HomeMy WebLinkAboutROSEBERRY PARK ESTATES BLK 2 LT 2Roseberry Park
Estates
Block 2
Lot 2
#050-315-37
Inspection Report _1-1-1$ldotr
Municipality of Anchorage
Community Development Department Page 1 of 3
On -Site Water and Wastewater Program
4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP121064
PID Number: 050-315-37✓❑ New ❑ Upgrade
Name:
Troy Davis Homes
ABSORPTION FIELD
❑ Deep Trench ✓❑ Shallow Trench E] Bed E] Mound
Address
165 E. Parks Highway, Wasilla, AK 99654
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
357-9394
4
1.2 GPD/SF
7 Ft,
LEGAL DESCRIPTION
Depth to pipe invert from original grade
3 Ft.
Gravel depth beneath pipe
4Ft.
Subdivision
Block Lot
Roseberry Park Estates
2 2
Fill added above original grade
1-2 Ft.
Gravel length
50 Ft.
Township Range Section
Gravel width
5Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Lift Station
i Tank
Line
500 Ft2
One
Ft.
Well
>100'
>100'
N/A
N/A
>25'
TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Anchorage Tank
Capacity
1,250Gal.
Surface water
>100'
>100'
N/A
N/A
Material
Number of compartments
Lot Line
>5'
>10'
N/A
NIA
Steel
Two
NA
Foundation
>5'
>10'
N/A
NIA
LIFT STATION
Manufacturer
Capacity
Curtain Drain
None
i Noted
Gal.
Remarks
Pump on level at
in.
Pump off level at
in.
rH,,water alarm at
in.
Pump make and model
Electrical Inspections performed by
Installer
PIPEMATERIAL Housetotank D3034 Tankto D3034
drainfeld
Pomraning Excavation
Dralnfield HDPE CO/MT D3034
Inspector MEA
BENCHMARK (Assumed elevation) 100.Oft
Inspection s,
� 6!4/12
6!5/12
Location and description
dates:
zed
Back Deck Lowest Step Southwest Corner.
3,d
41n
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
®�>!
OF
Conditional Approval:
Date
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M % MICHAEL L AW61:60N�
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CE � 4381 AN
Approved
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Inspection Report _1-1-1$ldotr
Municipality of Anchorage Page 2 of 3
Permit Number: OSP121064 DEVEOPMENT SERVICES DEPARTMENT PID No.:050-315-37
4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904
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MICHAEL E, ANDERSON -:'a
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C4—Cleanout
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FCO —Foundation Cleanout
TH—TootHo|o
W1—Monitor Tube
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SCALE 1' = 40'
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S1 Septic Vent
FCO —Foundation Cleanout
TH—TootHo|o
W1—Monitor Tube
PLAN AS BUILT
SCALE 1' = 40'
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Municipality of Anchorage Page 3 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
Permit Number: OSP121064
1,250 Gallon
Septic Tank
99.4
UU
PID No. 050-315-37
V
U
PROFILE AS -BUILT
No Scale
ID
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
MEMORANDUM
DATE: September 27, 2012
TO: Jeff Poet
FROM: Mike Anderson. P.E.
SUBJECT: Lot 2, Block 2, Roseberry Park Estates Subdivision
Septic System Permit No. OSP121064
Inspection Report/COSA
We have reviewed your comments pertaining to the inspection report and COSA for
the subject lot and have made the following revisions:
1. The ground surface on the lot was cleared and leveled prior to the construction
of the septic system. All organic material was removed. The absorption trench
was placed on level ground and the entire absorption area was below the
organic layer. The trench was placed near the test hole located on the lot. The
exact location of the test hole was not surveyed in or accurately placed on the
Site Plan for the design.
2. Test Hole No. 10 was not accurately located on the Site Plan submitted with the
design. The test hole was placed during the design phase of the subdivision and
the location shown with the subdivision information was not accurate. The
location shown on the inspection report was surveyed and accurately located.
The trench was placed near the test hole and within the 30' effective radius. A
second test hole was placed during construction to verify the consistency of the
accepting soils.
3. The arsenic results from the water from the well will be submitted as soon as it is
received. It will also be reported to the developer and the new owner of the
property. We request the COSA be issued based on submitting the arsenic
results when they become available.
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: LOT 2, BLOCK 2, ROSEBERRY PARK ESTATES SUB.
PERFORMED FOR: TROY DAVIS HOMES
DATE: 6/4/12 PROJECT No.:
PARCEL ID#: TECHNICIAN: MEA
DEPTH TEST HOLE A
(feet)
1
READING
OB/OG
NET TIME
(MINUTES)
a
NET DROP
(INCHES)
2
a
6/4
3
'..
10
.75v9.75"
.a
CLEAN WELL GRADED
4
1:38/1:48
SAND WITH GRAVEL
.88"/9.00"
8.12"
SW/SM
5
a
10
.75^/8.88^
d
6
a.
10
7
8.12"
BOH @ 7 -
SLOPE
?:'• 19S
t 49th !'V •.''�
MICHAEL E. ANDERSON
NO. CE -4381
SITE PLAN
SEE SITE PLAN
k
WAS GROUND WATER ENCOUNTERED? NO
10
IF YES a WHAT DEPTH? S
DEPTH OF WATER AFTER MONITORING: NONE 5%
11 DATE OF MONITORING: 11/26/09 0
1
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH To
MATER
(INCHES)
NET DROP
(INCHES)
TEST HOLE PRESOAKED PRIOR TO TESTING:
6/4
1
1:27/1:37
10
.75v9.75"
9.00"
2
1:38/1:48
10
.88"/9.00"
8.12"
3
1:50/2:00
10
.75^/8.88^
8.12"
4
2:01/2:11
10
.60^/8.75^
8.12"
5
2:13/2:23
10
.8811/9.001,
8.12"
6
2:24/2:34
10
.75^/8.88^
8.12"
PERCOLATION RATE: 1.2 (MINANCH) PERC. HOLE DIA. V (INCHES)
TEST RUN BETWEEN: 6.0 FT. and 7.0 FT,
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. PERCOLATION TEST TO DETERMINE CONSISTENCY OF SOILS.
TEST PERFORMED BY ANDERSON ENGINEERING. 1, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS
DATE: 9/25/2012
Cerfifteb Ort'Ifing log
by
DOG
co.
dba
SULLIVAN WATER WELLS
P.O. BOX 670272, CHUGIAK, ALASKA 99567 -TELEPHONE 688-2759
OWNER OF LAND: 72bVr 41r4'j BORE HOLE DATA
ADDRESS:
LEGAL DESCRIPTION! M - -_ii i iSL
DATE,
PERMIT NUMBER; L*PAW Bate of fswe
TAX IDENTIFICATION NUMBER:
Is well located at approved permit location? t:es
No
Method of Drilling: @'air rotary U cable tool
U No
Depth of well:
Casing Type 72��f Wall Thickness
inches
Diameter- inches, depth 'LA 44
feet
LinerType; -
Casing Stickup Above Ground:
feet
Static Water Level:
feet
Recover Rate;
_VfL gpm
Method of Testing:
Well Intake Opening Type: U open end 'teen hole
UScreahed;-_ __SVrtfaq1, Stopped —feet
U Perforations Start — feet Stopped — feet
Grout Type:
Volume
Depth: from feet, to
4 feet
Well Disinfected Upon Completion?mUYes
U No
Method of Disinfection:
Comments:
DEPTH
From TO
cl
3
9
1)
17
/3C
7
_2
f- T
Driller's Name —d.,4J
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,
W
� yy
Development Services Department
Building Safety Division G� a
On -Site Water & Wastewater Program o "
4700 Elmore Road a '
z a
P.O. Box 196650 LEW
MarkBe9kh Anchorage, AK 99507 s ' ` T"
Mayor www.muni.cro/onsite
(907)343-7904
Pump Installation Log
cltocq
Well Drilling Permit Nnmber:13W Date of Issue:
Parcel Identification Number:
Legal Description
Rcaebeqv� Pam- Loi- a i3ix- a
Property Owner Name & Address:
a Qv1)_ +Ov tS k1�rne S
Pump Installation Date:
Pump Intake Depth Below Top of Well Casing. a-7 JLfeet
Pump Manufacturer's Name: C-1pV \6S
Pump Model: 3- C -(--
Pump Size hp
Pitless Adapter Burial Depth: 10 feet
Pitless Adapter Manufacturer's Name: t�iCl 1�SC3 t�
Pidess Adapter Installer: po r,n run t ncq E XC00"WI C)o
Well Disinfected Upon Completion? dYes ❑ No
Method of Disinfection:
Ch101ztoc
Comments:
Pump Installer Name:
Cole SU t 1 I vc),n. 1 Gh0.oi Gro SS
v-CCA -0 its
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
On -Site Water & Wastewater System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number: OSP121064
Tax Code Number: 05031537000
Work Type: WellSeptic Initial
Permit Effective Dates: April 27, 2012 to April 27, 2013
Design Engineer: ANDERSON ENGINEERING
Subdivision: ROSEBERRY PARK ESTATES
Site Legal Address: ROSEBERRY PARK ESTATES BLK 2 LT 2 G:0154
Owner/Address: ROSEBERRY PARK ESTATES LLC
10230 RONALD PLACE EAGLE RIVER AK 995778769
Site Mailing Address: 11324 SITKA ROSE CIR, Eagle River Lot Size in Sq Ft: 48821
Total Bedrooms: 4
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank N Privy Y Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received
Issued By
MUNICIPALITY OF
ots)
Community Development Department
Development Services Division
On -Site Water & Wastewater Program
Mayor Dan Sullivan
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcell.D. 050-315-37
Property owner(s): Troy Davis Homes, Inc.
Mailing address: 165 E. Parks Highway, Wasilla, AK 99654
Site address: �k$Aitka Rose Circle, Eagle River, AK 99577
Phone: 907-343-7904
Fax: 907-343-7997
Day phone: 357-9394
Legal description (Sub'd., Block & Lot): Roseberry Park Estates, Block 2, Lot 2
Legal description (Township, Range & Section)
Lot Size: 48,821 S.F. Number of Bedrooms: Four (4)
THIS APPLICATION IS FOR: THIS APPLICATION IS AN:
(® all that apply)
Absorption Field X
Initial X
Septic Tank X Upgrade ❑
Holding Tank ❑ Renewal ❑
Privy ❑
Private Well X
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE 1 WAIVER REQUEST FOR:
I certify that the above information is correct. I further certify that this application is being made
for a Single Family Fammily Dwelliinng� siand isin accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: 's -j~3 CU
Date of Payment: L4 I&
Receipt Number: ori
Permit No. OS p jZj0(0y
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
C:1Users\AndEng\DesktopSMike%Roseberry Park EstatesTennit Application L2 B2.docC:\Users\AndEng\Desktop\Mike\Roseberry
Park EstatesTennit Application L2 B2.doc
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AFS 99524
522-7773 677-7766 (FAX)
April 23, 2012
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 2, Block 2, Roseberry Park Estates Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 2, Block 2, Roseberry Park 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 septic system along with the alternate site. No existing wells or septic
systems are closer than 100' from the proposed well or septic system. None of the lots
adjacent to Lot 2 have yet been developed. The 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 placed during the subdivision phase of the project indicated well graded
gravel with sand and silt (SP/GW). All of the test holes completed in the subdivision
revealed similar soils with similar percolation rates. The percolation rate of the soil on
this lot was determined to be between 1 and 5 minutes per inch. Verification of the
percolation rate will be made during the construction of the absorption trench and the
results will be submitted with the certified as built. Groundwater was not found during
the placement of the test hole. A recent inspection indicated no water in the monitoring
tube at any level. An application rate of 1.2 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 50' long by 5' wide by 4' 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 3.0' below the surface and the total depth will be 7.0'. 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.
Lot 2, Block 2, Roseberry Park Estates
April 23, 2012
Page Two
The ground surface on the lot in the area of the absorption trench slopes to the
southwest at a grade approximating 5%. The new trench will be constructed parallel
with the contours of the slope as much as possible in conformance with Municipal
requirements. The new septic system will be constructed a minimum of 100' from all
wells and any surface water and 10' from the proposed and existing water services in
the area.
If the system is constructed in accordance with our design the following statements
apply:
1. 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
MICHAEL E. ANDERSON
. No. CE -4381 .
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SV — Septic Vent
FCO — Foundation Cleanout
TH — Test Hole
MT — Monitor Tube
4
SITE
PLAN
VACANT
SCALE
1" = 40'
I
LOT 2, BLOCK 2, ROSEBERRY PARK ESTATES
SUBDIVISION
DESIGN FACTORS:
Four Bedroom House
Perc. Rate: 1-5 Min./Inch (Est.)
Application Rate: 1.2 GPD/SF
SYSTEM REQUIREMENTS:
5' Wide Trench System
1,250 Gallon Septic Tank
4' Drainfield Rock
4 Bedrooms X 150 GPD/1.2 GPD/SF (Application Rate) = 500 SF Absorption Area
500 SF/5 SF/LF'.5 (Red. Factor) = 50 LF Trench Length
THEREFORE: Construct an Abosrption Trench 50' Long x 5 Wide x 4' Effective Depth.
Flow Line Elevation in Trench to be 3' Below Original Ground Surface. Total Depth to be
7' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over
Absorption Trench.
26 Natural
Backfill Geotextile
Fabric
R5
EN
5'
4" Perforated
PVC (Holes Down)
Drainfield Rock
TYPICAL 5' WIDE TRENCH SECTION
(NO SCALE) ,
NOTE: Grade Area Over Trench to Drain Away. 941
Minimum 6' Separation From Bedrock. .�...::./. •.4
Minimum 4' Separation From Groundwater. (Y
.A ...............................
Minimum 100' Separation From Wells in the Area. 10� m : nnicwe�e. nNOEasoru
Minimum 100' Separation From Surface Water No. oErsa,
S❑ILS LOG - PERC❑LATI❑N TEST
fft Performed For: Lee Coy
r�
DEPTH
(FEET)
Organic
r^ 1- Groundwater Observed; None
2 - O .Q Depth To Water After Monitoring: None
3 - Date of Monitor, 11/23/03 & 5/1/04
�a 4 _
20 —
t o, 21 —
Percolation Rate: 1 rein,/inch
Pre -Soak Seeped Away
Perc Hole Diameter = E
Test Run Between 3' a
rv^Performed in Accordance with All State/Municipal
NOFRTHRIM *y�49 .• * TESTH❑LE LOG
r' ENGINEERING P (/�-
17237 Beor Paw Circ/e ZiIM e ���se.rerr 4r `�
Cagle .4i ver, Afasko 99577 '•
�fflh 6y44- 762 g GE❑TECHNICAL
M•
n Under 10 Minutes
d 4'
Guidelines in Effect
5 —
n
""
6 —
6
!�
7 -
:: Q
SP/GW
Oft
8 -
.,
Sand w/
9 -
d•... =.
Gravel
10 —
ops®ate
12 —
P
13 —
�"'
14 —
P'
15 —
�"
16 —
�"
17 —
!"
18 —
19 —
r
20 —
t o, 21 —
Percolation Rate: 1 rein,/inch
Pre -Soak Seeped Away
Perc Hole Diameter = E
Test Run Between 3' a
rv^Performed in Accordance with All State/Municipal
NOFRTHRIM *y�49 .• * TESTH❑LE LOG
r' ENGINEERING P (/�-
17237 Beor Paw Circ/e ZiIM e ���se.rerr 4r `�
Cagle .4i ver, Afasko 99577 '•
�fflh 6y44- 762 g GE❑TECHNICAL
M•
n Under 10 Minutes
d 4'
Guidelines in Effect
e' -
n
6
T.
H.
10
ops®ate
�e�s�®ate
20 —
t o, 21 —
Percolation Rate: 1 rein,/inch
Pre -Soak Seeped Away
Perc Hole Diameter = E
Test Run Between 3' a
rv^Performed in Accordance with All State/Municipal
NOFRTHRIM *y�49 .• * TESTH❑LE LOG
r' ENGINEERING P (/�-
17237 Beor Paw Circ/e ZiIM e ���se.rerr 4r `�
Cagle .4i ver, Afasko 99577 '•
�fflh 6y44- 762 g GE❑TECHNICAL
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d 4'
Guidelines in Effect
Oats: pall
9/05 110 of 29
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6
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10
Oats: pall
9/05 110 of 29
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 2, BLOCK 2, ROSEBERRY PARK 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 50' long X 5' wide X 4' effective depth
absorption trench at the location also shown on the Site Plan. The
distribution line in the trench will be placed at 3.0' below the existing ground
surface. Total depth of the trench will be 7.0' 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 and easements. 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 Development Services Department Building Safety Division On Site
Water and Wastewater Program for system installations. Owners installing
their own systems must receive prior approval from the On Site Water and
Wastewater Program 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.
Lot 2, Block 2, Roseberry Park Estates Subdivision
April 23, 2012
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.
3. 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 the distribution line must be perforated. The
portion above the distribution line must be solid.
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 2, Block 2, Roseberry Park Estates Subdivision
April 23, 2012
Page 3 of 3
MATERIAL SPECIFICATIONS:
1. 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).
3. 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, Fernco, 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.
O. Parcell.D.
Municipality of Anchorage
Development Services Department
Building Safety Division i
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR SINGLE FAMILY DWELLING G' 11
050-315-37 COSA # 05C is �g4o
Expiration Date: /
1. GENERAL INFORMATION
Complete legal description Lot 2, Block 2, Roseberry Park Estates Subdivision
Location (site address) 11324 Sitka Rose circle, Eagle River, AK 99577
Current Property owner(S) Troy Davis Homes, Inc.
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
165 E. Parks Highway Wasilla, AK 99654
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: Four (4)
Day phone 357-9394
Day phone
Day phone
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
❑✓
Individual On-site
❑✓
Individual Water Storage
❑
Individual Holding Tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. 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 912512012
5. DSD SIGNATURE
_Z� Approved for �f _ bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
1/ Seh rci
COSA Checklist X Arsenic Advisory
Septic System Advisory Maintenance Agreements
Well Flow Advisory Supplemental Engineer's Report
Nitrate Advisory Other
By: t Original Certificate Date:
(Rea 11/05)
�- Municipality of Anchorage
j• Development Services Department
\\ Building Safety Division`
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: Lot 2, Block 2, Roseberry Park Estates Subdivision Parcel ID: 050-31537
A. WELL DATA
Well type Private If A. B, or C provide PWSID # _ Well Log (YIN) Y
Date completed 5/14/12 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y
Total depth 300 ft. Cased to 124 ft. Casing height (above ground) >24 in.
FROM WELL LOG AT INSPECTION
Date of test 5/14/2012
Static water level 116 ft. ft.
Well production 2.5 9 -P.M. 9 RM
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mL Nitrate .316 mg/L Other bacteria 0 colonies/100 mL
Arsenic: mg/I Date of sample: 9/21/12 Collected by: MEA
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material steel/Septic Date installed 6/4/12
Tank size 1.256 gal. Number of Compartments Two Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N
Date of pumping New construction Pumper
C. ABSORPTION FIELD DATA
Date installed 6/4-5/12 Soil rating (g.p.d./ftz or ft2/bdrm)12 GPD/SF System type Shallow Trench
Length 50 ft. Width 5 ft. Gravel below pipe 4 ft.
Total depth 8-9 ft. Eff. absorption area 500 112 Monitoring tube Y Depression over field N
Date of adequacy test New Const. Results (Pass/Fail) For bedrooms
Fluid depth in absorption field before test in. Water added_ gal. New depth in.
Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date
D. LIFT STATION
Date installed Size in gallons
"Pump on" level at _ in. "Pump off' level at
Datum Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Manhole/Access(Y/N)
in. High water alarm level
Meets alarm & circuit requirements?
Septic tank/lift station on lot >109 On adjacent lots >100'
Absorption field on lot >low On adjacent lots >100'
Public sewer main »5' Public sewer manhole/cleanout >100'
Sewer /septic service line >25' Holding tank N/A
Animal containment areas >50' Manure/animal excrete storage areas >100'
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >5' Property line >5_ Absorption field >5'
Water main NIA Water service line >10' Surface water >100'
Wells on adjacent lots >100'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line >10' Building foundation >10' Water main >10'
Water Service line >10' Surface water >100' Driveway, parking/vehicle storage >25'
Curtain drain None Noted Wells on adjacent lots >too -
F. COMMENTS:
1I
G. ENGINEER'S CERTIFICATION
e (7^:'• =r "'f ®j
AO 9'
49�
'9
1 certify that I 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.
I� M �lNiCJfAi E ANSON
Engineer's Printed Name Michael E. Anderson, P.E.
�� J �, CE'.4ml •'\ate
Date 9/25/2012
COSA Fee $ (o nS �I Q4 k
Date of Payment —1 b(a I i a, cls
Receipt Number AC{ I (yD G
(Rev. 11105)
Waiver Fee $ _
Date of Payment
Receipt Number
in.
SGS Ref.#
PrintedDate/Time 10/02/2012 8:14
Collected Date/Time 09/21/2012 12:00
Received Date/Time 09/21/2012 12:45
Technical Director Stephen C. Ede
1124573001
Client Name
Ander n inee`rrr ..'
09/25/12 09/27/12
0 1
Client Sample/I
Client Sample ID
of 2 Block , osebeny Park
Matrix
Drinking Water
Sample Remarks:
Parameter Results LOQ
Metals. by ICP/MS
Arsenic ND 5,00
Waters Department
Total Nitrate/Nitrite-N 0.378 0.100
Microbiology Laboratory -
E. Coli Negative I
Total Coliform Negative 1
Allowable Prep Analysis
Units Method Container ID Limits Date Daze lnit
ug/L
EP200.8
C
(<10)
09/25/12 09/27/12
NRB
mg/L
SM21450ONO3-F
B
(<10)
09/25/12
CMA
100ml- SM219223B A
100mL SM219223B A
09/21/12 DLC
09/21/12 DLC
33.00
33.00
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TROY DAVIS HOMES
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GRAPHIC SCALE. 1 Inch ?0 Feel
20 0 20 0
80
h ORBES & A TES INC9-12- 12 1 "=40'
Grid As—Built
P.0. BOX 232293 NW 154 2120171
Anchorage, Alaska 99523
(907) 227-5881 Drawn by Field Bol
cef 240
1 hereby certify that the property described hereon has been surveyed
by me, or at my direction, and that the improvements situated thereon
are within the property lines and do not overlap or encroach on the
Property lying adjacent thereto unless otherwise shown. That no
improvements on the property lying adjacent thereto encroach on. the
Premises nes orin otheron and easementson that
said there
property except wassshownsmissi on
It is the responsibility of the owner or builder,00
to verify proposed buildingrelative
e finish prior [o d utruction, i
connections and to determine the existenceofanyeasements covenants,
or restrictions which do not appear on the recorded subdivision
Listed distances prevail over scaling. plat.
Reproduction may cause distortion.
.. gal Lescriptlon
Lot 2 Tlock 2
ROSEBERRY PARK
ESTATES
.. _ «........, .. 1.10
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