HomeMy WebLinkAboutPOTTER HIGHLANDS PH 2 BLK 4 LT 4 Onsite File
Potter
Highlands Ph2
Block 4
Lot 4
#020 - 281 - 83
Municipality of Anchorage
Community Development Department Page 1 of 2
On-Site Water and 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: OSP181205 PID Number: 020-281-83 ❑✓ New ❑ Upgrade
Name:
HAGMIER HOMES LLC ABSORPTION FIELD
Address
0 Deep Trench ❑✓ Shallow Trench ❑ Bed ❑ Mound
19141 POTTER HIGHLANDS DRIVE ❑ Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
4 6.0GPD/SF 6.0 Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot 5.5 Ft. 0.5Ft.
POTTER HIGHLANDS PH 2 4 4 Fill added above original grade Gravel length
Township Range Section 0.0 Ft. 20.0 Ft.
Gravel width Beds:Number of Lines Distance between lines
SEPARATION DISTANCES 5.0Ft. N/A N/A Ft.
Toff Septic Absorption Holding Sewer Total absorption area Number of trenches Dist.between trenches
From Tank Field Lift Station Tank Line 100 Ft2 1 N/A Ft.
Well 100.0 100+ N/A N/A 80.0 TANK El Septic 0 S.T.E.P. 0 Holding 0 Other
Manufacturer Capacity
Surface Water 100+ 100+ N/A N/A ADVANTEX 1500Ga1.
Material Number of compartments
Lot Line 5+ 10+ N/A N/A FIBERGLASS 2
NA
Foundation 10+ 10+ N/A N/A LIFT STATION
Manufacturer Capacity
Curtain Drain 50+ 50+ N/A N/A I Gal.
Remarks Pump on level at Pump off level a High water alarm at
in. in.
Pump make model Electrical Inspections performed by
to
drainfield MATERIAL House to tank 3034 Tank ld 3034
Installer
RED DOG Drainfield 3034 CO/MT 3034
Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 1045.0ft
Inspection �" 12/20/18 �a Location and description
dates: 2 12121/18
a° 12/21/18 4th 2/27/19 BOTTOM TRIM AT HOUSE POINT A
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp
kVo
Conditional Approval: Date �Gi pLSkkt
3#1141, * 0
�••tteveri 1Ianno e 9
E814
/
t*47'..v
Approved 1 4/l 26--/f
r Date Z- >,>>a� O0 ..
Inspection Report_1-1-12.doc
PRIMARY DESIGN PARAMETERS '
A B
NO. BEDROOM:4(600 gpd) • .
TANK SIZE: 1500G ADVANTEX(CAT 111) T1 54.8 52.7
PERC RATE: <1 MPI ( T2 65.5 62.9
SOIL RATING: 6.0 GPD/SF
AREA ROD: 100 SF I DCO 70.2 68.9
SYS.TYPE:WIDE TRENCH 0.5'ED I
MIN LENGTH: 20 LF C 1 91.3 86.8 5 /
ml 93.4 88.3
USED: I C2 115.6 110.1 11.20.0.0LFx5.0'Wx0.5' E.D.,6.0'TD TOTAL AREA: 100 SF.• I M2 112.1 107.0II\
IUNDEVELOPED
zit I INSTALLED ABSORPTION FIELD
1 i 20.OLFx5.0'Wx0.5'E.D.,6.0'T.D.
I I I W/ COs & MTs ON ENDS
I INSTALLED 2.0' FILTER SAND BENEATH FIELD
,. I 1\1 T _
RESERVE ABSORPTION FIELD(NIC) I '
20.OLFx5.0'Wx0.5'E.D.6.O'T.D.N 22.4 M INSTALLED 1500G ADVANTEX W/ AX-20 POD
• I I 1 2 ,.,,`_ • • 3 7.8 & FC BEFORE AND DCO AFTER TANK
F.A.P.
-I / I -I M1 ?. M
. �, I /
41
w ,. Ti /
" 1 F • \ .
DRIVEWAY \
n 135.4 A
I 4BR
'' ' N'
\ Z I SFD
WELL
\\// . f I
4
a / UNDEVELOPED —
W y,
0) m
H F
"'5 0 ccs RAIN R K "
...
o oW ABOVE PIPE INV o
2 g oV U
- - 4" 0 DRAIN PIPE
EL.1040.0 FI T R FA RI
�.2u OG EL.1040.0
Poo :114
•PROFILE'_ 0NROCKFAP19 AOVAN
\ \ •
2.0'SANG FILTER
\103a.5 •.,
SCALE:N.T.S. 1034.5/
1• • 12.0 100CT99
— (1020.5)
1{..
NOTES: _ PANNONE ENG SVC Date
RECORD DRAWING P.O. BOX 102954 ANCHORAGE, AK LLC
99510 P • 3/15/19
REV1 PER MOA PHONE (907) 272-8218 FAX (907) 272-8211 _••.
* Scale
COMMENTS 190322 ? i. % •.* 1" = 50'
POTTER HIGHLANDS PH2 B4 L4 , �•���1� ��•• ' 020 NO
-� 020-281-83
DRAWN ACP HAGMIER HOMES LLC :.even '•••ronnoaie' PERMIT NO.
;t•.. CE 8149
19141 POTTER HIGHLANDS DRIVE ., OSP181205
ANCHORAGE, AK i =:;� ,9 Sheet
\\ 2OF2
..dine Drilling & Enterprises .k,t,1,-\ -7--
i
Zi
Well Log l
1
Permit;Number: #SW181205 Date of Issue: 7-26-18 Parcel Identification Number: 02028183000
Date S l rted: 9-25-18 Date Completed: 9-25-18 Is well located at approved permit location?x Yes ❑ No s
Legal Description: Potter Highland Ph 2 Block 4 Lot 4
Property Owner Name&Address: Potter Creek Development, LLC John Hagmeier Homes
2204 Clevland#201
, Anchorage, Alaska
Borehole Data:
Soil Type,Thickness&Water Strata Depth (ft)
Prom To - Method of Drilling x air rotary ❑cable tool
Casing type: steel 1
stick-up 0 2 Wall Thickness: inches
gravelly silt 2 53 Diameter:6 inches Depth: 72 feet
Liner Type:
silt 53 65 Diameter: inches Depth: __feet
gravelly silt 65 70 Casing stickup above ground: 2 feet I
bedrock 70 206 Static water level(from ground level): 69 feet l
Pumping level: 200 feet after
• 2 hours pumping 12 gpm 's
Recovery Rate: 12 gpmfi
Method of Testing:airlift
Well Intake Opening Type:
x Open End ❑ Open Hole
❑ Screened Start feet Stopped feet
I ❑ Perforations Start foot Stopped feet 5
Grout Type: bentonite granules Volume: 2 bgs
Depth: Start 0 feet Stopped ? feet 4
Pump: Intake Depth feet H
WATER 0 UALITY TESTING Pump size hp Brand Name iii
Co'I/140mL
Coliform s Well Disinfected Upon Completion? x Yes❑No
Nitrates ME L Method of Disinfection: chlorine tablets
E.
Arsenic N D
Comments: t
}
Well Driller: Alpine Drilling&Enterprises
PO Box 110496
Anchorage AK 99511
3
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MUNICIPALITY OF ANCHORAGE 1
t
-----.-
i
Development Services Department 4.4 ;I Phone: 907-343-7904 1
On-Site Water& Wastewater Section Fax: 907-343-7997 I
!
Pump Installation Log
181205 07 26 18
Well Drilling Permit Number: Date of Issue: - -
Parcel Identification Number: 02(.281.83W° 3
i
Legal Description Block Lot Property Owner Name&Address:
Potter Highlands 4 4 John Hagmeier Co.
Phase 2 2204 Cleveland 1/201 g
Anchorage,AK 99517 a
Pump Installation Date: 1 _21 _2019 �v 4
I
Pump Intake Depth Below Top of Well Casing: 192 feet
Pump Manufacturer's Name: Goulds
Pump Model: 7HS07 j
C
Pump Size: 3/4 hp i1
Pitless Adapter Burial Depth: N/A feet
Pitless Adapter Manufacturer's Name: N/A
Pitless Adapter Installer: N/A
4
Well Disinfected Upon Completion? Cl Yes 0 No
Method of Disinfection: chlorine tablets
Comments: i
1
PLEASE SAVE FOR COSA. 1
t
2
I
Pump Installer Name:
Company: Aarow Pump & Well Service, LLC 1
5
Mailing Address: P.O. Box 110496
City: Anchorage State: AK Zip: 99511
Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. •
1
1
e
i
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Water & Wastewater System Permit
Permit Number: OSP181205
Work Type: WellSeptic Initial
Tax Code Number: 02028183000
Site Legal Address: POTTER HIGHLANDS PH 2 BLK 4 LT 4 G:3638
Site Mailing Address: 19141 POTTER HIGHLANDS DR, Anchorage
Owner: POTTER CREEK DEVELOPMENT LLC
Design Engineer: PANNONE ENGINEERING SERVICES
This permit is for the construction of:
0 Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy
Effective Date
Expiration Date:
Lot Size in Sq Ft
Total Bedrooms:
�JAIC�,(
Departnicnt
7/26/2018
7/26/2019
51868
2 Private Well ❑ Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Received B)
Issued By:
17eFaed '� i ekc�
Date:
Date:
4
MUNICIPALITY OF ANCHORAGE ta_' I it%
Community Development Department ``' Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On-Site Water& Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 020-281-83
Property owner(s) POTTER CREEK DEVELOPMENT LLC Day phone
Mailing address 561 E 36TH AVE STE 200
Site address NHN POTTER HIGHLANDS DRIVE
Legal description (Sub'd., Block & Lot) POTTER HIGHLANDS PH2 B4 L4
Legal description (Township, Range & Section)
Lot Size 51,868 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(®all that apply)
Absorption Field ❑X Initial 0 Single Family (SF) 0
(w/wo ADU)
Septic Tank Upgrade ❑
Duplex (D) ❑
Holding Tank ❑ Renewal ❑
Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
11,
(Signature of property owner or authorized agent)
Permit/Rush Fees: szt 1254.t-4o Waiver Fees:
Date of Payment: 1-11'-((� Date of Payment:
Receipt Number: n 01146 Receipt Number:
Permit No. Q3PIcj 12.06 Waiver No.
Permit App_. ::.,c
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP181205, Deb Wockenfuss, 07/26/18
NOTES & SPECIAL PROVISIONS: I U- ES
--- - - - - - -- --- I-- _I I \ - - - �- �- R CONSTRUCTION
1 SCOPE AND SPECIFICATIONS: /� \ - - - _ / (.?,(/,l -FO/
1.1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS
(MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS AND AND IN ACCORDANCE WITH I * 1
AMC 15.65 AND 15.55.
1.2. SCOPE OF WORK: INSTALL NEW 1500g ADVANTEX TANK W/ AX -20, AND SOIL ABSORPTION SYSTEM. INSTALL WELL I `�
1.3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 12.5 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT
WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 12.5 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY.
1.4. STRUCTURES DEPICTED ON THE SITE PLAN ARE BASED UPON ONE OF THE FOLLOWING: CONCEPTUAL PLOT PLAN DEVELOPED BY OWNER; A PLOT PLAN M I I b
DEVELOPED BY RLS; OR A SURVEY AS -BUILT.
5
2. CONSTRUCTION SPECIFICATIONS:
2.1. ALL EXCAVATION DEPTHS ARE ADVISORY. THEY ARE TO BE VERIFIED AND MAY BE MODIFIED BY THE ENGINEER IF ACTUAL FIELD CONDITIONS VARY FROM TRUE N21RTH � I SCA E : 1"= 50'
THOSE USED TO PREPARE THE DESIGN /
2.2. EXCAVATE THE DRAIN FIELD. BOTTOM OF EXCAVATION SHALL BE LEVEL AND SCARIFIED. RECORD ELEVATIONS AT BEGINNING, MIDDLE AND END OF TRENCH
BOTTOM. CONSTRUCTION EQUIPMENT SHALL NOT OPERATE ON THE FLOOR OF THE EXCAVATION. ANY MATERIAL COMPACTED BY THE OPERATION OF THE
CONSTRUCTION EQUIPMENT SHALL BE REMOVED AND REPLACED WITH UNCOMPACTED MATERIAL. z
2.3. PLACE THE SEWER ROCK TO THE SPECIFIED DEPTHS. DO NOT CONTAMINATE SEWER ROCK WITH NATIVE MATERIAL OR SPOILS FROM EXCAVATION. LEVEL UNDEVELOPED
ROCK SURFACE TO tl" PRIOR TO INSTALLING THE PERFORATED PIPE. aNn
2.4. ALL PIPE SHALL BE PVC CONFORMING TO ASTM D3034 OR ENGINEER APPROVED EQUAL. MINIMUM SOIL COVER SHALL BE 3 FEET OVER THE PIPE AND 4 I RESERVE ABSORPTION FIELD NIC / I gym
FEET OVER THE SEPTIC TANK. ONE INCH OF INSULATION MAY BE SUBSTITUTED FOR 1 FOOT OF SOIL COVER. I 6
D
5'E...0'T.D. / I
2.5. ALL INSULATION SHALL BE 2" THICK DOW HI -40 INSULBOARD OR ENGINEER APPROVED EQUAL. CENTER INSULBOARD WIDTH OVER SEPTIC TANK OR LINES. 20.OLFx5.0'Wx0.
I / / W <<
2.6. GEOTEXTILE SHALL BE MIRAFI 1405 OR ENGINEER APPROVED EQUAL. LAP ALL JOINTS 2 FEET MINIMUM. <
I / / I
2.7. COVER THE DISTRIBUTION PIPE WITH A MINIMUM OF 2" OF SEWER ROCK AND COVER WITH GEOTEXTILE BEFORE PLACING INSULATION AND BACKFILL. Um
2.8. MATERIAL USED AS FILL SHALL BE CLEAN AND FREE OF ORGANICS, TRASH AND CONSTRUCTION DEBRIS. I _ INSTALL ABSORPTION FIELD(P) 1 / a
2.9. SLOPE ALL FILL MATERIAL TO DRAIN AT 2% MINIMUM SLOPE AND 3:1 MAXIMUM SLOPE AND IN SUCH A MANNER THAT PONDING AT OR NEAR THE DRAIN FIELD I 20.OLFX5.0'WXO.5'E.D.,6.0'T.D. / 3� _W o
DOES NOT OCCUR. THE FILL SHALL BE LEFT AT 6" HIGHER THAN SHOWN TO ALLOW FOR SETTLEMENT. SEED SURFACE AFTER COMPLETING INSTALLATION AS o oz
PER MOA CODE. I c W/ COS & MTs ON ENDS
2.10. RECORD THE FINISH GROUND ELEVATION OVER THE BEGINNING, MIDDLE AND END OF SYSTEM. I ADD 2.0' FILTER SAND BENEATH FIELD,-&NSttff �/ 1
2.11. MAINTAIN 5' SEPARATION BETWEEN PERCOLATION HOLE AND THE DRAIN FIELD TRENCH. C=I 55.1 2.0' COV .. per p15 /I
2.12. EXPOSE, PUMP AND FILL LOG DISPOSAL CRIB OR CONCRETE TANK WITH SOIL TO ABANDON [AW WITH MOA CODE IF NEEDED.
3. CONTRACTOR RESPONSIBILITIES: m�1 INSTALL 150OG ADVANTEX W AX -20 PmUP
11
3.1. THE CONTRACTOR (BOTH WELL AND SEPTIC SYSTEM CONTRACTORS) SHALL HAVE ANY WELL LOCATION AND SEPTIC LOCATION STAKED AND ANY LOT LINE I �I & FC BEFORE AND DCO AFTER TANK I / .� W
>
AND WELL RADIUS SHOWN ON THE PLAN WITHIN 30 FEET OF THE PROPOSED SYSTEM STAKED BY A REGISTERED LAND SURVEYOR BEFORE STARTING THE I
W
WORK. �
3.2. THE CONTRACTOR IS RESPONSIBLE FOR ALL R.O.W. AND OTHER REQUIRED PERMITS, OTHER THAN THE ATTACHED. i Ain3.3. THE CONTRACTOR SHALL CALL FOR LOCATING OF ALL BURIED UTILITIES. +-38.9
47.8 TH- 4 / / / / / / '/ a Q Q
3.4. THE CONTRACTOR SHALL PROVIDE 24 HOUR NOTICE TO THE ENGINEER PRIOR TO START OF WORK. ALL SURVEYING AND LOCATES SHALL BE IN PLACE I / U) iz/ / / I G a
PRIOR TO NOTIFYING THE ENGINEER.
3.5. THE CONTRACTOR SHALL NOTIFY THE ENGINEER OF ANY DISCREPANCY BETWEEN THE APPROVED DRAWINGS AND SITE CONDITIONS/LIMITATIONS \ I DRIVEWAY 4BR / / / I Z J 0 -
POTENTIALLY CAUSING THE NEED TO MODIFY THE DESIGN. V 0 BF D 1 72.1 / / / Z =
3.6. AT THE COMPLETION OF THE WORK, THE CONTRACTOR SHALL SUBMIT RED -LINE AS -BUILT DRAWINGS TO THE ENGINEER. THE RED -LINES SHALL INCLUDE I / / / 1 $ 3 / / I e I ue
PIPE LENGTHS, ORIGINAL GROUND ELEVATIONS, PIPE ELEVATIONS, AND TANK ELEVATIONS.
3.7. THE CONTRACTOR SHALL PROVIDE PHOTOGRAPHS OF THE SYSTEM INSTALLATION TO INCLUDE BOTTOM OF EXCAVATION, TOP OF PIPE WITH CLEAN -OUTS J = _
AND MONITOR TUBES INSTALLED, INSTALLED TANK AND FINAL GRADING. _ I / / a 0 Z I-
4. THE CONTRACTOR SHALL SIGN THE FOLLOWING: I CERTIFY THAT ALL WORK WAS PERFORMED IN ACCORDANCE WITH THE APPEND PERMIT, AND ANY AND ALL
U =_ a_
CHANGE ORDERS, AND THAT THE AS -BUILT REDLINES ARE TRUE AND ACCURATE REPRESENTATION OF THE PROJECT AS CONSTRUCTED. _ / /� I - I% Z W
CONTRACTOR: BY; TITLE: DATE: iii U) _ I loaa
LLJloae WELL P' / I !
I. -
y
5.XCACTOR PROVIDED DATA (UPON WHICH THIS RECORD DRAWING IS BASED) APPEARS TO REPRESENT THE PROJECT AS CONSTRUCTED. THIS DATA INWITH THE PERIODIC FIELD OBSERVATIONS BY THE ENGINEER (OR HIS DESIGNEE) AS REQUIRED BY AMC 15.65 DOES NOT GUARANTEE THAT THEREEN DEFECTS BY THE CONTRACTOR. / 0
0- / UNDEVELOPED / _,4 7052 1os6
PRIMARY/RESERVE DESIGN SOILS LOG
PARAMETERS TEST HOLE 954
PRIMARY DESIGN PARAMETERS 1 OR I TOPSOIL
NO. BEDROOM: 4(600 gpd) 2
TANK SIZE: 150OG ADVANTEX (CAT III) 3
PERC RATE: <1 MPI
SOIL RATING: 6.0 GPD/SF 4 -
AREA ROD: 100 SF
SYS. TYPE: WIDE TRENCH 0.5'ED 5
MIN LENGTH: 20 LF
LU
_
Z
Z J om0m
0 Ix (n O y N N
LU
ZZ�m<r�
a W Lu
<
ABBREVIATIONS
WTH -TEST HOLE
6 1 / / (P) PROPOSED *: �•
USE: / 1 / / (E) EXISTING €Y
7 WAS GROUND WATER SOIL TEST RESULTS/ANALYSIS / / \ I - W -WATER LINE /WELL RADIA CO CLEAN OUT NO. m
20.0.OLFx5.0'WxO.5' E.D., 6.0' TO / II
TOTAL AREA: 100 SF g GM GRAVEL ENCOUNTERED? N PERCOLATION RATE <1 (minlinch) / / / / MT MONITOR TUBE N0. 1�j;
(Hydrologic Soils Group: HSG A) / / / / -�-1�EWSEPTIC TYP TYPICAL �y
`rbr•. .
IF YES, AT WHAT PERC HOLE DIAMETER 6" !e u 9 -DEPTH? -NA-' TEST RUN BETWEEN 5 FTAND 6 FT I #'
RESERVE DESIGN PARAMETERS 70 DEPTH TO WATER AFTER o 0
REVISIONS
QO � RAIN R K K REVI:IRJULIR
j�f lC 11 MONITORING? - 12.3' - � � a �_ , ABOVE PIPE INV . W z REV2'23JUL18
j t --Z m 4" 0 RAIN PIP z m ,-
DATE: 220CT7999 0 J J �o o
12 220CT99 �''U U U UO�I- FILTER FA RI �.UO REV4:O7AUGIR
NO. BEDROOM: 4(600 gpd) _TM1999
TANK SIZE: 150OG ADVANTEX (CAT III) 13 -
PERC RATE: <1 MPI 1 D OR
SOIL RATING: 6.0 GPD/SF 14 BOH jA YVAN
6.0
AREA ROD: 100 SF
SYS. TYPE: WIDE TRENCH 0.5'ED �0.5 4.G -
MIN
. u o N m
MIN LENGTH: 20 LFADVANTEX W N
USE: SAND 2.DI 6. a o 0
GM a om
20.0.OLFx5.0'Wx0.5' E.D., 6.0' TO ' 20.0 i 6 5 9. = N 3
U) g
TOTAL AREA: 100 SF SHEET
12.0 100CT99 C 3 • O
DATE PERFORMED: OCT1999 PROFILE
14.0 1 OF 1
WATER
RATE
READING DATE
NET TIME LEVEL NET
CROP
(MPI)
READING
1 04JANIB
8.398-
2
SEE
RECORDS
3.52'
0.3
3
4
3 s2-
0.3
PI -11
8.105'
6
1.5 MIN 11.900"
3.79"
0.4
LU
_
Z
Z J om0m
0 Ix (n O y N N
LU
ZZ�m<r�
a W Lu
<
ABBREVIATIONS
WTH -TEST HOLE
6 1 / / (P) PROPOSED *: �•
USE: / 1 / / (E) EXISTING €Y
7 WAS GROUND WATER SOIL TEST RESULTS/ANALYSIS / / \ I - W -WATER LINE /WELL RADIA CO CLEAN OUT NO. m
20.0.OLFx5.0'WxO.5' E.D., 6.0' TO / II
TOTAL AREA: 100 SF g GM GRAVEL ENCOUNTERED? N PERCOLATION RATE <1 (minlinch) / / / / MT MONITOR TUBE N0. 1�j;
(Hydrologic Soils Group: HSG A) / / / / -�-1�EWSEPTIC TYP TYPICAL �y
`rbr•. .
IF YES, AT WHAT PERC HOLE DIAMETER 6" !e u 9 -DEPTH? -NA-' TEST RUN BETWEEN 5 FTAND 6 FT I #'
RESERVE DESIGN PARAMETERS 70 DEPTH TO WATER AFTER o 0
REVISIONS
QO � RAIN R K K REVI:IRJULIR
j�f lC 11 MONITORING? - 12.3' - � � a �_ , ABOVE PIPE INV . W z REV2'23JUL18
j t --Z m 4" 0 RAIN PIP z m ,-
DATE: 220CT7999 0 J J �o o
12 220CT99 �''U U U UO�I- FILTER FA RI �.UO REV4:O7AUGIR
NO. BEDROOM: 4(600 gpd) _TM1999
TANK SIZE: 150OG ADVANTEX (CAT III) 13 -
PERC RATE: <1 MPI 1 D OR
SOIL RATING: 6.0 GPD/SF 14 BOH jA YVAN
6.0
AREA ROD: 100 SF
SYS. TYPE: WIDE TRENCH 0.5'ED �0.5 4.G -
MIN
. u o N m
MIN LENGTH: 20 LFADVANTEX W N
USE: SAND 2.DI 6. a o 0
GM a om
20.0.OLFx5.0'Wx0.5' E.D., 6.0' TO ' 20.0 i 6 5 9. = N 3
U) g
TOTAL AREA: 100 SF SHEET
12.0 100CT99 C 3 • O
DATE PERFORMED: OCT1999 PROFILE
14.0 1 OF 1
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP181205, Deb Wockenfuss, 07/26/18
EPUIMIS
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. 020-281-83 Expiration Date: z0 -1 cf
1. GENERAL INFORMATION
Complete legal description Potter Highlands Ph 2 B4 L4
Location (site address) 19141 Potter Highlands Drive
Current property owner(s) Hagmler Homes LLC Day phone
Mailing address 2204 Clevland Ave Suite 201 Anchorage, AK 99517
Real estate agent Day phone
2. TYPE OF DWELLING:
El Single Family(w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Private Well El Private Septic 0
Water Storage ❑ Holding Tank (1
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 $ 76- -
Waiver Fee $
Date of Payment 30/8 B//9 Date of Payment
Receipt Number 6(0IO5i ) Receipt Number
COSA# f)(01073 0 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.
In conducting an adequacy test, I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA
COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the
time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems
depend on the local soil condition,ground water levels that may fluctuate during the year,and the water usage of the family being served by
the system.These conditions are outside the control of the evaluator of this system.All systems eventually fail and satisfactory test results
do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore
we cannot provide any warranty for future performance, nor can we estimate remaining life of the system.The content of this report is for the
sole benefit of the owner listed above.
Name of Firm Pannone Engineering Services Phone (907) 745-8200
Address P.O. Box 1807 Palmer, AK 99645
Engineer's Printed Name Steven R. Pannone P.E. Date Jci123/ --
.77 TA
6. DSD SIGNATURE %•':•
System #1 Approved for �( bedrooms t . onnera�'
CE 8149
System #2 Approved for bedrooms
Disapproved llANNeec��'
Conditional approval for bedrooms, with the following stipulations:
4,0“
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CV
ON-SITE,
WATFR AND `"'
1:::aWASTEWATER o
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By: \ l� Original Certificate Date:
Y 9 S 2/ I�
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
COSA Checklist
Legal Description: Potter Highlands Ph2 B4 L4 Parcel ID: 020-281-83
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 12 gpm
Date drilled 912518 Water storage tank volume gallons
Total depth 206 ft Well disinfected for coliform test? ❑Yes ❑✓ No
Cased to 72 ft 0 Coliform bacteria is Negative
0 Sanitary seal is functioning correctly Nitrate 4.19 mg/L ❑ Nitrate less than MRL (ND)
0 Wires are properly protected Arsenic ND ug/L 0 Arsenic less than MRL (ND)
Casing height(above ground) 24 in. Collected by PES
Date of flow test for COSA New Date of Sample 2-14-19
Static water level at beginning of test 69 ft.
Comments
B. TANK DATA C. LIFT STATION
Age of tank(s) ,2'20'18 ears
g y 0 Required maintenance completed
Tank type/material Age of lift station years
Measured operating fluid level in septic tank New Lift station material
0 Standpipes/foundation cleanout per record drawing Comments:
Date of pumping New * FAP Advantex / Fiberglass
D. ABSORPTION FIELD DATA Shallow Trench
Which system tested (date installed) 12'21,18 Adequacy test date New
0 ALL standpipes present per record drawing Results ED Pass For 4 bedrooms
Total measured depth from grade 6.0 ft(max) Fluid depth prior to test in
Measured depth to pipe invert from grade 5.5 ft(min) Water added gal
El N/A—pressurized field
New depth in
0 Monitor tubes go to bottom of effective. If not, state Elapsed time min
depth into effective
0 Code-required soil cover over field Final fluid depth in
0 System presoaked Absorption rate gpd
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months)
date of test) If yes, enter date
Gallons introduced gallons
Comments/Deficiencies:
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'
0 Yes if No ft 0✓ Yes if No ft
Neighboring Tank > 100' Q✓ Yes if No ft Private Sewer/Septic Line > 25' ✓0 Yes if No ft
Absorption Field on Lot> 100' 0✓ Yes if No ft Holding Tank> 100' p Yes if No ft
Neighboring Absorption Fields > 100' Animal Containment>50' 0✓ Yes if No ft
✓❑Yes if No ft
Manure/Animal Excreta Storage> 100'
Community Sewer Main > 75' ✓0 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' I2 Yes if No ft
Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots:
Absorption Field > 5' E] Yes if No ft Private Wells > 100' ✓0 Yes if No ft
Water Main > 10' LI Yes if No ft Community Wells > 200' 0 Yes if No ft
Water Service Line > 10' 0 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' Q Yes if No ft Wells on Adjacent Lots:
Water Main > 10' 0 Yes if No ft Private Wells > 100' D✓ Yes if No ft
Water Service Line> 10' E Yes if No ft Community Wells>200' 0✓ Yes if No ft
Surface Water> 100' 0 Yes if No ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and review �.• 4
of Municipal records that the above systems are in conformance with *149 M. j" ',*
MOA COSA guidelines in effect on this date. •••• •• •
.. seven -. -annolge
v,,. CE 8149
•. ••• 'c•
COSA Checklist yellow sheet
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
BETWEEN MUNICIPALITY OF ANCHORAGE
AND Arthur Matteson
THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this
__14:7.Day of lA of 20141,by and between A-90w- 141 l --50r-
herein the"OWNER,"and the Municipality of Anchorage. herein the
"MUNICIPALITY."' In consideration oldie mutual covenants contained herein,the
parties to this Maintenance and Repair Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. Municipality grants permission to
Owner to utilize and operate an Advanced Wastewater Treatment System
(AWWTS),described as
AdVantex 1500
located at(legal description).
Lot 4 Block 4 Potter Highlands
2. Definitions.
Alteration. Any change to the design or function of an AWWTS that
includes the installation or removal of any parts,components or pieces not
included in the original construction permit and design.
Certificate of On-Site Systems Approval(COSA). An approval by the
Municipality of existing water and wastewater disposal systems given at
the time of property sale acid title transfer in accordance with Anchorage
Municipal Code(hereinafter."AMC") 15.65. These approvals certify that
the systems are adequate for the homes that they support and meet the
codes that were in place at the time of system construction.
Damage. Any man-made or natural change in a system that would inhibit
the system from performing as designed.
Maintenance and Repair. The scheduled and as needed replacement of
existing parts,components and pieces of an AWWTS that were included
in the original design which would allow the AWWTS to continue to
perform as designed.
Permit. An On-Site Wastewater Disposal Permit as required by AMC
15.65 to construct and operate an AWWTS.
3. Term. The term of this Maintenance and Repair Agreement shall begin on the
date of approval by the Municipality to operate the installed system or issuance of a
COSA,and shall continue while the AWWTS is in use or is operational or until the
property is sold or title is transferred by the owner and a new COSA is issued to the
new owner or transferee of the property.
4. Alterations. Installation and Removal of Additional Equipment. Prior to
performing any alterations to an AWWTS,the owner agrees to obtain an On-site
Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65.
S. Maintenance and Repairs.
A. Throughout the term of this Maintenance and Repair Agreement,the Owner shall
maintain theirAWWTS in a satisfactory condition capable of producing treated
septic effluent in accordance with the equipment's approval for operation in the
Municipality. The owner shall enter into a service agreement with an AWWTS
service and maintenance provider approved by the municipality and the
manufacturer of the AWWTS for the entire term of the AWW1'S. In addition, it
shall be the responsibility of the Owner during the term of this Maintenance and
Repair Agreement,and any renewals thereof;at the owner's sole expense, to pay
for any and all: (I) repair(s).(2)maintenance,(3)adjustment(s),(4) replacement
costs.and(5) inspection costs.
B. Owner agrees to comply with all applicable ordinance, laws. regulations, rules
and orders for the AWWTS.
C. Upon request by the Municipality,the owner agrees to provide the Municipality a
written schedule of routine maintenance and repairs which have been performed
on the system. When a record of maintenance is documented and maintained by
the system vendor, the owner agrees to allow the Municipality access to this
information.
D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS
may be assessed in accordance with AMC 14.60 for improper discharge.
E. Owner agrees that only maintenance and repair personnel approved by the
Municipality will inspect and make any necessary maintenance. repairs or
permitted alterations to the system.
F. Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS upon 24 hours written notice.
G. Owner agrees that any sale or transfer of'tide of the property will not occur
without a new Certificate of On-Site Systems Approval.
If
H. 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.
6. Nonwaiver. The failure of either party at any time to enforce a provision of this
Maintenance and Repair Agreement shall in no way constitute a waiver of the
provisions, nor in any way affect the validity of the Maintenance and Repair
Agreement or any part hereof.or the right of such party thereafter to enforce each and
every provision hereof.
7. Amendment.
A. This Maintenance and Repair Agreement shall only be amended,modified or
changed by a writing,executed by authorized representatives of the parties. with
the same formality that this Maintenance and Repair Agreement was executed
with,and such writing shall be attached to this Maintenance and Repair
Agreement as an amendment.
B. For the purposes of any amendment modification or change to the terms and
conditions of this agreement,the only authorized representatives of the panics
are:
a. Owner: Arthur Matteson
b. Municipality: Director.Community Development or designated authority
C. Any attempt to amend, modify,or change this contract by either an unauthorized
representative or unauthorized means shall he void.
8. Ju risdi iction: Choice of Law. Any civil action arising from this Maintenance
and Repair Agreement shall be brought in the Superior Court for the Third Judicial
District of the State of Alaska at Anchorage. The laws of the State of Alaska shall
govern the rights and obligations of the parties under this Maintenance and Repair
Agreement.
9. Severability. Any provisions ol'this Maintenance and Repair Agreement decreed
invalid by a court of competent jurisdiction shall not invalidate the remaining
provisions of the Maintenance and Repair Agreement.
OWNER:
/' /
By: `~'f ) �/ fes ��(signature) Date: 6'1- f C J 1
,-1/`/'t1V r M' -/-{,,,,, (print name)
STATE OF ALASKA )
)ss.
THIRD JUDICIAL DISTRICT )
The foregoing instrument was acknowledged before me this i I'Jday of_ui Ki
20 tOt by _—_
r . __: s rte ._ _ ���--sz� � EA c+A::CRS
O 1\IRY PUB ICF Z ALASKA tti • No;ar;public
aska
N Commissi expires: I' ' 1' 1-1-1 si!ooate Exof pires
My C^�^miss��:EzOiras Dec?.2G2:
____.-----
MUNICIPALITY:MUNICIPALITY:
By: 1",-"1 F s nature) Dai::: S -Z ) -'
__ (print name) Title:_____________
POTTER HIGHLANDS SUBDIVISION PHASE 2
LOT 4, BLOCK 4
51,868 S.F.
• S 89•49'55"E 298.00'
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BUILDING DETAIL
126.6, WELL
SCALE: 1"=20' 1 "=40'
St
77•53'0
5^E 309.03'
REVISED 3/15/2019 ADDED STAND PIPE.
AS -B U I L T I HEREBY CERTIFY THAT I HAVE SURVEYED THE
'PROPERTY GASTALDI LAND ENCROACHMENTS TEXI TT ED EXC OAS INDICATED. •THAT NO ,♦\\\�1\
SURVEYING. LLC IT IS THE RESPONSIBILITY OF THE OWNER TO .•'_f.••O•F•••Q(4�•
JEFF A. GASTALDI, R.L.S. DETERMINE THE EXISTENCE OF ANY EASEMENTS, •
,•`P•;•• Ss, ♦♦
2000 E.DOwUNG RO.,SUITE 8 COVENANTS OR RESTRICTIONS WHICH DO NOT a*;•4918
ANCHORAGE,ALASKA 99507 ■• ••••
APPEAR ON THE RECORDED SUBD(VISIDN PLAT.
PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA j'n, r�tt a Ges, • a
HEREON BE USED FOR CONSTRUCTION OR FOR ♦ :•
GRID DATE 15-6091 >`
Sw1638 2/11/2019 ESTABLISHING BOUNDARY OR FENCE LINES. ♦•'•.,*„../../20.4•.sq_
F D' JO8 NO.
NOTEANCH:
NO CORNERSE EG DISTRICT.
S ALASKA ••••\\s\\���•••
18-03 PHS244
