HomeMy WebLinkAboutHORIZON ESTATES LT 5'0
Horizon
Estates
Lot 5
#051-324-25
Municipality of Anchorage
On -Site Water and Wastewater Program • (907) 343-7904 Page of
ON-SITE. WASTEWATER INSPECTION REPORT
Permit Number: OSP141468 PID Number: 051-324-25
Dwelling: H Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: N New ❑ Upgrade
Name:
Troy Davis Homes
ABSORPTION FIELD
N Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound
Address
165 E. Parks Hwy #200 Wasilla, AK 99654
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
357-9394
3
.8 GPD/SF
10.9-11.0 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
2.9-3.0 Ft.8
Gravel depth beneath pipe
Ft.
Subdivision Block Lot
Horizon Estates 5
Fill added above original grade
.5-1 Ft.
Gravel length
36 Ft.
Township Range Section
Gravel width
3 Ft.
Beds: Number of Lines
Distance between lines
I FL
SEPARATION DISTANCES
To
Septic
Absorption
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Lift Station
Tank
Line
1576 Ftp
1
1 Ft.
Well
>100'
>100,
>100'
NA
>25
TANK ❑p septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Anchorage Tank
Capacity
1,000 Gal.
Surface Water
>100'
>100'
>100'
NA
Material
Steel
Number of compartments
Two
Lot Line
>5'
>10'
>5'
NA
NA
Foundation
>5'
>10'
>5'
NA
LIFT STATION
Manufacturer
Capacity
Gal
Curtain Drain
None
Noted
Pump on level at
Pump off level at
High water alarm at
Remarks
in.
in.
in.
Pump make and model
Electrical Inspections performed by
PIPE MATERIAL House to tank D3034 dTank to
D3034
Installer
Northern Excavation
Drainfield F810 COIMT
Inspector A. Harala
BENCHMARK (Assumed elevation) 100.0 ft
Inspection1' 11/15/14 11/5/14
Location and description'
2nd
sb 11/6/14 f1h
Garage Slab.
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
�%KWU,1
' OF. 44 4##
Conditional Approval: Date
5�4,
�t.
491H
a; .
40
E.
c••MICHAEL ANDERSON : a;
CE -4381 ; 44
ApprovedIle 6:6-t Date
+119*...®
::�•
Inspection Report_9-1-12.d
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904
Permit Number: OSP141468
S89°56'55'E 2.39-�
LOT
LOT 4
�j
.�•��E OF �.
4L 49th ? ��
.......... �� I
90. MICHAEL E. ANDERSON a;`
f4• No. CE -4381 •'ti %
ESSI��:��
28'45'E 12.49 11
N89°59'12'E 116.87
10' T& EESMT.
HORIZON ESTATES
LOT 5
40,028 SF
Alternate
Site
C
®TH8
THREE BEDROOM
HOME
M1 C4
CD
�
O
2Co
O°
S2
co
S1
O
O
®T
M
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_
0D
/ UI
FCO U1
Well
v15' T & E ESMT.
12.25 _
N89055'048E 133.31
PLAN AS -BUILT w
MULDROW STREET g
QrAI F 9" a An'
Page 2 of 3
PID No. 051-324-25
A B
Si 33.3' 38.0'
S2 38.3' 41.1'
C4 56.8' 61.1'
C5 39.1' 33.2'
Ml 152.8'155.9'
I11ijw:l
LEGEND
M1 — MonitorTube I
FCO — Foundation Clean Out
TH — Test Hole
Cl — Clean Out
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
Permit Number: OSP141468
1,000 Gallon
Septic Tank
r
93.4
Page 3 of 3
PID No. 051-324-25
H011115Ki
36' (Trench Length)
41
:.�
PROFILE AS -BUILT �t NC E. NDERS13N
No Scale
Feb.18.2025 05:05 PM
(907) 357-7987 fax
ACE WATER WELL DRILLING
A subsidiary of ACE Ventures, Tru.
P.O. Box 520090
11671V. Knapp Dr
Big Lake, Ak. 99652
(907) 376.7987 (907) 354-1398 cell
Well Owner 'Frog Davie Homes
Location: Tat $ Horizon — Uglc River
Date of Completion: QUISl2015 lobtt 15 -DI
uRofwetl. Domestic
Drilling Method: A€rRotary
Sirs of Casing: 6" Depth of hok 160 feet Cased to: 121 feet
Static Water Lcvck 71 feet below top of casing.
Finish of Well ( ) Open End ( x ) Grout/Seal (X ) ScreenlLirter (X ) Perforated
Describe screen, seal, or pertbrations Perforated From 118 to 120 feet. PVC Liner set from 120 to 160
r001. Bentonite surrace groat 80111.
Well Pumping Tost At 5 Gallons per { } hour ( X ) Minute -
suggested Pump setting depth: 150 feet lkom top of rasing.
Method or€nctablets
Depth in feet ttoln casing
to
Demils of FormationsAixe/colorl etc
0 to 2 feet
2 to 60 feet
Stick u
Sil# aval
60 to 63 fee#
63 to 119 feet
9il sand di water &ravel
siltv eia and avel __
119 to 121 feet
Water ave1— cobbles
121 to 160 feat
Bedrock
Driller Signatur Hate:
PAGE. 1/ 2
Ace
• Box 520090
Big Lake, A. 99652
(907)376-7987
Well Owner: Troy Davis Homes
Installation Date: 03/1612015
Legal Description: lot 5 Horizon - Eagle River
Pump Intake Depth: 113' feet below top of casing (TOC).
Pump Manufacturer. Goulds Well Depth: 125'
Model: Bruiser
Size: % horse
SN: H1443835
GPM: 10 gpm
! • f • • . • r • ' f ZSZME'
installer
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: OSP141468
Tax Code Number: 05132425000
Work Type: WellSeptic Initial
Permit Effective Dates: November 12, 2014 to November 12, 2015
Design Engineer: ANDERSON ENGINEERING
Subdivision: HORIZON ESTATES
Site Legal Address: HORIZON ESTATES LT 5 G:0553
Owner/Address: TROY DAVIS HOMES INC
165 E PARKS HIGHWAY STE 200 WASILLA AK 996540000
Site Mailing Address: 18231 MULDROW ST, Eagle River
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank
Lot Size in Sq Ft: 40044
Total Bedrooms: 3
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.
Receiv
Issued
ed By: Date: -
By. Date:
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-m343-7904 ®
Development Services Division Fa TTA
On -Site Water & Wastewater Program
OCT 2 0 2014
ON-SITE SEWER/WELL PERMIT APPLICATION Gretchen Stuller
Parcel I.D. 051-324-25
Property owner(s) Troy Davis Homes Day phone 310-2501
Mailing address 165 E. Parks Highway #200 Wasilla, AK 99654
Site address Fish Hatchery Road Eagle River, AK 99577
Legal description (Sub'd., Block & Lot) Horizon Estates, Lot 5
Legal description (Township, Range & Section)
Lot Size 40,044 Sq. Ft.
APPLICATION IS FOR:
10 all that apply)
Absorption Field
❑X
Septic Tank
Q
Holding Tank
❑
Privy
❑
Private Well
❑X
Water Storage
❑
Number of Bedrooms Three
APPLICATION IS AN:
TYPE OF DWELLING:
Initial 0
Single Family (SF) 0
Date of Payment:�olaT
(w/wo ADU)
Upgrade ❑
Receipt Number:
Permit No. 051PNI L!0
Duplex (D) El❑
Renewal
Multiple Dwellings ❑
(SF and/or D)
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
property owner or authorized
4
Permit/Rush Fees: ?-$ C/"
Waiver Fees:
Date of Payment:�olaT
Date of Payment:
Receipt Number: & A ] �
Receipt Number:
Permit No. 051PNI L!0
Waiver No.
Permit App__ :-:L.:c.
October 17, 2014
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 5, Horizon Estates Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer
The owner of Lot 5, Horizon Estates Subdivision intends to construct a new three-
bedroom home on the lot. We are 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
proposed and existing wells in the area and septic systems on surrounding lots. No
conflicts exist between the proposed septic system and the well or septic systems and
wells on adjacent lots. Drainage arrows and ground contours 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. All work will be completed in accordance with the
Site Grading and Drainage Plan for the subdivision.
The test holes placed on the lot indicated silty gravel with sand (GM). The percolation
rate of the soil was determined to be 6 to 15 minutes per inch. No groundwater was
found during the placement of the test holes 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 1,000 -gallon septic tank
and a 36' 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 2.5' below the surface and the total depth will be 10.5'. 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 and
northwest at a shallow grade with some cross sloping from the east. The new trenches
will be constructed parallel with the contours of the slope as much as possible in
conformance with Municipal requirements. The new septic system will be constructed a
minimum of 100' from all wells and any surface water and 10' the proposed and existing
water services in the area.
Lot 5, Horizon Estates
October 17, 2014
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. All work
will be completed in accordance with the Site Grading and Drainage Plan
developed for the subdivision.
Sincerely,
Michael E. Anderson, P.E.
Attachments
•� 9.
49th.
MICHAEL E. ANDERSON
NO. CE -4381
No Conflicts with r
Septic Systems t the North
N8 9'12" 116,87
10' T & E ESMT.
IZON E
LOTY 5
40,029 SF
36' Loqf x 3' Wide
x 8' Effective Denth
CONTOUR N o w
INTERVAL — 2'
1,0 Gallon
N w Sep' Tank \
£ w / SO m
CO THS SV _�----
V > o FCO TH7 R)
V OJ
CA
(11
4 THRE EDROOM
HOME
Proposed :?w:k•.•t vis<i;' 4:
Well
Pro posed
�4"' Well
9999
15' T E ESM
♦1 1225 .s•�_
...... ♦ .�° 9°55'04"E 3,3 Proposed
♦1
ell
49th •. g M RO STR T o L END
p..: X......'. ........ ......
Y/ _ //_ MT - Monitor T e
.%..�.'...�....... ............ .. FCO -Foundation Clean Out
MICHAEL E. ANDERSDN : • TH - Test Hole
C CO - Clem Out
�fn•% ''•'� / SINo. CE -4381 T� PLAN 2C0 - ouhle Clean Out
SCALE t" = -4 -
LOT 5, HORIZON ESTATES SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS
Three Bedroom Home Deep Trench System
Perc. Rate: 6-15 Min./Inch 1,000 Gallon Septic Tank
Application Rate: .8 GPD/SF 8' Drainfield Rock
3 Bedrooms X 150 GPD/.8 GPD/SF (Application Rate) = 562.5 SF Absorption Area
562.5 SF/16 SF/LF = 35.16 LF Trench Length
THEREFORE: Construct a 36' Long x T Wide x 8' Effective Depth Absorption Trench at the
Location Shown. Flow Line Elevation in the Trench to be 2.5' Below Original Ground. Total Depth
to Be 10.5' Below Existing Ground. Provide 4' of Cover Over Septic Tank and a Minimum of 3'
Cover Over Absorpiton Trenches. Maintain 100' Separation from Wells in the Area.
Natural
Backfill
2-0" Geotextile
Fabric
6-, O 4" Perforated
PVC (Holes Down)
8'0" 1 1 Drainfield Rock
3'
TYPICAL DEEP TRENCH SECTION
(NO SCALE)
NOTE: Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock.
Minimum 4' Separation From Groundwater.
Minimum 100' Separation From Wells in the Area.
Minimum 100' Separation From Surface Water or Streams: ��
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 BRAGAW STREET ANCHORAGE, AK 99519-6650
DEPTH
(feet)
1-
2-
3-
4 -
5 -
6-
7 -
9 -
10—
II
14
15
16
17
18
19
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: LOT 5, HORIZON SUBDIVISION
PERFORMED FOR: TROY DAVIS HOMES
DATE: 10/10/13 PROJECT No.:
PARCEL ID#: TECHNICIAN: A. HARALA
TEST HOLE 7
r�r
OB/OG
a
SILTY GRAVEL
WITH SAND
d GM
a
d
° DENSE
a
a
a
° BOH @ 17.5'
SLOPE
WAS GROUND WATER ENCOUNTERED?
NO
IF YES @WH
READING
S
DEPTH OF WATER AFTER MO
DEPTH ro
WATER
(INCHES)
NET DROP
(INCHES)
DATE OF MO.
TEST HOLE PRESOAKED PRIOR TO TESTING:
10/10
SITE PLAN
SEE SITE PLAN 8
2
AT DEPTH?
NFLORINS NoIWE L
*IITORING: 10/16.'13 EPU
2%
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUI
DEPTH ro
WATER
(INCHES)
NET DROP
(INCHES)
TEST HOLE PRESOAKED PRIOR TO TESTING:
10/10
1
12:19
6.38"
2
12:49
30
9.56"
3.19"
3
12:52
6.31"
4
13:22
30
9.56"
3.25"
5
13:23
6.38"
6
13:52
30
9.56"
3.19"
PERCOLATION RATE: 10 (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. 1, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 10/20/13
DEPTH
(feet)
1 -
2
3
4-
5-
6-
7-
8-
9-
11
12
13
14
15
17
18
19
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: LOT 5, HORIZON SUBDIVISION
PERFORMED FOR: TROY DAVIS HOMES
DATE: 10/10/13 PROJECT No.:
PARCEL ID#: TECHNICIAN: A. HARALA
TEST HOLE 8
OB/OG
Q
d
a.
SILTY GRAVEL
WITH SAND
°
a GM
c
d
a
° DENSE
a
d
a
° BOH @ 17.5'
SLOPE
N
IP
WAS GROUND WATER ENCOUNTERED?
NO
IF YES @ WH
DATE
DEPTH OF WATER AFTER MO
GROSS TIMEJ
(MINUTES)
DATE OF MO
DEPTH p
WATER (INCHES)
L
MICHAEL E. ANDERSON
No. CE -4381
SITE PLAN
SEE SITE PLAN
i
i
AT DEPTH? J
NITORING: NONE
NITORING: 10/16/13 pU
FC�
2%
DATE
READING
GROSS TIMEJ
(MINUTES)
NET TIME
(MINUTES)
DEPTH p
WATER (INCHES)
NET DROP
(INCHES)
TEST HOLE PRESOAKED PRIOR TO TESTING:
10/10
1
12:51
6.38"
2
13:21
30
9.50"
3.12"
3
13:26
6.31"
4
13:56
30
9.25"
2.94"
5
13:57
6.25"
6
14:27
30
9.13"
2.88"
PERCOLATION RATE: 10.4 (MIN/INCH) PERC. HOLE DIA.-±L(INCHES)
TEST RUN BETWEEN:: 4_5 FT. and 5_5 FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. 1, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 10/20/13
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COSA Checklist
Legal Description: HORIZON ESTATES LT 5
Parcel ID: 051-324-25
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system
❑E1 Well log is filed with Onsite (or attached)
Date drilled 2/18/15 Total depth 160 ft
Cased to 121 ft
❑0 Sanitary seal is functioning correctly
❑NI Wires are properly protected
Casing height (above ground) 24 in.
Date of flow test for COSA 7/23/24
Static water level at beginning of test 70 ft.
Comments
Measured operating fluid level in septic tank 48
Date of pumping 6/24/24
❑ Required maintenance completed, if AWWTS
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed) 11/15/14
0 ALL standpipes present per record drawing
Total measured depth from grade 12 ft (max)
Measured depth to pipe invert from grade 4 ft (min)
❑ N/A —pressurized field.
❑ Per record drawings, field is insulated.
FE1 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) _
If yes, enter date
COSA Checklist June 2022
Well production at time of test 4+ gpm
Water storage tank volume 0 gallons
Well disinfected for coliform test? ❑ Yes N No
X Coliform bacteria is Negative
Nitrate
Arsenic
Collected by
Date 7/23/24
mg/L ❑N Nitrate less than MRL (ND)
_ ug/L X Arsenic less than MRL (ND)
MINA
C. LIFT STATION
❑ Required maintenance completed
Age of lift station _ years
Lift station material
Comments:
Adequacy test date 7/23/24
Results Q Pass
Fluid depth prior to test 26 in
Water added 450+ gal
New fluid depth 36 in
Elapsed time 1440 min
Final fluid depth 26 in
Absorption rate 450+ gpd
FIELD STATUS — POST RECOVERY
Effective depth (per record drawings) 96 in
Effective depth used 26 in
Effective depth remaining 70 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'
❑m Yes
if No
Community Sewer Manhole/Cleanout > 100'
Fi Yes
if No
_ ft
❑� Yes
if No _ ft
Neighboring Tank > 100' ❑o Yes
if No
_ It
Private Sewer/Septic Line > 25' 0 Yes
if No _ ft
Absorption Field on Lot > 100' [E Yes
if No
_ it
Holding Tank > 100' Yes
if No _ ft
Neighboring Absorption Fields > 100'
if No
_ ft
Animal Containment > 50' Q Yes
if No It
❑i Yes
if No
ft
_ ft
_
_
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ❑� Yes
if No
_ ft
Q Yes
if No _ It
❑ 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'
❑m Yes
if No
_ ft
Surface Water > 100'
❑R Yes if No _ it
Tank to Property Line > 5'
g Yes
if No
ft
Wells on Adjacent Lots:
Field to Property Line > 10'
Q Yes
if No
_ ft
Private Wells > 100'
❑m Yes if No _ ft
Water Main > 10'
❑w Yes
if No
_ ft
Community Wells > 200'
Q Yes if No _ ft
Water Service Line > 10'
Z 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.
NameofFirm MIhC-N 4CLd(c-dq � � Phone 727-8864
Engineer's Printed Name r7 & wk c • Date �Z-_sb `f
COSA Checklist—June 2022
R1 Sh
i
Parcel I.D. 051-324-25
Municipality of Anchorage
On -Site Water.and Wastewater Program
(907)343-7904..;;
Certificate of On -Site SystomsApproval
1 0
Q
A $Ak kYY
V' l✓ %
Expiration. Date:
1. GENERAL INFORMATION
Complete legal description Horizon Estates Lot 5
Location (site address) lga%) Muldrow Street Eagle River, AK 99577
Current Property owners) Troy Davis Homes, Inc. Day phone 357-9394
Mailing address 165 E. Parks Highway, No. 200 Wasilla, AK 99654
Real Estate Agent .
2. TYPE OF DWELLING:
Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family arid/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
Three
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER
Individual Well
L7X�
Individual
Individual Water Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
RUSH!
APR 2 3 2015
WaiverNariance request for: C... a � L' Distance:
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ ��� • Waiver Fee $
Date of Paymentl6 Date of Payment
Receipt Number Qt'Q�D��] C� _ Receipt Number
COSA#-Q`JC���irG 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 that
procedures outlined in lCertificate
wastewater disposaltems system pis (arae) sal eelines functional andfor this padlequlate
shows that the on-site water supply
y and/or based
for the number of bedrooms and type of structure indicated my n. I further investigation and inspection"
cion "the on -sit information
obtained from the Municipality of Anchorage files and from my g
ordinances,
supply and/or
waregulationst i n effect attem the time e) in installation. compliance with all applicable Municipal and State codes,
Phone 522-7773
Name of Firm Anderson Engineering .
Address
P.O. Box 240773 Anchorage, AK 99524
Michael E. Anderson, P.E.
Engineer's Printed Name
6. DSD SIGNATURE
_AZ System #1 Approved for _3_ bedrooms
System #2 Approved for _ bedrooms
Date 4/23/15
Disapproved
Conditional approval for bedrooms, with the following
OF•A4Q o
49TH
CE -4381
?RDFESS1b� o®w
Original Certificate Date:
The �
e Municipality of Anchorage Development Services Division (DSD)issues Certificates of On -Site Systems Approval (COSAj based only
Th
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Naska. The Municipality
of Anchorage Is not responsible for errors or omissions In the professional engineers work.
7. ATTACHMENTS:
COSA Checklist
Septic system Advisory
Well Flow Advisory
COSAbluesheer_: .A s
X.
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: Horizon Estates, Lot 5
A. WELL DATA
Well type r-rlVate
If A. B, or C provide PWSID #
Date completed 2/18/15
Sanitary seal (Y/N) Y
Total depth 160 ft.
Cased to 121 ft.
FROM WELL LOG
2/18/15
Date of test
Static water level
71 ft.
5.0
Well production
g:p.m•
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mL Nitrate ND mg/L
Arsenic ND ug/L
Date of sample: 4/15/15
B. SEPTICIHOLDING TANK DATA
Parcel ID: 051-324-25
Well Log (Y/N) Y
Wires properly protected (Y/N) Y
Casing height (above ground) >18 in.
AT INSPECTION
ft.
(1!
Collected by: Anderson Engrg.
Tank Type/Material Septic/Steel Date installed 11/15/14
Tank size 1,000 gal. Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YIN) N
Date of pumping NewConst. Pumper
c. ABSORPTION FIELD DATA
Date installed 11/15/14 Soil rating (g.p.d.& or fiftdrm) •8 GPD/SF System type Deep Trench
Length 36 ft. Width 3 ft. Gravel below pipe 8.0 ft.
Total depth 11.5-12 ft. Eff. absorption area 576 f? 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.) (YIN & type) N If yes, give date
D. LIFT STATION
Date installed
Size in gallons
Manhole/Access (YIN)
"Pump on" level at in.
"Pump ofP level at
in. High water alarm level at in.
Datum
Cycles tested
Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/iift station on lot
> 100'
On adjacent lots >100,
Absorption field on lot
>100'
On adjacent lots >100'
Public sewer main N/A
Public sewer manhole/cleanout N/A
Sewer /septic service tine
>25'
Holding tank N/A
Animal containment areas
>50'
Manure/animal excrete storage areas >100,
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >51 Property line >50
Water main >10' Water service line >10'
Wells on adjacent lots >100'
ABSORPTION FIELD ON LOT TO:
Property line >10' Building foundation >10'
Water Service line >10' Surface water >100'
Curtain drain NOVO Noted Wells on adjacent lots > 100'
F. COMMENTS
Absorption field >5•
Surface water >100'
Water main N/A
Driveway, parkinglvehicle storage > 10'
G. ENGINEER'S CERTIFICATION OF A 1+
I certify that f have determined through field inspections and ,,;%`P,•'
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines In effect on this date. g ; G •.. ,¢
®. ... ... ..•y+
Engineer's Printed Name Michael E. Anderson, P.E. ® T PU.r
O VO *.MICHAEL E. ANDERSON = � 0
Date 4123115 $� CE -4381 a"®
+�h.'ROFESSIO�� eve
COSA brown sheet te-1P12.doc
Lot 5 has
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N89.55'04'E 133.31
8 MULDROW STREET 8
GRAPHIC SCALE: 1 loch = 60 Feet
30 15 0 15 30 60 120
FOR: TROY DAVIS HOMES
Date
Seale
Legal Descripti,
04-17-15
1" = 60'
`°t 5
Blnck
FORBES& ASSOCIATES, INC.
Grid
NW 453
Aa-guilt Survey
2150036
HORIZON ESTATES
P.O.
9
Anchoragee,, Alaaskasks 99523
SUBDIVISION
Drawn by
Field Book
(907) 227-5881
cef
246L
��1(,
I hereby certify that the property described hereon has been surveyed
♦�'`''
4
by me, or at my direction, and that the improvements situated thereon
♦�� ,� �t
• `••�s
are within the property lines and do not overlap or encroach on the
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"+
property lying adjacent thereto unless otherwise shown. That no
improvements the lying adjacent thereto encroach on the
69 +•�.
� ••� {
on property
A * * t�.9 TH
premises in question and that there are no roadways, transmission
i
lines or other easements on said property except as shown.
d++••• ....
It is the responsibility of the owner or builder, prior to construction,
��,'�"`••++•+••••••„•+.....,,.„E
to verify proposed building grade relative to finish grade and utility
f C14ARLES E. FMES e`
connections and to determine the existence of any easements, covenants,
Nj.'• 1$-72$ .• ab`r
or restrictions which do not appear on the recorded subdivision plat.
#! sf, "••04-17-15 • f
Listed distances prevail over scaling.
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\ Reproduction may cause distortion.