HomeMy WebLinkAboutCANYON VIEW ESTATES BLK 2 LT 5CANYON VIEW
ESTATES
Block 2
Lot 5
021 - 021 - 51
www.sullivanwaterwells.com
Pump Installation Log
Well Drilling Permit Number: OSP 241184 Date of Issue 7/9/24
Parcel Identification Number: 02102151000
Legal Description Property Owner Name & Address
Canyon View Estates BLK 2 LT 5 Hultquit Homes
13818 Canyon Rd.
Anchorage, AK 99516
Pump Installation Date:
1/17/25
Pump Intake Depth Below Top of Well Casing:
292 feet
Pump manufacturer’s Name:
Grundfos
Pump Model:
10SQE10-290
Pump Size:
1 hp
Pitless Adapter Burial Depth:
12 feet
Pitless Adapter Installer:
Pitless Manufacturer:
Disinfected Upon Completion?
yes no
Method of Disinfection:
Chlorine 50 PPM
Comments:
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.
Merrill
White Raven
(Rev 05/02/19)
Municipality of Anchorage
On-Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP241184
PID Number: 021-021-51
Dwelling: X Single Family (SF)
❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑■ New ❑ Upgrade
Name
Hultquist Homes Inc
ABSORPTION FIELD
❑ Deep Trench ❑■ Wide Trench El Bed El Mound
Site Address
13818 Canyon Road
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
5
1.2 GPD/SF
5.0 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
3.0 Ft.
Gravel depth beneath pipe
2.0 Ft.
Subdivision
Block Lot
Canyon View Estates
2 5
Fill added above original grade
0.5-0.8 Ft.
Gravel length
2 @ 45 Ft.
Township Range Section
Gravel width
5.0 Ft.
Beds: Number of Lines
na
Distance between lines
na Ft.
SEPARATION
DISTANCES
To
Septic
Absorption
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Lift Station
Tank
Line
642.8 Ft,
2
7.0 Ft.
Well
100'+
100'+
NA
NA
25'+
TANK ❑p Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Infiltrator
Capacity
1537 Gal.
Surface water
100'+
100'+
NA
NA
Material
Number of compartments
Lot Line
5'+
10'+
NA
NA
NA
Polypropylene
2
Foundation
10'+
101+
NA
NA
LIFT STATION
Manufacturer
Capacity
Gal.
Remarks
Alarm location
Electrical installed by
PIPE MATERIAL House to tank 3034Tank to 3034
drainfield
Installer
—_---............
Red Dog
Drainfield 3034 CO/MT 3034
Inspector PES
BENCH MARK (Assumed elevation) 100 ft
Inspection
` 12/3/24
12/4/24
Location and description
es:
31d 12/10/24
2nd
4" 2/4/25
First Floor Finished Floor
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
Conditional Approval:
Date
* 40
••$;even annoote
••. CE 8149
Septic Syste ,
( ofe: this approval does not include well permit require ents.
(Rev 05/02/19)
DESIGN PARAMETERS
PRIMARY SEPTIC SYSTEM
NO. BEDROOM: 5(750 gpd)
TANK SIZE: 1500ga1 MIN
PERC RATE: <1 MPI
SOIL RATING: 1.2 GPD/SF
AREA ROD: 625 SF
SYS. TYPE: WIDE TRENCH 2.0'ED
RF: 0.70
ADJ AREA: 437.5 SF
,MIN LENGTH: 87.5 LF
/10
/
/ �•'
/
ooe
x
O
oo-/
USED: Go��// v
TOTAL AREA:
Jv��
X 6420'8 x 2.0'E.D., 5.0'TD OSP\�� �� �� / �4<P
NEW
5BR
B HOUSE /
C3 M1
/ TH-2024-1 / M 3 FS
I II
M4 M2
I / /
\�_ ... C4 C2
RESERVE DRAIN FIELD (P)
25LF x 5.0'W x 0.5'ED x 5.0'TD
INSTALL MONITOR TUBE AND CLEAN OUT
AT EACHEND
NEW DRAIN FIELD
\
(2 EA) 45LF x 5.0'W x 2.0'ED x 5.0'TD
\ INSTALLED MONITOR TUBE AND CLEAN OUT
\ AT EACH END
\ NEW 1500g SEPTIC TANK
\ \ INSTALLED FOUNDATION CLEAN OUT
\ AND DOUBLE CLEAN OUT
RESERVE SEPTIC SYSTEM
NO. BEDROOM: 5(750 gpd)
TANK SIZE: 2500gal ADVANTEX W/
Zea AX -20 PODS
PERC RATE: <1 MPI
SOIL RATING: 6.0 GPD/SF
AREA ROD: 125 SF
SYS. TYPE: WIDE TRENCH 0.5'ED
MIN LENGTH: 25 LF
USE:
25LF x 5.0'W x 05E.D., 5.0'TD
TOTAL AREA: 125 SF
DCO
/-T2
\o o t
\ 1
� l
I
I ,
I •/
_
-d___� SEPTIC AREA (E) �
DRAINAGEWAY PREVIOUSLY n
MAPPED BY MoA
NO DEPRESSION OR WATER
/ RECORD DRAWING
/ THIS RECORD DRAWING REPRESENTS THE
AS -BUILT CONDITION OF THE PROPERTY
/ IMPROVEMENTS DESCRIBED ABOVE.
/ THE DRAWING AND ANY OTHER SUBSEQUENT
\ / ATTACHED OR INCLUDED INFORMATION IS
\ BASED ON PERIODIC VISUAL OBSERVATION
\ BY A REPRESENTATIVE OF PES ALONG WITH
\/ NOTES, PHOTOS, AND OTHER INFORMATION
PROVIDED BY THE INSTALLER OF THE
SYSTEM.
/ THE INFORMATION PROVIDED IN THE RECORD
DRAWING APPEARS REASONABLE AND
REPRESENTS THAT THE PROJECT WAS
DESIGNED AND CONSTRUCTED IN GENERAL
/ CONFORMANCE OF 18 AAC 72, THE ADEC
ONSITE WASTEWATER SYSTEM INSTALLATION
MANUAL, AND AMC 15.65 WHERE
/ APPLICABLE. PES SHALL NOT BE HELD
LIABLE FOR SYSTEM DEFICIENCIES WHICH
FALL OUTSIDE THE SCOPE OF THE REQUIRED
VISUAL OBSERVATIONS OR SUBSEQUENT
OBSERVATIONS IF REQUESTED BY THE
INSTALLER. SEPTIC SYSTEM INSTALLERS ARE
TRAINED AND APPROVED BY THE
MUNICIPALITY OF ANCHORAGE AND OR ADEC
AS APPLICABLE. INSTALLERS ARE
RESPONSIBLE FOR CONSTRUCTING THE
SEPTIC SYSTEM AS DESIGNED AND ENSURING
THEIR WORK CONFORMS TO THE CODES AND
POLICIES STATED ABOVE.
NOTES: PANNONE ENG SVC, LLC .... 9
Date
RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 p'�'• S ae2o25
PHONE (907) 272-8218 FAX (907) 272-8211 "y
...... ....... P.I.D. NO
DRAWN BY: DRM CANYON VIEW ESTATES, BLOCK 2, LOT 5 021-021-51
HULTQUIST HOMES INC �ie,3e►ron anrio�e PERMIT No.
13818 CANYON ROAD CE 814 OSP241184
PLAN ANCHORAGE, AK j Sheet
2 OF 3
A
B
FC
7.4
T1
32.9
45.9
T2
37.1
38.7
DCO
39.4
36.1
FS
57.7
29.8
Ci
62.4
23.8
M1
60.3
26.0
C2
69.5
62.2
M2
68.5
58.9
C3
73.9
36.6
M3
72.4
38.5
C4
82.1
70.5
M4
81.2
67.5
RESERVE SEPTIC SYSTEM
NO. BEDROOM: 5(750 gpd)
TANK SIZE: 2500gal ADVANTEX W/
Zea AX -20 PODS
PERC RATE: <1 MPI
SOIL RATING: 6.0 GPD/SF
AREA ROD: 125 SF
SYS. TYPE: WIDE TRENCH 0.5'ED
MIN LENGTH: 25 LF
USE:
25LF x 5.0'W x 05E.D., 5.0'TD
TOTAL AREA: 125 SF
DCO
/-T2
\o o t
\ 1
� l
I
I ,
I •/
_
-d___� SEPTIC AREA (E) �
DRAINAGEWAY PREVIOUSLY n
MAPPED BY MoA
NO DEPRESSION OR WATER
/ RECORD DRAWING
/ THIS RECORD DRAWING REPRESENTS THE
AS -BUILT CONDITION OF THE PROPERTY
/ IMPROVEMENTS DESCRIBED ABOVE.
/ THE DRAWING AND ANY OTHER SUBSEQUENT
\ / ATTACHED OR INCLUDED INFORMATION IS
\ BASED ON PERIODIC VISUAL OBSERVATION
\ BY A REPRESENTATIVE OF PES ALONG WITH
\/ NOTES, PHOTOS, AND OTHER INFORMATION
PROVIDED BY THE INSTALLER OF THE
SYSTEM.
/ THE INFORMATION PROVIDED IN THE RECORD
DRAWING APPEARS REASONABLE AND
REPRESENTS THAT THE PROJECT WAS
DESIGNED AND CONSTRUCTED IN GENERAL
/ CONFORMANCE OF 18 AAC 72, THE ADEC
ONSITE WASTEWATER SYSTEM INSTALLATION
MANUAL, AND AMC 15.65 WHERE
/ APPLICABLE. PES SHALL NOT BE HELD
LIABLE FOR SYSTEM DEFICIENCIES WHICH
FALL OUTSIDE THE SCOPE OF THE REQUIRED
VISUAL OBSERVATIONS OR SUBSEQUENT
OBSERVATIONS IF REQUESTED BY THE
INSTALLER. SEPTIC SYSTEM INSTALLERS ARE
TRAINED AND APPROVED BY THE
MUNICIPALITY OF ANCHORAGE AND OR ADEC
AS APPLICABLE. INSTALLERS ARE
RESPONSIBLE FOR CONSTRUCTING THE
SEPTIC SYSTEM AS DESIGNED AND ENSURING
THEIR WORK CONFORMS TO THE CODES AND
POLICIES STATED ABOVE.
NOTES: PANNONE ENG SVC, LLC .... 9
Date
RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 p'�'• S ae2o25
PHONE (907) 272-8218 FAX (907) 272-8211 "y
...... ....... P.I.D. NO
DRAWN BY: DRM CANYON VIEW ESTATES, BLOCK 2, LOT 5 021-021-51
HULTQUIST HOMES INC �ie,3e►ron anrio�e PERMIT No.
13818 CANYON ROAD CE 814 OSP241184
PLAN ANCHORAGE, AK j Sheet
2 OF 3
TEST
HOLE 2024-1
1
ORGANICS
OR
2
3-
4-
45
5—
SW/
SAND WITH
6
SM
SILTY SAND
7-
8-
89
9
10
11
12
BOH
DATE PERFORMED:3DEC2024
WAS GROUND WATER
ENCOUNTERED? N
IF YES, AT WHAT
DEPTH? N/A
DEPTH TO WATER AFTER
MONITORING? DRY
DATE: IODEC2024
<1 MPI
WATER ABSORBED TOO FAST TO ACCURATELY
READ. SEE SIEVE ANALYSIS
COMMENTS: Test hole excavated by RED DOG
PERFORMED BY: Pannone Engineering Services. I CERTIFY THAT
THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE
AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST.
z
0'
Q o O o ,,, o
0 Z Z Z J 0 Z
LiU U V DU
PROFILE SCALE: NTS
92.4
-1.0
TH-2024-1
80.4 "-12.0
(DRY 12/10/24)
DATE PERFORMED:
12/3/2024
NOTES: PANNONE ENG SVC, LLC Date
RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 �►,•••, S 28/2025
PHONE (907) 272-8218 FAX (907) 272-8211
. �* NTS
.... .. ....... P.I.D. NO
CANYON VIEW ESTATES, BLOCK 2, LOT 5 021-021-51
HULTQUIST HOMES INC "ie,3even ane PERMIT No.
CE
13818 CANYON ROAD 814 OSP241184
DESIGN DETAILS ANCHORAGE, AK �' 'j Sheet
3OF3
Certified Drilling Log
OWNER OF LAND: Hultquist Homes
ADDRESS: 13818 Canyon Rd. Anchorage, AK 99516
LEGAL DESCRIPTION Canyon View Estates B2 L5
DATE: 9/2/24
PERMIT NUMBER: OSP241184 DATE OF ISSUE: 7/9/24
TAX IDENTIFICATION NUMBER 02102151000
Is well located at approved permit location: Yes No
Method of Drilling: air rotary cable tool
Depth of Well: 300’
Casing Type: Steel Wall thickness .250 inches
Diameter: 6 inches, depth 88 feet
Liner type
Static Water Level: 116 feet
Recovery Rate 4 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 2 feet, to 42 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 12 Tight silty sand and gravel
12 48 Tight silty sand and gravel with clay
48 82 Hardpan
82 102 Bedrock gray broken
102 191 Bedrock gray
191 241 Bedrock yellow
241 279 Bedrock gray
279 300 Bedrock gray with fractures
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
hftp://www.muni.org/onsite
On -Site Water & Wastewater System Permit
Permit Number: OSP241184
Work Type: WellSeptic Initial
Tax Code Number: 02102151000
Site Legal Address: CANYON VIEW ESTATES BLK 2 LT 5 G:3042
Site Mailing Address: 13818 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:
7/9/2024
7/9/2025
Lot Size in Sq Ft: 81995
Total Bedrooms: -* - .5
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
c o y 2 � f Z3 /?o Z y /"� L. F-/ C_ LD C9
ON P(ZA- w
Received By: 5 5Date:
Issued By: Date: 7
S/J�oL'
ON -SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 021-021-51
Property owner(s) Hultquist Homes Inc
Mailing address 12750 Old Seward Hwy Ste 204
Site address NHN Canyon Road
Day phone
Legal description (Sub'd., Block & Lot) Canyon View 132 L5
Legal description (Township, Range & Section)
Lot Size - 81,995 —Sq. Ft. Number of Bedrooms-4"'
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(Z all that apply)
Absorption Field
0
Initial 5XI
Single Family (SF)
nx
-XI
(w/wo ADU)
Septic Tank
I
Upgrade R
Duplex
El
(D)
Holding Tank
❑
Renewal El
Multiple Dwellings
❑
Privy
❑
(SF and/or D)
Private Well
nx
Water Storage
n
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: $ / � I "Z? Waiver Fees:
Date of Payment: 6,1-z- 71-,7 Date of Payment:
Receipt Number: 3Z3 2-6 Receipt Number:
Permit No. Of----) 122-9 1/5 (-1 Waiver No.
Permit App_'-'- : - :'-..:c ;
Pannone Engineering Services uc
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: steve(@Panengak.com
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road
Anchorage, Alaska 99519
Subject: Canyon View B2 L5
Steep Slope Disposal Field Waiver Request.
Ladies and Gentlemen:
(0�4 :4
I am writing to request a waiver to the steep slope section of AMC 15.65. 15.65.210.4.a.iv requires that the
distribution pipe invert on the downhill side of the trench be a minimum of 36 inches below the natural organic
surface. Due to the groundwater elevation in the area, the proposed wide trench disposal field cannot be installed
at a depth which would allow for a depth of 36 inches to be met. As can be seen on the attached slope section the
proposed installation will not cause effluent to daylight at any distance of concern. We are requesting a reduced
distance of 2.7ft below the natural ground surface to the distribution pipe invert. The drain fields will be insulated
and out mounded to create a minimum of 3.0 ft of ground cover.
The soils in this area are typically Hydrologic Soils Group A which contains organics underlain by sandy gravel with
silt (GP/GM), as evidenced by the previously submitted sieve analysis. Due to the nature of and drainage capacity
of the soils found in the area (HSG A) the designed infiltration line of 45% for septic system installation on steep
slopes should be used instead of the assumed/worst case soil classification infiltration line of 25%. The slopes and
soil types enable installation of any system without the system effluent "daylighting" at any distance of concern.
Granting this waiver will not pose a threat to the safety of this lot or the surrounding lots. Please contact me if you
have any comments or concerns.
Sincerely,
Steven R. Pannone, P.E. F.ASCE
Owner/Civil Engineer
22 July, 2024
�t ip (,.,/ c t IL-I.D -- '—I
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Pannone Engineering Services LLC
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: steve@panengak.com
Mailing: P.O.Box 1807, Palmer, AK 99645
Telephone: (907) 745-8200 FAX: (907) 745-8201
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, Alaska
Subject: Canyon View B2 L5
Septic System Permit Request
This is a design narrative for a permit to install a well and septic system on the subject property. The proposed
installation will serve a proposed five (5) bedroom house. This lot and surrounding lots are served by private wells.
Currently there are no wells within 100ft of the proposed installation.
1. Soils: A test hole was performed on this lot by Pannone Engineering Services, LLC on 5/4/2023. Groundwater
was observed during the excavation of the test hole at a depth of 12.5 ft BGS, bedrock was not encountered.
Groundwater was observed in the test hole monitor tube after at a depth pf 9.0 ft BGS on 5/25/2023. Based on
the results of the percolation test and overall soils appearance an application rate of 1.2 gpd/SF was used for the
design of a conventional wastewater treatment system in the area of the test hole.
2. Soil Absorption System Design: See Sheet 1 of the design package.
3. Surface Water: There is a drainage easement which frequently flows water located between lots 4 and 5. There
is at least 100ft of worst-case overland flow between the proposed installation and the drainage.
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
2 July 2024
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241184, Curtis Townsend, 07/09/24
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NOTES: PANNONE ENG SVC LLC (C.I. 1088) REVISIONS DATE
FOR CONSTRUCTION P.O. BOX 1807 PALMER, AK 99645 OFAi 7/23/2024
PHONE 907 745-8200 FAX 907 745-8201 p'' SCALE
CHANGE ORDER k %om .* 1" = 60,
DRAWN ACP CANYON VIEW B2 L5 •••• •• ......• P.I.D. NO
CHECKED SRP HULTQUIST HOMES }ems cmnop• 021-021-51
CE $149 PERMIT N0.
SITE: NHN CANYON RD ;024.07.24 OSP241184
SITE PLAN ANCHORAGE, AK SHEET
1 OF 4
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NOTES: PANNONE ENG SVC LLC `C.I. 'IOSS) REVISIONS DATE
FOR CONSTRUCTION P.0 BOX 1807 PALf�ER, AK 9645 QF 7/23/2024
PHONE 907 745-8200 FAX (907) 745-8201 SCALE
CHANGE ORDER '• 1"=10'
DRAWN ACP CANYON VIEW 132 L5 ..•46I6!
••• P.I.D. NO
CHECKED SRP HULTQUIST HOMES Lisp anriae 021-021-51
CE 8149 PERMIT N0.
SITE: NHN CANYON RD 024.0 .z� OSP241184
SECTION ANCHORAGE, AK SHEET
2 OF 4
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NOTES: PANNONE ENG SVC LLC (C.1. 1088)
FOR CONSTRUCTION P.O. BOX 1807 PALMER, AK 99645
CHANGE ORDER PHONE (907) 745-8200 FAX 907 745-8201
DRAWN ACP CANYON VIEW 132 L5
CHECKED SRP HULTQUIST HOMES
SITE: NHN CANYON RD
NOTES ANCHORAGE, AK
REVISIONS JUAIL
7/23/2024
NO SCALE
.I.D. NO
021-021-51
ERMIT NO.
OSP241184
4OF4
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241184, Curtis Townsend, 07/09/24
PA
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COMMENTS: Test hole excavated by BROWNSON BROS.
PERFORMED BY: PANNONE ENGINEERING SERVICES, LLC. I CERTIFY THAT THIS TEST
WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES
IN EFFECT ON THE DATE OF THIS TEST.
·< 1.0 (min/inch)
·6"
·2 FT AND 3 FT
SOILS LOG & PERCOLATION TEST
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241184, Curtis Townsend, 07/09/24
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
OSC251066
Parcel ID 021 -021-51 Expiration Date:
Legal description CANYON VIEW ESTATES BLK 2 LT 5
Site address 13818 CANYON RD
Current property owner(s) HULTQUIST HOMES INC
X The On-site system(s) is/are approved for 5 bedrooms
1/17/2026
Conditional approval for bedrooms, with the following stipulations:
Comments or conditions:
No comments
By: -���— Original Certificate Date: 2/28/2025
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
sy tem(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage,
Development Service 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 submittal.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
MUNICIPALITY OF ANCHORAGE il.
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 02102151
Complete legal description Canyon View Est 132 L5
Location (site address) 13818 Canyon Rd
Current property owner(s) HUltquist Homes
2. ON-SITE SYSTEMS SIZED FOR + BEDROOMS
Day phone
3. TYPE OF WATER SUPPLY: ■❑ Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ❑ Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: ❑■ Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ❑ Steel ■❑ Plastic ❑ Concrete ❑ Fiberglass
Age new - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ❑■ Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: ❑■
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee $ Waiver Fee $
Date of Payment
COSA # C -S C-
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.
In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in
accordance with ADEC & MOA guidelines and regulations. The reported results describe the performance of the system
under the conditions encountered at the time of the test, and separation distances measured to readily identifiable
features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that
may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside
the control of the evaluator of this system. All systems eventually fail, and satisfactory test results do not guarantee future
performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore, we
cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this
report is for the sole benefit of the owner listed above.
Name of Firm
Phone
Engineer’s Printed Name
Date 2/28/25
Lot 5, Block 2,
Canyon View Estates Subdivision
Asbuilt
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
1/31/2025