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HomeMy WebLinkAboutCROSS VIEW ESTATES BLK 2 LT 15Cross View Estates Block 2 Lot 15 #015-221-77 Municipality of Anchorage Development Services Department Building Safety Division Onsite Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page of www.ci.anchorageek.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW070020 PID Number: 015-221-17 Name: Jim McAllen Wastewater System: ❑✓ New ❑ Upgrade Address: 11755 Wilderness Drive Anchorage, AK 99516 ABSORPTION FIELD Phone: 345-6593 Numberof Bedrooms: Q V Deep Trends ❑Shallow Trench 0 Bed El Mound ❑Other: LEGAL DESCRIPTION Soil Rating: Total Depth from original Beetle: .6 GPDXP 12 Ft. Block 2 Lot 15 Subdivision: Cross View Estates Depth to pipe bottom from original grade: Gravel depth beneath pipe: q 8 Ft. Township: Range: Secgon: Fill added above original grade: Gravel Length: 1-2 Ft. 73 Ft. Well: © New ❑ Upgrade Grovel wiMh: Number of fines: Distance behveen litres' 3 Ft 1 Ft. Claesification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material: Private 241 Ff. 241 Ft_ 1,168 FP ASTM D3034 PVC Dinner: Date Dtllled: Static Water Level: Instagec Data Installed: Alpine Drilling 4/12/07 181 Ft. Red Dog Excavating 4/5-6//2007 Yield: Pump Set at Casing Height Above Ground' 20 GPM Ft. 2 Ft TANK SEPARATION DISTANCES ® Septic ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption Lift Holding uoliGFinu to Manufacture[ Capacity: From Tank Field Station Tank Sewer Line Anchorage Tank 1,250 Gal. well >100, >100' N/A N/A >25' MatenaI Steel Number of Compartments: Two (2) Surface Water >100' >100' N/A NIA LIFT STATION Size: arafacture, Lot Line >5' >10' N/A N/A I V Gal, Foundation >5' >10' N/A NIA "Pump on'level at: "Pump off' level at: High water alar at: in. in. in. certain Dram None Noted Pump Make a Model Electrical Inspections performed by: Remarks: BENCH MARK Location and Description' NW Corner of Concrete Landing at Base of Back Deck Stairs. Assumed Elevation: 100.00 Pt w Inspections performed by: A. Harala Dates: tat 4/5/07 07. qwlltga 2nd 4/6/07 ©= Development Services Department Approval e. 4Q TH Conditional Approval Date:10 4 . „ M1CHA L E AP!'? 2 ON �+ 6i i C CE -4581 t '" Or ;pall a rove b Y r r� ,.. Reviewed and approved by: at Date: 9 27 O ey PROF cc)� b� " (per. 0406) 0:// /Y %4n 4 rvri­ec e Permit No.: SM70020 A 51 151' 21 s2 22 T 2! G 114' 11 C5 52 5' T M1 15.2' 1'. M2 788' 7: Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT Page 2 of 3 4700 Bragaw Street Anchorage, AK. 99519-6655-343-7904 On -Site Wastewater Disposal System or Well Inspection Report PID No. 015-221-77 2005-171 CROSS VIEW ESTATES SUBDIVISION LOT 15J59 BLOCK 2 yfRn PLAN AS -BUILT SCALE V - 50' S103Y Saw CWT. W cart. Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number. SW070020 PID No. 015-221-77 73' (Trench Length) 49th 93.4 PROFILE AS—BUILT '•0 No � 3R i �•.'. No Seale •11.tj'��u: �,� MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: LOT 15, BLOCK 2, CROSS VIEW ESTATES SUB. PERFORMED FOR: JIM MCALLEN DATE: 4/5/2007 PROJECT No.: PARCELID#: TECHNICIAN: A. HARALA Dern[ TEST IIOLE A (fix0 SITE PLAN SEE SITE PLAN q WAS GROUND WATER ENCOUNTERED? NO IF YES A WHAT DEP DEPTTi OF WATER AFTER MONITORING: NON[ 2% DATE OF MONITORING: 9i 1o/O DATE READING OB/OG 1 Dy ATERD (INCHES) NE,T DROP (INCHES) A 4/5 2 ° 3 ° 2 2:43 30 4 2.18" 5 e 2.13" A 6 ° 30 7 <. 8 3:16 SILTY SAND 2.38" • WITH GRAVEL 9 ° SM 4.50" 2.12" 0 10— A A 12 13 •A 14 . 15 A 16 17 • . a 18 BOH @ 18' 19 SITE PLAN SEE SITE PLAN q WAS GROUND WATER ENCOUNTERED? NO IF YES A WHAT DEP DEPTTi OF WATER AFTER MONITORING: NON[ 2% DATE OF MONITORING: 9i 1o/O DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) Dy ATERD (INCHES) NE,T DROP (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 4/5 1 2:13 2.25" 2 2:43 30 4.50" 2.18" 3 2:45 2.13" 4 3:15 30 4.25" 2.12" 5 3:16 2.38" 6 3:46 30 4.50" 2.12" PERCOLATION RATE• 14(MIN/INCII) PERC. HOLE DIA 6. " (TNCHES) TEST RUN BETWEEN:: 4_5 FT. w4-5-5—Fr. COMMENTS. TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY ANDERSON ENGINEERING. 1, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE* 9/26/2007 0 ■ ■NIFR : ALPINE DRILLING FAX N0. : 907 345 0202 Sep. 25 2007 06:39PM P1 ■ f■ ALPINE DRILLING & ENTERPRISES Permit Number. 4SW 7g 0020 Date of Issue: 14- 7 Parcel Identification Number: -221-77 Date Started: 4-11-07 Date Completed: 412-07 Is well located at approved permit location? ® 015Yes ❑ No Legal Description: Cross View Estates Block 2 Lot 15 Property Owner Name & Address: m 5 Allen ss Drive Anehnrane. Alaska 99516 Borehole Data: Depth (ft) SoU Type. Thickness & water Strata From To stick -Up 0 silt 2 gravelly silt 12 sandy silt 45 gravel 81 sandy gravelly silt 97 silty gravel 115 silt 180 silty gravel 201 silty water sand & gravel 238 2 12 45 81 97 115 180 201 238 Method of Drilling M air rotary ❑ cable tool Casing type: steel Wall Thickness: .280 inches Diameter: ¢ inches Depth: 241 feet Liner Type: Diameter: inches Depth: feet Casing stickup above ground: ,Z feet Static water level (from ground level): 181 feet Pumping level:_2-4Lfeet after 2 hours pumping 20 gpm Recovery Rate: 20 gpm Method of Testing: it ' Y41 Well Intake Opening Type: M Open End ❑ Open Hole ❑ Screened Start feet ❑ Perforations Start fed Stopped feet Ctnnned _feet Grout Type: bentonit gr -angles Volume: j n nfh- Start Q feet Stopped ? feet Pump: Intake Depth feet a hn Brand Name Well Disinfected Upon Completion? M Yes ❑ No Method of Disinfection:hlortn� o tablBts Comments: Well Driller. Alpine Drilling 8 Enterprises p0 Box 110496 Anchorage Alaska 99511 Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property to the Development Services Department within 60 days of completion. owner or the well driller shall provide a well 1 2006-171 CROSS VIEW ESTATES SUBDIVISION SLOT 15159 BLOCK 2 orwm IONS BASED DN ton mm ik, w (MYI 4S' 1 l.J f4'/TgCc ' C � DRIVE0 ���` t.rrsBrh CE w rt IC 1RORY OBNI ESlff. M W CYf. PrepwW Well 4C. A14T ' � 4 1 ip� #yw �E T / 3 \.� Septic canon Septic Tank n SR h 6 = eTN r Altamala Ste ST14A 17i2YLEff9ictho Depth ACsorpOan Trench - - - - - - - - - — - - - - - - - - - - - - - - - - - -- / - - - - - - - - - - - - - 20' .. DNNII Esw. ------------ 10' T. B E CYT. N 59'W'04'E 50.10' N ww'I5"E 15717 abre' ••••...p�\ %..„...�i• 49thr ....51.....E i. ..............`..... ............. SITE PLAN • a� :MICHAEL L ANDERSON •�1�({yrs., SCALE V = 50' Municipality of Anchorage Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.sk.us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Anderson Enalneerina Legal description: Cross view Estates. B2 L15 ®Permit ❑C.O.S.A. ❑Inspection Report The attached paperwork has been reviewed and is being returned for the following reasons: 1. Per our conversations on 419 and 518, additional Information Is needed because the system was not installed parallel to the contours of the slope. Please provide a cross-sectional profile view that shows that the system does not incroach on the separation distances to ground water or the Impenniable layer. Name of reviewer: Pgt§k Date: May 8. 2007 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 FAX MEMORANDUM DATE: April 7, 2007 TO: Deb Wockenfuss FROM: Mike Anderson, P.E.T'^EO. SUBJECT: Lot 15, Block 2, Cross View Estates Subdivision Well and Septic System Permit No. SW070020 The grades shown on the surveyors plot plan were in error at the location of the proposed septic system and we were unable to ascertain the exact topography of the ground during the design phase of this project due to the heavy snow cover. The ground surface slopes from the northwest to the southeast and then to the south. We have therefore reoriented the absorption trenches as shown on the attached Site Plan. A test hole and percolation test was completed near the south end of the trench. The results indicate similar soils and percolation rates as the original test hole. A copy of the soils log will be forwarded with the septic system as built in the near future. MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water d Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Permit Number: SW070020 Date Issued: Mar 14, 2007 Expiration Date: Mar 13, 2008 Parcel ID: 015-221-77 Legal Description: CROSS VIEW ESTATES BLOCK 2 LOT 15 Design Engineer: 0014 ANDERSON ENGINEERING Site Address: NHN HERITAGE HEIGHTS DRIVE Owner Name: JIM MCALLEN Lot Size: 51159 SQ. FT. Owner Address: 11755 WILDERNESS DRIVE Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE. AK 99516 - This permit Is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy 0 Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by catling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received B , Date: __911V4 .' - M /» K . Municipality of Anchorage Development Services Department Building Safety Division _ On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 9951916650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-221-77 Property owner(s) dim Mcwlen Day phone 345.6593 Mailing address 11755 Wilderness Drive Anchorage, AK Zip Code 99516 Site address Heritage Heights Drive Zip Code 99516 Legal description (Sub'd., Block & Lot) Cross View Estates, Block 2, Lot 15 Legal description (township, Range & Section) Lot Size 51.159 Sq. Ft. THIS APPLICATION IS FOR (® all that apply): Absorption Field M Septic Tank Holding Tank ❑ Privy ❑ Private Well Water Storage ❑ Number of Bedrooms Four (4) THIS APPLICATION IS AN: Initial Upgrade ❑ Renewal ❑ certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. P�C 64A� (Signature of propertyf owner or authorized agent) Permit/Rush Fees: T(�� �'l S� Waiver Fees: Date of Payment: Receipt Number. (Rev. 11/05) Date of Payment: Receipt Number. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 FAX March 6, 2007 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 15, Block 2, Cross View Estates Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 15, Block 2, Cross View Estates Subdivision intends to construct a new four-bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new well and septic system to accommodate the home. The attached Site Plan and backup documentation identify the location and configuration of the proposed well and septic system along with the alternate site. Also identified on the plans are the existing wells and septic systems on surrounding lots. No conflicts exist between the proposed septic system and well or septic systems and wells on adjacent lots. Drainage arrows are shown on the site plan showing the grade and direction of flow on the lot. The drainage pattern will not be changed as a result of this project. The test hole was placed on the lot in the area of the absorption trench and alternate site during the subdivision phase. The log indicates sandy silt to silt (SM -ML). The percolation rate of the soil was determined to be 6 minutes per inch. No groundwater was found during the placement of the test hole and none was noted during the monitoring period. An application rate of .6 gallons per day per square foot was used in the design of the absorption system. We are proposing to place a new 1,250 -gallon septic tank and a 72' long by 3' wide by 7' effective depth absorption trench to treat and dispose of the effluent generated in the house. The elevation of the distribution line in the absorption trench will be 4' below the surface and the total depth will be 11'. A minimum of 3' of fill or 2" of insulation and 2' of fill will be placed over the absorption trench and 4' over the septic tank. The ground surface on the lot in the area of the septic system slopes to the south. The new trench will be constructed parallel with the slope as much as possible in conformance with Municipal requirements. The new septic system will be constructed a Lot 15, Block 2, Cross Point Estates Subdivision March 6, 2007 Page Two minimum of 100' from all wells and any surface water and 10' the proposed and existing water services in the area. If the system is constructed in accordance with our design the following statements apply: The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, yy�� £ CLwC'-n Michael E. Anderson, P.E. Attachments LOT 19, BLOCK 1 Vacant ► LOT 16, BLOCK 2 LOT 14, BLOCK 2 Vacant Vacant r� _ 49th .`.•.I �` „ AREA MAP ....................._........_....._... . ��;MICHAEL E. ANDERSW i .�� No, cE-a3eI j'�a SCALE I' = 100' Q } 2006-171 CROSS VIEW ESTATES SUBDIVISION LOT 153S96FOCK 2 OXAMNS USED ON len NGS DM1UY M" w' I yf R f Mfg DRryE 0 4rrIIar� ..rM.4. N W7r4Y I Proposed Watl raw be.. Q' neo' k*w } .) 1.2so Callon /.i SapOC Tank b/ 72' Long N 3' Wide E Oective Depth s •TN jrAE.orptiw Trench utemat. WoId, 2Y slant 1NVM ESNr. WCL •EE51rt. SITE PLAN SCALE V = 50' L 1 FORM 0n E w. w E w. Id, LOT 15, BLOCK 2, CROSS VIEW ESTATES SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home Perc. Rate: 6 Min./Inch Application Rate: .6 GPD/SF Deep Trench System 1,250 Gallon Septic Tank T Drainfield Rock 4 Bedrooms X 150 GPD/.6 GPD/SF (Application Rate) = 1,000 SF Absorption Area 1,000 SF/14 SF/LF = 71.43 LF Trench Length THEREFORE: Construct a 72' Long x 3' Wide x T Effective Depth Absorption Trench at the Location Shown. Flow Line Elevation in Trench to be 4' Below Original Ground Surface. Total Depth to be 11' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption Trench. Maintain 100' Separation from Wells in the Area. Natural Backfill 1 Geotextile 3'6" 4 Fabric 6" 4" Perforated t PVC (Holes Down) Tty' 3' TYPICAL DEEP TR NOTE: Drainfield Rock H SECTIOP' Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 4' Separation From Groundwater. Minimum 100' Separation From Wells in the Area. Minimum 100' Separation From Surface Water or Streams. GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS.�� SOIL LOG — PERCOLATION TEST LEGAL DESCRIPTION: MLRITAGL HILL) ZVyulvulym we; va PERFORMED FOR: PROFESSIONAL TECHNICAL SERVICES DEPTH (feGl) ORGANICS TH 46 PTS 546 1 2 3 4 5 6 7 8 9 10 11 12 13 14 m:, 16 LOAM SOIL CLASSIFICATI NIS I NET TIME (MINUTES) 1 •- NET DROP (INCHES) 111111111ML II�111!11GM%//%CL — GCNHH • 2 IIIIIIIIIMH SIDCH %j �11lIII; Y.�� • •.,SC — SM/ML DEPTH TO DATE GROUNDWATER DRY 9/1/2005 DRY 9/19/2005 SEE ATTACHED SITE PLAN DATE READING CLOCK TIME I NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 9/6/05 1 3:00 — 6- — 2 3:30 30 0. 6- 3 3:30 — 6- — 4 4:00 30 1. 5- 5 4:00 — 6- — 6 4:30 30 1. 5- 19 PERCOLATION RATE •6 (MIN./INCH) PERC. HOLE DIA. 5 (INCHES) TEST RUN BETWEEN 5 FT. AND 6 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ® YES ❑ NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: CALEB CALL COMMENTS: - RECOMMEND USING A 0.6 APPLICATION RATE PERFORMED BY CEG. Ltd. I. JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PE FOR ED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: Iof ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 15, BLOCK 2, CROSS VIEW ESTATES SUBDIVISION GENERAL: The scope of this project includes the procurement and placement of a new 1,250 -gallon septic tank at the location shown on the Site Plan. Work also includes the construction of a new 72' long X 3' wide X 7' effective depth absorption trench at the location also shown on the Site Plan. The distribution line in the trench will be placed at 4' below the existing ground surface. Total depth of the trench will be 11' below the existing ground surface. The new absorption trench and septic tank must be placed a minimum of 100' from all private wells and any surface water in the area and 10' from the water service line proposed for the lot. A minimum of 3' of cover is required over the absorption trench and 4' of cover over the septic tank. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. The Contractor must also verify the location of wells in the area and assure that the separation distances are met. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION 1. A new 1,250 -gallon septic tank must be procured from an approved source and installed at the location shown. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. Lot 15, Block 2, Cross View Estates March 6, 2007 Page 2 of 3 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. 5. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trench to drain away. 8. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. Lot 15, Block 2, Cross View Estates March 6, 2007 Page 3 of 3 MATERIAL SPECIFICATIONS: Septic tanks must be constructed by a municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. Municipality of Anchorage Development Services Department • Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 ON-SITE SEWERIWELL SUBMITTAL COMMENT SHEET To: Anderson Engineering Legal description: Cross View Estates, 82 L15 ZD The attached paperwork has been reviewed and Is being returned for the following reasons: Original signature or stamp missing on Calculation error in design. _ Additional soils information needed. _ Water monitoring results inadequate. Discrepancy in information submitted. 31g107 RecuWA reyab�i/Aj butnof Topographic information missing or inadequate. _ Additional adequacy test information needed. e./10u9 h jearAnCG 40 bed roc k. 'e" X C 45• hb w,71 re de59n, Water sample unacceptable. _ Measured/proposed distances/dimensions missing. Locations of all soils, percolation and water monitoring tests not shown. Proposed system too deep for soils information submitted. _ Well log required. Omission in narrative. Insufficient fill over tank or field._ ® Other. 1 The site plan shall have a description of the topography, areas of excessive slope and extent of slopes and surface drainage patterns within 100 feet of 9" Krt of the system or portion of the lot intended for use for on-site wastewater disposal. AMC 15.65.030 D. Please provide this information on the site plan. 2. Please use the application rate recommended by the_engineer that did the soils/percolation test or provide your own soils test Name of reviewer. Deb Date: 3/8/07 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 F March 6, 2007 Municipality of Anchorage''1ti+�ffi'' Development Services Department �� � �` L;Zj _ L On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 15, Block 2, Cross View Estates Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 15, Block 2, Cross View Estates Subdivision intends to construct a new four-bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new well and septic system to accommodate the home. The attached Site Plan and backup documentation identify the location and configuration of the proposed well and septic system along with the alternate site. Also identified on the plans are the existing wells and septic systems on surrounding lots. No conflicts exist between the proposed septic system and well or septic systems and wells on adjacent lots. Drainage arrows are shown on the site plan showing the grade and direction of flow on the lot. The drainage pattern will not be changed as a result of this project. The test hole was placed on the lot in the area of the absorption trench and alternate site during the subdivision phase. The log indicates sandy silt to silt (SM -ML). The percolation rate of the soil was determined to be 6 minutes per inch. No groundwater was found during the placement of the test hole and none was noted during the monitoring period. An application rate of .8 gallons per day per square foot was used in the design of the absorption system. We are proposing to place a new 1,250 -gallon septic tank and a 63' long by 3' wide by 6' effective depth absorption trench to treat and dispose of the effluent generated in the house. The elevation of the distribution line in the absorption trench will be 4' below the surface and the total depth will be 10'. A minimum of 3' of fill or 2" of insulation and 2' of fill will be placed over the absorption trench and 4' over the septic tank. The ground surface on the lot in the area of the septic system slopes to the south. The new trench will be constructed parallel with the slope as much as possible in conformance with Municipal requirements. The new septic system will be constructed a 2006-m CROSS VIEW ESTATES SUBDIVISION LOT 15;S9BLOCK 2 C.EVATOS BASED ON Iffn MM OAItM "i eeS' SI �....J FR�A� f HC CIYTS DRIVE 0 M W2r47' O IPropwed Web raw .,, ILt � ��� 1.250 Oallan Septic Tank e 63'lan0 M 3' Wide ern■ 6 EHectiw pN _ STH ADeorp6on TnmcD� Altate Site 7 r 4 r 10' STOW D v EW 10' T. A E tsar. SITE PLAN SCALE 1' = 50' O ia• STEM DAM EDAM 90' OAS t3Mf. 49th MI04AEL E. ANDERSON LOT 15, BLOCK 2, CROSS VIEW ESTATES SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home Deep Trench System Perc. Rate: 6 Min./inch 1,250 Gallon Septic Tank Application Rate: .8 GPD/SF 6' Drainfield Rock 4 Bedrooms X 150 GPD/.8 GPD/SF (Application Rate) = 750 SF Absorption Area 750 SF/12 SF/LF = 62.5 LF Trench Length THEREFORE: Construct a 63' Long x 3' Wide x 6' Effective Depth Absorption Trench at the Location Shown. Flow Line Elevation in Trench to be 4' Below Original Ground Surface. Total Depth to be 10' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption Trench. Maintain 100' Separation from Wells in the Area. Natural Backfill Geotextile ,ea+� SOPp,/�_ v. 6 Q 4" Perforated �° PVC (Holes Down) 3' TYPICAL DEEP TR Drainfield Rock ;H SECTION NOTE: Grade Area Over Trench to Drain Away. a Minimum 6' Separation From Bedrock. y• Minimum 4' Separation From Groundwater. kk Minimum 100' Separation From Wells in the Area.' Minimum 100' Separation From Surface Water or Streams. �i, MEL E ANOER No. c i ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 15, BLOCK 2, CROSS rwESTATffS SUBD DSIO I]EV ws- GENERAL: The scope of this project includes the procurement and placement of a new 1,250 -gallon septic tank at the location shown on the Site Plan. Work also includes the construction of a new 63' long X 3' wide X 6' effective depth absorption trench at the location also shown on the Site Plan. The distribution line in the trench will be placed at 4' below the existing ground surface. Total depth of the trench will be 10' below the existing ground surface. The new absorption trench and septic tank must be placed a minimum of 100' from all private wells and any surface water in the area and 10' from the water service line proposed for the lot. A minimum of 3' of cover is required over the absorption trench and 4' of cover over the septic tank. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. The Contractor must also verify the location of wells in the area and assure that the separation distances are met. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION 1. A new 1,250 -gallon septic tank must be procured from an approved source and installed at the location shown. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 FAX MEMORANDUM DATE: March 9, 2007��,® TO: Deb Wockenfuss FROM: Mike Anderson, P.E. SUBJECT: Lot 15, Block 2, Cross View Estates Subdivision Well and Septic System Permit The percolation test performed at the location of the absorption trench designed for this lot indicates a rate of 6 minutes per inch. The engineer, however recommended an application rate of .6 square feet per bedroom, which seems conservative. We have revised our design to reflect his recommendation. The trench now has an effective depth of 8' as opposed to our original design of 6'. No significant ground slopes are located within 100' of the proposed absorption trench. We have added slope surface arrows to indicate the direction and slope of the existing ground in the area. In addition, the surveyor has placed ground surface elevations at each lot comer. The drop in elevation from the north property line to the south property line is minimal with only small variations in between. Please review this data and advise if further information is required prior to issuance of the permits. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 FAX March 6, 2007 Municipality of Anchorage Development Services Department SUP E E DED On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 15, Block 2, Cross View Estates Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 15, Block 2, Cross View Estates Subdivision intends to construct a new four-bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new well and septic system to accommodate the home. The attached Site Plan and backup documentation identify the location and configuration of the proposed well and septic system along with the alternate site. Also identified on the plans are the existing wells and septic systems on surrounding lots. No conflicts exist between the proposed septic system and well or septic systems and wells on adjacent lots. Drainage arrows are shown on the site plan showing the grade and direction of flow on the lot. The drainage pattern will not be changed as a result of this project. The test hole was placed on the lot in the area of the absorption trench and alternate site during the subdivision phase. The log indicates sandy silt to silt (SM -ML). The percolation rate of the soil was determined to be 6 minutes per inch. No groundwater was found during the placement of the test hole and none was noted during the monitoring period. An application rate of .6 gallons per day per square foot was used in the design of the absorption system. We are proposing to place a new 1,250 -gallon septic tank and a 63' long by 3' wide by 8' effective depth absorption trench to treat and dispose of the effluent generated in the house. The elevation of the distribution line in the absorption trench will be 4' below the surface and the total depth will be 12'. A minimum of 3' of fill or 2" of insulation and 2' of fill will be placed over the absorption trench and 4' over the septic tank. The ground surface on the lot in the area of the septic system slopes to the south. The new trench will be constructed parallel with the slope as much as possible in conformance with Municipal requirements. The new septic system will be constructed a Lot 15, Block 2, Cross Point Estates Subdivision March 6, 2007 Page Two minimum of 100' from all wells and any surface water and 10' the proposed and existing water services in the area. If the system is constructed in accordance with our design the following statements apply: The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments 4006-171 CROSS VIEW ESTATES SUBDIVISION LOT 15159 BLOCK 2 U VAMM MM M IM NCS DAV Y MP)f hFR ya hn D rvE N a Propwad AS row'' °� 'Lk 1.250 ca Septic Tank 63' Lang • 3' Vide Try .N 6' Effptlo Tn Dopth h Acoaptbn Tnn *"tomato Sita it/ F; -,;:l ]C STOW CPM ew SITE PLAN SCALE 1' = 50' IC 3i DM1 Eswr. w CAV CWT. LOT 15, BLOCK 2, CROSS VIEW ESTATES SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home Perc. Rate: 6 Min./Inch Application Rate: .6 GPD/SF Deep Trench System 1,250 Gallon Septic Tank 8' Drainfield Rock 4 Bedrooms X 150 GPD/.6 GPD/SF (Application Rate) = 1,000 SF Absorption Area 1,000 SF/16 SF/LF = 62.5 LF Trench Length THEREFORE: Construct a 63' Long x 3' Wide x 6 Effective Depth Absorption Trench at the Location Shown. Flow Line Elevation in Trench to be 4' Below Original Ground Surface. Total Depth to be 12' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption Trench. Maintain 100' Separation from Wells in the Area. Natural Backfill *M 3' TYPICAL DEEP TRENCH NOTE: (NO Drainfield Rock ECTUP' Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 4' Separation From Groundwater. Minimum 100' Separation From Wells in the Area. Minimum 100' Separation From Surface Water or Streams: ONSITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 15, BLOCK 2, CROSS VIEVrE�r•S1J�IV��' �ISION GENERAL: �s I�'ED The scope of this project includes the procurement and placement of a new 1,250 -gallon septic tank at the location shown on the Site Plan. Work also includes the construction of a new 63' long X 3' wide X 8' effective depth absorption trench at the location also shown on the Site Plan. The distribution line in the trench will be placed at 4' below the existing ground surface. Total depth of the trench will be 12' below the existing ground surface. The new absorption trench and septic tank must be placed a minimum of 100' from all private wells and any surface water in the area and 10' from the water service line proposed for the lot. A minimum of 3' of cover is required over the absorption trench and 4' of cover over the septic tank. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. The Contractor must also verify the location of wells in the area and assure that the separation distances are met. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION A new 1,250 -gallon septic tank must be procured from an approved source and installed at the location shown. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. CD CD CY) titl— or)CO M C7 I-- rl- 0 0 CY) CY) W C M rn o LL V � Q O i U z J 1..1.. C U o a) L L - � W W U <li .L �(/)o6 V) L c � E Q O a) cn 00 U Ln N O N N 00 Q) C) C O c0 .Q x W O 0 C) ti i N N LOQ r 0 a) U (B a_ LO H J N MJM rW V ) w I— CO >w w U) / U) U C O �F+ Q U 0 a) J LO C) Q U) cuL- 0 O U C U) F— C� w 2 LU w co ti LO Ln N N (1) W U) w w F- U) 06 Z LU LU J J O F- Y S� L a) C 0 V O Q c U K4 i� c O M a. N C 0 O ` ^ a) .0 U O O a) A u Eel I u 0 0 0 m ` CL ami CL 0 C. 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J o ❑ �L- ❑ a w E d N a w o ❑ a� d T wv co �y/"D 2JQ n♦ ^, G LL 11 0 V/ UJ D eI W w Cl) a) L v v_ Z V/ cn O ai O LL LL L riL a) H O O U _� LU LU 0 (D n >, O w CO a `m H Q > a M > m a N M d L6 CO wm 0 T a) LL N (D Cross View Estates Block 2 Lot 15 015-221-77 2.90 Forge Engineering 8/12/24 8/23/24 (Issac's) N/A N/A N/A Benjamin Schiller, P.E. (907) 522-7773 MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-221-77 1. GENERAL INFORMATION Complete legal description Expiration Date: Cross View Estates Sub, Block 2, Lot 15 Location (site address) 5578 Heritage Heights Drive Current property owner(s) Tyrone & Wanda Maxey Day phone (281) 731-8564 Mailing address Real estate agent 5578 Heritage Heights Drive, Anchorage, AK 99516 Lisa Hartlieb 2. TYPE OF DWELLING: ❑■ Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone (907) 257-0471 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: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 650 Date of Payment �-/— t lO — Receipt Number C7 Z 5? J COSA # 6)5C -,?-1W30 Waiver Fee $ Date of Payment Receipt Number 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 6. DSD SIGNATURE XSystem #1 Approved for —5-- bedrooms System #2 Approved for bedrooms Disapproved Date 4/9/21 ,r.0Fq�ll�1 % * .49 . 9 • benjadrvSchiller CE 12592 • ��G��� ,l\��pROFESSI�NP -� Conditional approval for bedrooms, with the following stipulations: 0 WAST--VATER Jr// iIWUhAM SER��G�c By; Original Certificate Date: q-/ ( 2 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: Cross View Estates Sub, Block 2, Lot 15 Parcel ID: 015-221-77 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA Q Well log is filed with Onsite (or attached) Well production at time of test 6.8 gpm Date drilled 4/12/07 Water storage tank volume N/A gallons Total depth 241 ft Well disinfected for coliform test? ❑ Yes FE -1 No Cased to 241 ft 0 Coliform bacteria is Negative ❑■ Sanitary seal is functioning correctly FE -1 Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA 4/6/21 Static water level at beginning of test 194 ft. Comments B. TANK DATA Age of tank(s) 14 years Tank type/material SEPTIC/STEEL Measured operating fluid level in septic tank 48 0 Standpipes/foundation cleanout per record drawing Date of pumping 4/21/20 Around the Clock D. ABSORPTION FIELD DATA DEEP TRENCH Which system tested (date installed) 4/6/07 0 ALL standpipes present per record drawing Total measured depth from grade 13.2 ft (max) Measured depth to pipe invert from grade 5.7 ft (min) ❑ N/A — pressurized field FE -1 Monitor tubes go to bottom of effective. If not, state depth into effective 7.5 FE -1 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 Nitrate 2.31 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L 0 Arsenic less than MRL (ND) Collected by Forge Engineering Date of Sample 4/2/21.1- Comments /2/21, C. LIFT STATION uired maintenance completed Age of lift sta years Lift station material Comments: Adequacy test date 4/6/21 Results Q Pass For 4 bedrooms Fluid depth prior to test 52 in Water added 703 gal New depth 61 in Elapsed time 1440 min Final fluid depth 52 in Absorption rate '600 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) 0✓ Yes Septic Tank/Lift Station on Lot > 100' ft Wells on Adjacent Lots: Community Sewer Manhole/Cleanout > 100' 0✓ ❑✓ Yes if No ft ❑✓ Yes if No ft Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line > 25' [✓ Yes if No ft Absorption Field on Lot > 100' F✓ Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ✓0 Yes if No ft ✓ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0✓ 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' 0✓ Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5' 0✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 0✓ Yes if No ft Private Wells > 100'✓❑ Yes if No ft Water Main > 10' ✓0 Yes if No ft Community Wells > 200' 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 Property Line > 10'✓❑ Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓Q Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' 0✓ Yes if No ft Surface Water > 100'✓Q Yes if No ft F. ENGINEER'S COMMENTS dqbl G. ENGINEER'S CERTIFICATION ~OF,se co ;Q�`l� I certify that 1 have determined through field inspections and review j *: • ll -I , 49 of Municipal records that the above systems are in conformance with .�-: _ • • • . ;�!ll���.VVV,., • ,� , , �� MOA COSA guidelines in effect on this date. / •�.. ...... . Benla.,' •chiller ��j�Fc • CE 12592 • �`�r� (, /�lF� • . , 4/9/21 • • ���i �ll , PROFESSO:.` COSA Checklist yellow sheet • '� Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval Parcel I.D. 015-221-77 1. GENERAL INFORMATION ZXL _F� APF? "1" 5 2014 Expiration Date: g S Complete legal description Cross View Estates, Block 2, Lot 15 Location (site address) 5578 Heritage Heights Drive Anchorage, AK 99516 Current Property owners) James & Beth McAllen Day phone 345-4417 Mailing address 5578 Heritage Heights Drive Anchorage, AK 99516 Real Estate Agent 2. TYPE OF DWELLING: Fx1 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Four Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual Fx I Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5J' ado �—I Date of Payment '12SI c� Receipt Number O&Q 35C') COSA# OSc](11154 Waiver Fee $ Date of Payment Receipt Number 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. Name of Firm Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 4/24/2014 1F �t 4 F- V TH 6. DSD SIGNATURE1 1 � 6d t t s9t L System #1 Approved for bedrooms�tP System #2 Approved for bedrooms Disapproved Fs-. Conditional approval for bedrooms, with the following stipulat ods = By:Original Certificate Date: S ✓C 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 engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheets .a e If more than 1 septic system is on the lot: COSA Checklist # _of _ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Cross View Est. Sub., Block 2, Lot 15 Parcel ID: 015-221-17 A. WELL DATA Well type Private If A, B, or C provide PWSID # Well Log (Y/N) Y Date completed 4/12/07 Sanitary seal (YIN) Y Wires properly protected (Y/N) Y Total depth 241 ft. Cased to 241 ft. Casing height (above ground) >18 in. FROM WELL LOG Date of test 4/12/07 Static water level 181 Well production 20 AT INSPECTION 4/23/14 ft. 182 ft. g.p.m. 6.3 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate 2.08 mg/L Arsenic N/D ug/L Date of sample: /1/14 Collected by: B. SEPTIC/HOLDING TANK DATA J. Anderson Tank Type/Material Septic/Steel Date installed 4/5/07 . Tank size 1,250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (YIN) N High water alarm (Y/N) N Date of pumping 12/4/13 Pumper Denali Sewer and Drain Service C. ABSORPTION FIELD DATA Date installed 4/6/07 Soil rating (g.p.d./fe or ftz/bdrm) .6 GPD System type Deep Trench Length 73 ft. Width 3-4 ft. Gravel below pipe 8 ft. Total depth 13-14 ft. Eff. absorption area 1,168 ft' Monitoring tube Y Depression over field N Date of adequacy test 4/23/14 ResultsPass/Fail ( )Pass For 4 bedrooms Fluid depth in absorption field before test 39/40 in. Water added 634 gal. New depth 51/51 in Elapsed Time: 1,440 min. Final fluid depth 39/40 in. Absorption rate >= 600 g p d Any rejuvenation treatment (past 12 mo.) (Y/N & type) / y If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons Manhole/Access (YIN) in. "Pump off' level at in. High water alarm level at Cycles tested Meets alar & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tankllift station on lot >100' On adjacent lots >100' Absorption field on lot > 100' On adjacent lots >1 00' Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line >25' Holding tank N/A Animal containment areas >50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Water main >10' Water service line >10' Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10, Water Service line > 10 Surface water > 100 Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that t have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. Date 4/24/14 COSA brown sheet_10-10-12.dw Absorption field >5' Surface water >100' Water main >10' Driveway, parking/vehiclestorage >10' c 0` ° L68IP'99ER'S',. no 0 2006-171 CROSS VIEW ESTATES SUBDIVISION LOT 15, BLOCK 2 51,159 S.F. GASTALDI LAND SURVEYING, LLC JEFF A. GASTALDI, R.L.S. 4726 WEST 88TH AVENUE ANCHORAGE, ALASKA 99502 PHONE 248-5454 GRID DATE 2737 8/30/2007 F.B. JOB NO. 07-10 CVE152 I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. ANCHORAGE RECORDING DISTRICT, ALASKA NOTE: NO CORNERS SET THIS DATE 10' STORM DRAIN ESMT. 20' GAS ESMT. 1 11=30' ���' 0F` q •1� 49 ill * � .. ...... ...... ....I0 •Jeffery A. Gasfaldi•. N LS -6091 •� -140 AF l ...�..•.•� a5��41p rOyessional �°� �•