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Home My WebLink AboutDENALY ESTATES BLK 2 LT 16Onsite File Denaly Estates Block 2 Lot 16 #067-062-23 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211346 PID Number: 067-062-23 Dwelling: ❑■ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project:❑ New ❑ Upgrade Name Eklutna Inc ABSORPTION FIELD ❑ Deep Trench M Wide Trench ❑ Bed ❑ Mound Site Address 25503 McIntyre Rd, Eagle River, AK 99577 ❑ Other Phone 907-310-2501 Number of Bedrooms 4 Soil Rating JTotal depth from original grade 1.2 GPD/SF 4.5 / 3.8 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3.5/2.7 Ft. Gravel depth beneath pipe 1.0 / 1.1 Ft. Subdivision Block Lot Denaly Estates 2 16 Fill added above original grade 4.4/0.1 Ft. Gravel length 44 / 44 Ft. Township Range Section Gravel width 5 Ft. Beds: Number of Lines N/A Distance between lines N/A Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 3$7.2 Ft2 2 4.8 Ft. -We.ii`` >100' >100' N/A N/A >25 TAN'* v'Septic 0 S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1250 Gal. Surface Water >100' >100' N/A N/A Material Plastic Number of compartments 2 Lot Line >5' 4' N/A N/A NA Foundation >10' >10' N/A N/A TATION Manufacturer Capacity Remarks Gal. Alarm location Electric ' ailed by Installer PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield MKS Rental & Equipment Drainfield D3034 co/MT D3034 Inspector J. Millette BENCH MARK (Assumed elevation) 100 ft Inspection 15� 10/6/21 10/7/21 Location and description dates: 3m m 10/11/26 411 Top of foundation at SW corner of Home ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp AQ•�- Conditional Approval: Date TH ® — •* .. .. Septic System Be�� / 1 �r 3chlller ��F%lF Approve �-._ `— Date 92 . , 12/ 1%21 . •a��`-,�/ Note: this approval does include not well permit requirements. kRCv UU/UL/ !0) DENALY ESATES SUB, BLOCK 2 LOT 16 PERMIT # OSP211346 4,5 --_EXf$TINGWELL 1250-GALSEPTIC TANK W/20" MANWAY C � � LOT�16 _0 T&E EASEME T ALTERNATE SITE`CA-T-III-SYSTEM- APP RATE 6.0,17.5! LONG k�' 5`WIDE, 'iT' EFF DEPTH/ ABSORPIONTREN H —FCO -`J � 4-BDRM HOME 2---44-LONG x 5' WIDE, 1' EFFECTIVE DEPTH ABSORPTION TRENCHES 114c, `\\ C 3 \ \ Nr�R� f?o 71 RGE .j ENGINEERING *:49TM . .......... . Benja i Schiller 2/21/21 (�l\��PROFESSIONP��.� � PLAN AS -BUILT 0100 " � J FEET 1 "=50' PID # 067-062-23 0 LOT 1! \ A B C FCO 11.6 13.4 SV1 32.9 75.5 2CO 40.2 81.4 FS 43.6 84.4 C01 48.3 61.7 MT1 48.4 63.2 CO2 48.4 87.4 MT2 48.7 87.0 CO3 57.9 70.6 MT3 55.2 68.8 C04 59.2 94.8 MTA 60.6 94.3 LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE DENALY ESATES SUB, BLOCK 2 LOT 16 PERMIT # OSP211346 PID # 067-062-23 88.5— F- o� �o 96.4 FINISH GRADE 92.0 ORIGINAL GRADE U DRAINFIELD ROCK 88.5 87.5 87.5 44' 75 GROUNDWATER 10/6/21 76.0 OCo Co 02 89.6 FINISH GRADE 89.5 ORIGINAL GRADE Ov - H H 1nn mr 86.8 86.8 DRAINFIELD ROCK 85.7 85.7 r® 44' eNe�HeeaiNe 74.5 GROUNDWATER 10/6/21 73.5 PROFILE AS -BUILT (NO SCALE) .......... • ' • • • • Benja . Schiller ' `��F��JT • • . CE vi� 21 .'�� PROHWONP�..v PERMIT # OSP211346 GIN EIRING PID # 067-062-23 U -t. V ! - (NO SCALE) . .. . .......... • ' ' Benja'n Schiller ' •' CE 12592 ��\w�PROFESSIONP�'.` SOILS LOG AND PERCOLATION TEST E N G I N E E H I N 6 LEGAL DESCRIPTION: DENALY ESTATES BLOCK 2 LOT 16 PERFORMED FOR: HULTQUIST HOMES DATE: 12121121 PROJECT No.: PARCEL ID#: 067-062-23 TECHNICIAN: J.MILLETTE DEPTH TEST HOLE 1 (feet) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Illlilllllll! 11 OB :+• GM (SILTY SANDY GRAVEL) 4• . m 5 COMMENTS: SLOPE SITE PLAN WAS GROUNDWATER ENCOUNTERED? YES GROSS TIME (MINUTES) IF YES a WHAT DEPTH? 15' L 9/30/31 DEPTH TO WATER AFTER MONITORING: 15' 0 3:22 DATE OF MONITORING: 10/6/21 P 2 DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH To WATER (INCHES) NET DROP (INCHES) 9/30/31 1 3:22 10 0-3%6 3%6 2 3:33 10 0-35/16 35/16 3 3:44 10 0-3%6 35/16 4 3:55 10 0-35/16 3%6 5 4:06 10 0-3%6 35/16 6 4:17 10 0-35/16 39/16 PERCOLATION RATE: 3.3 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 3 FT. and 4 FT. Unsubdivided S 89'59'20"E 181.44' TREE Lot 16 \ 56,722 S.F. \ 30' T&E EASEMENT r \ 20' M.E.A. EASEMENT o� \ N Lot 15 a \ M N SETBACK LINES IROSEC�N� WELL �• co X00 P CLEARING :, -,Lot ' " LIMITS �r SEPTIC PIPE-- \ • �` %'`� - j 3``'�S.g•`' S££ y0 MANHOLE—� \~+• 0�11�USE / ?SO SEPTIC PIPES . �. �• 400.0 400.0 o IV 15'x15' T&E EASEMENT TBM — EDGE OF ASPHALT ELEVATION = 397.47 tT 'Y � � q ® \ HOUSE DETAIL Scale: 1"=30' 104.8 103.0 .0'x5.0' ANT . EXISTING ELEVATION PROPOSED ELEVATION SURFACE DRAINAGE PLOT PLAN —__ AS BUILT _X_ SCALE _ 1" == 60' _ GRID _ SW 0_362 Project No. 21-511184 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associatesinc. (907) 522-6476 Phone 9(907) 522-4625 Fax � F �oa�� Professional Land Surveyors ken0longsurvey.com v • �� 4� jonathan0longsurvey.com a 1 hereby certify that I have surveyed the following described property: oD�. 49TH LOT 16, BLOCK 2, DENALY ESTATES SUBDIVISION (PLAT No. 2018-29) Anchorage Recording District, Alaska, and that the improvements situated thereon are "" .............. .... within the property lines and do not encroach onto the property adjacent thereto, that Q G no improvements on the property lying adjacent thereto encroach on the surveyed Q'� KENNETH �LAG <r premises and that there are no roadways, transmission lines or other visible �^�, easements on said property except as indicated hereon. QD� �, pFAF L-502.• yJpO Dated this the --:L!--- Day of at Anchorage, Alaska 6Qp� o • • • • • NO�o y04ROF£SSIONA4- it is the responsibility of the owner to determine the existence of any easements, �Opppoo� covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Water & Wastewater System Permit Permit Number: OSP211346 Work Type: WellSeptic Initial Tax Code Number: 06706223000 Site Legal Address: DENALY ESTATES BLK 2 LT 16 G:0362 Site Mailing Address: 25503 MC 1NTYRE RD, Eagle River Owner: EKLUTNA INC Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date Expiration Date Lot Size in Sq Ft: Total Bedrooms: No � f Departrnont 8/23/2021 8/23/2022 56722 Q Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy 0 Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (2417). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: 1. The recorded plat for this subdivision notes that artesian wells are common and that special drilling methods may be required to prevent waste of water via surface discharge. 2. A test hole is required prior to construction of the absorption field, in location shown on site plan. Test hole shall confirm minimum separations to seasonal high groundwater and impermeables, as well as percolation rate of the accepting soil. Construction may proceed at your own risk prior to 7 -day groundwater monitoring. If I results require a design change, construction shall stop pending Onsite approval of a change order. Please I submit results with inspection report (or change order, if required). Veronica Pope *Wl� 2021.08.23 Received By. 11:01:33 -08'00' Issued By: 61;11Z� Date: Date: 242 Q S Anchorageicipality of i P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 99519-6650 0 (907) 343-7904 0 Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Department On -Site Water and Wastewater Section Waiver#: OSV211057 COSA#: Permit#:OSP211346 PID#: 067-062-23 Legal Description: Denaly Estates Block 2 Lot 16 Engineer: Forge Engineering Applicant: Eklutna Inc �wcnt S � n s 1)��artment 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 7.0 feet. See engineer's waiver request for justifications. 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. M v v v v m v m m v m 0 0 v m v v 0 v m v v v v v v O m 0 v 0 m m O v v m 0 v v m O v v v m v v v O m O v v v m m v v v m v v v m v v v v m m m v v v v m m I Waiver is Granted: X Waiver is not Granted: Date: d 3/o O oa 1 _ Approved by: " , (LS Name of Reviewer ■vavvmvmmvvvvavvvvvvvamvmmavvvvvvevavvvavvvvavvamvvvmvvvvvavmmvvvvvvamvvavvmvv� UMCIPALITY OFANCHORAGE PSI' s Community Development Department - Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 067-062-23 Property owner(s) Eklutna Inc Day phone 907-310-2501 Mailing address 16515 Centerfield Drive, #100, Eagle River, AK 99577 Site address NHN McIntyre Road Legal description (Sub'd., Block & Lot) Denaly Estates Sub, Block 2 Lot 16 Legal description (Township, Range & Section) Lot Size 56,722 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑x Initial ❑x Single Family (SF) ❑x (w/wo AD U) Septic Tank ❑x Upgrade ❑ Duplex (D) F-1Holding Tank F-1Renewal El Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well x❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Absorption trench to property line Distance:7 I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. �v (Signature of property owner or authorized agent) Permit/Rush Fees: g oC d+ y% Waiver Fees: 14 Q a 5 t# 13 5 Date of Payment: 1 '7 •Z (? 2 I Date of Payment: X17 �..n Receipt Number: 660 `% b Receipt Number: Permit No. 03F.2 1 f 9q(0 Waiver No. 0 S V 2 1 1 0 517 Permit App_-'- : .-.,:c August 18, 2021 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 8/18/21 Subject: Denaly Estates Sub, block 2 Lot 16 – McIntyre Rd Septic system design Dear On-Site Services Engineer: The owner of the above lot intends to build a 4-bedroom home on the property, so we are submitting this permit application for the construction of a new well and septic system. The attached site plan identifies the location of the home as well as the proposed well, septic location and alternate site. The ground surface on the lot is variably sloped with grades between 25-40% running to the south. The system will be placed near the south property line on a slope at or under 35% and will be located up gradient from a slope at or under 40% with an elevation drop less than 10’. The current design meets all steep slope provisions as stated in 15.65.210.B.4 of the MOA Wastewater Code. Contour lines are shown on the site plan identifying the elevations. Stormwater drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. We are requesting a variance waiver for the south trench to be 7’ away from the southern property line. If the waiver is granted, 100’ separation will be achieved from all potentially impacted wells. This will ensure that the Municipal regulations are satisfied and there will be no adverse impact to the well water on this lot or adjacent lots. The alternate site is located greater than 6’ away from the primary site, and the tank will be a minimum of 5’ from proposed trenches. Please refer to the attached test hole logs, soils lab analysis, plan and profile pages for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211346, Rebecca Carroll, 08/23/21 EXISTING WELL Benjamin Schiller CE 12592R EGISTEREDPROFES S I O N ALENGINEER 1"=50' 2- 44' LONG x 5' WIDE, 1' EFFECTIVE DEPTH ABSORPTION TRENCHES CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND DENALY ESATES SUB, BLOCK 2 LOT 16 FEET 0 50 100 NOTE: NO SLOPES >25% WITHIN 50' EXCEPT WHERE NOTED OR SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. McI N T Y R E RO A D 4-BDRM HOME 8/13/2021 15' x 15' T&E EASEMENT CLEARING LIMITS 30 T&E EASEMENT 20' M.E.A. EASEMENTEXISTING WELL PROPOSED WELL 395 400 405 410 415 420 425 430 435 440 445 440 455 1250-GAL SEPTIC TANK W/20" MANWAY PROPOSED TEST HOLE CO CO CO CO MT MTMT MT FCO2CO FS ALTERNATE SITE CAT III SYSTEM: APP RATE 6.0, 17.5' LONG X 5' WIDE, 1' EFF DEPTH ABSORPTIONTRENCH ≥7' EXISTING SLOPE IN THIS LOCATION IS ABOUT OR UNDER 33%. THE CURRENT SEPTIC DESIGN MEETS STEEP SLOPE PROVISIONS AS STATED IN 15.65.210.B.4 OF MOA WASTEWATER CODE. MUST BE SEEDED TO ENSURE SLOPE STABILIZATION. IF FOUNDATION DRAINS INSTALLED ENSURE 10' SEPARATION FROM ABSORPTION TRENCHES Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211346, Rebecca Carroll, 08/23/21 TYPICAL TRENCH SECTION (NO SCALE) NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY Benjamin Schiller CE 12592R EGISTEREDPROFE S S I O N ALENGINEERDESIGN FACTORS:SYSTEM REQUIREMENTS: 600 GPD PEAK FLOW PERK RATE: 3.4 MIN/IN APPLICATION RATE: 1.2 GPD/SF 5' WIDE TRENCH SYSTEM 1250 -GAL SEPTIC TANK BOTTOM OF TRENCH: 4.5' BELOW GRADE FLOW LINE ELEVATION: 3.5' BELOW GRADE TOP OF TRENCH: 0.5' ABOVE GRADE 600 GPD / 1.2 GPD/SF /5' WIDE *0.88 RED FACTOR = 88 LF TRENCH REQUIRED ( 88 LF SPECIFIED) 8/13/2021 4" PERFORATED PVC (HOLES DOWN) DRAINFIELD ROCK 5' 6" 6" 3' 1' DENALY ESATES SUB, BLOCK 2 LOT 16 MUST BE SEEDED TO ENSURE SLOPE STABILIZATION. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211346, Rebecca Carroll, 08/23/21 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. 067-062-23 1. GENERAL INFORMATION Expiration Date: �� 7— Complete legal description Denaly Estates Block 2 Lot 16 Location (site address) 25503 McIntyre Road Current property owner(s) Mailing address Real estate agent Eklutna Inc. Day phone 907-310-2501 16515 Centerfield Drive, #100, Eagle River, AK 99577 2. TYPE OF DWELLING: ❑■ Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic Q Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ `7S Waiver Fee $ Date of Payment 12J 3 0Z 2 Date of Payment Receipt Number b(0ys7 ( Receipt Number COSA # SSC 2 It 7 L(r) Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone (907) 522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503 Engineer's Printed Name Benjamin Schiller, P.E. Date 12/21/21 ."V *: 49TH •* / 6. DSD SIGNATURE " ' �' ::'-' : :: System #1 Approved for bedrooms r B�enjaa .. Chiller CE System #2 Approved for bedrooms ��s,Fq. • 2121521, Disapproved `liPROFESS10�p Conditional approval for bedrooms, with the following stipulations: PN_ITY QF 6f O qTF p T� o ROn:t'q By V" Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSA Checklist Legal Description: Denaly Estates Block 2 Lot 16 Parcel ID: 067-062-23 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA 0 Well log is filed with Onsite (or attached) Date drilled 10/14/2021 Total depth 121 ft Cased to 121 ft ®❑ Sanitary seal is functioning correctly Fml Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA 10/14/21 Well production at time of test 20 gpm Water storage tank volume NSA gallons Well disinfected for coliform test? ❑ Yes ❑ No 9 Coliform bacteria is Negative Nitrate 0.392 mg/L ❑ Nitrate less than MRL (ND) Arsenic 2.50 ug/L ❑ Arsenic less than MRL (ND) Collected by Wheaton Water Wells Date of Sample 12/7/21 Static water level at beginning of test 0* ft. Comments Flowing Atesian Well, no well pump needed. Jet -pump installed inside home. B. TANK DATA Age of tank(s) <1 years Tank type/material Septic / Plastic Measured operating fluid level in septic tank New R Standpipes/foundation cleanout per record drawing Date of pumping New D. ABSORPTION FIELD DATA 5' Wide Trench Which system tested (date installed) 10/6/21 0 ALL standpipes present per record drawing Total measured depth from grade 8.9/3.9 ft (max) Measured depth to pipe invert from grade 7.9/2.8 ft (min) ❑ NIA — pressurized field no Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet STATION ❑ Require aintenance completed Age of lift station years Lift station material Comments: Adequacy test date esults ❑ Pass For bedrooms Fluid th prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Yes Community Sewer Manhole/Cleanout > 100' ft Q Yes if No ft Q Yes if No ft Neighboring Tank > 100' Property Line >10' Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No ft Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' M Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' Q Yes if No ft 0 F71 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5' Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' P/ Yes if No ft Private Wells > 100' ❑✓ Yes if No ft Water_Main.>_ 10' . Yes if No ft Community Wells > 200' Q Yes if No ft Water Service Line > 10' 0 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Yes if No ft If absorption field is under driveway comment below 4 Property Line >10' Q Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l 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. COSA Checklist yellow sheet Aw *.-'49 TM �..• Benja 'm�'r -Schiller •:� CE 12592 AQ-k`� ��1� • 2/4/2022 . • � �� PROFESS01\:, Arlheaton Wat"-carr VVeflo Inca 1190 N. Wasilla-Fish hook Road Wasilla, AK 99654 (907)376-2041 Name: Hultquist Homes, Inc Address: 12570 Old Seward Hwy #204 City: Anchorage State: AK Zip Code: 99515 Well Site: Denaly Lot/Block: L16 132 Additional: 25503 McIntyre Rd Well Depth: 121 ft. From: To: Formation: 0 2 stick up Below Ground: 119 ft. 2 14 sand/gravel/silt Above Ground: 2 ft. 14 32 gravel/sand/wet Gal/Min: 20 32 39 gravel/silt _ _ 3.9 55 silt Static Level: Flowing, Art 55 115 clay 115 121 water/gravel/sand Casing: 121ft. of 6 in. x .25 in. steel Liner Pipe: N/A Screened: N/A Perforated: N/A Grouted: Yes WATER QUALITY TESTING Coli Depth: orm CoG/�OOrr�L Nitrate�_.3Y 2 mg//L 5 bags Arnic 2 , S Ug/L Develop. Method: Air ��- /o-W-V Use of Well: Residential Drilling Method: Rotary Misc: Other: Chlorinated to 50ppm The well was pumped 5' off the bottom with 100% draw down for 2 hours and recovered at 20gpm . Date Drilled: 10/14/2021 Driller: Seth Moore