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HomeMy WebLinkAboutDENALY ESTATES BLK 2 LT 1Onsite File t 2f Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181282 PID Number: 067-062-08 Dwelling: ❑■ Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑■ New ❑ Upgrade Name: Troy Davis Homes ABSORPTION FIELD ❑ Deep Trench R Shallow Trench ❑ Bed ❑ Mound Address 1689 Knik Goose Bay Rd 400 Wasilla, AK 99654 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 310-2501 4 1.2 GPD/SF 5.8 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 1.8 Ft. Gravel depth beneath pipe 4.0 Ft. Subdivision Block Lot Denaly Estates 2 1 Fill added above original grade 1.8/2.5 Ft. Gravel length 51 Ft. Township Range Section Gravel width 5.0 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 510 Ft 1 Ft. Well >100' >100' N/A N/A >25' TANK 9 Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity 1 1,250 Gal. Surface Water >100' >100' N/A N/A Material Number of compartments Lot Line >5' >10' N/A N/A Steel 2 NA Foundation >10' >10' N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain None Noted Gal. Remarks Tank vents & FCO pipe material: Pump on level at in. Pump off level at in. High water alarm at in. ABS ASTM F628 Pump make and model Electrical Inspections performed by Installer PIPE MATERIAL House to tank F628 Tank to drainfield D3034 Ursa Minor Landscaping & Excavation Drainfield D3034 CO/MT Inspector J. Williams BENCH MARK (Assumed elevation) 100 ft Inspectes: 1tion51 10/26/18 10/26/19 Location and description Znd 3'd 4th Bottom of siding @ point A. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp OF �..,•®® Conditional Approval: Date ®®� ��"" ® 49th MF o..... .........................i �nJO 1AICHAEL E. ANDERSON to o 6���J,.• No. CE -4381 _® �i Approved Date ��d `� T®oj 6/17/19 �'Fp"• ••e��=�� 11 wNccuvi i rcepui i_a- i - i Z.aoc DENALY ESTATES, BLOCK 2, LOT 1 PERMIT # OSP181282 PID # 067-062-08 / 7.---- K-- --.S' moo LOT 3 15'T& ASEMENT 10'T&E EASEMENTS // / / • LOT1 �- ' / - E WELL / 50' ONG x 5'WIDE x 4' ECTIV ! - H / ABSORPTION TRENC 100'WE RADIUS / 4-BDRM ( - / • HOME �� / TH1 / MT .0O2 FCOO j / S/1 0 �' PROPOSED WELL / 2��' © 4 / 0 (n / 1,250 GALLON Z / SEPTIC TANK .37 / ® ALTERNATE SITE C01 , Z / LOT / 1 \ 4 / LOT 25 1 1 \_____________: ; 1 C 20'DRAINAGE EASEMENT \ \ c ..�.�lMsrwii4_ A B C 1 P..-� ,. „�l4,q% EGO 7.5 ' 7.5 LEGEND a-)..• •' "''... s SV1 15.8 24.8 CO-CLEANOUT • PLAN AS-BUILT SV2 23.3 31.0 Jam:: �'� \" 2C0-DOUBLE CLEANOUT lit • • 2C0 32.0 38.9 57111- 1:1 • a 49yth� C01 49.8 51.0 FCO-FOUNDATION CLEANOUT [- �-�aZ3L MT-MONITORING TUBE •/.0 MICHAEL E. ANDERSON l = CO2 33.8 44.5 -, : 0 50 100 MT 36.9 47.8 SV-SEPTIC VENT • No. CC-4381 :• .z. TH TEST HOLE �iA'F,QF. 6/17/19 •'•.�• GE FEET CONTOUR INTERVAL 5' • ����pROFESS\�P..� �.a M<<.,M• 1°=50' DENALY ESTATES B2 L1 PERMIT # OSP181282 PID # 067-062-08 N 0 O In (n 0 - - /_ 98.0 - - - ^ 93.9 V93.3 1250 GAL 93.1 SEPTIC TANK -N"":� -. 89.0 96.6/97.3 FINISH GRADE Ov2 94.8 ORIGINAL GRADE Ov IIuI I\ III I 93.0 a 93.0 89.0 51, 89.0 GROUNDWATER @ 82.8 8/19/18 c., 78.8 II- m .�omisi illi. ■ 49th '.VAItMICHAEL E. ANDERSON r ill#WiPGE PROFILE AS-BUILT "�s'••. NO CE-4381 .'_= (NO SCALE) �.♦♦•_Q,eD p 6/17/19 ,.P,,,• \ T 396.2 \ \ 396.2 \ >0'q>'q1 , P 124•27• � /^0 15' T&E /EASEMENT \ Lot 3 cv/ / I WELL 1 / 10' T&E EASEMENTS \ �. 6 ry GARAGE / \ EL. 386.1 / 20.0. / 106.0 0 / 2 STORY RESIDENCE / SEPTIC PIPES / N / Lot 1 / 1 49,376 s.f. / / A / / Lot 2 20' DRAINAGE EASEMENT 375.2 I I 375.2 1 II 1 11 1 II 1 II 1 II I. u4D Lot 25 L=17.06' \ R=320.00' \ � 1 3 4q�2F g \ 97g0 L=27.73' R=20.00' ,0'x11.0' CANT / 7'x24 0' PORCH 97.0" .5'x4.2' CANT 12.1'03.0' DECK / TBM - TOP OF REBAR ELEVATION = 391.94 N ch J m a 3p �y O icto' X to N: ops �I 1n�< rn: :z ° Y m O O � L QO �• C o O m °� o 0 0 0 0 m E'& e o 0 «oma r o 0 n � p 0 t> c m 0 tNt9m O CV m L Od O am °L e c n � 104 G V aN an d e N C-00 m O O C C 40 2Z>0 a.0 e o 0g EwO•coo mm m L 2 m O 0 v— o O e m xe� c=s°c`EL o0 O" at �0v FcF O% L°° O° C O a oo-00-�0 a a° �y0m°13e o0 � en r� C �``�a °c a0 W a g .� C X O O L e m o r-.�O > m O OL aLo a`° c ; a z n m e m 0 o m— c� a Lac cc a« w O oa —c :E a o f tmoeaEc0 m0 0-e°,e>°e a moi Emc t me mpoca°eE -0 0LEEm nm m — > L (30c am o sv Wheaton Water Well, Inc. 1190 N. Wasilla-Fishhook Road Wasilla, AK 99654 (907)376-2041 Name: Troy Davis Homes Address: 1689 S Knik Goose Bay Rd. #400 City: Wasilla State: AK Zip Code: 99654 Well Site: Denaly Estates Lot/Block: 1/2 Additional: Well Depth: 126 ft. From: To: Formation: 0 32 silt/gravel Below Ground: 124 ft. 32 56 silt Above Ground: 2 ft. 56 109 clay 109 122 clay/gravel/wet Gal/Min: 35 122 126 sand/gravel/water Static Level: Artesian 15 GPM Casing: 126ft. of 6 in. x .25 in. steel Liner Pipe: N/A Screened: N/A Perforated: N/A WATER QUALITY TESTING Grouted: Yes, 6 Bags of Bentonite I COIF ° �U100mL Nitrates �L Depth: N/A I Arsenic - Develop. Method: Air Use of Well: Residential Drilling Method: Rotary Other: well chlorinated to 50ppm The well was pumped 5'off the bottom with 100%draw down for 2 hours and recovered at 35 gpm. Date Drilled: 1/23/2019 Driller: Ben Mattson Development Services Department ' • Building Safety Division s. • Awe On-Site Water & Wastewater Program o P 6B y 14. 4700 Elmore Rood =. .. . P.O. Box 196650 < i�Li 1 i c Mark Begich Anchorage, AK 99507 SA ETY Mayor www.muni.org/onsite (907)343-7904 Pump Installation Log Well Drilling Permit Number: SW Date of Issue: Parcel Identification Number: Legal Description Property Owner Name & Address: LOT 1,BLOCK 2 DENALY ESTATES TROY DAVIS HOMES 1689 KNIK GOOSE BAY ROAD SUITE 400 WASILLA,AK 99654 Pump Installation Date: NA Pump Intake Depth Below Top of Well Casing:NA feet Pump Manufacturer's Name: NA Pump Model: NA Pump Size NA hp Pitless Adapter Burial Depth: NA feet Pitless Adapter Manufacturer's Name: NA Pitless Adapter Installer: NEC CONSTRUCTION Well Disinfected Upon Completion? Yes ❑ No Method of Disinfection: RECIRCULATION Comments: JET PUMP INSTALLED IN HOUSE.NO PUMP IN WELL Pump Installer Name: FORM COMPLETED BY WHEATON WATER WELL INC 1190 N.WASILLA FISHHOOK RD WASILLA,AK.99654 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. MUNICIPALITY OF ANCHORAGE tib\t I 1 On-Site Water&Wastewater Program S' a PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 �� http://www.muni.org/onsite / +` 3 1)cpartml•nt 4j`,C Fl OR G0 On-Site Water & Wastewater System Permit Permit Number: OSP181282 Effective Date: 8/21/2018 Work Type: WellSeptic Initial Expiration Date: 8/21/2019 Tax Code Number: 06706208000 Site Legal Address: DENALY ESTATES BLK 2 LT 1 G:0362 Site Mailing Address: 25518 MC INTYRE RD, Eagle River Owner: TROY DAVIS HOMES INC Lot Size in Sq Ft: 49376 Design Engineer: FORGE ENGINEERING Total Bedrooms: 4 This permit is for the construction of: 2 Disposal Field Q Septic Tank 0 Holding Tank 0 Privy Er Private Well 0 Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: 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. � I Received By: Date: at Issued By: Date: ®18 :) G56 789 76 MUNICIPALITY OF ANCHORAG Q A�62o ' 1111 a. 2018 Community Development DepartmentPhone: 9 /�' -7904 ,� Development Services Division Fax: 907- -79971 On-Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Rus* Parcel I.D. 067-062-08 Property owner(s) Troy Davis Homes Day phone 310-2501 Mailing address 1689 Knik Goose Bay Rd #400, Wasilla, AK 99654 Site address 25518 McIntyre Rd. Chugiak, AK 99567 Legal description (Sub'd., Block & Lot) Denaly Estates, Block 2, Lot 1 Legal description (Township, Range & Section) Lot Size 49,376 Sq. Ft. Number of Bedrooms Four (4) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field (XI Initial x Single Family (SF) X (w/wo ADU) Septic Tank X Upgrade Duplex (D) Holding Tank Li Renewal n Multiple Dwellings Privy n (SF and/or D) Private Well ►I Water Storage THIS APPLICATION INCLUDES A VARIANCE I WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. 1--t (ice (Signature of property owner or authorized agent) Permit/Rush Fees: i 125040 40 Waiver Fees: Date of Payment: [2t In Date of Payment: Receipt Number: 03t0L200 Receipt Number: Permit No. C5P1 IZa Waiver No. Permit App_'••• :: .,c ' GE ENGINEERING PO BOX 240773 ANCHORAGE,AK 99524 522-7773 677-7766(FAX) August 18, 2018 MOA Development Services Dept, On-Site Water& Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Denaly Estates Block 2 Lot 1 —25518 McIntyre Road Septic System Design Dear On-Site Services Engineer: The developer of the subject lot intends to construct a 4-bedroom home on the property. We are submitting this design and permit application for the construction of a new well and septic system. The attached site plan identifies the location of the home and the proposed well, septic location and alternate site. No conflicts exist between this proposed system and any other well or septic system,whether on this lot or adjacent lots. The ground surface on the lot slopes moderately to the southwest. Ground contours are shown on the site plan showing the grade and direction of flow. Storm water drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. Lot 2 to the west is currently being developed and the proposed well radius is shown. The new septic system will be a minimum of 100' from all wells and surface water, and more than 5' away from the septic tank. The alternate site is located more than 10' from the primary site. Please refer to the attached test hole logs, and plan and profile sheets for the septic design. If this design is followed,there will be no adverse impacts to adjacent properties. Sincerely, P .A�qS�� *:� 49TH �� -.* /� Michael E. Anderson, PE � ```z .�'`•.• Michael E.Anderson Attachments #��FG�l 4381-E� ��rx/ �k, ;DPRoiESsI#—.4'r DENALY ESTATES, BLOCK 2, LOT 1 - / -----/ � � NMN / / � , FRS � cS5 / 15'T8, AISEMENT 741114441411111111r 14() LOT 3 / / PROPOSED WELL 10'T E EASEMENT / / / LOT 1 __ ___ ____ _/::&////// 50'LO G x•5'WlDT x 4' `\ 5.ox �EFE' TIVE I ' � / //- / -"ABS�2PTION TRENCH \ 4 BDRM / / / . N ` •ME � / / �� SV'SVzooFCO , • • • // . , / M • \ / / / / • \.?'• TH PROPOSED WELL / \ — -- / V. 1,250 GALLON Q 4- ' / ;.1...../..... SEPTIC TANK / ` �0 — ' // 37® ALTERNATE SITId ' / ' 1 II -- — — — 37 / LOT 2 „--/1 i / / 1 B� 1\ / LOT 25 /y \\ \ r 20'DRAINAGE EASEMENT // \ m \ 2 N N \. 1 / / 1 \ \ ��OFq� a NOTE: LEGEND /'��P•••' 1�'�8 �,+� NO SLOPES>25%WITHIN 50'OR SURFACE WATER WITHIN 100'OF THE PROPOSED SEPTIC SYSTEM CO-CLEANOUT /*:49TH i\ •.* / 2C0-DOUBLE CLEANOUT / - ..... ... / ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH FCO-FOUNDATION CLEANOUT j°' WELLS OR SEPTIC SYSTEMS. MT-MONITORING TUBE '. Michael E.Anderson : / SV-SEPTIC VENT I,�FFG •.• CE 4381 .•4 0 50 100 TH-TEST HOLE sF `' = = NM MN FEET CONTOUR INTERVAL-5' +�� illiiiiiPGE �l�9F�PROFESSIONP�.�'�' `A.Wklee°` telG,14...,.G 1"=50' DENALY ESTATES, BLOCK 2, LOT 1 DESIGN FACTORS: SYSTEM REQUIREMENTS: 600 GPD PEAK FLOW 5' WIDE TRENCH SYSTEM PERK RATE: 1-5 MIN/IN 1,250-GAL SEPTIC TANK APPLICATION RATE: 1.2 GPD/SF 600 GPD / 1.2 GPD/SF /5' WIDE * .5 RED. FACTOR = 50 LF TRENCH REQUIRED (50 LF SPECIFIED) BOTTOM OF TRENCH: 6' BELOW GRADE FLOW LINE ELEVATION: 3' BELOW GRADE TOP OF TRENCH: 1.5' ABOVE GRADE TOPSOIL & REVEGETATE TO PREVENT EROSION liAun 1'-6" 111 MI I I I m 0 I I i= ,i1�I 11—'1 =1 I mill-I1=I I . AMR. . 1u n. 1=il_011 1t!,nom I II L �I :n 1'-6" 1�'--I II-I 11 II n � I n 11.: tglimIlLII _n..,. R1 6" 4" PERFORATED PVC (HOLES DOWN) di; Iz „"•-•`•'"•'""•'"•=•= MUNICIPALITY OF ANCHORAGE ''''''.49t 4‘4• 11kki DEVELOPMENT SERVICES DEPARTMENT ...,(1).• • �I, 1 r *•49TH ii'‘ * 4700 ELMORE ROAD ANCHORAGE, AK 99519-6650 •• /0 SOILS LOG AND PERCOLATION TEST // •. Michael E.Anderson LEGAL DESCRIPTION: DENALY SUB LOT I �,I;F�PRpFSs.....• ." PERFORMED FOR: TROY DAV IS \\�����z~ DATE: 8/12/18 PROJECT No.: Professional Engineers Stamp: PARCEL ID#: 067-062-08 TECHNICIAN: J. MILLETTE N. SHAFER DEPTH HOLE DUG TEST HOLE 1 (feet) 8/08/18 1' OB SLOPE SITE PLAN 1 3 ; 2 . ; : ., 1:. : ,...tr:` "'" SANDY SILTY GRAVEL _a..j.3,.-: ...- GM 5 _:;�' ;�:;�:- SEE SITE PLAN ''.'1.:1145;S: t 9 :0. - 10 ....'•<'•"^'i.'•. WAS GROUND WATER ENCOUNTERED? NO '!:.: 4;.::.'4;.Z IF YES @ WHAT DEPTH? - DEPTH OF WATER AFTER MONITORING: 14' 11 1.:::;;'.1:: DATE OF MONITORING: 8/19/18 12 ,.:r`�`:A: , - ...: DEPTH To =:4!•::.:',,«'' DATE READING GROSS TIME NET TIMEWATER NET DROP 13 `%?:� :::.:; (MINUTES) (MINUTES) (INCHES) ",;•.r...1;: (INCHES) 14 .'x'"•'f•` 8/12 TEST HOLE PRESOAKED PRIOR TO TESTING: 15 1 12:40/12:50 10:00 4"/716" 316" 16 2 12:51/13:01 10:00 4 /76" 36" 3 13:02/13:12 10:00 4"/716" 316" 17 4 13:13/13:23 10:00 4"/7 6" 316" 18 5 13:24/13:34 10:00 4"/716" 316" 19 6 13:36/13:46 10:00 4"/716" 316" 20 PERCOLATION RATE: 2.8 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 5 FT. and 6 FT. COMMENTS: MUNICIPALITY OF ANCHORAGE i C.P,� �OFi4VOte DEVELOPMENT SERVICES DEPARTMENT A �I .•y 4700 ELMORE ROAD ANCHORAGE, AK 99519-6650 0*• 49TH i`‘a;*.�,%/� SOILS LOG AND PERCOLATION TEST �/ •. Michael E.Anderson : / +#+P•Fc•'. e 4381 •.•it/ LEGAL DESCRIPTION: DENALY SUB LOT 1 ,i1 -PROFESSIONP� r PERFORMED FOR: TROY DAVIS `•\\����•` DATE: 8/11/18 PROJECT No.: Professional Engineers Stamp: PARCEL ID#: 067-062-08 TECHNICIAN: J. MILLETTE N. SHAFER DEPTH HOLE DUG TEST HOLE 2 (feet) 8/08/18 1' OB SLOPE SITE PLAN • . 2 -:')::::..4:.f.?".::::; 3 ..14:!,::i;:;,..•,-i,• � i.:•-.t• . 4 '.-_ ' •:> 5 + '*'i'%+;• 'r• SEE SITE PLAN ;:...:,.,yam::;:,:: -;":;1:.:•--:.::,!!., SANDY SILTY GRAVEL 6 -; : GM 7 :- .• :r 1 0 ?• �•'' •.• WAS GROUND WATER ENCOUNTERED? YES -"•`•!'1••+^• IF YES @ WHAT DEPTH? 11 + DEPTH OF WATER AFTER MONITORING: 12' '�'::•;•.�::• DATE OF MONITORING: 8/19/18 12 �* :; , - O ''''•• •:';.: :1 DATE READING GROSS TIME NET TIME WATEHR NET DROP 13 > I'•;;•.: (MINUTES) (MINUTES) (INCHES) (INCHES) -5 ' ": 14 ; �•'i8/11 TEST HOLE PRESOAKED PRIOR TO TESTING: 115 :,-,..:,....1:.:::,!'":`.'''" . 1 15:50/15:56 6:20 4"/ 10" 6" "`'"•l 2 15:57/16:04 6:58 4"/ 10" 6" 3 16:05/16:12 7:28 4"/ 10" 6" 17 4 16:13/16:20 7:18 4"/ 10" 6" 18 5 16:21/16:28 7:18 4"/ 10" 6" 19 6 16:29/16:36 7:20 4"/ 10" 6" 20 PERCOLATION RATE: 1.2 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 4.5 FT. and 5.5 FT. COMMENTS: Olt 11,046 MUNICIPALITY OF ANCHORAGE EpIas • , fr--1 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. 067-062-08 Expiration Date: —26 ^ I 1. GENERAL INFORMATION Complete legal description Denaly Estates, Block 2, Lot 1 Location (site address) 25518 McIntyre Road, Eagle River, AK 99577 Current property owner(s) Troy Davis Homes Day phone 907-357-9394 Mailing address 1689 Knik Goose Bay Road #400 Wasilla, AK 99654 Real estate agent Day phone 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex n Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic Water Storage [ Holding Tank n Community Well [ Community n Public Water System ❑ Public Sewer LJ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ "HO Waiver Fee $ Date of Payment t'/ o f i/) Date of Payment Receipt Number 0/Q56 Receipt Number COSA# On('�9/x111 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 Michael E. Anderson, P.E. Date 6/19/19 6. DSD SIGNATURE to PT/ System #1 Approved for 4 bedrooms 0 ;MICHAEL E ANDERSON j 0• '`�f�' No. CE-438t • _4. System #2 Approved for bedrooms •i '••. s 19 19 ••••� �� •''••.......0•''•� ��► Disapproved Conditional approval for bedrooms, with the following stipulations: G01,LITYQ(i,f o �wq RS/TE �`0 1 :771:7-(<\7A a� �Rq Ftf5R �, � y�`�i sFRVECES5 ��' "//►))))))l) By: Original Certificate Date: V 2-CJ—t/ 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 1 Parcel ID: 067-062-08 If more than 1 septic system on lot: COSA Checklist# of Structure served by this system A. WELL DATA ❑■ Well log is filed with Onsite (or attached) Well production at time of test 15 gpm Date drilled 1/23/19 Water storage tank volume None gallons Total depth 126 ft Well disinfected for coliform test? ❑ Yes It No Cased to 126 ft Coliform bacteria is Negative ❑ Sanitary seal is functioning correctly Nitrate mg/L ❑■ Nitrate less than MRL (ND) ❑■ Wires are properly protected Arsenic ug/L N Arsenic less than MRL(ND) Casing height(above ground) 24 in. Collected by Forge Engineering Date of flow test for COSA New Date of Sample 6/6/19 Static water level at beginning of test 0 ft. Comments Well is Artesian. B. TANK DATA C. LIFT STATION Age of tank(s) <1 years ❑ Required maintenance completed Tank type/material SEPTIC/STEEL Age of lift station years Measured operating fluid level in septic tank Lift station material Q Standpipes/foundation cleanout per record drawing Comments: Date of pumping New Construction D. ABSORPTION FIELD DATA Shallow Trench Which system tested (date installed) 10/26/18 Adequacy test date New Construction ■❑ALL standpipes present per record drawing Results ['Pass For bedrooms Total measured depth from grade 7.6/8.3 ft(max) Fluid depth prior to test in Measured depth to pipe invert from grade 3.6/4.3 ft(min) Water added gal ❑ N/A—pressurized field New depth in ❑■ Monitor tubes go to bottom of effective. If not, state Elapsed time min depth into effective ❑� Code-required soil cover over field Final fluid depth in EI presoaked Absorption rate gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) date of test) Gallons introduced N/A gallons If yes, enter date Comments/Deficiencies: COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout> 100' p Yes if No ft ❑✓ Yes if No ft Neighboring Tank > 100' ✓0 Yes if No ft Private Sewer/Septic Line > 25' D Yes if No ft Absorption Field on Lot> 100' Q✓ Yes if No ft Holding Tank > 100' 0✓ Yes if No ft Neighboring Absorption Fields > 100' Animal Containment> 50' 0✓ Yes if No ft ✓0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' p Yes if No ft El Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' p Yes if No ft Surface Water> 100' ❑✓ Yes if No ft Property Line > 5' El Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ✓0 Yes if No ft Private Wells> 100' ✓0 Yes if No ft Water Main > 10' El Yes if No ft Community Wells > 200' ✓0 Yes if No ft Water Service Line > 10' ✓Q Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ✓0 Yes if No ft If absorption field is under driveway comment below Property Line > 10' ✓❑ Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' 0✓ Yes if No ft Water Service Line > 10' ✓❑ Yes if No ft Community Wells > 200' 0 Yes if No ft Surface Water> 100' p Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION .•v�•�F q��'�� • ..u.... I certify that I have determined through field inspections and review .••'`P;.••'•�.. •�'•••�4��j of Municipal records that the above systems are in conformance with ��' �) •'•.``.YY �� MOA COSA guidelines in effect on this date. 4 49th " ° •0 S MICHAEL E. ANDERSON•• �: ••:, No. CE-4381 ;•��'= •• ,Cn 1'•.,...6/17/19....� <. . COSA Checklist yellow sheet ♦•44,;:OFES;;;�4•••