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MOOSE RUN LT 3
Moose Run Lot 3 #015-164-23 Feb -15-2023 09:56 AM Anchorage Well & Pump Service Inc 9072430742 MUNICIPALITY OF ANCHORAGE Development Services Department n Phone: 907 On -Site Water & Wastewater Section - Fax: 907 Pump Installation Lo Well Drilling .hermit Number: Date of Issue: -� Parcel )Identification Number: 015 - 164 - 23 #7243 P 1/ 1 i-7904 G-7997 Legal Description MOOSE RUN Block Lot 3 Property Owner Name & Address: MILAN MARK A DECLARATION OF TRUST 2022 261 E 26TH AVE ANCHORAGE AK 99503 Pump Installation Date: 02 - 13 - 2029 Pump Intake Depth Below Top of Well Casing:. 270 feet Pump Manufacturer's Name: ORUNDFO 15 SQE1 -290 Pump Model- Pump Size: 1.50 hp Pitless Adapter Burial Depth: -----.1-0-- ---- feet Pitless Adapter Manufacturer's Name: MARTIN ON Pitless Adapter Installer: Well Disinfected Upon Completion? XYes C No Method of Disinfection: PELLETS Courimeaft4 Pump Installer Name: _ ANCHORAGE WELL & PUMP SERVICE Company: 7640 ICING STREET ANCHORAGE, AIC 99515 Mailing Address: 907-243-0740 City: State: Zip: Attention: The pump installer shall provide a pump installation log to Onsite within 30 days of pump instaliatio . Municipality of Anchorage 14 r^' Development Services Department Building Safety Division On -Site Water and Wastewater Program, 4700 Bragaw St. _ P.O. Box 196650 Anchorage, AK 99519-6650 Page 1 of 6 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW060330 PID Number: 015-164.23 Name: Wastewater SysVy tem: ® New El Upgrade ABSORPTION FIELD Address: Phone: Number of Bedrooms: ❑ DeeD Trench ®Shallow Trench ❑Bed ❑ Mound ❑Other. Soil Rating: Total Depth from original grade: LEGAL DESCRIPTION 6 GPD/Fe 2 Ft. Block: Lot: Subdivision:Depth to pipe bottom from original grade: Gravel depth beneath pipe: 3 Moose Run 1.5 Ft. 0.5 Ft. Township: Range: Section: Fill added above original grace: Gravel Length: 2 Ft. 30 Ft. Well: ® New ❑ Upgrade Gravel width: 5 Number oflines: Distance between lines: 1 0 Ft. Ft. Classification (Private, A, B. C): Total Depth: Cased to: Total absorption area: Pipe Material Private 506 Ft. 1 20 Ft. 150 FP 1 3034 PVC Driller: Date Drilled: Static Water Level: Installer: Date Installed: AI ine Drilling 5/24/2005 I 7 Ft. BTH Construction 10/1912006 Yield: Pump Set at. Casing Height Above Ground: TANK 15 GPM Ft. 2 Ft. SEPARATION DISTANCES ❑ Septic ❑ Holding ® S.T.E.P. ❑ Other: To' Septic Absorption Lift Holding ublic/Prlvate Manufacturer: Capacity: From Tank Field Station Tank Sewer Line Anchorage Tank 1500 Gal. Well 211.5 450.8 217.0 211 Material: Steel Number of Compartments: 2 Surface Water 134.5 101.5 142.2 LIFT STATION Lot Line 143.7 19.9 140+ Size: 250 Gal. Manufacturer. Orenco 6.6 269 13.0 'Pump on" level at: •Pump err level a,: High water alum a,: Foundation +40 in. +36 in. +45 In. 316 100+ 27.5 Pump Make &Model Electrical Inspections performed by: Curtain Drain . Orenco P2005.1 Oliver Burnbrid a/MoA Remark' 2" Rigid Insulation over field and discharge line. Revised 070222 BENCH MARK Location and Description: per MoA Comments. Garage Finish Floor Assumed Elevation: 100.0 Ft. Engineer's Stamp Inspections performed by: PANNONE ENG. SVC, LLC Dates: 1' 11/9/2005 OF qOil. 2"d 1011912006 �.E.+♦♦ Development Services Department Approval J* C--) 9 �� TH �:♦♦ Conditional Approval Date: , ............. ♦ •• A i ;Steven R. annone$ ♦1� . Steven 8,11499AV Reviewed and approved by: Date: 6 O No. CSE, � ��1�, ... 1 E� Pannone Engineering Services, LLC P.O. Box 102954 Consulting Engineers Anchorage, Alaska, 99510 (_907) 272-8218 (907) 272-8211 Fax March 30, 2007 Ms. Debbie Wockenfuss Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: Lot 3 Moose Run S/D Septic System Record Drawings Ms. Wockenfuss: I am writing in response to your "Pink Sheet" dated February 23, 2007 concerning the Record Drawings submitted to your department on November 16, 2006 by PES, LLC. I will respond in the same order in which the comments were presented. Comment: A waiver request for the excessive slope is required to be submitted for our review. Waiver Fees are not required. Response: I am requesting a waiver be granted to install a septic system on a slope that exceeds 25%. The soils in this slope are silty gravel that typically has an angle of repose of 30 to 35 degree off vertical (Terzaghi & Peck, Table 7-1, page 107). The soils are course grained with some silt content. Water flow through soils course grin soils at the angle of repose or steeper. The slope this system is installed on is at a 30% slope (off the horizontal — 73 degrees off vertical). The liquid from this system will absorb at an angle from straight down to a thirty degree off vertical. The soils along this hillside are consistent based on the information gathered from soils logs performed by Lee Reid, PHD, P.E. and PES, LLC. The soils in PES's test holes logged for the lower septic system are similar in nature to the accepting soils of the upgraded system. Based on the soil information gathered to date, the effluent will not day -light out of the bank within fifty feet of the soil absorption system. By approving this waiver the health and safety of this lot will not be compromised. Comment: The profile sheet needs to be reprinted to show all details. Response: Revised per comment. Revised detail sheet attached. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Civil Engineer Attachments: Revised Detail Sheet PERMIT NO: SW060330 RECORD DRAWING P.I.D. NO: 015-164-23 WASTEWATER DISPOSAL SYSTEM Lot 3 Moose Run Subdivision _s________� �noluni _ __--__L__________ � � r - --'' EXIST'G WELL i LOT DEVELOPED NO WELLS OR SEPTICS 1 EXIST'G 4 BR W/IN 100 FEET OF PROPOSED HOUSE UPGRA it "--T EXIST'G DRAINFIELD I � I ABANDONED PER CODE , � I (L ✓ 134.5 , --- _- t OT DEVELOPED - 3 1010838 NO WELLS OR SEPTI S , W/IN 100 FEET OF PR POS [I UPGRADE. I i • \\ �0X \\ U- x \ I O )n 5 O \ f T 6.1 "X 10% �8% TH PE6 I \ NEW DRAINFIELD I I % -\ UPGRADE. SEE 60 SCALE LOTUNDEVELOPED SHEET FOR DETAILS NO WELLS OR SEPTICS I W/IN 100 FEET OF PROPOSED UPGRADE. 2- s a, I NOTES: 3) Connect post tank line to end of drain field, Ll III 1) All work shall be performed in typical. QF Maintain • ... • • ♦ all lot lines 2) Materials used shall be in 100'to surface water. = �: ♦j A � ;; ♦♦ �........i..... accordance with those specified in AMC15.65, Wastewater 5) Drainfield distribution lines be 1.25" 49TH Disposal. shall o diam, with 3116"0 perforations every 3.5 feet. ................ tev•••••••on Steven R. Pannone PREPARED FOR: PANNONE ENG. SVC, LLC e ♦ G ♦ No. CE 8149 '� � Greg Sarber 3220 Michigan P. O. BOX 102954 - ♦ AV ♦j ©6�i1 S.••Od��� Ave, Apt B Anchorage, AK 99516 ANCHORAGE, ALASKA 99510 ♦1,',E;�•� 242-6000 272-8218 P, 272-8211 Fax 111"= 100S PLAN SCALE: 00' PERMIT NO:SW060330 RECORD DRAWING P.I.D. NO: 015-164-23 WASTEWATER DISPOSAL SYSTEM Lot 3 Moose Run Subdivision 211 / T E EXIST'G 1 OOg S.T.E.P. TANK w/ AX20 A B AD TE ODi. & AUX PUMP VAULT S2 o EXIST'G T1 LS1 WE[L� 7ff4.5 1. " DIAM. LINE TO DRAIN TOPITCH FIE S EXIST'G FIELD ABANDONED / D\ \ IN PLACE PER CODE. / \ \ u) 05`3 % / \ 1040926 F�E' SER E MLU,,��D, \ \ 5'Wx3OLLF}-,-TD E Isrc N EXISTG CONNECTTTH 2040 I LL i, DI$IjHARGE LINE \ TH 16-1 EXISTG STRM \ EXIST'G 18" CMP DRAIN \ \ 6% 141.6 Cl) CULVERT \ 1.25" DISCHARGE1001 5 /�' LINE FROM PUMP \ \ '8 Mz VAULT TO DRAIN \�.1/ FIELDA M, 101.5 \ co T 6-2 TUPGRADED FIELD, SURFACE WATERER 30% 5'Wx30LFx0.5ED, � R _mss% 31.4 \ \ TH PES4 \ 105.5134.0 \ l \ V 3 % A B FC 17.8 12.9 T1 16.4 18.0 PIPE DAYLIGHTS LS1 15.0 26.0 IN EXIST'G DITCH EXIST'G OPEN LS2 15.4 31.5 VI DITCH M1 287.7 296.8 DRAINAGE M2 269.6 280.5 EASEMENT— I 24" 0 STORM CO 290.5 299.2 \S OS J DRAIN PIPE Revised 070222 per MoA Comments NOTES: 1, 1) All work shall be performed in OF q4; t% accordance with AMC15.65. P. Sy1�� 2) Materials used shall be in accordance with those specified in TH�j AMC15.65, Wastewater Disposal. a e} ••• PREPARED FOR: 'en R. PonnoneE GregSarber No 2C X08149'•: 320 Michigan Ave, Apt B �,,\ Anchorage, AK 99516 cr""" "'rwW✓ �� 242-8000 3' U 3) Connect post tank line to end of drain field, typical. 4) Maintain 10' separation to all lot lines & 100'to surface water. 5) Drainfield distribution lines are 1.25" diam, with 3/16"0 perforations at 3.5 feet O.C. PANNONE ENG. SVC, LLC P. O. BOX 102954 ANCHORAGE, ALASKA 99510 272-8218 P. 272-8211 Fax 60 SCALE PLAN PERMIT NO: SW060330 RECORD DRAWING DETAILS WASTEWATER ABSORPTION SYSTEM Lot 3 Moose Run Subdivision P.I.D. NO: 015-164.23 Z O p v �5 l3 to N Z O dtl MmONV310.04 L N O 38n1210LNOW A n O w O r ~~ LL r K N d on � F o wa Cl _ (L w u Z Co 2 0p n n � w J F b Cl Z o0 Y O 3LQ U O N U W Q 0 Z � L/ 1 M a Z o W (n W a p � \ OI N J W ON3 HOVa IV LL 0 3eniHOLNOLN O O Z' (N 11 � N � r 0_ H 3 i o 0 r` O c7 a 31OHNVVI O L i m i 31OHNVNI `o ai m � rna 1noNV310 Noow x�vi w�vi Lq M ■ ��, NR11 NN 33 ONVf103 _ %c Steven R. Pd No 3117/0751, s e .....O Revised 070317 per MoA Comments _ PARED FOR: PANNONE ENG. SVC, LLC i Greg Sarber P. O. BOX 102954 i 3220 Michigan Ave, Apt B ANCHORAGE, ALASKA 99510 Anchorage, AK 99516 242-6000 272_8218 PHONE/ 272-8211 FAX DATE: 11-09-06 SECTIONS NOT TO SCALE FEB -23-2006 09:36 AM SRRSER DESIGNS 346 1391 P.01 Stick-up 0 2 wall Thioknnss: = Inches silt 2 3 ALPINE DRILLING & ENTERPRISES Permit Number: #SWQJQM Date of Issue: I Farces Identification Number. 23 Date Started: 5--aina Date Completed: 3.2405 Is Weil located at approved permit loeation? _ Ne T*pl Descriptlow Moose 6A Lot 3 Properly Owi-er Name & Addreav Grog d Vicki Sarber 11018 Boulder Cirols 44 Anchorage, Alaska 99511 !Borehole Data: Depth (ft) Method of Drilling 0 air rotary ❑ cable tool Soil Type, Thickneus & Water Strata From To CAe1D{; types slow Stick-up 0 2 wall Thioknnss: = Inches silt 2 3 Diameter; .@ inches Depth: 2Q Teel gravelly slit bedrock 3 10 10 506 Liner Type: Marneter:_ inches Depth: feet Casing stickup above around: 2 feet Static water levci (from ground level): •_feet Pumping levet: 'f�i50 feet after 2 hours pumping Jj gpm 1 qpm 20 480 Recovery Rate: 1§ gpm 14 gpm 480 506 Method of Testing: M & Well Intake Opening Typet ❑ Open End ® Open Hole ❑ Screened Start _ feet Stopped feet ❑ Perforations Start ! feet Stopped _ feet Grant Type- benrcrair� Volume- l Depth: Start ig feet Stopped _ feet Pump: Intake Depth — feet Pump size ---, hD Brand Name _. _... Well Disinfected Upon Completion? f9 Yes [] No Method of Disinfection: chladpfj�eblets Comments - Wall Griller: Alpine Drilling & Enterprises PO Bax 11049E Anchorage AK 99511 Attention. The well driller shall provide a well log to the property owner within 30 days of completion and the property ., u 1 HI , u f„ . 1. 11 n t. . ..I r . i. . n I. . •.n •. io ,. . . r , From 4pliedMicrosystems Fri 20 Oct 2_000 0_5;34:0_3 AM AKDT Page 1 of 1 MUNICIPALITY OF ANCHORAGE, BUILDING SAFETY DIVISION 4700 SOUTH BRAGAW INSPECTION INFORMATION & HELP: 343-7982 INSPECTION: VOICE 343-8300 INSPECTION: FAX (907)249-7777 www.muni.org/BSD/Inspections.cfm NAME: greg PERMIT#: 04-1275 COMPANY: owner INSPECT DATE: 10120/2006 PHONE #: 242-5000 PHONE #: PHONE #: ADDRESS: 10851 VOSIKOF PL LOT 3 SUBDIVISION: MOOSE RUN GRID #: SW2841 COMMENTS or DIRECTIONS pm Piz TYPE OF INSPECTION: Other Electrical . COMMENTS: (FOR INSPECTOR USE ONLY) PRINTED NAME , i I%('.-rr /sirJ >;' f r' DATE: (.'/'-" MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Permit Number: SW060330 Legal Description: MOOSE RUN SUBDIVISION LOT 3 Design Engineer: 0093 G. SCOTT CROWTHER, PE Owner Name: JON & VICKI SARBER Owner Address: 320 MICHIGAN AVE #B ANCHORAGE, AK 99516 - Renewal Date Issued: Oct 06, 2006 Expiration Date: Oct 06, 2007 Parcel ID: 015-164-23 Site Address: 11018 BOULDER CIRCLE 44 Lot Size: 138792 SO. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy All construction must be in accordance with: 1. The attached approved design. ❑ Private Well ❑ Water Storage 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 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: Date: ©&C001 Issued By: 1 t Date: l D Munic' o nc orage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 ON-SITE SEPTIC/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D.D1 7�' /w //-f`�3 C Property owner(s)^S C k E6 S'"8 CA'�p Day phone Mailing address 3 2,ao m le4tAAN 1W A -PT Azip Code - Site address IS Code 2 c/ 2 �9dVo Legal description (Sub'd, Block & Lot) L-07- 3 X6i10 iE k'4W S'U, Legal description (Township, Section & Range) Lot Size / 34?'11?;- Sq. Ft. Number of Bedrooms THIS APPLICATION IS FOR (®all that apply) Absorption Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ THIS APPLICATION IS AN: Initial ❑ Upgrade ❑ Renewal ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Fam"ellingaracois in accordance with appAcable Municipal Codes. (Signature of j5roperty owner or aupojlzed agent) Permit/Rush Fees: 115 p /- Waiver Fees: Date of Payment: Pff 04 ' Date of Payment: Receipt Number: Ko'u Receipt Number: (Rev. 11/05) Pannone Engineering Services, LLC Consulting Engineers (9071272-8218 September 7, 2006 Municipality of Anchorage Development Services Department On -Site Water 8s Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: Lot Moose Run S/D Septic System Modification to Approved Permit Request Ladies and Gentlemen: P.O. Box 102954 .ge, Alaska, 99510 )071272-8211 Fax I am writing to request a modification to permit No. SW050374 be approved to construct an upgraded septic system for this property. The existing system installed in November of 2005 and that was awaiting an electrical inspection, is being inundated with water being generated by development uphill of the new septic system. The Owner of Lot 4 was directing ground water down hill into this septic system. The water has since been redirected to a ditch along his driveway to a dedicated drainage easement. The proposed systems will serve a new four-bedroom house that is under construction at this time. It will be installed in the designated reserve area shown on the approved plans and the area where a conventional septic system was approved to be installed in 2004. The well has been installed and is located to the north of the new house, over 100 feet from the proposed septic system location. The existing Advantex tank, treatment pod and auxiliary pump vault were installed in November of 2005. The surrounding lots are served by private water systems and are over 100 feet from the proposed soil absorption system. 1. Soils. See the attached soils logs that are also on file with your Department. Ground water was monitored from October of 200 through August of this year. Ground water was encountered in the test hole in the forms of seeps, and the free water table stabilized at a minimum depth of six feet below ground water after the water -monitoring period (October of 2004). The ground water was measured at a depth of eight feet in August of this year. Bedrock was not encountered in the test hole. It is my opinion that the overall soils appearance of the soils, an application rate of 6.0 gallons/day/square feet should be used using an advanced treatment system (Advantex AX 20 pod). Page 2 of 2 2. Trench Design. a. Percolation Rate: b. Application Rate: c. Number of Bedrooms: d. Design Flow: e. Min. Absorption Area: f. Total depth: g. Effective Depth: h. Width: i. Reduction Factor: j. Minimum Length: k. Design Length: 1. Effective Absorption Area: m. Septic Tank Size: 2.6 to 5 Min Per Inch 6.0 gpdpsf 4 600 gallons per day 100 sf 2 feet 0.5 feet 5 feet 0.0 20 feet 30 feet 150 sf 1500 gallon Advantex (existing) 3. Surface Water: There is an open ditch located to the south and west of the proposed installation. A 24" diameter pipe allows the water to cross under the driveway on Lot 4 and flow into the existing drainage ditch (in a dedicated drainage easement) along the south property line of Lot 3. The proposed system will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The average topography in the area of the proposed septic system is approximately 30 percent based on contours generated during the subdivision processes. The proposed system will be installed along the southeastern boundary of the lot. The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells or septic systems within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, G. Scott Crowther, P.E. Civil Engineer Attachments: ���N,c9dn�L LNG, SVE LLC C:\Work\Letters\3 Moose Run.003.doc -�; 49TH G. Scott Crowther CE 6491 c� PERMIT NO:SW06XXXX DESIGN DRAWING - P.I.D. NO: 015-164-23 WASTEWATER DISPOSAL SYSTEM Lot 3 Moose Run Subdivision I _s________� ______ y_______________________ Li01V016m1IL Off_ \ I I 1 1 I \ --- EXIST'G WELL I\ I' LOT DEVELOPED I I NO WELLS OR SEPTICS �) EXIST'G 4 BR WAN 100 FEET OF PROPOSED 12 HOUSE UPGRA I /I I , I / / I I I I I I ----r EXIST'G DRAINFIELD I TO BE ABANDONED I , I I �i- I - 1° 111. OT DEVELOPED I NO WELLS OR SEPTI S \ WAN 100 FEET OF PR POS UPGRADE. b I \- iX lbl I • I I I ax x I I Il. O \ Y \ II U) 5 I > pox II I I I �aR I I II PROPOSED DRAINFIELD z UPGRADE. SEE 60 SCALE SHEET FOR DETAILS LOT UNDEVELOPED\ NO WELLS OR SEPTICS W/IN 100 FEET OF PROPOSED UPGRADE. I wl 2sl �I I I NOTES: 3) Connect post tank line to end of drain field, 1) All work shall be performed in typical. / OF f�� accordance with AMC15.65. 4) Maintain 10' separation to all lot lines & ........... �P '�• ..�� 100'to surface water. �� 2) Materials used shall be in accordance with those specified in IF :• 49TH �� AMC15.65, Wastewater Disposal. 5) Drainfield distribution lines shall be 1.25" diam, with 3116"111 perforations every 3.5 feet. %,,,,,E ,,, ,,,,,,,,, r ••••••••••••••'.•.. • r PREPARED FOR: ■ Scott Crowther ■ PANNONE ENG. SVC, LLC c Greg Sarber P. O. BOX 102954 ��!n•.. No. CE 6491 i �� 3220 Michigan Ave, Apt B Anchorage, AK 99516 ANCHORAGE, ALASKA 99510 ,• .•'`•�� • zaz-ao00 272-8218 P, 272-8211 Fax DATE: 9-5-06 t ": tJ ;'��� , DESIGN SCALE: 1"=100' TO PERMIT NO: SW06XXXX DESIGN DRAWING WASTEWATER DISPOSAL SYSTEM Lot 3 Moose Run Subdivision 7 0 EXISTG DIWHARGE LINE♦ EXIST'G STRM \ \ DRAIN \ in 1.25' DISCHARGE � LINE FROM PUMP VAULT TO DRAIN FIELDT SURFACE WATERER DRAINAGE EASEMENT S.T. E.P. TANK w/ AX20 Df & AUX PUMP VAULT EXISTG WELL'��o " DAM. LINE TO DRAIN E S EXIST'G FIELD - BEING INUNDATED BY THE UP 6 DEVELOPMENT. ABANE PLACE PER CODE 1 104092e / PIPE DAYLIGHTS IN EXIST'G DITCh OS ---- NOTES: ••���„��111, 1) All work shall be performed In OF accordance With AMC15.65. p•�E�Gq b♦ . `P .............. ��••, �♦♦ 2) Materials used shall be in accordance with those specified in 49TrI•••••�°_�� AMC15.65,WastewaterDisposal. Scott Crowther GregSarber No. CE 6491 ` 320 Michigan Ave, Apt B Anchorage, AK 99516 2>V 4• 242-8000 16-1 P.I.D. NO: 015-164-23 N /E FIdL�, -TfD DISTG ELL EXIST'G 18" CMP 153.3 rj)CULVERT �FIELD, 1 1 . ■ V EXIST'G OPEN DITCH 24" 0 STORM DRAIN PIPE 3) Connect post tank line to end of drain field, typical. 4) Maintain 10' separation to all lot lines & 100'to surface water. 5) Drainfield distribution lines shall be 1.25" diam, with 3/16"0 perforations at 3.5 feet PANNONE ENG. SVC, LLC P. O. BOX 102954 ANCHORAGE, ALASKA 99510 272-8218 P, 272-8211 Fax kTE: 8-21.06 DESIGN ]ALE 1"=R(Y PERMIT NO:SW06XXXX DESIGN DRAWING DETAILS P.I.D. NO: 015-16423 WASTEWATER ABSORPTION SYSTEM Lot 3 Moose Run Subdivision a gi Po Z 30 LLw O� � D M gq U W m N Z dVO/M1nONV310.V4 L p U ON3 HOV3IV r0 Q 3an1N011N0N Z O_W ~ LL N W O M p 11 W LL � � Q ry Q LU LL W a 0 Fa a w Z N UZ n N C; W� z �o Y O U _ WN O W U Of I—' o as z Ci m oa ;C W �Z o U) W O ON3 HDtl IV W d' O 3af11 NO11NOw O O OI "DIM 1nONtl3l0.b/L W_ LL .- Q W � I W W W � 0 3 � a O O_ g 0 a � o N 3101-INW4 AJ ¢a> O a I I 1noNv310 a �x a� co o,d 1nONd310 xn� ............. . ♦♦ i �,•�' ♦ ll�� NNyye� NAi OONf10B ••♦♦� � 49TH , � %'• ............................ .......I �Wi�••••• ♦♦':•G. Scott Crowther:; REPARED FOR: PANNONE ENG. SVC, LLC i ♦' '• No. CE 6491. • Greg Sarber 9 P. O. BOX 102954 ♦ • ♦♦i• 3220 Michigan Ave, Apt B Anchorage, ANCHORAGE, ALASKA 99510 ♦1•,,, AK 99518 242.8000 PHONE/ 272-8211 FAX ..•• I DATE218 ? 9 DESIGN NOT TO SCALE PERMIT NO:Sw06 DESIGN DETAILS WASTEWATER ABSORPTION SYSTEM LOT 3 Moose Run S/D P.I.D. NO: 015-164-23 DESIGN CALCULATIONS Number of Bedrooms - 4 Total Bedrooms -4 Design flow- 150 gal/br/day, Total flow - 600g/day Scott Crowther No.CE 6491 E: ADVANTEX TANK DETAIL TANK SIZE: 1500 gallon Advantex tank SOIL ABSORPTION SIZE: Advantex Sewer System AX20 Pod - Class III System PercRate= 1-5 min/inch Application Rate= 6 GPD/SF Size Required= 600 GPD/6 GPD/SF = 100 SF Use 5 -Wide Trench, 0.5' effective 30 Feet Long 30 LF x 5'x 0.5'= 150 SF Total PREPARED FOR: PANNONE ENG. SVC. Greg Sarber P. O. BOX 102954 3220 Michigan Ave, Apt B ANCHORAGE, ALASKA 99510 Anchorage, AK 99516 242-8000 272-8218 PHONE, 272-8211 FAX CALCS ) M. E ml+(I)!a H alweuAa��I ( � $ j ZZ & / / $ 22I $ M. E ml+(I)!a H alweuAa��I \ --E!`f-TlEn!!EmT--- \k�/})£/\)\{f!f!§ 3ƒ)\k)\)22);k£{ 1-,2±\:` ;6! ® )§ . ] ] 73 ; icl \Ti 9 Of ) \z 15 Zfi}I/7 )§ } f!{ 22I K22`§§'J2§ \ --E!`f-TlEn!!EmT--- \k�/})£/\)\{f!f!§ 3ƒ)\k)\)22);k£{ 1-,2±\:` ;6! ® )§ . ] ] 73 ; icl \Ti 9 Of ) \z 15 Zfi}I/7 )§ } PERMIT NO:SW06XXXX DESIGN DRAWING P.I.D. NO: 016-164-23 WASTEWATER DISPOSAL SYSTEM Lot 3 Moose Run Subdivision z �a &J a EXISrG OWIR MOUND FIELD P OSED PRI S: ARY FIELD E SECTION / P ROPOSED RES 3 RVE FIELD -E SECTIONFINISH C u g MADE a 11116 Y. MIN SLOPES MAX ° TOPSOIL & SEEDING d0' �DROI SEAS 3W NOWATER DWATEH / IND WATERa 6 M 4.0 J)4 1114 0 tt 10 11 00 1 00 10 W 10 70 10 80 10 W 10 40 10 30 lam 10 10 10 W 8 9 8 0 1233 9 LH %.....: io PREPARED FOR: PANNONE ENG. SVC, LLC /••••:•:•• /• Scott Crowther ♦ •. No. CE 6491 i Greg Sarber P. O. BOX 102954 / ♦/�j� • •' 3220 Michigan Ave, Apt B Anchorage, AK 9951 ANCHORAGE, ALASKA 99510 `a,•�• 242-8000 272-8218 P, 272-8211 Fax DATE: 9-6-06 . DESIGN SCALE: H 1:20, V 1:6 OF SOILS LOG - PERCOLATION 'PEST gr� �P.•• VT-:1� PANNONE ENGINEERING SERVICES ` P.O. BOX 102954= ° ....: 491H...................i.,. ANCHORAGE, AK 99510 i (907) 272-8218 ♦ .. •. . • ................}� *,1,6 -.Steven R. Ponnone'� 1)N6 No. CE 8149 PERFORMED FOR: Charles Higgins DATE PERFORMED: 8/13/00 LEGAL DESCRIPTION: Boulder Spings Resubdivision TEST HOLE 4 F7---1SLOPE Organics 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Brown silt Brow Silty Sandy Gravel Dense, Moist TEST WAS GROUND WATER ENCOUNTERED? YES DEPTH TO WATER AFTER MONITORING? -15 DATE: 9-7-2000 W cA 6 0A ro1q1041 SLOPE TEST HOLE READING DATE GROSS TIME NET TIME DEPTH OF WATER NET DROP 8-t3-00 12.20 — 61W — 12:50 30 1W' 6' 12:50 •- 619 — 13:20 30 1w 6' 13:20 — 619' — 13:50 30 114' 6' PEROLATION RATE 5 (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN AT BETWEEN 7 AND 8 FT COMMENTS: Test hole excavated by C. hole excavated by C. Hips. Test Hole was presoaked before perc test. Hole was presoaked before perc test. PERFORMED BY: Steven R. Pannone P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE _WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. PERFORMED LEGAL 1 1C 11 12 13 14 15 16 17 18 19 21 Municipality of Anchorage DEPARTMENT OF HEALTH 8, HUMAN SERVICES 825 "12' Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST DATE Lange, Section: 49TH �.... ....- .................b IF tEROY C. REID, JR. D �+ S CE - 2251 �qt� It /U la,P J S SITE PLAN WAS GROUND WATER ENCOUNTERED? /1✓O COMfc PERFO ACCOR 72-00841 - - rION RATE J (minutestinch) PERO HOLE DIAMETER d BETWEEN 1'5— FT AND 2' O FT CERTIFY THAT THIS TEST WAS PERFORMED IN . IN EFFECT ON THIS DATE DATE ro PERFORMED LEGAL 1 2 3 4 5 6 7 - 8- 9- 10 11 12 13 14 15 16 17 18 19 20 'OMMENTS j Municipality of Anchorage DEPARTMENT OF HEALTH $ HUMAN SEROfC 825 "L" Street, Anchorage, Alaska 99502-opq SOILS LOG — PERCOLATION TEgt Ty /5 - 2 . �- ..• •�••�•T%1!EN G INEER 49TH 1ROYC. RED, �aoCE-R �'e4r' Wim" VD. e-7 •P L: WAS GROUND WATER ENCOUNTERED? J� ' - (minO1es/inch) PERC HOLE DIAMETER TEST RUN BETWEEN _ 7 C- FT AND —4?— FT 'ERFORMED BY: ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE CERTIFY THAT THIS TEST WAS p I� (Rev, 4/85) PERFORMED IN MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program p� 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 b� (907) 343-7904 i ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Renewal Date Issued: Sep 29, 2005 Expiration Date: Sep 29, 2006 Permit Number: SWO50374 Parcel ID: 015-164-23 Legal Description: MOOSE RUN SUBDIVISION LOT 3 Design Engineer: 0062 Pannone Engineering Services Site Address: 11018 BOULDER CIRCLE 44 Owner Name: JON & VICKI SARBER Lot Size: 138792 SQ. FT. Owner Address: 320 MICHIGAN AVE #B Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE, AK 99516 - This permit is for the construction of: ❑✓ Disposal Field ❑✓ 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. -THE UPPER SIX INCHES OF THE MOUND SYSTEM MUST CONSIST OF TOP SOIL AND THE MOUND MUST BE VEGETATED SUFFICIENTLY TO PREVENT EROSION. Received B Date:jOCKS Issued By: I 1 � Date: Z 7 af- enevua_L Municipality of Anchorage ® Development Services Department L s Building Safety Division c On -Site Water and Wastewater Program s F 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. U/,5' //0t/-';2 3 Permit Number SW Propertrt Mailing Site adc Legal description (Lot, Block & Sub'd.) Legal description (Section, Township & Range) Lot Size /,9a Acr Sq.Ft. THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool I certify that the above information Single Family Dw9A jg and is in a of property Permit/Rush Fees: Date of Payment: ( phone P _Z516 Code 7 n`Z574 Code q�5 Number of Bedrooms 7 Well Only ❑ ❑ Water Storage ❑ ❑ Jacuzzi ❑ ❑ Water Softening Unit ❑ El correct. I further certify that this application is being made for a rdance with applicable Municipal Codes. agent) Waiver Fees: Date of Payment: Receipt Number: 24(4;pil ( Receipt Number: (Rev. 09104) MUNICIPALITY OF ANCHORAGE - Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street Ibu P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Date Issued: Oct 05, 2004 Expiration Date: Oct 05, 2005 Permit Number: SW040418 Parcel ID: 015-164-23 Legal Description: °MO68E RUN SUBDIVISION`LOT 3 Design Engineer: 0062 Pannone Engineering Services Site Address: 11018 BOULDER CIRCLE 44 Owner Name: JON & VICKI SARBER Lot Size: 138792 SQ. FT. Owner Address: 11018 BOULDER CIRCLE 44 Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE, AK 99507 - This permit is for the construction of: Z Disposal Field 7 Septic Tank ❑ Holding Tank ❑ Privy 0 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904(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 Issued By: Date: Date: Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 3 Permit Number SW n 41-O6� /8 mel/ .24/2-90ec) Property owners) Greg Sather Day phone 346.1590 Mailing address (1)10640 Yosikof Place �r -�Matl ag address (Z)11Q1$ f� ( p�) L=1A Ce Trp Code ; _ . %R✓a� Legal description (Lot, Block & Sub'd.) Lot 3 Moose Run SID Legal description (Section, Township & Range) Lot Size 136.792 Acres/SQ.Ft. Number of Bedroom$ 4 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ® Water Storage ❑ Sewer Upgrade ❑ THI,%PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: Date of Payment: Receipt Number. (Rev. 12100) Waiver Fees: �-49 0G Date of Payment: Receipt Number. Pannone Engineering Services, LLC Consulting Engineers September 26, 2004 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: Lot 3 Moose Run S/D Well & Septic System Permit Request Gentlemen: P.O. Box 102954 ge, Alaska, 99510 My firm was contacted to investigate the possibility of installing a new septic system serving this lot. Dr. Lee Reid excavated two test holes on July 21, 1991 for the original subdivision. I also excavated numerous test holes on these lots for a potential purchaser on August 13, 2000. Dr. Reid's soils logs & percolation test results are on file with your department. I am attaching a copy of my soils test Number four. Ground water was monitored through the seasonal high period of 2000. The ground water stabilized at a depth of six to 10 feet below the surface. Bedrock was not encountered in either test hole. The lot is 138,792 square feet (3.1862 acres) in size. Lot 3 slopes to the west at approximately 8 to 30 percent. The proposed installation will be located in the eastern portion of the lot, along the east property line. The proposed well will be located in the northern portion of the lot, greater than 100 feet from the proposed system and from the neighboring septic systems. The proposed location of the septic system is greater than 100 feet away from surface water, existing neighboring wells, and 25 feet from the water service lines. The septic area is located on a 30% slope. The drain fields will be installed at minimum depth to maintain vertical separation to ground water. Fill will be placed over the drain field to achieve the required cover. A 1250G S.T.E.P. Tank will lift the septic effluent to the proposed fields. The surrounding wells are located greater than 100 feet from the proposed installation. The proposed installation will not affect the future development of the surrounding or existing lots. See the attached design. If you have any questions or concerns, please contact me at 227-3522 or 272-8218. Sincerely, Steven R. ParIne, E. Civil Engineer Attachments: C:\W0rk\Letters\3 Moose Run.001.doc i `�Jp •' ' 49TH 17 �s PERMIT NO: SW04 DESIGN DRAWING P.I.D. NO: WASTEWATER DISPOSAL SYSTEM Lot 3 Moose Run Subdivision E NOTES: 1) All work shall be performed in accordance with AMC 15.65. 2) Materials used shall be in accordance with those specified in AMC 15.65, Wastewater Disposal. 3) Connect post tank line to end of drain field, typical. 4) Maintain 10' separation to all lot lines & 100' to surface water. 5) Drainfield distribution lines Shall be 1.25" dram, with 0.25" perforations every 1.5 feet. M"I 49TH jr----' LOT UNDEVELOPED. NO t ; WELLS OR SEPTICS W/IN JW OF PROPOSED SYSTEM 23 .5 18" SURDRAIN PROPO 1I ,}J N E ROPOSED 15009 S.T.E.P. TANK w/ 4 1 - AX20 ADVANTEX POO. INSTALL AUX PUMP VAULT .25" DIAM. DRAIN �.4 / FIELDS LOT UNDEVELOPED. NO WELLS OR SEPTICS WIIN iW OF PROPOSED SYSTEM K PROPOSED PRIMARY FIELD. 5'Wx301-Fx0,5ED, 1'TD 16-R "Ll"ANru 7UN: PANNONE ENG. SVC, LLC en R. onnone E = Greg Surber P. 0. BOX 102954 ln� 149 Anchorage, Vosiage, AK Place ANCHORAGE, ALASKA 99510 Anchorage, AK 99516 227-3522 P, 272-8218 Fa) TESS, w 346-1590 ;;;`�;:�� DATE: 9-26, 2004 DESIGN PERMIT NO:SW04 DESIGN DETAILS TO AMBIENT AIR INSTALL 4" RIGID INSULATION OVER TANK & DRAINFIELD. EXTEND R.12' BEYOND SIDE OF TANK. INSTALL R.1, AROUND AX -20 FILTER. WASTEWATER ABSORPTION SYSTEM LOT 3 Moose Run SN AX -21) FILTER P.I.D. NO: DESIGN CALCULATIONS Number of Bedrooms - 4 Total Bedrooms -4 Design flow -150 gallbr/day, Total flow - 600g/day ADVANTEX TANK DETAIL TANK SIZE: 1500 gallon Advantex tank NHOLE SOIL ABSORPTION SIZE: Advantex Sewer System AX20 Pod - Class III System Perc Rate= 5-15 minfinch Application Rate= 5 GPD/SF Size Required= 600 GPD/5 GPD/SF =120 SF �♦��%p44 Use 5 -Wide Trench, 0.5' effective ♦ (E q( +j .24 Feet Long i►♦�P•'"� 30 LF x 5' x 0.5'= 150 SF Total s � 49'm ' 8149 Greg Sarber )G ` 10840 Vosik Vosikof Place Anchorage, AK 99516 ;Ir�1PL�♦� 346-1590 P. O. BOX 102954 ANCHORAGE, ALASKA 99510 272-8218 PHONE & FAX DESIGN PERMIT NO: SW04 P ig DESIGN DRAWING DETAILS i�;° O WASTEWATER ABSORPTION SYSTEM I • Lot 3 Moose Run Subdivision """" "•' •' ""'""" i 9�=Steven R. Pannone • O NOTES: N Greg Sarber 10840 Vosikof Place Anchorage 1) ALL WORK SHALL BE PERFORMED � 1 AK 99516 346-1590 IN ACCORDANCE WITH, AND ALL MATERIALS • . SHALL CONFORM TO, AMC15.65. 0 2) ADD A MINIMUM OF 2" OF R.I. OVER ng ENTIRE DRAINFIELDS AND 2 FEET OF COVER. 3) DRAIN FIELDS ARE ON 30% SLOPE. PLACE In DRAINFIELDS AT MIN DEPTH TO MAINTAIN z SEPARATION TO GROUND WATER avuMulaNv31o.m1My UN3 HOW IV 3911131a11NOW c i G ig a HOV31V 39HLila11NOW dVWM InQNV3 &J l inONV310 inONV3l0 N611VM 'j-�jj W LL nnO L l� Pannone Eng. Svc., LLC P. O. BOX 102954 ANCHORAGE, ALASKA 99510 272-8218, PHONE & FAX aTE: 9-2-2004 DESIGN nT Tn crni c i�;° O I- I • """" "•' •' ""'""" i 9�=Steven R. Pannone • O PREPARED FOR: N Greg Sarber 10840 Vosikof Place Anchorage I 7n � 1 AK 99516 346-1590 • . G I•, ,.... • Y P a, a HOV31V 39HLila11NOW dVWM InQNV3 &J l inONV310 inONV3l0 N611VM 'j-�jj W LL nnO L l� Pannone Eng. Svc., LLC P. O. BOX 102954 ANCHORAGE, ALASKA 99510 272-8218, PHONE & FAX aTE: 9-2-2004 DESIGN nT Tn crni c i�;° O I- I ... ......... ..:....., """" "•' •' ""'""" i 9�=Steven R. Pannone • O PREPARED FOR: N Greg Sarber 10840 Vosikof Place Anchorage I 7n � 1 a HOV31V 39HLila11NOW dVWM InQNV3 &J l inONV310 inONV3l0 N611VM 'j-�jj W LL nnO L l� Pannone Eng. Svc., LLC P. O. BOX 102954 ANCHORAGE, ALASKA 99510 272-8218, PHONE & FAX aTE: 9-2-2004 DESIGN nT Tn crni c i�;° 49LH ... ......... ..:....., """" "•' •' ""'""" i 9�=Steven R. Pannone • PREPARED FOR: CE 8149�+ ,•��i_ p�M.rr Greg Sarber 10840 Vosikof Place Anchorage d•�• AK 99516 346-1590 a HOV31V 39HLila11NOW dVWM InQNV3 &J l inONV310 inONV3l0 N611VM 'j-�jj W LL nnO L l� Pannone Eng. Svc., LLC P. O. BOX 102954 ANCHORAGE, ALASKA 99510 272-8218, PHONE & FAX aTE: 9-2-2004 DESIGN nT Tn crni c U � OF q ,...., ..... , C 4 SOILS LOQ - PERCOLATION TEST �� �P,•. '••: �,.• Iy �1 PANNONE ENGINEERING SERVICES i � :• P.O. BOX 102954 = 491 ANCHORAGE, AK 99510 (907) 272-8218 f.....; ... ... . .................. ff .Steven R. Pannone ♦ ••t, No. CE 8149 �\ �f f q Coo cf ..•°�'u�` PERFORMED FOR: _ Charles Higgins DATE PERFORMED: 9/28/04 ff Eat' . LEGAL DESCRIPTION: Boulder Spings Resubdivision ►►*�~���� TEST HOLE 1-040928 SLOPE -------- _ ,________} __ --------- ,-------- _---- _____ -- Organics 2 3 SP/GP Poorly graded ream x Sands & Gravels. q 4 Trace Silts TEST HO t j--- ! - �• y,. GM Browm Silty 13 8 Sandy Gravel Dense, Moist �^ 10 BOH I I 1 13 WAS GROUND WATER SLOPE 14 ENCOUNTERED? YES is IF YES, AT WHAT 16 DEPTH? SEEPAGE & -9 TEST H + 17 DEPTH TO WATER AFTER MONITORING? -5 18 DATE: 10-4-2004 19 READING DAZE GROSS NET DEPTH OF NET 20 TIME TJME WATER DROP 9-28-404 13:45 — 61/4" — 14:75 30 1/4" 8" 14:75 — 8914 _ 14:45 30 1/4" 6' 1445 8 714" 15:56 30 tf4" G PEROLATION RATE 5 )min/inch) PERC HOLE DIAMETER 6 inches TEST RUN AT BETWEEN i AND 2 FT COMMENTS: Test hole excavated by KC INC. Test Hole was presoaked before pert test PERFORMED BY: Steven R. Pannone P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. — SOILS LOO - PERCOLATION TEST ; ........... -q mss# ♦ �P.•• #A PANNONE ENGINEERING SERVICES A P.O. BOX 102954 i.' 492i% �.....P ` .............h;., ANCHORAGE, AK 94510 .................... annoneP(907) 272-8218 .................. sSteven R. 8149��!.. .. PERFORMED FOR: Charles Higgins DATE PERFORMED: 9-28-04 LEGAL DESCRIPTION: Boulder Spings Resubdivision TEST HOLE 2-040928 OR Organics 1 2 3 4 5 6 7 8 9 10 11 12 13 14 1s 16 17 18 - 19 - 20 - SP/GP Poorly grade Sand 8: gravels Trace Silts GM Browm Silty Sandy Gravel Dense, Moist BOH SLOPE TEST HO WAS GROUND WATER ENCOUNTERED? YES DEPTH TO WATER AFTER MONITORING? -5 DATE: 10-4-2004 SLOPE READING DATE GROSS TIME NET TIME DEPTH OF WATER NET DROP 9-2a-04 13:60 — 6114" 14:20 30 1w 6" 14:20 — 61/4 14:60 30 114" 6• 14:50 — 6 19w, 15:20 1 30 1 1W 6" PEROLATTON RATE 5 (minjinch) PERC HOLE DIAMETER 6 inches TEST RUN AT BETWEEN 2 AND 3 FT COMMENTS: Test hole excavated by KC Inc. Test Hole was presoaked before perc test i)i:M9 Municipality of Anchorage *AE Development Services Department Building Safety DivisionOn-Site Water and Wastewater Program 4700 Elmore 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 Ra- s S v e - Parcel I.D. Orr_ r 6'Y - 2-3 COSA# OSS i -2 3 Expiration Date: 'Jam- /2- 1. GENERAL INFORMATION Complete legal description 1-0 t 3; i" 1 ease 't?,-tn S l.D Location (site address) 1 o as -1 tle r f ky>F Pletce AncAcvf!5w Current Property owner(s) ,6-r2 £ Yr e - k; sorb er Day phone 2 Y E'-BGt:�1® Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Po, Box 2EYoo No .+e At< 99603 Day phone. PafIL (ey oc r (D Rarmsfv Tetra, Day phone Z0 - 7SS"Y Unless otherwise requested, COSA will be held by DSD for pickup. Pleare 'e -MAW Reoel {moi- 6z rnf-e� (g recrosq {zzZM 2. NUMBER OF BEDROOMS: ly 4-Vq.6A CASA 'v 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class 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 sample results. (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 r?eAeWcc( o'F COSA #- OSC Ill f 23 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 _ EfAfler_ TccA ni c col Servccei Phone 3 H6- 13 .5' Address IF/5'30 Echo �unya.� Rc{ Aa+ckofir eO Alc 9-9.5'1( Engineer's Printed Name _ ��o�� �, r"rc6rco Date 6/ 1 / 2-017- 5. ©12 5. DSD SIGNATURE Approved for Disapproved. �- bedrooms, Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: _� Original Certificate Date: 1 (Rev. 11105) SGS Ref.# Client Name Project Name/# Client Sample ID Matrix Sample Remarks: 1121841001 Flattop Technical Srv. Lot3 Moose Run SD Lot3 Moose Run SD Drinking Water Printed Date/Time Collected Date/Time Received Date/Time Technical Director 06/01/2012 10:48 05/24/2012 14:50 05/24/2012 15:16 Stephen C. Ede Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Waters Department Total Nitrate/Nitrite-N 0.100 U Microbiology Laboratory E. Coli Negative Total Coliform Negative 0.100 mg/L SM21450ONO3-F B (Q0) 100mL SM219223B A 100mL SM219223B A 05/30/12 AYC 05/24/12 DLC 05/24/12 DLC SGS Ref.# 1120480001 Client Name Flattop Technical Srv. Project Name/# Water Samples Client Sample ID L3 Moose Run SD Matrix Drinking Water Sample Remarks: Printed Date/Time 02/17/2012 16:39 Collected Date/Time 02/14/2012 10:50 Received Date/Time 02/14/2012 11:30 Technical Director Stephen C. Ede Parameter Results LOQ Units Method Container ID Allowable Limits Prep Analysis Date Date , Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 02/15/12 02/16/12 SCL Waters Department Total Nittate/Nitrite-N ND 0.100 mg/L SM20 4500NO3-F B (<10) 02/14/12 CMA Microbiology Laboratory E. Coli Negative I 100mL SM21 9223B A 02/14/12 DLC Total Coliform Negative 1 100mL SM21 9223B A 02/14/12 DLC bb/18/. Loll UI: 4b 8bbb l I HYLUb HAUL ld owan 5 am ONE a MEN No NOR MEN M owns 171 367 MEN I OEM an I`� SIMON ■ MiRii *vanTeje FWd Maintenance Report Annual Inspection AnchorageTank & Welding, Ing 907-272-3543 P'P"ow /Rea v«' CUT el oPwm« No Greg & Vicki Sarber ltd Compartment Mike Blakeslee I PraWous stmaeeres AudOle and Wsual alarms pbtm 10851 Vesikof Place, Anchorage AK 99517 ❑Yes No (907) 345-1590 i4x$ ID# Ca my re st Pade MWULIom a Lam Nepuw<:em AX -106068 SVW40418 206633 RTL1105269 10/2012610 Retrieve O&M Info Daly flow near: redo Timor set ingr: Perform Heid Samplirg/Observntlons 'Q11,5*N"j �.I� '0� Odor of Semple le lyPlcal Icy ❑ Earthy © Malay Nor,typlcml ❑Silgde ❑Cabbage ODecay omv fllnn m Pvu oyes CUT el cam In tank ❑ Yee No C c Control Panel ltd Compartment MIPs I PraWous Dmclmrge Am Pa AudOle and Wsual alarms KOK Dial tone(teleme" only) ❑Yes No InspectfOlsan Pump system Impact Clean nlswP.Jd .......... Spice Box .................... Float Gorda .....................p�_r Floala........................ PUMP........................ Blotubee Filter .............. Biotube Pump Vault ....... �(. Reclrcakaing Spider Varve...... , slenatdre _��- i/ . �w� �I tDpp`'�If Measure Sludge/Scum S WdN SOum 1st Gompartmant CUT el pmvious I GUnerlt I Pmvloue ltd Compartment c,7t fI I PraWous current P evlow InspectfClean AdvanTex Filter Odor. @rC,X1/Nomad ❑Pungent inspect Letwals/Odtic"2 - Glean glunei;-�YNOFmeI ©Excosslae I Pod Bottom ❑ ❑ Bnd�rglPonrting;,,NonelMlrror ❑ Exceearve Intake Vent Inspect/Clean Discharge PumP System Inspect Inspect Aisar/lid � Floats Space sox Pump �(� Float cwds pa._.. Inspectlaarvlee Other System Components Inspect Clean Inspect Clean Olstnrection Eaulpmerd ❑ ❑ Dispersal Laterawo'Iflces ❑ ❑ Additional Services Rendered ❑ Cleaned textile eheela? ❑ Roplaced UV Items? ❑ POPlamdAlsad other ROM? Parts Used: W = Warranty, B . Billable V appropriate eelectlpn) w B item Number Deecnptmn rr ��.vt x Fina afety Irmpection ` ` relnstabd da baked on N 1anHoid re naotedi flush valves closed Control panel reactrvat d am perPoRnittg; no Rrrdrx actlm needed []Tank needs Pumping for aaM // , ❑ other? ,�mhvc{,rt tV &,a)1 cc. r T Date G41(11 �,g� Prgpa�gxJ=rnp fed mct� i.tll� �rp,4�S. I4.[�{h4 lnk.M. t f c Rf :�i4 �rsP�? ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWEEN MUNICIPALITY OF ANCHORAGE AND N()L 9vy14� THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this L Day of J UNr of 20�, by and between AWK kLG/1 herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Memorandum of Understanding agree as follows: 1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AW WTS), described as 1a �'i kt e X located T at U 5 % Anchorage, Alaska. vos�vT 2. Definitions. A. Alteration. Any change to the design or function of an AW WTS that Includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Prior to performing any alterations to an AW WTS the owner must obtain a Wastewater Disposal System Construction Permit from the Municipality pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65. B. Certificate of On -Site Systems Approval. An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with AMC 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. C. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. D. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. E. Permit (Construction) An On -Site Wastewater Disposal System Construction Permit as defined by AMC 15.65. F. Permit (Operating) An Advanced Wastewater Treatment System Operating Permit. An annual permit, issued by the Municipality, that allows the Owner to operate an AWWTS, upon meeting all the requirements of this agreement, the conditions of Operating Permit, the requirements of the On -Site Wastewater System Construction Permit and all relevant provisions of AMC 15.65 3. Fee. Owner shall pay to Municipality an annual fee of Z. -GY'�, ($ 0.00), payable on or before the issuance of the operating permit and annually thereafter. The annual fee is due on or before the anniversary date of the approval by the Municipality of installed system. 4. Term. The term of this Memorandum of Understanding shall be for the life of the AWWTS. The term begins on the date of approval by the Municipality of the installed system and shall continue while the AWWTS system is in use or operational or until the property is sold or title is transferred by owner and a new certificate of On -Site approval is issued to the new owner or transferee of the property. 5. Alterations, Installation and Removal of Additional Equipment. Owner agrees not to make any alterations, removal of parts or additions to the AWWTS without a Construction Permit from the Municipality. 6. Maintenance and Repairs. A. Throughout the term of this Memorandum of Understanding, the Owner shall maintain AWWTS in good repair. In addition, it shall be the responsibility of the Owner during the term of this Memorandum of Understanding, and any extensions or renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. Further, Owner agrees to comply will all applicable ordinance, laws, regulations, rules and orders for the AWWTS. B. Owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system pursuant to the terms and conditions contained in the Owner's AWWTS Operating Permit. This schedule shall be submitted to the Municipality annually upon the renewal of the permit. The schedule of maintenance and repair contained in the Owner's AWWTS Operating Permit is: r �f C. Owner acknowledges that the fine schedule for failing to maintain and repair an AWWTS are codified in AMC 14.60. D. Owner agrees that only maintenance, repair personnel certified by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. E. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. F. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. G. Owner agrees that the relevant provisions of the standard specification guidebook for AWWTS is the governing professional guidelines for the construction, maintenance and repair of the Owner's AWWTS. 7. Nonwaiver. The failure of either party at any time to enforce a provision of this Memorandum of Understanding shall in no way constitute a waiver of the provisions, nor in any way effect the validity of the Memorandum of Understanding or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 8. Amendment. A. This Memorandum of Understanding shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality of this Memorandum of Understanding was executed and such writing shall be attached to this Memorandum of Understanding as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this contract, the only authorized representatives of the parties are: Owner: Anchorage: Purchasing Officer C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of Understanding shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Memorandum of Understanding. 10. Severability. Any provisions of this Memorandum of Understanding decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Memorandum of Understanding. OWNER:% _ MUNICIPALITY: By. - By. Title: Date: Date: STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this` day of \-PP W 20V2., by , the 11 �Q ) ffr.,TAr,L'TALAsKA O RYPUBLIC FORALASKA 1 NO)Aommission expires: 1t u 2 W) uaiN11v Z1, x 12 Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore 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. _d'+S- f 6Y - Z 3 COSA # C 3 Expiration Date: 1. GENERAL INFORMATION Complete legal description 3, m &ore R an S lb t�2q)V106 T Location (site address) _ f o 6 SI Vox ,ko F )'force Ah c ha! a%0, Arc ?9,!5"1/ Current Propertyowner(s) _6 U 4 ti'icry; Scuba Day phone 2YZ-Bea Mailing address -r-e- 60)d 7-aaw -0 1 6,ner� Prk 99603 Lending agency Day phone Mailing address Real Estate Agent PDay phone '24i0 -76-S-9 Mailing Address Unless otherwise requested, COSAA will behold by DSD for pickup. P I eare a —met / Aee Oor -Ai 2. NUMBER!OFBEDROO S; jAFc)& r4mseyfeAm when Cern} ,. M �— e1 reeuvty kY prcie-ayo 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 ❑ 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 sample results. (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, f 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. NameofFirm_F(etl-fop Techrntce( Phone 3�IS-13sS' Address )NS3D Echo Lt/yo� Rd;o Anc , A-tc 99S�G Engineer's Printed Name i Aeo ,-Z re Date 2 / ZO / aat 2 -3ncaxae s®®e®aaoa®s4®t 5. DSD SIGNATURE Approved for cA bedrooms. CE `moo- r° eacaRe Disapproved: Conditional approval for bedrooms, with the following stip ulatrons } Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Nitrate Advisory Other t3yIf2 `'rLVti (Rev.1 Vis) Original Certificate Date: ( Municipality of Anchorage • "� Development Services Department Building Safety Division ° 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: Lo f 3, Me, o CLQ R cin S /1) Parcel ID: O IS'- 16y - 23 A. WELL DATA Well type _JLw/- If A, B, or C provide PWSID #_ Date completed 5/2Y IDS Sanitary seal (Y/N) Y Total depth S�Lft. Cased to 2O ft. FROM WELL LOG Date of test .S / 2 Y /OS Static water level 7 ft. Well production IS g.p.m. WATER SAMPLE RESULTS: Coliform Qcolonies/100 mL Nitrate 40.1 mg/L Arsenic: < S ug/L date of sample:2 / 0/ / r'Z B. SEPTIC/HOLDING TANK DATA Tank Type/Material AdyGn ><t x Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) Z y in. AT INSPECTION 'Y / lH /li 2 Y ft. 3.S t g.p.m. Collected by: Flach/ov Tfc% Svc Date installed IG / 19 /D,<' Tank size 1500 gal. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YIN) Y ATS ry p.rho^ Date of pumping -r / 18 / It Pumper Aer��co� C. ABSORPTION FIELD DATA Date installed W 119 /6G Soil rating (g.p.d./ft2 or fe/bdrm) .<. G Length 30 ft. Width S ft. System type S"'-6f1de drum l=ie/a( Gravel below pipe 0-5- ft. Total depth.! ." ft. Eff. absorption area tso fe Monitoring tube`t Depression over field AJ Date of adequacy test `//1,Y/fl Results(Pass/Fail) Pati For N bedrooms Fluid depth in absorption field before testaS in. Water added 61616 gal. New depths in. Elapsed Time:128 min. Final fluid depth Y in. Absorption rate >= e0e g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date N. 4. D. LIFT STATION Date installed 10 / 19 /Ol Size in gallons ZS -0 Manhole/Access (YM) Y "Pump on" level at Hb in. "Pump off' level at 3j� in. High water alarm level at Ys in. Datum So Ho m Cycles tested 104- Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot ?Uo' Absorption field on lot � yoo' Public sewer main N. A. On adjacent lots > 10o' On adjacent lots > fool Public sewer manhole/cleanout A1. A. Sewer /septic service line -> 2S ' Holding tank P. k. Animal containment areas JV.A. ( > tcV.) Manure/animal excrete storage areas M. A. ( > «' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 6 Property line wog' Absorption field -a 7-5Z:51 Water main /J. A• Water service line > 1,0' Surface water 1040 >< Wells on adjacent lots > 1U0 ' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 2a' Building foundation 270' Water main N. A. Water Service line > 'a' Surfacewater 7 tvo' Driveway, parking/vehicle storage > 1 ao Curtain drain PcvAe Seen Wells on adjacent lots > I F. COMMENTS jt TRp f%lvCrn f e?, 'f!'e..n lam' it 10o' ± � m *-� e e enft-- o34 4t C4rryrng Wei/-er 1r1 f'r+e 20' A onR /*1i ,So-A4ru-p4 �mper G. ENGINEER'S CERTIFICATION ly bou�cleery Y �� I certify that I have determined through field inspections and review of Municipal records that the above systems are in ave axle!' sf xt u: conformance with MOA COScA�/guidelines in effect on this date. /�CLG�O/E Engineer's Printed Name Date Fa6rlta.y 2Uy Zoll 2r2o%zp$ % COSA Fee $ Ileo ewer Date of Payment y a �, // j Receipt Number Uy S12 C (Rev. 4110) Waiver Fee $ Date of Payment Receipt Number C 'tel r Municipality of Anchorage PPVE $4 Development Services Department Building Safety Division On -Site Water and Wastewater Program s q'' E. r 4700 Elmore 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 1. D. 0l5' - 16 1/ ^ 23 1. GENERAL INFORMATION COSA # 0z JL l V I I a3 Expiration Date: & av Complete legal description !-of 4: M 00se Run S 1-1 Location (site address) 10691 V&r,kcf Plate? Ancli&e-5 e Current Property owner(s) 6 re d- 1/te_k, Setr- hen Day phone 2 4 Z Mailing address 1085-1 !/arike P /'lacep Individual Water Storage Anc& A} 945I,< Lending agency ❑ Community Class Well ❑ Day phone Mailing address Public Water System ❑ Public Sewer ❑ Real Estate Agent , rL'y McNed, , A floc PnG/y. Day phone 229 -SSS ci Mailing Address P.a. Sox Z y 1 ! 6 a AmeA. +k 995 2y Unless otherwise requested, COSA will be held by DSD for pickup. N~d_ eu 11 Rea tlrvr(0 2Z9 SBSo' All when CCuA U ✓L�ua(y rreLr-ado 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site 9 Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ 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 sample results. (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. 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 _ FlaFfee 'Tee4niec l (ervrcU Phone 3 YS -135's - Address _ IgS30 ea<nyo/Rot AnC47 99S !( Engineer's Printed Name 7—Aeodore /_. I�faoo-o_ Date a' 6RN .PC8.4 5. DSD SIGNATURE Approved for ! bedrooms. / Disapproved. , Conditional approval for bedrooms, with the following stipulations ' Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Nitrate Advisory Other By: (Rev. 11105) Original Certificate Date: <, o2C' // Municipality of Anchorage • �` Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore 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: Lel U0 M &OX& Run S /D Parcel ID: O 1,5- 16`l - Z3 A. WELL DATA Well type __F v f If A, B, or C provide PWSID # Date completed S /Z°1 /0S Sanitary seal (Y/N) Y Total depth Sad ft. Cased to 20 ft. Date of test Static water level Well production FROM WELL LOG 5/ 2y 10S7 WATER SAMPLE RESULTS: f1# Ir g.p.m. Coliform O colonies/100 mL Nitrate <0, I mg/L Arsenic: < ug/L date of sample: 1111'Y111 B. SEPTIC/HOLDING TANK DATA Tank Type/Material 14!i vols %LX Z, Well Log (Y/N) Wires properly protected (YIN) Y Casing height (above ground) 2 Y in. AT INSPECTION y/1v/u 2 Y ft. 3.S t g.p.m. Other bacteria G colonies/100 mL Collected by: I e c -A -roc Date installed 16 / 19 / OG' Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YIN) Y Date of pumping 1009110 Pumper A 4 1il* me Ser✓!� �� C. ABSORPTION FIELD DATA Date installed O t G Soil rating (g.p.d./ftZ or ft2/bdrm) li• O Length 30 ft. Width S ft. System type T'- L f de GPrr{,n f rreC Gravel below pipe 0-s— ft. Total depth S' -S' ft. Eff. absorption area ISO ft2 Monitoring tube Y Depression over field N Date of adequacy test Y /11Y / f I Results (Pass/Fail) PeX" For _Y _ bedrooms Fluid depth in absorption field before test CAS in. Water added SIS gal. New depth 9 in. Elapsed Time: 126 min. Final fluid depth 4f in. Absorption rate >= 600 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) IV If yes, give date N-,+. D. LIFT STATION Date installed 10119104' Size in gallons 2 -SW Manhole/Access (Y/N) "Pump on" level at `!O in. "Pump off" at in. High water alarm level at YS— in. Datum Be, Cycles tested 10 + Meets alarm & circuit requirements? Y E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot � 200' On adjacent lots > 100 Absorption field on lot lie Public sewer main N• A. Sewer /septic service line > 2,9' Animal containment areas Nan! On adjacent lots > 100 Public sewer manhole/cleanout N• A. Holding tank M. A. Manure/animal excrete storage areas 1Vc-n e SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 6 Property line �' Absorption field x ZS0 Water main IV • A. Water service line > to ` Surface water t 00 Wells on adjacent lots > r 0& ' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 20' Building foundation 2 7G' Water main N • A•, Water Service line > t0 ` Surface water '> t!z ' Driveway, parking/vehicle storage 7 t CG Curtain drain Nano Seen Wells on adjacent lots > lyo' F. COMMENTS*The AefvCtn t tic 'he.n Le it t fto' t CGtrry,ng in "ire 20' C(rtrenagP fc G. ENGINEER'S CERTIFICATION I certify that l 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 7-4 t0 e -low F. Ha o ve Date Aaw, l 26 2011 COSA Fee $ 'Y 90 =� Date of Payment `i Receipt Number (Rev. 11/05) Waiver Fee $ fir.Gn, tAe ten I -e,^ of 9:k at, tee, ;(Pmevtt a lar+* +'�df S&"A&�Af f Date of Payment Receipt Number a U F- ZZJ N U H z 1 W w M� UJZZ Z 2' Z N o O O bw 0 C / t ? W W O OM N 00'08'05"W 165.32' $ VOSIKOF PLACE / 7 �r'i -I�� O Z m i a. a to N N 0 8 0 v Y 0 II� U c L w 0 U ID (n N x °U 0 J U) Q O C/) J m Q a M cd L IL J O J a vis yoOV os aV (7 N ,. O Ln z�: Y 4e /f "r, Y o _ O 8l M„L0,80.00 SI { O O / oLZaQ / w M — q W N •a Lo q C ^'1 w / ;• D L A._ r 02 c0 cv as / W U , a o m o o ? mm 0 v EaLno O I ry�01 W i m G m�E- we v�-0m. m cor t E= c So. 0w a 0 m O Ji N Oo Efv p'c0 0 FmO s w 0 o«.o v Q - 7 �r'i -I�� O Z m i a. a to N N 0 8 0 v Y 0 II� U c L w 0 U ID (n N x °U 0 J U) Q O C/) J m Q a M cd L IL J O J a vis yoOV os aV (7 N ,. O Ln z�: Y 4e ° Y mr LL O O O oLZaQ E'&w w M — q 0 t N •a Lo q C OO m q ;• D L A._ r � cv as CL q°0c = a o m o o ? mm 0 v EaLno NLo m m £ c c C (10. q m �`0��amOcc m G m�E- we v�-0m. m cor t E= c So. 0w a m O Ji N Oo Efv p'c0 0 FmO s w 0 o«.o v Q - Z �• 'O pj •0 �a m fl o c Do c v y FL E-00 �oc � o`o c v'O L rZyc oa C mo O O O 3 N>am 0 0 CL 0 cam£ O �. .'c-3 >Mr sv�iootma OR o oc — Z C" m P °• r O v O 0- c WimwLa � qm L o wOv E Q -cc !E o O o £co _ .0-c- ai oL 70 0 a •�a o m> > q Loi « oL « L c 0.00 E O O=q0 O mJ l—£ m wm L o q c a — > _ 3 C GO o = v