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HomeMy WebLinkAboutCROSS VIEW ESTATES BLK 2 LT 1Cross View Estates Block 2 Lot 1 #015-221-63 Development Services Department Building Safety Division • On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Mark Begich Anchorage, AK 99507 s A E T r Mayor www.muni.org/onsite (907)343-7904 Pump Installation Log Well Drilling Permit Number: SW 121255 Date of Issue• 8/9/2012 Parcel Identification Number: 01622163000 Legal Description Block 2, Lot 1 Cross View Estates Property Owner Name & Address: Harding Homes 5771 Heritage Heights Dr. Anchorage, AK 99516 Pump Installation Date: 2/8/2,13 Pump Intake Depth Below Top of Well Casing: 282 feet Pump Manufacturer's Name: Grundfos Pump Model: 15 SQE-15-290 Pump Size 1 1/2 hp Pitless Adapter Burial Depth: N/A feet Pitless Adapter Manufacturer's Name: N/A Pitless Adapter Installer: N/A Well Disinfected Upon Completion? Z Yes ❑ No Method of Disinfection: Comments: Pump Installer Name: Aarow Pump & Well Service, LLC P.O. Box 110496 Anchorage, AK 99511-0496 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. 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: OSP121225 PID Number: 015-221-63 ❑✓ New ❑ Upgrade Name: Harding Homes of Alaska, Inc. ABSORPTION FIELD ❑✓ Deep Trench ❑ Shallow Trench ❑ Bed El Mound Address 5771 Heritage Heights Drive Anchorage, AK 99516 El Other Phone Number of Bedrooms Soil Rating Total depth from original grade 350-1860 5 -8GPDISF 12 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 4 Ft. Gravel depth beneath pipe 8.OFt. Subdivision Block Lot Cross View Estates 2 1 Fill added above original grade Gravel length Township Range Section 0-i Ft. 62 Ft. Gravel width 3Ft. Beds: Number of Lines Distance between lines SEPARATION DISTANCES Ft. TO Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 992 One Ff Ft. Well >100' >100' N/A N/A >25' TANK❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Surface Water >100' >100' N/A NIA Anchorage Tank 1,50OGal. Material Number of compartments Lot Line >5' 5'** N/A N/A Steel Two NA Foundation >5' >10' N/A N/A LIFT STATION Capacity Curtain Drain None Noted Gal. Remarks "See Lot Line Waiver EManufacturer at in. Pump off level at in. High water alarm at in. Pump make and model Electrical Inspections performed by Installer PIPEMATERIAL Housetotank Tankto D3034 D3034 drainfeld Harding Homes of Alaska, Inc. Drainfield HDPE CO/MT D3034 Inspector MEA BENCHMARK (Assumed elevation) 100.0ft Inspection1si dates: 8/24/12 2- 8/25/12 Location and description s" 8/26/12 a'" Garage Slab. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp I OF t Conditional Approval: Date ���(E.•••••:QIq�f, 49it1 6 ..•.......0 �i i J Schiller; e� Approve •Benja �1�9F Date a( a •j3 .: �,�� h�pROFesstaN�:•� Insoection Re° 1-1-19 tlnc M M U N 0 N N c U a o - avoa H0818 z 0 rs X0 CL u) z $ U W I I 'iVIS'3 9 1 .Ol viiiw, — — _--_— -- a Oz I i W n c zU LijOW of m 5 2 vi W m I I ZIP, '® J H mW0) 1 0 0 M 0 Q U Y y Ip w oI L: a a In N V7 O ":ryJ�y--�� .' W mN N QI— W00 f (n N 0 C7 w W .a .a F— 0 0 O (/� S ,02 n M U Z U N Z U) CLU w w a I E v �d¢ a o 0 O a°�i f6 0_ LU �- 7 L w mE 0 w Z Q W O 1 G J W -I 3 ">= _ of > j W O n N mC0 LL � 00 C/) O r U a r N U I 1 m n � e h uJ O .09 _-----iNS3 SVD ,Ol----- ---- 2�a ,09'96 M„bb,OZ.00 N 80 L2=1 oo'ozz=a nNi 310810 30ViI83H ?Dddf1 w Cr IL N0 0 10 S : n: Z 4 l 4. 0 �: 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: OSP121225 DC7 98.1 U) r� U U PID No. 015-221-63 v e Ln 62' (Trench Length) PROFILE RS -BUILT No Scale 92.0 01.1 :Alpine Drilling FAX N0. :907 345 0202 Feb. 12 2013 09:56AM P1 Alpine Drilling & Enterprises Well Log Permit Number: #SW12 25 Date of Issue: 8-9-12 Parcel Identification Numbe : 163000 Date Started: 10-8-12 Date Completed: 10-10-12 is well located at approved permit locatio Yes N Legal Description: CI•ossvlew Estates Block 2 lot 1 Property Owner Name & Address: H2L Investments, LLC 633 E 81a1 Ave Anohorape, Alaska 88518 Borehole Data: Soil Type, Thickness & Water Strata Depth (ft) From To Method of Drilling x air rotary ❑ cable tool Casing type; steel Stick-up 0 2 Wail Thickness: .250 inches silt gravelly silt 2 7 7 74 Diameter..6 inches Depth: 294 feet Liner Type: Diameter: inches Depth: _feet silly gravel 74 111 Casing,stickup above ground: 2 feet Static water level (from ground level): 22afeet gravelly silt 111 144 silt 144 194 Pumping level: 290 feet after 194 239. 2 }tours pumping 15 gpm Recovery Rate; j 4 gpm silt 239 280 Method of Testing: air lfit silty water sand &gravel 280 294 Well Intake Opening Type; x Open End ❑ Open Hole 0 Screened . Start. feet Stopped _ feet ❑Perforations Startfeet Stopped_feet Grout Type: bentonite eranules Volume: 2 bPs Depth: Start 0 &ot Stooped ?feet Pump: Intake Depth _ feet Pump size _ hp Brand Name Well Disinfected Upon Completion? x Yes © No WATER QUALITY TESTING Coliform- Ne wi Vf CoU100ML Nitrates N 1J L Arsenic 1 S Method of Disinfection. chlorine tablets Comments: WellDriller. Alpine Drilling &Enterprises PO Box 110494 Anchorage AK 99511 Pump Installation Date: 2/8no13 Intake Depth Below Top of Well Casing: 262 feet Pump Manufacturer's Name: Grundtos Pump Model: 15 see -15.290 Pump Size 1 112 hp Pitless Adapter Burial Depth: N/A feet Pitless Adapter Manufacturer's Name: 01A Pitless Adapter Installer: N/A Well Disinfected Upon Co letiQn? 91 Yes F1 No Method of Disinfecrc f� 1,loN:�.¢-TabIC�SA u nts: Comme_ �r�x7• Pump Installer Name: Aarow Pump & Well SeMce, LLC P.O. Box 110496 Anchorage, AK 99511-0496 Attention: The pump installer shall provide a pump installation log to the ASD within 30 days of pump installation. Development Services Department Building Safety Division • a ra On -Site Water & Wastewater Program a`p6� 4700 Elmore Road P.O. Box 196650 Mark Begieh Anchorage, AK 99507 Mayor wwwrnuni.org/onsite (907)343-7904 Pump Installation Log Well Drilling Permit Number 121255 Date of Issue: 61912012 Parcel Identification Numb 01 zl6s000 Legal Description Property Owner Name & Address: Bloch 2, Lot 1 Herding Homes Cross View Estates 5771 Hedlage Heights Dr. ' Anchorage, AK 99516 Pump Installation Date: 2/8no13 Intake Depth Below Top of Well Casing: 262 feet Pump Manufacturer's Name: Grundtos Pump Model: 15 see -15.290 Pump Size 1 112 hp Pitless Adapter Burial Depth: N/A feet Pitless Adapter Manufacturer's Name: 01A Pitless Adapter Installer: N/A Well Disinfected Upon Co letiQn? 91 Yes F1 No Method of Disinfecrc f� 1,loN:�.¢-TabIC�SA u nts: Comme_ �r�x7• Pump Installer Name: Aarow Pump & Well SeMce, LLC P.O. Box 110496 Anchorage, AK 99511-0496 Attention: The pump installer shall provide a pump installation log to the ASD within 30 days of pump installation. SGS SGS Ref.# 1130597001 Client Name Anderson Engineering Project Name/# Ll, B2 Cross View Estates Client Sample ID Lot 1 Block 2 Cross View Eats Matrix Drinking Water Sample Remarks: Printed Date/Time 02/22/2013 13:09 Collected Date/Time 02/15/2013 12:15 Received Date/Time 02/15/2013 12:15 Technical Director Stephen C. Ede Parameter Results LOQ Units Method Container ID Allowable Limits Prep Analysis Date Date Init Metals by ICP/M3 Arsenic 25.0 * 5.00 ug/L EP200.8 C (40) 02/19/13 02/20/13 SCL Waters Department Total Nitrate/Nitrite-N ND 0.100 mg/L SM21 4500NO3-F B (<10) 02/15/13 AYC Microbiology Laboratory E. Coli Negative 1 IOOmL SM21 9223B A 02/15/13 LCE Total Coliform Negative 1 100mL SM21 9223B A 02/15/13 LCE 2 of Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage Alaska 99519-6650 s (907) 343-7904 • Fax (907) 343-7997 http://www.muni.or-q/Onsite Development Services Division On -Site Water and Wastewater Program picric 1� arS ems. Deptment **** VARIANCEIWAIVER REVIEW **** Waiver#: OSP131019 PID#: 015-221-63 COSA#:OSC131055 Permit#:OSP121225 Legal Description: Cross View Estates, Block 2. Lot 1 Engineer: Anderson Engineering Applicant: Harding Homes of Alaska. Inc. Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 5.0 feet. This waiver approval applies to the existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ® Notarized letter(s) of non -objection have been received from the owner(s) of the affected adjacent property. ❑ Adjacent properties are not affected by this waiver. ......................................................... a . . . . . . . . . 0........... Waiver is Granted: X Waiver is not Granted: Date: a a� !3 Approved by Name of Reviewer .............................................................................. Rec#: 06406G Amount: $200.00 Date Paid: 2/25/2013 **** VARIANCEMAIVER REVIEW **** ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) February 24,'2013 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Lot 1, Block 2, Cross View Estates Subdivision Separation Distance Waiver Absorption Trench to Lot Line Dear On Site Services Engineer: The east end of the absorption trench recently constructed on Lot 1, Block 2, Cross View Estates Subdivision was inadvertently placed 5' from the south property line. The lot line is heavily treed making site distance difficult and was not clearly marked at the time of construction. The trench does not impact the property to the south as it is more than 50' from the absorption trench on this lot. In addition, soils in the area are very good for the absorption of septic effluent and the migration to the south is unlikely. We recommend a waiver be issued allowing the trench to remain 5' from the south property line at its east end. Sincerely, Benjamin {chiller, P.E. �?' � '•.may , 4g T -H 6enlain 1 Schiller; C� 1 92 �'�z E► ANDERSON ENGINEERING O. BOX 240773 A1►10RAGE, K 99524 6221773 � _ 4766 (FAX) February 24, 2013 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Lot 1, Block 2, Cross View Estates Subdivision Separation Distance Waiver Absorption Trench to Lot Line Dear On Site Services Engineer: The east end of the absorption trench recently constructed on Lot 1, Block 2, Cross View Estates Subdivision was inadvertently placed 5' from the south property line. The lot line is heavily treed making site distance difficult and was not clearly marked at the time of construction. The trench does not Impact the property to the south as it is more than 50' from the absorption trench on this lot. In addition, soils in the area are very good for the absorption of septic effluent and the migration to the south is unlikely. We recommend a waiver be issued allowing the trench to remain 5' from the south property line at its east end. Sincerely, Michael E. Anderson, P.E. 49th AEL E. ANDERSON No. CE -43a1 1 Individual Acknowledgement State of N U-sga Judicial District 3 r a SS. On this 14n day of �@ for X in the year X13. ,before ?fie, the undersigned notary public, personally appeared: -Jr known to me to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged that he/she/they executed the same for the purposes therein contained. In ' egg -Whey o set my hand and official seal. Ct:ar!yPju% (Si nature) Oz'te ` 1, N O2 or (Notary's printed name) p 4 My commission expires d 1 � Idol a 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: OSP121225 Tax Code Number: 01522163000 Work Type: WellSeptic Initial Permit Effective Dates: August 09, 2012 to August 09, 2013 Design Engineer: ANDERSON ENGINEERING Subdivision: CROSS VIEW ESTATES Site Legal Address: CROSS VIEW ESTATES BILK 2 LT 1 G:2737 Owner/Address: H2L INVESTMENTS LLC 633 E 81 STAVE ANCHORAGE AK 995180000 Site Mailing Address: 5796 HERITAGE HEIGHTS DR, Anchorage Lot Size in Sq Ft: 45568 Total Bedrooms: 5 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 ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program Mayor Dan Sullivan ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcell.D. 015-221-63 Property owner(s): H2L Investments Day phone: 350-1860 Mailing address : 6393 East 81st Avenue Anchorage, AK 99516 Site address: -5010 Heritage Heights Drive Anchorage, AK 99518 Legal description (Sub'd., Block & Lot): Cross View Estates, Block 2, Lot 1 Legal description (Township, Range & Section) Lot Size: 45,568 Sq. Ft. Number of Bedrooms: Five (5) THIS APPLICATION IS FOR: THIS APPLICATION IS AN: (® all that apply) Initial X Absorption Field X Upgrade ElSeptic Tank X Renewal Holding Tank ❑ ❑ Privy ❑ Private Well X Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: I 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. (Signature of property owner or authorized agent) Permit/Rush Fees: 47-50 Waiver Fees: Date of Payment: Date of Payment: Receipt Number: 01025 G Receipt Number: Permit No. OSP 121225 Waiver No. C:\Users\AndEng\Desktop\MikelCross View Estates\PennitApplication Lot 28 H2L.docC:\Users\AndEng\Desktop\Mike\Cross View Estates\Permit Application Lot 28 H2L.doc ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 FAX July 30, 2012 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 1, Block 2, Cross View Estates Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer The owner of Lot 1, Block 2, Cross View Estates Subdivision intends to construct a new five -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 well and septic system and wells or septic systems 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 placed on the lot in the area of the absorption trench and alternate site indicates silty sand (SW/SM). The percolation rate of the soil was determined to be 6.1 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 1,500 -gallon septic tank and a new 59' 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 4.0' below the surface and the total depth will be 12.0'. 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. The ground surface on the lot in the area of the septic system slopes to the north at a shallow grade. 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 minimum of 100' from all wells and any surface water and 10' the proposed and existing water services in the area. Lot 1, Block 2, Cross Point Estates Subdivision July 30, 2012 Page Two 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, W �-;- dL-, Michael E. Anderson, P.E. Attachments ��,......����---------------------- 'Z � '• 9 ♦j 0N:6 m ai :TIS /i''ti u d /�j z ••• r o / G �N m / r I^ x D / r D N m A � � o N m I r k m n I I S A r+ o O O R \+ f _Y}l ay. ,p m«v nu fi�' o I PPE- X AGE CIRCLE _ _________ _____ ®t I A j I ? 0 T.D 9 I N sG I I © I I 0 g r o � N I I N 5 I I Qm I� 1 Z > 0 ym I N I I aytir. I •w I __-____ 9RCR RGAD ♦����rrr %lit ♦♦ 193aE i> �1 i�ar Z m'E No- % a $e UPPER HERITAGE CIRCLE ♦�_`7 ♦.�•':� is Ar R�220.00' Rz ♦1 i=37.08' N 00'20'44"W 96.60' L�3 o0 I ��'NE'f ♦♦ aI 10' GAS MT. �s m 1 j fa 1 m n� II j mm I Q f o m")• u o 0 0 756' X X 756' , < A CC V' `2 Z 0 U 0 m Nm 0a y m D A� o m o 'o o MO uo W f0'1 D10 w x� ]56' X3 I v 30' _ m O v y X 756' 1 Rj W D F- m 2 a o 1�1 C S n 7, n I ~Ul N < I N O M 01 • � w m v A !n II �3o a o I `l v, m o r Foo _--50'--1 m cn I D sfm I I c 0wf I I N � I YsI z I G Pxmi I N 10. m > I p0� ®? — o M, m a: m I m Q I Ys wl p YS 0-1n2 r 'aur I ITI xs a nm m�e i n i o s 10' T. & E. ESMT. 01° N 0922'37W 132.24' ZOp01' o � o— .. BIRCH ROAD LOT 1, BLOCK 2, CROSS VIEW ESTATES DESIGN FACTORS: SYSTEM REQUIREMENTS Five Bedroom Home DeepTrench System Perc. Rate: 6-15 Min./Inch 1,500 Gallon Septic Tank Application Rate: .8 GPD/SF 8' Drainfield Rock 5 Bedrooms X 150 GPD/.8GPD/SF (Application Rate) = 937.5 SF Absorption Area 937.5 SF/16 SF/LF = 58.6 LF Trench Length THEREFORE: Construct a 59' Long x T Wide x 8' 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. 3'6" Natural Backfill Geotextile Fabric 6" O 4" Perforated PVC (Holes Down) 8 0 I I ----\--4— Drainfield Rock 3' TYPICAL DEEP TRENCH SECTION ,..•••_•���, (NO SCALE)•��0P,CE...... ... •��i1 NOTE: Grade Area Over Trench to Drain Away. -07 Minimum 6' Separation From Bedrock. 49th Minimum 4' Separation From Groundwater. •.� e Minimum 100' Separation From Wells in the Area. ��.%. MICHA1. EL E. ANDERSON Minimum 100' Separation From Surface Water or Streams: %' ,�., No. CE4381 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 DEPTH (feet) 1- 2- 3- 4- 5- 6- 7- 8- 9- SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION• LOT I, BLOCK 2, CROSS VIEW ESTATES PERFORMED FOR: HARDING HOMES DATE: 7/20/2012 PROJECTNo.: PARCEL ID#: TECHNICIAN: JKB TEST HOLE OG/OL Sand with Silt SW/Sm Dry N 0 WAS GROUND WATER ENCOUNTERED? No 10 IF YES @ WHAT DEPTH? DEPTH OF WATER AFTER MONITORING: None 1 1 DATE OF MONITORING: 8/8 1 1 1 m 0 49th E. ANDERSON 2% DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH TO WATER (INCHES) NET DROP (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 7/23 1 4:10 5.3811 2 4:40 30 11.3811 6.0011 3 4:41 4.8811 4 5:11 30 9.75" 4.88" 5 5:12 4.00" 6 5:42 30 8.8811 4.8811 PERCOLATION RATE: 61 (MIN/INCH) PERC. HOLE DIA. 9 (INCHES) TEST RUN BETWEEN: 4 FT. and 5 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 8/8/12 MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section Certificate of On -Site Systems Approval Phone: 907-343-7904 Fax: 907-343-7997 Parcel I.D. 015-221-63 Expiration Date: `30 `Zd� o 1. GENERAL INFORMATION Complete legal description Cross View Estates, Block 2, Lot 1 Location (site address) 5796 Heritage Heights Drive Anchorage, AK Current property owner(s) Gulshan Kumar & Parveen Lata Soni Day phone 907-227-6972 Mailing address 5796 Heritage Heights Drive, Anchorage, AK 99516 Real estate agent Shari Boyd 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 907-229-0132 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well E Private Septic 0 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 $ �# 912. Waiver Fee $ Date of Payment 6/2 517-0 Date of Payment Receipt Number. 06 `{Z9D Receipt Number COSA # Q.S C 2012gg Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone 907-522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage AK 99503 Engineer's Printed Name Michael E. Anderson, P.E. Date 5/22/19 l Original Certificate Date:" 3 d — ?_V 2_0 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 �F A�.. ... ®®�P� AV i v: 49th a� 6. DSD SIGNATURE r ot••••• •: •'••••••e c System #1 Approved for 0............... ....... ......................... bedrooms , � ".MICHAEL E. ANDERSON : System #2 Approved for �. 06- � No. CE -4381 r��� i bedrooms ®®s'F`•.. 6/25/20 ,.•••<�® ®� Disapproved ®�®�@ ®°O"RO.......'Inta Conditional approval for bedrooms, with the following stipulations: l Original Certificate Date:" 3 d — ?_V 2_0 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 Legal Description: Cross View Estates, Block 2, Lot 1 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 10/10/12 Total depth 294 ft Cased to 294 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) '18 in. Date of flow test for COSA 5/9/19 Static water level at beginning of test 238 ft. Comments B. TANK DATA Age of tank(s) 7 years Tank type/material Septic/Steel Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping 5/24/19 - McDonald's Pumping Service P D. ABSORPTION FIELD DATA Deep Trench Which system tested (date installed) 8/24/12 ❑ ALL standpipes present per record drawing Total measured depth from grade 13.5 ft (max) Measured depth to pipe invert from grade 5.5 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced NA gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 015-221-63 Structure served by this system Well production at time of test 3.6 gpm Water storage tank volume None gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic 10.5 ug/L ❑ Arsenic less than MRL (ND) Collected by Forge Engineering Date of Sample 3/18/20 -- C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: NA Adequacy test date 5/9/19 Results ❑✓ Pass For 5 bedrooms Fluid depth prior to test 5 in Water added 800 gal New depth 14 in Elapsed time 1440 min Final fluid depth 5 in Absorption rate 750+ gpd Any rejuvenation treatment (past 12 months) If yes, enter date 010-A E. SEPARATION DISTANCES ' From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' 0 Yes Community Sewer Manhole/Cleanout > 100' ft ❑✓ Yes if No ft 1-7 Yes if No ft Neighboring Tank > 100' FV -1 Yes if No ft Private Sewer/Septic Line > 25' 177� Yes if No ft Absorption Field on Lot > 100' F/71 Yes if No ft Holding Tank > _100' 0 Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ❑✓ Yes if No ft 7 Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0 Yes if No ft 1`71 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'✓❑ Water Main > 10' Yes if No ft Wells on Adjacent Lots: ❑✓ Yes Absorption Field > 5' E Yes if No ft Private Wells > 100' ❑✓ Yes if No ft Water Main > 10'✓❑ Yes if No ft Community Wells > 200'✓Q Yes if No ft Water Service Line > 10' F/I 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' 121 Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No 5* ft Wells on Adjacent Lots: Water Main > 10' F-11 Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS Lot line waiver issued. Waiver No. OSP131019 G. ENGINEER'S CERTIFICATION I certify that 1 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. COSA Checklist yellow sheet OF "J e 49 th a® 0!098 Y ORaHaR 0080 Ota 0000■ HHlH at0000tt ,gyp aaaa0a00alsacQaataaccastaaazalaRQRaavasana9ta99 0 a MICHAEL E. ANDERSON V Ay ^ea No. CE -4381 eeeQ 05/26/19 0.0p� QoQQQ9a 9a aQlal0."a09 PROFESS MUNICIPALITY DEVELOPIVIENT -SERVICES DEPARTMENT907-343-7904 Can -Site Water and wastewater Section Fax: 343-7997 WAJVIJ.r 111ni.org/onsite - Arsenic Advisory Certificate of On -Site Systems Approval # OSC201288 Subdivision: Cross View Estates, Block 2, Lot 1 A water sample revealed an arsenic concentration of 10.5 micrograms per liter (ug/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Information on arsenic is available from the On -Site Water and Wastewater Program website (WWW.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. ressto B96650 IM- hog- mftwl' rage; Y" 6951��i665* wwvmurn :.�?1 h pp3 • '� Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904; Certificate of On -Site Systems Approval Parcel I.D. 015-221-63 Expiration Date: S a /3 1. GENERAL INFORMATION Complete legal description Cross View Estates, Block 2, Lot 1 Location (situ address) 5796 Heritage Heights Drive Anchorage, AK 99516 Current Property owners) Harding Homes of Alaska Day phone 350-1860 Mailing address` , 5771 Heritage Heights Drive Anchorage, AK 99516 Real Estate Agent 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Five Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for:, l r Received by: Ar i) ,i �. Date P ` J COSA to be releasel to the,,engineer, unless otherwise requested by the engineer. COSA Fee $ I WgVgA Date of Payment dh5//� . Receipt Number 0/ ;�, V& 6- COSA # C?S C 1314 SS' Waiver Fee $ d0o lad P,, Xs4 Date of Payment5- /3 Receipt Number 006 4 iT Waiver# 0 -WI -sl o% 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 Address P.O. Box 240773 Anchorage, AK 99524 Phone 522-7773 Engineer's Printed Name Benjamin J. Schiller, P.E. Date 2/24/2013 6. DSD SIGNATURE L/ System #1 Approved for 5 bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the Bv��.2AtiU&L-7 Original Certificate Date: ? 7 /, unicipality 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 bNe sheet° . - 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 1 Parcel ID:015-221-63 A. WELL DATA Well type Private If A, B, or C provide PWSID # Well Log (Y/N) Y Date completed 10/10/12 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 294 ft. Cased to 294 ft. Casing height (above ground) >18 in. FROM WELL LOG AT INSPECTION Date of test 10/10/12 Static water level 229 Well production 15 g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate N/D mg/L Arsenic 25 ug/L Date of sample: 2/15/13 Collected by: J. Anderson B. SEPTIC/HOLDING TANK DATA TankType/Material Septic/Steel Tank size 1,500 gal. Number of Compartments 2 Foundation cleanout (YIN) Y Depression over tank (Y/N) N Date of pumping New Pumper Construction C. ABSORPTION FIELD DATA Date installed 8/24/2012 Cleanouts(Y/N) Y High water alarm (Y/N) N Date installed 8/24/12 Soil rating (g.p.d./ftZ or ftzlbdrm) • 8 GPD System type Deep Trench Length 62 ft. Width 3 ft. Gravel below pipe 8 ft. Total depth 12 ft. Eff. absorption area 992 ftZ 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 "Pump on" level at Datum Size in gallons _ in. "Pump off' level at E. SEPARATION DISTANCES 171k1j:114It@P1I[0]a03 Cycles tested Septic tank/lift station on lot >1 00' Absorption field on lot >100' Public sewer main N/A >25' Manhole/Access(Y/N) in. High water alarm level at in. Meets alarm & circuit requirements? On adjacent lots >100' On adjacent lots >100' Public sewer manhole/cleanout N/A Sewer /septic service line Holding tank N/A Animal containment areas >50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5r Property line >51 Water main > 10, Water service line >10' Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: 5'*** >10' Property line Building foundation Water Service line > Surfacewater >100' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS *** See Lot Line Waiver G. ENGINEER'S CERTIFICATION I 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. Engineer's Printed Name Benjamin J. Schiller P.E. Date 2/24/2013 COSA brown sheet 10-10-12.doc Absorption field >5' Surface water > 100' Water main >10' Driveway, parking/vehicle storage >10' 4���aaastt! OC G:.OF"Q4 041 A �r ,, • `F9 TH� •s�y}°°� ...�•...0 ;r,� ,Eenjami Schiller „ C 192 •.�faSt.�• Municipality of Anchorage • Community Development Department Development Services Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Arsenic Advisory Certificate of On -Site Systems Approval # OSC131055 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 2, Lot 1 of Cross View Estates Subdivision. This inspection revealed an arsenic concentration of 25 micrograms per liter (ug/L) for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. 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