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HomeMy WebLinkAboutHERITAGE HEIGHTS LT 6H eritage Heights Lot 6 #015-361-22 Municipality of Anchorage Community Development Department Page 1 of 3 Onsite Water & Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http:/Avww.muni.org/onsite • (907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP 141391 PID Number: 015-361-22 ❑ New ®Upgrade Name: ALAN JACKSON NORTH/SOUTH ABSORPTION FIELD D ❑ Deep Trench AShallow Trench ❑ Bed ❑ Mound Address: 6000 YUKON RD, ANCHORAGE, AK, 99507 ❑ Other Phone: No. of Bedrooms: Soil Rating: Total Depth from original grade: (907) 349-6379 5 1.2 GPD/Sq. Ft. 6.0/7.0 MAX Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade: SEE DWG. F Gravel depth beneath pipe: 4.04-/4474Ft. Subdivision: Block: Lot: HERITAGE HEIGHTS — 6 FII added above original grade: Gravel length: SEE DWG. 35/3 � TOTAL) Ft. Ft. Township: Range: Section: Gravel width: Beds Number of ea. ante n lines: Ft. SEPARATION DISTANCES Total sorytion area: '' L, GS umber of tranches: 2 Dist. between trenehee: 10+ TO Septic Absorption Lift Holding Public/Private Private From Tank Field Station Tank Sewer tines <D, Ft Well N/A N/A N/A - N/A TA Se ® .T. E.P. ❑Hoclin El Other Manufacturer. Capacity: Surface Water 100'+ 100'+ 100'+ — ANCHORAGE TANK 2000 Cal. Lot Line 5'+ 10'+ ,o'+ - N/A Mutenal: STEEL Number of compartments: 2 Foundation 5'+ 10'+ 10'+ - LIFT STATION Curtain Drain NONE KNOWN Manufacturer: Capacity: ANCHORAGE TANK/ORENCO 2000 cal. Remarks: "Pump on' level at: 39 ''f�TANK "Pump off" level at: - 39 High water alarm at: -*r 45 OLD WAS ABANDONED IN PLACE, PER UPC. PER CONTRACTOR Pump Make & Model: PF -20-05 Electrical Inspections performed by: M.O.A. -sF"i 3 (r Giir �'^i-6'...�r c.. (.t,;•c. r'- t—�'_tk,d'✓�x r ' eco- PIPE MATERIAL SCH 40 House to tank EXISTING Tank to D2665 drainfield Installer A+ HOME SERVICES Drainfield D2665 CO/MT D3034 Inspector GEG, Ltd. BENCH MARK (Assumed elevation) 95.08 Ft, Inspection Dates: 1st 10/9/2014 2nd 11/5/2014 Location and Description: CONCRETE SLAB OF LANDING FROM DECK 3rd 11/6/2014 4th 11/7/2014 ON WEST SIDE OF HOUSE, NEAR POINT 'A' Community Development Department Approval ENOINOWS SEAL 006000 q Conditional approval: Date: Qo P �...... a..j........ .............. � 0 i .. po . f r A. Gar ess;' Approved- pproved Date: ...5 A d Pma of ssion ��0000�n L— Inepectian Report'. -1— 12.doc PERMIT NUMBER: AS -BUILT DRAWING PARCEL ID NUMBER: OSP 141391015-361-22 i i i WATER MAID i YUKON DRIVE ASSUMED LOCATION OF KEYBOX. SEE AWWU CONNECT CARD. I I � I � I i I I I I 1 I I I I _ _ J 1 HERITAGE HEIGHTS S/D: LOT 7 1 14 V SrRUCr�N .. Id I a I' p 4 1 � a 'I dp, URIVEpWAY f p L a PER CONTRACTOR (A+ HOME SERVICES) INTERIOR ALARM WAS INSTALLED. OJSE l00 580 -41K, `✓x\�j\�O NIFW I MT3 L L___ JO MT4 7H#2 I I 0 ft ° MH ST2 I � I I NEW 2000 N GALLON STEP TANK EXISTING TRENCH CONNECTED AS RESERVE SITE. EXACT LOCATION UNKNOWN. LETTERS OF NON -OBJECTION ON FILE AT MOA CRESTWOOD S/D; LOT 3 GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS re., - ._ PREPARED FOR: ALANJACKSON LEGAL DESCRIPTION: HERITAGE HEIGHTS S/D; LOT 6 TYPE OF WORK: AS -BUILT OF SEPTIC UPGRADE PHONE NUMBER: PAGE NUMBER: ( 907) 349-6379 2 OF 3 DRAWN BY; A.J.G. DATE: 11/18/2014 I I I I I 'I DRY ON 4 I I I I I I I I I im e- ey A. Gamess -79 2 . i 1 IYs !!#•' • F�'i pR�FESS���.♦♦ i I / I I I I I I I A B C ST1 45.85 19.68 - ST2 56.74 31.17 - MH 58.80 32.55 - MTI - 54.39 1927 MT2 - 23.30 36.54 MT3 - 21.27 53.54 MT4 - 47.31 78.69 I OJSE l00 580 -41K, `✓x\�j\�O NIFW I MT3 L L___ JO MT4 7H#2 I I 0 ft ° MH ST2 I � I I NEW 2000 N GALLON STEP TANK EXISTING TRENCH CONNECTED AS RESERVE SITE. EXACT LOCATION UNKNOWN. LETTERS OF NON -OBJECTION ON FILE AT MOA CRESTWOOD S/D; LOT 3 GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS re., - ._ PREPARED FOR: ALANJACKSON LEGAL DESCRIPTION: HERITAGE HEIGHTS S/D; LOT 6 TYPE OF WORK: AS -BUILT OF SEPTIC UPGRADE PHONE NUMBER: PAGE NUMBER: ( 907) 349-6379 2 OF 3 DRAWN BY; A.J.G. DATE: 11/18/2014 I I I I I 'I DRY ON 4 I I I I I I I I I im e- ey A. Gamess -79 2 . i 1 IYs !!#•' • F�'i pR�FESS���.♦♦ i I / / I I NOTE: CUTBANK LOCATION I SHOWN ON DESIGN DRAWING I ) WAS APPROXIMATE. 30' SEPARATION TO NORTHWEST Z z DRAINFIELD WAS CONFIRMED DURING CONSTRUCTION. w w I I MT1 > NEW 35'TRENCH I > J I o b l 1 i OJSE l00 580 -41K, `✓x\�j\�O NIFW I MT3 L L___ JO MT4 7H#2 I I 0 ft ° MH ST2 I � I I NEW 2000 N GALLON STEP TANK EXISTING TRENCH CONNECTED AS RESERVE SITE. EXACT LOCATION UNKNOWN. LETTERS OF NON -OBJECTION ON FILE AT MOA CRESTWOOD S/D; LOT 3 GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS re., - ._ PREPARED FOR: ALANJACKSON LEGAL DESCRIPTION: HERITAGE HEIGHTS S/D; LOT 6 TYPE OF WORK: AS -BUILT OF SEPTIC UPGRADE PHONE NUMBER: PAGE NUMBER: ( 907) 349-6379 2 OF 3 DRAWN BY; A.J.G. DATE: 11/18/2014 I I I I I 'I DRY ON 4 I I I I I I I I I im e- ey A. Gamess -79 2 . i 1 IYs !!#•' • F�'i pR�FESS���.♦♦ PERMIT NUMBER: PARCEL ID NUMBER: OSP141391 AS -BUILT DRAWING 015-361-22 TH#2 FINAL GRADE = 94 44-94.72 ST1 ST2 MH -\ TOP OF TANK AT INLET= 88.76 \ (I NEW 2000 GALLON INVERTOFBUNG 1 S.T.E.P. TANK AT INLET = 88.13 (6' BURIAL RATING) SOUTH TRENCH FINAL GRADE = 99J9 99.92 FILTER FABRIC RELATIVE ELEVATION OF BOTTOM OF TESTHOLE = B4.26 (DRY) -: i, L GRADE AT HIGHEST POINT = 9926— 2" INSULATION ON WEST HALF OF TRENCH INVERT OF PIPE = 96.30 — BOTTOM OF TRENCH =92.26 10'+ PRESSURE DISTRIBUTION LINES ARE 1.25" SCH 40 PVC W13116' HOLES SPACED 24" O.C. - TOP OF TANK AT OUTLET = 88.81 NORTH TRENCH MT FINAL GRADE 100.47-1 WJt r ORIGINAL GRADE AT f HIGHEST POINT =9945 r/ TH#1 FI TLTEEFAINSUTAB OIN RELATIVE ELEVATION OF BUT TOM OF TESTHOLE = 85A5 (DRY) ii GARNESS ENGINEERING GROUP, Ltd -- - CIVIL & ENVIRONMENTAL ENGINEERS• 3701E. TNEOR ROAO, NUIE101'ANCHORPOE.MNNN-PHONEPC7)3319118'FAXNN7)3M3206- WEBSITE: xww.gamrsxlgmrenng com , �•••• PREPARED FOR: ALAN JACKSON PHONE NUMBER: ( 907) 349-6379 PAGE NUMBER: 3 OF 3 LEGAL DESCRIPTION: HERITAGE HEIGHTS S/D; LOT 6 DRAWN BY: A.J.G. �♦C TYPE OF WORK: DATE: � PROFILE AS BUILT OF SEPTIC UPGRADE 11/18/2014 7 >f ff IT Print I Close Permit #: RETROE141633 Type: Site Location: Primary Applicant: Issue date: Legal Occupancy: Description of work: Milestone: Dynam!cPORTAL Building Permit Report Created by CAPSTONE ELECTRIC, LLC* Retrofit - Electrical, Mechanical or Plumbing 5000 YUKON RD Anchorage, AK 99507 CAPSTONE ELECTRIC, LLC* 11/18/2014 Residential Retrofit Installing power and controls for lift station. Inspections 11/20/14, 11:20 AM Item Description Status Verify Inspection(s) Complete Successful Inspections Inspection # Description Requested Date Schedule Date Completion Date Status 333021 Electrical Inspection 11/19/2014 11/19/2014 11/19/2014 Approved Fees Description Total Unpaid Status Paid Date Retrofit Permit Inspection Fee $150.00 $0.00 Paid 11/18/2014 Page 1 of 1 On -Site Wastewater Disposal System Permit Permit Number: OSP141391 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Tax Code Number: 01536122000 Work Type: Septic Upgrade Permit Effective Dates: September 24, 2014 to September 24, 2015 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: HERITAGE HEIGHTS Site Legal Address: HERITAGE HEIGHTS LT 6 G:2438 Owner/Address: JACKSON ALAN J & TINA R 6000 YUKON RD ANCHORAGE AK 995076664 Site Mailing Address: 6000 YUKON RD, Anchorage This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy Lot Size in Sq Ft: 21873 Total Bedrooms: 5 N Private Well N Water Storage // a o 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: The Inspection Report is to show the private water line. Received Issued By b Municipality of Anchorage Development Services Division On -Site Water and Wastewater Proaram went S, v epartment **** VARIANCE/WAIVER REVIEW **** Waiver#: OSP141392 COSA#: Permit#:OSP141391 PID#: 015-361-22 Legal Description: Heritage Heights Lot 6 Engineer: Garness Engineering Group Applicant: Alan Jackson Your request for a waiver of the required 50 feet horizontal separation from the absorption field to the excessive slope has been approved. The approved separation distance is 30.0 feet. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances 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. ................................................•.............................1 Waiver is Granted: X Waiver is not Granted: Date: 9 /-Z- L / Approved by: Name of Reviewe ..................................... 0..................... ........ a......... **** VARIANCEMAIVER REVIEW **** MUNICIPALITY OF ANCHORAGE Community Development Department Development Services On -Site Water & Wastewater Program Mayor Dan Sullivan On -Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 015-361-22 Property owner(s) ALAN JACKSON Mailing address 6000 YUKON, ANCHORAGE, AK, 99507 Site address 6000 YUKON, ANCHORAGE, AK, 99507 Legal description (Sub'd, Block & Lot ) HERITAGE HEIGHTS S/D LOT 6 Legal description (Township, Section & Range) Lot Size Phone: 907-343-7904 Fax: 907- 343-7997 Day phone (907) 349-6379 Sq.Ft. Number of Bedrooms 5 APPLICATION IS FOR: APPLICATION IS AN: ( all that apply) Initial ❑ Absorption Field Upgrade Septic Tank Holding ❑ Ren Alm Tank 4 MSpEanCW � PAID F-1 Private Well ❑ SEP 15 2014 Water Storage ❑ AMOUNT' $ THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: TYPE OF DEWELLING: Single Family (SF) (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) DRAINFIELD TO 25%+ SLOPE Distance: 30 FEET I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: �21V' Waiver Fees: a15 . Date of Payment: Date of Payment: q1/5 -//y Receipt Number: 6(ggblpp� Receipt Number: O c)16-6 Permit No. 05VI`Waiver No. 05etg139z (Rev. 01/11) y_ uanic GARNESS ENGINEERING GROUP, Ltd�w - CME & ENVIRONMENTAL ENGINEERS - -- - September 12, 2014 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic System for Heritage Heights; Lot 6 To whom it may concern: The existing 5 bedroom house is served by a community well and a private septic system. The drainfield is in a state o'ffailure and needs to be upgraded. We are proposing to install a new dual 5 wide trench type drainfield, as well as a 1500 gallon septic tank and a 500 gallon lift station. One test hole was excavated on the property. The drainfields are to be designed around the 30 foot radius of this test hole. Comments regarding the design are summarized as follows: 1. SOILS: See the attached 2014 log which shows the soil classifications, groundwater monitoring, and the percolation test results. A sand filter is not proposed for this design because of the GM/ML (visually classified by GEG) soil from 8 to 14 feet. This insitu soil layer will serve as a filter for the downward migrating effluent. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: There are no surface water concerns. 4. TOPOGRAPHY: The average topography in the area of the proposed drainfields is relatively flat. However, there is a slope greater than 25% located 30 feet from the proposed drainfield. 5. SLOPE WAIVER: Due to site constraints, we are requesting a 30 foot waiver to slopes in excess of 25%. See attached topo drawing and profile drawing. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. bf"you have any questions, please contact us at 337-6179. Thank you for your assistance. SincereIly, Je roy�A. Galss, P.E., M.S. 3701 East Tudor Road, Suite 101 *Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com --------- i ---------� HERITAGE HERITAGE PREPARED FOR: HEIGHTS HEIGHTS PAGE NUMBER: LOT 19 LOT 20 907-349-6379 1 OF 3 ALL LOTS IN HERITAGE HEIGHTS SUBDIVISION ARE DRAWN BY: HERITAGE HEIGHTS S/D; LOT 6 SERVED BY COMMUNITY WATER WELL TYPE OF WORK: — -- -- - - - - - - - - - - ------------ 10'Elec Esmt Bk661 P 6 I HERITAGE HERITAGE I HEIGHTS HEIGHTS LOT 22 LOT 21 ----------- YUKON ROAD __ HERITAGE HEIGHTS LOT 4 IRMAIN ____________________ HERITAGE HEIGHTS LOT F-1 ---T 11 I I v CRESTWOOD S/D; LOT 4 HERITAGE HEIGHTS LOT 8 I I I I T HERITAGE HEIGHTS LOT 7 c�(G NOJ� I I I I I I I I I GPS ' I I P N I J I I HERITAGE HEIGHTS SID#1; LOT 26A 1"=1UC _______________ HERITAGE HEIGHTS S/D #1; LOT 2/A I I I I I I NOTE 2011 COSA\ PROPOSED APPROVED WELL ASA � DRAINFIELDS PRIVATE WELL \ I r \ I I I 100'WELL RADIUS I I I I I I \ r I I \ I I � --J L ------------- --------------- CRESTWOOD S/D; LOT 1 CRESTWOOD S/D; LOTS I CRESTWOOD S/C; LOT 1 I / I� SEPTIC SEPTIC ARE ARE / SEPTIC AREA I _ I II 100'WELL RADI US ) i II \) I 100, WELL RADIUS 100'WELL RADIUS LL______ I �I _—___—____- ---------------�-----------t---- BARRY AVEf)IiJE — ------ rt------------- \\ GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS ,+ - ]]01E.TI:GOR ROAD. SHITE 101ANCHORAGE.M99507' PHONE(90I)M}.179'lM-VEBSIiE:mwi,.Tmce ....nq.com PREPARED FOR: PHONENUMBER: PAGE NUMBER: ALAN JACKSON 907-349-6379 1 OF 3 LEGAL DESCRIPTION: DRAWN BY: HERITAGE HEIGHTS S/D; LOT 6 A.J.G. TYPE OF WORK: DATE: � SITE PLAN 9/8/2014 1... .. -ROFESSON o NUMBER OF BEDROOMS: 5 GALLONS PER DAY (GPD): 750 PERCOLATION RATE/S: <IMIN/IN PROPOSED APPLICATION RATE: 1.2 MINIMUM DRAINFIELD SQ.FT.: 625 FEET° MAXIMUM DEPTH OF EXCAVATION: 7 FEET WIDTH: 5 FEET MAX LENGTH: 35 & 30 FEET M.O.A. APPROVED SAND FILTER: N/A EFFECTIVE: 4 FEET REDUCTION FACTOR: 0.5 ACTUAL SQ.FT.: 650 FT' YUKON RD. 20' SLOPE CONSTRUCTION & MAINTENANCE ESMNT. PRESSURE SERVICE LINE SHALL BE 1.25" SCH 40 PVC WITH 3, HOLES SPACED 24" ON CENTER HERITAGE HEIGHTS LOT 4 NOTE:. CONTRACTOR SHALL HAVE THE EAST EASEMENT, NORTHEAST PROPERTY CORNER AND WATER SERVICE LINE PROFESSIONALLY LOCATED PRIOR TO CONSTRUCTION CO 1 LEETTER THAT FF -- _ . PERTAINS TO THIS DESIGN. NOTE: DESIGN CHANGE IS BASED UPON. TO OBTAIN A COPY OF THE LETTER BUYER'S REQUEST TO ACCOMMODATE CONTACT GEG. BY PROCEEDING FORWARD GARAGE BUILDING. GEG WITH THIS INSTALLATION, THE ENGINEER, POTENTIAL SHOP/GARAGE WELL DRILLER, CONTRACTOR AND HAS NOT REVIEWED A PLOT PLAN OR PROPERTY OWNER AGREE THAT THEY STRUCTURAL DESIGN DRAWING AND CANNOT HAVE READ THESE SPECIFICATIONS AND CONFIRM THE VIABILITY OF ANY FUTURE AGREE �m�HPnP1ANDnmmIM1 BUILDING PROJECT ON THE SUBJECT LOT. b I° l e.' DRIVEWAY IIdds s � ` APPROXIMATE LOCATION OF SLOPE I CUTBANK. GEG CONFIRMED 30'+ TO NEW DRAINFIELD DURING CONSTRUCTION.it w I � I o 30.35% HERITAGE HEIGHTS KEY LOT 7 DRAINFIELD. 35' LONG, 5' WIDE, 4'+ EFFECTIVE NopSE O0M OR 5 eE MTI TH#2 w � I of I / I PROPOSED DRAINFIELD. 30' LONG, 5' WIDE, 7' MAX DEPTH, 4' EFFECTIVE EXISTING DRAINFIELD TO BE CONNECTED IAS RESERVE SITE OLD TANK TO BE DECOMMISSIONED PER UPC 10' UNDERGROUND APPROXIMATE UTILITY ESMNT. -LOCATION OF OLD DRAINFIELD EXISTING FCO LETTERS OF NON -OBJECTION FROM UTILITY COMPANY ARE ON FILE WITH MOA. GARNESS ENGINEERING GROUP, Ltd . - CIVIL & ENVIRONMENTAL ENGINEERS 3701 E 3UWR RW, SURE 101 • ANCHORAGE M 99507 • PN NE (907) 3S/-5179 • FAX (90n 338-3]{8 • NE89lE: vw.00meex,w,xem PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ALAN JACKSON 907-349-6379 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: HERITAGE HEIGHTS; LOT 6 A.J.G. TYPE OF WORK: DATE: �_ DESIGN OF PROPOSED SEPTIC UPGRADE 10/23/2014 0 A. OF o,E.�aROPOES ENGINEERING GROUP, Ltd : X49' Gt�RNE5 CIVIL & ENVIRONMENTAL ENGINEERS _ i i IiE ,01'PNGHORAGE. AK F1950]' PHONE (90])33JA 1]9'F4S (90])3303246 WEB$iE mvry ga ng nconng com•• • i•..........f ............ PREPARED FOR: PHONE NUMBER. PAGE NUMBER: r fi ; •• e fey kGamess e ■ ALAN JACKSON ( 90n 349-6379 3 OF 3 ; i a CE -795 LEGAL DESCRIPTION: DRAWN BY: ♦ F .., 33II '; ` :� HERITAGE HEIGHTS S/D; LOT 6 A.J.G. �� �� •`•.kJ,;;,... TYPE OF WORK: DATE: 1%"f0FES": �- PROFILE DRAWING FOR SLOPE WAIVER REQUEST 9/12/2014 z Z w �Q J z w W Z_ O� N Y N E Z_ Z ~ J o 7 Up o� Z as O ao m OF o,E.�aROPOES ENGINEERING GROUP, Ltd : X49' Gt�RNE5 CIVIL & ENVIRONMENTAL ENGINEERS _ i i IiE ,01'PNGHORAGE. AK F1950]' PHONE (90])33JA 1]9'F4S (90])3303246 WEB$iE mvry ga ng nconng com•• • i•..........f ............ PREPARED FOR: PHONE NUMBER. PAGE NUMBER: r fi ; •• e fey kGamess e ■ ALAN JACKSON ( 90n 349-6379 3 OF 3 ; i a CE -795 LEGAL DESCRIPTION: DRAWN BY: ♦ F .., 33II '; ` :� HERITAGE HEIGHTS S/D; LOT 6 A.J.G. �� �� •`•.kJ,;;,... TYPE OF WORK: DATE: 1%"f0FES": �- PROFILE DRAWING FOR SLOPE WAIVER REQUEST 9/12/2014 i m Ea. :Ny �e+ fi! GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS . 3701 E NWR ROA0.9VITE 101 -AN CHO RA°E, AN 9007 -PHONE (PPS 9315179 -PAN (90/1 3963246' WE96RE'. w ge nong nee,"vom SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: HERITAGE HEIGHTS; LOT 6 PERFORMED FOR: ALLEN JACKSON DEPTH ORG (feet) 2 +•e SP/SM GW 10 11 GM/ML 12 13 14 B.O.H. 15 16 17 18 19 20 DATE: 08/29/2014 DEPTH TO GROUNDWATER TEST HOLE #1 DRY 08/29/2014 UPPER BENCH 09/05/2014 SOIL CLASSIFICATIONS `;`'o': GW ^ ORG :.::: arI GP 6 ML 3:52 - GM 6" CL 4 GC OL 6 SW 401 MH 6" SP 6 CH SM 6 OH 4:09 - SC 6" DEPTH TO GROUNDWATER DATE DRY 08/29/2014 DRY 09/05/2014 6" - 2 DATE READING CLOCK NET TIME TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 09/02/2014 1 3:45 - 6" - 2 3:51 6 DRY 6 3 3:52 - 6" - 4 3:59 7 DRY 6 5 401 6" 6 4:08 7 DRY 6 7 4:09 - 6" _ 8 4:16 7 DRY 6 9 4:17 - 6" 10 4:24 7 DRY 6 PERCOLATION RATE 1.17 (MIN./INCH) PERC. HOLE DIA. TEST RUN BETWEEN 2 FT. AND 3 FT. A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES ONO 6 (INCHES) SOILS LOGGED BY: ANDREW GRAY PERCOLATION TEST PERFORMED BY: DAVIDGARNESS COMMENTS: PERCOLATION READINGS ARE WITHIN 1116 OF INCH. PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: G GARNESS ENGINEERING GROUP, Ltd -- -- -- CIVIL & ENVIRONMENTAL ENGINEERS ... .. ._. 3101 E. TV WR ROAD, SUITE 101' ANCHOMpE AK..H]' PHONE (.7) 33'/11)9'. (BO'7) 33832J6' WEBSITE: wem'gamassenONeemgwm SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: HERITAGE HEIGHTS; LOT 6 PERFORMED FOR: ALLEN JACKSON DEPTHORG (feeU V2 SP/SM 9 10 11 12 13 14 15 16 17 18 19 20 GW GM/ML DATE: 08/29/2014 DEPTH TO GROUNDWATER TEST HOLE 41 DRY 08/29/2014 LOWER BENCH 09/05/2014 SOIL CLASSIFICATIONS GMMOH CL GCOL °o°D o SWMH ': �•• : SPCH SM SC DEPTH TO GROUNDWATER DATE DRY 08/29/2014 DRY 09/05/2014 Em DATE READING CTIME (MINUTES) LOCK � NET TIME I WATER READING LEVLL N NCDRO) 09/02/2014 1 ABSORBED 10" 2 TIMES IN <10 MIN; ABSORBED 6" 4 TIMES IN 4 MIN PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. TEST RUN BETWEEN 5 FT. AND 6 FT. A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES NO 6 (INCHES) SOILS LOGGED BY: ANDREW GRAY PERCOLATION TEST PERFORMED BY: DAVID GARNESS COMMENTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH. PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFOR ED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: i GOA GARNESS ENGINEERING GROUP, Ltd. = s CIVIL & ENVIRONMENTAL ENGINEERS= = �_ 3701 EWMRRp .SUITE 101'ANCHOR F,AKO 07'P E(OOT =Z1i0'FAx 100 M8348'WDSITE: ww.'gammxn8mee,i,q,wm ;....• SOIL LOG - PERCOLATION TEST # LEGAL DESCRIPTION: HERITAGE HEIGHTS: LOT 6 PERFORMED FOR: _ DEPTH —� (feeORGANICS q S' p0 D 1 ALLEN JACKSON 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 GW TO SW SAND & GRAVEL W/ SOME SILT PRESENT SM TO ML SILT & SAND W/SOME GRAVEL PRESENT 10/23/2014 TEST HOLE #2 SOIL CLASSIFICATIONS DEPTH TO DATE GROUNDWATER DRY 10/23/2014 DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MINUTES) READING (INCHES) 10/23/2014 AFTER ABSORBING 12" PRE-SOAK IN 7 MINUTES, PERK HOLE ABSORBED 6" OF WATER IN 5 MINUTES OR LESS, 3x. 19 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 4.5 FT. AND 5.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES ENO SOILS LOGGED BY: ANDREW GRAY PERCOLATION TEST PERFORMED BY: ANDREW GRAY COMMENTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH. PERFORMED BY GEG, Ltd. 1, JEFFREY A. GARNESS, CERTIFY THAT THIS WASP RFOMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: Z IIIIIIIII 111191 %//% � MEN • WAY���y�'.y' iY AY Il411�� • /VIZZ2I 7I/Y� DEPTH TO DATE GROUNDWATER DRY 10/23/2014 DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MINUTES) READING (INCHES) 10/23/2014 AFTER ABSORBING 12" PRE-SOAK IN 7 MINUTES, PERK HOLE ABSORBED 6" OF WATER IN 5 MINUTES OR LESS, 3x. 19 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 4.5 FT. AND 5.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES ENO SOILS LOGGED BY: ANDREW GRAY PERCOLATION TEST PERFORMED BY: ANDREW GRAY COMMENTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH. PERFORMED BY GEG, Ltd. 1, JEFFREY A. GARNESS, CERTIFY THAT THIS WASP RFOMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: Z Municipality of Anchorage DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION POUCH 6.650 ANCHORAGE, ALASKA 99501 REPORT ON ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL ,INSPECTION NAME D r �O 4 � LOCATION '72Y57 p< ADDRESS SO` Y �p� �� . LEGAL DESCRIPTION PERMIT NUMBER MATERIAL P- #OF COMPARTMENTS INSIDE DIMENSION S PHONE(S) DEPTH #OF BEDROOMS SEPTIC TANK TO ❑ TILE DRAINFIELD MANUFACTURER CAPACITY IN GALS. LENGTH EACH TOTAL LENGTH MATERIAL P- #OF COMPARTMENTS INSIDE DIMENSION DISTANCE BETWEEN LINES a LENGTH WIDTH DEPTH SEEPAGE SYSTEM TO ❑ TILE DRAINFIELD SEEPAGE NUMBER OF LINES LENGTH EACH TOTAL LENGTH FROM TANK SYSTEM DISTANCE BETWEEN LINES TRENCH WIDTH DEPTHS: TILE TO GRADE FILL BELOW TILE FILL ABOVE TILE WELL C?OSEEPAGE TRENCH OR ❑ PIT WIDTH 7 f r LENGTH d I DEPTH ` 7 ❑ LOG CRIB LIRINGS- DIA. FILL MATERIAL DEPTH EFFECTIVE ABSORPTION AREA TOTAL: /n� _ 5 _ SO FT. WELL CLASSIFICATION DEPTH PIPE MATERIAL INSTALLER REMARKS DATE./O,k- 7 APPROVED 4, 72-012 (9/77) DISTANCES TO SEPTIC SEEPAGE SEWER FROM TANK SYSTEM LINE CESSPOOL WELL WELL F I) LOT: BLOCK: SUBDIVISION: L,i I I I I d I 111-::. N 1 IJI I Fi I I H H N ut I HI F , I I-I.A... 1 .1. t N - D J, "'IA 1 NIJ. LWO q �yl I N 1-11 141"1 1 LLI I k -A Jr -I I L_% I E 1--:. 1 E:: !_, IJ N t.-.; I I. I -IN J I J N kJ `A.1 F- I lllF H I,:- A L) ee -7 WJ u_...... ?/a 717) Lj 1-:' A .1. NI I J. h- L I LI-,.-.rAkJ I F-1 U' J. Pl Im 1'. E L I j LJF I I I [ -1Y (L.;I . I HE 1 1 -1 L.: Fn 111— 1 1 14114:. .i F;. kj LI r FINI. L ! )L1- 1 1.1 I.J H U F. 1-3- N. FT-e'k,_ I N 11- i+_. kJO I 1- 1-11 A j I- !I: -- I 1 11"] OF L: FV -r, FI I J. I-jr-4 12.1 r f % I:-- I ? . If n" 11_ U J_ B-^` 0. ir .4 1k.-3 `k_: 17 ... R 0 Uo rl `-4, H—' 0 X 11, __ H II I r ... ........ ........ I fF—." H-9 R---' H II --w H--:4 11:=. I _.." 9 A. .. ......... ........ .... . ....... ...... I F"I Wi� 1::.' E .IN�'::- I I -IL I LL L.1 H I I I LE, LI I I f Uhl JBJ E(; I I J I fie. .1. 1 1 11-HN.LIVEL) ILl lhI I 111HY I FILA E% I.,". --1 Li H. In � -4 1 ' .1. F. H M P -I l. CA I N 1, 1 N UL.:. F -i t..: ir-j I I'll -1 J. N I Er-4-11"Al F-.. I _� PIES VD J'A I H I L:1. -IF.' : E N I '.rUkJ I "11.1ke E.'E. I kj I. L F.1 I k. F -j r --i F -i rd I ki I Y LJ I I M H "r, L.: L.. IJ I.—, J L. L; I I Ll HRU'.L.L.A.-I 1 11 IN. .... .. ...... . ..... . .. . ........ .......... ------ 11 C_ IF=. III -I". ff.j PA L.:.n. L. -A It .... fi 1. ....... .. ..... . E!n. HHI F- 1. L I J. N IJ LIF. 1-1 N Y _-Y'_-' I L I "I HLJIJ I F- .1. .7,1_ E L,' I I LIN HNI-) BY I F -I HL -s-4 I L.I.I. LA 1:::; 1.-`_:;1.141:14.11:: I I I I I F' F!. LI'D E., L.: u I I. tj rk I F I r.', k', I_ Im L. P F -I W L FIND FINIT, IJPd ..J.:L 1 1:- : L: U Ll I L E I I•Uk! ii I 'I e 1" FII E WI -A-E 01-e. 'a.,O�j 1-Lca 1 til I k, I HFI'I I I J. C: (j VT,.!:, I 1 .1. LIN . ". 11:::. I'A I C'11Ir I IJ 1. PA U I , I,--- PI LFII I'A IJ r F.. IIIL F-'-[,'. UN 'I I-. LII:' I I. -I EV'r, I F-11 U YA 1 U. J. F., F I L, .1. 1 ki F- F1 r.,t 1-1 u l." F -I G In. e, I I. -I L. L IIIk. _`,11-11 .1. 1•4 I. -Il L: I ... I I,, I.,:, 1 -1 r -,l (..: F% W .1. 1 1 -1 IHC UA J L." HI. -I I I E W 17.. 1 p I F -I Y I 1-.::, kA 0 11 F -I F-. F. In 1 0 L N 1-. .1. P1 IJ U' L.. I .D 11.1 .1. r -,I I L_ U L) In P1 g'I":- I HF -IN Z-) L., I 1_1 1e. U t", I'l �/7 1 C_ �Yomrc) ....... ..... .... ........ ..... .. . ... .... ................ I "OtL, fu Pa SOILS LOS PP.CCOL-1T10%_1 BEST pa-�O--aa `or J� Din � l (^��Date Per£o_a:,ed-!5-t '� o.. if WD �o s;� i�lc�cs ��-) �.�swLlb�r _ D� b Y o cs � S c:,., � ., � ra v a ! w � 5 Obv► e. S �� ¢ � K � CSS (;ej toter i� c � e.S Lio ""►' GU� " 180 �f t'��rYv► L D. 2 erL �eaf --S+0 J 1" 16 1 J 20 cue"se Ore.,, S •� �� - 2. ks- t o n6ra�H �]�ra/(vim (+ct1�/sdv-.%c Y►o Lo&-4cr i wb{e e,n�ao��et�d Tofr.l I),Pfi- = %6 �cef Date G Net Tim: - 2. ks- t o -- ---ja 3 k ;f.� tcS F � _ :-.�.... � �;:• � Com._ a..w�_}� � r • NJr-------' •let Aim✓i IRi- Date re=Tire SOILS LOS P E SCOL_AT.i CD : TEST Pax�o a:l for �l DIA i (� 1 l �r Yt „n l Date Perfor�mec2_ e) - LegalDescxl�i_10f? Or to FICr �t_0._t F� Ct1 L4 %p +-o <',A 1ticLjc,& L"L) D� � 1 Y o w t� S a �n � �� ova ✓ e + w f 5 d1 v► c 51 � � /A�G..<t F(CIC& cS 6 � . P�r� �C6f Fn s C'"A CG 12- cl 14 .•, • Yeo WaJer �U lo�e evicco,"4e fed to 20d I •let Aim✓i IRi- Date re=Tire L4 pninutog C?�11c,h tq 4 V MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF HEALTH & 825 L Street - Anchorage, Alaska 99501 tNVIRONMENTAL PROTECTION" ENVIRONMENTAL ENGINEERING DIVISION SEP 181918 Telephone 264-4720 E)c(C� ��%% ED REQUEST FOR APPROVAL OF INDIVIDUAL. WATER AND SEWE C 4 -d. - DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER PHONE Ej 6. TYPE OF RESID CE NUMBER OF BEDROOMS MA 'NG ADD ESS _ &Ce7 L10, glly T� /� C' PROPERTY RESIDENT (If different from ab vel PHONE [- SI GLE FAMILY 2. BUYER - PHONE MAILING ADDRESS 3. LENDING INSTITUTION PHONE MAILING ADDRESS 4. REA TOR/AGENT PHONE MAILING ADDRESS DK PUBLIC UTILITY LVA 5. LEGAL DESCRIPTION STREET LOCATION O 6. TYPE OF RESID CE NUMBER OF BEDROOMS ❑ One ❑ Four ❑ Other [- SI GLE FAMILY ❑ Two J9 Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY ❑ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well DK PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE***If individual/on-site, give installation date If system is over two (2) years old an adequa y test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) aL j / �_ L a P/ 6 �j THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED TIME TIME TIME DATE DATE DATE INSPECTOR - INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITL ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED ) . / INSTALLER ❑Septic Tank or ❑ Holding Tank Size: 4-'�P6. If Tank is homemade give dimensions: SOILS RATING TYPE OFTANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL r-� 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS E9" APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY (Title) f LEGAL DESCRIPTION 72-010 (Rev. 3/78) 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. 015-361-22 Legal description Heritage Heights Lot 6 Site address 6000 Yukon Rd, Anchorage Current property owner(s) Curtis and Erin Andersen Expiration Date: Z D Zo 2,3 X The On-site system(s) is/are approved for 5 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: By: Original Certificate Date: 11/28/2022 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 MUMC OPAU Il Y OF HCHOR CSC Tj Development Services Department \ Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-361-22 Complete legal description Heritage Heights, Lot 6 Location (site address) 6000 Yukon Road, Anchorage, AK 99507 Current property owner(s) Curtis & Erin Andersen Day phone 2. ON-SITE SYSTEMS SIZED FOR 5 BEDROOMS 3. TYPE OF WATER SUPPLY: ❑ Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ■❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ❑■ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑■ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 8 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ❑■ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee Waiver Fee $ Date of Payment l l I ILI COSA# o� caa(5-14a 0 752 D Date of Payment Waiver # COSA Applicationjune 2022 1 Legal Description: Heritage Heights, Lot 6 Parcel ID: 015-361-22 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA LT�o is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative NitraLe mg/L ❑ Nitrate less than MRL (ND) Arsenic ❑ Arsenic less than MRL (ND) Collected by Static water level at beginning of test ft. Date _ comments Property is served by city water. B. TANK DATA Measured operating fluid level in septic tank 39" Date of pumping 11/08/22 * ❑ Required maintenance completed, if AWWTS Comments: *See Maintenance Log D. ABSORPTION FIELD DATA Which system tested (date installed) 10/9/14 ❑ ALL standpipes present per record drawing Total measured depth from grade 6.2/7.5 ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced N/A gallons N/A date Any rejuvenation treatment (past 12 months) N/A If yes, enter date Comments/Deficiencies: COSA Checklist June 2022 C. LIFT STATION ❑ Required maintenance completed Age of lift station 8 years Lift station material Steel Comments: North Trench/South Trench Adequacy test date 10/31/22 Results [O]Pass— Fluid PassFluid depth prior to test 0/9 in Water added ......4 gal New fluid depth 5/26 in Elapsed time 1440 min Final fluid depth 0/12 in Absorption rate ' 750 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 48/48 in Effective depth used 0/12 in Effective depth remaining 48/36 in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' R Yes Community Sewer Manhole/Cleanout > 100' nYes if No ft ❑ 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 ft Holding Tank > 100' ❑Yes if No ft Neighboring Absorption Fields > 100' 0 Yes if No ft Water Main > 10' Animal Containment > 50' ❑ Yes if No ft ❑ Yes if No ft FEI Yes if No ft Water Service Line > 10' Yes if No Manure/Animal Excreta Storage > 100' If tank or field is under driveway comment below Community Sewer Main > 75' ❑Yes if No ft rl Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' R Yes if No ft Surface Water > 100' M Yes if No ft Tank to Property Line > 5' ❑® Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10' Yes if No ft Community Wells > 200' FEI Yes if No ft Water Service Line > 10' Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Forge Engineering Engineer's Printed Name Benjamin Schiller, P.E. COSA Checklist June 2022 Phone (907) 522-7773 Date 11/4/22 OF`'d Tw _ . Benjarrir Schiller • .: I 2 • CE 12592 .•�����' MUNICIPALITY OF ANCHORAGE Development Service: i Department Phone: 9073 7904 On -Site Water & Wasi ewater Section Fax: 907-3-Q-7997 Lift Station/Pump Vault Maintenance Log Owne -t Street Address &000 i it i:�L P; Phon -- egal Desc. _ PID 3eaye Tank: SA - -Sludge levet�' �inc'ies Pumping: required y 'Pumping completed`5-Q Lift station_ Pump basket cleanec-Effluentfffter cleaned es no -Control floats cleaner *Proper float settings confirmed A& na -Operation satisfactorl Alarm System, -Dedicated electrical a arm circuit no -Audible and visual alarm inside dwellingM -Alansystem operation a n t satis.-actoEy &_5 ManliplaRise -Ground water intrusio i at riser to tank connection -Ground water intrusio i around pipe penetrations s no -Weep hole functional f nn -Manhole lid: Functii,,nal �flg Insulated Properly Secured r�9 Qxhe -All manufacturer requi red inspections and maintenance completed (F)m Camml1l1s: Maintenance �P,a=Idei i -T - Technician �SOG� TaiJ�-rs Company �?>`✓Yr��, Date of maintenance#0 ))- • 56789 1.--9 ),.01o. • Municipality of Anchorag:�ti3 '° • On-Site Water and Wastewater Program (907) 343-7904 Al/G? o S A F E T V Certificate of On-Site Systems App o, al �ti 8L qh 6^1/ Parcel I.D. 015-361-22 Expiration Date: 1. GENERAL INFORMATION: Complete legal description HERITAGE HEIGHTS; LOT 6 Location (site address) 6000 Yukon Road*Anchorage 99507 Current Property owner(s) Todd &Shannon Dow Day phone 227-5557 Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well I I Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System Public Sewer ❑ WaiverNariance request for: Distance: Received by: . _ Date: Wie) COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 524 Waiver Fee $ Date of Payment 11/24v.IN Date of Payment Receipt Number 6 5,51 Receipt Number COSA# 05(1'8 .l(P 1 Z. Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101-Anchorage,Alaska 99507 i Engineer's Printed Name: Jeffrey A. Garness Date: `1 1zs/•`� Q,a000004� In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system o OF , in accordance with the guidelines and regulations established by the Municipality of Anchorage and 0� ••.•...1. c J industry practices. The reported results describe the condition of the system/s on the date/s of the O P.• • evaluation. Separation distances were measured to readily identifiable features. Hidden defects or � A_•• T /�, encroachments may exist that were not identified during the evaluation. The operational life of all wells * ; . * and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and • VA workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the • -'f - A. • s•• 2 system/s: therefore, GEG makes no warranty (express or implied) regarding the future performance of Ql C —79r 3 • the well or septic system. GEG makes no representation whether an alternative well or septic system 09 •• �c`Q can be installed on the property in the event either of the current systems fail to perform adequately in D� P� lI .Z .f I." 44' the future. The content of this report is for the sole benefit of the person/party that retained GEG too ��PaprO{eSSlon�d perform the evaluation. Reliance upon the information provided in this report by any other person or ��0040o�a party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE System #1 Approved for J bedrooms System #2 Approved for bedrooms v -`�0 Disapproved ON-SITE `Pen Conditional approval for , bedrooms, with the following sttoul'c TTR AND "' WASTEWATER PROGRAM 0 cC <4ir SFR\I\ ' By: Original Certificate Date: )/r2-P—( 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 Nitrate Advisory >• Septic System Advisory Arsenic Advisoryc. , Well Flow Advisory Other COSA blue sheet 10-1O.12.doc 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: HERITAGE HEIGHTS; LOT6 Parcel ID: 015-361-22 A. WELL DATA PW\iv V1 94- PWSID# 14 Well Log (Y/N) Well type GY If®, B, or C provide Date completed Sanitary seal (Y/N) Wires properly protected (Y/N Total depth ft. Cased to ft. Casing height (abo - •round) in. FROM WELL LOG AT I - ` CTION Date of test Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RES : Coliform colonies/100 ml. Nitrate mg./L. Collected by: enic: ug./L. Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material S.T.E.P./STEEL Date installed 11/7/14 2 Cleanouts (Y/N) YES Tank size 2000 gal. Number of Compartments Foundation cleanout(Y/N) YES Depression over tank (YIN) NO High water alarm (Y/N) YES Date of pumping 11/20/18 Pumper MCDONALD'S PUMPING C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE AT NORTH MONITORING TUBE NORTH/SOUTH Date installed 10/9-11/14 Soil rating �p.d./ or ft2/bdrm) 1.2 System type 5 WIDE TRENCH Length 35/30 ft. Width 5/5 ft. Gravel below pipe 4.04/4.04 ft. Total depth *6.7+ ft. Eff. absorption area 650 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 11/16/18 Results (Pass/Fail) PASS For 5 bedrooms Fluid depth in absorption field before test 0 in. Water added 789 gal. New depth 0 in. Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 750+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NO If yes, give date - TESTED NORTH TRENCH ONLY-INTRODU*CED H2O DIRECTLY INTO NORTH TRENCH SOUTH TRENCH HAD APPROXIMATLEY 9"OF LIQUID UPON ARRIVAL&9"OF LIQUID AFTER TESTING *SEE 11/20/18 MAINTENANCE LOG BY A+ HOME SERVICES **SECOND COMPARTMENT OF 2000 GALLON S.T.E.P.TANK D. LIFT STATION Date installed 11/7/14 Size in gallons **686 Manhole/Access (Y/N) YES "Pump on" level at * in. "Pump off' level at * in. High water alarm level at * in. Datum * Cycles tested * Meets alarm & circuit requirements? `11E- E. SEPARATION DISTANCES PE2. T-+0,4 SEPARATION DISTANCES FROM WELL ON LOT TO: COMMUNITY 64--re_«A t 0 S Pte+--Iit)" i iii6 A Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main '•. . sewer manhole/cleanout Sewer/septic service line Holding tank - . containment areas 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 100'+TO PRIVATE&200'+TO COMMUNITY 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 100'+TO PRIVATE&200'+TO COMMUNITY F. COMMENTS *MET CODE AT TIME OF INSTALLATION **1977 TRENCH LOCATION RELATIVE TO LOT LINE IS UNKNOWN. 1977 TRENCH IS ALSO PARTIALLY UNDER THE DRIVEWAY,WHICH MET CODE AT TIME OF INSTALLATION. '.*loom'•.I I ..,4� OF � ;.. G. ENGINEER'S CERTIFICATION *.c...,' \>:••••'' • t. I certify that I have determined through field inspections and 4' "' �� • review of Municipal records that the above systems are in i conformance with MOA COSA guidelines in effect on this s•• • • '•I ;• •i MUNICIPALITY OF ANCHORAGE • Phone: 907-3.43-7904 Development Services De.pa anent ` ; Fax: 907-3.43 %907 Ori-Sic:Water&Wastewater Section r y� Lift Station/Pump Vault 0t Maintenance Log ,) s Street Address_ L'YYJ /A.11)01-1 Owner_ 1 cid a- '<-�i PVD Phone.,.. 221.5'55-1 Lege;Desc. rgp3jc Tank: -Sludge level j/ inches -Pumping: required y , j -Pumping completed(Ye.• Lift station; -Pump basket cleaned.fy ;, -Effluent filter cleaned `Yom? no •Control floats cleaned yam' o -Proper float settings confirmed ,j/es) pno -Operation satisfactory(5 no Alarm System; -Dedicated electrical alarm circuitr'y:4.� no •Audible and visual alarm inside dwelling yes :he -Alarm system operation ( i a_ti Dot satisfactory -Ground water intrusion at riser to tank connection yes no -Ground water intrusion around pipe penetrations yes Vin_ -Weep hole functional yes no .Manhole lid. Functional no Insulated yes no Properly Secured, yam' no Other •Ali manufacturer required inspections and maintenance completed 'y(2;x; no Comments; LL !! ...:.Relit F'iil.'`.. �i�'t"�.l d/-{!'•!•�T'd 'f ", Maintenance Provider: y�,+ �" ^ '0% e.49: Date of maintenanCC i' 0 '!f� Technician Itr�ty. ?91. 4 _._� Company 42 1 Sud�•� T Signature �` �` .r/://" Date Mailing Address:P.O.Box 196650•Anchorage,Alaska 99519-6650•www.muni_arq 2 YUKON _ ROAD N 0 0 0 N 89 59' 30" W 165.001 w 0 0 0 0 THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOWN HEREON ( UNLESS INDICATED) NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. 00OF A 0000��O 49 TH a- o 0� SHANE A. HOLT LS -6914 �JoO �ofessiona\ �Qo �O�O000�� AS -BUILT SURVEY 1" = 20' NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT 6, HERITAGE HEIGHTS SUB. ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE,ALASKA THIS _12 TH DAY OF _NOVEMBER , 2018 12754. F5 168-76.193-28 HOLT LAND SURVEYING 9309 GROVER DRIVE ANCHORAGE,AK 99507 223.8615 Municipality of Anchorage $° < On -Site Water & Wastewater Program. ,'.`"''` (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 015-361-22 Expiration Date: 1. GENERAL INFORMATION Complete legal description HERITAGE HEIGHTS SID; LOT 6 Location (site address) Current Property owner(s) Mailing address Real Estate Agent 6000 YUKON ROAD, ANCHORAGE, AK, 99507 ALANJACKSON 6000 YUKON ROAD, ANCHORAGE, AK, 99507 Day phone 349-6379 Day phone 2. TYPE OF DWELLING: Single Family (w/wo ADU) UBMiTTAL ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex NOV 18 2014 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class A Well Public Water System Received by�_X,1-4 COSA to be released to the engineer, 5 TYPE OF WASTEWATER DISPOSAL: ❑ Individual On-site ❑ Individual Holding tank ❑ 0 Community On-site ❑ ❑ Public Sewer ❑ requested by the engineer. Gush COSA Fee $ ��.? f Iw% = 4a 60 Date of Payment I1 I l t k C r' Receipt Number ow_mol COSA 9 05clq1(P0- Date: .-(1 Waiver Fee $ _ Date of Payment Receipt Number, Waiver # Distance: 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. t 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. Address 3701 E. TUDOR ROAD, SUITE 101 ' ANCHORAGE, AK, 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LfD. 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 ofthe 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 ofthe system. satisfactory test results do not guarantee future performance ofthe system, nordo 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 ofthe ADEC or MOA DSD. The content of this reportis 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 6. with the following Phone 337-6179 Date ill1`3)IL( Original Certificate Date: Thc,Mdnicipality, or Anchorage Develop,emt Services Division (DSD) issues Cenl'ficates of On -Site -Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineerregisterad 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 m— innonoi 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: A. WELL DATA Well typecOMMUNiry Date completed Total depth ft. Date of test Static water level Well production WATER SAMPLE HERITAGE HEIGHTS SID; LOT 6 Parcel ID: 015-361-22 li(A)B, or C provide PWSID# 210087 Well Log (Y/N)- Sanitary seal (Y/N) Wires properly protected Cased to ft. Cas=CTI (abo n FROM WELL LOG ATION 11 Coliform colonies/100 ml. Nitrate mg./L. ft. g.p.m. g.p.m. 11 Coliform colonies/100 ml. Nitrate mg./L. Collected by: enic: ug./L. Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material S.T.E.P./STEEL Date installed 11/7/2014 Tank size 2000 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) YES Date of pumping NEW Pumper NORTH/SOUTH TRENCH C. ABSORPTION FIELD DATA eELow FiNaL cRnoe Date installed 1019-11/6/2014 Soil rating (4Er ft2/bdrm) 1_2 System type 5 WIDE TRENCH Length 35/30 ft. t 5/ ft. Gravel below pipe 4.0414.04 ft. Total depth *7.0-7.3 ft. Eff. abs rp i n �ft24'0 ring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fail) ` For IP bedrooms Fluid depth in absorption field before test in. Water added =gal. New depth in. Elapsed Time: = min. Final fluid depth = in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 1 0. ( & type NONE KNOWN If yes, give date - * Per/ G to FI,,W- Ti'i ,r:,er, a/GQ',-.�.•�a 2' D. LIFT STATION Date installed 11/7/2014 Size in gallons 2000 Manhole/Access (Y/N) YES "Pump 9 "Pump J65 on" level ata in. off' level a?t39 in. High water alarm level at in. Datum BOTTOM OF BASKET Cycles tested NEW Meets alarm & circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on Public sewer main COMMUNITY WELL On adjacent lot: On adjacent lots manhole/cleanout Sewer /septic service line Holding tank An4m containent areas mManure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 54 Property line 51+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ PRIVATE/ 200'+ COMMUNITY SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 101+ Building foundation 104 Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway. parking/vehicle storage '10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ PRIVATE/ 200'+ COMMUNITY F. COMMENTS '1977 TRENCH LOCATION RELATIVE TO LOT LINE IS UNKNOWN. 1977 TRENCH IS ALSO PARTIALLY UNDER THE DRIVEWAY. WHICH WAS CODE COMPLIANT IN 1977. G. ENGINEER'S CERTIFICATION I certify that / 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 I %' I O I I U (Rev. 10112/12) Z p p m a 6 O S Mo p03-Icn IZm -ommH S�m�ZW�p Zir"i zcC'lN"�tnp (nz ^�ZONm> :Em0,Zcnpvg zmoH�omz S p 2� p m Z r m a n v p X p m H H 1 a O H N p r-ir Z 3 Z��AOZH Dov =Z�0 mH y DGI 7070 90M Zc-1 0 a�Vo 1m p Z Z H C C N OHS MO;170 H N Z a O a A v m r C7 r $ Z p m c 3: z c H m m Z hi c--�1� l z ONa Zmo AvZ m' m -i m r N n Z a:A M H N ;D 3: H m O OOy0 m p G y N O Z rZC �m 0(A G m i-1 O m a v cnmD v o zOa� v mpma m -mi zm3� m� m z =�Na m p Z D n 2 ZS^v� H cn a Z ti Om-I<D D X 2 H Z z�Hmvin Omen H2 <-0030�o w 3 >00 m D W —1 � -0 m m 2 m H m zDm;o3 n 0 m m O S r C 0 zDHmv D Z z:3 0 G) mmH mz(Azz D-ADv�im r m z 0 DDO(AH y 7 z (D OcDH F, —I < —1 n �H HA --I LA"O Go -I D ILA m N A w mm;Iqz = nzD O D D waa2 Dzz Azo �==rj nmO = O"' m N 2 W Z1 2 > a); v O N ;E C Z = C ov O m (M" m G T cn m Z N DO 02' 40" E 744.41 z D r0H o (q �1 O A = � m z C O� m z m W c m O m C Arn Z7 H r m i < Li H H D m G) -< m m mv—I ° c~i vmi D it N O LA W H o�000Op�O 0 D w < p�L' vm OOor D Q �� m T ON m z �n mLn D D O� do v�O A �Q eyOF � o0 m 4pp0�000a Municipality of Anchorage Development Services Department IL Building Safety Division On -Site Water& Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D..O /S 3 ee i 1. GENERAL INFORMATION Expiration Date: 3 Complete legal description HERITAGE HEIGHTS LOT 6 Location (site address) 6000 YUKON ROAD *ANCHORAGE AK 99507 Current Property owner(s) DON AND JOAN SHEPPARD Day phone 346-2017 Mailing address 6000 YUKON ROAD *ANCHORAGE AK 99507 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 5 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System a 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 INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, l 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 riles 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. Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LID. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines 8 Regulations. The reported results described the performance of the system under the conditions encountered at the time of the lost, 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 benerit 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 Jz_� Conditional approval for Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Phone 337-6179 DateSI `� 08 bedrooms, with the fllowing stipulations: Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other ONSITE WATER AND 'nu 01 By: Original Certificate Date: O tR«. i frost Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: HERITAGE HEIGHTS LOT 6 Parcel ID: is(S---3 61 - a;Z, A. WELL DATA Well type A If A. B, or C provide PWSID# 210087 Wires properly protected Well Log (Y/N) Date completed _ Sanitary sea] (Y/N)— Total depth —ft. Date of test Static water level Cased to —ft. FROM WELL LOG Well production WATER SAMPLE RES Coliform colonies/100 mi. Arc: —ug./L. B. SEPTIC/HOLDING TANK DATA Nitrate —mg./L. Date of sample: Casing height (ab round) in. AT I CTION ft 9 -p.m - Other bacteria Collected by: - colonies/100 mi. Tank Type/Material SEPTIC/ FIBERGLASS Date Installed 10/20/1977 Tank size 1 500 gal. o Number of Compartments' 2 Cleanouts (YIN) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO iHigh water alarm (Y/N) N/A Date of pumping 9/19/2007 Pumper MCDONALD PUMPING C. ABSORPTION FIELD DATA 1 -BELOW EXISTING GRAD Date installed 10/20/1977 Soil rating (g. p.c!Jfto</bdr 275 System type DEEP TRENCH Length i18 ft. Width 3 ft. Gravel below pipe 7 ft. Total depth 011.6 ft. Eff. absorption area 1652 ft' Monitoring tube YES Depression over field NO Date of adequacy test . 9/19/2007 Results (Pas s/Fail) PASS For 5 bedrooms Fluid depth in absorption field before testL7—.75in. Water added 810 gal. New depth 26 in. Elapsed Time: 189 min. Final fluid depth23 in. Absorption rate >= 750+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN — If yes, give date D. LIFT STATION Date installed "Pump on" level at —in. E. SEPARATION DISTANCES Size in gallons Manhole/Access "Pump off" levetat i . High water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot On adjacent Absorption field on lot On adjacent lots Public sewer main Sewer /septic service Holding tank manhole/cleanout areas 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 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line **,3' Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage '0 Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *SIGNIFICANT PORTION OF DRAINFIELD UNDER THE DRIVEWAY OR PARKING AREA. •• WAIVER REQUESTED NO FREEZING ISSUES PER OWNER 0006oOpO�nw G. ENGINEER'S CERTIFICATION t certify that I have determined through field inspections and review of Municipal records that the above systems are In conformance with MOA COSA guidelines in effect on this date. Engineers Printed Name JEFFREY A. GARNESS Date 3 [zo /u 6 4 000000 COSA Fee 4 q,3 V'yy Date of Payment 3 Receipt Number 0 (Rev. 11x15) Waiver Fee $ 1 ! -00 / Date of Payment &-4-L-S 3 Receipt Number O 7 1 CY Municipality of Anchorage � s. 'r- \ CU. lbs Vxg'al •.lnehurn3!q .4la,ki 7A51!Lliliill • 471X117.Inmrc Mod Office; 0)(M343-901 • 1'as: 1!X171343-RLIXI Iuryr.//a„sc.nnmi.orl; Mayor Mark- Begich Developn4enl Services Depurinrenl 3/26/2008 Jeffrey Gamess Gamess Engineering Group, Ltd. 3701 E. Tudor Road, Suite 101 Anchorage, Ak. 99507 Subject: Waiver Request for Heritage Heights Lot 6 Waiver Request #W11080016 Parcel ID #015-361-22 HAA# 080071 Dear Engineer, ru• n t L)t•par[ment Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 3.0 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, cA�_ Jeffrey W. Poet Engineering Technician On -Site Water & Wastewater Program Community, Security, Prosperity Municipality of Anchorage Development Services Department 0 Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 1%650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Waiver Review Worksheet WR#: 080016 PID#:015-361-22 HA#:080071 Permit#:, Date Received: U24108 Legal Description: Heritage Heights Lot 6 Engineer. Jeffrey Garness Garness Engineering Group Inc. 3701 E. Tudor Road Suite 101 Anchorage Ak 99507 Applicant: Don and Joan Sheppard Waiver Requested: 3 feet separation distance absorption field to Property line Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: ...................................................................... snesea... i Waiver is Granted: �_ Waiver Is not Granted: List Conditions or Reasons for above: Date: 3- o2(p-0g By: ................ sense seeness...mass ..... .::—::i:::...•:......................... 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