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SOUTH HILLS BLK 7 LT 3
e . 3 mrml, v a Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181326 PID Number: 017-071-30 Dwelling: 0 Single Family (SF) ❑ Duplex(D) E Multiple (SF and/or D) Project: 0 New ❑ Upgrade Name: Cody and Justine Hultquist ABSORPTION FIELD Address ❑ Deep Trench ❑ Shallow Trench ii Bed ❑ Mound 15790 Elizabeth St. Anchorage, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 770-1536 3 6.0 GPD/SF +2.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot +2.5 Ft. 0.5 South Hills 7 3 Ft. Fill added above original grade Gravel length Township Range Section 5.9 Ft. 30 Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES 15 Ft. 3 5 Ft. To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist.between trenches Tank Field Lift Station From Tank Line 450 Ft2 Ft. Well >50' >50' N/A N/A >25' TANK ❑Septic 0 S.T.E.P. 0 Holding ❑� Other Manufacturer Capacity Surface Water >100' >100' N/A N/A Orenco /Advantex (FAP) 1500 Gal. Material Number of compartments Lot Line >5' >10' N/A N/A Fiber Glass 2 NA Foundation >10' >10' N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain None Noted Orenco /Anchorage Tank 100 Gal. Pump on level at Pump off level at High water alarm at Remarks Bed is Insulated. Ultra Violet Tube placed in system. See Letter concerning 13 in. 25 in. 11 in. final grading and conditional approval. Pump make and model Electrical Inspections performed by PF2005 MOA PIPE MATERIAL House to tank D3034 Tank to Installer drainfield D3034 White Raven Development Inc. Drainfield D3034 co/MT D3034 Inspector J. Williams / J. Millette BENCH MARK (Assumed elevation) 100 ft Inspection 15 9/26/18 2nd 10/2/18 Location and description 3d 4th Bottom of siding on South wall of home. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp .•'••SOF "IItt Conditional Approval: Date .•\p, •....... ..... •••. Mctc0Ø 9th � • MICHAEL E. ANDERSON 0�ig r� �/ k1 II 1 —, • No. CE-4381 r_. Approved til - _ Date sZ T—f? �...��',o p•.4/19/19,•..���.•. ROFESS\C •• Inspection Report_9-1-12.doc SOUTH HILLS B7 L3 Sf) PERMIT # OSP181326 PID # 017-071-30 RABBIT HILL DRIVE i ROW EASEMENT / �' '. . . ' __.. 50'WELL RADIUS : ; . .. EXISTING WEL' / 10'UTILITY EASEMENT — IN, \' . `. ' / :.�:'.'% �, LOT 3 LOT 4 3-BDRM HOME 1i • i jR LOT 2 • t TH#1 IR MH1 MT1 4, MT4 ALTERNATE SITE I STH#2 \?'It� • H2 M. 30'LONG x 15'WIDE,0.5'EFFECTIVE • MT2DEPTH ABSORPTION BED IiR ... . •rMT3 IA '. 1500-GAL ADVANTEX TANK W/AX20 PUD 150'CLASS C WELL RADIUS I // LOT 13 LOT 15 LOT14 //1 /ii I fGE l/ NG1N!l.IN6 I I I �•OP4�,,,�F..gCiii♦♦♦ A B LEGEND • �• _ `9 ♦ FCO 19.3 22.8 CO CLEANOUT 49th ,,` 1st♦♦♦ MH1 24.6 32.1 2C0 DOUBLE CLEANOUT �' •� MH2 32.2 39.9 FCO FOUNDATION CLEANOUT �•••••r••-••••••••- ••••••••• • PV 28.8 42.4 PV-PUMP VAULT • • MICHAEL E. ANDERSON :L•' •�"s a W' MT1 57.0 29.5 MH-MANHOLE ••s's No. CE-438, 1 W: 0 50 100 ••f�"'"• °'19"9 �'F � FEET MT2 59.7 40.8 MT-MONITORING TUBE ♦♦♦44,- ;,5".,0' 1"=50' MT4 85.6 52.0 MT3 87.3 59.1 SV-SEPTIC VENT TH-TEST HOLE SOUTH HILLS B7 L3 PERMIT # OSP181326 PID # 017-071-30 O cV LL 2 99.1 2 a /_ — AX-20 POD fJ Q n I ,1 CL 71 95.2 1500 GAL ADVANTEX FAP TANK -'. -- 91.0 V '''''-- 89.5 100.6 ORIGINAL GRADE I- 106.5 FINISH GRADE I- 2" INSULATION 103.1 wandsvisramehammstourimem103.1 102.6 -_1 � � 102.6 100.6 milzt o IN BS 100.6 MOA APPROVED FILTER SAND .. .....i�i;i�i .,i'i2 "fie g; =Q "� "�i'i •s tt;c',.00;$4.�4/ . . .'�,� IIZ*ZAIWAIZIWWISI%% 1' FILTER SAND 1' FILTER SAND GROUNDWATER @ 100.0 9/26/18 92.6 6 I. a • 49th %\ '_i}�. rill PROFILE AS-BUILT /T^ MICHAEL E. ANDERSON I, GE •�S•' •No. CE-4381 s'�- !�� N!!N (NO SCALE) �Qi qc;). . ....r,,�� , Certified Drilling Log P DOC CO dba BILL Et. COLE 1111► ULLIVAN WATER WELLS P.O. Box 670269, Chugiak,AK 99567 688-2759 OWNER OF LAND: Hultquist Homes Bore Hole Data ADDRESS: LEGAL DESCRIPTION South Hills Block 7 Lot 3 Depth From To DATE: 1-15-18 0 I 3 Casing Stickup PERMIT NUMBER: OSP171155 DATE OF ISSUE: 6-28-17 i TAX IDENTIFICATION NUMBER 01707130000 3 5 Overburden Is well located at approved permit location: Yes No 5 25 Silty Sand & Gravel Method of Drilling: air rotary cable tool 25 48 Silty Sand &Gravel w/Clay Depth of Well: 380' 48 109 Tight Silty Sand &Gravel Casing Type: Steel Wall thickness .250 inches 109 118 Broken Bedrock Diameter: 6 inches, depth 124 feet Liner type 4.5" PVC 118 1221 Bedrock Dark Gray Static Water Level: 71 feet 221 280 Bedrock Black Recovery Rate 1.5 gpm gph 280 322 Bedrock Dark Gray w/Quartz Method of Testing Air 322 380' Bedrock Dark Gray Well Intake Opening Type: open end open hole Screened Start feet Stopped Perforations Start feet Stopped Grout Type: Bentonite Volume: 50 lbs Depth:from 3 feet,to 43 feet Well Disinfected Upon Completion: yes no Method of Disinfection: Chlorine 50 PPM Comments: i WATERITY TESTING Coilform Pie5 Co!/100mL Nitrates N S7 mg/L -Arsenic N 9 ug/L y-1t-tq Drillers Name: Cole Sullivan ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough: Department of Environmental Conservation. Doc CO dba IIJLL1VthJ WATER WELLS alirk P.O. Box 670269, Chugiak,AK 99567 688-2759 www.sullivanwaterwells.com Pump Installation Log Well Drilling Permit Number:SW OSP171155 Date of Issue 6-28-17 Parcel Identification Number: 01707130000 Legal Description Property Owner Name&Address South Hills Lot 3 Block 7 Hultquist Homes Pump Installation Date: 4-2-19 Pump Intake Depth Below Top of Well Casing: 370 feet Pump manufacturer's Name: Franklin Pump Model: 10SD0754-PE Pump Size: 1.5 hp Pitless Adapter Burial Depth: 10 feet Pitless Adapter Installer: White Raven Disinfected Upon Completion? ® yes ❑ no Method of Disinfection: Chlorine 50 PPM Comments: Pitless Manufacturer: Martinson Pump Installers Name: Sullivan Water Wells Attention:The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. ?/26//8 govi �°","11,z, MUNICIPALITY OF ANCHORAGE oent ' On-Site Water&Wastewater Program \0 5�, • .!r PO Box 196650 4700 Elmore Road ��. { l �I Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997r. 13"w http://www.muni.org/onsite epartment 44c N ORPVt. On-Site Water & Wastewater System Permit Permit Number: OSP181326 Effective Date: 9/20/2018 Work Type: WellSeptic Renewal Expiration Date: 9/20/2019 Tax Code Number: 01707130000 Site Legal Address: SOUTH HILLS BLK 7 LT 3 G:2940 Site Mailing Address: 8038 RABBIT HILL DR, Anchorage Owner: HULTQUIST CODY& JUSTINE Lot Size in Sq Ft: 27225 Design Engineer: FORGE ENGINEERING Total Bedrooms: 3 This permit is for the construction of: 2 Disposal Field Q Septic Tank 0 Holding Tank 0 Privy t1 Private Well 0 Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: _.( � / Date: / Z°// K Issued By: s`a.iDate: q/f 0M8 ‘D6 i 8 9 707 MUNICIPALITY OF ANCHORA ��� =;4. �D i r• D I S D III i_ Community Development Department , Pt e: 907-343-790•ti Development Services Division • 907-343-79: On-Site Water & Wastewater Programp1 g !� 686 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 017-071-30 Property owner(s) Cody and Justine Hultquist Day phone 770-1536 Mailing address 15790 Elizabeth Street Anchorage, AK 99516 Site address NHN Hillside Way Anchorage, AK 99516 Legal description (Sub'd., Block & Lot) South Hills, Block 7, Lot 3 Legal description (Township, Range & Section) Lot Size 27,225 Sq. Ft. Number of Bedrooms Three (3) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (Ei all that apply) Absorption Field Ix I Initial ❑ Single Family (SF) Ix I (w/wo ADU) Septic Tank ❑ Upgrade Duplex (D) Holding Tank ❑ Renewal 7 Multiple Dwellings I_J Privy ❑ (SF and/or D) Private Well Ix Water Storage n THIS APPLICATION INCLUDES A VARIANCE I WAIVER REQUEST FOR: 2:1 Side Slopes Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. -04,..)--,e- 6) "2_, (Signature of property owner or authorized agent) °� t X15 Permit/Rush Fees: o1 Ba'Y ch °rte` Waiver Fees: Date of Payment: Date of Payment: ,/02-2 f/ 7 Receipt Number: ()gam) Receipt Number: G a /yq 6 Permit No. OSPI ?1 , Waiver No. CSV r1 l O1,6 Permit App_9-1-12.doc Imo► ' GE ENGINEEf11 we PO BOX 240773 ANCHORAGE,AK 99524 522-7773 677-7766(FAX) September 17,2018 MOA Development Services Dept, On-Site Water&Wastewater Program 4700 Elmore Rd Anchorage,AK 99507 Subject: South Hills,Block 7,Lot 3 Septic System Design Dear On-Site Services Engineer: The owner of Lot 3, Block 7, South Hills Subdivision intends to construct a three bedroom home on the lot. We are therefore requesting a permit be issued to allow the construction of a new well and septic system to serve the home. The attached Site Plan and backup documentation identify the location and configuration of the proposed well and septic system. No existing wells are less than 100' from the proposed septic system. In addition, the proposed well to serve the lot does not conflict with septic systems in the area. The surface drainage on the lot is to the northwest as shown by the drainage arrows on the plan. The drainage pattern will not be changed as a result of this project. The new absorption bed will be constructed with Engineered Receiving Soils (E.R.S.) in accordance with proposed AMC 15.65.201.D3c along with an Advantex Treatment System with an AX-20 Filter Pod and an ultraviolet treatment tube. Horizontal conveyance will be utilized to transport the effluent through the organic material surrounding the absorption bed and away from the area. The distribution line in the bed will be placed at 2.5' above the existing ground to provide 4.5' of clearance from the in situ silt below which has been found to be inconsistently permeable throughout the area. Sections of subsurface soils in the area have been determined through percolation testing to absorb water at rates faster than 120 minutes per inch, but these sections are inconsistent and the majority of the subsurface soils are thought to be impermeable. A minimum of 2' of MOA approved coarse sand will be placed below the bed and 2' of clean well graded gravel (GW) meeting the requirements of Municipality of Anchorage Standard Specifications for Type II or Type IIA select backfill will be placed under the sand and to a depth of 2' below the surface or to the silty in situ layer. The test holes placed on the lot in the past and monitored for many months indicated no groundwater developed on this lot. The engineered fill will be placed in 12" lifts and compacted to create a stable base for the absorption bed. The fill slopes will be constructed at a 2:1 angle of repose with a 4"topsoil cover. All disturbed or new surfaces shall then be seeded to produce vegetation and prevent erosion. We are proposing to construct a new 450 square foot by .5' effective depth absorption bed to treat and dispose of the effluent generated in the house. The additional porous material beneath the bed will provide surge volume and septic treatment and increase the surface area for water absorption to the surrounding strata. Water will flow horizontally through the 90' LF perimeter of the bed by 1' effective depth sidewalls or a total effective area of 90 SF. A percolation rate of 4-5 minutes per inch has been utilized for the peat with an application rate of 6 GPD/SF. The design was completed in accordance with the proposed AMC 15.65.201.D3c. The ground surface on the lot in the area of the absorption bed slopes to the northwest. The new bed will be constructed parallel with the contours of the slope as much as possible in conformance with Municipal requirements. The new septic system will be constructed a minimum of 100' from all wells and any surface water and 10' from the proposed and existing water services in the area. If the system is constructed in accordance with our design it will not conflict with adjacent wells and septic systems. Sincerely, Michael E. Anderson, P.E. Attachments •,,,IOF it%it • ?tit 49th �\ •': , jet t. • -7j2,1%MICHAEL E. ANDERSON 1p •I ••.� No. CE-4381 �_- j♦���8%7"17-(.b <z:.. i LOT 14 LOT 15 LOT 13 -- .- -1_ -- • --_- q• c� a `� 9 SPQ(n 9 S' Existing Well • - Existing Well RABBIT HILL DRIVE `' -_--_____-- - osed • tic ® w PropWell R`°`•�' i ^q Sep Proposed®Well LOT 3 �� �� �, LOT 1 VACANT , r, LOT , LAND r' • , . 0 O r `y;,..- 0 10 . e• i Existing Septic Area Z Existing Septic Area Exact Location Unknown Exact Location Unknown \\p.` VACANT VACANT / LOT 12 LOT 13 LOT 14 LOT 15 LOT 16 According to the owner this well also serves Lot 14. It Is not registered os a Class C Well, but meets the criteria. Exlstlnq Well Possible Class C I 1 1 �••*-- Of... . k 4.1� SOUTH HILLS SUBDIVISION 4'�P� �•, LOT 3, BLOCK 7 �1, • n' 49th - ' �% • •�t,,MICHAEL E. ANDERSON AREA A P lit t r•' NO. CE-4381 ' 4/ v k�,OFES;; �� _ii4 SCALE 1" = 80' SOUTH HILLS SUBDIVISION LOT 3, BLOCK 7 27,225 S.F. RABBIT HILL DRIVE r _____________ ....._._ _ _.._ _ __ ......._ ..._ _____ . . . . . .. . . ''; :,. .. Proposed :..... Well 71 1 x 4 3 \ o \ W \ 0. \ N LOT 4 - g • i Three Bedroom Home LOT 2 AO0 ,,I \� , '_ - . z - _ 1,500 Gallon Advantex \* v, 7� Treatment System \�` �•1 P4 ® MT \i` w/AX-20 Pod & Pump \ Vault O r 1� TH2 -^� te gate MT (--; - -. -"s• MT 30' Long x 15' Wide Wte�co �\ �,- N Absorption Bed w/2:1 Fill ' a sv Slopes. \� MT of 7::k\ .doe L— S89'54'03"W 152.53' NOTE: .����umi,I, Place Septic Tank a minimum of 10' from • foundation 4.,`p, ...........: .. ... LEGEND alico `� ♦. — FCO — Foundation Clean Out 49th MT Monitor Tube 0 "•• TH — Test Hole ';MICHAEL E. ANDERSON Itici SITE PLAN PV — Pump Vault tVCr No. CE-4381 / ',C S<(' ''� •�''(� h. <c,�.0: SCALE 1' = 40' 444PRI3FSw IO °: � LOT 3, BLOCK 7, SOUTH HILLS SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Three Bedroom Home Raised Bed System w/Engineered Receiving Fill Perc. Rate: 4.2-4.8 Min./Inch Advantex Treatment Sytem Application Rate: 6 GPD/SF Add On Lift Station & UV Tube Pressure Distribution System 3 Bedrooms X 150 GPD/BDRM = 450 GPD 2.0' Coarse Sand and 2.0'Type IIA Classified Fill 450 GPD/6 GPD/SF = 75 SF Vertical Absorption Area 75 SF/1 LF (Effective Depth of Peat) = 75 LF Perimter of Bed 30' Long x 15' Wide = 90 LF Bed >> 75 LF - Bed is Sufficiently Sized. THEREFORE: Construct a 30' Long x 15'wide absorption bed as shown below. Remove existing peat and organic material to in situ sandy silt. Place 2' of Type IIA Classified Fill with 2' of Coarse Sand atop the Type IIA Fill. Construct absorption bed atop the sand layer. Distribution line to be constructed 2.5' above original ground surface. Place 2"of insulation and 2'of fill over bed and 4' over Advantex Treatment Tank. Fill slopes must be 2:1 with outer 6" revegetated to prevent erosion. Maintain 100' separation from all private wells in the area and 100'from Class C Well to the south. �i= n- -u---u---- - ----u-- u- n--=-u-ii =.0T.- l �i_ 2 =T- -iii. 2 Topsoil and Seed 1F—_,;!t��'' ��''-ti';,- Outer 6"of Mound =ii�� 2"Insulation&2'Cover(Min.) ==ii_ Ii to Prevent Erosion 1_�1;i�"' / / / / / / / / / "ili_ ar .5' 0 0 O 1"PVC 117P - �i i'i;.' �� — Drainfield Rock =0 _i,if- .5' 10-3/16"Diamete'=74 1�" Holes per Lateral '��n 7iw 2 0' MOA Approved Coarse Sand @ 3'OC `fti�i�., =i- Original Ground Original Ground 411 r 1.0' Remove all organic 2'Type IIA Classified Fill Remove all organic material to 1'Depth PT material to 1'Depth and Replace with and Replace with MOA Approved -- MOA Approved Sand. ML Sand. Maximum Excavation 2'Below Existing Ground Exact Limits of Excavation to be Determined in the Field by the Engineer. 2.5' 5.0' 5.0' 2.5' I I I I ••. �4.3•+ allit TYPICAL •RAISED BED SECTION :��` ` 49th '''',N ..* 0S (NO SCALE) = NOTE: Grade Area Surrounding Bed to Drain Away. • Minimum 6' Separation From Bedrock. o Michael E.Anderson:plc i p No.CE-4381 z� Minimum 4' Separation From Groundwater. ���1, ... Minimum 100' Separation From Wells in the Area. .• Y-(7-4.6/.01.: Minimum 10' Separation From Water Service Line. -4j" ""'.. N, 4,, MUNICIPALITY OF ANCHORAGE �l��+lkrrM111, DEVELOPMENT SERVICES DEPARTMENT •..• _ Yt• ••4 •,�, 4700 BRAGAW STREET ANCHORAGE, AK 99519-665 "\ 4• .• .. 49th SOILS LOG - PERCOLATION TEST ;/* 4 ';MICHAEL E. ANDERSON Ii��j V,''• NO. CE 4381 LOT 3, LEGAL DESCRIPTION: BLOCK 7, SOUTH H ILLS SUB. ..�,�:- ,_,6,;: 4'.• PERFORMED FOR: HULTQUIST HOMES �14U P�*•� DATE: 5/12/2017 PROJECT No.: Professional 4-11lEngineers Stamp: PARCEL ID#: TECHNICIAN: JAKE M ILLETTE DI P I 1 I TEST HOLE 1 (reed 0(.;/P.1 SLOPE SITE PLAN 1 2 3 4 BOTTOM OF PEAT @ 2' 5 SEE SITE PLAN 6 1 SANDY SILT W/GRAVEL 7 ML 8 9 10 BOH @ 8' WAS GROUND WATER ENCOUNTERED" NO IF YES @ WHAT DEPTH? DEPTH OF WATER AFTER MONITORING: NONE 10% 11 DATE OF MONITORING: 10/15/06 12 GROSS TIME NET TIME DEPTHOF NET DROP 13 DATE READING (MINUTES) (MINUTES) WATER (INCHES) (INCHES) 14 TEST HOLE PRESOAKED PRIOR TO TESTING: 15 4/11 I 1:08 7.75" 16 2 1:38 30 1.50" 6.25" 3 1:39 7.50" 17 4 2:09 30 1.25" 6.25" 1$ 5 2:10 7.75" 19 6 2:40 30 1.50" 6.25" 20 PERCOLATION RATE: 4.8 (MIN/INCH) PERC. HOLE DIA. 6" (INCHES) TEST RUN BETWEEN: 1.0 FT. and 2.0 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST TO DETERMINE POROSITY OF PEAT. TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 6/20/17 • MUNICIPALITY OF ANCHORAGE ...�� •>,i,a/ DEVELOPMENT SERVICES DEPARTMENT 41�P� • "'•••..• . 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 ;' 49th --.4—�\ `; •�� ift SOILS LOG - PERCOLATION TEST • •o, MICHAEL E. ANDERSON j LEGAL DESCRIPTION: LOT 3, BLOCK 7, SOUTH HILLS SUB. ,.0n_,,,•.\ No. CE-4381 ;•',fir PERFORMED FOR: HULTQUIST HOMES 444ESSOik, DATE: 4/11/2017 PROJECT No.: �-ivim����-4 PARCEL ID#: TECHNICIAN: JAKE MILLETTE Professional F:ngineers Stamp: I)I.i'I I I TEST HOLE 2 IIcoII OG/PT SLOPE SITE PLAN 1 2 3 4 BOTTOM OF PEAT @ 2' 5 SEE SITE PLAN k 6 SANDY SILT W/GRAVEL.. 7 ML 8 R01-I @ 8' 9 0 WAS GROUND WATER ENCOUNTERED? No 1 IF YES WI IAT DEPTII? S DEPTH OF WATER AFTER MONITORING: NONE i 10% 1 1 DATE OF MONITORING 10/15'06 12 GROSS TIME NET TIME DEPTH OF NET DROP 13 DAZE READING (MINUTES) (MINUTES) WATER (INCHES) (INCHES) 14 TEST HOLE PRESOAKED PRIOR TO TESTING: 15 4/Il I 1:20 8.25" 16 2 1:50 30 1. 15' 7.12" 3 1:51 8.50" 17 4 2:21 30 1.38" 7.12" 18 5 2:22 8.25" 19 6 2:52 30 1.13" 7.12" 20 PERCOLATION RATE: 4.2 (MIN/INCH) PERC. HOLE DIA. 6" (INCHES) TEST RUN BETWEEN: 1.0 FT. and 2.0 FT. COMMENTS: FEST HOLE PRE SOAKED PRIOR TO TEST. FEST 1.0 DETERMINE POROSITY OF PEAT. TEST PERFORMED BY ANDERSON ENGINEERING. I. MIC:HAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 6/2.0/17 HOMES 12570 Old Seward Highway,Suite 204,Anchorage,Alaska 99515 Phone:(907)522-3204 Fax:(907)522-3211 September 14, 2018 Mr. Mike Anderson, P.E. Forge Civil Engineering RE: South Hills, Lot 3 Block 7,Number of Bedrooms for Septic Design Dear Mike, Attached are the current house plans for the proposed home on Lot 3 Block 7 South Hills Subdivision. As you can see on the plans,this house is designed for, and will be constructed, marketed and sold as a 3-bedroom home. Please complete the septic system design, and permit the septic system construction,for a 3-bedroom home. Hopefully this clarification will satisfy the MOA On-Site Services plan review engineer. Please give me a call at 907-770-1536 if you have any additional questions. Sincerely, Brian T. Harten, P.E., Development Manager Hultquist Homes, Inc. MUNICIPALITY OF ANCHORAGE ,gent On-Site Water&Wastewater Program PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 http://www.muni.org/onsite I ehartmcnt 44CM PAGE On-Site Water & Wastewater System Permit Permit Number: OSP171155 Effective Date: 6/28/2017 Work Type: WellSeptic Initial Expiration Date: 6/28/2018 Tax Code Number: 01707130000 Site Legal Address: SOUTH HILLS BLK 7 LT 3 G:2940 Site Mailing Address: Owner: HULTQUIST CODY& JUSTINE Lot Size in Sq Ft: 27225 Design Engineer: ANDERSON ENGINEERING Total Bedrooms: 3 This permit is for the construction of: El Disposal Field El Septic Tank ❑ Holding Tank 0 Privy El Private Well 0 Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72)and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: VeoGl ' " ` Q Date: 62v dei Issued By: PC eCG, C'aityits-C1Date: t/ W/ 2 '17 a.nr Municipality of Anchorage % l)eparrm-1 P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http://www.muni.orgiOnsite Development Services Division On-Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV171060 COSA#: Permit#: OSP171155 PID#: 017-071-30 Legal Description: South Hills Block 7 Lot 3 Engineer: Anderson Engineering Applicant: Cody&Justine Hultquist Your request for a waiver to utilize an Engineered Receiving Soil (ERS) absorption system and use 2:1 slopes on the fill for the mound has been approved. See engineer's letter for waiver request. This waiver approval applies to the proposed primary and alternate absorption fields only. Any future upgrade to the on-site wastewater disposal system will require all code requirements be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. ' Waiver is Granted: X Waiver is not Granted: Date: (p t2S12D/7 Approved by: lat -4 rOcArtirel Name of Reviewer **** VARIANCE/WAIVER REVIEW **** MUNICIPALITY OF ANCHORAGE (ra 4 ' A Community Development Department 21 2017 'hone: 907-343-7904 Development Services Division -` SUN Fax: 907-343-7997 On-Site Water& Wastewater Program ^' w ON-SITE SEWER/WELL PERNA)T APPLICAT ON Parcel I.D. 017-071-30 Property owner(s) Cody and Justine Hultquist Day phone 770-1536 Mailing address 15790 Elizabeth Street Anchorage, AK 99516 Site address NHN Hillside Way Anchorage, AK 99516 Legal description (Sub'd., Block & Lot) South Hills, Block 7, Lot 3 Legal description (Township, Range & Section) Lot Size 27,225 Sq. Ft. Number of Bedrooms Three (3) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (El all that apply) Absorption Field DI Initial 0 Single Family (SF) 0 (w/wo ADU) Septic Tank 0 Upgrade ❑ Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE I WAIVER REQUEST FOR: 2:1 Side Slopes/New Municipal Code w/Horizontal Conveyance Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. ti4J`J, (Signature of property owner or authorized agent) Permit/Rush Fees: 5 a)S = 789 Waiver Fees: Date of Payment: ‘1.2?-hi Date of Payment: ‘"?.?- Receipt _?a_Receipt Number: 01+1-61 CS1 Receipt Number: 02 14-1t4G Permit No. 059111/66 Waiver No. 05V 11 13 `r Permit App_9-1-12.doc ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) June 20, 2017 Municipality of Anchorage Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 3, Block 7, South Hills Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 3, Block 7, South Hills Subdivision intends to construct a three bedroom home on the lot. We are therefore requesting a permit be issued to allow the construction of a new well and septic system to serve the home. The attached Site Plan and backup documentation identify the location and configuration of the proposed well and septic system. No existing wells are less than 100' from the proposed septic system. In addition, the proposed well to serve the lot does not conflict with septic systems in the area. The surface drainage on the lot is to the northwest as shown by the drainage arrows on the plan. The drainage pattern will not be changed as a result of this project. The new absorption bed will be constructed with Engineered Receiving Soils (E.R.S.) in accordance with proposed AMC 15.65.201 .D3c along with an Advantex Treatment System with an AX-20 Filter Pod and an ultraviolet treatment tube. Horizontal conveyance will be utilized to transport the effluent through the organic material surrounding the absorption bed and away from the area. The distribution line in the bed will be placed at 2.5' above the existing ground to provide 6' of clearance from the in situ silt below which has been found to be inconsistently permeable throughout the area. Sections of subsurface soils in the area have been determined through percolation testing to absorb water at rates faster than 120 minutes per inch, but these sections are inconsistent and the majority of the subsurface soils are thought to be impermeable. A minimum of 2' of MOA approved coarse sand will be placed below the bed and 4' of clean well graded gravel (GW) meeting the requirements of Municipality of Anchorage Standard Specifications for Type II or Type IIA select backfill will be placed under the sand and to a depth of 4' below the surface or to the silty in situ layer. The test holes placed on the lot in the past and monitored for many months indicated no groundwater developed on this lot. The engineered fill will be placed in 12" lifts and compacted to create a stable base for the absorption bed. The fill slopes will be constructed at a 2:1 angle of repose with a 4" topsoil cover. All disturbed or new surfaces shall then be seeded to produce vegetation and prevent erosion. We are proposing to construct a new 450 square foot by .5' effective depth absorption bed to treat and dispose of the effluent generated in the house. The additional porous material beneath the bed will provide surge volume and septic treatment and increase the surface area for water absorption to the surrounding strata. Water will flow Lot 3, Block 7, South Hills Subdivision June 20, 2017 Page Two horizontally through the 90' LF perimeter of the bed by 3' effective depth sidewalls or a total effective area of 270 SF. A conservative percolation rate of 60 minutes per inch has been utilized for the peat with an application rate of 2 GPD/SF. The design was completed in accordance with the proposed AMC 15.65.201.D3c. The ground surface on the lot in the area of the absorption bed slopes to the northwest. The new bed will be constructed parallel with the contours of the slope as much as possible in conformance with Municipal requirements. The new septic system will be constructed a minimum of 100' from all wells and any surface water and 10' from the proposed and existing water services in the area. If the system is constructed in accordance with our design the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, G Michael E. Anderson, P.E. Attachments ..'..� aa. ,a' MICHAEL E. ANDERSON ♦n ws ♦ ��: NO. CE-4381 �r ♦v��pRorF9S0N°�•.. I '`LOT 14 LOT 15 LOT 13 I 1 6 , I '\ , ,s .„,„.", , Existing Well i �` I I ; , ..„0, , , 1 `i i Existing Well i \ _ i k Ns,` RABBIT HILL DRIVE -------- L 1- I rr`'I i' I 1 ML-- i e Neo S �, 'Proposed®eIl i I Provo:wMi tI?I I is,511.,,,,,, I1 ,Proposed Weil I 1 LOT 3 11\ i� �� i\ OT 1 VACANT 1' LOT 4 i 'r LAND i , ' 0 07 ; _— , ss Existing Septic Area Existing Septic Area ..'•'4, •�y\ Exact Location Unknown Exact Location Unknown T VACANT VACANT LOT 12 LOT 13 LOT 14 ,I LOT 15 LOT 16 According to the owner this well also 1 serves Lot 14. It Is not registered as a I Class C Well, but meets the criteria. I 1 I Existing Well i Poasibls Claes C I, ..•�E of,4147. SOUTH HILLS SUBDIVISION ir��P ++, LOT 3, BLOCK 7 • i` 49th %'• .E.1241.----) - * # of MICHAEL Er ANDERSON' it ��J'' NO, CE-4381 ti, AREA Iv AP_ �1I �f� PROF- :4-:•- SCALE 1" = 80' SOUTH HILLS SUBDIVISION LOT 3, BLOCK 7 27,225 S.F. RABBIT HILL DRIVE L --\ I If s Proposed Well )c) Iv W ` m W Three Bedroom Home O N LOT 4 - LOT 2 o O c0 Z p4H `�0 1,500 Gallon Advantex ' p,0\ \� TH1 Treatment System PVCO 0 .i. w/AX-20 Pod & Pump Vault TH2 ,. e oke`�,k30' Long x 15' Wide 1,01\ \\'MT ' Absorption Bed w/2:1 Fill 1::` \- N Slopes. \� \* S89'54'03'W 152.53' ••••vo OF Ai`N ••• E.,, ...... ss'•• LEGEND .L � :, •*• FCO — Foundation Clean Out 49th -\ # MT — Monitor Tube --• - TH — Test Hole f PV — Pump Vault 0,�';MICHAEL E. ANDERSON SITE PLAN 'j4.24. .� CE-4381' .ti 's SCALE 1' = 40' ♦• 4/RD ES� •••• LOT 3, BLOCK 7, SOUTH HILLS SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Three Bedroom Home Raised Bed System w/Engineered Receiving Fill Perc. Rate: 60 Min./Inch -Conservative for Peat Advantex Treatment Sytem Application Rate: 2 GPD/SF Add On Lift Station & UV Tube Pressure Distribution System 3 Bedrooms X 150 GPD/BDRM =450 GPD 2.0' Coarse Sand and 4.0'Type IIA Classified Fill 450 GPD/2 GPD/SF = 225 SF Vertical Absorption Area 225 SF/3 LF (Effective Depth of Peat) = 75 LF Perimter of Bed 30' Long x 15'Wide = 90 LF Bed » 75 LF- Bed is Sufficiently Sized. THEREFORE: Construct a 30' Long x 15'wide absorption bed as shown below. Remove existing peat and organic material to in situ sandy silt. Place 4' of Type IIA Classified Fill with 2'of Coarse Sand atop the Type IIA Fill. Construct absorption bed atop the sand layer. Distribution line to be constructed 2.5'above original ground surface. Place 2"of insulation and 2'of fill over bed and 4' over Advantex Treatment Tank. Fill slopes must be 2:1 with outer 6" revegetated to prevent erosion. Maintain 100' separation from all private wells in the area and 100'from Class C Well to the south. ii-u a-u an nuuun..un..u..u..u..u-uu-u..iu-u n-u u..0a- =II- u= -117L.. 2 -u2 Topsoil and Seed 1 !�_' •'�'' Outer 6"of Mound------ .0'.� 2" Insulation &2'Cover(Min.) -I•=11-�1 to Prevent Erosion _==;i'" / / / / / / / / / -i!;,_ , .5' 0 0 O '�u i°ii u -- 5— Drainfield Rock 10-3/16"Diameteu - = =u -�I'- Holes per Lateral "-4=, -ii° 2.0' MOA Approved Coarse Sand @ 3'OC -4,(T . 1111=1, , ,�y" Original Ground Original Ground 1.0' —Remove all organic 4'Type IIA Classified Fill Remove all organic material to 1'Depth PT material to 1'Depth and Replace with and Replace with MOA ApprovedML MOA Approved Sand. Sand. Maximum Excavation 4' Below Existing Ground Exact Limits of Excavation to be Determined in the Field by the Engineer. 2.5' 5.0' 5.0' 2.5' I I I I I TYPICAL RAISED BED SECTION ::; • �_.. (NO SCALE) 49th' j' S i� __) ig NOTE: Grade Area Surrounding Bed to Drain Away. 4/14-4��h:.4�'�' � i • Minimum 6'Separation From Bedrock. •0,: Michael E.Anderson ;./ Minimum 4' Separation From Groundwater. . --%• No.CE-4381 ;•••�_� Minimum 100' Separation From Wells in the Area. •j<4',1,%•A- Le- !7.••••".v-. .• '< i. Minimum 10' Separation From Water Service Line. .�-�.FESS\.&44 MUNICIPALITY OF ANCHORAGE .40,16+irr>,t4 DEVELOPMENT SERVICES DEPARTMENT 4P' :•• '' '''''''... ... 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 ,; 49th 'fl = `�� SOILS LOG - PERCOLATION TEST JLJZL = -, MICHAEL E. ANDERSON.i:t f LOT 3, BLOCK 7, SOUTH HILLS SUB. No. CE 4381 LEGAL DESCRIPTION: S 4�' 4,� PERFORMED FOR: HULTQUIST HOMES ��1 t . DATE: 5/12/2017 PROJECT No.: PARCEL ID#: TECHNICIAN: JAKE Mi LL E T T E Professional Engineers Sump: DEPTH TEST HOLE 1 (feet) 1 OG/PT SLOPi SITE PLAN 2 3 - 4 - - BOTTOM OF PEAT @ 4' 5 N SEE SITE PLAN 6 SANDY SILT W/GRAVEL 7 ML 8 9 BOH @ 10' WAS GROUND WATER ENCOUNTERED? No 1 O [F YES @ WHAT DEPTH', DEPTH OF WATER AFTER MONITORING: NONE 10% 11 DATE OF MONITORING: 10/15/06 12 GROSS TIME NET TIME DEPTH OF NET DROP 13 DATE READING (MINUTES) (MINUTES) WATER (INCHES) (INCHES} 14 TEST HOLE PRESOAKED PRIOR TO TESTING: 15 ./II I 1:08 7.75" 16 2 1:38 30 1.50" 6.25" 3 1:39 7.50" 17 4 2:09 30 1.25" 6.25" 18 5 2:10 7.75" 19 6 2:40 30 1.50" 6.25" 20 PERCOLATION RATE: 4.8 (MIN/INCH) PERC. HOLE DIA. 6" (INCHES) TEST RUN BETWEEN: 3.0 FT. and 4.0 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST TO DETERMINE POROSITY OF PEAT. TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 6/20/17 MUNICIPALITY OF ANCHORAGE ♦'.♦ 7 tit, 'f. DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 j� I` 49th i\ II' 0 SOILS LOG - PERCOLATION TEST C1J1 IiiiiNt.MICHAEL E. ANDERSON•it= LEGAL DESCRIPTION: LOT 3, BLOCK 7, SOUTH HILLS SUB. I�♦,f,;,.. No. CE-4381 r�. HULTQUIST HOMES .. 0..4 44ig ` C:+i PERFORMED FOR: .4166, ��♦ DATE: 4/11/2017 PROJECT No.: PARCEL ID#: TECHNICIAN: JAKE M ILLETTE Professional Engineers Stam DEPTH TEST HOLE 2 (feet) OG/PT SLOPE SITE PLAN 1 — 2 — 3 4 BOTTOM OF PEAT @ 4' 5 e SEE SITE PLAN k 6 SANDY SILT W/GRAVEL 7 — ML 8 9 10 BOH @ 10' WAS GROUND WATER ENCOUNTERED? NO IF YES @ WHAT DEPTH'' 1 DEPTH OF WATER AFTER MONITORING: NONE 10% 11 DATE OF MONITORING: 10/15/06 12 GROSS TIME NET TIME DEPTH OF NET DROP 13 DATE READING (MINUTES) (MINUTES) WATER (INCHES) INCHES) 14 TEST HOLE PRESOAKED PRIOR TO TESTING: 15 4/11 I 1:20 8.25" 16 2 1:50 30 1. 13" 7. 12" 3 1:51 8.50" 17 4 2:21 30 1.38" 7. 12" 18-- 5 2:22 8.25" 19 6 2:52 30 1. 13" 7. 12" 20 PERCOLATION RATE: 4.2 (MIN/INCH) PERC.HOLE DIA. 6" (INCHES) TEST RUN BETWEEN: 3.0 FT. and 4.0 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST TO DETERMINE POROSITY OF PEAT. TEST PERFORMED BY ANDERSON ENGINEERING. I,MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 6/20/17 MUNICIPALITY HR Development Services Department 1 Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 017-071-30 1. GENERAL INFORMATION Expiration Date: O/ -25__-2_1 Complete legal description South Hills Sub, Block 7, Lot 3 Location (site address) 8038 Rabbit Hill Drive Current property owner(s) Aubin & Brittany QueSnell Day phone (907) 360-3560 Mailing address 8038 Rabbit Hill Drive, Anchorage, AK 99516 Real estate agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: _ 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic 0 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 $ 55 0 Waiver Fee $ Date of Payment 5/�1 ZDQ1 Date of Payment Receipt Number. 3 `� g q -b Receipt Number COSA # 0 S C 1 1 (o (r, Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone (907) 522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503 Engineer's Printed Name Benjamin Schiller Date 05/04/21 r�P• • • 4!s 'F �* 49TM9*i 6. DSD SIGNATURE • • : ' System #1 Approved for bedrooms r% Benjarr�'r�5chiller System #2 Approved for bedrooms �ic,�l�� CE 12592 Disapproved iliFOpROFESSIONP Conditional approval for bedrooms, with the following stipulations: O 00� 92 m ' CD to ST: F 0 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: iii, 11 IF 1 �_ South Hills Sub, Block 7, Lot 3 Parcel ID: 017-071-30 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 1/15/18 Total depth 380 ft Cased to 124 ft ®❑ Sanitary seal is functioning correctly ®❑ Wires are properly protected Casing height (above ground) 27 in. Date of flow test for COSA 4/19/21 Static water level at beginning of test 55 Comments B. TANK DATA Age of tank(s) 3 years Tank type/material FAP/Fiberglass ft. Measured operating fluid level in septic tank N/A ® Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA Mound/Bed Which system tested (date installed) 9/26/18 FE -1 ALL standpipes present per record drawing Total measured depth from grade 3.5 ft (max) Measured depth to pipe invert from grade ft (min) 9 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 Well production at time of test 1.0 gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L FE Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Forge Engineering Date of Sample 4/14/21 C. LIFT STATION ❑ Required maintenance completed Age of lift station 3 years Lift station material PVC Comments: Adequacy test date 4/19/21 Results [I Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 477 gal New depth 0 in Elapsed time 1440 min Final fluid depth 0 in Absorption rate '450 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' F✓ Yes Community Sewer Manhole/Cleanout > 100' Q Yes if No ft M Yes if No Neighboring Tank > 100' Q✓ Yes if No ft Private Sewer/Septic Line > 25'✓0 Yes if No Absorption Field on Lot > 100' 7 Yes if No ft Holding Tank > 100' E✓ Yes if No Neighboring Absorption Fields > 100' Yes , if No Animal Containment > 50' C]✓, Yes if No Fv Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑✓ Yes if No ft EZI Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ✓0 Yes if No ft Surface Water > 100' ft ft ft ft ft M Yes if No ft Property Line > 5' F✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 0 Yes if No ft Private Wells > 100' Yes if No Water Main > 10'✓Q [D Yes if No ft Community Wells > 200'✓1 Yes if No 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' E✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' Fv Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓� Yes if No ft Private Wells > 100' Water Service Line > 10' [D Yes if No ft Community Wells > 200' Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that 1 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 ft ft ®✓ Yes if No ft Q✓ Yes if No ft Amw TH .- :.............. � Benjarr wSchiller .• �F� •.. CE 12592Alw 5/4/21 ••�`��'� ���FopR.....O. ��� I_t t,: Lt'L L1 1!:,: 42 dbo*b, r Lt Al 'LU b 364036 Bloom # } c: so Boons a Booms =0 i 0 man oil F#�dvanTex Field Maintenance RePOrt. AncharageTank Annual Inspe,c tiara 907--272-3543 operator PmparrV ownnr/Tracking a Larry Betts Brittany & Aubin QW. Meli Canttl:i Phone SitaAadresn (206) 914-1357 8038 Rabbit Hill Driv Anchorage AK 99516 AX SUS 14 a TCQ1j"MtY ID M ?otl P fU WULR Date o4 Last Inapectlon ------- --AX-145223p171155 429524 RTU138048 02113/2020 Retrieve O&M info Daily Rocirc ratio Timer settings: Perform Field Samplli l9/Observations Nl'1/1(IS tt NTUS) 1313'1 (6-9) DO (2-6) Odor of Sample Typical Usb. ❑ Earthy ❑ Moldy Non -typical ❑ Sulfb: 1❑ Cabbage ❑1 DwaY oily film in PVU (,. Yes ❑ No Foam in tank jYen ONO Check Control Paned Recirc Amps pischarge Amps 1��7 �2I Audible and visual alt ne UK Dial tone (telemetry ra A des ❑ No Inspeot/CleAn Puml System Insp�t Clean Risor/Ud ..... ... • . Splice, Box ... I ..... ........ . Float Cords ........ ...... . Floam............ ..........I Pump ............ .......Biotubr.'° Filterr .... ,•.•..••--4Slotube Pump Vault .... .....~ Recirculating Splitter lalve...... Comments Signature Measure Sludge/Scum sludge scum 1st Comportment C Previous Current Previous 2nd Compartment Current Previous Current Previous inspect/Clean AdvanTex Filter Odor: ,_ Nor'mol ❑ Pungent Blomat: ormal ❑ Excessive Bridging/Ponding: ;�plpne/Minor ❑1 Exorsslve Inspect/Clean Discharge Pump System Inspect Rlser/Lid Splice Box Float cords Inspect/Service Other SVStetn Gomponenti lnspoct Clean LateraWOriflces Pod Bottom Intake Vent I Inspect Clean Floats izZ Pump Inspect Clean Inspect Clean Dlsinfe.tion Equipment ❑ ❑ Dispersal Laterals/Orifice. ❑ ❑ Observations Additional Services Rendered ❑ Cleaned textAc sheets? I❑ 1 Replaced UV Items? 17 Replaced/Used other Items? parts Used. W = Warranty, S s Billable (✓ appropriate selection) inr R ttarn Number De-terlption Final/Safety Inspection Y��V fold r cod anifOld reconnected; flush valves dosed Summary/Recommendations 711em performing; no further action needed ❑ call for sorvice ��ds bolted on ontrol p:enel reactivated ❑ Tank needs pumping ❑ other? -- Y3att Fay completed form to 1-$66-384.7404 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 Day ofi c of 20 , by and between rl;v jAc,tyll6;-w 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 Advantex Waste Water Treatment System located at (legal description) South Hills Block 7 Lot 3 2. Maintenance, Repairs and AIterations. (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 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. j 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. Owner agrees that any sale or transfer of title of the property will not occur without a new / Certificate of On -Site Systems Approval. 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. 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 Latin. 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 nature) it name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) Date: (,� (Z (:�1Z { The foregoing instrument was acknowledged before me this2.5"day of Tv yn.2 , 2021 , byTobu CLA v L Hvgh NOTARY PIJB , C FOR ASKA. STATE OF ALASKAIV My Commission expires: 1 III 2'-( NOTARY PUBLIC Aurora Land u fikj cwrr ks m &PVM 1 2 MUNICIPALITY: l By. (signature) (print name) Date: Z S Title: (rev. 05/18/2018) Page 3 of 3 0 r) LO N LO I n LC) b) 00 Cf) K777 7%L L-13 U) a) rz U) CD colo a) 0 0 Q) O 0 0 n o 0 0-0,0 0- o 0) 0 AC :;,- a a) C: o 0 c- 0 C 0 0 En 0 0— 0. c Q) V) Z Q) ir yo) Q) 0 0) o U) O @) 0 CL 0 C) C: CD E 0) 0 E o -E m > o 0 0 0 c c J V) LL- > o 0 Q) C) Ll -j - K777 7%L L-13 U) a) rz U) CD colo a) 0 0 Q) O 0 0 n o 0 0-0,0 0- o 0) 0 AC :;,- a a) C: o 0 c- 0 C 0 0 En 0 0— 0. c Q) V) Z Q) ir yo) Q) 0 0) o U) O 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. 017-071-30 Expiration Date: 7%2' '( 1. GENERAL INFORMATION Complete legal description South Hills, Block 7, Lot 3 Location (site address) 8038 Rabbit Hill Drive Anchorage, AK Current property owner(s) Hultquist Homes Inc Day phone 907-770-1536 Mailing address 12570 Old Seward Hwy, Ste 204, Anchorage, AK 99515 Real estate agent Day phone 2. TYPE OF DWELLING: Ei Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic CI 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 $ 12 0 Waiver Fee $ Date of Payment a a 19 Date of Payment Receipt Number 0 lo 0 alb Receipt Number COSA# OSC 11 a1 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 4/19/19 i z 49th �� 0 6. DSD SIGNATURE ; ? �-i System #1 Approved for 2 bedrooms s ;MICHAEL E. ANDERSON ; t • • I•Cr• No. CE-4381 •:=moi System #2 Approved for bedrooms • /•....,, 4/19/19 ctc': 0 • • Disapproved •.'h.PRoFr;�o:..•� Conditional approval for bedrooms, with the following stipulations: Ng 1410 ON-SITE v WATER " AND rn ' PRoGGR, ER z; O AM �.; e•scr j 1)))))»))))) _-- ----------- / / , By: 1 ='% Original Certificate Date: 2•(-0- \I-19 The Municipality of Anchorage Development Services Divis• (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 COSA Checklist Legal Description: South Hills Block 7 Lot 3 Parcel ID: 017-071-30 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) Well production at time of test 1.5 gpm Date drilled 1/15/18 Water storage tank volume N/A gallons Total depth 380 ft Well disinfected for coliform test? ❑ Yes ❑■ No Cased to 124 ft Coliform bacteria is Negative ll Sanitary seal is functioning correctly Nitrate mg/L ❑ Nitrate less than MRL (ND) Wires are properly protected Arsenic ug/L ❑� Arsenic less than MRL(ND) Casing height (above ground) 24 in. Collected by Forge Engineering Date of flow test for COSA 1/15/18 Date of Sample 4/11/19 Static water level at beginning of test 71 ft. Comments B. TANK DATA C. LIFT STATION Age of tank(s) <1 years ❑ Required maintenance completed Tank type/material FAP/ Fiberglass Age of lift station <1 years Measured operating fluid level in septic tank N/A Lift station material PVC ❑ Standpipes/foundation cleanout per record drawing Comments: New Lift Station Date of pumping New Tank Advantex Treatment System w/Ultra Violet Tube D. ABSORPTION FIELD DATA Mound/ Bed Which system tested (date installed) 9/26/18 Adequacy test date ❑ALL standpipes present per record drawing Results ❑Pass For bedrooms Total measured depth from grade 3.9 ft(max) Fluid depth prior to test in Measured depth to pipe invert from grade ft(min) Water added gal ❑■ N/A—pressurized field New depth in f1❑ Monitor tubes go to bottom of effective. If not, state depth into effective Elapsed time min 0 Code-required soil cover over field Final fluid depth in El presoaked Absorption rate gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) date of test) Gallons introduced N/A gallons If yes, enter date Comments/Deficiencies:New septic system COSA Checklist yellow sheet 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' Community Sewer Manhole/Cleanout> 100' ❑Yes if No >50 ft 0 Yes if No ft Neighboring Tank > 100' ❑Yes if No ft Private Sewer/Septic Line > 25' ❑Yes if No ft Absorption Field on Lot> 100' ❑Yes if No >50 ft Holding Tank> 100' ['Yes if No ft Neighboring Absorption Fields > 100' Animal Containment> 50' El Yes if No ft 0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water> 100' El Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' El Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' 0 Yes if No ft Water Service Line > 10' ❑Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 0 Yes if No ft If absorption field is under driveway comment below Property Line > 10' El Yes if No ft Wells on Adjacent Lots: Water Main > 10' El Yes if No ft Private Wells> 100' Cl Yes if No ft Water Service Line> 10' El Yes if No ft Community Wells > 200' El Yes if No ft Surface Water> 100' 0 Yes if No ft F. ENGINEER'S COMMENTS The septic system is a Category III Advantex Treatment System with Ultraviolet Treatment. G. ENGINEER'S CERTIFICATION _�siiiistii4, •••-�E 0F••Ake'. I certify that I have determined through field inspections and review �0'eP:•• 7j of Municipal records that the above systems are in conformance with �•'• . '; �v MOA COSA guidelines in effect on this date. i .v. 49th i'N = 0 ; Rabbit Hill Drive —r Warrant Deed Bk66 P 792 = ==__ Y g - - - " ::: . 4.31(0`€:__>;;:>: :=i>"';-__' a>:_._:. tt NSA 05...45:_E:< . =k: :.:. a >s:>:<•-?}...:_,,,:X>i>_iE isroS:=':'=<:: a:=:-'>== -;>;- ., CD Lot 3 U a 27,338 sf w � o d- N -4411- 45.7' _ ,s.so, o etS w ExistingHouse m Lot 4 N0 � N ,,,:s Lot 2 O O rn v °D w i.t D — L ' 10' Util. Easement — S89'53'15"W 152.53(R) �0000 OF A 4°N axe C7 49TH —1- A 0 4 -4 QO Thomas H. Ore ;.,O �h�m LS-7625 ��,aned 4/24p, f See Forge Engineering's septic plans for all septic information and descriptions. ��oressionot c-1 0`,OpC �a Ordered by. Hultquist Homes Inc. Legend: S4 Legal Description: Set Rebar with Cap O As-Burt AL. Monument Found Rebar 0 Lot 3.Block 7, Monument G South hills Subdivision Well O Group Excepting Warrant Deed BK66 PG792 Septic Pavement Land Surveying Survey Certification: I hereby certify that a Mortgagee's Land Development Consultants Inspection was performed on the described property. Overhang Notes: It is the owner's responsibility to determine the Wood Deck Subdivision Specialists existence of any easements, covenants, or restriction Construction Surveying which are not on the recorded subdivision plot. This Concrete pp 1-7-771 asbuilt shall not be used for construction or for r°``` ''y Tom H Dreyer,P.L.S. establishing property lines. 124 E 7th Avenue • 4 Anchorage,Alaska 99501 Checked by. CB Scale 1" 30' Drawn by. AR Grid SW2940 mail106 8104 mail@S4AK.com Job 2016-19 Plat P-636 Field Book: 139-74 Date: 4/24/2019 Iiiii 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 tQ Day of Js(Yr• -' of 20 lex , by and between Ak—\'' 41 ec\A 611-1 1- Qu�511-e\\ ,herein the"OWER."and the Municipality of (� �1`''_s ,,.L� 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 Waste Water Treatment System located at(legal description) South Hills Block 7 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 1v 0 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 11,-,k repair(s). maintenance,adjustment(s),replacement costs,and inspection costs. This includes an annual maintenance fee (typically$400 to$600). tQ Owner agrees that only maintenance and repair personnel approved by the Municipality Oaor the manufacturer's representative will inspect and make any necessary maintenance. repairs or permitted alterations to the system. QOwner acknowledges that regular maintenance of an AWWTS reduces the potential„3 Mi )\ failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 t ler a,now ledges that the'Municipality may request records of mnintenance and repairs from the manufacturer's representative or maintenance provider. Ck Owner acialowkdees that the fine for failing to maintain and repair an AWWTS may he a. weed in aecordance with AAMC 14.60.030. G• (Tuner gees to grant the Mlunicipality reasonable access to test and inspect the AWWTS. The Municipality will give at lcat 24-hour notice. %, ,, Owner agrees that any stile or transfer of title of the property will not occur without a new Certificate of On Sire Systems Approval. C't.„,jk Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vcndorinstaller and approved by the Municipality are the governing guidelines for the construction,maintenance and repair of the Owner's A\V\\"l'S. Owner agrees to maintain remote monitoring of the A\\'\\TS as required by the a. i i AWWTS approval. ,. Term. The terns 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. Noneeaiver. 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 he brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The lays of the State of Alaska shall govern the rights and obligations of the parties under this Agtree:nent 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;1S 201S) Paye 2 of 3 OWNER 'UYAAtl ii n to IL it I (print name) A Wk;,. ,,...i. -----/"'-A STATE OF-M7161454 sYu ws3-� r se s i The fon:wing insane-hem was acknowledged before me th sf day of AVT-4 I- - 2'J1°1, h`- A Qv61,P�t, t f i N Ovi eU- NO RY PUBLIC FOR 1'L'.rY° 1 sVIlt Q)' JEANETTE POP My Commission cxpines: 0(p 1 1 S 124.77....e7_ Notary Public Stale of Washington license Number 200706 !Av Commission Expires June 15.2022 MUNICIPALITY: By: -1R9VCA5k- \.S c Y (s ne) D8 2 4/2 3 1 1 Rt e CA-0. C ro U. (prig wane) Tih1e. 1 • i (rev.05/18.2018) Page 3 of 3 1 I