HomeMy WebLinkAboutCANYON VIEW ESTATES BLK 2 LT 8I- •
r--
•
•
�, •
�� t:
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2
ON -SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP231164
PID Number: 042-081-43
Dwelling: 0 Single Family (SF)
❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: 9 New ❑ Upgrade
Name
Hultquist Homes, Inc.
ABSORPTION FIELD
❑ Deep Trench 0 Wide Trench ❑ Bed ❑ Mound
Site Address
13868 Canyon Road
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
3
1.2 GPD/SFJ
3.0 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
1 Ft.
Gravel depth beneath pipe
2 Ft.
Subdivision
Block Lot
Canyon View Estates
2 8
Fill added above original grade
31 Ft.
Gravel length
60 Ft.
Township Range Section
Gravel width
5.0 Ft.
Beds: Number of Lines
n/a
Distance between lines
n/a Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
I
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
429 Ftz
1
n/a Ft.
Well
100'+
100'+
NA
NA
25'+
TANK X Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
GREER
Capacity
1000 Gal.
Surface Water
100'+
100'+
NA
NA
Material
Number of compartments
Lot Line
10'+
10'+
NA
NA
NA
HDPE
2
Foundation
10'+
10'+
NA
NA
LIFT STATION
Manufacturer
Capacity
Remarks
Gal.
Alarm location
Electrical installed by
Installer
PIPE MATERIAL House to tank 3034 Tank to 3034
drainfield
Brownson Bros, LLC.
Drainfield 3034 CO/MT3034
Inspector PES
BENCH MARK (Assumed elevation) 100.0 ft
Inspdection vt 02/29/24
d 02/29/24
Location and description
2
srd 03/06/24
4'h 03/14/24
See Site Plan, Bottom of House trim
ON -SITE WATER AND WASTEWATER SECTION APPROVAL
Engineers Stamp
Conditional Approval:
Date
,�,..,•
.... .. .. .......
'even annoAe
CE 8149
'•••2 024.03.12�••
Septic System
Approved
Date 2 /ho Z'
Note: this approval does not include well permit requireme ts.
�_..
k .�v ��
1000 GAL GREER
POLY TANK
PROFILE
PA
N
N
O
N
E
E
N
G
S
V
C
,
L
L
C
(
C
.
I
.
1
0
8
8
)
Lot 8, Block 2,
Canyon View Estates Subdivision
As Built
Land Surveying
Land Development Consultants
Subdivision Specialists
Construction Surveying
AEC# 173042
S4
Group
124 E 7th Avenue
Anchorage, Alaska 99501
(907) 306-8104
mail@S4AK.com
03/11/2024
www.sullivanwaterwells.com
Pump Installation Log
Well Drilling Permit Number: SW OSP231164 Date of Issue 7-11-23
Parcel Identification Number: 04208143000
Legal Description Property Owner Name & Address
CANYON VIEW BLOCK 2 LOT 8 HULTQUIST HOMES
Pump Installation Date:
3-12-24
Pump Intake Depth Below Top of Well Casing:
132 feet
Pump manufacturer’s Name:
GRUNDFOS
Pump Model:
10SQE07-240
Pump Size:
3/4 hp
Pitless Adapter Burial Depth:
12 feet
Pitless Adapter Installer:
BROWNSON BROS.
Disinfected Upon Completion?
yes no
Method of Disinfection:
Chlorine 50 PPM
Comments:
Pitless Manufacturer: MARTINSON
Pump Installers Name:
Sullivan Water Wells
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
Certified Drilling Log
OWNER OF LAND: Hultquist
ADDRESS: 13868 Canyon Rd. Anchorage, AK 99516
LEGAL DESCRIPTION CANYON VIEW ESTATES BLK 2 LT 8
DATE: 10/30/23
PERMIT NUMBER: OSP231164 DATE OF ISSUE: 7/11/23
TAX IDENTIFICATION NUMBER 04208143000
Is well located at approved permit location: Yes No
Method of Drilling: air rotary cable tool
Depth of Well: 145’
Casing Type: Steel Wall thickness .250 inches
Diameter: 6 inches, depth 124 feet
Liner type
Static Water Level: 89 feet
Recovery Rate 6 gpm gph
Method of Testing Air
Well Intake Opening Type: open end open hole
Screened Start feet Stopped
Perforations Start feet Stopped
Grout Type: Bentonite Volume: 50 lbs.
Depth: from feet, to feet
Well Disinfected Upon Completion: yes no
Method of Disinfection: Chlorine 50 PPM
Comments:
Bore Hole Data
Depth
From To
0 2 Casing Stickup
2 4 Overburden
4 10 Sand and gravel
10 18 Gravel silt water
18 30 Silty sand gravel water
30 38 Silty sand some gravel
38 60 Silty sand some gravel water
60 118 Hardpan with clay
118 145 Broken bedrock
Drillers Name: Cole Sullivan
ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority.
Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation.
MatSu Borough: Department of Environmental Conservation.
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: OSP231164
Work Type: WellSeptic Initial
Tax Code Number: 04208143000
Site Legal Address: CANYON VIEW ESTATES BLK 2 LT 8 G:3042
Site Mailing Address: 13868 CANYON RD, Anchorage
Owner: HULTQUIST HOMES INC
Design Engineer: PANNONE ENGINEERING SERVICES
This permit is for the construction of:
Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy
Effective Date
Expiration Date:
Hunt S
UCI)�ll'Clll�ilt
7/11/2023
7/10/2024
Lot Size in Sq Ft: 67265
Total Bedrooms: i31
�7
Q 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 (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
0- J_ I NC P-0 o/ti CGvn/�
Received By: S S�
II r
Issued By: V1ti
Date:
Date:
/Ij ZG23
MUNICIPALITY OF ANCHORAGE
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. 042-081-43
Property owner(s) Hultquist Homes, Inc. Day phone _
Mailing address 12570 Old Seward Highway Anchorage, AK 99515
Site address 13868 Canyon Road
Legal description (Sub'd., Block & Lot) Canyon View Estates Block 2 Lot 8
Legal description (Township, Range & Section)
Lot Size 67,265 Sq. Ft. Number of Bedrooms
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption FieldX❑
Initial X❑
Single Family (SF) X❑
Septic Tank
X❑
Upgrade ❑
(w/wo ADU)
Duplex (D) E]Holding
Tank
El
Renewal El
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
X❑
Water Storage
❑
THIS APPLICATION
INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: Waiver Fees:
Date of Payment: lb 2v Z13 Date of Payment:
Receipt Number: $ n Ci Receipt Number:
Permit No. OS p2-�, l l H `i Waiver No.
Permit App_'- : . L.A
Pannone Engineering Services LLC
Steven R. Pannone, Principal
Registered Professional Engineer J
E-mail: steve(cDpanengak.com
11 September 2023
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, Alaska 99519
Subject: Canyon View Estates Block 2 Lot 8
Well & Septic System Permit Request
Septic System Design Narrative
This is a design narrative for a permit to install an initial well and septic system on the subject property. The proposed system
will serve a proposed four-bedroom (4) house. Currently the lot is undeveloped. This lot and surrounding lots are served by
private wells. Currently there are no wells within 100 feet of the proposed system.
1. Soils:
A test hole was performed on this lot by Pannone Engineering Services, LLC in May of 2023. Groundwater was not observed
during the excavation of the test hole, and bedrock was not encountered. Groundwater was observed in the test hole
monitor tube after 7 -days at a level of (7.0') below grade on (05/25/2023). Based on the results of the percolation tests,
overall soils appearance, and the selection of the proposed drain field; an application rate of 1.2 gallons/day/square feet
was used for a conventional wastewater system in the area of the test hole.
2. Soil Absorption System Design.
a. See Sheet 1 of the design package.
3. Surface Water:
There is no surface water within 100' of proposed septic system.
4. Topography:
See attached site plan for area topography.
5. Drawing Markings: The Drawings are marked "For MOA Review Only". When written notification that the review is
complete and no further comments are received from MoA On -Site Department, the note will be removed and "For
Construction" drawings will be issued.
The proposed installation will not affect the future development of this or the surrounding lots.
If you have any questions or concerns, please contact me at (907) 745-8200.
Sincerely,
SRP
Steven R. Pannone, P.E. F. ASCE
Owner/Civil Engineer
Mailing: P.O.Box 1807, Palmer, AK 99645
Telephone: (907) 745-8200 FAX: (907) 745-8201
DESIGN PARAMETERS
PRIMARY/RESERVE SEPTIC SYSTEM
NO. BEDROOM: 4(600 gpd)
TANK SIZE: 1250gal
PERC RATE: <1 MPI
SOIL RATING: 1.2 GPD/SF
AREA RQD: 500 SF
SYS. TYPE: WIDE TRENCH 2.0' ED
RF: 0.70
MIN LENGTH: 70 LF
USE:
75LFx5.0'Wx2.0'E.Dx3.0'TD
TOTAL AREA: 535 SF
TH-31
/v
-'/ Lot 8
� DRIVEWAY 4' 1220 / \
\ / \ 4BRHOUSE
\
TH-2023-8 \ H�v v/ \
• \ I
\ I
\
\ INSTALL 1250 al S PTIC TANK P \
/ \ INSTALL FC BEFORE AND DCO AFTER. 1
\ \ IF BOTTOM OF TANK WILL BE AT A
GREATER DEPTH THAN 8.0' BELOW
\ 1200 ORIGINAL GRADE INSTALL STEEL TANK.
\ IF PLASTIC TANK IS USED INSTALL
\ \ MONITOR TUBE. \
\ 1180
\ PRIMARY HES-RVE DRAIN FIELD P
75LF x 5.0'W 2.0'ED 3.O'TD
\ x x
\ INSTALL CLEAN OUT AND MONITOR TUBE L O t
AT EACH END.
\ \
\
ENSURE MIN. 3.0' OF COVER OR R.I.
\
\ PER 15.65 (3.• 1 SLOPE ON FILL)
\
\ MIN. 6.0' SEPARATION BETWEEN PRIMARY
\
AND RESERVE TRENCHES
I \
I \
l
�
NOTES:
PANNONE ENG SVC LLC
P.O. BOX 100217 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211
Q'�•'"
*: •� :*
.... .. . .......
••$even anrio�e
Date
9/15/2023
FOR CONSTRUCTION
Scale
1 "=50'
CANYON VIEW ESTATES, BLOCK 2, LOT 8
HULTOUIST HOMES INC.
P.I.D. NO
042-081-43
DRAWN BY: DRM
PERMIT No.
13868 CANYON ROAD
CE 8149$
osPxxxxxx
Sheet
PLAN
ANCHORAGE, AK
'•••••''
1 OF 3
SPECIAL PROVISIONS TO SPECIFICATIONS OI, -site Water and Wast
1. SCOPE AND SPECIFICATIONS: REpV,IE�WED�F�ORR�CODE COM UANC
1.1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MOA COMPONENT PARTS AND MATERIALS USED NS T 07/11
CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS AND AND IN ACCORDANCE WITH AMC 15.65 AND 15.55.
1.2. CONTRACTED WORK WILL BE IN COMPLIANCE WITH MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) DIVISION 10 & DIVISION 20 AS
APPROPRIATE.
1.3. SCOPE OF WORK: INSTALL SEPTIC TANK, DRAIN FIELD, AND WELL.
1.4. GROUNDWATER WAS ENCOUNTERED AT A DEPTH OF 7.0 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. 'IF AN APPARENT WATER
TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 7.0 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY.
1.5. STRUCTURES DEPICTED ON THE SITE PLAN ARE BASED UPON ONE OF THE FOLLOWING: CONCEPTUAL PLOT PLAN DEVELOPED BY OWNER; A PLOT PLAN
DEVELOPED BY RLS; OR A SURVEY AS—BUILT.
2. CONSTRUCTION SPECIFICATIONS:
2.1. ALL EXCAVATION DEPTHS ARE ADVISORY. THEY ARE TO BE VERIFIED AND MAY BE MODIFIED BY THE ENGINEER IF ACTUAL FIELD CONDITIONS VARY FROM
THOSE USED TO PREPARE THE DESIGN
2.2. EXCAVATE THE DRAIN FIELD. BOTTOM OF EXCAVATION SHALL BE LEVEL AND SCARIFIED. RECORD ELEVATIONS AT BEGINNING, MIDDLE AND END OF TRENCH
BOTTOM. CONSTRUCTION EQUIPMENT SHALL NOT OPERATE ON THE FLOOR OF THE EXCAVATION. ANY MATERIAL COMPACTED BY THE OPERATION OF THE
CONSTRUCTION EQUIPMENT SHALL BE REMOVED AND REPLACED WITH UNCOMPACTED MATERIAL.
2.3. PLACE THE SEWER ROCK TO THE SPECIFIED DEPTHS. DO NOT CONTAMINATE SEWER ROCK WITH NATIVE MATERIAL OR SPOILS FROM EXCAVATION. LEVEL
ROCK SURFACE TO t1" PRIOR TO INSTALLING THE PERFORATED PIPE.
2.4. ALL PIPE SHALL BE PVC CONFORMING TO ASTM D3034 OR ENGINEER APPROVED EQUAL. MINIMUM SOIL COVER SHALL BE 3 FEET OVER THE PIPE AND 4
FEET OVER THE SEPTIC TANK. ONE INCH OF INSULATION MAY BE SUBSTITUTED FOR 1 FOOT OF SOIL COVER.
2.5. ALL INSULATION SHALL BE 2" THICK DOW HI -40 INSULBOARD OR ENGINEER APPROVED EQUAL. CENTER INSULBOARD WIDTH OVER SEPTIC TANK OR LINES.
2.6. GEOTEXTILE SHALL BE MIRAFI 140S OR ENGINEER APPROVED EQUAL. LAP ALL JOINTS 2 FEET MINIMUM.
2,7. COVER THE DISTRIBUTION PIPE WITH A MINIMUM OF 2" OF SEWER ROCK AND COVER WITH GEOTEXTILE BEFORE PLACING INSULATION AND BACKFILL.
2.8. MATERIAL USED AS FILL SHALL BE CLEAN AND FREE OF ORGANICS, TRASH AND CONSTRUCTION DEBRIS.
2.9. SLOPE ALL FILL MATERIAL TO DRAIN AT 2% MINIMUM SLOPE AND 3:1 MAXIMUM SLOPE AND IN SUCH A MANNER THAT PONDING AT OR NEAR THE DRAIN
FIELD DOES NOT OCCUR. THE FILL SHALL BE LEFT AT 6" HIGHER THAN SHOWN TO ALLOW FOR SETTLEMENT. SEED SURFACE AFTER COMPLETING
INSTALLATION AS PER MOA CODE.
2.10. RECORD THE FINISH GROUND ELEVATION OVER THE BEGINNING, MIDDLE AND END OF SYSTEM.
2.11. MAINTAIN 5' SEPARATION BETWEEN PERCOLATION HOLE AND THE DRAIN FIELD TRENCH.
2.12. EXPOSE, PUMP AND FILL LOG DISPOSAL CRIB OR CONCRETE TANK WITH SOIL TO ABANDON IAW WITH MOA CODE IF NEEDED.
3. CONTRACTOR RESPONSIBILITIES:
3.1. THE CONTRACTOR SHALL FAMILIARIZE THEMSELVES WITH THE SITE CONDITIONS AND LOCATIONS OF ALL LOT LINES, EASEMENTS, WELLS (E & P), SEPTIC
SYSTEMS (E & P) AND SHALL MEET MINIMUM SEPARATION DISTANCES OR AS NOTED.
3.2. THE CONTRACTOR (BOTH WELL AND SEPTIC SYSTEM CONTRACTORS) SHALL HAVE ANY WELL LOCATION AND SEPTIC LOCATION STAKED AND ANY LOT LINE
AND WELL RADIUS SHOWN ON THE PLAN WITHIN 30 FEET OF THE PROPOSED SYSTEM STAKED BY A REGISTERED LAND SURVEYOR BEFORE STARTING THE
WORK.
3.3. THE CONTRACTOR IS RESPONSIBLE FOR ALL R.O.W. AND OTHER REQUIRED PERMITS, OTHER THAN THE ATTACHED.
3.4. THE CONTRACTOR SHALL CALL FOR LOCATING OF ALL BURIED UTILITIES.
3.5. THE CONTRACTOR SHALL PROVIDE 24 HOUR NOTICE TO THE ENGINEER PRIOR TO START OF WORK. ALL SURVEYING AND LOCATES SHALL BE IN PLACE
PRIOR TO NOTIFYING THE ENGINEER.
3.6. THE CONTRACTOR SHALL NOTIFY THE ENGINEER OF ANY DISCREPANCY BETWEEN THE APPROVED DRAWINGS AND SITE CONDITIONS/LIMITATIONS
POTENTIALLY CAUSING THE NEED TO MODIFY THE DESIGN.
3.7. AT THE COMPLETION OF THE WORK, THE CONTRACTOR SHALL SUBMIT RED—UNE AS—BUILT DRAWINGS TO THE ENGINEER. THE RED—LINES SHALL INCLUDE
PIPE LENGTHS, ORIGINAL GROUND ELEVATIONS, PIPE ELEVATIONS, AND TANK ELEVATIONS.
3.8. THE CONTRACTOR SHALL PROVIDE PHOTOGRAPHS OF THE SYSTEM INSTALLATION TO INCLUDE BOTTOM OF EXCAVATION, TOP OF PIPE WITH CLEAN—OUTS
AND MONITOR TUBES INSTALLED, INSTALLED TANK AND FINAL GRADING.
4. THE CONTRACTOR SHALL SIGN THE FOLLOWING: I CERTIFY THAT ALL WORK WILL BE PERFORMED IN ACCORDANCE WITH THE APPROVED PERMIT, AND ANY AND
ALL CHANGE ORDERS, AND THAT THE AS—BUILT REDLINES ARE TRUE AND ACCURATE REPRESENTATION OF THE PROJECT AS CONSTRUCTED.
CONTRACTOR: BY:
TITLE: DATE:
NOTES: PAMONE ENG SVC, LLC Date
FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 P•(�i, •.. Scale /2023
PHONE (907) 272-8218 FAX (907) 272-8211
:4931 �* NTS
.... .. .. ....... P.I.D. NO
CANYON VIEW ESTATES, BLOCK 2, LOT 8 an **me 042-081-43
"even
HULTQUIST HOMES INC. PERMIT No.
CE 8149
13868 CANYON ROAD osPxxxxxx
DESIGN DETAILS ANCHORAGE, AK Sheet
2OF3
1
2
3
4
5
6
7
8
9
10
11
12
13
14
TEST HOLE 2023-8
OR I ORGANICS
GRAVELLY SAND
WITH SILT
SOILS LOG - PERCOLATION TEST
WAS GROUND WATER
ENCOUNTERED? N
IF YES, AT WHAT
DEPTH? -DRY
DEPTH TO WATER AFTER
MONITORING? -8.0'
DATE: 5/10/23
DEPTH TO WATER AFTER
MONITORING? -7.0'
DATE: 5/25/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMANC
OSP231164, Curtis Towr�n , 07/11,
READING
DATE CLOCK WATERTIME NET TIME LEVEL NET DROP
READING
1
5/3/23
2
3
4
WATER ABSORBED TOO
QUICKLY TO ACCURATELY READ
5
6
a
9
10
11
12
PEROLATION RATE <1 (min/inch) PERC HOLE DIAMETER 6 inches
TEST RUN BETWEEN 3 FT AND 4 FT " SEE SIEVE ANALYSIS
BOH COMMENTS: Test hole excavated by BROWNSON BROTHERS.
DATE PERFORMED: 5/3/23
PERFORMED BY: PANNONE ENGINEERING. I CERTIFY THAT THIS TEST
WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL
GUIDLINES IN EFFECT ON THE DATE OF THIS TEST.
INFILTRATION SECTION
SCALE 1"=5'
FINISHED GRADE
NOTES:
1. SOILS ON THE LOT ARE USDA HSG 'A' SOILS
WITH AN ASSUMED INFILTRATION LINE OF 46%.
EFFLUENT WITH AN INFILTRATION LINE OF 46%
WILL NEVER DAYLIGHT ON A SLOPE OF 33%.
2. SECTION SHOWS FIELD CLOSER TO SLOPE
THAN DESIGN LOCATION FOR THE PURPOSE OF
DEPICTING THE SLOPE OF INFILTRATION LINE VS
THE SLOPE OF THE TERRAIN.
NOTES: PANNONE ENG SVC, LLC Date
FOR CONSTRUCTION P.O. BOX 102954 ANCHORAGE, AK 99510E 7/10/2023
PHONE (907) 272-8218 FAX (907) 272-8211 �` ••• ••• Scale
*'•�� �* NTS
•••• ••••••• P.I.D. NO
CANYON VIEW ESTATES, BLOCK 2, LOT 8 ••�}ven •. rio�042-081-43
eane
HULTQUIST HOMES INC. 8149 PERMIT NO.
13868 CANYON ROAD IOSPxxxxxx
SOILS LOG ANCHORAGE, AK •�•,•�••••.Sheet
'mAt� 3 OF 3
040.002
Client: Pannone Engineering Services
Project: Canyon View SD Block 2
Date: May 18, 2023
Crowther Associates
Particle Size Distribution Table
(percent-_p'assi '§"subject sieve size)
1 f{Y
Sample Source
7
8
10
Moisture
7.0%,
6.9%
%
12.1%
ContentR
Sieve Size
Percent Finer
Percent Finer
Pe'' ent Finer
Percent Finer
3 inch
100
100
P.i
100,
100
ni
1-1/2 inch
100
100
100;
100
3/4 inch
96 r
91
92 `'
100
#4
58 tk
56
57 R,
93
#10
38
66
37
82
#40
14 A19
15
24
#100
7
12
10
10
LY`
yJy}
Sj
#200
6
11
9
7
0.02 mm
xx �;
xx
xx A
xx
Classification
Gravelly Sar
Gravelly Sand
Grave'lly Sand
Sand with Silt
with Silt
with Silt
with hilt
(SP -SM)
(SP -SM)
-SM)
(SPSM)
Invoice 192
1632 Bellevue Circle /Anchorage, Alaska 99515
Telephone (907) 349-2198 /E mail: ct•owther@alaska.net
MUHMPAUTY OF ° HCHOR UGC
0
Development Services Department - ' Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Parcel I.D. 042-081-43
Certificate of On -Site Systems Approval
Expiration Date: �� Z J
Legal description CANYON VIEW ESTATES BLK 2 LT 8
Site address 13868 CANYON RD Anchorage AK
Current property owner(s) HULTQUIST HOMES INC
X The On -site system(s) is/are approved for 3 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
Original Certificate Date: 3/21 /2024
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of
Anchorage, Development Services Department (DSD) issues COSAs based upon
representations provided by an independent professional engineer. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
COSA Approvaijune 2022
MUMCPAM_ff V OF ,NCH u R ,\ G ,=
Development Services Department ``
_= Phone: 907-343-7904
On -Site Water & Wastewater Section Fax. 907-343-7997 14,Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 042-081-43
Complete legal description Canyon View Estates Block 2 Lot 8
Location (site address) 13868 Canyon Road
Current property owner(s) HultgUlst Homes, Inc
2. ON -SITE SYSTEMS SIZED FOR 3 BEDROOMS
Day phone
3. TYPE OF WATER SUPPLY: 0 Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ❑ Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: * Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ❑ Steel ❑® Plastic ❑ Concrete ❑ Fiberglass
Age < 1 - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ❑® Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: ❑
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On -site staff
to verify the accuracy of the information provided.
COSA Fee $ Z�
Date of Payment
COSA # �� GZ`%'l b
Waiver Fee $
Date of Payment
Waiver #
COSA Application —June 2022
COSA Checklist_June 2022
COSA Checklist
Legal Description: Parcel ID:
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____
A. WELL DATA
Well log is filed with Onsite (or attached)
Date drilled Total depth ft
Cased to ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) in.
Date of flow test for COSA
Static water level at beginning of test ft.
Well production at time of test gpm
Water storage tank volume gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by
Date
Comments __________________________________________________________________________________
B. TANK DATA
Measured operating fluid level in septic tank
Date of pumping
Required maintenance completed, if AWWTS
Comments:
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed)
ALL standpipes present per record drawing
Total measured depth from grade ft (max)
Measured depth to pipe invert from grade ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
Monitor tubes go to bottom of effective.
If not, state depth into effective
Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months)
If yes, enter date
Adequacy test date
Results Pass
Fluid depth prior to test in
Water added gal
New fluid depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) in
Effective depth used in
Effective depth remaining in
Comments/Deficiencies:
COSA Checklist_June 2022
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100’
Yes if No ft
Neighboring Tank > 100’ Yes if No ft
Absorption Field on Lot > 100’ Yes if No ft
Neighboring Absorption Fields > 100’
Yes if No ft
Community Sewer Main > 75’ Yes if No ft
Community Sewer Manhole/Cleanout > 100’
Yes if No ft
Private Sewer/Septic Line > 25’ Yes if No ft
Holding Tank > 100’ Yes if No ft
Animal Containment > 50’ Yes if No ft
Manure/Animal Excreta Storage > 100’
Yes if No ft
N/A – Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10’ Yes if No ft
Tank to Property Line > 5’ Yes if No ft
Field to Property Line > 10’ Yes if No ft
Water Main > 10’ Yes if No ft
Water Service Line > 10’ Yes if No ft
Surface Water > 100’ Yes if No ft
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No ft
Community Wells > 200’ Yes if No ft
If tank or field is under driveway comment below
F.ENGINEER’S COMMENTS
G.CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm Phone
Engineer’s Printed Name Date
2024.03.18