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Home My WebLink AboutDENALY BLK 1 LT 15bencxly Block 1 Lot 15 #067 - 041-21 Municipality of Anchorage Uhl: 4 2014 On-Site Water and Wastewater Program • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number OSP131391 PID Number: 067-041-21 Dwelling: ■ Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: • New ❑ Upgrade Na T Tro Troy Davis Homes ABSORPTION ❑ Deep Trench FIELD • ❑ other Shallow Trench 0 Bed ❑ Mound Address 165 E. Parks Hwy #200 Wasilla, AK 99654 Phone 357-9394 Number of Bedrooms 4 Soil Rating .8 GPD/SF Total depth from original grade 5.8 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot Denaly 1 15 1.8 Ft. 4 Ft Fill added above original grade 1-2 Ft. Gravel length 58 Ft. Township Range Section Gravel width 5 Ft. Beds: Number of Lines Distance between lines Ft SEPARATION DISTANCES To From Septic Tank Absorption Field Lift Station Holding Tank Sewer Line Total absorption area - 580 Ft2 Number of trenches 2 Dist. between trenches >10 Ft. Well >100' >100' >100' NA >25' TANK ❑Septic NIS.T.E.P. • Holding El Other Manufacturer Anchorage Tank/Orenco Capacity 1,250 Gal. Surface Water >100' >100' >100' NA Material Steel Number of compartments Three Lot Line >5' >10' >5' NANA Foundation >5' >10' >5' NA LIFT STATION Manufacturer Anchorage Tank/Orenco Capacity 250 Gal. Curtain Drain None Noted Remarks Pump on level at 42 in. Pump off level at 38 in. High water alarm at 44 in. Pump make and model OSH P2005-11 Electrical In pections performed by Commercial Electric, Inc Installer Northern Excavation PIPE MATERIAL House to tank D3034Tankto D3034 drainfield Drainfield D3034 CO/MTD3034 Inspector A. Harala BENCH MARK (Assumed elevation) 100.0 R Inspdeii Sn 1n 3/27/14 2�d 3/27/14 Location and description Garage Slab. 3" 3/28/14 4m COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Conditional Approval: Date '':ntOF �'ly''' e. eb :As,. ..;s`A,, lk; 49I • to N HY •••• • ••c. OH Inter see #11 re MICHAEL E. ANDERSON • 4 Al 0r^• d' . ff� fie .' L 4381Ng , ... ��a — ? • t41a�'dD7;5'0�a et .R.,.ay Approved _/j tV Date la'S-l`i Inspection Report_9-f-17do Page 2 of 3 PID No.:067-041-21 Permit Number: OSP131391 / Munpipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904 S1 S2 MH M1 M2 A 22.1' 28.3' 29.5' B 47.3' 45.5' 45.4' 10.6' C 16.3' 27.5' 30,2' Nt. Site patTB Nay ,esaagi s,,(�, .9:...:4C. 49th - - • • 4 0 sr MICHAEL E. ANDERSON ••• No. CE -4381 ;D -I -04**** •..„�•� (3a ALTERNATE SITE: Advantex Treatment System with 15' Long x 5' Wide x 4' Effective Depth Absorption Trench. Application Rate 3 GPD/SF. DENALY SUBDIVISION LOT 15, BLOCK 1 PLAN AS BUILT SCALE 1" = 50' Permit Number OSP131391 Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Page 3 of 3 PID No. 067-041-21 Finished Grade x 1- 98,0 f 99.8 2 / Existing Grade Geotextile Fabric f 96.2-' Drainfield Rock 92.2 --' 86.0 29' (Trench Length) Groundwater @ 88' 10-9-13 Finished Grade SOUTH TRENCH x r- 102.4 / / 100.6 2 Existing Grade Existing Grade Geotextile Fabric Existing Grade f 98.9_\ Drainfield Rock 94.9—if 86.0 Groundwater @ 88' 10-9-13 29' (Trench Length) NORTH TRENCH PROFILE AS -BUILT No Scale F. p 4_' i 4`• 49th • ��J afi MICHAEL E ANDER 1sri� �1 No. CE -4381 ' 1 4I COMMERCIAL ELECTRIC, INCm MMIERCIA( RESIDEN i,ALIINDUSTRfAL OFFICE, 907-841-1009 FAX: 907-631-4999 Troy Davis Homes, 12-2-14 The lift station @ 15-1 Denali Home in Eagle River Alaska was installed by Commercial Electric Inc. to NEC code and 100% workmanship. Thanks, William Regallo President/ Owner 907-841-1007 Admin. #1904 3 8 9 10 I I 12 13 14 15 16 17 18 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT/ON-SITE WATER AND WASTEWATER PROGRAM 4700 ELMORE ROAD, ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST PROJECT #: PERFORMED FOR' Troy Davis Homes DATE PERFORMED: 9/25/2013 LEGAL DESCRIPTION' 4 OG/0L 4 o 4 Loh 15, Block 1, Denaly Subdivision TEST HOLE # 1 SLOPE Silty Gravel aGW/GM • • COMMENTS' BOH WAS GROUNDWATER ENCOUNTERED? Yes IF YES, WHAT DEPTHS 10' DEPTH OF WATER AFTER MONITORING. ��• (E OF qC qyiii, 49th _ D yo MICHAEL E. ANDERSON j w rn ; ., � O Sr . ND. CE -4381 .•' •/'..ROF SS0114• ......... 10' DATE 10/9/13 S L 0 P E SITE PLAN See Site Plan READING DATE GROSS TIME NET TIME DEPTH To WATER NET DROP 1 9/25 1:32 3.75" 2 2=02 30 6.00" 2.25" 3 2:04 3.75" 4 2:34 30 6.00" 2.25" 5 2:35 3.75" 6 3:05 30 6.00" 2.25" PERC RATE: 13 MIN./INCH PERC. HOLE DIAMETER: 6" TEST RUN BETWEEN 4.0 FT AND 5.0 FT Test Hole Pre Soaked Prior To Percolahion Test. TEST PERFORMED BY: WADE I, MICHAEL E. ANDERSON CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 10/16/13 Certified Drilling Log BILI. & COLE C CO dba ULLIVAN9WATER WELLS �P.O. Box 670269, , AK 99567 6811-2759 OWNER OF LAND: Troy Davis Homes ADDRESS: LEGAL DESCRIPTION DATE: 4/1/14 Denaly Lot 15 Blk 1 PERMIT NUMBER: OSP131391 DATE OF ISSUE: 3/25/14 TAX IDENTIFICATION NUMBER 06704121000 Is well located at approved permit location: Yes UNo Method of Drilling: Mair rotary ❑cable tool Depth of Well: 211 ft Casing Type: steel Diameter: 6 Liner type none Wall thickness 0.25 inches inches, depth 207 feet Static Water Level: Flowing feet Recovery Rate 20 gpm U gph Method of Testing air Well Intake Opening Type: IA open end ❑ Screened Start ❑ Perforations Start feet feet Stopped open hole Stopped Grout Type: bentonite Volume: 100 lbs Depth: from 0 feet, Well Disinfected Upon Completion: o 20+ feet yes U no Method of Disinfection: Chlorine 50 ppm Comments: Bore Hole Data Depth From To 0 2 2 4 4 24 24 32 32 46 46 55 55 70 70 71 71 149 149 204 204 211 Casing Stickup Overburden Sand and Gravel Silt, Sand, and Gravel with Clay Hardpan Clay, Silt, and Gravel Hardpan Silt and Water Clay Clay and Gravel Gravel and Sand Drillers Name: Cole Sullivan ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough: Department of Environmental Conservation. Municipality of Anchorage Community Development Department On -Site Water & Wastewater Program 4700 Elmore St. P.O. Box 196650 Anchorage, AK 99507-6650 www,muni.org/onsite (907) 343-7904 Pump Installation Log Well Drilling Permit Number: SW OSP131391 Date of issue 3/25/14 Parcel Identification Number: 06704121000 Legal Description Denaly Lot 15 Mk 1 Property Owner Name & Address Troy Davis Homes Pump Installation Date: 6/11/14 Pump Intake Depth Below Top of Well Casing: 130 feet Pump manufacturer's Name: Gould Pump Model: 75B05412CL Pump Size: 1/2 hp Pitless Adapter Burial Depth: 10 feet Pitless Adapter Installer: Northern Excavating Disinfected Upon Completion? yes ❑ no Method of Disinfection: Chlorine 50 PPM Comments: Pitless Adapter Manufacturer's Name: Harvard Pump Installers Name: Cole & Chad Sullivan Water Wells Attention: The pump installer shall provide a pump installation log to the 050 within 30 days of pump installation. Well Disinfected Upon Completion? 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: OSP131391 Tax Code Number: 06704121000 Work Type: WellSeptic Permit Effective Dates: March 25, 2014 to March 25, 2015 Design Engineer: ANDERSON ENGINEERING Subdivision: DENALY Site Legal Address: DENALY BLK 1 LT 15 G:0363 Owner/Address• TROY DAVIS HOMES INC 165 E PARKS HWY #200 WASILLA AK 996547059 Site Mailing Address: 7000 KULCHAY CIR, Eagle River 4111 -fry Lot Size in Sq Ft: 59924 Total Bedrooms: 3 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy Y Private Well N Water Storage Yid 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. L'oi lid di iOc& 101" v`e 'Led. 4/1/14 Received By: P( ®/ Date: Issued By: ��1'j1 �� I �jl�% Date: S MUNICIPALITY OF ANCHORAGE Community Development Department Development Services Division On -Site Water & Wastewater Program Parcel I.D. Property owner(s) Troy Davis Homes Day phone 310-2501 Mailing address 165 E. Parks Highway #200 Wasilla, AK 99654 Site address 7000 Kulchay Circle Eagle River, AK 99577 Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION 067-041-21 Legal description (Sub'd., Block & Lot) Denaly, Block 1, Lot 15 Legal description (Township, Range & Section) Lot Size 59,924 Sq. Ft. Number of Bedrooms Three APPLICATION IS FOR: (® all that apply) Absorption Field Septic Tank Holding Tank Privy Private Well Water Storage APPLICATION 1S AN: Initial Upgrade Renewal TYPE OF DWELLING: Single Family (SF) 0 (w/wo ADU) Duplex (D) 0 Multiple Dwellings ❑ (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Dis tance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: Permit No. Permit App.: 'La.; 4330 1010 113 3 053434 OSP 13'.59/ Waiver Fees: Date of Payment: Receipt Number: Waiver No. ANDERSON ENGINEERING' P.O.' BOX 240773 ANCHORAGE, AK 99524 677-7766 (FAX) October 16, 2013 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 15, Block 1, Denaly Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer The owner of the subject lot intends to construct a new three-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 altemate 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 indicate the presence of sandy silt sand with gravel. The percolation rate of the material was determined to be 13 minutes per inch. Groundwater was found during the placement of the test hole at 10' below the surface and remains at that location today. 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 STEP tank and 2 new 28' long by 5' wide by 4' effective depth absorption trenches to treat and dispose of the effluent generated in the house. The elevation of the distribution line in the absorption trench will be 1' below the existing ground surface and the total depth will be 5' below ground. 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 at a grade approximating 15%. 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 15, Block 1, Denaly Subdivision October 16, 2013 Page Two 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, a/ -1 --, Michael E. Anderson, P.E. Attachments COI 1 IULORAY CIR. 2-ge' Long x 5' wide x 4 Effective Depth Absorption Trenches eV: 11 7/ 11 f, I e Existing Well 14 Septic Area �Cs9 •TRA/CT B /ALTERNATE SITE: • Advantex Treatment Systen' with 15' Long x 5' Wide x $� Effective Depth Absorption Trench. Applicatiga Rote 3 GPD/SF. / 1 e: 0)$, `+s .4 NOTE: No Conflicts with Wells or Septic Systems on Adjacent Lots. No Slopes >25% are Within 50' of the Proposed Absorption Site. DENALY SUBDIVISION LOT 15, BLOCK 1 SITE PLAN SCALE 1" = 50' LOT 15, BLOCK 1, DENALY SUBDIVISION DESIGN FACTORS: Three Bedroom System Perc. Rate: 13 Min./Inch Application Rate: .8 GPD/SF SYSTEM REQUIREMENTS: 5' Wide Trench System 1,250 Gallon STEP Tank 4' Drainfield Rock Pressure Distribution System 3 Bedrooms X 150 GPD/.8 GPD/SF (Application Rate) = 562.5 SF Absorption Area 562.5 SF/5 SF/ LF* .5 (Red. Factor) = 56.2 LF Trench Length THEREFORE: Construct 2 New 28' Long x 5' Wide x 4' Effective Depth Absorption Trenches. Flow Line Elevation in Trenches to be at 1' Below Original Ground Surface. Total Depth to be 5.0' Below Existing Ground. Provide 4' Cover Over STEP Tank and 3' Cover Over Absorption Trench. Place 6" Topsoil and Revegetate Mound 4'0" 1.25" Perforated PVC (Holes Down) 15 - 3/16" Diameter Holes Per Lateral @ 1.9' Spacing Drainfield Rock 5' Existin. Ground TYPICAL 5' WIDE TRENCH SECTION �.�P�E.. ..: OF q< •ip. � 49thyt° * 3 ter. •'�l° the Area. I A MICHAEL E. ANDERSON W • Water or Streams. O.`'?- Na CE -0381 :411 NOTE: (NO SCALE) Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 4' Separation From Groundwa Minimum 100' Separation From Wells in Minimum 100' Separation From Surface MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT/ON-SITE WATER AND WASTEWATER PROGRAM 4700 ELMORE ROAD, ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST PROJECT #: PERFORMED FOR: Troy Davis Homes DATE PERFORMED' 9/25/2013 LEGAL DESCRIPTION' 2- 3 4- 7- 8- 9- 10- II - 12 13 14 15 16 17 18 n 4 4 n 4 . COMMENTS' 0G/OL Lot 15, Block 1, Denalv Subdivision TEST HOLE # 1 SLOPE Silty Gravel GW/GM BOH WAS GROUNDWATER ENCOUNTERED? Yes IF YES, WHAT DEPTH? 10 DEPTH OF WATER AFTER MONITORING: .amil24q ts‘ 49th 0 p, ? oEasoN ^w •W #r'rJ :, No. EE -1381 �C2I 10' DATE' 10/9/13 S L 0 P E SITE PLAN See Site Plan READING DATE GROSS TIME NET TIME DEPTH To WATER NET DROP 1 9/25 1:32 375" 2 2:02 30 6.00" 2.25" 3 2:04 3.75" 4 2:34 30 6.00" 2.25" 5 2:35 3.75" 6 3:05 30 6.00" 2.25- PERC RATE: 13 MIN./INCH PERC. HOLE DIAMETER' 6" TEST RUN BETWEEN 4.0 FT. AND 5.0 FT Test Hole Pre Soaked Prior To Percolation Test. TEST PERFORMED BY: WADE _ I, MICHAEL E. ANDERSON CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 10/16/13 MUNICIPALITY OF ANCHORAGE tDevelopment Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 067-041-21 Certificate of On -Site Systems Approval Expiration Date: 8-19-22 Legal description Denaly Block 1 Lot 15 Site address 7000 Kulchay Circle Eagle River Ak 99577 Current property owner(s) John Krajzynski X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA ApprovMjune 2022 MUNICIPALITY OF ANCHORAGE Development Services Department y Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 067-041-21 Complete legal description DENALY BLOCK 1 LOT 15 Location (site address) 7000 KULCHAY CIRCLE EAGLE RIVER, AK 99577 Current property owner(s) JOHN & KATHERINE KRAJZYNSKI Day phone 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: ® Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ® Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 8 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ® Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ 5 5 Waiver Fee $ Date of Payment T o� Date of Payment COSA # SCS 1 3 I Waiver # COSA Application—July 2022 copy.doc COSA Checklist Legal Description: DENALY BLOCK 1 LOT 15 Parcel ID: 067-041-21 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 4/1/14 Total depth 211 ft Cased to 207 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 24+ in. Date of flow test for COSA 8/3/22 Static water level at beginning of test 0 ft. Comments: APPARENT ARTESIAN WELL. Well production at time of test 4.5 gpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate _mg/L ® Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by FWN z Date 8/3/22 B. TANK DATA C. LIFT STATION Measured operating fluid level in septic tank 50" ® Required maintenance completed Date of pumping 8/3/22 Age of lift station 8 years ❑ Required maintenance completed, if AWWTS Lift station material STEEL Comments: Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 3/27/14 ® ALL standpipes present per record drawing Total measured depth from grade 6_9 ft (max) Measured depth to pipe invert from grade _ft (min) ® N/A — pressurized field. ❑ Per record drawings, field is insulated. ® Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date 8/3/22 Results E Pass Fluid depth prior to test 0 DRY in Water added 600 gal New fluid depth 7 in Elapsed time <1440 min Final fluid depth 0 DRY in Absorption rate 600 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 48 in Effective depth used 48 in Effective depth remaining 0 DRY in Comments/Deficiencies: MT WAS FOUND BY DIGGING NEAR DRIVEWAY & WAS DRY. TESTED LOWER TRENCH. COSA Checklist—July 2022 copy.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' ® 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' ® Yes if No ft Holding Tank > 100' ® Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' ® Yes if No ft ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ®Yes if No ft ® Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ® Yes if No ft Tank to Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' ® Yes if No ft Private Wells > 100' ® Yes if No ft Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft Water Service Line > 10' ® Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer's Printed Name CURTIS HUFFMAN, PE Date 8110/22 Comments: This investigation was completed in compliance with MOA guidelines, regulations, "\ and best industry practices / methods. The assessment of the condition of the well and septic �� k`` applies only to the conditions as of the day tested. The flow and absorption rates may change � A �``, due to subsurface conditions that may not be observed from the surface, changes in land use, A A�i, • • ' • • • : ry� 11 local soil characteristics, groundwater levels that may fluctuate during the year, quality of `'•' ;,` construction (workmanship & materials), the water usage of the family being served by the �g�•• •.'9 ��j system and maintenance. The operational life of all well and septic systems are subject to *� TM • * (� these various and dynamic characteristics and are outside the control of the evaluator of the , • .. .... ......... . well and septic system. Therefore, any estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or F .... ... . discrepancies exist can be given by First Water Consulting & fWGS 4 '• Curtis Huffman �'c�`G, •. CE 128991 Ldp • 8/10/22 v� FqF�••...••'\:C.*� COSA Checklist—July 2022 copy.docx MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Lift Station/Pump Vault Maintenance Log Owner Street Address 7L6?) ,LK Septic Tank: Ili -Sludge level B, inches -Pumping: required ygs-Q -Pumping completed ( �Rno Lift station: zso�y -Pump basket cleaned es no -Effluent filter cleaned Ce )s no .Control floats cleaned ,e no.- -Proper float settings confirmed (S)no- -Operation satisfactory Fen o Alarm System: -Dedicated electrical alarm circuit (yej no -Audible and visual alarm inside dwelling /Ves no -Alarm system operation satisfacto , not satisfactory Manhole Riser -Ground water intrusion at riser to tank connection yes no -Ground water intrusion around pipe penetrations es o -Weep hole functional es no -Manhole lid: Functional Insulated Properly Secured es Other -All manufacturer required inspections and maintenance completed"lye-k, no Comments: Qualified Maintenance Provider: Technician Loscq 1z, Company Signature Date of maintenancekq+ll Date L3U%__A1 Parcel I.D. 067-041-21 Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Complete legal description Denaly, Block 1, Lot 15 Expiration Date: 3- S / S Location (site address) 7000 Kulchay Circle Eagle River, AK 99577 Current Property owner(s) Troy Davis Homes, Inc. Day phone 357-9394 Mailing address 165 E. Parks Highway, No. 200 Wasilla, AK 99654 Real Estate Agent Day phone 2. - TYPE OF DWELLING: ❑ Single Family (w/wo ADU) ❑ Duplex \VI \-----S-1 9 Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Three 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual Holding Tank Community Public Sewer 0 WaiverNariance request for: Distance: Received by: COSA to be releaser' e engineer, unless otherwise requested by the engineer. Date: IQ.5 COSAFee $ cg.%t tiIPo -7- t"l�6 Waiver Fee $ Date of Payment I2!/t / j )y (J> Date of Payment Receipt Number t52to?�a1�1 dd Receipt Number COSA # O i I 141- I 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. 1 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. 6. DSD SIGNATURE System #1 Approved for 3 bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for By: :gate 12/1/14 f. -,r tri\\\ O� OF A(\I11 �� ''••••...;45111 P•'' *al `�49� I. t.`r r�c`•f:4.7 I A„ .II a *a E ANDBtSON .:,..t, :: 1044.7A CE -4381 .'�a� + ilik, 0 ES I ��= bedrooms, with the following stipulations: `PJ�Y tOF '`1Nf. S.,�- �Z WATFR AND `� v WASTEWATER 1 3% �C) .' JPAITSFION Original Certificate Date: (.2 — ST' / 'L The 114 nchorage 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 Septic System Advisory Well Flow Advisory COSA blue sheet f "- 33 Nitrate Advisory Arsenic Advisory Other 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: Denaly, Block 1, Lot 15 Parcel ID: 067-041-21 A. WELL DATA Well type Private If A, B, or C provide PWSID # Well Log (Y/N) Y Date completed 4/1/14Sanitary seal (Y/N) Y Wires properly protected (YIN) Y Total depth 211 ft. Cased to 207 ft. Casing height (above ground) >18 18 in. FROM WELL LOG AT INSPECTION Date of test 4/1/14 Static water level 0 ft. ft. Well production 20 g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate 4.00 mg/L Arsenic ND ug/L Date of sample: 10/7/14 Collected by: Anderson Engrg. B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEP/Steel Date installed 3/27/14 Tank size 1,250 gal. Number of Compartments 3 Cleanouts (YIN) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) Y Date of pumping New Const. Pumper C. ABSORPTION FIELD DATA Date installed 3/27/14 Soil rating (g.p.d./ft2 or ft2/bdrm) .8 GPD/SF System type 5' Wide Length 2 @ 29 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth 8.5 ft. Eff. absorption area 580 ft2 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. N Any rejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date D. LIFT STATION No Add On Manhole - Gravity Flow to Absorption Trench. Date installed 3127/14 "Pump on" level at 42 in. Datum Bottom of Tank E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service line Animal containment areas Size in gallons 250 "Pump off' level at 38 in. Manhole/Access (Y/N) High water alarm level at Y 44 in. Cycles tested New Const. Meets alarm & circuit requirements? >100' >100' >100' >100' N/A N/A >25' >50'Manure/animal excrete storage areas >100' On adjacent lots On adjacent lots Public sewer manhole/cleanout N/A Holding tank Y 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 4' Building foundation >10' .10 Water Service line >10Surface water > Curtain drain None Noted F. COMMENTS Wells on adjacent lots >100' Absorption field >5' Surface water >100' Water main N/A Driveway, parking/vehicle storage >10' 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 Michael E. Anderson, P.E. Date 12/1/14 COSA brown sheet 10-10-12.doo ..ail,OF•gL tt i*' 49 •*e d "I : NOVA E. ANDERSON: W N '. CEE-4381 •'2`"s ♦ttttlt (5 -4r LOT 15 BLOCK 1 HAS 59,924 SQ.FT. OF AREA KULCHAY CIR. / / / 16 14 S_ 9 <4 (,)op TRACT B fG0 7 8, 9 GRAPHIC SCALE: 1 /nch = 40 Feet 80 Recert 11-13-14 FOR: Troy Davis Homes FORBES & ASSOCIATES, INC P.O. BOX 232293 Anchorage, Alaska 99523 (907) 227-5881 Date 8-27-14 Scale 1" = 40' Grid SW 363 As -Built Survey 2130194 Lot Drawn by CEF Field Book 244 I 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 adjacenttheretoencroach on the premises in question and that there are no roadways, transmission lines or other easements on said property except as shown. It is the responsibility of the owner or builder, prior to construction, to verify proposed building grade relative to finish grade and utility connections and to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. Listed distances prevail over scaling. Reproduction may cause distortion. M Legal Description 15 Block 1 DENALY SUBDIVISION •N OF 441 _ (.2,„• . r v pIO S* 4918 /\. t x/.....4.....1'' * !. CHARLES• FORBES :6' r E. t* 7r�•. LS -7326 �� I• : I�e�. 11-26-14 • ,Dt_ i