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MOUNTAIN PARK ESTATES #2 BLK 3 LT 20
Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP231054 PID Number: 017-022-32 Dwelling: [Z Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑ Upgrade Name Brian & Krista Kuhn ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ® Bed ® Mound Site Address 12921 Foster Road ® Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 4.0 GPD/SF 2.68* Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 2.43* Ft. Gravel depth beneath pipe 0.25 Ft. Subdivision Block Lot Mountain Park Estates #2 3 20 Fill added above original grade +0.06 - +0.86 Ft. Gravel length 20 Ft. Township Range Section Gravel width 18 Ft. Beds: Number of Lines 8 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 300 Ft z Ft. Well 100'+ 100' 100'+ 25'+ TANK El Septic [@ S.T.E.P. [I Holding EI Other Manufacturer Capacity Surface Water 100'+ 1009+ 1001+ Anchorage Tank 1500 Gal. Material Number of compartments Lot Line 59+ 109+ 59+ NA Epoxy- Coated Steel 2 FoundationLIFT 101+ 101+ 101+ STATION Manufacturer Capacity Remarks Bed is an intermittent sand filter system. Existing** Gal. *Original grade from prorile as -built from Forge Engineering Alarm location Garage Electrical installed by Larry Betts dated 11/6/19. ** Lift station pump replaced 8/17/22 & reinstalled. Installer PIPE MATERIAL House to tank D3034 Tank to drainfield D1785 Northern Excavation Drainfield D1785 CO/MT D3034 Inspector Arcterra Consulting BENCH MARK (Assumed elevation) 100 ft Inspection sc dates: .5/30/23 2nd 5/30/23 Location and description p 3rd 5/31/23 4'h 6/1/23 Garage Floor Slab ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp OF44t Conditional Approval: Date+�P� aft 410, % ` int 4981 WYdYiYWYIWYfiiWYY�YYYiYiY L ,7 o %, KENNETH UUFFUS + ♦ CE 711 1# Septic System Approved Date 2�+�,, � Note: this approval does not include well permit requirements.� i1%��+�• �i v v:nvu ro) AS—BUILT SYSTEM DETAILS/SITE PLAN Permit ❑SP231054 MOUNTAIN PARK ESTATES #2 BLOCK 3 LOT 20 PID# 017-022-32 i � I 1 A -C=56.5' A -J=43.0' B -C=57.4' B -J=74.7' A -D=62.8' A -K=45.6' B -D=64.6' B -K=76.1' A -E=39.5' A -L=47.7' H B -E=58.4' B -L=77.6' o A -F=56.4' A -M=49.4' B -F=71.7' B -M=78.8' o A -G=40.3' A -N=52.1' � B -G=72.9' B -N=80.6' A -H=57.6' A-0=54.8' A o B -H=84.3' B-0=82.5' y A -I=40.1' A -P=57.0' a B -I=73.4' B -P=84.1' Fla NMLKJI G RF� EXISTING C AIR LINE I R-100• r .°F -AZ4 1 S*49TH *� EENNM K DWYUS / ' CE -7118 �w ■ SSI 95.6 d 500 GAL STEP DRIVEWAY A k CDRESSUR I NP EXISTING HOUSE --------------------- 10'UtR Esmt 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 I 1 I I I i I I ---------- SCALE; 1' = 30' LINES )KPER 6/21/2000 GARNESS AS -BUILT SCALE: NTS NOTES ALL CONTAMINATED SAND REMOVED AND REPLACED. AIRLINE REPAIRED AND ALARMS, AIR COMPRESSOR, AND COMPRESSOR GAGE ALL VERIFIED TO BE OPERATIONAL, PREPARED F❑R1R��ER pp BRIAN & KRISTA KUHN 12921 FOSTER ROAD ANCHORAGE, AK 99516 FIELD BOOKS BOUNDARY: N /A SrMNG: N /A ASBUILT: HOLT DWC, FILE: ACRD FILE` FILE — Filed By Legol COMPUTED: DRAWN: KSO CHECKED: K Mo DATE 7Z26 DR11): SW281" 'IDB No.: 23113 O YARD , IGHF 0' OF A�q�;�p 49 TH* v u o a SHANE A. HOLT LS -6914 y�o0 44a a o \\"fessioW Loo O O O r LLI U7 7t co O O m FOUND NO. 5 REBAR S 79 59'E. 0.61' FROM COMPUTED POSITION. ASPHALT DRIVEWAY S 89 56'06" E 183.00 (RECORD) S 89048'10"E 182.81' (MEAS.) o 2� z T c 4.0 lL DECK OG s� o% �d ail —RETl7✓AYL� O WELL 10' UTILITYEASEIvITNT N 89048'10"W 182.81' NOTE: NW CORNER OF LOT 20 COMPUTED FROM SOUTH AND EAST SUBDIVISION BOUNDARY. NE CORNER FOUND AS SHOWN HEREON; THE SOUTH EAST AND SOUTHWEST CORNERS WERE COMPUTED AT RECORD BEARING AND DISTANCE FROM THE TWO NORTH CORNERS. THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPEOFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. EASEMENTS OF RECORD OR OTHER RIGHTS OF WAY, OR ANY ENTITY NOT ON THE RECORD PLAT ARE NOT SHOWN HEREON, UNLESS NOTED. NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAYBE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. FOUND REBAR FENCE W/PLASTIC CAP LS 5773 I , I IAC i AS-BU/LT SURVEY 1" =30' NO CORNERS SET THIS DATE 1 HEREBY CERTIFY THAT 1 HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT20, 9106K3, MOUNTAINPARKESTATESNO. 2 ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED ATANCHORAGE,ALASKATHIS 21ST DAYOF JUNE 2023 11123, F8137-36, 201-8 232-22 HOLT LAND SURVEYING 9309 GROVE DRIVE ANCHORAGE,AK 99507 345-5513 O Z O W W O r W � L.I.. j Ln o � M O O U) CHAIN IINKEENCE AS-BU/LT SURVEY 1" =30' NO CORNERS SET THIS DATE 1 HEREBY CERTIFY THAT 1 HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT20, 9106K3, MOUNTAINPARKESTATESNO. 2 ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED ATANCHORAGE,ALASKATHIS 21ST DAYOF JUNE 2023 11123, F8137-36, 201-8 232-22 HOLT LAND SURVEYING 9309 GROVE DRIVE ANCHORAGE,AK 99507 345-5513 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road �- Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 V http://www.muni.org/onsite J Depa1'tillellt On -Site Wastewater Disposal System Permit Permit Number: OSP231054 Effective Date: 4/14/2023 Work Type: Septic Upgrade Expiration Date: 4/13/2024 Tax Code Number: 01702232000 Site Legal Address: MOUNTAIN PARK ESTATES #2 BLK 3 LT 20 G:2839 Site Mailing Address: 12921 FOSTER RD, Anchorage Owner: KUHN BRIAN & KRISTA Lot Size in Sq Ft: 20130 Design Engineer: ARC TERRA CONSULTING INC Total Bedrooms: 4 This permit is for the construction of: Q Disposal Field K Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing /-ZoZ 3 Cj,+ Received By:1 155 VCD Issued By: t _ l �-r✓%c Date: Date: MUNICIPALITY OF ANCHORAGE Development Services Department P P Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 017-022-32 Property owner(s) Brian & Krista Kuhn Mailing address 12921 Foster Rd. Anchorage, AK 99516 Site address 12921 Foster Rd. Anchorage, AK 99516 Day phone Legal description (Sub'd., Block & Lot) Mountain Park Estates #2 Block 3 Lot 20 Legal description (Township, Range & Section) Lot Size 20.130 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ® Initial ❑ Single Family (SF) ❑X Septic Tank ❑ Upgrade (w/wo AD U) Holding Tank El Renewal❑ (D) E]Renewal Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. Dea Duffus (Signature of property owner or authorized agent) Permit/Rush Fees: $S 91 Waiver Fees: Date of Payment: Receipt Number: Date of Payment: Receipt Number: Permit No. C) SP Z 3 10 'yj Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsWermit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231054, Curtis Townsend, 04/14/23 0 WASTEWATER DISPOSAL SYSTEM CHANGE ORDER MOUNTAIN PARK ESTATES #2 BLOCK 3 LOT 20 PID# 017-022-32 STEP TANK TO BE REPLACED (/ R --loo, / 1500 STEP TANK TO BE INSTALLEDI PER CODE / iT/ / I / \ FLAG PROPERTY LINES WELL RADII & EASEMENTS PRI❑R TO C❑NSTRUCTI❑N '• JDf2IVEWAY."^r,: SHED • EXISTING AIR / CD/PRESSO� EXISTING HOUSE WELL 1. DEC❑MMISSI❑N EXISTING SEPTIC TANK PER CODE. 2. INSTALL NEW 1500 STEP TANK PER C❑DE, 3. TANK TO HAVE MIN. 20' MANWAY RISER. 4. MAINTAIN 101+ FROM F❑UNDATI❑N & 51+ EXISTING FIELD. NO PUBLIC WELLS VITHIN 200' OF 5. MAINTAIN 1001+ FROM PRIVATE WATER WELLS. PROPOSED SYSTEM, NO PRIVATE WELLS WITHIN 100' OF PROPOSED SYSTEM EXCEPT AS NOTED. NO SEPTIC SYSTEMS WITHIN 200' OF NOTES PROPOSED WELL EXCEPT AS NOTED. OF :4 Tx *� KENNETH s C —7116 ��® ® Scale: 1'= 30' 1 NO WELLS ON ADJOINING LOTS ARE WITHIN 100' OF PROPOSED TANK PLACEMENT. NO SURFACE WATER NOTED WITHIN 100' OF PROPOSED TANK PLACEMENT. CONTRACTOR WILL ENSURE MINIMUM 21 SLOPE INT❑ SEPTIC TANK, CONTRACTOR WILL ENSURE ALL SEPARATI❑NS TO ADJACENT WELLS, SEPTICS EASEMENTS, PROPERTY LINES, ETC... PAGE 1 OF 1 PREPARED FOR: BRIAN & KRISTA KUHN 12921 FOSTER ROAD ANCHORAGE, AK 99516 FIELD BOOKS BOUNDARY: N /A SrMNG: NI/A ASBUILT: HOLT DWG. FILE ACAD Flm' FILE COMPUTED: DRAW: KSD CHECKED: KMD DAT* 5/31j GRID: SW2& '10B N°' 23113 1 MT IIGTAt1. �y y-EPTIC ° -/XISTiNG BED 1 BED WMi / HE BEHOVED 6 SNO FIL� REPLACED PREVIOUS I VT EXISTING AIR LINE\ t' - STEP TANK TO BE REPLACED (/ R --loo, / 1500 STEP TANK TO BE INSTALLEDI PER CODE / iT/ / I / \ FLAG PROPERTY LINES WELL RADII & EASEMENTS PRI❑R TO C❑NSTRUCTI❑N '• JDf2IVEWAY."^r,: SHED • EXISTING AIR / CD/PRESSO� EXISTING HOUSE WELL 1. DEC❑MMISSI❑N EXISTING SEPTIC TANK PER CODE. 2. INSTALL NEW 1500 STEP TANK PER C❑DE, 3. TANK TO HAVE MIN. 20' MANWAY RISER. 4. MAINTAIN 101+ FROM F❑UNDATI❑N & 51+ EXISTING FIELD. NO PUBLIC WELLS VITHIN 200' OF 5. MAINTAIN 1001+ FROM PRIVATE WATER WELLS. PROPOSED SYSTEM, NO PRIVATE WELLS WITHIN 100' OF PROPOSED SYSTEM EXCEPT AS NOTED. NO SEPTIC SYSTEMS WITHIN 200' OF NOTES PROPOSED WELL EXCEPT AS NOTED. OF :4 Tx *� KENNETH s C —7116 ��® ® Scale: 1'= 30' 1 NO WELLS ON ADJOINING LOTS ARE WITHIN 100' OF PROPOSED TANK PLACEMENT. NO SURFACE WATER NOTED WITHIN 100' OF PROPOSED TANK PLACEMENT. CONTRACTOR WILL ENSURE MINIMUM 21 SLOPE INT❑ SEPTIC TANK, CONTRACTOR WILL ENSURE ALL SEPARATI❑NS TO ADJACENT WELLS, SEPTICS EASEMENTS, PROPERTY LINES, ETC... PAGE 1 OF 1 PREPARED FOR: BRIAN & KRISTA KUHN 12921 FOSTER ROAD ANCHORAGE, AK 99516 FIELD BOOKS BOUNDARY: N /A SrMNG: NI/A ASBUILT: HOLT DWG. FILE ACAD Flm' FILE COMPUTED: DRAW: KSD CHECKED: KMD DAT* 5/31j GRID: SW2& '10B N°' 23113 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231054, Curtis Townsend, 04/14/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231054, Curtis Townsend, 04/14/23 Seo 152003.18p An, c h o - a g -a i,J e 11 ex Pur i - p Sar 9C172430742 Parcel Idexaffication Nunaber-07.1- 02 2 & es &4o Pump Ir stailatiun Date: Pump lntnlic Der)th ,.?e,,cw'rop,3f vven casing: feet Nimp "MarufactumFIS N'-ne- Zpl`-�� Purnp NNIod 1 0; Pomp Size I'p '.7 Phless Adapter D>uy Jull Depth: iZ ' , fee pffltes-s Advilter N -.MC'. Pifless Adapter Inst-Akr: Well DisinCected I you Compietion? �a'yvs Lj No ?a of Disinfecdow Coninlents. Pump Inswfler Name: C# tsrage Weil & pu� %0 iServca 33G East 76th Avenue An,,�Orage, AK f99518 hm-- 907 -MI -0740 A.ttentioa-. The PL'Mr, sholl provi&, $ purl-ip Inst -Illation log -to the DSJD wi:hio .30 hays olfPuln.- irsta!af;ojl. M. � tis ,X y$ R Y T-9 Municipality of Anchorage ^� /e On -Site Water and Wastewater Section • (907) 343-7904 Pa C1'o n`• ON-SITE WASTEWATER INSPECTION REPORT ©c g Permit Number: OSP191328 PID Number: 017-022-322019 Dwelling: W Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name Eric & Robyn McGhee ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑■ Bed ❑ Mound Site Address 12921 Foster Road Anchorage, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 529-1052 4 4.0 GPD/SF 2.9 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 2.7 Ft. Gravel depth beneath pipe 0.2 Ft. Subdivision Block Lot Mountain Park Estates #2 3 20 Fill added above original grade 0.0 Ft. Gravel length 20 Ft. Township Range Section Gravel width 18 Ft. Beds: Number of Lines 8 Distance between lines 2.0 Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 300 Ft2 Ft. Well >100' >100' N/A N/A >25' TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Existing Gal. Surface Water >1 >100' N/A N/A Material Number of compartments Lot Line >5' >10' N/A N/A NA Foundation >10'1 >10' N/A I N/A I LIFT STATION Manufacturer Existing Capacity Gal. Remarks Absorption bed is insulated. This is an I.D.S.F. bed system. Alarm location Electrical installed by PIPE MATERIAL House to tank EXISt. Tank to D1785 drainfield Installer Northern Excavation Drainfield D1785 CO/MTD3034 Inspector J. Mlllette BENCH MARK (Assumed elevation) 14'0 ft Inspection1s 8/30/19 Location and description dates:2 Garage slab. 3m 4m ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp 4! jYe �� Or ........ � Conditional Approval: Date ���P,.•••`° 49th �,,......gg��}}ie 3anne� • e •✓ njj+,�jeaeo 0ausm n e ■ean......................... ;•MICHAEL E. ANDERSON ♦ !J No. CE -4381 ,•' �� Septic System 0/3)19 Approved Date ��F,�,� x..,•10/22/19 ,,.•` CirPI ®RO®ESS® ��le� Note: this approval does not include well permit requirements. (Kev Ub/U1i16) MOUNTAIN PARK ESTATES #2, BLOCK 3 LOT 20 PERMIT # OSP191328 PID # 017-022-32 \ I / LOT 2 ( LOT 3 / \ I \ I \ LIGHT POLE \ I ----I EXISTING WELL I / I / m I I� I I o/ ---I D/ — I /<\I\ .............. :••• 49th _ MICHAEL E. ANDERSON No. CE -4381 ,p' 10122n9 •'� w.s r���pR4FFSS\�P I\ \ I I I� / LOT 18 I/ 0 50 100 FEET 111=50' LOT 7 MT 140.0 58.8 M 2 56. ---f----- -------- I ----\--L-- - 40.2 --73,7- I / I \ I 40.9 72.8 FV21 LOT 21 ® I LOTI 44.8 75.1 FV4 46.6 76.2 NEW 20' LONA G x 18' WIDE I.DAF. 49.0 EXISTING WELL / FV6 51.1 79.2 —FV7-7 53.1 80.6 FV8 \ 55.3 82.1 / TH 1 Gj, ESS 911N' i Y , IkPUMP & AfikLINESHSAN OPERATIO LZT o IMT MT3 I ,� I i;J� liMT1 ///0 41�� I / \ LOT 5 MT A 4 LOT 20 \\ m > ' \ m ® IEZ z I I\ EXI Tll IG WELL ' 10' UTILITY EASEMENT EXI5\T\I G S.T.E.P.T NK VISUA�Y INSPECTED ( II / I FOR CNNTINUED USE. LOQ` 6 \ / \\\ LOT 19 I // y \/A B I\ \ I I I� / LOT 18 I/ 0 50 100 FEET 111=50' LOT 7 MT 140.0 58.8 M 2 56. 71.6 T3 40.2 --73,7- MT4 56.2 83.7 FV1 40.9 72.8 FV21 43.0 74.0 FV31 44.8 75.1 FV4 46.6 76.2 FV5 49.0 77.7 FV6 51.1 79.2 —FV7-7 53.1 80.6 FV8 \ 55.3 82.1 LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEAP FV - FLUSH VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE •m 93.8 93.5 • ..M, 11 lilit.111111 • • 1 PERMIT # OSP191328 P I D # 017-022-32 2" INSULATION F- BOTTOM OF EXCAVATED SAND 96.7 ORIGINAL/FINAL GRADE PEA GRAVEL BOTTOM OF EXISTING SAND LINER EXISTING AIRLINE -� 20' GROUNDWATER @ 86.0 9/23/99 84.7 TH#1 GARNESS 9/15/99 EXISTING SAND LINER FOUND TO BE CLEAN WITH SOME CONTAMINATION. ALL CONTAMINATION WAS REMOVED AND THE SAND FILTER RECONSTRUCTED AS SHOWN. THE MAJORITY OF THE ORIGINAL SAND LINER REMAINS IN PLACE. FHGIH@FRIHC PROFILE AS -BUILT (NO SCALE) 94.0 93.8 93.5 .00 N � 3�St.£Do0 S sw3116sV3,ltn1117 Al Q IGT O Q =° LLl LLl ` O O l— O C� 00 LIJ W G Cfl O \AOLO 0 �S � OC) 4.2 -- I -d n z zo0 o a o J � W O u 0 W . F y n :umia ; o oK 00'0 L D.Stc0o0 S - - - - ------------' OdO�J - .lel SOS ------ - - xmaM o�P* , ofaV44 W Q: �zz w LL • _ !� w C Q C Z J Z o 13 O c O r ¢ ¢ O j 0 L§ �wz � R� I U Ln H U�Z 2 �n O II a U Ow ti �- Qm o m W zU Ea z Q ?�¢puP ], ti I'll ? c W WZQrn R80 OLu JK KOU LU cwo 0aww¢ >W �Luoz Q J; z W W o p J �Op m! W x�x Q'¢>� W O o�P* , ofaV44 h Q: ¢ p LL • _ !� w C Q C Z J Z o j ¢ ='r�� w 3 d U�Z 2 �n O a pwo z o m W zt"„'oz O ozo_� � ti ti � � Z OZ UUx O W ¢ ¢ v 0 0 gp .-,Zrn3 per¢ OvQiQO NIX 000 C-) � °�� wax W�p��ooQ cc w r Yro2 ��ow�aom o�z� 0� -Wo - oaz=� J¢QQ zoo >z� O o' . ; o��Ozo �m=�a zea �r 00 It aozzv~i cL�w¢oW 8' w,: w �z , 0 o c O 2 0 Z w w W 2 W 0 3 O �' p l Z Z W 0 m j o p r Q ¢ m O 0 W Z h u-, cvma�n g�p�xUJO omclz z 0 ,-z T,%w. LL�OwOWW¢ Z J ti W W w w a on w w ZZWpmO �azzoo or -o �U=�~¢P 0 C)O zzmzwaz 0 o�P* , ofaV44 Q: c LL • _ !� w o MUNICIPALITY OF ANCHORAGE ,,rersr On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road r. Anchorage, Alaska 99519-6650 Phone: (907) 343.7904 Fax: (907) 343-7997 ` http://www.mu6.org/onsite epartment On -Site Wastewater Disposal System Permit Permit Number: OSPI91328 Effective Date: 8/6/2019 Work Type: Septic Upgrade Expiration Date: 815/2020 "fax Code Number: 01702232000 Site Legal Address: MOUNTAIN PARK ESTATES #2 BILK 3 LT 20 G:2839 Site Mailing Address: 12921 FOSTER RD, Anchorage Owner: MCGHEE ERIC M & ROBYN E Lot Size in Sq Ft: 20130 Design Engineer: FORGE ENGINEERING Total Bedrooms: 4 This permit is for the construction of: Q Disposal Field © Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with. 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions:. A flushing valve shall be provided at the end of all 8 distribution lines in the IDSL= bed. Received By: V�� Date: l Issued By: Date: 6(a l _ 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. 017-022-32 Property owner(s) Eric and Robyn McGhee Mailing address 12921 Foster Road Anchorage, AK 99516 Site address Same Day phone 529-1052 Legal description (Sub'd., Block & Lot) Mountain Park Est. #2, Block 3, Lot 20 Legal description (Township, Range & Section) Lot Size 20,130 Sq. Ft. Number of Bedrooms Four (4) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑X Septic Tank p ® Upgrade ❑X , (w/wo ADU) (D) ❑ Holding Tank ❑ Renewal 1-1Duplex Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST', FOR: Distance: I certify that the above information is correct. I further certify that this is�in accordance with applicable Municipal Codes. a oct'4� (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: lig Receipt Number: Q_/W Permit No. 05P191 _5a? Permit App_:- : - : '-.,:c Waiver Fees: Date of Payment: Receipt Number: _ Waiver No. PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) July 30, 2019 MOA Development Services Department On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Mountain Park Estates #2, Block 3, Lot 20 – 12921 Foster Road Septic System Design Dear On-Site Services Engineer: The absorption bed on the subject lot has failed and must be reconstructed before a COSA can be issued for the property. We are submitting this design and permit application for the construction of a new Intermittent Dosing Sand Filter (IDSF) to serve the four-bedroom home. The attached site plan identifies the location of the home and the existing well and septic system. The IDSF filter will be constructed at the same location as the existing filter. No conflicts exist between this proposed system and any other well or septic system on this lot or adjacent lots. All contaminated material in the absorption bed location will be removed and disposed in accordance with Municipal Code. MOA approved sand will be utilized to raise the bed area to required grade. The new bed will be constructed in accordance with the attached design documents and to the specified elevations. The ground surface on the lot is contoured in the area of the proposed bed to shed drainage. The final surface of the new bed will be similarly contoured and graded. There are no slopes greater than 25% within 50 feet down slope of the proposed absorption bed. Ground surface contours are shown on the site plan indicating the grade and direction of flow. Storm water drainage will not impact this septic system. The new bed will be constructed parallel to the slope as much as possible. Wells on this and adjacent lots are shown. The new system will be a minimum of 100’ from all wells and surface water, and more than 5’ away from the septic tank. Please refer to the attached test hole logs and plan and profile sheets for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Michael E. Anderson, P.E. 7-30-19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191328, Rebecca Carroll, 08/06/19 // // // // // // // EXISTING WELL 10050 0 FEET 1"=50'4-BDRM HOMENOTE: NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND MT MOUNTAIN PARK ESTATES #2, BLOCK 3 LOT 20 FOSTER ROAD7/30/19 10' UTILITY EASEMENT 10' UTILITY EASEMENTSHED DECOMMISSION EXISTING 1,500 GALLON S.T.E.P. TANK PER MOA CODE. PLACE NEW 1,500 GALLON S.T.E.P TANK w/20" MANWAY. LIGHT POLE REMOVE EXISTING 20' LONG x 18' WIDE I.D.S.F. AND ALL CONTAMINATION TO ACCEPTING SOILS BELOW. DISPOSE PER MOA CODE. CONSTRUCT NEW 20' LONG x 18' WIDE I.D.S.F. PER PLAN. MT MTMT CONNECT TO EXISTING 1 2" PVC AIR LINE. VERIFY EXISTING AIR PUMP FOR CONTINUED USE. EXISTING WELL FILE TH MH MH 2COSV FLUSHING VALVES 5% 5% 5% 5% EXISTING WELL Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191328, Rebecca Carroll, 08/06/19 MOUNTAIN PARK ESTATES #2, BLOCK 3, LOT 20 DESIGN FACTORS: SYSTEM REQUIREMENTS: 600 GPD PEAK FLOW PERK RATE: 16.6 MIN/IN APPLICATION RATE: 4 GPD/SF TYPICAL TRENCH SECTION (NO SCALE) NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY BOTTOM OF BED: 2.5' BELOW GRADE FLOW LINE ELEVATION: 2.25' BELOW GRADE TOP OF BED: .5' ABOVE GRADE 600 GPD / 4 GPD/SF /18' WIDE = 8.3 LF TRENCH REQUIRED (20 LF SPECIFIED) 7/30/19 18' 6" 2' 2' 6" THICKNESS OF 3 8" PEA GRAVEL. GEOTEXTILE FABRIC & 2" INSULATION 2' MINIMUM MOA APPROVED SAND AIR LINE 18" BELOW TOP OF SAND3 4 " PERFORATED PVC PLACED MIDWAY IN THE 6" STRATUM REMOVE ALL CONTAMINATION AND PLACE MOA APPROVED SAND TO 94.0 6" 2' 2' 2' 2' 2' 2' 2' 2' 2' I.D.S.F. SHALLOW BED SYSTEM 2' MOA APPROVED SAND FILTER 1,500 GALLON S.T.E.P. TANK VERIFY EXISTING AIR PUMP FOR CONTINUED USE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191328, Rebecca Carroll, 08/06/19 Municipoli[y of Anchorage Poe, 1 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES · ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 543-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number:. SW990401 PID Number. 017--022--32 Nome: JEFF' AND LYNN EVANS Wastewater System: [] New · Upgrade 12921 FOSTER RD. ANCHORAGE AK. 99516 ABSORPTION FIELD P~°ne:(907) 727-1366 No. of ~,droom,: LEGAL DESCRIPTION ~' "~ 2 ==o/s, rt 4.7 MAX. 20 3 MOUNTAIN PARK EST. #2i 0.74 - 2.54 rt 0.25 -I - 0 - 0.5 r~ 20 WELL: [] New D 18 ~ ~ rt. 360 m. RI. D 3054/ $CH 40 PVC ~. DENALI SEWER &: DRAIN e/e/oo - e/7o/oo ~ ~ TANK SEPARATION DISTANCES osapu= n ,olcnng · S.T.E.P. From Tank Field StaUon Tank ~ L~. ANCHORAGE TANK 1500 Well 100'+ 100'+ 100'+ - 25'+ ~ STEEL ~ '~ ~ 2 Su,OC,wotor 700'+ tOO'* ~00'* - - LIFT STATION Une 5'+ 10'+ 5'+ -- - 1500I ANCHORAGE TANK FoundaUon 5'+ 10°+ 5'+ -- ~ .e' ~ e~ F~.~ e~' ~ - 42" 42' 46' Omln N~NF KNOW~ ' 120 OSI OS HHF, M.O.A. Remarks: * eorrouLrss im'eEurrr~w' s~ro nLTL*R BENCH MARK GARAGE FLOOR SLAB. I*"""'~ 103.47 Inspections performed by: AWWC, INC. Dates: 1st e/8/oo ~' *~'O."' ' ~ ~/~/ 2nd e/e/aa "'"'"'""~'~"' - ......... 3rd 6/9/oo ~/~ ~/~' ~..~...~. 4th 6/70/00 .~,,~_.~j _.'' ~1 ey ~,. Carhe.J's./: Department of Health and Human Services approval u~.~.v......~, 7953......~t,,~ R~viewed and approved by: ~ ~ ~. ~O,-~Date: -~ ' ~ ..... e~'~ ~%~.o pERU,1' NUMBER: sw 9o o1 AS-BUILT DRAWING 017-022-32 / / ' ~ ST2 61.15 63.6 0 ~ ,... ....... MT2 40.0 71,5 x /- ~.4 (AV~.) W I¢~ ~LOM e/z~/zooo JEFF AND LYNN EVANS (907) 727-1366 2 OF 3 MOUNTAIN PARK ESTATES ~2. LOT 20, BLOCK 5 ;' AS-BUILT OF SEPTIC SYSTEM UPGRADE Al ASIa., WATER & WASTEWATER K.D.W. CONSULTANTS, INC. s c,~.~ JEFF AND LYNN EVANS (907) 727-1366 MOUNTAIN PARK ESTATES ~2, LOT 20, BLOCK AS-BUILT PROFILE OF SEPTIC SYSTEM UPGRADE PR~ : Denali Sewep & D~ain PHONE NO. : 9~? ddd 9776 Dec. 15 Z:~ ~9:28AM P1 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 O/q IcrO OlloJ. a - Upgrade Date Issued: Oct 26, 1999 Expiration Date: Oct 25, 2000 Permit Number: SW990401 Parcel ID: 017-022-32 Legal Description: MOUNTAIN PARK ESTATES #2 BLK 3 LT 20 Design Engineer:. 0041 AK Water & Wastewater Consulta Site Address: 012921 FOSTER RD Owner Name: Bob Stevens Lot Size: 20130 SQ. FT. Owner Address: 7451 Our Own Lane Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE, AK 99516-0000 This permit is for the construction of: [] Disposal Field [] SepticTank [] Holding Tank [] Pdvy [] Pdvate Well [] Water Storage All construction must be in accordance with: I. 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 Ddnking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours pdor to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4, From October 15 to Apdl 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. 5. The following special provisions. THIS PERMIT ISSUED FOR THE CONSTRUCTION OF AN ALTERNATIVE INTERMITTENT DOSING SAND FILTER (IDSF) WASTEWATER SYSTEM. THE ATTACHED PROPERTY OWNER AGREEMENT SHALL BECOME A PART OF THIS PERMIT PACKAGE. Received By: Issued By: Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2B ~ Anchorage ~ Alaska 99504 (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers October 15, 1999 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic Design for Mountain Park Estates//2, Lot 20, Block 3 To whom it may concern: The existing 4 bedroom house is served by a private well and septic system. The existing septic system is encroaching groundwater and a new septic system must be installed. Comments regarding the proposed upgrade are summarized as follows: 1. SOILS: Attached is the soil log which shows the soil profile, and the percolation test results. Below the organics was a ML layer to a depth of 4 feet followed by a SM material to a depth of 8 feet. At 8 feet, the soils transition to a SM/GM material to a depth of 12 feet (bottom of test hole). Groundwater was weeping at 7.5 feet during the excavation of the test hole. Eight days later, groundwater was found at 10.7 feet below grade. A percolation test was performed at the depth of 4.75 to 5.25 feet and the soil perked at a rate of 16.6 min./inch. 2. BED DESIGN: Based upon the limited space available and the soil/groundwater evaluations, it is our opinion that the best option for the new septic system is a intermittent dosing bottomless sand filter system. a. Percolation Rate: 16.6 minutes/inch b. Allowable Application Rate: 4 gallons/day/ft2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 150 ft2 L Total Depth: 5 feet g. Effective Depth: 3 inches h. Width: 20 feet i. Length: 18 feet i. Sand Filter: 2 feet j Effective absorption area = 360 ft2 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPItY: The proposed septic area slopes from east to west at less than a 5% slope. In short, there are no slope concerns. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179. Thank you for your assistance. ~j~.. M.$. Pres[debt NOTE: Attached is a site plan drawing, a design drawhtg, a detail drawing of the proposed ISF bed, one soil log and a 4 page constntction specification letter which are all part of the design package for this septic system. I I I ~ I I i I I I I I I I I I ~ I I LOT;, eLOCK 3 I I LOT 2, BLOCK 4 I LOT 2x, BLOCK 3 MOUNTAIN PARK EST 12 I ~ IdOUNTAIN PARK EST 12 MOUNTAIN PARK EST 12 I I I I I I ~ I I LOT I I I I ~ LOT ~2./eLOC~ ~ I I \ I I LOT .1. 8LOC~ 4 I ~OU~N PAR~ EST t2 I I \ / I I MOU~AIN PARK EST 12 I I j / I I /\ I I LOT 4. BLOCK 4 I TO Bt: V~RIF'IED u LOT 21, BLOCK 3 I I LOT 4, BLOCK I I I I ~N nELO, I I[ UOUNTAIN PARK EST 12 I I UOU.NT~N PARK EST 12 ~--PROPOSED $E.J:qlC UPGRAD£ , I / __.~ ~___~ .... ~=.--....[. r~__'~_~.__-' .... .~ L___~_ ....... __.~ ..... _.. ..... ,., /__',L~_ ...... /._d ....... , F I ?- r . I LOT 6, BLOCK 4 -' ~ I MOUNTAIN PARK EST 121 / "' .... ~ IAOUN1AJN PARK EST 12 e..~I I % / LOT 6, BLOCK 3 I I I i %'~. i I // MOUNT.NN I I & ~o / I I I I \ / I I I I \ I I I I I I aOUNTAIN P~r~EST 12 ~/ I LOT ?. LOt 18, BLOCX ~ j ~0UNTNN PARK EST 12 I I ~ ..... ~¥j MOUNTAIN pARK EST 12 I I I I I I ~ I I I J I I I I I I I I J I I J J LOT 8, BLOCK 4 MOUNTAIN PARK EST 1~ MOUNTAIN PARK EST 12 I I a0UmAIN PAR~ EST i~ I I ~ I I I I J I I ALASKA WATER/LND WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SUITE 2B. ANCHORACE. AK. 99504 IdOUNTAIN PARK ESTATES S/D ~2; LOT 20, BLOCK ,:$ ff~.."'-'l' SITE PLAN FOR PROPOSED SEPTIC SYSTEId UPGRADE PREPARED FOR: PHONE .u~ere: qtM~.~ .... C~-7953 BOB AND WENDY STEVENS (907) 727-1566/545-1566 I I I .......... ~i[:l 0/I 5/99 O~WN ~: SC~.F.: J.L,M. 1 : 100' 1 OF $ D(ISllNO SEPTIC ?,~ PROPOSED BOTTOMLES~ INT[RUF~CT *~AND RL'r~R. ~(CAVAT~ A BED I~-IAT IS 5 FOOT DEEP MAXIMUM BY 20 FEET WIDE BY 18 FEET LONG. SEE ATTACHED DETAJL AND PROFILE (PA(;:[ ,3 OF' ,3) FOR COSTRUCTION OETAJLS AND REQUIREMD4TS.- ~TO / / \ \ \ \ \ ~ B£C / ? A~.~NDONED DRNCWAY NOTE) (.DO NOTE: THE CONTRACTOR SHALL HAVE THE 100' WELL RADIUS FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO ANY CONSTRUCTION. ;-7953 ALASKA WATER AND WASTEWATER CONSULTANTS, I~N'C. 6901 OEBARR ROAD. SUITE 2B. ANCHORAGE, AN. 99504 PHONE: (907) 337-617g/FAX; (907) 3[38-3248 LEGAl. DESCRIPTION: MOUNTAIN PARK ESTATES S/D ~2; LOT 20, BLOCK 5, OF WORK: DESIGN FOR PROPOSED SEPTIC SYSTEM UPGRADE (BOTTOMLESS I.S.F.) PREPARED FOR: PHONE NUMBER: BOB STEVENS (907) 727-1366/5,45-1366 DAT~: ~,N,.[; PAGE; 10/15/99 J.L.M. 1 = 30' 2 OF ,3 ~'~'~ P~N VIEW ~'~'~ ~~ PROFILE VIEW PHON~ (907) 337-6179 / F~: (907) ~-3245 MOUNTAIN PARK ESTATES ~2, LOT 20, BLOCK ~ .. ~ ......... BO~OMLESS SAND FILTER (ISF) DETAIL ; .... :....~ BOB AND WENDY STEVENS (907) 727-1366/545-1366 ALASKA WATER & WASTEWATER CONSULTANTS, INC. ~,=,~.-:? 0..F'. ,~o~ ~£~ ~o~. su~ :, · ,.~c,oP~. ,,x. ~o,, ~_?qx.~..r-l. '~57:..,~,,~,,--~ iSOIL LO(3 - PERCOLATION TEST I DATE PERFORMED: 9/lS/99 tr.. I .." 2_ :::z: SOIL C~SSIRCATIONS ~ I ~ GW - - : ORG~"~ r~lp = I00' I ~ 21. BL~ ~ I II MOU~NN P~K ~ ~2 I 5-- UL ~ 6P HL ] ~ I I 4-- GC OL / =,SW I MH ~ / I I 5-- ,.~-.-.. SP CH ,~ . ~ ~ DEPTH TO ~ 7-- SM (D~K GROUNDWATEE DATE - s- ,N COLOR) , ~ .... ~ ....... 30.7' 9/23/99 ~ L~ 19. ~K 3 ' MOUTON ~ P~K ~ 10 -- SM/GM % 11-- DATE RE. lNG CLOCK NET TINE WATER LEVEL NET DROP TINE (HINGES) RE. lNG (INCHES) 12-- 9/20/99 PERC. HO~ W~ PRESO~ED 4+ HOURS PRIOR TO ~NG B,O~ 13 -- 1 2:20 ~ 6' 2 2:50 30 4 1/4' 1 14-- 3 2:51 ~ 6" 15-- 4 3:21 30 4 3/16" 1 13/16' 5 3:22 -- 6' 16-- 6 3:52 30 4 13/16" 1 13/16" 17-- 18-- 19-- PERCO~TION ~TE 16.6 .(HIN./INCH) PERC. HO~ DIA. 6 (INCHES) 20~ ~ TEST R~ BET~EN 4.75 FT. ~D 5.25 FT. COHHENTS: PERFORMED BY ~S~ WATER & WA~A~R. I. JEFFR~ A. GARNESS. CERTI~ THAT THIS W~ PERFUMED IN ACCORDANCE W~ ~ STATE ~D MUNICIP~ GUIDEUNES IN EF~CT ON DEPTH TO GROUNDWATE~ DATE 7.5' 9/15/99 10.7' 9/23/99 O, 0 0 Oi;;" 0 0 0 0 j~;s~?/,.~ .~,e'//.aw 7' a~,Z~ .1,~,~' :~-t~4a;~'2:¢-, ,.x;~.,, Se?J,>..~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 · ON-SITE WELL SYSTEM PERMIT PERMIT NUMBER:SW930397 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:PENDERGRASS MOSE W OWNER ADDRESS:P. O. BOX 110804 ANCHORAGE, ALASKA 99511 PARCEL ID:01702232 LEGAL DESCRIPTION: MOUNTAIN PARK ESTATES #2 BLK 3 LT 20 LOT SIZE: 19800 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 9/28/93 EXPIRATION DATE: 9/28/94 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 DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS ISSUED BY: /~-~cw~__ DATE: DATE: uni¢ip q yo Anchorage P.O. '"'"~X 196650 ANCHORAGE, ALASKA 99519-6650 (907) 264-4111 TONY KNOWLES, MA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES March 26, 1987 Mose Pendergress PO Box 110804 Anchorage, Alaska 99511 Subject: Lot 20 BLock 3 Mountain Park Estates Subdivision #2 On-site Well Permit #860078 A permit issued by this Department for an individual well and/or on-site sewer system has expired as of March 25, 1987. Your permit expired on the date of issue basis by authority of Municipal Ordinance existing at that time. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. The new permit will come under the calendar expiration date as per the new Wastewater Ordinance (effective May 20, 1986). If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system the original as-built inspection report (three part form) must be sent to this office for review and approval, and for documentation. If there are any further questions, please call this office at 343-4744. Since{ely, Program Manager On-site Services RWR/ljw #7 enc: copy of permit ()3/'" . . ,~.,.. 186 APF'L I CANT: CONTACT PHOIxlE: Lu. J 8iZE: MOSE PENDE:RSRESS P,,CJ. BSX ! 10804 ANCHORAGE, AK 9951t 345- 1888 .~:~UEDI ¢IoI[)N. MI". PARK ESTATIES SE[iT I [:)lq: :i. 6 'TOWNSH :i: P: 12N 20130 (SQ,, FT. (:11::;'. ACRES) LOT: 2) RANGE: 3W BL.Ui,.k.. 3 c:er't i ~'y that~ 1,. I am ¢ami].ia:' wi+_h the i*equiremen±.s ('or c~n--"site set, ers and ~ells as set {'or'th by the Munic:[pa].ity o¢ Anchorage (MOA) and the State oF Alaska. ~?.,, t will install the sy:tem in actor-dance w:i.t.h all MBA codes and pegu].at:[ons, and :i.n compliance with the design c~'iter'ia oF this pe:'mit,, 3. I ~,~:i. ll adher'e to all MOA and State oF Alaska :"equi:*ements {of the set back d:i. stances Fpom any existing ~,~e].:l., wastewate~' disposal system op public sewer'.age system on 'f. his of any adjacent or neapby lot. ~7~ ~ .............. AF'PL.:[CANT: M8SE PENDERGRESS ......................... :~;. ¢ ............. ¢.-~-...=~ ~ ...... MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE [~I~EW NAME 405e []UPGRADE MAI L~G ADDRESS EEGAE DESCRIPTION ~0~ ~X~ Abs°rpt)9¢ea Dw~n~ / PERMIT NO, ~ ~ DISTANCE TO: ~ ~ ~anufacturer ~3~/~ -~~ ~at~ ~.~ NO. of compa r~nts__ ~ Eiq. ~pacity ~n gallons Inside length ~idth liquid depth ]/z~ ~ IF HOME.DE: ~ ~ DISTANCE TO: Well DwelHng PERMIT NO. O ~ ~ Manufacturer Material Liquid capacity in gallons ~O;i :' aZ No. of linesj__/ Length ~ line__ / Total lenities ~ Tre~w~h inchesinChesDistance ~lines Total effective absorption area Length Width ~ Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO, Building foundation Sewer line Septic tank Absorption area{s) ~ DISTANCE TO: OTHER PIPE MATERIALS SOiL TEST RATING REMARKS APPROVED DATE LEGAL 72-013 (Rev. 3/78) DEPARTMENT OF:' HEAl_TH AND ENVIROI".IMENTAL PRO'TEC]"ZON 825 i.... STF~Iiii:ET, AIqCHORAGE, Al< 995() 1 264-4720 F'EF;:M ]: 'T' Iq[]: DAT'E I SSLII']i:D [: AF'F:'L I CANT: ADDRESG: CONTAC'T PHEINE L..EGAL. DESCR I I::::: LOT SI ZE: MAX BEDF:d3OMS: MOSE PENDERGRASS F'.D. BOX 110804 ANCHORAGE, AK 995:L :1. 3zl-5.,-. SLIBDZVIS]:ON,', MDUNTAZN PK EST SEE:T I [:]N: ;?.6 TDWNSH I F': 12. N 20 I::"-";0 (S6!. F"l". OR ADRES ) L f3 T:,~:'"'(.}" RANGE: 3W BL[]CK: 3 I...isi:.ed t::)elo~g ar'e t.h(~.~ op'~.i(mns avail, able to yOLt ir'i'designir'lg yc)t.tr s'ept, ic system,, Ch[mc)se the option ".~-at best Fits yot.H" site, DEF'TH 'f'F) F:']ZF'E BE)]"I"OM (FT. 'I"OTAL DIL:F'TH (Fl'.) GRAVEL. WI[i]"H (F:T,,) GRAVEl.... I....ENGTH (FT.) GRAVEl.... VOL. UME (CU, YDS,, ) lANK SIZE (GALS) SOIL RAT]:NG (SQ, F'"i". /BR) 4.. 0 4.0 4., 0 8.0 () ,, 5 3.5 · ? ("] ..... ~ 4 ,, 5 '7 ~::' ~,.:: ,, 5 2'7.0 5.0 5(). 4 52.0 82. ,, 3 250.0 -~{.-~- 1,25C),, 0 .~. 1,250,, 0 256 232 256 ~,~"~ .:~I'~...~bI:L ,.l:N.=th > '75 F]". REDLIIRES HL_I Ih[ ,- RUNS (NO'T tEXCEEDING 75 F'T EACH) · ~'~4' , ..... MUST HA, V[:? A'/ .... *'" ..... ~' 'r: ~. ~: 1.4~: t /~,'~.., COJ"tF'ARTMEN-F.~3 ]: cz e i" t :i. ¢ y 't'. h a t: !. :i? am familiar w:i.'t:.h the requir'emen'Es ~cH". on.--sit, e sewers ancl we].ls as set Forth by the Mun:i. cipa].-ity oF Anchoraqe (MOA) and the State c)F Alaska. 2.', :[ (*.]J.].:l.instatl the system in accc)rdanc:e with ali MOA c:(3dE~!B ¢2d]cJ "egj..~].ations, Ed3d J.l"i comp].:i, ance ~JJ. th thE, design cr'iter:(a oF th:is pel"mit,, 3,, :[ ~:L:t.:l. ?~dl"H~!t"6~-to a].l MOA and State (::)~ Alaska requiPements t'clr the set back (:listar'ic:es from ar]y ex:i. stin~ Nell, waste~.~ater disposal system EiR.)~epage system (:)n 'KhJ. s (~I" ari'y' adja(:eri't:, cm i"leaPby 4,, Z undel"S'J'.al-id that this per, mit is valid For a max:[RILt[~ oF 4 b6~dl"Qo~s aFld any er]].argement wi].1 )',~Dq~.(J.i*~) an addit, icirial permi{. Il:: A LZF'T S]~A'TtZON IS INS'I"AL..LJED IN AN Af-.ER COVERED BY ME)A BUILDING CODE:S, ':... ( ) AN EI.J:.C,,-,lt..~l_ I:::'EF~IdIT AND INSPECTION MUST .~'.E OBTAINED~ (2) ~c~ [U~I.I,_ WILL NOT BE APF"RGVED WI'FHOU]" AN E.,...ECf,~J. CAL INSF'EC'I"ION REF'ORT; AND (3) THE E!_..~:EC]'I:'t ]: CAL. WOt:~K I~ILCF~(31qE: 13Y A L I CENSED EZL..EE[..~-I"I:~ l C I AN. , , )ATE: ................. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch ~650, A~chorage, Alaska 99502 276-222~ SOILS LOG -- PERCOLATION TEST PERFORMED FOR: [] SOILS LOG .'- ~PERCOLATION TEST (FEET} 1 2 3- 4- 5 6 7 8 9 10 12 13 SI_OPE SITE PLAN Depth to Net Water Drop .., [ I ~ r c r Time Time 16 17 ' ' PI'I~(:OI /,FION HATE Z.b (minutes/inch) MUNICIPALITY OF ANCHORAGE Development Services Department 1 Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 017-022-32 Certificate of On -Site Systems Approval Expiration Date: Legal description MOUNTAIN PARK ESTATES #2 BLK 3 LT 20 Site address 12921 FOSTER RD Current property owner(s) KUHN BRIAN & KRISTA The On-site system(s) is/are approved for /-/ bedrooms Conditional approval for t bedrooms, with the following stipulations: Comments or advisories: The following conditions are to be met by 6/15/23: 1. Replace the field, and maybe tank, per OSP23105 y T A.vc,_ A^-6 f--, 2. Submit a Lift Station Maintenance Log. 3. Submit an IDSF Maintenance Log. If the field is repaired, the Log will have the Absorption Field section filled out also. By: OFiginal Certificate Date: 4/24/23 11-712 /J This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory x Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 Development Services Department On -Site Water & Wastewater Section n70Df�j V �4 ANCHORAGE 5 6 Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 017-022-32 Complete legal description Mountain Park Estates #2 Block 3 Lot 20 Location (site address) 12921 Foster Rd. Anchorage, AK Current property owner(s) Brian & Krista Kuhn Day phone 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: 0 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: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ® Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 23 - 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: ❑ 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 $ Y 3 y2 Date of Payment ( t'� 2p2 3 `1�2y��3 COSA # Waiver Fee $ Date of Payment Waiver # COSA Application—June 2022 Legal Description: Mountain Park Estates #2 Block3 Lot 20 Parcel ID: 017-022-32 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) Date drilled_ /94 Total depth 547 ft Cased to 152 ft F,/-1 Sanitary seal is functioning correctly © Wires are properly protected Casing height (above ground) 25 in. Date of flow test for COSA 3/28/23 Static water level at beginning of test 75 ft. Comments B. TANK DATA Measured operating fluid level in septic tank New Date of pumping New install 5/31/23 ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 5/31/23 ALL standpipes present per record drawing Total measured depth from grade 3.54 ft (max) Measured depth to pipe invert from grade 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 ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: COSA Checklist June 2022 Well production at time of test 3.5 gpm Water storage tank volumed gallons Well disinfected for coliform test? ❑ Yes Q No 21 Coliform bacteria is Negative Nitrate 7.77 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L © Arsenic less than MRL (ND) Collected by Arcterra Consulting Date 3/23/23 C. LIFT STATION M Required maintenance completed Age of lift station <1 years Lift station material Steel Comments: Adequacy test date Results F1 Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) in Effective depth used in Effective depth remaining in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' ✓0 Yes if No Community Sewer Manhole/Cleanout > 100' ❑�/ Yes if No ft 0 Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' © Yes if No ft Absorption Field on Lot > 100' M Yes if No ft Holding Tank > 100' Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' Q Yes if No ft Q Yes if No ft ft If tank or field is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ©Yes if No ft Q Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' ✓0 Yes if No ft Surface Water > 100' Q Yes if No ft Tank to Property Line > 5' R Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' ❑✓ Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10' Yes if No ft Community Wells > 200' © Yes if No ft Water Service Line > 10' © Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS 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 Arcterra Consulting Phone (907)-696-6111 Engineer's Printed Name Kenneth Duffus Date Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations.AMS R♦+♦ The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The Q N 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 V ..�(�'•� and the water usage of the family being served by the system. The operational life of all well and septic s ♦c �� yiT>f systems are subject to these various and dynamic characteristics and are outside the control of the evaluator jr�„i,�M..M.............Mf/µ��•11MN..aa«« Ild of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will r function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen 0. .+.........+..»::..».......r.y� encroachments, deficiencies or discrepancies exist. f♦ KENNETH M_ RUFFUS ♦♦`�� �., CE 17118 COSA Checklist June 2022 ♦RR j ESS����! —Nitrate Advisory Certificate of On -Site Systems Approval # OSC231095 Subdivision: Mountain Park Estates #2, Block: 3, Lot: 20 A water sample revealed a nitrate concentration of 7.77 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. *Mailing Address P O Box 196650 *Anchorage, Alaska 99519 6650 *www muni org MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this 50^' Day of —Av �. of 2013, by and between I' OA--Qie.huc,'� 4 Salu YKA14iY14QCi , 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: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as 5 T P aMd Z 0 S E located at (legal description) : MOkr%�&iv\ eq jQt— 3 k g -A -N R?5�VL. VA, , AvL e-, Ate- 44 5L (.v ?. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) tJ) Throughout 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 accordance with the equipment's approval for operation in the Municipality. It shall 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 includes an annual maintenance fee (typically $400 to $600). y�-- VAOwner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. 01 'Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Pagel of3 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. AOCAA Owner agrees that any sale or transfer of title of the property will not occur without anew Certificate of On -Site Systems Approval. KI Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. 04A Owner 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. Nonwaiver. 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 OWNER: STA THIRD JUDICIAL DISTRICT re) Date: (print name) } ss. } The forego' n instrument was acknowledged before me this 5'day of i 20Q, by h L- V\ e NOTARY PUBLIC FO ALASKA SHANNON WHORLEY My Commission expires: klzlzas Notary Public, State of Alaska Commission # 210625008 My Commission Expires June 25, 2025 MUNICIPALITY: By: (signature) (print name) (rev. 05/18/2018) Date: z�` 0-3 Title: Page 3 of 3 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. 017-022-32 1. GENERAL INFORMATION Expiration Date: F—e-6 1 i I � 0)_ 0 Complete legal description Mountain Park Estates #2, Block 3, Lot 20 Location (site address) 12921 Foster Road Anchorage, AK Current property owner(s) Eric & Robyn McGhee Day phone 529-1052 Mailing address 12921 Foster Road, Anchorage, AK 99516 Real estate agent 2. TYPE OF DWELLING: E] Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic FE 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 $ 65b Waiver Fee $ Date of Payment lQ 13®10 Receipt Number 05,300D COSA # ()5 cl I; 512 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 Michael E. Anderson, P.E. Date 10/30/2019 6. DSD SIGNATURE / System #1 Approved for �( bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: "r(((((((wf,. By: IPL -rM cx j2 l u. -i 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: Mountain Park Estates #2, Block 3, Lot 20 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 4/5/94 Total depth 547 ft Cased to 152 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) '24 in. Date of flow test for COSA 9/24/19 Static water level at beginning of test 141 ft Comments B. TANK DATA Age of tank(s) 19 years Tank type/material S.T.E.P./Steel Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping 7/15/19 - A Plus Home Services D. ABSORPTION FIELD DATA Bed - IDSF Which system tested (date installed) 8130/19 ❑ ALL standpipes present per record drawing Total measured depth from grade 2.8 ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 017-022-32 Structure served by this system Well production at time of test 3.0 gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 2.14 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by FORGE ENGINEERING Date of Sample 10/30/19 C. LIFT STATION ❑ Required maintenance completed Age of lift station 19 years Lift station material Steel Comments: See Maintenance Log Adequacy test date New Construction Results ❑ Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' 121 Yes Community Sewer Manhole/Cleanout > 100' r, Yes if No ft r Yes if No ft Neighboring Tank > 100' 17 Yes if No ft Private Sewer/Septic Line > 25' E✓ Yes if No ft Absorption Field on Lot > 100' F71 Yes if No ft Holding Tank > 100' 2✓ Yes if No ft Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' 21 Yes if No ft F,71 Yes if No ft if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0✓ Yes if No ft F,71 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 121 Yes if No ft Surface Water > 100' ®✓ Yes if No ft Property Line > 5' 121 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 0✓ Yes if No ft Private Wells > 100' F✓ Yes if No ft Water Main > 10'✓Q Yes if No ft Community Wells > 200' r✓l Yes if No ft Water Service Line > 10' F✓ 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' 121 Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓1 Yes if No ft Private Wells > 100' ®✓ Yes if No ft Water Service Line > 10' 0 Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS New I.D.S.F. bed constructed at location of old bed. Existing air pump and S.T.E.P. Tank inspected and found suitable for continued use. G. ENGINEER'S CERTIFICATION 1 certify that t 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. COSA Checklist yellow sheet -_ . .' ' i .- (,~.__~ DEPARTMENT OF HEALTH &HUMAN SERV CES ." --' -~ --: :DNisionofEnvironmentaISe~ces · ' - . , ' '-' On-S~te Sew ces Sect on - - - / ' ?,."'' :-' -,' .,.. ' ' .- ~" P:O: Box 196650 Anchorage~ Alaska 99519-6650 ' CERTIFICATE OF HEALTH AUTHORI APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D.# 017-022-32v . . -- 'HAA# 1. GENERAL INFORMATION Complete'legaldescription Lot 20; Block 3; Mountain Park Estates #2 Location (site address or directions) 12321 Foster Rd. ANchorage, AK Property owner Mailing address Lending agency Mailing address Bob Stevens 7541 Our Own Lane Day phone 345-1366 Anchorage, AK 99516 Day phonel Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 ~ TYPE OF WATER SUPPLY: ×× Individual well Community well Public water NOTE: If community well system, p~:o, vide written confirmation from State ADEC attest- ing to the legality and status ~f system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: xx If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the. Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Alaska Water & Phone ~: Weltewater Consultanfs, ~ Address . 6~; ~eBarr R~d, S~ ~ ~. EngineeCs signature Anchorage1 AK ~ Date Alaska Water & -~'~ .... Wastewater Cor~ultants, thc, ,.;`! Shall be PAID $ i~''°O ,¢~-., at, or Prior to, closing for the Engineedn.~ ~i~i~t~ Pi'evide~. DHHS SIGNATURE ~/" Approved for :~ ~"~' bedrooms. o Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of'Health and Human Services (DHHS} issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or.analyze data before a certificate is issued, The Municipality¢of Anchorage is not responsible for errors or omissions in the professional engineer's work. ?2-025(Rev. 1/91) Back MOAlI21 RECEIVED Municipality of Anchorage MAY 05 DEPARTMENT OF HEALTH & HUMAN SERVICESt~uNici~^u~y Environmental Services Division ~NVIRON~Nr~.s~WC~I[~j~[r~ 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist Legal Description: /~'~NZm'~J ~- ~'~'~/~r~,-~ Parcel I.D,: A. WELL DATA Well type Log present ~'N) Total depth Sanitary seal ((~N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed ~- 5- ~ . +~ Cased to J~P' ~=~.~r~oc~c Casing height (above ground) Wires properly protected (~) Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform Date of sample: FROM WELL LOG Nitrate B. SEPTIC/HOLDING TANK DATA Date installed I,/t~./$ Foundation cieanout (~) Date of Pumping g.p.m. Collected by: AT INSPECTIO/~I '~ ~), V ~ g.p.m. Other bacteria ~ Tanksize J~ Number of compartments ~ Cleanouts(~_~) ~ Depression (Y/~J~ ~ High water alarm (Y/I~ /"J//~ Pumper C. ABSORPTION FIELD DATA Date installed 11/16/~5 W L_~ luid depth in absorption field before test (in.); Fluid depth (ins) Minutes later: Peroxide treatment (past 12 months) (Y/N) 72-026 (Rev. 3/96)* Soil rating (g.p.d./ft~ o~. Length ~r Width --~ Gravel thickness below pipe Effective absorption area 10~, ~, Monitoring Tube present ~Y,~N) ~ Depression over field (Y~_~ Date of adequacy test~,~ z~/~o/?~ Results(Pass/Fail)~=~ ~'~£~For Immediately after gal. water added (in.): System type ~ "~ I~' /~E~, Total depth bedrooms Absorption rate = .g.p.d. If yes, give date Man~ ~ "Pump off'level at* Septic/holding tank on lot /0~ ~¢ On adjacent lots /oo Absorption field on lot / O O On adjacent lots / Public sewer main )U/'~ Public sewer manhoie/cleanout Sewer/septic service line ~ r~ Lift station /~///;) SEPARATION DISTANCES FROM SEPTIC/Ht~I~C~NG TANK ON LOTTO: Foundation /0 Property line I o '.L- Absorption field .~. Water main/service line (5 'J- Surface water/drainage. /©O '~ Wells on adjacent lots /OO '-/' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /0 Building foundation (0 ~- Water main/service line Surface water /0~ ''/- Driveway, parking/vehicle storage area Curtain drain ~.)0~ ~r4~J Wells on adjacent lots /0D '-/-- F. ENGINEER'S CERTIFICATION I certify that l h~ve~rt~ in conformaT~ wi~ ) Signature Na/~e Engineer's Date field inspections and review of Municipal relines in effect on this date. HAAFee $ ~ Lb'~-- ' ~ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* AI.ASKA WA'rER & WASTI:/;WAT~:R CONSULTANTS, INc. 6901 DF..BARR ROAD, SUITE 2B * ANCHORAGE, ALASKA 99504 * PHONE: ~7-6179 FAX: 3~-3246 WELL FLOW TEST DATA L~GAL DESCRIPTION: ~ ;~ ~/~'~ /~J~'~'~ ~/''~' C~ ~ STRE~ ADORESS:~ cuE.T:- ~ .~ d~/e,~,~,.O.E NU~BE.: NUMBER OF BEDROOMS F~ F.H.A. - FOUR HOUR FLOW TEST: YES / NO TEST DATE START ~/~3/'~ TEST DATE END ~/'/~' ~/~'~- WELL DE~H (PER WE~ ~G): ~ C~ING DEPTH (PER WE~ LOG): /~ C~INO HEIGHT (~OVE GROUND): w~ ~'/.o WATER S~MPLES TAKEN: (:~'/ NO TIME METER READING TOTAL FLOW IF YES, DATE: /--/',/'~z3.,/'~ ~; 1 5q'7 WATER LEVEL (.._BELOW TOP OF CASING FLOWRATE (G.P.M.) DRAWl)OWN Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2-B ~ Anchorage ~ Alaska 99504 Phone (907) 3:57-6179 - Fax (907) 3:58-3246 May 3, 1999 REVISED ON 5/6/99. The revisions are underlined Rabbit Creek Construction 7541 Our Own Lane Anchorage, Alaska 99516 Attn: Bob Stevens RECEIVED MAY 7 1999 Municipality ot Ancl3orag. e Dept. Health & Haman Serv,ces Subject: Inspection of Private Well & Septic System at 12921 Foster Road Dear Mr. Stevens, Per your request were evaluated the well and septic system serving the subject lot for the purpose of obtaining a Municipal health authority approval (HAA). The results of the field investigation and adequacy tests are summarized as follows: A. WELL: On the day of our test (, the static water level in the well was measured at 138 feet below the top of the casing (BTC). A meter was connected to the water system and the flow turned on full. Based upon our data, it was concluded that the well production exceeds Municipality of Anchorage (MOA) minimum flow requirements for a four bedroom dwelling, which is 0.42 gallons per minute. It should be noted that seasonal fluctuations in the well production can occur, and that future performance is not guaranteed. B. WATER QUALITY: Water samples were taken and analyzed for nitrates and bacteria. The results are still pending. C. SEPTIC SYSTEM ADEQUACY TEST:/ffTheSeptic'~stem consists ora 1500 gallon steel septic tank, and a trench type drainfield that i~36 inches widp, 68 feet long, and has an effective depth of 8 feet (96 inches). Based upon ohr,.fiel~d~d me~ugurements, the bottom of the sump (monitoring tube) only extends 87 inches below-fhe ~ainpipe invert. The septic system was installed in November of 1985 (13.5 years ago), however, a structure was not built on the property until 1998; consequently, the septic system has never been used. MOA regulations dictate that an unsaturated septic system be presoaked with 2000 gallons of water, prior to being tested. On 4/26/99, Old McDonalds Pumping injected 2000 gallons into the trench. On 4/28/99, prior to starting the adequacy test, the liquid level in the drainfield was 33.5 inches below the drainpipe invert (trench 65% full). Over a period of about 20 minutes, 1000 gallons was introduced via a pump truck, causing the level in the field to rise 21 inches (trench 87% full), which corresponds to roughly 47.6 gallons per inch. Twenty-four (24) hour (4/29/99) later the level had dropped 6.5 inches, indicating that approximately 309 gallons had been absorbed, which does not meet the MOA absorption requirement for a four (4) bedroom house (600 gallons per day). Twenty (20) hours later, on 4/30/99, the liquid level in the trench had dropped only 1 inch, indicating that about 357 gallons had been absorbed in 44 hours. In a final attempt to achieve a higher absorption rate, the trench was dosed with an additional 1000 gallons of water, causing the liquid level to rise 21 inches (trench 100% full), which corresponds to 47.6 gallons per inch. Three hours later the liquid level had dropped approximately 5 inches, indicating that approximately 238 ga~R~been absorbed. Based upon this data, it was determined that the absorption rate of t~e ~ e~ceeds 600 gallons per day, as required for a 4 bedroom house. However, it should~at the septic system had to be filled to 100% of its capacity in order to achieve this absorption rate. NOTE: The adequacy of a septic system is influenced by numerous factors; including, but not limited to, seasonal surface water infiltration, groundwater variations, septic system maintenance (frequency of septic tank pumping, usage of biological additives), condition of drain pipe and pipe joints (which can be damaged by seismic activity and deteriorate with age), type of substances deposited in septic system (cigarette butts, sanitary napkins, misc. objects), and the amount of water being introduced on a continual basis. Consequently, the results of this adequacy test are only valid for the specific day of the test. Furthermore, because of the limited nature of this investigation, it is possible that there are hidden defects which may not have been detected No warrantee is made regarding the future performance of this well or septic system If you have any questions, pl~ ~0~,~Sincerel, ~ ~ Pres~deht (J ase contact us at 337-6179. Alaska Water & Wastewater Consultants, Inc. 6910 Debarr Road, Suite 2B ~ Anchorage ~ Alaska 99504 Phone (907) 337-6179 ~ Fax (907) 338-3246 May 4, 1999 Bob Stevens Rabbit Creek Construction 7541 Our Own Lane Anchorage, AK 99516 REFERENCE: Lot 20; Block 3; Mountain Park Estates #2 Dear Bob, Per you request, the following is a proposal for a possible upgrade of the wastewater disposal system on your property. on-site · Engineering services to perform a soils evaluation and percolation test: $400.00* for one perc test. · Excavator to dig one test hole: $400.00 We can provide you a list of recommended contractors. You should call them for costs and contract with them directly. · Engineering services to design the septic system: $500.00* This is based on a conventional gravity flow septic system with no waivers to surface waters, or nearby wells. · M.O.A. sewer permit: $320.00* Payable to the M.O.A. · Engineering services to inspect the installation of the septic system and prepare asbuilt drawings. Assuming a conventional gravity flow septic system with a single trench/bed and no sand filter: $450.00. · If an innovative septic system is required, add $950.00 to the design and inspection costs. We will not know whether this is necessary until after the soils testing is done. The items marked with an asterisk must be paid prior to submitting the design package to the M.O.A. The cost for the excavator to perform the installation is unknown at this time. Atter the design is comPleted you should obtain bids from several reputable contractors. We can provide you with a list of recommended contractors. Page Two Lot 20; Block 3; Mountain Park Estates Once the upgrade is completed, new water samples will need to be taken, if the current samples are over 30 days old. Once the samples are received, we will submit for Health Authority Approval (HAA). Costs are as follows: Water Samples $100.00 Health Authority Approval $300.00 If you have any questions or concerns, please contact us. We look forward to assisting you with your further engineering needs. Jeff}bb. p~trness, P.E., M.S.~~x~~ JA~/g~i Iff MUNICIPALITY OF ANCHORAGE M E M 0 R A N D U M WATER WELL ADVISORY HEALTH AUTHORITY APPROVAL NO. ~ / ~ During a recent Health Authority Approval on-site inspection and test of ~, t~.e potable water supply well on Lot ~0 B10~]k 3 Of~ou~i~ ~zk Ss~Subdivision, the well's productivity was determined to be 0~ gallons per minute. The minimum well productivity required by this Department (}~C 15.55) for a /0~ bedroom.residence is ~ ~ ~ gallons per minute. Although the subject well currently e~ra~=ess 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 - ~ h ' =t~=c_~ee to all copies ~f the subject Health Authority Approval.