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HomeMy WebLinkAboutVALLEY #1 LT 2AOnsite File •� t Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP151369 PID Number: 051-105-36 Dwelling: N Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: X New ❑ Upgrade Name: Troy Davis Homes ABSORPTION FIELD ❑ Deep Trench H Shallow Trench ❑ Bed ❑ Mound Address 165 E. Parks Hwy #200 Wasilla, AK 99654 ❑ other Phone Number of Bedrooms Soil RatingTotal depth from odginal grade 357-9394 4 1.2 6.5 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 2.5 Ft. Gravel depth beneath pipe 4.0 Subdivision Block Lot Valley 2 Ft. Fill added above original grade 1-2 Ft. Gravel length 50 Ft. Township Range Section Gravel width 5 Beds: Number of Lines Distance between lines SEPARATION DISTANCES Ft. FL To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 500 Ftp 1 Ft. Well >100' >100' >100' >75' >25' TANK Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity 1,250 Gal. Surface Water >100'>100' >100' NA Material Number of compartments Lot Line >10' >10' >5' NA Steel Two NA Foundation >5' >10' >5' NA LIFT STATION Manufacturer Capacity Curtain Drain None Noted Gal. Remarks Pump on level at in. Pump off level at in. High water alarm at in. Pump make and model Electrical Inspections performed by Installer PIPE MATERIAL House to tank D3034 Tankto drainfeld D3034 Northern Excavation Drainfeld F810 CO/Mr 03034ft Inspector W. Roberts BENCH MARK (Assumed elevation) 100.0 Inspddatis: is' 11/27/15 2N 11/27/15 Location and description 3b a'^ NW Comer Back Deck. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL En i mp Conditional Approval: 4, ........ OF q It Date � np 49TH f1'lV� 0, .:.. � •.�.. �, rte„ - MICHAEL E. ANDERSON •:00 Approved Date 6" l �/Fq pROFESS10Na� �� Ilrrre�.��� w........r,..., o.....,.. n a" n spG r, apo _ -­ Municipality of Anchorage Page 2 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 — 343-7904 Permit Number: OSP151369 PID No. 051-105-36 I LOT 2, VALLEY SUBDIVISION 44.967.52 SQ.FT. I ---- --------------------1------ VALLEY AVENUE o 1 N 89'59'10"E 150.03' \30.0' o ROADWAY & PUBLIC UTILITY RESERVATION I 1 I 1 'I I I I I WELL I I I 1 I 1 \ I%1 1 Four Bedroom i Home N 1 A FCO Z' m O Q I o Lot 1 0 ®H1 c4 Ml S2- "51 o N y Q %1 H2 2CO m mK N *5.4' .6' .6'M2 ,' Altsmeate mc ? m .8'Am m' .5'C n.4'8.9' I Lot 2 44,968 s.f. LEGEND O. I M1 — Monitor Tube FCO — Foundation Clean Out S1 — Septic Vent TH — Test Hole Clean u •.•`E OF r'�V'� 2CODouble Clean Out ••�P�•. ......... 1� N 8959'52"W 150.04' '•�' ��i Lot 50 49th ..........C.4....LE...NDERSN.�, PLAN AS BUILT �'; MICHAEL E. ANDERSON .� •� f':, �Na. CE -4361 � •1+, ........ SCALE 1" = 50' Permit Number: OSP151369 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 PID No. 051-105-36 5115/15 PROFILE AS -BUILT No Scale Development Services Deportment Building Safety Division el, On -Site Water & Wastewater Program u 4700 Elmore Road P.Q. Bax 196650 Anchorage, AK 99507 s E T . Mark Beglch w .munLora/onsite Mayor (907) 343-7904 Well Log Permit Number: 05P151369 Date of Issue:11-12-15 Parcel Identification Number: n/a Date Started: 11-16-15 Date Completed: 11-16-15 Is well located at approved permit location? U Yes U No Legal Description: T1SN R1W SEC 9 LT43 6:1358 Property Owner Name & Address: Troy Davis Homes Inc. site: 21986 Valley Ave. 165 E. Parks HwySTE200 Chugiak,AK Wasilla, AK 99654 Borehole Data: Depth (ft) Soil Type, Thickness & Water Strata From To Stickup 0 2 overburden 2 4 coarsegravel 4 7 silty gravel 7 19 wet silt & gravel 19 23 dry silt & gravel 23 30 gravel w/ clay 30 40 coarse gravel w/ H2O 40 42 �BfHQ Water Sample Results: Arsenic: _ ug/L Nitrates: _ mg/L Total Coliform Bacteria: _ colonies/100mL Other Bacteria: col/100mC, Method of Drilling U air rotary EJ cable tool Casing type: steel Wall Thickness: .250 inches Diameter: _6 inches Depth: 42 feet Liner Type: Diameter: inches Depth: = feet Casing stickup above ground- 2 feet Static water level (from ground level): lis feet Pumping level: feet after hours pumping gpm Recovery Rate: 15 gpm Method of Testing: airlift Well Intake Opening Type: n Open End ❑ Open Hole E] Screened Start feet Stopped feet n Perforations Start feet Stopped —feet Depth: 20' Start 0' feet Stopped 20' feet Pump: Intake Depth feet () Pump size hp Brand Name _ Well Disinfected Upon Completion? F1 Yes © No Method of Disinfection: chlorine Comments: Well Driller: Hefty Drilling, Inc. 3540 Akula Dr. Anchorage, AK 99516 Attention: The well driller shall provide a well log to DSD within J0 days of completion. Development Services Department Building Safety Division 1© pG 4 { ,a On -Site !Nater & Wastewater Program r 4 E 8 'gid 4700 Elmore Road z P.O. Box 196650 Mark Begich Anchorage, AK 99507 Mayor www.muni arahmlte (907)343-7904 Pump Installation Log Well Drilling Permit Number: &W_-jZP 151 ?j(e 9 Date of Issue: Parcel Identification Number: Legal Description Property Owner Name & Address: T15A/ g i V SCC. 9 L+43 .raY )?A V6 14"407 G; 135$ lba E. {�avl(SN�j -K,1oo 1✓�,�lay AK 94.G1N 11 Pump Installation Date: 01-1-15 Pump Intake Depth Below Top of Well Casing: 3a feet Pump Manufacture'r's Name: web krb' Pump Model: JzLP QPM'+ 250d. .2W. WTO705A Pump Size , 1/6L hp Pitless Adapter Burial Depth: 1) feet Pitless Adapter Manufacturer's Name: C-6," bet t 6-10 Pitless Adapter Installer: 1 V%0Z Vet/ -1 Ou"f S Well Disinfected Upon Completion? IO Yes n No Method of Disinfection: Un Comments: p,/� , / A1-1 6 e -11t, fvc• Pump Installer Name: C. t e I- Rel ,� 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: OSP151369 Tax Code Number: 05110536000 Work Type: WellSeptic Initial Permit Effective Dates: November 12, 2015 to November 11, 2016 Design Engineer: ANDERSON ENGINEERING Subdivision: VALLEY Site Legal Address: VALLEY LT 2 G:1358 Owner/Address: TROY DAVIS HOMES INC 165 EAST PARKS HIGHWAY STE 200 WASILLA AK 996547059 Site Mailing Address: 21986 VALLEY AVE, Chugiak Lot Size in Sq Ft: 44967 Total Bedrooms: lely 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. co ( Lr nGreuse5 /7un+k-r � Received By: /%/w Issued By: hed rovo'5 _/U Lt. Date: Or. II iZ ry MUNICIPALITY OF ANCHORAGE 4p.•. o Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 051-105- Oy Property owner(s) Troy Davis Homes Day phone 310-2501 Mailing address 1689 Knik Goose Bay Road #400 Wasilla, AK 99654 Site address 21982 Valley Avenue Chugiak, AK 99567 Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) Valley Subdivision, Lot 21115N 91 W Ste -9 Lot Size 44,967 Sq. Ft. Number of Bedrooms Three L—q-3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial (] Single Family (SF) ❑X Septic Tank ❑X Upgrade (] ' (w/wo ADU) Duplex (D) ❑ Holding Tank El Renewal 0 : Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑X Water Storage ❑ 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. (Signature of property owner or authorized agent) I9 q. qD Permit/Rush Fees:9A+245- q7§0 Waiver Fees: Date of Payment: I I SII J Date of Payment: Receipt Number: t7dlot GN Receipt Number: Permit No. _ 05el5 :�i Cl Waiver No. Permit App_.:- : . :_'.,:c_ CO -e32- ( November 3, 2015 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 2, Valley Subdivision Well and Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 2, Valley 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 those on adjacent lots. No existing wells are closer than 100' from the proposed septic system. Drainage arrows and ground surface 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. The test holes placed on the lot in the area of the absorption trench and alternate site indicated silty gravel with sand (GM) material. The percolation rate of the soil was determined to be 4-5 minutes per inch. Groundwater was found at 14' beneath the surface during the placement of the test holes and remained at that level 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 3' below the surface and the total depth will be 7'. 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 absorption trench slopes from the southeast to the northwest at shallow grades. The new trench will be constructed parallel with the contours of the slope as much as possible in conformance with Municipal requirements. The new septic system will be constructed a minimum of 100' Lot 2, Valley Subdivision November 3, 2015 Page Two from all wells and any surface water and services in the area. 10' from the proposed and existing water If the system is constructed in accordance with our design the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments MICHAEL E. ANDERSON No. CE 4381 j �ialinq Well I W II OOPta - e2 BOtlrMF -Hone I / O Log ' Eb.ael - St CPM 13' , , 34 B S , \ Existing I / , 33 C I �J wen lMd.o.k - � w Laq - S. GPM W , 33A 'W.n BeOmck - PM ® In GPM 33 B - Lu \` __--_ ! \ Existing W / I E.iW. 34 WWO`, A well 1 SePlic No Mlorma0on 1 U L ® / r -tea —r, / VALLEY AVENUE / 1 I Septic I AreO 1 t Lu Li VACANT Q 44 A 1 ` 44 B I I t Exl.ting well / \ NO lnlOrmptbn , D 49th AEL E.ANDERSDN No. CE -4381 11-7-15 _.•••C` 50.00 nW n...W t V O b LOT 1 o LOT 2 44,951.99 SQ.FT. 44,967.52 SQ.FT. J 12 T15N R1W SECTION 9 BLM LOT 50 AREA MAP SCALE 1" = 100' \ 1 1 i -----,1 LOT 2, VALLEY -SUBDIVISION / 44,967.52 SO.FT. CONTOUR INTERVAL - 2' M1 - Monitor Tube FCO - Foundation Clean Out _ - SI - Septic Vent - TH - Teal. Hole - - C4 - Clean Out S I T E PLAN 2CO _ able lean Out VALLEY AVE.. �d NB9°59'10'E 15 0� E04 RG DWAY k tN PUBWC UTI RESERVATION "Y ' +� �e9 3c h ® 1 Proposed Well wuRr9 µMi \ rµi VRCPO 01 192 Gr.6 FLfV. 19i \ Four Bedroom / \ Home / g ZO > yoc ®TH— 5VCD TH2 S0 —03 0 ea ,250 Gallon s eotic Tank ri LOT 1 N a MT t4 J CO 0' Long x 5' Wide x Effective Depth Absorption Trench W NOTE: N1) o Ar as of Excessive,Sfope are- .. Within 50` Downslope or Surface Wat Within -100' of Any Partof .the Ne Septic System. _ 199 30.00 C0 o -- 42 50 51 LEGEN CONTOUR INTERVAL - 2' M1 - Monitor Tube FCO - Foundation Clean Out _ - SI - Septic Vent - TH - Teal. Hole - - C4 - Clean Out S I T E PLAN 2CO _ able lean Out SCALE 1" = 50' C D 4r( LOT 2, VALLEY SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home 5' Wide Trench System Perc. Rate: 1-5 Min./Inch 1,250 Gallon Septic Tank Application Rate: 1.2 GPD/SF 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' Lang x 5' Wide x 4' Effective Depth Absorption Trench at the Location Shown. Distribuiton Line to be Placed 3' Below Ground. Total Depth to be 7' Below the Surface. Provide 3' Cover Over Absorption Trench and 4' Cover Over Septic Tank. Construct System a Minimum of 100' From All Wells in the Area. 2'6" Geotextile Fabric 4" Perforated i PVC (Holes Down) II i I ' d 1 4' i Drairfiiefd Rock 61 TYPICAL & WIDE TRENCH SECTIONOF .....• •..�lo (NO SCALE) •• p(E.............• ��i NOTE: Grade Area Over Trench to Drain Away. C v astn Minimum 6' Separation From Bedrock. 0.........).......�.......�f� Minimum 4' Separation From Groundwater' s �s.G....i•. Minimum 100' Separation From Private Wells in the Area. �� ; MIGR FLE MDERSON ; u Minimum 100' Separation From Surface Water or Streams. ®�� L No. CEAW, .[� 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 - SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: BLM LOT 43, T15N, RIX SECTION 9 PERFORMED FOR: TROY DAVIS HOMES. INC. DATE: 2/27/15 PROJECT No.: PARCEL ID#: TECHNICIAN: L. BETTS TEST HOLE 1 " �r v77BZH SILTY GRAVEL WITH SAND GM SITE PLAN SEE SITE PLAN G WAS GROUND WATER ENCOUNTERED? YES IF YES Q WHAT DEPTH'? 14 DEPTH OF WATER AFTER MOMTORING: 14' 2% DATE OF MONITORING: 5/ 15/15 BOH @ 16' COMMENTS: TEST HOLE PRE SOAKED PRIOR TO DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH To WATER (INCHES) NET DROP ET DRO TEST HOLE PRESOAKED PRIOR TO TESTING: 2/29 1 2:14 0.75" 2 2:44 30 8.00" 7.25" 3 2:45 0.63" 4 3:15 30 7.88" 7.25" 5 3:16 0.75" 6 3:46 30 8.00" 7.25" PERCOLATION RATEA.2 (MINANCH) PERC. HOLE DIA.. W ((INCHES) TEST RUN BETWEEN: 4.0 FT. and 5.0 FT, 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 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- 17 1 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: BLM LOT 43, T15N, RIW, SECTION 9 PERFORMED FOR: TROY DAvls HOMES, INC. DATE: 2/27/15 PROJECT No.: PARCEL ID#: TECHNICIAN: L. BETTS TEST HOLE 2 OB/OG a SILTY GRAVEL d WITH SAND d. GM c . a d SLOPE SI I L PLAN SEE SITE PLAN O WAS GROUND WATER ENCOUNTERED? YES IFYES@ WHATDEPTH? 14' DEPTH OF WATER AFTER MOMTORING: 14 0 2/e d DATE OF MONITORING: 5/15/15 a d a d BOH @ 16.5' DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH ro WATER (INCHES) NET DROP (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 2/29 1' 2:30 1.38" 2 3:00 30 8.00" 6.75" 3 3:02 1.50" 4 3:32 30 8.13" 6.75' 5' 3:33 1.25" 6 4:03 30 1 8.00" 6.75" PERCOLATION RATEA4 (MIN/INCH) PERC. HOLE DIA.. 6:I ((INCHES) TEST RUN BETWEEN: 4.0 FT. and 5.0 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: 4/30/15 CD V/ rn rn c ) co I-- r -- C) C) CD 0') W o c L V � a 0 i U Z a " '} 0 I..V ( U (D o UCO Z o� M N U L m � c L c � E 0- 0— a) - O a) cn a DO co 0 Q.. 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Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume 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 Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank Date of pumping Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade 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) If yes, enter date Adequacy test date Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) in Effective depth used in Effective depth remaining in Comments/Deficiencies: COSA Checklist_June 2022 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 Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ 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 Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ 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 Phone Engineer’s Printed Name Date C&M ENGINEERING CHARLES BALZARINI, PE 6/14/24 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On-Site Systems Approval Parcel I.D. 051-105-37 Expiration Date: I £ —. '"-i 1. GENERAL INFORMATION Complete legal description Valley #1 Lot 2A Location (site address) 21986 Valley Avenue Eagle River, AK Current property owner(s) Dawn Campbell Day phone 242-4503 Mailing address P.O. Box 772863 Eagle River, AK 99577 Real estate agent Kathi Olmstead Day phone 244-8020 2. TYPE OF DWELLING: ❑ Single Family (w/wo ADU) ❑ Duplex E Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Q Private Septic ❑ 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 $ 550.00 Waiver Fee $ Date of Payment 4`2.(Q 201 Date of Payment Receipt Number 00(0S ` 1) Receipt Number COSA# 05G1912102_ Waiver# tPlart. 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 6/26/19 44's , ik.a♦i,a •NI ` • IN •• •��' 1 zO • 49th •i 6. DSD SIGNATURE , t ri , ,• •System #1 Approved for 4 bedrooms I)VMICHAEL E. ANDERSON•/�: ��•'•. No. CE-4381 _ , System #2 Approved for bedrooms �•S,'F,QF..,., 6/26/19 ••°� ilr •.• .. • Disapproved ��44i�Ra; ;;�:0•• Conditional approval for bedrooms, with the following stipulations: .akk((((((((((o fffi N_s/�-E o d WATFRt, WI S--E�4ND rn FlR ATFR i o,% °GRAM .. %;�SPPviC,--��' Ch1 fl)1)),}� )0 -- 7 B_______ y:f ` L t-\_. (".1i. Original Certificate Date: j— 3 ' 19 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 COSA Checklist Legal Description: Valley#1, Lot 2A Parcel ID: 051-105-37 If more than 1 septic system on lot: COSA Checklist# of Structure served by this system A. WELL DATA ❑Q Well log is filed with Onsite (or attached) Well production at time of test 4.2 gpm Date drilled 11/12/15 Water storage tank volume gallons Total depth 42 ft Well disinfected for coliform test? ❑ Yes ❑ No Cased to 42 ft Coliform bacteria is Negative ❑■ Sanitary seal is functioning correctly Nitrate 2.89 mg/L ❑ Nitrate less than MRL (ND) ❑Q Wires are properly protected Arsenic ug/L ❑■ Arsenic less than MRL (ND) Casing height (above ground) 28 in. Collected by Forge Engineering Date of flow test for COSA 6/13/19 Date of Sample 6/14/19 Static water level at beginning of test 16 ft. Comments B. TANK DATA C. LIFT STATION Age of tank(s) 4 years ❑ Required maintenance completed Tank type/material Septic/Steel Age of lift station years Measured operating fluid level in septic tank 49" Lift station material ❑■ Standpipes/foundation cleanout per record drawing Comments: Date of pumping 6/25/19 Sanitary Pumpers D. ABSORPTION FIELD DATA 5'Wide Trench Which system tested (date installed) 11/27/15 Adequacy test date 6/13/19 N ALL standpipes present per record drawing Results Q✓ Pass For 4 bedrooms Total measured depth from grade 7.6/8 ft(max) Fluid depth prior to test 1/0 in Measured depth to pipe invert from grade 3.813.8 ft(min) Water added 750 gal ❑ N/A—pressurized field New depth 3/0 in Q■ Monitor tubes go to bottom of effective. If not, state Elapsed time 1440 min depth into effective 0Code-required soil cover over field Final fluid depth 0/0 in Absorption rate 600+ gpd El System presoaked (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) No date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet 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' Community Sewer Manhole/Cleanout> 100' 0 Yes if No ft El Yes if No ft Neighboring Tank> 100' 0 Yes if No ft Private Sewer/Septic Line >25' 0 Yes if No ft Absorption Field on Lot> 100' 0 Yes if No ft Holding Tank> 100' ✓�Yes if No ft Neighboring Absorption Fields> 100' Animal Containment> 50' 0 Yes if No ft 0 Yes if No ft Manure/Animal Excreta Storage> 100' Community Sewer Main > 75' Q Yes if No ft Q Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations> 10' I✓ Yes if No ft Surface Water> 100' ❑✓ Yes if No ft Property Line > 5' ✓❑ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Q✓ Yes if No ft Private Wells > 100' ID Yes if No ft Water Main > 10' Q Yes if No ft Community Wells >200' ✓Q Yes if No ft Water Service Line> 10' p✓ 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' ❑✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' ✓0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' ✓0 Yes if No ft Private Wells > 100' 0 Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft Community Wells >200' 0 Yes if No ft Surface Water> 100' El Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION �.+.A���O� 44wist, I certify that l have determined through field inspections and review �, '\ ..ifs' .�� �+ of Municipal records that the above systems are in conformance with = 1 MOA COSA guidelines in effect on this date. i {�=. 49th i\ ; *� % Y+7/i,. ..•►.. ..........M...R...WMN..........m.+ f MICHAEL E. ANDERSON p• N • :41 ii ;!S i� No. CE-4381 / �• f(� 6/25/19 ..r<„' COSA Checklist yellow sheet #�!glA , aS`;;«�1�� DI Parcel I.D. 051-105-36 r9 70 t A FF., Munnnicipality of AnnchorageOn-Site Water and Wastewater Program(907)343-7904 Certificate of On -Site Systems Approval Expiration Date: t g —1 C, 1. GENERAL INFORMATION Complete legal description Valley, Lot 2 Location (site address) 21982 Valley Avenue Chugiak, AK 99567 Current Property owner(s) Troy Davis Homes, Inc. Day phone 357-9394 Mailing address 1689 Knik Goose Bay Road, No. 400 Wasilla, AK 99654 Real Estate Agent Day phone 2. TYPE OF DWELLING: I] Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Four 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual (] Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request Received by: �/�� Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ f t'. �¢� Waiver Fee $ Date of Payment x'9�rli(,o Date of Payment 3--yj(y Receipt Number 0 !! Receipt Number COSA# 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 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE 4 System #1 Approved for V bedrooms 0 System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, Phone 522-7773 Date 616116 OF`A��1��'0 49 TH r7 n eMICHAEL E: _ANDERSON =� 9� �f CE -4381 =�® "ROFESS1ONA4©© with the following stipula�i�m;� i0��� Original Certificate Date: 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 engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSAbluesheet t I- 7. c 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: Valley, Lot 2 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 11-16-15 Sanitaryseal (Y/N) Y Total depth 42 ft. Cased to 42 ft. Date of test Static water level FROM WELL LOG 11-16-15 15 ft Well production 15 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate 2.34 mg/L Arsenic ND ug/L Date of sample: 5/23/16 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1,250 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Depression over tank (Y/N) N Date of pumping NeW Const._ Pumper Parcel ID: 051-105-36 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) >18 in. AT INSPECTION ft. Collected by: And. Engineering Date installed 11-27-15 Cleanouts (Y/N) Y High water alarm (Y/N) N C. ABSORPTION FIELD DATA Date installed 11/27/15 Soil rating (g.p.d./fe orft2 bdrm) 1.2 GPD/BDRM System type 5' Wide Length 50 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth 7.7 ft. Eff. absorption area 500 fe Monitoring tube Y Depression over Feld N . Date of adequacy testNewConst._ Results (Pass/Fail) For 4 bedrooms Fluid depth in absorption Feld 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) N If yes, give date D. LIFT STATION Date installed Size in gallons "Pump on" level at in. "Pump off" level at Datum Cycles tested _ _ Manhole/Access (YM) in. High water alarm level at in. Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot >100, On adjacent lots >100, Absorption field on lot >100' On adjacent lots >100, Public sewer main >75' Public sewer manhole/cleanout >100, Sewer /septic service line >25' Holding tank >75' Animal containment areas >50' Manure/animal excrete storage areas >100, SEPTIC/HOLDING TANK ON LOT TO: Building foundation >59 Property line >51 Absorption field >51 Water main >10, Water service line >10' Surface water >100' Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10, Water main >10, Water Service line >10, Surface water >100, Driveway, parking/vehicle storage >10 Curtain drain Nolle Noted Wells on adjacent lots >100, F. COMMENTS 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 6/6/2016 CASA brown sheet_10-10-12.doc iAEL E. ANDERSON : 'r CE -4381 : ��A °ROFESso VALLEY AVENUE o / N 89'59'10"E '150.03' 030.0' ROADWAY & PUBLICJ ROADWAY & PUBLIC UTILITY RESERVATION ro �RppUS — — — — — N 89'59'52"W 150.04' — — Lot 50 WELL g 20.0.0 20.0' i PLOT PLAN AS BUILT X SCALE 1" —=50' GRID NW 1358 J N w Lan & Associates, inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang \ O_ 69.2' ken*longsurvey.com / jonothan0longsurvey.com o`er OP ` gs0ao Moo 4§���G� �r TH9oQ 49 \ N 12.0' \. N za FF Anchorage Recording District, Alaska, and that the improvements situated thereon are .. � i N no Improvements on the property tying adjacent thereto encroach on the surveyed there transmission lines or other visible 54.0' G Z N rrJ Dated this the (*" Day of G 1.at Anchorage, M Lot 1 A Sslom%- " N 0R� �DO�o��o I M m m o SEPTIC ( M PIPES M 1 Lot 2 44,968 s.f. ROADWAY & PUBLICJ UTILITY RESERVATION — — — — — N 89'59'52"W 150.04' — — Lot 50 PLOT PLAN AS BUILT X SCALE 1" —=50' GRID NW 1358 Project No.16-004/At Lan & Associates, inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang r (907) 522-6476 Phone Registered Land Surveyors (907) 522-4625 Fax 000p0 OF A��4 ken*longsurvey.com / jonothan0longsurvey.com o`er OP ` gs0ao I hereby certify that I have surveyed the following described property: �r TH9oQ 49 LOT 2, VALLEY SUBDIVISION (PLAT 2015-119) * : Anchorage Recording District, Alaska, and that the improvements situated thereon are .. within the property lines and do not encroach onto the property adjacent thereto, that no Improvements on the property tying adjacent thereto encroach on the surveyed there transmission lines or other visible KEN G premises and that are no roadways, easements on said property except as indicated hereon. Dated this the (*" Day of G 1.at Anchorage, Alaska�4ncb ''•-520.•'" gJp� Sslom%- It is the responsibility of the owner to determine the existence of any easements. 0R� �DO�o��o covenants, or restrictions which do not appear on the recorded subdivision plat.