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HomeMy WebLinkAboutMOUNTAINSIDE VILLAGE #1 BLK 6 LT 3Municipality of Anchorage Community Development Department Page 1 of 3 On-Site Water & Wastewater Program 4700 Elmore St. - P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: SW000308 PID Number: 020-172-31 0 New El Upgrade Name; PAUL GREEN ABSORPTION FIELD ❑ Deep Trench ■ Shallow Trench ❑ Bed ❑ Mound Address: 7016 BIG MOUNTAIN DRIVE *ANCHORAGE, AK 99516 ❑ Other Phone: No. of Bedrooms: Sall Rating: Total Depth from original grade: (907) 261-6536 5 3.0 GPD/sq. Ft. SEE DWG. Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade: Gravel depth beneath pipe: SEE DWG. Ft. 1 Ft. Subdivision: Block: Lot: Fill added above original grade: Gravel length: MOUNTAINSIDE VILLAGE #1 6 3 SEE DWG. 2 © 45 FL Ft. owns ip: angst ec ion: Gravel width: Beds Number of lines: Distance between linea: SEPARATION DISTANCES Total absorption area: 257 & 257 514 TOTAL umbar of trenches: 2 Dist. between trenches: 10 TO Septic Absorption Lift Holding Public/Private From Tank Field Station Tank Sewer Linea Sa. R. Ft. Well too'+ 100'+ too'+ — 25'+ TANK ❑Septic ■ S.T. E. P. ElHolding ❑Other Manufacturer: capac;ly. Surface Water 100'+ 100'+ 10o'+ — ANCHORAGE TANK 2000 Gal. Lot Line 5'+ 10'+ s'+ - NA Material: Number of compartments: STEEL 2 LIFT STATION Foundation 5'+ t0'+ 5'+ — Curtain Drain NONE KNOWN Manufacturer: capacity: ANCHORAGE TANK/ORENCO 2000 G.I. "Pump on" level at: "Pump off" level at: High water Is. et: Remarks: TIMER TIMER 45 35'+ WAIVER TO CUTBANK ISSUED AT TIME OF CONSTRUCTION RESERVE SITE WAS INSTALLED WITH A BULL RUN VALVE Pump Make & Model: 20—OSI-05—HHF Electrical Inspections performed by: MOA - • -iy.�� - .z - 7 W "'° 1.44 �jU�9WAtLEO IWOCT06ER OF PIPE MATERIAL *BASED UPON RECOLLECTION AND VISUAL INSPECTIONS PIPE MATERIAL RECORDING WAS NOT REQUIRED DURING INSTALL House to tank *D3034 Tank to *D3034 drainfield Installer BEEK CONSTRUCTION Drainfield *F810 CO/MT *D3034 Inspector GEG, Ltd. BENCH MARK (Assumed elevation) 143.25/105.56 Ft. Inspection Location and Description: Dates: 1st 10/2/2000 2nd 10/2000 3rd 10/2000 4th 10/6/2000 TOP OF WELL CASING/TOP OF STEP TANK MH LID ENGINEER'S SEAL Community Development Department Approval oo� o0 Conditional approval: Date: : 4 ................... 0 QO�'•,J f y Garn ss:' Q Q CE 795 �p .�.T23�� Approved: Date: c°joOOf 044d oo �( prof essio 4���0p0o V 'V v PERMIT NUMBER: PARCEL ID NUMBER: SW000308 AS -BUILT DRAWING 020-172-31 � I i 100 \ I WE L RADIU / • T FA 2000 GALLON S.T.E.P. - TANK WITH TRICKLING FILTERS (ADVANTEX)-,, -' t TED MOORE TED MOORE ZJ P.E. TH#9 P.E. TH#8 MT2 MT1 /COi° /:: ' INSULATION (ASSUMED) rw i \_�' FIVE Np�SE �1 g�pRppM GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS 3701 E. TIOOR RO . SURE 101 ' NlGIrAA M 9850] . PMNF (QI i17-P1J9 . CAV !9(!11 IU -19Y . od1koW uu�mnu.unnlnuN PREPARED FOR: PHONE NUMBER: PAGE NUMBER: PAUL GREEN 261-6536 2 OF 3 LEGAL DESCRIPTION: • DRAWN BY: MOUNTAINSIDE VILLAGE 1; BLOCK 6, LOT 3 PNB TYPE OF WORK: DATE: l AS -BUILT DRAWING 7/10/14 rmI DBL1 13.71 15.26 DBL2 13.54 15.96 STI 85.49 85.75 MH 89.05 84.90 DBL3 83.81 77.84 DBL4 83.03 76.86 FD 83.03 76.46 PCO 83.34 75.72 C01 96.06 89.10 MT1 98.21 91.15 CO2 121.64 104.65 MT2 122.13 105.47 CO3 83.54 75.46 MT3 82.39 73.94 C04 110.15 90.91 MT4 111.11 93.22 ......... T ... ... pROFESSOilo PERMIT NUMBER: SW000308 2" FILTER FABRIC AS -BUILT DRAWING rFINAL GRADE = TOP OF TANK AT� I 104.32-105.23 PASSIVE VENT INLET = 100.00 AlI AX -10\ ■ 1 1 ■ AX -10 ■ ■ AX -10 PARCEL ID NUMBER: 020-172-31 TOP OF TANK AT OUTLET = 100.00 INVERT OF BUNG 2000 GALLON u BIOTUBE AT INLET = 99.21 (0 S.T.E.P. TANK (10 SCREENED VAULT GALIE OR THICKER) PREPARED FOR: PHONE NUMBER: PAUL GREEN 261-6536 ORENCO4 ��� EFFLUENT DRAWN BY: PNB J PUMP DATE: 7/10/14 FINAL GRADE = 104.79+ T O.G. = 103.20 TO 104.12. T.D. _ FINAL GRADE 2.96' TO 3.88'. = 99.51+ FILTER FABRIC O.G. = 97.27 (WEST END) TO 98.69 (EAST MT CO p END). T.D. = 3.08' I I (WEST) TO 4.5' II (EAST) PE�--INVERT OF PIPE :.. . BOTTOMTRENCH 100.24 95.19 TRENCH = 94.19 RELATIVE ELEVATION OF BOTrOM RELATIVE ELEVATION OF BOTTOM DR �OFESSI�Pi GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS 3701 L N00R R . SORE 101 • ANCHORIIO: M 09507 • PHONE (907) 337-8170 • FM (BOJ) 330-32/0 • WE - .w'.9amneen0lnserin PREPARED FOR: PHONE NUMBER: PAUL GREEN 261-6536 PAGE NUMBER: 3 OF 3 ��� LEGAL DESCRIPTION: MOUNTAINSIDE VILLAGE #1; BLOCK 6, LOT 3 DRAWN BY: PNB J TYPE OF WORK: PROFILE AS -BUILT DRAWING DATE: 7/10/14 �OFESSI�Pi - } . Inspection Report Municipality of Anchorage, Building Safety Division a 4700 Elmore Road INFO & HELP.(907) 343-6211 INSPECTION: VOICE (907) 343-8300. FAX (907)249-7777 www.muni.org Name Paul Green Permit # 00-0925, Company Inspection Date 05 -Sep -2008 AM . Address 7016 BIG MOUNTAIN DR Phone 240-3127 Grid SW3439 345-7935 Subdivision MOUNTAINSIDE VILLAGE #1 LOT 3 BK6 TR n/a Work Daseription 4965 sq ft garage 1350 sq it unfinished 996 sq It garage Permit Technician Comments or Directions - Please call 30 minutes prior for access. - This is a re -inspection on the final electrical. Inspection Type Fire:Final Fire Comments (for inspector use only) Inspector -1—e— r_ _ Date - %r Rick Mystrom Mayor Municipality of Anchorage Department of Health and Human Services 825 "U Street P.O. Box 196650 Anchorage, Alaska 99519-6650 httpl/wh adanchorage.ak. us Permit Number: #SW 000308 Date of Issue: 8-18-00 Parcel Identification Number: 020-172-31 Date Started: 9-29-00 Date Completed: 9-30-00 Is well located at approved permit location? ® Yes ❑ No Legal Description: Mountainside Village #1 Lot 3 Block 6 Property Owner Name & Address: Paul Green PO Box 113328 Anchorage, Ak 99511 Borehole Data: Depth (ft) Method of Drilling ® air rotary ❑ cable tool Soil Type, Thickness & Water Strata From To Casing type: steel stick-up 0 2 Wall Thickness: .025 inches Broken Rock 2 9 Diameter: 6 inches Depth: 20 feet Bedrock 9 327 Liner Type: Diameter: inches Depth: feet Casing stickup above ground: 2 feet Static water level (from ground level): 55 feet Pumping level: 327 feet after 2 hours pumping 15+ gpm Recovery Rate: 15 gpm Method of Testing: 15+ Well Intake Opening Type: ❑ Open End ® Open Hole ❑ Screened Start feet Stopped feet ❑ Perforations Start feet Stopped feet Grout Type: Bentonite # 8 Volume: 1 br Depth: Start 0 feet Stopped ± feet Pump: Intake Depth feet Pump size hp Brand Name Well Disinfected Upon Completion? ® Yes ❑ No Method of Disinfection: Clorine Tablets Comments: Well Driller: Alpine Drilling & Enterprises P 0 Box 110496 Anchorage AK 99511 Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property mampr nr flip nmll AAIIAp *hall to flip Tlpnt of ppaw, R, T7nman rn Aa,,* of rmm�lptinn nm evEwrrr. �a ,, n. Q,�Q Vitlaer , #l. Block 6, ADt 17016 Big ALASKA WATER & WASTEWATER CONSULTANTS, INC. July 27, 2001 Reference: Mountainside Village # 1 Lot 3, Block 6 To Whom it may concern: The above mentioned property's permit was issued on 8/18/00. The installation for this property was completed in Ocotober of 2000. Installation inspection dates are as follows: - 9/2 1 /00 1 st. - 10/02/00 2nd. - 10/6/00 3rd. Paul and Karen Green the property owners have their home scheduled to be completed in approximately two years. They will then have an as -built survey completed which will enable us to submit the Inspection Report. If you should have any questions regarding this notice please give us a call at 337-6179. Thank you. 6901 Debarr Road, Suite 2B • Anchorage, AK 99504 Ph: (907) 337-6179' Fax: (907) 338-3246 • Website: akwwc.com MUNICIPALITY OFANCHORAGE 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 lalcvIo-0 Plow ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Permit Number: SW000308 Date Issued: Aug 18, 2000 Expiration Date: Aug 18, 2001 Parcel ID: 020-172-31 Legal Description: Mountainside Village #1, Lot 3, Block 6 Design Engineer: 0041 AK Water & Wastewater Consultant Site Address: unknown Owner Name: Paul Green Lot Size: 91905 SO. FT. Owner Address: PO Box 113328 Total Bedrooms: 5 Permit Bedrooms: 5 Anchorage , AK 99511 - This permit is for the construction of: Q Disposal Field E Septic Tank Holding Tank El Privy Q✓ Private Well E] 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 DHHS at least 2 hours prior 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 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. 5. The following special provisions. THIS PERMIT ISSUED FOR THE CONSTRUCTION OF AN INNOVATIVE ADVANTEX WASTEWATER TREATMENT SYSTEM. AS A CONDITION OF THIS PERMIT, THE OWNER SHALL MAKE ARRANGEMENTS FOR THE SYSTEM TO BE SAMPLED ONCE A MONTH FOR A MAXIMUM OF 12 CONSECUTIVE MONTHS AFTER BEING PUT IN USE. THE ATTACHED PROPERTY OWNER AGREEMENTS BECOME A PART OF THIS PERMIT PACKAGE. Received By: _me9 (S(nr )� Issued By: etvLl 7` / -t � Date: I SIOCA Date: ALASKA WATER & WASTEWATER CONSULTANTS, INC. August 16, 2000 Municipality of Anchorage Department of Health R Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 f .4r-jrBu0NA6;4-S Ac"GwLao( AU -1 6� PCZ— ^rn GpLtovl. Ref: Welland Septic System Design for Lot 3, Block 6, Mountainside Village #1 RECIRCULATING TRICKLING FILTER (AdvantexT%l) SYSTEM To whom it may concern: 1. GENERAL: The proposed 5 bedroom house will be served by a private well and septic system. The proposed septic system will be designed around the 30 foot radii of test hole #8 and #9; both performed by Ted Moore, P.E. on 9/30/96. We are proposing that a 2000 gallon S.T.E.P. tank with the Advantex recirculating trickling filter system and a five foot wide drainfield be installed. There are numerous site constraints which are as follows: • The slope contours • The presence of shallow bedrock • The presence of cutbanks Given these site constraints, we are proposing to install the Recirculating Filter system, now trade named by Orenco Systems, Inc. as AdvantexT*'. 2. SOIL CONDITIONS: The two test holes performed by Ted Moore, P.E. were excavated north of the proposed house. In TH98, the soils below the organic layer is a SM material to depth of 2 feet and then transitions to a GP/GM material to a depth of 5 feet and then transitions to a GM material to a depth of 10 feet (bottom of test hole). In TFI#9, the soils below the organic layer is a SM material to depth of 1.5 feet and then transitions to a GP/GM material to a depth of 5 feet and then transitions to a GM material to a depth of 10.5 feet (bottom of test hole). No groundwater was encountered during the excavation of the test holes. A percolation test was performed in TII#8 between 2.25 feet to 2.75 feet and found the rate to be I minute/inch. A percolation test was performed in TII#9 between 5.0 feet to 5.5 feet and found the rate to be 1 minute/inch. Original copies of Ted Moore, P.E.'s soils logs are to follow. 3. DRAINFIELD: The intent is to install a Recirculating Trickling Filter (Advantex) System that will allow the use of a small drainfield in the area around a 30 foot radius of TFI#9 . The size 6901 Dcbarr Road, Suite 2B — Anchoraege, AK 99504 — Ph: (907)337-6179 — Fax: (907)338-3246 of the drainfield will be based upon an application rate of 3 GPD/FT2. Due to the fact that the Advantex system intermittently doses the drainfield, we can utilize the application rates for a category II, pressurized dosed system (per Jim Cross, P.E.). We are proposing to install a 5 foot wide drainfield that is 45 feet long and has a total depth of 4 feet. Then, add I foot of clean, washed sewer drainrock below the distribution line. This corresponds to an absorption area of 259 0, or an application rate of 3 gpd/ft2 (assuming 750 GPD total flow). 4. TRENCH DESIGN: a. Percolation Rate: 1 A 1 minutes/inch b. Allowable Application Rate: 3 gallons/day/ft2 c. Number of Bedrooms: 5 d. Design Flow: 750 gallons per day e. Minimum Absorption Area: 250 ft2 f. Total Depth: 4 feet (max.) g. Effective Depth: 1 foot h. Width: 5 feet i. Reduction Factor: 0.87 i. Minimum Length: 45 feet long j Effective absorption area = 257 f12 5. ORENCO PACKAGE SYSTE11i: The STEP tank with the trickling filters will be manufactured by Anchorage Tank & Welding to meet the latest design criteria established by Orenco Systems, Inc. The point of contact at Anchorage Tank is Lowell McNutt. As with their standard STEP tank, it is equipped with a high water alarm per M.O.A requirements. 6. SURFACE WATER: There is no surface water within 100 feet of the proposed septic system upgrade. 7. TOPOGRAPHY: As can be seen on the attached topography site plan, the average topography of this property is a 30 to 35 percent slope running from approximately south to north on a slope that is naturally vegetated. The trench is to be installed parallel to slope contours. A cutbank exists 35+ feet north of the proposed drainfield. It is our opinion that due to the porous soil conditions, the effluent will migrate downward rather rapidly. With the heavy vegetation, and the use of the Advantex system, there is minimal risk of daylighting effluent downhill from the proposed drainfield. We request that the 50 foot setback to a cutbank be waived to 35 feet. In addition, we are requesting that you allow the proposed trenches to be installed on a slope up to 35 percent. 8. CLOSING: I am open to any suggestions from your department that would be an improvement to the -3roposed system. I am unaware of any negative impacts that this installation would impose on jacent wells, or septic systems. If you have any questions, please call us at 337-6179. Lim, elp y. Gamess, .E., M.S. Presifle it 6901 Debarr Road, Suite 2B -- Anchorage, AK 99504 — Ph: (907)337-6179 — Far: (907)338-3246 ALASKA WATER Fy WASTEWATER CONSULTANTS, INC. April 17,2000 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 System for Lot 3, Bk 6, Mountainside Village #1 To whom it may concern: Attached is soils information for the subject property that was performed by Ted Moore, P.E. Also attached is a 100 scale site plan and a topography drawing prepared by AWWC, Inc.. Both engineering firms have evaluated the lot and concur that the slopes in the vicinity of the proposed septic site (test holes #8 & #9) are approximately 30%. Furthermore, it is anticipated that the lower (reserve) trench will be approximately 35 feet from the road cutbank. Prior to my client purchasing the property he would like some assurance that your department will be receptive to waiving the maximum slope requirement to 35% and allowing the trench to be 35 feet from the road cutbank, so that a septic system can be installed. The plan is to utilize an alternative technology system such as the Reactex, BioCycle, or Intermittent Sand Filter. Given the level of treatment and the porosity of the soil, it is certain that the wastewater will migrate downward rather rapidly and have minimal potential to migrate lateral and daylight. If necessary, fill could be placed downhill of the trenches so as to modify the slope. We are requesting an expedited response from your department so that our client can move forward with the purchase. Thank you for your co ideration of this matter. If you have any questions please contact me at 337-6179. - . If M.S. 6901 Debarr Road, Suite 2-B' Anchorage, Alaska 99504 Ph: (907) 337-6179 • Fax: (907) 338-3246' akwwc.com Sent By: CTO 4TH • ',rad -.{a -9s FL; 19072616515; SHuT''ee'226 IM 3).R06EI:S Jan -26-00 7:09PM; CML a ENVIRONMENTAL ENGINEERING • ENERGY CONSEavAYtoN • ANALYSIS Page 2/5 P; 16 ;i2 n THEODORE F. MOORF, P.F. 14530 ECHO ST. PH: 0907) 345.1355 ANCHORAGE, ALASKA 99516 October 24.1996 Dan Rogers. Jr. ( �04 17901 Mountainside Village Drive Anchorage, AK 99516 S Dear Dan: Per your request on September 30, 1996 we dug .10 test holes to assess the feasibility of constructing on -six wastewater di sal facilities of Lot 3, Block 6. Mountainside Village SID.. Soils logs'and pecc test results for a two most promising test holes as well w a site:phindepicting the location of all test holes and possible sites for a house, well and septic system ens enclosed. The lot is characterized by steep north facing slopes with shallow bedrock.,Th=factors make the siting of on-site wastewater disposal facilities difficult for a cumber of reasons. Municipal wastewater regulations specify that soil absorption systems be c6nsmxt6d 50 feet uphill of cutbanks and slopes in excess of 25%. and that the bottom of the sewer. gravel be al least 6 feet vertically above the Wrock surface. Tire natural slopes on the majority of this lot are at least 30%, and the constnktion of Big Mountain Drive created a et-abank which. parallels the north property line. In eight of the ten test holes bedrock was encountered at soil depths of 2.75 - 7 feet, which is too shallow to design a workable soil absorption system on these steep slopes. Luckily, test holes #8 and #9 encountered soil depths of 10 feet, and the soils perc'ed at a good rate for design purposes. These test holes were located in an area with slopes of 30%. Based on past experience 1 expect that the Health Department will be willing to waive their slope requirements sufficiently to allow a soil absorption system to be constructed in this area. A small section of the lot located ,further north of test hole #9 has somewhat gentler slopes, and it is quite possible that suitable soils may be found in that area as well, however getting a backhoe into that area to dig test holes would entail significant damage to a beautiful stand of mountain hemlocks. Because of the extremely limited area with suitable soils and the relatively steep slopes. I strongly recommend that whoever builds on this lot seriously consider the installation of either an intemlittent sand filter or a'Biocycle" aerobic treatment unit. These units produce a much cleaner effluent than a conventional septic tank which then requires a smaller residual disposal field. Because of the cleaner effluent, it stands to reason that the disposal field should last longer, other factors being equal. In planning driveway access for a house on this lot, it will also be important to avoid compromising the available area for septic system construction, i.e. the driveway should not cut across the proposed area or pass below it, thereby creating a cutbank requiring a 50 foot setback. Please feel free to give me a call if you have any questions on this mpor . Sincerely. '.ao, _ ""_ Ted Moore, P.E. ............ ....... . lent By: CTO4THFL; 19072818515 . Jan -28-00 7 tOPN, rage 5t5 •�110v i8�3/6 'f:Wn QB 'j!'rFf. vl,. ROt`.CRY ti; �i f.. " �• 4i r mi,.... r dAW AORJO Ii AIAtSMQ*51S UWHOLE0 9 LEautLDEeoRIFmoN: La l.81adc6s.MooaaarhimgWoaoV8—4A�aSEIDpCOUTi�N TEST . ... ..•...:— .... ......�..�,...7...,.• 40 u.. r. •b DATEPERFOPAIED: ¢Vrny.[i11.1996 / .3.` �.�r'�r• �,•,'. r'� 16 �• ) PERFORNM FOR: Tteatn h. (A 11— 12— 13.— N SLOPE PL ' Sl( Sandylam i.,... OP/W SomtewW si ty lady travel ............ j OM 81ky g mvd whh *"I" 'LidLW1a laui*n ham ova)yfnt atmtum )301. j(om yDophb Gicum"rr D^DateLU M= l0R/9eig Dar Rwdh9 Cod` Tlma 15 ,jgla 1Z'Prew+k ... 16� Add warm A 14M 3:19:26 �_ AM Hier ,_� 3: •W 17— tI2 3:241)% Ada nae i5 1e_ *rm FLAN NdTktr Pnoomobt 1101p�op (R* mu) It"dinp (lnd ) B 1511 21 174 7116. 115116 70•• PERCOLATION RATE _�(mlmutWnah) FERC NOLE VLAWMR A. .» TEST RUN B67WEEN__"_FTANO_ s_ FT COk"NTs: %np Wab"M rA aA Iowa AoM. wNeh was d awe Dlomed tgtbe{t asvNsimpb wasldvrl,. Tlr oum.W H y.rwmlNla 4tiwih _ m^ktclwL lMndlk�tbnr.�e en n(w* a iM mnimwm drmh w bwJrock to Irl wr hob. PERFOR1iD$Y. PlA77OP.�HMCAL8EAVI.OFS...: ,. • ( /�c�►.�at .. , , CEATW7-YHAT..11SS7E6T Wl1YPlRFORMIEOIN _. ACCORDMiCE1MtN1a.L4TwTR/IlICs7rAlNIW.Mt:OtitOELa1CSINEFFECTOkTi1�DATQ. bATE !a/z.vf9�' �. ::: Sefit 8y: CTO 4TH FL; 19072616515; Jan_ -28.00 7:10PM; h0V7+l�i�9[ TMU 010320 PM' D.ROCERa '- •--7- - � ��"�.'-.'`� FLATTOP TECHMCALSERVICES �r�; �,.;•.I::' 14WECHO ST. ;�`'v• `t. ,I I ANCHORAOE.ALASKAt19S1! �. •J _.v ._— TEST HOLEY 8 S61LS LOQ - PERCOLATION TEST f...:.: ' • LEGALDeWRIPTION: Lot], block 6.M"t ! W6VW1teSV OATEPERFORMEo:` eManLerT0.19M Peirott EO DEPTH ^ v ("0 �`" PL SM Sully loon OPIOM SottlewAK Silty 6u1dy naval OM Silty gtwvol Wath wbhlea Ltereninsiy doles cad damp with depth Page 415 rte' SLOPE SITE PLAN I DOM to WOW~ 0814 1 .. ..' .... �............... ............... N' 1! 0%1 ata i ; ; �ry— 1..... ,. +' .. clot:k Nat Tuna Pow ow Na, Does, a R0adNO•• Time I (mrutaa) R�aOjv (ktd+aal L 10%I P.atook 21 7 Adel wk,,r _ _ j's3:252,57-1s2) ] — „ •2 2,t7t ,� 21 S/16 21116 AMw.w _21I:GS. 711116 1 1a i .........93 43 ,._�. 2 ... 21 21116 } :20— PERCOLATION RATE_ 1 . , (ntwtaaMch) PERC HOLE 01AMETER a• ~ TESTRUNBMEEN, 22S FTAND •.. FT COMAENTS:-_Ths k"igLw q all 10 tw1. holes which were duixo laund fn 1143r appm4unaleywifiwlf, 7M hambet in pveMMtet Denauh _tljE tat hole Idmurkstiqu mmLpms refers to ItK maeimwn depth to Eedttick in Hat tw hole. _ ''PAiPOAMtD V;:rl'ATTD!P7iCNNICJIk,BERNCEB. :..•: ...1 •.(,..f,� ib� CERIVy TRAY TWSTESt WA7 PAPJF00 1)M• ... AOCOf1MM Adm ALLSiA4AND.UMOIPPJLGi J1DLiUNE61NEfMlCTON THIS DATE. :DATE: .. ./Olit y)��f-yj'...',; •., - :, Sent By: CTO 4TH FL; 19072616515; ROGER$ LOT 14 BLOCK 4 • LOT 17 BLOCK 4 HOUSE R , WELL , SEPTIC SYSTEM • LOT 15 BLOCK4 HOUSE J • R . Jan -28-00 7:09PM; Page 115 LOT 14, BLK. 4. "' : ` •' (VACArrn r i, � — WELL Tx.. SITE FOR PRIMARY pori SOIL ABS. SYSTEM ',—SITE FOR REPL. ' • 0 *�?�t• o :� i o SOIL ABS. SYSTEM i M411� R7h• Tx.l Kv) ((ao� HOUSE WE WELL SITE ' -�y'o -, -- - •LOT 3 LOT --WELL LOT 1 LOT 1 BLOCK4 LOT 4 (VACANT) la;a�c� F. inou d CE -35".7 r' LOT S. BLK. 8, MTNSIOE. Vku- mlt PROP. WELL ANd SEPTIC SYSTEM SITE PLAN FLATTOP TECHNICAL SERVICES I INCH. 100 FEET 14530 ECHO STREET DRAWN BY TFM ANCHORAOLALASKA "S16 CCTOB6R,1a98 NdFB •"- M N6T 119UAVEYEO PLrkT. a U.LO �j;10N, Alib iltltErAPpROXIMATE:, ._•::•' MOUNTAINSIDE VILLAGE 01 LAT 15, BLACK 4 MOUNTAINSIDE VILLAGE 11 LAT 16, BLACK 4 100' WELL RADIUS ALASKA WATER & NVASTEWATER CONSULTANTS, INC. 6901 DEBARK ROAD, $UTE 29 • ANCHORAGE. AK 99504 • PHONE (907)377-6179 • PAX (907)3567246 PREPARED FOR PHONE NUMBER: PAUL GREEN (907) 261-6536 LEGAL DESCRIPTION: MOUNTAINSIDE VILLAGE S/D #1; LOT 3. BLOCK 6 TYPE OF WORK: SITE PLAN FOR PROPOSED WELL LOCATION AND SEPTI MOUNTAINSIDE VILLAGE /1 LOT 14, BLACK 4 C MOUNTAINSIDE VILLAGE /1 LOT 4, BLOCK 6 DATE: 6/16/2000 -OF QF DRAWN BY: ��!• .; 7 (1V� K.D.W. SCALN too' ` ...... PAGE NUMBER: ��• 1 OF 3 *.Jeff, �:....—5s.:.. y'1> -7953 e, yy4ki, s ....... SYSTEM PROPOSED 2000 GALLON RECIRCULATING SEPTIC TANK WITH TRICKLING FILTER (ADVANTEX) INSULATE UNDER DRNEWAY (4 INCHES THICK, 4 FOOT WIDE) I ALTERNATE SITE i -PROPOSED DRAINFTELD. EXCAVATE A TRENC THAT IS FOUR FEET DEEP MAXIMUM (ON UPHILL SIDE), BY 3 FEET WIDE, BY 43 FEET LANG. ADD 1 FOOT OF CLEAN, WASHED SEWER DRAINROCK. INSTALL TRENCH PARALLEL TO SLOPE CONTOURS DATE: 8/16/2000 ._ . _.._ ........ .. _.,... DRAWN BY: ALASKA «'OYER & WASTEWATER SCALE. K.D.W. CONSULTANTS, INC. 1"-50' PREPARED FOR: PHONE NUMBER: PAGE NUMBER: PAUL GREEN (907) 261-6536 2 OF 3 LEGAL DESCRIPTION: MOUNTAINSIDE VILLAGE S/D #1: LOT 3, BLOCK 6 TYPE OF WORK: DESIGN FOR SEPTIC SYSTEM AND PROPOSED WELL LOCATION AdvanTex Treatment System AX Series - Mode la Three (3) 34x48 Pods NOTE JIM CROSS,I NOTE: THE BOARD INSULATION TO BE P.HAS THE INSTALLED OVER THE SEPTIC TANK & 4' /--�,� ADVANTEX MANUAL BEYOND ON ALL SIDES EXCEPT UNDER Ca THE ADVANTEX FILTER. THIS WILL ALLOW D-minrn�9 FOR HEAT TO ESCAPE FROM TANK & RISE TO THE FILTER ABOVE R. I 194' THREE (3) AX -10 FILTERS CONNECTED TOGETHER rFROM TANK TO FILTER L� n FI I I _ C'� I _ 1 I 60' I I u U TO DRAINFIELD ITHE TANK SHALL BE SIZED PER ANCHORAGE TANK FOR A FIVE BEDROOM HOUSE FINAL GRADE TOP OF TANK AT - 99.0 + rAsm AN %w INLET - 98.81 TOP OF TANK AT OUTLET - 96.73 -------------- NSt(Alm 1lOIGA9 I1DS 2' INSULATION ^ •• •• ^ ^ ^ • 1'1/6 THE AX -10 PODS a41w wl-0• SHALL BE PLUMBED )w SO THAT THEY CAN INLET EACH BE ISOLATED. ORENCO INVERT OF BUNG 2000 6&LON ( MIN.) L s10CRNEEB,.,ED AT INLET - 96.31 L 5.1'�p, 1• . VAULT .p_ ORENCO EFFLUENT PUMP DATE: 8/16/2000 DRAWN BY: ALASKA WATER & WASTE AVATERs� K.D.W. CONSULTANTS, INC. 6901 OERARR ROAD. SUITE EB • ANCHORAGE. AK 99504' NIONE (907),537-0179' FAX (907I736J746 N.T.S. PREPARED FOR: PHONE NUMBER: PAGE NUMBER: PAUL GREEN (907) 261-6536 3 OF 3 LEGAL DESCRIPTION: MOUNTAINSIDE VILLAGE S/D $1; LOT 3, BLOCK 6 TYPE OF WORK: PROFILE VIEW OF PROPOSED TRENCH AND ADVANTEX SEPTIC TANK DATE: f MOUNTAMIEIDL vILLACE P IOT 14, OLO,n koNL)EVELOPEDI G1 � PHOIyE: (C 147-517 g \ \ DT BLOCK \ PHONE ),\2 /� �� 90 261-6 6 3 79 \�\I \ PAGE:'\ \\ 1 =100' OF IUNDEVELOPEDL .'-Sent By: Alaska Water & Wastewater Consu; 907 338 3246; Aug -17-00 10:19; fain �nf�Ct�. Dear Homeownedl The on-site wastes disposal system. T undergoing testing Wastewater Dispos of one of these syst age Services Page 1/1 ag is an "alternative" wastewater lystem Septic system:, is Altemative System section of the risks involved with the ownership 1. The technology used in this system has been shown to be effective in other areas. The system is currently undergoing a two-year testing period in Anchorage under the guidance of the Department of Health & Human Service$ (DHHS) and the State of Alaska Department of Environmental Conservation (ADEC) to determine its effectiveness in a subarctic environment. 2. The system for this property received a vertical separation distance waiver from both the State of Alaska and Anchorage Municipal Codes to ground water. This waiver was granted due to the system's expected performance within the site conditions on this property. I (we) certify that I (we) have read the above statements and am(are) aware of the risks outline. I (we) also certify that I (we) am (art) in the pro"& utyua�iiugjproperty legal description): � o p LU( 3 tL40c� h 04t. S1h Vjl(ae W4 �,P6 -u.>_ ureG�Ch N) _ (Purchaser Name) (Pumbaser Signanae) (Purchaser Sigarture) NotarIm Below stare of A'L.ASIt'A- On this 1, "'day of .20.6a PA U L 1✓ . pertowlly appeared before me, who is personally known to ma IL SGl 3 i, n i! t� �( 6'L _whose identity I proved on the basis of whose Identity I proved on the "affirmation of a credible witness to be the slgaer of tho above documeot, and he/she Imowledted that pe/she ar it (Notary Public Signawre) lots o. ¢-Ivy (Notary Public P ` My commission expiresMY Jum 21.2002 MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section Parcel I. D. 020-172-31 ANCHORAGE Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: 3' �?, ® -2-0 Complete legal description MOUNTAINSIDE VILLAGE #1 BLOCK 6, LOT 3 Location (site address) 7016 BIG MOUNTAIN DRIVE, ANCHORAGE, AK 99516 Current property owner(s) SUNDRAYAH & JEREMY STOLLER Mailing address Real estate agent Day phone 7016 BIG MOUNTAIN DRIVE, ANCHORAGE, AK 99516 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 5 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 $ 55U Date of Payment �'o Igo /z Receipt Number m oggcl COSA # 05C 2616 ,26 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 1/27/2020 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change ��► `1 due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of s��•' •' ' • • ' • .` j construction (workmanship & materials), the water usage of the family being served by the '`• (I system and maintenance. The operational life of all well and septic systems are subject to •. 1 these various and dynamic characteristics and are outside the control of the evaluator of the � * ; TM •.* well and septic system. Therefore, any estimate of how long a system will function satisfactory .. ... • • . • • • • • • • • • for current or future occupants or guarantee that no unseen encroachments, deficiencies or % discrepancies exist can be given by First Water Consulting & FI5 �% • • • • • • • • • • • • • `J ► Curtis Huffman 6. DSD SIGNATURE �Ec •. CE 128991 .•4 �fj • . • 1 /27/2020• . • \ AW System #1 Approved for bedrooms �� N)f .' Nab + k`. ROFi8*5% ,`-� System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stip gtiomfir(q pA-ITY 01 r� Original Certificate Date: 2--2)-2_0Z-0 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Legal Description: MOUNTAINSIDE VILLAGE #1 BLOCK 6 LOT 3 Parcel ID: 020-172-31 If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system _ A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 9/30/2000 Total depth 327 ft Cased to 20 ft (INTO BEDROCK) ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 1/20/2020 Static water level at beginning of test 159 ft. Well production at time of test 6+ gpm Comments B. TANK DATA Age of tank(s) 19 years Tank type/material ADVANTEX-STEP / STEEL Measured operating fluid level in septic tank 50"+ ® Standpipes/foundation cleanout per record drawing Date of pumping 8/9/2019 D. ABSORPTION FIELD DATA Which system tested (date installed) 10/6/2000 ® ALL standpipes present per record drawing Total measured depth from grade 5_1 ft (max) Measured depth to pipe invert from grade 4.1 ft (min) ❑ N/A — ressurized field Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® Nc ® Coliform bacteria is Negative Nitrate 2.29 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by F ES Date of Sample 1/20/2020 C. LIFT STATION ® Required maintenance completed Age of lift station 19 years Lift station material STEEL Comments: See attached Advantex maint report. Adequacy test date 1/20/2020 Results Z Pass For 5 bedrooms Fluid depth prior to test 0 in Water added 900 gal p New depth 6 in ® Monitor tubes go to bottom of effective. If not, state Elapsed time 1440 min depth into effective ® Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 750+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) If yes, enter date Gallons introduced gallons MIS Comments/Deficiencies: Tested North trench — Next maintenance A+ will switch flow to South trench. �:.I E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ® Yes if No Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ® Yes if No ® Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ® Yes if No _ Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: ® Yes Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No _ Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No —ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION 1 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. -.100- *�Ikl ,� OdF .. .rte•° ....•...��� .... ....t:.�.':.. r • Curtis Huffman 0 CE 128991 ,• c�`�.b/ is�F'QFo .IJ27/2Q28�PROFESSVAN .� ft ft ft ft ft ft ft ft 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 1 Day of ut r of 20 ),,-- , by and between H A Q\A,�T4� 2���c i' herein the "O�Wi ER," 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 ADVANTEX SYSTEM located at (legal description) MOUNTAINSIDE VILLAGE #1 BLOCK 6, LOT 3 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) 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 VC 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). Owner 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. 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) Page 1 of 3 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 a-rees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. \Owner agrees that anv sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. 9�__\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. NOwner 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 111 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 OWNE By:(signature) Date: 2 1igfZ� 1a 20 (print narne) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this2l day of Jc,h\j U 20'W , by (3 (A1n1nG1 Ntr4rry 111tiblic NOTARY PUBLIC FOR .ALASKA BREANNA HOMESTEAD My Commission expires: j 2,0 7,(D S!aEe or Alaska My Commission Expires February 6, 2020 MUNICIPALITY: By: (signature) rint name) (rev. 05/18/2018) Date: / Z1 --Z0 -ao Title: Page 3 of 3 08/09/2019 16:15 8686770 APLUS 339819 a poll mommun� a III III M mums III III on III MEN 0 1 a M III III a a �'Ovarffexo Field Maintenance Report Annual Inspection PAGE 06 AnchorageTank 907-272-3543 Pmr". Own-Wrmckinq,-T Inspect Opnmtor l7 Earthy El Moldy Sundrayah & Jeremy Stoller '7Cabbage El Decay La" Betts _r907-349-9737 Foam in Mink ❑Yes Sito Addrt&t Check Control Panel — Ph6nt 7016 Big Mountain Drive, Anchorage AK 99516 D' scharge A 12,- AX Sito ID il County 10 4s Pad 4� Dial tone (telemetry only) KFUJYAJ� 4 t a of LaM In8pottlon AX -100078 SW0O0308 1 RTU13906 10/0112CI8 Retrieve O&M Info Daily flow Recirc ratio Timersettings; Iz--- C-104 Gl n rlhoeinm#;Anit "IEL fP, w 1�1 # - Odor of Sample Inspect Typical PErmusty l7 Earthy El Moldy Non -typical E]Sufflde '7Cabbage El Decay Oily film In PW Yes L No Foam in Mink ❑Yes o At'No Check Control Panel RlserjUd El Re,drc Amps 1 3 D' scharge A 12,- Float cords ❑ Audible and visual alarms t Dial tone (telemetry only) No Insp"t/Clean Pump System Commenft Measure Sludge/Scum Sludge Scum 1 %t Compartment Inspect Clean Rlserll.ld .......... .......... Previout 2nd Compartment Splice Box .................... Previous Current Float Cords .................... RlserjUd El Floats..................... Float cords ❑ Pump, ....... t Inspect 13iotube' Filter ................. Disinfection Equipment tg.-- Dispo Motubo Pump Vault ............ Recirculating Splitter Val ve------- Commenft Measure Sludge/Scum Sludge Scum 1 %t Compartment Current Previous Current Previout 2nd Compartment Current Previous Current ?11)vious Inspect/Clean AdvanTex Filter Odor: 9<1 Normal El Pungent Normal ExostgiVa Bridging/Ponding, V—qvon?±/Mlnor ❑ Excessive Inspect/Olean Discharge Pump System, Inspect RlserjUd El Splice sox El Float cords ❑ Inspect/Service Other System Components Inspect Clean Disinfection Equipment tg.-- Dispo Insi:ioct Olean Late rala/Crificas Pod Bottom i l I nteKs Vent Inspect Clean FlQat-R Pump lnfpw Clean MI Laterats/Cirivcq"k,G-� Observations Additional Services Rendered Ej Cleaned textile sheets? Ej Replaced UV items? L7 ReplacedfUsed other Items? Parts Used: W = Warranty, B = Billable W appropriate selection) W 13 Item Number Dosoription Finall-Safety Inspection V RSV reinstalled IM, 90�ifold mconntoted; flush valves closed SumMary/Recommendatlons Z'Aystern performing; no further action nmclod 0 CV11 for service nLlds bolted on (Control panel macv,,ited ❑ Tank needs pumping ❑ Other? Fax completed form to 1.866-384-7404 • Municipality of Anchorage LIN - On -Site Water and Wastewater Program <' (907)343-7904 sa E Parcel I.D. 020-172-31 Certificate of On -Site Systems Approval ,,2e Expiration Date: 3 - ' is - 1. GENERAL INFORMATION Complete legal description Mountainside Village #1, Block 6, Lot 3 Location (site address) 7016 Big Mountain Dr. Current Propertyowner(s) Paul & Karen Green Mailing address Real Estate Agent Day phone 7016 Big Mountain Dr. Anchorage, AK 99516 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual FI Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNadance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Waiver Fee $ Date of Paymentr2. Date of Payment C� Receipt Number hr %- 3 7 C, Receipt Number COSA # 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 Pannone Engineering Services LLC Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE System #1 Approved for �_ bedrooms System #2 Approved for bedrooms Disapproved Phone (907)272-8218 Date 12/5/2014 Conditional approval for bedrooms, with the following stipulations: By: 0eP� Original Certificate Date: The .icipality of An orage 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. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSAblueshe S .., If more than 1 septic system is on the lot: COSA Checklist # 1 of Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: Mountainside Village #1, B6, L3 Parcel ID: 020-172-31 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 9/30/2000 Sanitary seal (YIN) Y Total depth 327 ft. Cased to 20 ft. FROM WELL LOG Date of test 9/30/2000 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 18+ in. AT INSPECTION 5/19/2014 Static water level 55 ft. 129 Well production 15+ g.p.m. 6.44 WATER SAMPLE RESULTS Coliform Neg colonies/100 mL Nitrate 1.3 mg/L Arsenic ND ug/L Date of sample: 11/25/2014 B. SEPTIC/HOLDING TANK DATA Tank Type/Material S.T.E.P/Steel Collected by: PES 711 Date installed 10/6/2000 Tank size 2,000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Date of pumping 6/3/2014 Depression over tank (Y/N) N High water alarm (Y/N) Pumper A+ Home Services Y C. ABSORPTION FIELD DATA Date installed 10/6/2000 Soil rating (g.p.d./ftz orft2/bdrm) 3 GPD/SF System type Shallow Trench Length 45/45 ft. Width 5/5 ft. Gravel below pipe 1/1 ft. Total depth 4.6/5.4 ft. Eff. absorption area 514 ftz Monitoring tube Y Depression over field N Date of adequacy test 5/19/2014 Results (Pass/Fail) Pass For 5 bedrooms Fluid depth in absorption field before test 0 in. Water added 1,540 gal. New depth 8 in. Elapsed Time: 1,090 min. Final fluid depth 0 in. Absorption rate >= 750+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. LIFT STATION Date installed 10/6/2000 "Pump on" level at Timer in. Datum Bottom of Tank E. SEPARATION DISTANCES WELL ON LOT TO: Size in gallons 250 "Pump off"level at Timer in Cycles tested 6 Septic tank/lift station on lot 100+ Absorption field on lot 100+ Public sewer main 75+ Sewer /septic service line 25+ Animal containment areas 50+ Manhole/Access (YIN) Y High water alarm level at 45 Meets alarm & circuit requirements? Yes On adjacent lots 100+ On adjacent lots 100+ Public sewer manhole/cleanout 100+ Holding tank 100+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Water main 10+ Water service line 10+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water Service line 10+ Surface water 100+ Curtain drain 50+ 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 Steven R. Pannone Date COSA brown sheet 10-10-12.doc 12/5/2014 Absorption field 5+ Surface water 100+ Water main 10+ Driveway, parking/vehicle storage 110+ in. Parcel I.D. 020-172-31 Municipality of Anchorage t': G On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Expiration Date: /L6-14 Complete legal description Mountainside Village #1, Block 6, Lot 3 Location (site address) 7016 Big Mountain Dr. Current Property owner(s) Paul & Karen Green Day phone Mailing address 7016 Big Mountain Dr. Anchorage, AK 99516 Real Estate Agent 2. TYPE OF DWELLING: I] Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 Day phone Is U (3 T a' JUL 2 5 2014 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well El Individual El Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System L -i Public Sewer ❑ WaiverNariance request Received by: " Date: COSA to be released to the engineer unless otherwise requested by the engineer. COSA Fee $ SZ - Date of Payment l I a -Si! fq /� r Receipt Number C)S��vl COSA# oSCIg13Sc► 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. Name of Firm Pannone Engineering Services LLC Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE System #1 Approved for 5 bedrooms System #2 Approved for bedrooms Disapproved Phone (907) 272-8218 Date 7/24/2014 Conditional approval for bedrooms, with the following stipulations: =z WANER AND ar, ?= By:r Original Certificate Date: The unici it o14,5hrage 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 r - - c If more than 1 septic system is on the lot: COSA Checklist # of 1 Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: Mountainside Village #1, B6, L3 Parcel ID: 020-172-31 A. WELL DATA Well type Private If A, B, or C provide PWS ID # Date completed'7/30/a0Oe Sanitary seal (YIN) Y Total depth 327 ft. Cased to 2 ® ft. FROM WELL LOG Date of test /�Q / 3-00 Static water level Well production 15+ g.p.m. WATER SAMPLE RESULTS: Coliform Neg colonies/100 mL Nitrate 1.91 mg/L Arsenic ND ug/L Date of sample: 5/2/2014 B. SEPTIC/HOLDING TANK DATA Tank Type/Material S.T.E.P/Steel Tank size 2,000 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Date of pumping 6/3/2014 C. ABSORPTION FIELD DATA Well Log (Y/N) /L/P's Wires properly protected (Y/N) Y Casing height (above ground) 18+ in. AT INSPECTION 5/19/2014 129 6.44 ft. Collected by: Garness Engineering Group Date installed 10/6/2000 Cleanouts (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) Pumper A+ Home Services Y Date installed 10/6/2000 Soil rating (g.p.d./ft2 or ftz/bdrm) 3 GPD/SF System type Shallow Trench Length 45/45 ft. Width 5/5 ft. Gravel below pipe 1/1 ft. Total depth 4'6/5'4 ft. Eff. absorption area 514 ft Monitoring tube Y Depression over field N Date of adequacy test 5/19/2014 Results (Pass/Fail) PASS For 5 bedrooms Fluid depth in absorption field before test 0 in. Water added 1,540 gal. New depth 8 in. Elapsed Time: 1,090 min. Final fluid depth 0 in. Absorption rate , 750+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) No If yes, give date D. LIFT STATION Date installed 10/6/2000 Size in gallons 250 "Pump on" level at Timer in. "Pump off' level at Timer in Datum Bottom of Tank Cycles tested 6 E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100+ Absorption field on lot 100+ Public sewer main 75+ Sewer /septic service line 25+ Animal containment areas 50+ Manhole/Access (Y/N) Y High water alarm level at 45 Meets alarm & circuit requirements? Yes On adjacent lots 100+ On adjacent lots 100+ Public sewer manhole/cleanout 100+ Holding tank 100+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Water main 10+ Water service line 10+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water Service line 10+ Curtain drain 50+ F. COMMENTS Surface water 100+ Wells on adjacent lots 100+ Absorption field 5+ Surface water 100+ Water main 10+ Driveway, parking/vehicle storage 10+ �A—la �2oylJtlJ� ��r�ti s �� 4- C12elop t_77) G. ENGINEER'S CERTIFICATION 1 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 Steven R. Pannone Date COSA brown sheet 10-10-12.doc 7/24/2014 ral I /1�E� ,::;ate ,Of e am O O Z d ¢ O ¢ F Ln w 0U) cc O '00 O w 03 O W m w N N W 0 K Z X J W J W ¢ Z (n zQ O IW-tnz 6 r a c- 4 0 oEm o;�u 0 2 > o a n m£E mQa� -O 4 c� ^ m ct7 Tm v u � m�v na�'n If mdmu ca ��m amvc- c e, ytlw mE Y m om ce °c o� Mp O j...bw xaEL m8a4 `o yVjom CT QO§ Opym o F O Q� L• �Tm YG F'a me �'otac C- E 42 o m � 7 u mbc'• X -g. �nmo wm8 cc$. Cn c Q p. 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