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HomeMy WebLinkAboutTHE CASCADES BLK 2 LT 3The Cascades Block 2 Lot 3 #078-321-09 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: OSP141408 PID Number: 078-321-09 1 New ❑ Upgrade Name: Steve & Linda Quigley ABSORPTION ❑ Deep Trench FIELD • 1 Other Shallow Trench ❑ Bed ❑ Mound Address 12916 Rosser Drive Eagle River, AK 99577 Phone 632-0234 Number of Bedrooms 4 Soil Rating 1.2 GPD/SF Total depth from original grade 9.2 R. LEGAL DESCRIPTION Depth to pipe invert from original grade 5.2 Ft. Gravel depth beneath pipe 4OFt. Subdivision Block Lot The Cascades 2 3 Fill added above original grade 0-1 Ft. Gravel length 50 Ft. Township Range Section Gravel width 5Ft. 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 500 Ft' Number of trenches One Dist. between trenches Ft. Well >100' >100' >100' >75' >25' TANK ❑p Septic ❑ S.T.E.P. ❑ Holding 0 Other Manufacturer Anchorage Tank Capacity 1,250GaI. Surface Water >100' >100' >100' >100' Material Number of compartments Lot Line >5' >10' N/A N/A NA Steel Two Foundation >5' >10' N/A N/A LIFT STATION Manufacturer Capacity Gal. Curtain Drain None Noted Remarks Pump on level at In. Pump off level at in. High water alarm at in. Pump make and model NW Deck Foundation Cap Electrical Inspections performed by Installer Richey Construction PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield Drainfield F810 CO/MT D3034 Inspector MEA BENCH MARK (Assumed elevation) 100.Oft Inspection 1ection 6' 9/26/14 2^^ 9/26/14 Location and description Deck Footing NW Corner. e 5/22/14 a'h COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Conditional A royal: Date 4,-,sc.: '� � I1 i+, •• ••• S'f.• ' • •pp s CO,fid: +*� 49T *�i ::04110 440 0000r •MICHAEL E. ANDERSON : e; ill 0I s•. -4381 ,-2`"a **II* fio ,. Z./5,.� ���-" ''•11"0FEs ko• kt, Approved a P Date G ;2- /,�- Inspection R _1 -1(j 6c Permit No.: OSP141408 RIVER DRIVE a 30.00 Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report 5 S89°55'51T 230.22 Page 2 of 3 PID No. 078-321-09 THE CASCADES SUBDIVISION LOT 3, BLOCK 2 47,218 S.F. C4 _ Alternate Site Mi TH 2C0 TEINAIN Conc. Fooblgg ® Well N83°13'18"W 147.31 2 PLAN AS -BUILT SCALE 1` = 40' A S1 S2 C4 C5 M1 M2 35.5' 43.7' 76.3' 53.5' 74.5' 56.5' B 45.5' 53.8' 85.1' 75.9' 83.3' 78.3' 4 LEGEND: TH — Test Hole CO — Clean Out FCO — Foundation Clean Out M1 — Monitor Tube 200 — Double Clean Out : 49th risVN MICHAEL E. ANDERSON •���:, No, CE -4381 .'i Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: OSP141408 PID No. 078-321-09 Page 3 of 3 1 U 96.3 2-0 UU 90.9 ,250 Gallon Septic Tank 90.7 0 Finished Grade 2 F 91.1 N LO U Existing Grade Geotextile Fabric 85.9- Drainfield Rock fry-- 75.1 81.9 PR 50' (Trench Length) PILE AS-3UILT No Scale 85.9 -• �,,/ %�� 49th �� MICHAEL E. ANDERSON j ♦rl�T; r. CE -43131 �'ti,- Certified Drilling Log DOC CO dee. SII�IiYAII WATER WELLS P.O. Box 670269, Chugiakr AK 99567 688-2759 OWNER OF LAND: Woodbuilt Homes Inc, (Steve Quigley) ADDRESS: 11019 Hannah Jane Place, Eagle River, Ak 99577 LEGAL DESCRIPTION DATE: 1/13/15 The Cascades Blk 2 Lot 3 PERMIT NUMBER: OSP141408 DATE OF ISSUE: TAX IDENTIFICATION NUMBER 07832109000 9/25/14 Is well located at approvedrovlpermit location: VVes r INo Method of Drilling: Nair rotary cable tool Depth of Well: 84' Casing Type: Steel Diameter: 6 Liner type None Wall thickness .250 inches, depth 82 inches feet Static Water Level: Flowing feet Bore Hole Data Depth From To 0 2 2 6 6 30 30 72 72 84 Casing stickup overburden Sand & gravel w/ clay Hardpan & boulders Sand & gravel some clay - Water Recovery Rate 12 • gpm ❑ gph Method of Testing Air Well Intake Opening Type: ® open end ❑open hole ❑ Screened Start feet Stopped ❑ Perforations Start feet Stopped Grout Type: Bentonite chips Volume: 75Ibs Depth: from 2 feet, to 22 feet Well Disinfected Upon Completion: ®yes no Method of Disinfection: Chlorine 50 ppm Comments: 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 Splices and/or Department of Environmental Conservation. MatSu Borough: Department of Environmental Conservations jULLIVAN CWATER WELLS P.O. Box 870269, Chugiak, AK 99587 688-2758 www.sullivanwaterwells.com Pump Installation Log Well Drilling Permit Number: SW OSP141408 Date of Issue 9-25-14 Parcel Identification Number: 07832109000 Legal Description The Cascades Block 2 Lot 3 Property Owner Name & Address Steve Quigley 11019 Hannah Jane Place, Eagle River, AK 99577 Pump Installation Date: 5-7-15 Pump Intake Depth Below Top of Well Casing: 52 feet Pump manufacturer's Name: Goulds Pump Model: 105805412CL Pump Size: 1/2 Pitless Adapter Burial Depth: 10' Pitless Adapter Installer: Unknown hp feet Disinfected Upon Completion? /1 yes ❑ no Method of Disinfection: Chlorine 50 PPM Comments: Pitless Manufacturer: Martinson B1OX Artesian Well Plug Installed Pump Installers Name: Terry Worrell & Cole Sullivan- Sullivan Water Wells 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: OSP141408 Tax Code Number: 07832109000 Work Type: WellSeptic Initial Permit Effective Dates: September 25, 2014 to September 25, 2015 Design Engineer: ANDERSON ENGINEERING Subdivision: THE CASCADES Site Legal Address: THE CASCADES BLK 2 LT 3 G:0958 Owner/Address: KAANDA LLC 2431 W 100TH AVENUE ANCHORAGE AK 995152213 Site Mailing Address: 2695 WEST RIVER DR, Eagle River 24-/y,-/1:co0 Lot Size in Sq Ft: 47218 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 By: Issued By: MUNICIPALITY OF ANCHORAGE f RU Community Development Department Develoj ment Services Division Srte Water & Wastewater Program r ON-SITE SEWER/WELL PERMIT APPLICATION Phone: 907-34 Fax: 907 -343 - Parcel I.D. Property owner(s) Kaanda LLC Mailing address 2431 W. 100th Avenue Anchorage, AK 99515 078-321-09 Site address Day phone 632-0234 2695 West River Drive Eagle River, AK 99577 Legal description (Sub'd., Block & Lot) The Cascades, Block 2, Lot 3 Legal description (Township, Range & Section) Lot Size 47,218 Sq. Ft. Number of Bedrooms Four APPLICATION IS FOR: (® all that apply) Absorption Field Septic Tank Holding Tank Privy Private Well Water Storage ❑x 0 APPLICATION IS AN: Initial Upgrade Renewal ❑X TYPE OF DWELLING: Single Family (SF) (w/wo ADU) Duplex (D) Multiple Dwellings (SF and/or D) SUr4 asiTTAL SEP 242014 vett THIS APPLICATION INCLUDES A VARIANCE 1 WAIVER REQUEST FOR: 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) = 1254.Yo Permit/Rush Fees: ff 4-Zl51" 910.40 11 Waiver Fees: Date of Payment: a 12-4/1" (.i'J_ Date of Payment: Receipt Number: 09142 �r�TTT Receipt Number: Permit No. 05914 l( -40F Waiver No. Permit App_:-: • ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) September 24. 2014 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 3, Block 2, The Cascades Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 3, Block 2, The Cascades Subdivision intends to construct a new four- bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new well and septic system to accommodate the home. The attached Site Plan and backup documentation identify the location and configuration of the proposed well and septic system along with the alternate site. All surrounding lots in the subdivision are currently vacant. No conflicts exist between the proposed septic system and well or septic systems and wells on adjacent lots. Drainage arrows are shown on the site plan showing the grade and direction of flow on the lot. The drainage pattern will not be changed as a result of this project. A test hole was placed on the lot in the area of the absorption trench and alternate site. The log indicates well graded gravel (GW/GM) with sand in the zone specified for the absorption trench. The percolation rate of the soil was determined to be 4.9 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 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 4' below the surface and the total depth will be 8'. 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 northeast 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 Lot 3, Block 2, The Cascades Subdivision September 24, 2014 Page Two constructed a minimum of 100' from all wells and any surface water and 10' the proposed and existing water services in the area. If the system is constructed in accordance with our design the following statements apply: 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 THE CASCADES SUBDIVISION LOT 5 VACANT z co co 0 WEST RIVER DRIVE N LOT 3, BLOCK 2 47,218 S.F. N89'55'51"W 230.22 50' Long x 5' Wide x 4' Effective Depth Absorption Trench Co Pfit1POS. FCO Four Bedroom Home Prpposed Well 0 NOTE; No Slopes >25% Within 50' or Groundwater Within 100' of the Proposed Septic System. 2C0 \ SV 1,250 Gallon Septic Tank All Surrounding Lots are Vacant. No Conflicts with Wells or Septic Sytems. 4-- N 83'13' W 147.31' LOT 2 VACANT Alternate Site e TH1 CO SITE PLAN SCALE 1' = 40' 4 LOT 4 VACANT LEGEND MT — Monitor Tube FCC/ — Foundation Clean Out TH — Test Hole CO — Clean Out FSV — Flow Splitter Valve .4 A 49th,¢ �� .'* • i hit.[. 70 ;MICHAEL E. ANDERSON 17QII r� fT: No. CE -4381J LOT 3, BLOCK 2, THE CASCADES SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home Perc. Rate: 1-5 Min./Inch Application Rate: 1.2 GPD/SF 5' Wide Trench System 1,250 Gallon Septic Tank 4' Drainfield Rock 4 Bedrooms * 150 GPD/Bedroom = 600 SF Absorption Area 600 SF/1.2 GPD/SF/5 SF (Width) `.5 (Red. Factor 50 LF Trench Length THEREFORE: Construct a 50' Long x 5' Wide x 4' Effective Depth Absorption Trench. Flow Line Elevation in Trench to be 4' Below Original Ground Surface. Total Depth to be 8' Below Existing Ground. Provide 3' Cover Over Absorption Trench and 4' Cover Over Septic Tank. 3'6" 0 5' iGeotextile Fabric 4" Perforated PVC (Holes Down) Drainfield Rock TYPICAL 5' WIDE TRENCH SECTION (NO SCALE) •P(E. .......4±. NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 4' Separation From Groundwater. Minimum 100' Separation From Private Wells in the Area. Minimum 100' Separation From Surface Water or Streams: 'p 49th ilam : MICHAEL E. ANDERSON = j•. No. CE -4381 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 DEPTH (feet) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: LOT 3, BLOCK 2, THE CASCADES SUBDIVISION PERFORMED FOR: WOODBUILT HOMES DATE: 9/2/2014 PROJECT No • PARCEL ID#: TECHNICIAN: M. ANDERSON Q • Al TEST HOLE 1 OB/OG a CLEAN WELL GRADED GRAVEL WITH SAND GW/GM BOH @ 16' SLOPE WAS GROUND WATER ENCOUNTERED' No IF YES «. WHAT DEPTH' DEPTH OF WATER AFTER MONITORING: NONE DATE OF MONITORING 9/20/14 49 d.... . . ♦°;MICHAEL E. ANDERSON.; G"`• • '•. NO. CE -4381 ti 4444 PkmaEiSiiIte. Professional Engineers Stamp: SITE PLAN SEE SITE PLAN DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH To WATER (INCHES) NET DROP (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 9/2 1 1:14 1.13" 2 1:44 30 7.25" 6.12" 3 1:45 1.00" 4 2:15 30 7.13" 6.13" 5 2:16 1.25" 6 2:46 30 7.38" 6.13" PERCOLATION RATE: 4.9 (MIN/INCH) PERC. HOLE DIA. 6" (INCHES) TEST RUN BETWEEN: 4.5 FT. and 5.5 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: 9/24/14 Municipality of Anchorage Community Development Department Planning Division MEMORANDUM Date: September 19, 2014 To: File: R12-2422 From: Nicole Jones -Vogel, Associate Planner Long -Range Planning Section Subject: The Cascades Block 2 Lot 3; Wetland Unit 148A "P" Potential wetland During the review of building permit R12-2422, the Long -Range Planning Section was notified of a potential wetland impact associated with the building permit, On September 19th MOA staff (N. Jones -Vogel) and U.S. Army Corps of Engineers staff (S. Moore as A. Park) conducted a site visit to determine the presence of wetlands. Due to work that had already occurred on site we assessed the edges of the previously disturbed areas. Two holes were dug to determine soils type and the presence of hydrology. While formai data sheets were not completed, the site did not show any wetland presence. Since this area is identified in the Wetlands GIS layer as "P" Potential wetlands a Jurisdictional Determination (JD) from the Corps is not necessary. Corps and MOA staff agreed that the disturbed area was in fact uplands. The Long -Range Planning Section does not object to the issuance of the building permit with regard to wetlands issues. If the applicant (or the property owner) wishes to expand the area of development, awetland delineation should be conducted. it appears (from vegetation communities) that wetlands may present when in closer proximity to the stream. See attached photos. MUNICIPALITY OF ANCHORAGE Development Services Department p p Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 078-321-09Expiration Date: 'L G 20Z Legal description THE CASCADES BLK 2 LT 3 Site address 2695 WEST RIVER DR Eagle River AK Current property owner(s) MUELLER 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 Approval_June 2022 MUNICIPALITY OF ANCHORAGE o Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 078-321-09 Complete legal description The Cascades Block 2 Lot 3 Location (site address) 2695 West River Dr. Eagle River, AK Current property owner(s) Michael Heather Mueller Day phone 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: V 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 9 - 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 $ S�s� Waiver Fee $ Date of Payment i 0� z z_9 z 3 Date of Payment COSA # O SC 2 .3 / 3 Xo u Waiver # COSA Application—June 2022 Legal Description The Cascades Block 2 Lot 3 N Parcel ID: 078-321-09 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA F,/] Well log is filed with Onsite (or attached) Well production at time of test 3.7 gpm Date drilled 1/13/15 Total depth 84 ft Water storage tank volume NA gallons Cased to 82 ft Well disinfected for coliform test? ❑ Yes 0 N ✓❑ Sanitary seal is functioning correctly © Coliform bacteria is Negative © Wires are properly protected Nitrate 0.517 mg/L ❑ Nitrate less than MRL (ND) Casing height (above ground) 34 in. Arsenic ug/L n Arsenic less than MRL (ND) Date of flow test for COSA 9/21/23 Collected by Arcterra Consulting Static water level at beginning of test X ft. Date 9/20/23 Comments * Flowing, per Sullivan Water Wells 1/13/15. Artesian Well B. TANK DATA Measured operating fluid level in septic tank 49" Date of pumping 10/10/22 ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 9/26/14 ❑✓ ALL standpipes present per record drawing Total measured depth from grade 9 ft (max) Measured depth to pipe invert from grade 5 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 F,/] Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced 2000 gallons 9/21/23 date Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: COSA Checklist June 2022 STATION ❑ Require ` tenance completed Age of lift stationeters Lift station material Comments: Adequacy test date 9/22/23 Results 0 Pass Fluid depth prior to test 0 in Water added 600 gal New fluid depth 12 in Elapsed time 120 min Final fluid depth 0 in Absorption rate 600+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 48 in Effective depth used 0 in Effective depth remaining 48 in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Yes if No ft Field to Property Line > 10' Community Sewer Manhole/Cleanout > 100' ✓❑ Yes if No ft 0 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' J❑ Yes if No ft 0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ✓❑ Yes if No ft Q 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' J❑ Yes if No ft Surface Water > 100'✓❑ Yes if No ft Tank to Property Line > 5'❑ Yes if No ft Field to Property Line > 10' ❑./ Yes if No ft Water Main > 10' 0 Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft F. ENGINEER'S COMMENTS Wells on Adjacent Lots: Private Wells > 100' Community Wells > 200' Q Yes if No ft © Yes if No ft If tank or field is under driveway comment below 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 Areterra Consulting Phone (907)-696-6111 Engineer's Printed Name Kenneth Duffus Date Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. COSA Checklist June 2022 Parcel I.D. 078-321-09 Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Expiration Date: 1 - a - /5 Complete legal description The Cascades, Block 2, Lot 3 Location (site address) 2695 West River Drive Eagle River, AK 99577 Current Property owner(s) Steven & Linda Quigley Day phone 632-0234 12916 Rosser Drive Eagle River, AK 99577 Mailing address Real Estate Agent Day phone 2 TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex El Multiple Dwellings (Single Family and/or Duplex) Four 3. NUMBER OF BEDROOMS: 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 0 WaiverNariance request for: Distance: Received b . COSA to be release. o t gineer, unless otherwise requested by the engineer. flush COSA Fee $ �O 1.0D, 1!�((t/ 41,11g= Date of Payment W 5— Receipt Number 05318'' COSA# lf.�GSl25g Date: e0 - 2 Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Michael E. Anderson, P.E. Date .6/2//2015 Engineer's Printed Name .4•Vi'lath •,•E OF q< 4d agfr e w*: 49THe, 6. DSD SIGNATURE !, ., ; 17 System #1 Approved for if bedrooms i MICHCENDERSON ®Ii', CSE -4381 ./SZ System #2 Approved for bedrooms ®� es..�� • 2- IS,,•°•“� Disapproved ��Is kROFEss oO e o Conditional approval for bedrooms, with the following stipulatiot . 1/4LO0 (OFtt ``'4 o let ON-SITE WATER AND WASTEWATER o^ PROGRAM wSERv\G`�\' flrl�irwa`� Original Certificate Date: G - oC - ice Th un'rage Development Services Division (050) issues Certificates of Onsite Systems Approval (COSA) based only upon the rept 'ntations given in paragraph 5 by an independent professional civil engineer registered In the State of Alaska. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineers work. - - 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheel_f . 1.t 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: The Cascades, Block 2, Lot 3 Parcel ID: 078-321-09 A. WELL DATA Well type Private Date completed 1/13/15 Total depth 84 ft. Date of test Static water level 0 ft. Well production 12 g.p.m. WATER SAMPLE RESULTS:— Coliform 0 colonies/100 mL Nitrate.315 mg/L If A, B, or C provide PWSID # Sanitary seal (Y/N)N Cased to 82 ft. FROM WELL LOG 1/13/15 Arsenic Well Log (Y/N) Y Wires properly protected (Y/N) Casing height (above ground) >18 in. AT INSPECTION ft. g.p.m. NDug/L Date of sample: 5/22/15 collected by: Anderson Engrg. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 9/26/14 Tank size 1,250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping Pumper New Construction C. ABSORPTION FIELD DATA Date installed 9/26/14 Soil rating (g.p.d./ft2 orft2/bdrm) 1.2 GPD/SF Length 50 ft. Width 5 Total depth 9.2 ft. Eff. absorption area 500 ft2 Dateot'adequacy test N,taWSCortst. 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 System type 5' Wide Trench ft. Gravel below pipe 4 ft. Monitoring tube Y Depression over field N Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION No Add On Manhole - Gravity Flow to Absorption Trench. Date installed "Pump on" level at in. "Pump off" level at Datum Cycles tested Size in gallons Manhole/Access (Y/N) in. High water alarm level at Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main >100' >100' >75' >25' >50' Sewer /septic service line Animal containment areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation > 0' >5' Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line On adjacent lots On adjacent lots Public sewer manhole/cleanout in. >100' >100' >100' >75' Holding tank Manure/animal excrete storage areas >100' >5' Absorption field >5' >10'Surface water >100' Buildin foundation >10' Property line >10' 9 Water Service line >10 Surface water >100' None Noted Wells on adjacent lots >100' Curtain drain F. COMMENTS Water main N/A Driveway, parking/vehicle storage >10' G. ENGINEER'S CERTIFICATION 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. Engineer's Printed Name Michael E. Anderson, P.E. 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