r)
I
LnN
1ta tits
L ' \ / I'
I
FILLED ADDED
in PREVIOUSLY
3- 3R
N EXISTING HOUSE -;
TH DHI W/ AX-20 DOI
-- --; --FCO-- -- - ----
3 CO , `i TALL DIV.
,,�+�� • „ CO ►kra CO
T � *��
MT I-3'-i
CO 1 �'
1--- - L CO
T
Y EXISTING TREN- - MT- - — - __ __
u
fl ° IC � � r 0' ESMT' - _
3 Nk
t FLAG PROPERTY LINES
WELL RADII & EASEMENTS
PRI❑R TO CONSTRUCTION Scate: 1'= 20'
46:410116.1%,,N, PAGE 2 OF 2
Di adr. �� OF <Q
PREPARED FOR: ts.RATER DD
,4s , 1- 1 DUSTIN SHANNON ti =L,4 ��
a �� `� 7777 OLD HILLSIDE WAY +° ��+
* 9 TH * ANCHORAGE, AK 99516 % \
I , / • I 907-360-6251
13. r s /
FIELD BOOKS �� �' 1 x
A
a CE-71 w� eairnutY:N/A DRAWN: BMW z a”" �.
a
V 1 4 �yti STAXING: N�A CHECKED' K M D % \ i -1,R°
1 �o� ���/�*vr / , tLT: SEN oar 09/22/17 .�iF �i
`'taES3i0�� �� #
f DWG. FILE GRID 2940 !� c'p� jyC �1
`_� ACRO FILE as Nn-: 17-181 R/k. S k 99577-
tot`
Municipality of Anchorage
Development Services Departmentt fy� yy:
J, Building Safety Division
' On -Site Water and Wastewater Program, 4700 Elmore Road
P.O. Box 196650 Anctarege, AK 99507 Page 1 of 4
www.d.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. SW070271 PID Number. 017-072-10
tisM:
Dustin Shannon
Wastewater System: El New ❑ Upgrade
�ear.Il
7777 Hillside Way
ABSORPTION FIELD
Peaty Hines of anoanr
3
ODIIPTr-d 8Shro Tact OBerl OMann OOIMr
LEGAL DESCRIPTION
RaW
100 ~
10Cattegory ul opt a
F.
Blov<4 Let 1 Sa»wIIMI
South Hills
DIM b FO10oeae carr! Iron
DM �
4.8 Ft.
3.93
3.93 tt
TanYlp. Ra" Swmn
Fol aeae aeaw englM Qeel:
C/M Llnale:
0 Ft.
65.0 fl.
Well: 21 New ❑Upgrade
G,1YMv0°
Mnewarlrwl:
waswewwls aw:
5.0 fl.
1
NA Ft.
CMIPM1tlIen (Rin . A B. Q.
TM DaM. Cure b'.
Taal waapamn imi,
Pp Mrs W.
private
400 ft. 1 109 Fa
643 Ft'
ASTM D3034 / F810
Daw:
Dws wwa BIIwc Wrs I.wM-
Ielt~
DIu ImrYW
Sullivan
8/8/08 71 FI
A+ Home Services
7/30108
Yw
0.5
Pl sw w.
364
2aerp tte
c"'i GraMq
AdvanTex AX20 TANK
GPM
fl.
Fl
SEPARATION DISTANCES
0 Septic ❑ Holding ❑ S.T.E.P. ❑ Other.
To
Septic
Absorption
I
LIR
Holding
lutilriPrWrte
'° .
Y
From
Tank
Field
Station
Tank
Sewer Line
Anchorage Tank
1500 G.I
Ivw
100'+
100'+M
100'+
NA
100'+
3116 3!16' steel - epoxy coated
wriow aDarpMYaw..
2
$uelaawMw
100•+
100'+
100'+
NA
LIFT STATION
La Lw
20'+
10+
201+
NA
Gel
FoaIWaM1+
5'
10+
5'*
NA
•Perp arM a w
t+Gn wMw alrmw
n
cwnd.n
NA
NA
NA
NA
FMIp M alM Elselme ImpKemN Psramlle t7
Ramwtl
Groundwater monitoring tube Installed to 16.5 ft. Dry after 7 days.
BENCH MARK
tnrlun.ae
West 16 4 of drain6eld was Insulated w2• blueboard. Pipe from
Finished floor of entry way
house to tank was Insulated w/4'.
w
100.00
tt
•
Engineer's Stamp
Inspections performed by: Cindy W. Ellis, P.E. Dates: 1w 7/30/06
2nd 7/31106
��aoepp0
OF.!q (N
�y
;4
Development Services Department Approval
sS
TH � ••.
j�
Conditional Approval Date:
•' Cl w. ELLIS
•:
- 10677 .'
GlJ• � � - Lf'C
v^yr;ee
Reviewed and approved by: Date: L
s �l
--�O\ RABBIT CREEK
i
14.81
34,gg
ST2
22.85
42.35
C01
37.71
N 86°11'19" W 152.30' \
CO2
63.09
96.51
oo
36.37
40.94
MT2
64.15
97.33
I500
Well
RIW..l
o A
O WI
1
Z a
�I I
i
NOTE: Location of water line
added on Feb. 16, 2009.
LU
'Z
A 8
STI
o
g
Q
IN
2
i
Greater than 50 It from reserve
field tree to Wlbank.
AdvanTex
1500 pal tank HOUSE
WAX -20 pod
AS -BUILT
1 \
/ — \
p
M
i
Based upon an asbuilt survey
se OTHY1\ ST1 �.
I
I DHI H
i
by Sentec, Michael Home, LS -5318 I CO2
Date: October 20, 2008
`—
2 7TW--
0
-.CQ _
\'\ /� 83°45'15" W 154,15?
---_--�-__H� SIDE_WAY
—
South Hills Blk 4 Lot 1��o
Record Drawing of Septic Upgrade
oF,g4
Dustin Shannon
Parcel ID -.017-072-10
Watkins Engineering, Inc.
Permit No. SW070271
CAI W. ELue
Cindy W. Ellis, P.E. P.O. Box 110443
February 16, 2009
Anchorage, Alaska 99511-0443`2
Scale 1 Inch 50 ft
Phone. (907) 349-1851, Fax (907) 349-1934
14.81
34,gg
ST2
22.85
42.35
C01
37.71
42.67
CO2
63.09
96.51
MT1
36.37
40.94
MT2
64.15
97.33
FCO Sj: j T1
96.98
96.35
Bottom of
Trench 90.86
Bottom of
I—
West end of drainfield
insulated for 16 ft
Pipe from house to tank
insulated w/4" blueboard.
SEPTIC SECTION
N.T.S.
FINAL GRADE= 100.85
100.91
ADVANTEX I MAN -
AX -20 POD HOLE
STEEL ADVANTEX TANK
1500 GALLON
NOTE
Original Grade =
MT1 Final Grade = 98.70-101.21 MT2 98.38-100.86
South Hills Blk 4 Lot 1
Record Drawing of Septic Installation
Dustin Shannon
Parcel ID: 017-072-10
Permit No. SW070271
Cindy W. Ellis, P.E
September 25, 2008
Not to Scale
FILTER FABRIC + INSULATION 95.12
1.25"0
65.0'
AS -BUILT
Bottom of
MT2Ccb 90.86
Relative Depth of
Bottom of GW Mon Tube = 84.36 (no water)
Bottom of TH (Dee High) = 84.86
Watkins Engineering, Inc.
P.O. Box 110443
Anchorage, Alaska 99511-0443
Phone: (907) 349-1851, Fax: (907) 349-1934
OF A (°a4
..............q U
,�P•' X11' •S,f..�0i
e? 49 TH 1Z 9;
° C 0A . ELUS ,•
;E . 10577.... ,`
Development Services Department
Building Safety Division
'", On -Site Water B Wastewater Streeter Progr¢m
��� 4700 Bragaw Street
P.O. Bax 196650
Mark Segich Anchoroae, AK 99519.6650
Mayor wrw mpN ari1nn<1re
(907)343.7904
Pump Installation Log
Well Drilling Permit Number: Svvh�wi Date of Issue: _
Parcel Identification Number: b� 2'' l U
Leval D.e{lcription/ Property Owner Name & Address:
{ .y SI,OLr` �, �oU,� I-�/I�c7✓B 1")U3 f.14 G6ahvkO rV
-7-177Ht11slOG t. eQ y
Pump Installation Date:
Pump Intake Depth Below Top of Well Casine:3 8 t feet
Pump Manufacturer's Name: PCz'[CCC_VC1 "
Pump Model: 15 Q 3 II GN 2.5 U -S
Pump Size lc 5 hp
Pitless Adapter Burial Depth:/ 2 feet
Pitless Adapter Manufacturer's Name: M Q(.�g�yt t D (Jes rt 6 J I
Pitless Adapter Installer: h1 !nr is UQ N w(N 5 el- Der_
Well Disinfected Upon Completion": KYes ❑ No
Method of Disinfection:
GG-�cCc.,m, Y i° �orrte
Comments:
Pump Installer Name: 5 TGVC n S P,+zASO ✓t-
A�.>
Attention: The pump installershall provide a pump installation log to the DSD within 30 days of pump installation.
Certifieb OrifYing log
6
DOCCo.a
SULLIVAN WATER WELLS
P.O. BOX 670272, CHUGIAK, ALASKA 99567 -TELEPHONE 688.2759
CWNEROf LAND: 0,..d:7 rAJ ,dill fUniAA
ADDRESS:
LEGAL DESCRIPTION: SD tlrr/��iGc,�
T t'
DATE: -F&LO F'
PER!NIT NUMBER: 070971 Date of IssuelO - -
TAX IDENTIFICATION NUMBER: n/7 -.t� -./0_
Is well locat.d at approved permit location?
Method of Drilling: blawrotay O Cable foci
Depth of well: eo �.
casing Type .$. Z77iU Wall Th:ekness - a o2 S_rJ inches
i
Diameter C% inches, depth t) C/ _feet
Liner Type: t.-: i
Casing Stickup Above Ground: feet
Static Water Levek V feet
Recover Rate: _L;L gpm
Method ofTast:ng: A114—
t:)
1L
::J Perforations Start feet Sfppped feet
Grout Type: Ar: ••+�• -^' YE Vo�i me%/J
Depth: from 0 feet to feel
Method of Disinfection:—OIA-4•G�.Z 421
-se — --
EJLart J-:Anr.
/711 <AVWv-A
-.LES£
d��trc l%irtK C-cAi
6-4 of
'57,f "13 a va
&Zidc W_ 6ACIIA:e
Oriller'sName LCk.-_ vtc,,Wjd1 .
A77EN flON: It is the responsibility of the property owner to submit a copy of the well tog to the proper authority. Mini; ipality
of Anchorage: Department of Health di Hu nate Services and/or Department of Ernirormental Conservation. MatSu Rorough:
Department of Environmental Consewation_
ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT
Initial
Permit Number: SW070271
Date Issued: Oct 02, 2007
Expiration Date: Oct 01, 2008
Parcel ID: 017-072-10
Legal Description: SOUTH HILLS BLOCK 4 LOT 1
Design Engineer: 0855 GARNESS ENGINEERING GROUF Site Address: 7777 HILLSIDE WAY
Owner Name: DUSTIN SHANNON Lot Size: 52967 SO. FT.
Owner Address: 7777 HILLSIDE WAY Total Bedrooms: 3 Permit Bedrooms: 3
ANCHORAGE. A 99507 -
This permit is for the construction of:
❑✓ Disposal Field E Septic Tank ❑ Holding Tank ❑ Privy Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 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.
712408 Ar THE riA,rOF ryc1fvATtov Of THE p/etiWifley P,?otvF/6L0 7/ 6.vG/.tfEp
SH,PLL Veltify SOIL eu/44i1'YTO P1rewwA1,r A0E4P,4i+TE to/j. YON"r
THE DESIGN *PPLIC07-1V ' RAM TH/S OFf/CE Tv Or ,NOr0FISP i/C/!
CO,vO/rleN Pix/STS pnine re Pl/4CE^.ENrof :rztrER poafe,
p/o►u Yl.! p
/3o�a� e;f v //,_&, L 6/v
Received By:
Issued By:
Date: 0 2 7
Date: ioi
/itltoC,Ek. tu�r�t�✓a,o-„o�i: �'piG✓ �'�.'v)l � -"�"'� J
t+1-346$
!P 6z
MUNICIPALITYOFANCHORAGE
Development Services Department
[
?� I Qa
,,
'n
,Z v
`P
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: SW070271
Date Issued: Oct 02, 2007
Expiration Date: Oct 01, 2008
Parcel ID: 017-072-10
Legal Description: SOUTH HILLS BLOCK 4 LOT 1
Design Engineer: 0855 GARNESS ENGINEERING GROUF Site Address: 7777 HILLSIDE WAY
Owner Name: DUSTIN SHANNON Lot Size: 52967 SO. FT.
Owner Address: 7777 HILLSIDE WAY Total Bedrooms: 3 Permit Bedrooms: 3
ANCHORAGE. A 99507 -
This permit is for the construction of:
❑✓ Disposal Field E Septic Tank ❑ Holding Tank ❑ Privy Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 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.
712408 Ar THE riA,rOF ryc1fvATtov Of THE p/etiWifley P,?otvF/6L0 7/ 6.vG/.tfEp
SH,PLL Veltify SOIL eu/44i1'YTO P1rewwA1,r A0E4P,4i+TE to/j. YON"r
THE DESIGN *PPLIC07-1V ' RAM TH/S OFf/CE Tv Or ,NOr0FISP i/C/!
CO,vO/rleN Pix/STS pnine re Pl/4CE^.ENrof :rztrER poafe,
p/o►u Yl.! p
/3o�a� e;f v //,_&, L 6/v
Received By:
Issued By:
Date: 0 2 7
Date: ioi
/itltoC,Ek. tu�r�t�✓a,o-„o�i: �'piG✓ �'�.'v)l � -"�"'� J
Municipality of Anchorage
-Yl Development Services Department
Building Safety Division �l °
On -Site Water & Wastewater Program °
4700 Bragaw St.
P.O. Box 196650
Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
Parcel I.D.
ON—SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
_ 07-Z
Property owner(s) DUSTIN SHANNON Day phone 360-6551
Mailing address 6800 OVALLEY ROAD. ANCHORAGE, AK
Site address Zip Code 99507
Legal description (Sub'd, Block & Lot) SOUTH HILLS SUBDIVISION. LOT 1. BLOCK 4
Legal description (Township, Section & Range) NIA
Lot Size � r °I ( 7 Sq.Ft. Number of Bedrooms 3
THIS APPLICATION IS FOR (® all that apply):
Absorption Field
Septic Tank
❑
Holding Tank
❑
Privy
❑
Private Well
Water Storage
❑
THIS APPLICATION IS AN:
Initial
Upgrade
❑
Renewal
❑
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.
ci60 t l75
Permit/Rush Fees: uu>�
Date of Payment: "/ S 3 S 7
Receipt Number: / I ! J —7
(Rev. 11/05) T ppJul
Waiver
Date of
Receipt
Watkins Engineering, Inc.
P.0 Box 110443, Anchorage, AK 99511
(907)349-1851 cwellis@gci.net
July 24, 2008
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
RE: South Hills Blk 4 Lot 1
Septic System Design Change
Permit No. SW070271
Attention: Deb Wockenfuss
In response to your questions about the proposed design change for the septic system at the
subject property, see below.
1. Maintenance Agreement.
Signed by the owner.
2. Application rate.
The application rate used in the design is 1.0 gpd/ 112. The prescribed application rates
for Category 3 systems with the percolation rate of 30 to 60 minutes is 2.0 gpd/ Wand for 60 to
120 minutes, it is 0.5 gpd/ ft2. The percolation rate in Dee High's test hole was 60 minutes per
inch. Thus, I used an intermediate value (somewhat conservative) of 1.0 gpd/ W.
3. System too deep for measured ground water.
The adjacent property to the west, Lot 2, had 2 test holes dug in 2001 and evaluated by
Micahel E. Anderson, P.E. The holes were dug to a total depth more than 18 ft, and
encountered no water while digging or after more than 7 days of monitoring. The soil logs are
attached. The owner of Lot 1 has been monitoring groundwater throughout the month of May
and the test hole has remained dry. I propose that we verify the water depth during construction
with a test hole to 16 ft. Groundwater monitoring will be performed for a minimum of 7 days,
and the test hole will be installed where the drainfield is within 30 ft.
4. Fill to obtain 25% slope will be provided for.
If you have any further questions, please call me at 349-1851. Thank you.
Sincerely,
1,?2d' W
Cindy VN. is, P.E.
President
Watkins Engineering, Inc.
P.0 Box 110443, Anchorage, AK 99511
(907)349-1851 cweliis@gci.net
July 12, 2008
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
RE: South Hills Bik 4 Lot 1
Septic System Design Change
Permit No. SW070271
To Whom It May Concern:
Attached please find a revised septic system design for a proposed 3 bedroom house
on the subject lot. A permit was approved for a design submitted by another engineer.
An AdvanTex AX -20 Category III advanced septic system is proposed. The drainfield is
designed around a test hole evaluated by Dee High, P.E. on June 20, 1996.
The proposed changes are:
1) Change the advanced wastewater treatment system from a Quanics to an AdvanTex,
2) increase the maximum depth from 9 ft to 10 ft, which is 6 ft above the bottom of the
test hole,
3) Change the required absorption area from a total of 900 ft2 (based upon a Category II
application rate of 0.50 gpd/ ft) to 450 ft2 (based upon a Category III application rate of
1.0 gpd/ ft2.
4) Change the drainfield length from 2 trenches at 45 ft each to one 60 ft long. The
reserve drainfield is 45 ft long.
Soils logs were submitted with the original permit package.
There are no surface waters within 100 ft of the proposed septic system.
A topographical map was submitted with the original permit package. Fill will be
brought in to create a slope less than 25% within 50 ft downhill of the drainfield.
am unaware of any adverse impact that this installation would have on adjacent
properties' water or wastewater treatment needs.
Septic Design Change for South Hills Blk t Lot 1
Watkins Engineering, Inc.; July 12,2008; page 2
If you have any questions or need further information, please call me at 349-1851.
Sincerely,
Cindy W. Ellis, P.E.
President
2 I
I
1
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
BLOCK 4
I
I
I
I
I
I
I
I
I
I
I
I
I
I
Well is 247' north of
NE House comer
Proposed AdvanTex
AX -20 w/ -j500 gal Proposed
steel tank 3 BR House
I
I_
Rese rainfield, 45' long
I
j MTs &I , DHI TTH#1
ICOS
----
10'uUllty ----____
Dee High
Test Hole #1
6/20/96
4.5
SM/
GM/
ML
No Water
I� GEG fH51
Prop so ed
Trench
6.0 4" pert
pipe
I_Proposed drainfield
60' long, 5'wide
4.0' effective
4.0 ft sewer
rock
10.0 O�
S�Gpy�
16.0 G�005G
2-TOONE 153-50-
HILLSIDE WAY
DESIGN DETAILS
3 BR, 450 GPD
1.0 gpd/ft2
Requires 450 ft2
5 -wide Trench
4.0 ft effective
RF = 0.50
Max 10 ft deep
South Hills Bik 4 Lot 1
Proposed Septic Installation, oF,ni
Dustin Shannon Watkins Engineering, Inc=4.
49?H.Y
Parcel ID: 017-072-10
Cindy W. Ellis, P.E.
July 12, 2008
Scale: 1' - 30'
P.O. Box 110443 Cl�Y.W ESUS
Anchorage, Alaska 99511-0443 �•''7cL3..:O$
Phone: (907) 349-1851, Fax: (907) 349-1934
I ,
BLOCK 3 1 1 e
_WEEK- %
I �
I , j
I ,
1 1
9 ,
- _ OLD
3
2
IWELL I
/ I I PROPOSED I /
WELL i I /WELL
South Hills Blk 4 Lot 1
Site Plan tJF q
Dustin Shannon Watkins Engineering, Inc A�
Parcel ID: 017-072-10 0 ' 49 TH�
Cindy W. Ellis, P.E. P.O. Box 110443
July 12, 2008 Anchorage, AK 99511-0443
Scale: 1' -100' Phone: (907) 349-1851 Fax: (907) 349-1934
I
PROPOSED
I
I
BLocl<a I
1 3 BR HOUSE
I
II
sl ocics —
�
I
l
I
PROPOSEDI
i
I
I
, I
/
4vELL
SEPTIC 11
SYSTEM
I
Are j l
i I
'Septic
Area
❑
I
I
I,
— -
— - — - — - — - — - —
Septic I
Area ,
, Septic
, Area
I J
I
13
vacant
BLOCK5
l0
3
2 I
I
iU)
South Hills Blk 4 Lot 1
Site Plan tJF q
Dustin Shannon Watkins Engineering, Inc A�
Parcel ID: 017-072-10 0 ' 49 TH�
Cindy W. Ellis, P.E. P.O. Box 110443
July 12, 2008 Anchorage, AK 99511-0443
Scale: 1' -100' Phone: (907) 349-1851 Fax: (907) 349-1934
GARNESS ENGINEERING GROUP, Ltd.
7- CONSULTANTS & GENERAL CONTRACTORS v , r :• 1 • - ------
September 18, 2007
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907)343-7904
Ref: Proposed Well and Septic System for South IIills; Lot 1, Block 4,
To whom it may concern:
The proposed 3 bedroom house is to be served by a private well and septic system. We are proposing to
install a 1500 gallon septic tank with a Quancis 650 aerocell unit, and dual 5 -wider trench type
drainfields. Four test holes were excavated on the property. The drainfield will be designed around the 30
foot radii of GEG test whole #1, and Dee high, P.E, test hole #1. Comments regarding the design are
summarized as follows:
1. SOILS: See the attached logs which show the soil classifications, groundwater monitoring, and the
percolation test results.
2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications.
3. SURFACE WATERS: 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 27-35 percent slope running approximately north to south. We are proposing to place fill so
as to create a slope of less than 25 percent within 50 feet downhill from the drainfield.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems.
If you have ar A questions, please contact us at 337-6179. Thank you for your assistance.
P.E., M.S.
NOTE: Attached is a site plan drawing, a design drmving, one soil log, which are all parr ofthe design package for
this septic system. (Contact G.E.G. Ltd. for 7 page construction specification letter.)
3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507-1259
Ph: (907) 337-6179' Fax: (907) 338-3246' Websitc: www.gamcssenginceritig.com
ii
SOUTNHI
Nn L07 2 BLOCKS3D I I LDTUTMT BHILLS LOCK SID
Y I I
n
I I
I I
I I
I 1
/
\\OLD RABBIT CREEK RD.
X \
PROPOSED
SEPTIC SYSTEM
I
AR� DHIT I
PROPOSED 100'
WELLWELL READ IIUS IIUS
I
I SLOTH BILLLS OCK 4D /
I /
I w
1 -o
N
I �N
I
PROPOSED
3 BEDROOM HOUR
I •/
LOT B!;LcsKS60
�I
SOUTH HILLS
LO BLOCKS6D
8 I
I
I
_�-ZsC --] I
J I
_- ,n,i I V) --------
I
I
'I
I
I
I
I
I
I
I
I
I
I
I
L--
HI LL SIDE GEG� j
AY ctG
. . . . . . . . . . . . . . . .
�SEPT,G
ARES I I
i
SOUTH HILLS S/D I I ---
LOT 2 BLOCK S I I SOUTH HILL
LOT 1 BLD
GARNESS ENGINEERING GROUP, Ltd.
- CONSULTANTS 3 GENERAL CONTRACTORS--- ^'�+•^•••p••�••••
C 1000 IIOb. f111R 101 . II,CIIORIG[. M p502 • P • LAY 7) 2 32"
EPARED FOR: IPHONE NUMBER: I PAGE NUMBER:
DUSTIN SHANNON
LEGAL DESCRIPTION:
SOUTH HILLS S/I
360-6551 1 OF 3
BLOCK 4. LOT 1
OF WORK:
PROPOSED SEPTIC SYSTEM DESIGN
(R" 01105)
K.D.M.
I
O
2
J
_- ,n,i I V) --------
I
I
'I
I
I
I
I
I
I
I
I
I
I
I
L--
HI LL SIDE GEG� j
AY ctG
. . . . . . . . . . . . . . . .
�SEPT,G
ARES I I
i
SOUTH HILLS S/D I I ---
LOT 2 BLOCK S I I SOUTH HILL
LOT 1 BLD
GARNESS ENGINEERING GROUP, Ltd.
- CONSULTANTS 3 GENERAL CONTRACTORS--- ^'�+•^•••p••�••••
C 1000 IIOb. f111R 101 . II,CIIORIG[. M p502 • P • LAY 7) 2 32"
EPARED FOR: IPHONE NUMBER: I PAGE NUMBER:
DUSTIN SHANNON
LEGAL DESCRIPTION:
SOUTH HILLS S/I
360-6551 1 OF 3
BLOCK 4. LOT 1
OF WORK:
PROPOSED SEPTIC SYSTEM DESIGN
(R" 01105)
K.D.M.
3ER OF BEDROOMS:3
DNS PER DAY (GPD): 450
'OLAT10N RATE/S:60-120 MIN./INCH
'OSED APPLICATION RATE:
FOR PRIMARY SITE AND 1.0
M2 FOR THE RESERVE SITE
IUM DRAINFIELD SO.FT.:900
IM DEPTH;9 FEET
5 FEET
1:90(2 045) FEET
APPROVED SAND FILTER:N/A
IVE:4 FEET
DON FACTOR: 0.50
. SO.FT.: 900
SOUTH HILLS S/D
LOT 2, BLOCK 4,
AREA TO BE FILLED TO
LESS THAN 25X SLOPE
ALTERNATE SITE
CSE
RTIC
EA
N
PROPOSED
H
HILLSIDE WAY DRAINFIELD
THAI DHI,
TH/1
iN
H
TALL FLOW
SPLITTER
GEG. Ltd. HAS A 7 PAGE SPECIFICATION
LETTER THAT PERTAINS TO THIS DESIGN. I I
TO OBTAIN A COPY OF THE LETTER
CONTACT CEG. BY 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
CONDITIONS OUTLINED.
SOUTH HILLS S/D
LOT 2, BLOCK 5,
SOUTH HILLS S/D
LOT 1, BLOCK 5,
� PROPOSED 1500
GALLON SEPTIC TANK
•OUANICS 650
AEROCELL UNIT
76' DIAMETER OUANICS
RECIRCULATING PUMP
VAULT
[SEPTIC
AREAS
GARNESS ENGINEERING GROUP, Ltd. per*
• •-- CONSULTANTS S GENERAL CONTRACTORS-
3"l
ONTRACTORS-]]01 G TD011 VOID. fun[ 101 • MoaNaG Mt FM 01Q?1» " • �v9rt: ....pnwnnyn•.w,aw Q
PREPARED FOR: PHONE NUMBER: PACE NUMBER:•
DUSTIN SHANNON 360-6251 2 OF 3
LEGAL DESCRIPTION: DRAWN BY: BOO
SOUTH HILLS, BLOCK 4, LOT 1 K.D.M. C
TYPE OF WORK: DATE:
PROPOSED SEPTIC SYSTEM DESIGN 9/18/2007
(R. 01105)
.. *
..... ............
PROPOSED
3 BEDROOM
INSTALL FOUNDATION
HOUSE
CLEANOUT AND IF
NEEDED GRINDER PUMP
., ;•a
IN HOUSE
THJ2 DEC
12 DHI
GEG. Ltd. HAS A 7 PAGE SPECIFICATION
LETTER THAT PERTAINS TO THIS DESIGN. I I
TO OBTAIN A COPY OF THE LETTER
CONTACT CEG. BY 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
CONDITIONS OUTLINED.
SOUTH HILLS S/D
LOT 2, BLOCK 5,
SOUTH HILLS S/D
LOT 1, BLOCK 5,
� PROPOSED 1500
GALLON SEPTIC TANK
•OUANICS 650
AEROCELL UNIT
76' DIAMETER OUANICS
RECIRCULATING PUMP
VAULT
[SEPTIC
AREAS
GARNESS ENGINEERING GROUP, Ltd. per*
• •-- CONSULTANTS S GENERAL CONTRACTORS-
3"l
ONTRACTORS-]]01 G TD011 VOID. fun[ 101 • MoaNaG Mt FM 01Q?1» " • �v9rt: ....pnwnnyn•.w,aw Q
PREPARED FOR: PHONE NUMBER: PACE NUMBER:•
DUSTIN SHANNON 360-6251 2 OF 3
LEGAL DESCRIPTION: DRAWN BY: BOO
SOUTH HILLS, BLOCK 4, LOT 1 K.D.M. C
TYPE OF WORK: DATE:
PROPOSED SEPTIC SYSTEM DESIGN 9/18/2007
(R. 01105)
.. *
..... ............
)Fw. OIM)
GARNESS ENGINEERING GROUP, Ltd.
-I • - , --, • CONSULTANTS 3 GENERAL CONTRACTORS woe....,-��•�
SOIL LOG — PERCOLATION TEST
LEGAL DESCRIPTION: SOUTH HILLS, LOT 1, BLOCK 4
PERFORMED FOR: DUSTIN SHANNON DATE:
DEPTH
(feet) 737 TEST HOLE # 1
1
-�-- ORGANICS
aa�a
2
1111111110
7-
8-
9-
10-
11
891011
12
13
14
B.O.H.
15-
16-
17-
18
5161718
SM/ML
TIGHTLY BONDED
•Witt
•
DRY
7/2/2007
DRY
1
•-
9/18/2007
2
3:05
III111111
5 3/4' 1/4-
31191
3:05
—
o//Z.
4
%/2
30
5 3/4' 1/4-
NNH
•
O
1 6- —
6
IIIIIIIII
30
5 3/4- 1/4 -
-
ADVANCED WASTEWATER TREATMENT
SYSTEM WILL BE REQUIRED
DEPTH TO
GROUNDWATER
DATE
DRY
7/2/2007
DRY
7/10/2007
DRY
9/18/2007
2
3:05
DATE READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL NET DROP
READING (INCHES)
7/3/2007 1
2:35
—
6' —
2
3:05
30
5 3/4' 1/4-
3
3:05
—
6- —
4
3:35
30
5 3/4' 1/4-
5
3:35
—
1 6- —
6
4:05
30
5 3/4- 1/4 -
ADVANCED WASTEWATER TREATMENT
SYSTEM WILL BE REQUIRED
19 PERCOLATION RATE 120 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 6.5 FT. AND 7.0 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO
SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: BENNY MAUS
COMMENTS:
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERF RMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE:==W-24v
ooQ�40
GARNESS ENGINEERING GROUP, Ltd. _ y440
+•.---+ CONSULTANTS 6 GENERAL CONTRACTORS ��������•�•-• it 4
3701 L Tro AW O. WK 101 • NNCHORACL N *QW7 •ROK: (W7)W-Gin • Fw • WLBWL ywn ,w Vwww"- n
......... .
SOIL LOG — PERCOLATION TEST
LEGAL DESCRIPTION: SOUTH HILLS, LOT 1, BLOCK 4 e •.Jeff A. am s: 0
PERFORMED FOR: DUSTIN SHANNONDATE: �. —7953
7 2 2007 4 • •C7
DEPTH- �a f°�0\ o
(feet) y»>_ TEST HOLE#21�00000��oa
1 �»y ORGANICS
SOIL CLASSIFICATIONS
2 yam» _ ! = 1
-===`•4;ro-; GW = ORG jE z
3 r :r+ t GP r ML
GM CIL A3
4 ML GC OL
°.Woo SW MH
5
•: SP CH { 1 N
SM x OH
SC
L'------IH(1 TH/ ; - 1
6 HILLSIDE WAY —
9 SM/ML ; scaLE:l
10 TIGHTLY BONDED An c I ' CsEUI
11
12
13
14
13.0.11.
15
16
17-
18-
19-
7
18
19 PERCOLATION RATE - (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 6.5 FT. AND 7.0 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO
SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: BENNY MAUS
COMMENTS:
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERF RMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE:
DEPTH TO
GROUNDWATER
DATE
DRY
7/2/2007
DRY
7/10/2007
DRY
9/18/2007
6"
-
DATE
READING CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
7 3/2007
1 2:35
-
6"
-
2 3:05
30
6'
0'
UNSUITABLE FOR ONSITE
SEPTIC SYSTEM
140-C4-CT 12:2° FP:1.4- T-410 P.004/C0T F-004
.. 96268 • I�.AI 1.— yC'
1 A
- Municipality CF Anchorage (At; w'"+''' .•
tr. r
•
OEPARTMEN7 OF HEALTH £ HUMAN SrnviCts 44.r, e;,�sit, � v /
8251:Siveet, Anchorage,Alaska 11/150:i-06543 lip ..:w_ 1I �s -
SOILS LOG P flCOLAYION TEST ek-4% fir •, .�/
Test 11o1 1 `1 47
rERronwco ,or .1�.oil DCT% ) band Tnvectrientes _, CATE eta ts2• 1 ♦�
1 p4 Soul I1 1111.1 Township.flsl,pa. Section:
LEGAL OESCR1r n*I. .
$I.Or'E 117E r1,;1N
-� .-, , _ ■lim iii■■ ■
3 -.--• •:"• I 1 _ .17,p i `■■■ ■
., • i
__
....,. I /4.1 ii
• al 1
rte_ ■ IN III
�� I.•'• Slightly Sandy, Slightly Pr IIII
s - t � Gravelly 6flt with IL I IC ._I ■ll
r tccaantonal Rock to 8" . ■a
7 -! Pry, prune
,-- I i I ■■■ ■ ■■
9 til I ■ ■ 1�1 ■■■
wASCA01,r+e1w>,TaM1
10 •-�` ,• ' ENCbt1NTERfnI NOW::
r -- 3 N —
IIIIC RS,AT WNAT pv
r ; 0e0T111 r ■� N■■■
r . I �w» "dor 2, a,IC 6/14/.96■ E ■■111111
•r + Gifts' Iw. n.A lw I, Nil
14 ---L;,., i r'dtriy alb T..nr T11M YV.a.0 OPOP
,
+-L. ' I 1 _ /14/96 - 30 ". 1 l
•1
15 �� I.- I • 2 /14/96 30 G" 1 2"
1a 1- • ` 1lottom or _ ) /14/96 3Q ..$_i 1.121`
Test (tole
1) - _ — '
18 --- -.- - s
_ - - '
70 -
r`ErcOLATroM!►AAI ...f.1— In• .vm IsPC,Kxtt ssAAIEM1 F"
I..
11$rROM e11WEEN . 5•O .rrANr., FT •
commENTs SOi]E were pre noaked prior 19 running •tentr (8 hlourh) •
rrAlOnuro ay. USS R1 L • of
Y IIIA1 T►ag MT WAS PERFORMED IN
I
ACCOr+CA►+Crt Ws films STALE AND siu,CIPAI cuturtasEseN iFICCT ,'ai • . DAfe: 6120/96
mar*Irk ♦.na} - I
. I
WAY -04-07 12:25
TEST II
6
LEGAL DES
FR01f-
W v• 96268 1'
MunlclPAIlly of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
I .8251.' SVa91, Anchorage, Alaska 8902-0650
SOILS LOG — PEFICOLATION TEST
OATC
T-410 P.005/001 F-004
C-.� tj s I T'F— r (— c s,
LOTTp/a(LOOCCKSID
3 I I LOT BLOCK
NO
n
HILLS
6
GARNLSS LNGINLCRING GROUP, Ltd.
--- CONSULTANTS& GENERAL CONTRACTORS------ ......•• ......••
nor c noon ■ao. sure +or • u+cwnicc..�c Nw� • nqw[ (007)."7-61» • Iur (OOn].b-]1b • Y'[MIt - w..
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ....... ......•••
DUSTIN SHANNON 360-6551 1 OF 1 �Q '• (r Y A. Garness:'
LEGAL DESCRIPTION: DRAWN BY: OO CE 79531 `�
SOUTH HILLS S/D• BLOCK 4• LOT 1 K.D.M. �� e ' Ol j J.13 FQ o
TYPE OF WORK: DATE. �4, j,,r ooOoo
TOPO DRAWING 6/28/2007
MUNICIPALITY •_4 ANCHORAGE
Development Services Department
On -Site Water & Wastewater Section
Parcel I. D. 017-072-10
q.; b
Phone: 907-343-7904
Fax: 907-343-7997
Certificate of On -Site Systems Approval
1. GENERAL INFORMATION
Complete legal description
Location (site address)
Expiration Date:.!j ' "'2-1
South Hills Block 4 Lot 1
7777 Old Hillside Way
Current property owner(s) Jeffrey Hall
Mailing address
Real estate agent
Day phone
7777 Old Hillside Way, Anchorage, AK 99516
Brandy Pennington
2. TYPE OF DWELLING:
0 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 2
Day phone (907) 336-7653
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: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ -550
Date of Payment /Ac'A1
f
Receipt Number 0/2 931D
COSA # 0S G Z I I QZ6
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 Forge Engineering Phone (907) 522-7773
Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503
Engineer's Printed Name Benjamin Schiller Date 1/26/2021
6. DSD SIGNATURE
System #1 Approved for
.- bedrooms
System #2 Approved for bedrooms
Disapproved
Conditional approval for bedrooms,
STH
... el..: ..........
Benjarr :y5chiller
6"CE 26 292
pROFESSO .
with the following stipulations:
'7"6. if= C /14+fA e,En, �✓� l tl U i`t:rth. / r -A f't A rte! Z,.,,, .4t
•err,-
;�
%V1>
tJti`
,,J�eI-W�ENT
By: Original Certificate Date:
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 Checklist blue sheet
Legal Description:
COSA Checklist
South Hills Block 4 Lot 1
If more than 1 septic system on lot: COSA Checklist # of
A. WELL DATA
❑ Well log is filed with Onsite (or attached);
Date drilled 8/8/08
Total depth 400 ft
Cased to 109 ft
❑E Sanitary seal is functioning correctly
0 Wires are properly protected
Casing height (above ground) 21 in.
Date of flow test for COSA 12/16/20
Static water level at beginning of test 49.7 ft.
Comments
B. TANK DATA
Age of tank(s) 3 years
Tank type/material SEPTIC/STEEL
Measured operating fluid level in septic tank
❑t Standpipes/foundation cleanout per record drawing
Date of pumping
D. ABSORPTION FIELD DATA Shallow Trench
Which system tested (date installed) 9/29/17
❑■ ALL standpipes present per record drawing
Total measured depth from grade 11,7/10.4 ft (max)
Measured depth to pipe invert from grade 75/7.1 ft (min)
❑ N/A — pressurized field
❑E Monitor tubes go to bottom of effective. If not, state
depth into effective
Parcel ID: 017-072-10
Structure served by this system
Well production at time of test .5 gpm
Water storage tank volume 120 gallons
Well disinfected for coliform test? ❑ Yes ❑■ No
le❑ Coliform bacteria is Negative
Nitrate mg/L X Nitrate less than MRL (ND)
Arsenic ug/L ❑■ Arsenic less than MRL (ND)
Collected by FORGE ENGINEERING
Date of Sample 12/10/20
C. LIFT STATION
❑ Required maintenance completed
Age of lift station N/A years
Lift station material N/A
Comments:
Adequacy test date 1/12/21
Results [D Pass For 2 bedrooms
Fluid depth prior to test 31/19 in
Water added 1649 gal
New depth 50/30 in
Elapsed time 1440 min
❑ Code -required soil cover over field
Final fluid depth 47/27 in
❑ System presoaked Absorption rate 312 gpd
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months)
date of test) If yes, enter date
Gallons introduced gallons
Comments/Deficiencies: Two systems with a bull -run valve, both trenches tested together. Valve set to neutral to divide flows
,COSA Checklist yellow sheet
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Building Foundation > 10'
Septic Tank/Lift Station on Lot > 100'
Yes
if No
Community Sewer Manhole/Cleanout > 100'
0✓ Yes
if No
ft
7] Yes
if No ft
Neighboring Tank > 100' Q✓ Yes
if No
ft
Private Sewer/Septic Line > 25' 0 Yes
if No ft
Absorption Field on Lot > 100' 0✓ Yes
if No
ft
Holding Tank > 100' 0 Yes
if No ft
Neighboring Absorption Fields > 100'
if No
ft
Animal Containment > 50' 0 Yes
if No ft
❑✓ Yes
if No
ft
ft
F. ENGINEER'S COMMENTS
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' �✓ Yes
if No
ft
0✓ Yes
if No ft
From Septic/Holding Tank on Lot to: (Please
enter
distances if less than required)
Building Foundations > 10' Q✓ Yes
if No
ft
Surface Water > 100' Q✓ Yes
if No ft
Property Line > 5'✓Q Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5' 0✓ Yes
if No
ft
Private Wells > 100' ❑✓ Yes
if No ft
Water Main > 10'✓❑ Yes
if No
ft
Community Wells > 200' 0✓ Yes
if No ft
Water Service Line > 10' Yes
if No
ft
If septic tank is under driveway comment
below
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10'
❑✓
Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
Yes
if No
ft
Wells on Adjacent Lots:
Water Main > 10'✓Q
Yes
if No
ft
Private Wells > 100' 0✓ Yes if No ft
Water Service Line > 10'
Yes
if No
ft
Community Wells > 200' 0 Yes if No ft
Surface Water > 100'✓Q
Yes
if No
ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION
\
1 certify that 1 have determined through field inspections and review `,�., OF !�,ql�i
of Municipal records that the above systems are in conformance with �r,`Q�• ' • �i�• ��
MOA COSHguidelines in effect on this date. j* .�
.49TH
. ........ ...
�• Benja ' chiller
��,��sl�C:. • 1/26 292 ..����� A'COSA Checklist yellow sheet lii��PROFESSlO�P����
Municipality of Anchorage
Development Services Department :x
Building Safety Division �...:.. A
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
Septic System Advisory
Certificate of On -Site Systems Approval # OSC211026
A recent adequacy test was performed on the septic system for Block 4, Lot
1 of South Hills subdivision. Results indicate that both trenches are at or
near end of life. Please note the system passed for meeting the needs of a
two-bedroom home, the remaining life expectancy may be limited.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval
Municipality of Anchorage ::.:::.R�
Development Services Department "`<:�
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
Water Well Advisory
Certificate of On -Site Systems Approval (COSA) 4 OSC211026
During a recent COSA on-site inspection and test of the potable water
supply well on Block 4, Lot 1 of South Hills subdivision, the well's
productivity was determined to be .5 gallons per minute. The minimum well
productivity required by this Department (AMC 15.55) for a 3 -bedroom
residence is .31 gallons per minute. Although the subject well currently
exceeds this minimum requirement, all parties concerned,are advised that the
production capacity of the well may fluctuate. Restriction of non-critical
water uses such as washing cars and watering lawns and gardens may be
required.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
51,
GE
E N G I N E E R I N G
PO BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
January 26, 2021
Municipality of Anchorage
Development Services Dept- On -Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: South Hills Sub, Block 4 Lot 1— 7777 Old Hillside Way
Septic system testing and COSA
Dear On -Site Services Engineer:
The owner of this lot is selling the home, and it currently has an Advantex system with two septic
trenches on it. The original trench had reached failure in 2017 and a new trench was installed that
year. During the installation, the two trenches were connected with a bull -run valve.
In our testing in December of 2020, the newer trench did not absorb enough water on its own to
pass for a COSA. However, we were able to test the two trenches together, and the older trench
had recovered enough to assist in the test. Together they absorbed 312 gallons in a 24-hour period.
We have adjusted the bull -run valve to a neutral position that will evenly split the flow between
the two trenches. We hereby request a two-bedroom COSA for this combined system. As we are
technically making use of the alternate site for this system, the new alternate site will need to be a
re -build of one of these two trenches to allow for it to function individually.
Sincerely,
Benjamin Schiller, PE
uci �an q�ywi unci
CE 12592
.1/26/21 v ,�
Uv�i Lif tULV 1J. YL VVVVi fC
Hr -L. Z-
369 599
�. ■ via an no R R■■ R■
rranT Field Maintenance Report
Annus1 lnspe•( tion
Praparty OWnurrr}tdking c
Jeff ball
Slt? Addrd"
77777 Old Hillside 1N,r !, Anchorage AK 99516
AX Stto ID iF County 1�
AX -118135 SV 070271
Retrieve O&M Info
Dally flow--..
Retire ratio_
Timer settings:
Perform Field SaMP'll Ig/Observations
NTU (15 1- NTUs) pit (6-9) Do (2-a)
7
Odor of Sample
Typical AMUST ❑ Earthy F7 Moldy
Non -typical I4 SUlfi t : ❑ Cabbage ❑ Dscay
Oily film in PVU Yee No
Foam in tank Yes No
Check Control penFr
Recite Amps Discharge Amps
/0
Audible and visual al;e ms ()K
Dial tone (telometry rr ly) ❑ Yes o
lnspeCVClean Puml SyStam //
Inspoot Clean
Rlser/Lid ......... ...........
Splice Box . . . ..... ........ . .
Float Cords ....... ...... • .. .
Floats ............ ...........
Pump............
Biotubee' Filter, ... .....
elotubo Pump Vault: ....... _ .. .
Reclrcr lating Splittcrl Ja1Ve.......
comments _
Signature°
Pod t
406454
r-Hl7C Q0
R ■■ R■■ ■ E
M ■ R1■ IE
A maps PRO � w,
AnchorageTank
907-272-3543
ator
rry Betts
i_._
Slomat: Normal
INone/Minor
_j
Ogntact Plronn
❑ Excessive
(907) $10-8004
RRU gAjLft
nate of Lett Inepe,ttan
RTU114546
07130/2019
Measure Sludge/Scum
Sludge Scum
Inspect/Clean Advan'lex Filter
Odor: Normal
❑ Pungent
Slomat: Normal
INone/Minor
❑ Excessive
Bridging/Ponding;
❑ Excessive
Inspect/Clean Alscharga Pump System
inspect
Riser/Lid u
Splice Box ❑
Float cords ❑
Ins,,,--pefffct Clean
Laterals/Orifices tri
Pod Bottom ��Jy�
Intake Vent:
Inspect Clean
Floats �••� l J
Pump ❑ ❑
llnspect/Service Other System Components
lnspcot Clean InWrt Clean
Disinfection Equipmerd 01� � Diepsmal Laterals/Oritices ,_eY
Observations —�
Additlorial ServiCeS Rendered
❑ Cleaned textile sheets? ❑ Replaced UV items?
❑ Rcplaced/Used other lterrts?
Parts Used: W = Warranty, B = Billable (.✓ appropriate salactlon)
in? a roam fJumbpr Deseerl"on
Final/Safety inspection
SV reinstalled
manifold reconnected; flush valves closed
Su m mery/R a commandations
❑ System performing; no further action needed
.n Call for service
La Llds bolted on
-Pfontrol panel reactivated
[]Tank needs pumping
❑ Other? _
bate 1
Fax completed form to 1-$66,384-7404
uocuciign tnveiope ID: CCDA9892-F8C9-4765-B750-09OA78ADEFIC
MUNICIPALITY OF ANCHORAGE
F
�kyj�, * :�.
a
0
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of this 28 Day of January
JEFFREY R HALL
of 2021 , by and between
herein the "OWNER," and the Municipality of
Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
I • Advanced Wastewater Treatane;Int .Sys#ems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as Advante x Waste haler Treatment System
located at (legal description)
South Hills Block 4 Lot 1
2. Maintenance R—Dairsand Al ns.
EosT4(Owner is required to read, understand and. initial each section)
ughout the term of this Agreement, the Owner shall enter into a service agreement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
D8 accordance with the equipment's approval for operation in the Municipality.
�tsjall be the responsibility of the Owner during the term of this Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
os includes an annual maintenance fee (typically $400 to $600).
—er agrees that only maintenance and repair personnel approved by the Municipality
or the manufactur'er's representative will inspect and make any necessary maintenance,
Zirs or permitted alterations to the system.
Lz er acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or dlainfield
replacement.
(rev. 05/18/201.8)
Page 1 of 3
N
vocu5ign Envelope ID; CCDA9892-F8C9-4765-8750-090A7BADEFIC
anj4acknowledges that the Municipality may request records of maintenance and
LoS repairs from the manufacturer's representative or maintenance provider.
69er acknowledges that the fine e for fading to maintain and repair an AWWTS may be
5DSCassessed in accordance with AMC 14.60.030.
er agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give. at least 24-hour notice.
DS AEWWTS
er agrees that any sale or transfer of title of the property will not occur without a new
IDS:, Lcertifcate of On -Site Systems Approval.
er agreesthat the AWWTS installation and maintenance requirements asp rovided
by the AWWTS vendor/installer and approved by the Municipality are the governing
=FZer
lines for the construction, maintenance and repair of the Owner's AWWTS.
agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. ANOnwaive'r. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7, Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
(rev. 05/18/2018)
Page 2 of 3
—cualgn tnvelope 1p: CCDA9892-F8C9-4765-B750-090A7BADEF1C
OWNER:
DocuSi ned by:
By: Z(signature)
111822EC7ACA475...
JEFFREY R HALL
(print name)
Date: 1/28/2021 1 3:29 PM PST
STATE OF ALASKA )
) ss.
THIRD JUDICIAL DISTRICT )
The foregoing instrument v as acknowledged before me this o?8 day of
20 by
NOTARY PUBLIC F ALASKA
My Commission expires: "Jov / Y, zvt
MUNICIPALITY: �
By: � ` �16- ` (signature)
(rev. 05A%TM)
NOTARY PUBLIC
Brandy B. Pennington
STATE OF ALASKA
My Commission Expires Nov. 14, 2021
Date: --,Zg2 /
—
(print name) Title:
Page 3 of 3
3 3 fU
•
4 �
• ": Municipality of Anchors '>�c
On-Site Water and Wastewater Program ; J 'Lu i( ��'
(907) 343-7904 1 ! S T
CERTIFICATE OF ON-SITE SYSTEMS AP.RROV/�,LC,"
Parcel I.D. 017-072-10 Expiration Date: (-17-lei)
1. GENERAL INFORMATION
Complete legal description SOUTH HILLS BLOCK 4, LOT 1
Location (site address) 7777 OLD HILLSIDE WAY,ANCHORAGE, AK 99516
Current Property owner(s) DUSTIN &ASHLEY SHANNON Day phone
Mailing address 7777 OLD HILLSIDE WAY,ANCHORAGE, AK 99516
Real Estate Agent Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ 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 ❑ Public Sewer ❑
Public Water System ❑
WaiverNariance request for: Distance:
Received by: y �j // / ;,,/ Date: /U /
COSA to be released to the engineer, unless oth J /requested by the engineer.
COSA Fee $ Waiver Fee $
Date of Payment ��! �Q / Date of Payment
Receipt Number 0 9790 Receipt Number
COSA# aben InD 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 10/4/2017
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. OF .4Z4
Aar
* 4• TH A.
6. DSD SIGNATURE /—
ySystem #1 Approved for LI bedrooms. 4 ,;r; E1„ M. rIP \ `
System #2 Approved for bedrooms. + %� 7�s �
Disapproved. \ P`` .ifs 1o`�`
Conditional approval for bedrooms, with the following stipulations:
v
ON
=z �PN0R o=
�
� � � cn
o �p,S��GRP _:
MENT
• Original Certificate Date: 1017 —(7
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 1 Parcel ID: 017-072-10
A. WELL DATA
Well type PRVT If A, B, or C provide PWSID # Well Log (YIN) Y
Date completed 8!812008 Sanitary seal (Y/N) Y Wires properly protected (YIN) Y
Total depth 400 ft. Cased to 109 ft. Casing height (above ground) 24+_ in.
FROM WELL LOG AT INSPECTION
Date of test 8/8/2008 7-17-2017
Static water level 71 ft. 24 ft.
Well production _ 0.5 g.p.m. *3.1 g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 mL Nitrate ND mg/L
Arsenic: ND ug/L Date of sample: 9114/2017 Collected by: ARCTERRA
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC 1 STEEL Date installed 7130/2008
Tank size 1500 gal. Number of Compartments 2 Cleanouts (YIN) Y
Foundation cleanout (YIN) Y Depression over tank (Y/N) N High water alarm (Y/N) Y
Date of pumping 7/7/2017 Pumper __A+
C. ABSORPTION FIELD DATA
Date installed 9/2912017 Soil rating (g.p.d./ft2 or ft2/bdrm) 1 System type ADVANTEX-SHALLOW TRENCH
Length 45 _ _ft. Width 5 ft. Gravel below pipe 4 ft.
Total depth 9.3—11.9 ft. (Measured 10/4/17) Eff. absorption area 450 ft2Monitoring 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) N 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 5'+ 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 100'+
F. COMMENTS
*2015 well frac by WPS. 160-gallon water storage tank inside house.
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. OF t \ '
Engineer's Printed Name KENNETH M. DUFFUS �`�`
f * ,
Date 10104/2017vomit
,� 4 • TH
-4111
COSA canary sheet_2-6-15 doc KENNETH M. DI �
4011
PRop ss oc'‘' i
``+41"
OLD RABBIT CREEK ROAD -------
-C)
--ro
Ci
tO
N86'06'01"W 152.27'
(N85'52'10"W 152.30' R) 1
50.0'
;® WELL
f
1
--2 1
CV -
OQ
in
h'7 LLI P'7 N NOz
>_. CD
,. tf] O
J NO tr)
0Li
3 o LOT 1 �' o f
'- o
i* BLK 4 W3 a)
oo x
0
Z4 � N
v 0 Q
zo 1
!► DECK 27.0'
v7.9' TEMP SHED 37.0'
NO RCN
`( 'vi '0 EXISTING
n HoUJt. ry 2.5'x14.5'
I CANT
i 37-0' 28.5'
COVERED �'71�1,
ENTRY . N 5 N 17.0.• I
SEPTIC .
• SYSTEM GRAVEL
'r) D/W
_� l0' U7lLITY_~
t; ESMT
CD N83'42'pp��W 50.0' 1
o
BASIS 153.15' (R&M)
OF BEARING
G- - _ --
iOn
HILLSIDE o
_ -- WAy
ANCHORAGE RECORDING DISTRICT,ALASKA �,„
ASBUILT OF: ~'�-
SOUTH HILLS SUBDIVISION OO =FND REBAR --
LOT I BLOCK 4 PLAT P-636 in
�4�!"``
SURVEY CERTIFICATE: I,John L.Schuller,Have conducted a of'v,,
OF A�,` ..,,„1, LAND�v
physical survey of this property as shown on this drawing and that the '/ �`S.. '' • 1t5 11 �•�tiQ � f
improvements situated hereon are within the property lines and no . (_ 4+ y,� G�,
enchroachments exist other than noted Under no circumstance should / ?: 49TH j • o f
CI
any information on this drawing be used for construction of fences, * •�
structures,improvements,or for establishing boundary lines. if •
EXCLUSION NOTES:It is the owners responsibility to determine / 70 . il `''�
the existence of any easements,covenants,or restrictions which L.�. L. SCHULLER. / ' _ Q }
do not appear on the recorded subdivision plat. �� LS-10408 "t .�,
@„ �c/ 1831 Talkeetna Street
WORK t>1t0E. Nuua(t: °'"E E-Wrl: 1 •eo •'<f9:.'S.:(•' a i Anchorage. Alaska 99508
OCT 3, 2017 1'=40' N A t`
17-047 *"B1^°E°®rr MD NUM rooKAAGL \�0ressi0n0\ ; (907) 227-1455 office
JLS SW2940 170161 `\��`��� (907) 274-4992 fax
ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND
REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE
AND_(Buyer) -tom- I- Hit,),\
THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this
I() Day of c c1�� of 2011,by and between \ f 4-- k u
herein the"OWNER,"and the Municipality of Anchorage,herein the
"MUNICIPALITY." In consideration of the mutual covenants contained herein,the
parties to this Maintenance and Repair Agreement agree as follows:
1.Advanced Wastewater Treatment Systems. Municipality grants permission
to Owner to utilize and operate an Advanced Wastewater Treatment System
(AWWTS),described as Advantex AX20
located at(legal description). 7777 Old Hillside Way,Anchorage,AK 99516
SOUTH HILLS BLOCK 4,LOT I
2. Definitions.
Alteration. Any change to the design or function of an AWWTS that includes
the installation or removal of any parts,components or pieces not included in the
original construction permit and design.
Certificate of On Site Systems Approval (COSA). An approval by the
Municipality of existing water and wastewater disposal systems given at the time
of property sale and title transfer in accordance with Anchorage Municipal Code
(hereinafter,"AMC") 15.65. These approvals certify that the systems are adequate
for the homes that they support and meet the codes that were in place at the time
of system construction.
Damage. Any man-made or natural change in a system that would inhibit the
system from performing as designed.
Maintenance and Repair. The scheduled and as needed replacement of
existing parts,components and pieces of an AWWTS that were included in the
original design which would allow the AWWTS to continue to perform as
designed.
Permit. An On-Site Wastewater Disposal Permit as required by AMC 15.65 to
construct and operate an AWWTS.
3.Term. The term of this Maintenance and Repair Agreement shall begin on the date
of approval by the Municipality to operate the installed system or issuance of a
COSA,and shall continue while the AWWTS is in use or is operational or until
1
the property is sold or title is transferred by the owner and a new COSA is issued
to the new owner or transferee of the property.
4.Alterations, Installation and Removal of Additional Equipment. Prior to
performing any alterations to an AWWTS, the owner agrees to obtain an On-site
Wastewater Disposal Permit from the Municipality in accordance with AMC
15.65.
5. Maintenance and Repairs.
A. Throughout the term of this Maintenance and Repair Agreement,the Owner shall
maintain their AWWTS in a satisfactory condition capable of producing treated
septic effluent in accordance with the equipment's approval for operation in the
Municipality. The owner shall enter into a service agreement with an AWWTS
service and maintenance provider approved by the municipality and the
manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it
shall be the responsibility of the Owner during the term of this Maintenance and
Repair Agreement,and any renewals thereof, at the owner's sole expense,to pay
for any and all: (1)repair(s), (2)maintenance, (3)adjustment(s),(4)replacement
costs, and (5) inspection costs.
B. Owner agrees to comply with all applicable ordinance, laws, regulations,rules
and orders for the AWWTS.
C. Upon request by the Municipality, the owner agrees to provide the Municipality a
written schedule of routine maintenance and repairs which have been performed
on the system. When a record of maintenance is documented and maintained by
the system vendor,the owner agrees to allow the Municipality access to this
information.
D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS
may be assessed in accordance with AMC 14.60 for improper discharge.
E. Owner agrees that only maintenance and repair personnel approved by the
Municipality will inspect and make any necessary maintenance,repairs or
permitted alterations to the system.
F. Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS upon 24 hours written notice.
G. Owner agrees that any sale or transfer of title of the property will not occur
without a new Certificate of On-Site Systems Approval.
H. Owner agrees that the AWWTS installation and maintenance requirements as
provided by the AWWTS vendor/installer and approved by the Municipality arc
2
the governing guidelines for the construction,maintenance and repair of the
Owner's AWWTS.
I. Owner agrees to provide and maintain a telephone connection to the AWWTS as
required by the AWWTS approval.
6. Nonwaiver. The failure of either party at any time to enforce a provision of this
Maintenance and Repair Agreement shall in no way constitute a waiver of the
provisions,nor in any way affect the validity of the Maintenance and Repair
Agreement or any part hereof,-or the right of such party thereafter to enforce each
and every provision hereof
7.Amendment.
A. This Maintenance and Repair Agreement shall only be amended, modified or
changed by a writing, executed by authorized representatives of the parties,with
the same formality that this Maintenance and Repair Agreement was executed
with,and such writing shall be attached to this Maintenance and Repair
Agreement as an amendment.
B. For the purposes of any amendment modification or change to the terms and
conditions of this agreement,the only authorized representatives of the parties
are:
a. Owner: )12.141"6.5.,- ( nGG L
b.Municipality: Director,Community Development or designated authority
C. Any attempt to amend,modify,or change this contract by either an unauthorized
representative or unauthorized means shall be void.
8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance
and Repair Agreement shall be brought in the Superior Court for the Third
Judicial District of the State of Alaska at Anchorage.The laws of the State of
Alaska shall govern the rights and obligations of the parties under this
Maintenance and Repair Agreement.
3
9. Severability. Any provisions of this Maintenance and Repair Agreement decreed
invalid by a court of competent jurisdiction shall not invalidate the remaining
provisions of the Maintenance and Repair Agreement.
OWNER:
By: - (signature)
AM. I- (print name)
. r
STATE OF ALASKA )
) ss.
THIRD JUDICIAL DISTRICT)
Date: / i(- - 20 1 7
The foregoing instrument was acknowledged before me this 1 CAy of OG 60e--"‹
2011, by C'e- c-• 1A-74- •\
.SN%II` Al. "--5 NOTARY PUBLIC FOR ALASKA
My I mission 'M,ires: 14—?I^ ?U 121 ii
MUNI ALITY: + LORIN LYyPublic I
HIGGINS
of Alaska
IiAy Commission ExplrosApril 21,2021
lay.:.-- _ ` (signature) State
(print name)
Date: 1 0^ ( 1 —(1 Title:
4
Municipality of Anchorage
as e
Development Services Department �'�'" '"`�'•
Building Safety Divisionv-3 e
Onsite Water and Wastewater Program s e
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519.6650
www.muni.org/ons4e
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcell.D, 017-072-10
1. GENERAL INFORMATION
Complete legal description $oUth Hills Bloat 4 Lot 1
Location (site address) 7777 Hillside way, Andarage. AK 99516
COSH# Oq 0053
Expiration Date: (o —6 -09
Current Property owner(s) Dustin a Ashley Shannon Day phone
Mailing address 68000'MalleyRd. Anctwage,AK 99507
Lending agency Day phone
Mailing address
Real Estate Agent Day phone
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual Well
✓❑
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
❑✓
Individual Holding Tank
❑
Community On-site
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of Onsite 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 Onsite 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 Onsite 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 sample results. (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 engineers work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seat affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of OnSfte 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 Watkins en¢tneedrg, Inc.
Address ISO Box 110443. Arwhorege, AK 99511-0443
Engineer's Printed Name Cindy W. Ellis
S. DSD SIGNATURE
Approved for � bedrooms.
Disapproved.
Phone 907-a°a118511
Date 2/16/09
49 7t1
Conditional approval for bedrooms, with the following stipulations:
W. euu
- loll"
M
• ON-SITE
AlhKANU
WARTFWATFR =
PROGRAM
Attachments:
COSA Checklist X Arsenic Advisory
Septic System Advisory Maintenance Agreements
Well Flow Advisory Supplemental Engineer's Report
Nitrate Advisory Other
By�: Original Certificate Date: 3
(RW« 11W)
Municipality of Anchorage
Development Services Department
Building Safety Division
Onsite Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519.6650
www.muni.org/onsRe
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: southHllls 8lock 4 Lot 1 Parcel ID: 017-072-10
A. WELL DATA
Well type Pri If A. B, or C provide PWSID # _ Well Log (YM) Yes
Date completed 918109 Sanitary seal (YIN) Yes
Total depth 400 ft. Cased to 109 ft.
FROM WELL LOG
Date of test 918108
Static water level 71 ft,
Well production 0.5 g,p.m,
WATER SAMPLE RESULTS:
Coliform o coloniesH00mL Nitrate 0 mg/L
Arsenic: 11.2 mgA Date of sample: 1/28/09
B. SEPTICIHOLDING TANK DATA
Tank Type/Matedal steel septic tank
Tank size 1500 gal. Number of Compartments 2
Foundation cleanout (YM) Yes Depression over tank (YM) ra
Date of pumpingNA - new Pumper NA
C. ABSORPTION FIELD DATA
Date installed 7/30108 Soil rating (g.p.d.M" or ft21bdrm) t.o Cat lll
Wires properly protected (YAV) yes
Casing height (above ground) 24 in.
AT INSPECTION
ft.
g.p.m.
Other bacteria a colonies/100 mL
Collected by: Raley Trainor, Watkins Engr
Date installed 7/30/08
Cleanouts (YM) yes
High water alarm (YAV) yes
System type shallow trench
Length 55 fL Width 5.0 ft. Gravel below pipe 3.93 ft.
Total depth 8.7 ft. Eff. absorption area E3 ft' Monitoring tube Yes Depression over field no
Date of adequacy test NA -new Results (PassTail) For 3 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 None Size in gallons
'Pump on' level at _ in. 'Pump off level at_ in.
Datum Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on tot 200+
Absorption field on lot 200+
Public sewer main too•+
Sewer /septic service line 100'+
Manhole/Access (Y/N)
High water alarm level at
Meets alar 8 circuit requirements?
On adjacent lots 100'+
On adjacent lots too'+
Public sewer manhole/cleanout too•+
Holding tank 100'+
Animal containment areas 100'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT T0:
Building foundation 6'+ Property line z0� Absorption field 8
Water main 100'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots IW+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main 100'+
Water Service line 10'+ Surface water 100'+ Driveway, parkingfvehide storage 101+
Curtain drain 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
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name Cindy W. Ellis
Date 2116/09
COSA Fee $1j /
Date of Payment Z2 &
Receipt Number _ �.L o "T
(Rev. 11105)
Waiver Fee $
Date of Payment
Receipt Number ''
in.
Municipality of Anchorage
�B4
• Development Services Department
Building Safety Division
- On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
Arsenic Advisory
Certificate of On -Site Systems Approval # 090053
A Certificate of On -Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block 4, Lot 1 of
South Hills Subdivision. This inspection revealed an arsenic concentration
of 11.2 micrograms per liter (ug/L) for the property's well water sample.
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 ug/L for public drinking water systems.
While private wells are not subject to this regulation, EPA standards are
based on existing health information and can therefore be used to gauge the
relative quality of water from private wells. Information on arsenic is
available from the On -Site Water and Wastewater Program website
(www.muni.or /og nsite) or at 343-7904.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
2
J
OLD RABBIT CREEK s
eo 3-STWf
N OWaUW m ('
N I
9.6• Vit, ~.r 't.oz0• ' 25' I
_...___ 3.9'
N 86.11'19' w
I
I
I
_I
i
I
I
I
I 1
1.2 Ac
I
I
I
I
I �
I 0�
I �
I el detiaQ
N 83'4515' W 1
HILLS/DE A y
NOTE: 1) Bearings and distances areas per plat 11P-636 (Plat Illedgible) • Found property comer
NOTE: 2) Driveway not constructed at time of survey. o Septic vent pipe
50.00'
5ENTEC
Surveying • Engineering EXCLUSION NOTES: It is the arCo jl Q TM • ;9
2525 Gambell Street, Suite 200, Anchorage, Alaska 99503 owners responsibility to determine
>I••u• • • • o•
Tele: 907)563 3835 Fax: (907)5633817 the existence of any easemrnts
ASBUILT OF: LEGAL DESCRIPTION covenants, or restrictions which do •i•�•S�•?•^•'•'.7 •.••w•••••i
Lot 1 Block 4 not appear on the recorded 0 v ;MICHAEL J. HORNED €
r subdivision plat. NOTE: Under no L„ .• No. 18 P
m�
South Hills Subdivision, Alaska circumstances should any data Fye .,� p•,. ,os
hereon be used for the construction o • •• ••+� •
p mom or for the establishing of property ,� °pFE$stwa`�•�
07-472$ TUN MEe "` �� lines.
,��%��•-