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Home My WebLink AboutHILLSIDE PARK PUD LT 2H 0 illside Park Lot 2 #015-122-49 F` Municipality of Anchorage Page of 2 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report ^� �8 PID Number: 015 '� 2'Z -4I9 Permit Number: n(o Name:` '(,1' aKd 6b 2� 2 Wastewater System: 11 New ❑ Upgrade 76 ss: ,T� —r e P � �Jr1:iaiQO)eA K ABSORPTION FIELD Phona�,u/ l�O Z 7(O No. of Bedrooms: / T C3 Deep Trench Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: 6.8- Total Depthfrom original U o g' - s7 S ± 7 T GPD/Sq. Ft. • Lot: Block: w • bdi ' io Depth to pipe bottom from original grade: 2. 9 TD 4. + +_ Ft. Gravel depth beneath pipe q Ft. Township: Range: Section: Fill added above on incl grade: 7• Gravel length: 6 D —' 6.15— D Ft, Ft. WE ft •Ctrs"" A ❑ New ❑ Upgrade Gravel width: � Number of lines: DistancetetweenlinFt Ft. Ft. Classification (Private, Total Cased To: Total absorption area: Pipe material: STM D-303/- F- 8 Ft. Ft. Aoo so. Ft. Driller: rilled: Static water Level: Installer: Date installed: 19 Ft. T T Yield: Pump Set at: Casing Height,40ve Ground: y TANK GPM Ft. Ft. SEPARATION DISTANCES 3iLSeptic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift HoldingPublic/Private Manufacturer: �— /. Capacity in gallons: / 0 From Tank Field Station Tank Sewer Lines jg/7C�7Q✓Q /CINI� c;G6 Welt �} — Material: I r ems/ t Number of Compa ^ments: o`- , f, Surface WaterLot /00 J*/D� 01 —' -- LIFT STATION /Size in g llons: Manufacturer. Line 104- Foundation 5�4- 10 -!- -. .. --� "Pump on" level at: 'level at: High water alarm at: CurtainPump I'IO h UJh Make el Electrical Inspections performed by: Drain BENCH MARK Remarks: Exce�L T' SoiliS Location and Description: To 61C e Assumed ElevatiooEn::�Sc NGI'1, S� IF h p '�� • • •" •• .y Inspections performed by: Aw 1tvc- Dates: 1st l 2nd ... ..... .t�� F,ha1 a/ay/fy o�td' )e E795 '•may`/ Department of Health and Human Services approval 4 k,9 �``�� Date: 99 �aa- l�'Q'it/� 13' WMA.•«•••'•• $, Reviewed and approved by:.� 72-019 (Rev. WM) MOA 25 PERMIT NUMBER: SW980466 - AS -BUILT DRAWING PARCEL INUMBER: 015-11 22-49 A B C ST1 10.1 17.7 -"-' ST2 8.5 26.1-..---'- D1 9.6 28.4 D2 11.9 29.6 COt 62.8 86.0 CO2 89.1 64.7 — — — — — — — _. CO2 ------ MT1 —�'��,.,� M71 64.9 85.7 MT2 C01 MT2 85.0 62.4 ��rPINN-Ci?PUG 95fTH#1- Mf i96M-97.?iB Hat Ij/l 006INN- C t�(L. / t 51 S D2 D INNW or ?m 9231 wri,oM OF M.'NMCRI 'z NAVR LEWL-- fLm-88,29 MOF I/4/98-85.10 GRLONR B01i0M OF 95d m a 80,10 ORLOW "12�70 PIN& Com fOOafmK-fOFafm Af INLET-99B6Af OUlff - 9991 NSR oP AT &V - 9932 Af 0111LCf - 99.1 ALASSA WATER AND WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SURE 2B. ANCHORAGE. AK. 99504 PHONE: (907) 337-6179/FAX: (907) 338-3246 LEGAL DESCRIPTION: HILLSIDE PARK SUBDIVISION, LOT 2 TYPE OF WORK: AS -BUILT OF SEPTIC SYSTEM-- UPGRADE PREPARED FOR: PHONE NUMBER: WILLY AND ABBY HENSLEY 346-1802/273-9130 DATE: DRAWN BY: SCALE: PAGE: 3/3/99 A.C.G. 1 = 40' 2 OF 2 EXISTING 4 BEDROOM HOUSE F . .... * O P J ff A. Gare S 4 m ' • —7953 �0W1 ProfassiovIcy 00000�a MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW980466 Legal Description: HILLSIDE PARK PUD LT 2 Design Engineer: 0041 AK Water & Wastewater Consulta Owner Name: WILLY & ABBY HENSLEY kOrr-\ i` a-V� Date Issued: Dec 10, 1998 Expiration Date: Dec 10, 1999 Parcel ID: 015-122-49 Site Address: 007045 TREE TOP CIR Lot Size: 24662 SQ. FT. Owner Address: 7045 TREETOP CIR Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE , AK 99516-6829 This permit is for the construction of: 0 Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: I'm Date: 10 Date:12 _ Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 211 — Anchorage .- Alaska 99504 (907) 337-6179 — Fax (907) 338-3246 Consulting Engineers November 24, 1998 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic Design Upgrade for Lots 2, Hillside Park Subdivision To whom it may concern: The existing 4 bedroom house is served by a private septic system and a private well. The existing septic system will not pass an adequacy test and must be upgraded prior to the sale of the house. Comments regarding the proposed design are summarized as follows: 1. SOILS: Attached is a log which shows the soil profile, and the percolation test result. The soils below the organic layer are a SM material (soft silty sand) with some SP pockets and lenses to a depth of 14 feet (bottom of the test hole). Groundwater was encountered at 13 feet during the excavation of the test hole. After 14 days, the monitoring tubes in the test holes were checked and water was found to be at 11 feet. Given the close proximity of the test hole to the surcharged drainfield, it is possible that the "groundwater" is actually migrating wastewater. Regardless, we are going to assume it is groundwater. A percolation test was performed between the depth of 6.0 feet to 6.5 feet. The percolation rate was 9.4 minute/inch 2. TRENCH DESIGN: a. Percolation Rate: 9.4 minutes/inch b. Allowable Application Rate: 0.8 gallons/day/ft2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 750 ft2 f. Total Depth: 4.5 feet above groundwater elevation. g. Effective Depth: 4.5 feet h. Width: 5 feet (minimum) i. Minimum Length: 75 feet j Effective absorption area = 750 ft2 OK 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: As can be seen on the attached topography site plan, the existing trench is located in a swale. The lot slopes steeply downhill from the house to the existing/proposed trenches and then gradually rises to the north, where it peaks, and then steeply drops off to the south. Therefore, we are proposing to place the bottom of the new trench 4.5 feet above the groundwater elevation encountered. This should be conservative since it is certain that the groundwater table gradient drops towards the north (In short, it doesn't rise into the knob). I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have y questions, please contact me at 337-6179, or 244-9612. Thank you for your assistance. Sincerely, , M.S. LOT 3, BLOCK 2 GOLDEN HILLS S/D SEPTIC SYSTEM , PAGE 2 OF 2) LOT 1, HILLSIDE PARK I � \ EXISTII 4 BEDRC EXISTING SEP11C - HOUS SYSTEM I \ \ I �\ TRACK A, SE 1/4 OF SEG. 14, T12N, R3W ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 7320 E. CHESTER HEIGHTS CIRCLE, ANCHORAGE, AK 99504 PHONE: (907) 337-6179/FAX: (907) 338-3246 3L UESUKl1'IIUN: HILLSIDE PARK SUBDIVISION, LOT 2 E OF WORK: SITE PLAN PREPARED FOR: PHONE NUMBER: WILLY AND ABBY HENSLEY 346-1802/273-9130 11/23/98 ( A.C.G./J.L.M. 1 1 = 100' 1 1 OF 2 ..... .. ..... f e . :......ess:... CE 7953v LOT 4, BLOCK 1 I GOLDEN HILLS S/D PRIVATE WELL. AND SEPTIC \ ' NO ENCROACHMENTS I I � I SEPTIC SYSTEM , PAGE 2 OF 2) LOT 1, HILLSIDE PARK I � \ EXISTII 4 BEDRC EXISTING SEP11C - HOUS SYSTEM I \ \ I �\ TRACK A, SE 1/4 OF SEG. 14, T12N, R3W ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 7320 E. CHESTER HEIGHTS CIRCLE, ANCHORAGE, AK 99504 PHONE: (907) 337-6179/FAX: (907) 338-3246 3L UESUKl1'IIUN: HILLSIDE PARK SUBDIVISION, LOT 2 E OF WORK: SITE PLAN PREPARED FOR: PHONE NUMBER: WILLY AND ABBY HENSLEY 346-1802/273-9130 11/23/98 ( A.C.G./J.L.M. 1 1 = 100' 1 1 OF 2 ..... .. ..... f e . :......ess:... CE 7953v PROPOSED DRAINFIELD- (SEE NOTE FOR DEPTH) 5' WIDE BY 75' LONG. ADD 4' OF CLEAN, WASHED SEWER DRAINROCK. TRENCH IS TO BE CURVED TO SLOPE CONTOURS. EXSIIING TRENCH TO BE ABANDONED COMPLETELY. EXISTING SEPTIC TANK TO BE ABANDONED COMPLETELY FSr EXISTING 4 BEDROOM HOUSE NOTES: 1) TRENCH DEPTH TO BE ESTABLISHED DURING PRE SITE VISIT WITH ENGINEER. -CONSTRUCTION PA (5� TRENCH DEPTH ELEVATION WILL BE 4.5 FEET' <v ABOVE GROUNDWATER ELEVATION. �4r 2) THE CONTRACTOR SHALL. HAVE THE EAST \ PROPERTY LINE FLAGGED PRIOR TO THE PRE- \ �4 � \ CONSTRUCTION SITE VISIT BY A REGISTERED ` \ LAND SURVEYOR. VA ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 7320 E. CHESTER HEIGHTS CIRCLE, ANCHORAGE. AK 99504 PHONE: (907) 337-6179/FAX: (907) 338-3246 HILLSIDE PARK SUBDIVISION, LOT 2, OF WORK: DESIGN OF SEPTIC SYSTEM UPGRADE PREPARED FOR: PHONE NUMBER: WILLY AND ABBY HENSLEY 346-1802/273-9130 11/23/98 I J.L.M./A.C.G. I 1= 40' I 2 OF 2 i C EpTIC AREA INSTALL DBL CO PROPOSED 1250 GALLON SEPTIC TANK LINE LOCATION) KEY BOX �F . ...:... e r y A. Garness; C 7953 eA� cid Qa�ed pro f 4wv'_ , low Owl, owl vZXI 1,,xZ, NMI, U."Maw ISM SO -9.AOM- M 1 - SWAIN �Wffl- p, SIM ALASKA WATER & WASTEWATER CONSULTANTS, INC. 7320PHONE (907) 337-6179 CIRCLE FAX (907) 338 9504 3246 G FS-01L LOG - PERCOLATION TEST �G� LEGAL DESCRIPTION: HILLSIDE PARK SUBDIVISION, LOT 2 PERFORMED FOR: WILLY AND ABBY HENSLEY DATE PERFORMED: 11/2/98 rk j MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME Q j NEW ❑ PGRADE MAI LI NG ADDRESS 4f� "ISO LEGAL DESCRIPTION ^^ LOCATIOPd NO. OF BEDROOMS VY DISTANCE TO: Absorption�e Dwelling/ 2 PER az W Manufacturer n MateriaC�ry{ No. of compar ents rn Liq� a it in gallons IF HOMEMADE: Inside length Width ^—+ !� _. Liquid dept 0 C7z DISTANCE TO: Well Dwelling PERMIT NO. 2 F Manufacturer Material Liquid capacity in gallons O w = DISTANCE TO: We Foundation J Nearest lot line ( Y_�! PERMIT NO. J LL z z w No. of line Length o ea h line ( Total lent of lines r .Trench wh inches Distance betwe�ryli N �.. 0 Top of tile to finish grade Material beneath tile inches Total effe ive a orption area w Length Width Depth PERMIT NO. C7 Q F wa Type of crib Crib diameter Crib depth Total effective absorption area wWell W DISTANCE TO: Building foundation Nearest lot line J J Class Depth Driller Distance to lot line PERMIT NO. W i� DISTANCE TO: Building foundation Sewer line Septic tank Absorption areals) d�. OTHER PIPE MATERI#LS� A SOIL TEST RATING AJ dr INSTALLER/ iceREMARKS I APPROVED ��r e.p�,�, A� ��0 DATE LEGAL 19-/ 1( t/k/ m u " i nz-- i F=" " L_ i -r y #D F= r-.# oz_= i --i # -# f;F - " ir-3 - /,:�, E:7 DEPARTMENT � HEALTH AND ENVIRONMENTAL- ) ITECT ION 825 `L STREET, ANCHORAGE., AK'. 9`+,_••.:+11 264-4720 PERMIT NO. 810523. 16 APPLICANT CHUCK HADDY NEW WORLD I PO BOX 10-1314 99511 345-3854 LOCATION TREETOP CIRCI-E LEGAL L2 HILLSIDE PARK LOT SIZE 43.'500 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS 4 SOIL RATING (SQ FT,,'BR)= 125 LD L.-) THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: r -s EF F -u 7'"~= -1 :2 1 E7 t-41:3 -r-"== --U;2 9_3 F- I ED, EF F' *7 F -1 -.— THE -1 --- THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIEL.D. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET), THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). P.* ET CA 13 1 Fico FE C.- _"EF EE F' ...8._. T iZ- -IF n r4 P-. "H. 1 .0 E= ::L.=-"v5PZl CiF:41L PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. - C A U I R c»F= 97-.- "T* 3: #7_1 r-4 -0-7- R e I -"EF- _r [A I IZI C. ;2- 1 r -A �_-.F F� F F= Fi BACKFIL.LING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SiTE SEWAGE DISPOSAL SYSTEM Is 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. C.-EEl::-F=rlE�F=FZ I .S K 01:3 -1 I CERTIFY THAT 1: 1 AM FAMILIAR WITH THE REQUIREMENTS FOR ON --SITE SEWERS AND WELL.S AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ,3: 1 UNDERSTANDAFT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS -RE 4orDIVED TO INCLUDV MORE THAN 4 BEDROOMS. SIGNED: --- ------ --- - --------- _70" NE41R�L_ LICANT HU", HA.DY NEW _RLD INC V4. 0 ISSUED BY t . MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6.660, Anchorage, Alaska 99602 276-2221 SOILS LOG - PERCOLATION TEST 2' SOILS LOG PERCOLATION TEST PERFORMED FOR: /lg=�K/ Llagla ®°. /A/C . DATE PERFORMED: 5-//214fl c7x/® LEGAL DESCRIPTION: 1-07- Z 61141- S/Oso' A>A.eik ✓• 0, SLOPE SITE PLAN (FE TH. FT I _>-- —T—F—I—I--�----', 1 2 3�° ,4 5 � 6/ZAvez4 y 5_/47- 7 Gross Time Net Depth to Time Water Net Drop { 8_ 9 10- 11 Q - 12 13- 14 Obi Q t o t •pd 15- 5 16 16 17 rdsr sx .14140" 61Z46/EL.Gy 5,AA1/0i sg� .SA"C145)x C7%C/Q!/EG __ r w -,,;PW cG Ay WAS GROUND WATER S � _� ENCOUNTERED? &a Lj I 18 T ., ° 0 4 r, � 6 �0• a a°°emvx °ow°m aa• 19 Earl R. Barnard 9 J� 20 ®® °° 754-E COMMENTS P j:: E IF YES, AT WHAT -- ------ DEPTH? _ j _ _ _DEPTH? Reading Date Gross Time Net Depth to Time Water Net Drop S-, Z/.* Z. Zai I r / /Oow d-/ PERCOLATION RATE 4-5,® (minutes/inch) TEST RUN BETWEEN L__. FT AND A#in FT PERFORMED BY: h0;411P/Q}0" .3flTE.S CERTIFIED BY: 72-008 (7/76) 4CC.. wmd..< vs&z�,. DATE: S1/Zlkf Municipality of Anchorage On -Site Water & Wastewater Program14 (907)343-7904 n Ve C5S>^CA- CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 015-122-49 Expiration Date: 7 Z3- 1. GENERAL INFORMATION Complete legal description HILLSIDE PARK S/D• LOT 2 Location (site address) Current Property owner(s) Mailing address Real Estate Agent 7045 TREETOP CIRCLE ANCHORAGE, AK, 99507 TONY & CHARLENE VICARI Day phone 771-895 7045 TREETOP CIRCLE, ANCHORAGE, AK, 99507 DAR WALDEN W/ KELLER WILLIAMS Day phone 2. TYPE OF DWELLING: N Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: 865-6406 TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class A Well 0 Community On-site ❑ Public Water System ❑ Public Sewer ❑ Received by: Z Date: a., COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee Date of Payment Receipt Number COSA 0 —7 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, t verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK, 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineers Comments: In conducting this evaluation, GEG, Lb). attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSO Guidelines & Regulations. The reported results described 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 soils condition, groundwater 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 the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will if confer any legal right whatsoever. 6. DSD SIGNATURE L'� System #1 Approved for —lil— bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. 337-6179 Date �l°�3 H v��d r f r A. Gar ess. QOy. CE -79 ev0 4004 pro fessloo�\ bedrooms, with the following stipulations: ON-SITE WATER AND TcIAtATFR VVAa 1 """, •-• • Original Certificate Date: //7' ' l The MuunicipMty or Anchorage Develop,emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the represenatations 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. ATTCHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev. 11105) If more than 1 septic system is on the lot: COSA Checklist # _of_ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: HILLSIDE PARK S/D; LOT 2. Parcel ID: 015-122-49 A. WELL DATA Well type COMMUNITY Date completed Total depth ft. IG B, or C provide PWSID# 212461 Well Log (Y/N)- Sanitary seal (Y/N)_ Wires properly protected Cased to ft. Casing height (abo n FROM WELL LOG Date of test Static water level ft. Well production g.p.m. WATER SAMPLE RES Coliform colonies/100 ml. Nitrate mg./L. AT Collected by: ft. in. Vinic: ug./L. Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 2/19-24/1999 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 5/20/2013 Pumper A+ HOME SERVICES C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE Date installed 2/19-24/1999 Soil rating .p.d./ r ft2/bdrm) 0_8 System type WIDE TRENCH Length 80 ft. Width 5 ft. Gravel below pipe 4.14 ft. Total depth *7.8+ ft. Eff. absorption area 800 ft' Monitoring tube YES Depression over field NO Date of adequacy test 7/23/2011 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test DRY in. Water added 1 180 gal. New depth 3 in. Elapsed Time: 68 min. Final fluid depth DRY in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date NOTE: DRAINFIELD WAS DRY WHEN INSPECTED ON 6/7/2013 D. LIFT STATION Date installed Size in gallons Manhole/Access "Pump on" level at in. "Pump off' level E. SEPARATION DISTANCES level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on Public sewer main Sewer /septic service COMMUNITY WELL On adjacent On adjacent lots manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 2 o& + Nr> Lek 4-A CX-= 4 p P -k V-4 G SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ PUBLIC/100'+ PRIVATE F. COMMENTS G. ENGINEER'S CERTIFICATION P OF. - 1 certify that l have determined through field inspections and 4 review of Municipal records that the above systems are in "'' ' ' ' • • •' • "' • conformance with MOA COSA guidelines in effect on this date. Q . .J f A. mess;' Engineer's Printed Name JEFFREY A. GARNESS Qpo4� C 9 3 .•'.o Date b/I vJ13 pQ°reap �.I.Q I•�Q\�c°v 0 _rofesslon o0 (Rev. 11105) Municipality of Anchorage i� Develop ent Services Department 1161" JBuilding Safety Division `` On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 VJY�JJ.m i�ni.Orgi�r'iSi ie (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-122-49 COSA# C)_C2 C) 1. GENERAL INFORMATION Expiration Date: Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address HILLSIDE PARK SUBDIVISION LOT 2 7045 TREE TOP DRIVE *ANCHORAGE AK 99516 CRAIG & BARBARA DOTSON Day phone 7045 TREETOP DRIVE *ANCHORAGE AK 99516 Day phone 346-6228 BETHANY MEHNER—WEISNER W/ PRUDENTIAL Day phone 762-3111 3801 CENTERPOINT DRIVE #200 *ANCHORAGE, AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class A Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF !NS!IECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, i verr',y 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/bor wastewater disposal system lc /are) safe functional and adequate. for the number of bedrooms and type of structure indicated herein. l further verify that based on the ii"iforn-Cation obtained from a ie 0 inicialii of nnchora^ e 4770 d ;F rn ' investigation and ins eot;on the N Y g C� and ,�C,�, � ,� y,, p,..,.. on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name Engineer's Comments: JEFFREY A. GARNESS, P.E. In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described 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 soils condition, groundwater 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 the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the, system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE r Approved for bedrooms. Disapproved. Phone 337-6179 Date 15 11 Conditional approval for bedrooms, with the following stipulations: Attace Ei nerlts: C OSA Checklist Septic System Advisory Well Flow Advisory Nlitlrate Advisory AI.rcanic ,Advisoif Maintenance Agreements Supplemental Engineer's Report Other � F �6N 9 d yQ *� a uarner>s.° �— 95 ofesslo�—, By:Original Certificate Date: (Rev. 11 %05) Municipality of Anchorage Development Services Department Building Safety Division o.: f.T.,.. On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: HILLSIDE PARK SUBDOVISION LOT 2 Parcel ID: 015-122-49 A. WELL DATA Well type COMMUNITY Date completed Total depth ft. Date of test Static water level Well production COMMUNITY WATER If A, B, or C provide PWSID# 212461 Well Log (Y/N) Sanitary seal (Y/N) Wires properly protected (Y/N' Cased to ft. Casing height (above round) FROM WELL LOG ft. fIM g.p.m. g.p.m. WATER SAMPLE RESU Coliform colonies/100 ml. Nitrate mg./L. A ic: ug./L. Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Tank size 1250 gal. Number of Compartments 2 Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO Date of pumping 7/28/11 Pumper C. ABSORPTION FIELD DATA IMBELOW EXISTING GRADE Date installed 2/99 Soil rating (g.p.d./Wo 2/bdr 0.8 System type SHALLOW TRENCH Length 80 ft. Width 5 ft. Gravel below pipe 4.14 ft. Total depth *7.83 ft. Eff. absorption area 800 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 7/23/11 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 1180 gal. New depth 3 in. Elapsed Time: 68 min. Final fluid depth 0 in. Any rejuvenation treatment (past 12 mo.) (Y/N & type) _ Collected by: Date installed 2/99 Cleanouts (Y/N) YES High water alarm (Y/N) N/A A+ HOME SERVICES in. Absorption rate >= 600+ g.p.d. NONE KNOWN If yes, give date — Dim 4IA9&-tf_1%II*)k,I Date installed Size in gallons Manhole/Access WN "Pump on" level at in. "Pump off' level High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service line nment areas COMMUNITY WATER On adjacent On adjacent lots manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 200'+ PUBLIC/100'+ PVT. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ PUBLIC/100'+ PVT. F. COMMENTS G. ENGINEER'S CERTIFICATION I 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. Engineer's Printed Name JEFFREY A. GARNESS Date $� It COSA Fee I Date of Payment g l! Receipt Number ®g71 -Z_7 (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number �� F • A q�a4 f re A. Garnes � 9 • mG e c -rof ession�oo qw Comm >,mm smwa HIwIT MUM Ma UWA sOt MLON6 M1aAb1 Km IYNMIr 09MOCK LOT i $69' 59' OO'E 110.00' O, N N W b 0 8 N LOT 3 UNDER NO CIRCUMSTANCES SHOULD AN AS -BUILT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE UNES. THE SURVEYOR TAKES RESPONSIBILITY FOR TfIE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL LIABILITY ONLY FOR THE COST OF THE SURVEY. LISTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCALE. LOT SAWY SURVEY TYPE ftum Im AS—VU&T FINAL i7RIICI= AS -WILT PWT ftm ... AS -MILT ... LOT sww%'Y ... TOPOQRAPHY IT IS THE RESPONSIBILITY Of THE 13UILDER OR OWNER, PRIOR TO CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE TO FINISHED GRADE AND UTIUTY CONNECTIONS AND TO DETERMINE THE ENSTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS WHICH 00 NOT APPEAR ON THE RECOROED SUBDIVISION PLAT. SURVEY CERTIFICATION .�r�rTi1•>1�� PLOT PLAN••'`` 1OF I ISow"7 O,go I.M.M PbMM1YY �L.M)•• �,[ �.,...•..us...••••. ,. IMM /.WN .f rhYWM 11 J M 1 o W " � '• •q 1MMM a YMWpp11��I1 N� N oww" sf .,M }� rN IMAIIMr NII N.w,L.� •MMI �! AV Y •. FOUNDATION AS-6UL1 �•• •• •• •••••� 4 Nwn C IOIMM +r Mrlly aNt 1 1 bM MArW M AYaMN M W .� I.o,M ni uu,umu..M a•.� 1�NYWM M wN IMI MM MMI a 0. —*"mi d uwi.Mtiw.. r1IM0 low. E w AM wI,MMdMMrIM wq FNM. I� P .,M,».a.... j.�: FINAL SWJCTYK AS-SUILT VAN. 4121—S •' + 4 A,6rI c At�r,M, + Iver arab YMI I OWNS IMM �rilm.o O M-a.n .inn u 1br : °O p'•••• •••••'• poi • of 4600wi M w 6f Md Nw o m a,�:'"w. wi,M� " am wow 'w,1 `O va iwnoA �.�.• 1,... MYWMUM. e�>rnTr�� SET MAR irp =r DRAINAGE ASPHALT O FOUND REBAR 0.st- 0 WOOD FENCE ": CONCRETE ASSUMED ELEV. *+-*—* METAL FENCE WOW DECK ONLY THOSE IMPROVEMP06 ABOVE GROUND AND VISIBLE WILL BE SHOWN. FENCES, WELL8.1 SEPTIC CLEAHOUTS. SIDEWALKS, DRIVEWAYS. ETC.. ARB SHOWN IN THEIR APPROXIMATE LOCATION. ONLY. SNOW MAY PREVENT SOME INPIPOVEMENTS FROM BEING SEEN AND LOCATED. ALL DISTANCES ARE1• RECORD UNLESS OTHERWISE NOTED. :Prepared by Robert E. Johns, Jr. & Assoc. Professional Land Surveyors 000 Brink Grim + ANCHORAGE, ALASKA 99504 Sods: 1„ = 401 Rte. Lot S.F. Roc. Plot MIS Nt. Dots $urvepet 08/03/11 °raven by REJ hael`"d 9WL Dat* Draw 08/03/11 0,101`SW25391M0' 11-247 HILLSIDE PARK PUD LOT 2 MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 015-122-49 HAA # �-A(1g91L l 1. GENERAL INFORMATION Complete legal description Lot 2; Hillside Park Subdivision Location (site address or directions) 7045 Tree Top Circle Anchorage, AK Property owner Will & Abby Hensley Day phone �46-1802 Mailing address 7045 Tree Top Circle Anchorage, AK 99516 Lending agency Mailing address. Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well Community well xx Public water Day phone Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site xx Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compllpnce with all Municipal and State codes, ordinances, and regulations in effect on the date of thi inspection. Name of Firm Address Engineer's signature Alaska Water i r�'V Wastewater Consultants Inc` r Shall be PAID alit, z or prior to, closing for the Engineering Services Provided. 6. DHHS SIGNATURE _ V Approved for �UZ bedrooms. Disapproved. Conditional approval for Additional Comments By: :11Rr: Phone 33 7 - 6 77 Date 3 bedrooms, with the following stipulations: Date - Is .92 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-M (P�• 1/91) Back MOA 021 L Lj Municipality of Anchorage APR o5 DEPARTMENT OF HEALTH & HUMAN SERVICES MUNIQPAuiYo�A Environmental Services Division ENy1RQNMENig4SER 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Qui Health Authority Approval Checklist Legal Description: Ze-71- a , �s/U� Park Parcel I.D.: 615 -122- A. WELL DATA Well type If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed Total depth Cased to Casing heigh ove ground) Sanitary seal (Y/N) Wires perly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test Static water level Well production g.p.m. g•p•m• WATER SAMPLE LTS: Coliform Nitrate Other bacteria to of sample: Collected by: B. SEPTIC/HOLDING TANK DATA �� U Date installed9/ "9 Tank size 1t3150 Number of Compartments oZ Cleanouts (6)N) Foundation cleanout �Y)N)-e. Depression (Y(1�}1 High water alarm (Y l�G 0 Date of Pumping _ Pumper C. ABSORPTION FIELD DATA/ - Date installed 4q Soil rating (g.p.d./ft2 or ft2/bdrm) do System type J, a) bene- I Length 80 Width Jr Gravel thickness below pipe Gi• 141 Total de th %- O Effective absorption area 00 Monitoring Tube presentY/) Depression over field (Y&j N Date o test Results (Pass/Fail) For bedrooms Fluid depth in absorption field before tes I e y after_ gal. water added (in.): Fluid depth (ins) Minutes Absorption rate = g.p.d. Peroxide treatment 2 months) (Y/N) If yes, give date 72-026 ( ev. 3/96)" D. LIFT STATION Date installed Manhole/Access (Y/N) High water alar el at* tested E. SEPARATION DISTANCES "Pump on" level at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main service line gallons lots "Pump off" level at* _ On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation 5 4- Property line /Q f Absorption field /r7 r , / Water main/service line (:95 -F- Surface water/drainage /Do Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line g) Building foundation /D f Water main/service line a 5 Surface water /00 /-1-- Driveway, parking/vehicle storage area 50 ff Curtain drain fior2- tn0 W (t Wells on adjacent lots /00 +- F. F. ENGINEER'S l certify that 1 ave)d%rnip'eru fi�ld inspections and review of Municipal in conform ce with = H guide hes in effect on this date. Signature ul �%- 7 Enginee7;7W*Q '4. Greg Date HAA Fee $ -3 V7Z5% ' CM Waiver Fee $ Date of Payment `T � Date of Payment Receipt Number % S% �Z ZJReceipt Number 72-026 (Rev. 3/96)* 117 OF A a F't'i are