HomeMy WebLinkAboutCHEROKEE RIDGE LT 1Cherokee Ridge
Block
Lot 1
# 015-272-94
Municipality of Anchorage
On -Site Water and Wastewater Program - (907) 343-7904 Page of
-SITE WASTEWATER INSPECTION REPORT
Permit number: OSPI61198 PID Number: 015-272-94
Dwelling; Q Single Family (SF) Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New [9 Upgrade
Name.
White Raven Development, Inc. ABSORPTION FIELD
Address
12080 Old Seward Hwy. Anchorage, Ali 99515 Deep french El Shallow Trench �] Coed [:1 Mound
D Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
5 .8 GPD/SF 11
Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot 3 Ft, 8 Ft.
Cherokee Ridge 1 Fill added above original grade Gravel length
Township Range Section .5-1 Ft. 60
Ft.
Gravel width Beds: Number of Lines Distance between lines
S
EPARATION DISTANCES Ft. Ft..
Septic Absorption ; Holding Sewer Total absorption area Number of trenches Dist. between trenches
I Lift .station i
"rank i Field f ; Tank i_ine
_� _____.. 960 Ft` One Ft.
100' y1{)�}' ! �100` � �f r i � J'TANK9 Septic E] S.T.E.P. C] Holding El Other
-_._ IManufacturer Capacity
( Anchorage Tank 1,500 Gal.
100 >100 NA i I\!AMaterial Number of compartments
->5°1(}` iNA I NA i Steel Two
I
NA
Foundation( >5fi >10F NA ° l A LIFT TATO
Manufacturer Capacity
Curtain Drain I None i N ted ( Gal.
s
RemarksTrench Extended to 60'to Satisfy Pump on level at Pump off level at High water alarm at
Requirement for Five Bedroom Norrie ir,. in. n.
..._ _ _ _ .
1,500 {gallon Septic Tank Placed. Pump make and model Electrical Inspections performed by
PIPE € A T EI IAL House to tank D3034 rank to D3034
Installer drainfie(d
White Raven Development, Inc. Drainfield F810 COrMT
Inspector W. Roberts BENCH MARK (Assumed elevation) 100.0 ft
Inspection 1" 7/24/1.6__._ r 7/24/16
Location and description
4rrt __.._m.. -- Garage Slab
COMMUNITY DEVELOPMENT CEPA T 3E " APP OVAL
Conditional Approval; Date
'Oeco
.- 49
T
.,«.......
I
...
`« Michael E. Anderson�01 «'
43Eit_E
Approved .._. � '. ' ' ?` . _ Date .. t OPR. SS- � W,
- _ - ...__
Inspection Report. 9-1-12.doc
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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: OSP161198
1.1
95,8
00
0
Page 3 of 3
PID No. 015-272-94
INU 1-71 UU1 JUVvdLt:�1 414 it I '+
60' (Trench Length)
PROFILE AS--BUILT-
No Scale
49th
................ C111<_J11'
441CHAEL E..ANDERSON
% No. CE -4381
kit
MW
On -Site Wastewater Disposal 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: OSP161198
Tax Code Number: 01527294000
Work Type: Septic Upgrade
Permit Effective Dates: July 14, 2016 to July 14, 2017
Design Engineer: ANDERSON ENGINEERING
Subdivision: CHEROKEE RIDGE
Site Legal Address: CHEROKEE RIDGE LT 1 G:2635
Owner/Address: Hultquist Homes, Inc.
12580 Old Seward Highway Anchorage AK 99515
Site Mailing Address: 11448 ELMORE RD, Anchorage
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank N Privy
All construction must be in accordance with:
Lot Size in Sq Ft: 57246
Total Bedrooms: 5
N Private Well N Water Storage
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater
Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80).
3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received
Issued By
MUNICIPALITY OF ANCHORAGE
� eeik_"�)j
Community Development Department 'Phone: 907-34
Development Services Division ` RUSH! + Fax: 90 i® d)
On -Site Water & Wastewater Program J u
you
ON-SITE SEWER/WELL PERMIT APPLICATION �uL 1 � 13
a
Parcel l.D.015-272-94 sy�
Property owner(s) Hultquist Homes, Inc. Day phone t� « ni a Q L0
Mailing address 12580 Old Seward Highway Anchorage, AK 99515
Site address NHN Elmore Road Anchorage, AK 99516
Legal description (Sub'd., Block & Lot) Cherokee Ridge, Lot 1
Legal description (Township, Range & Section)
Lot Size 57,246 Sq. Ft. Number of Bedrooms
Five (5)
APPLICATION IS FOR: APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field E] Initial ❑
Single Family (SF) El
ADU)
Septic Tank ElUpgrade El(w/wo
Duplex (D) ❑
Holding Tank F-1Renewal ❑
Multiple Dwellings ❑
Privy ❑
(SF and/or D)
Private Well ❑
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.a, ,
(Signature of property owner or authorized agent)
Permit/Rush Fees: I$ q10,0 0 Waiver Fees:
Date of Payment:
Receipt Number:
Permit No.
Permit App_9-1-12.doc
Date of Payment:
Receipt Number:
Waiver No.
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 FAX
July 11, 2016
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 1, Cherokee Ridge Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 1, Cherokee Ridge Subdivision intends to construct a new five -
bedroom home on the lot. The recently completed septic system was only constructed
for four bedrooms. We are therefore requesting a permit be issued for the
reconstruction of the septic system to accommodate the home. The attached Site Plan
and backup documentation identify the location and configuration of the existing well
and proposed septic system along with the alternate site. Also identified on the plans
are the existing wells in the area and septic systems on surrounding lots. No conflicts
exist between the proposed septic system and well or septic systems and wells on
adjacent lots. Drainage 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
areshown on the Site Plan. The test holes indicated silty gravel with sand (GM). The
percolation rate of the soil was determined to be 6-15 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 remove the
existing 1,250 gallon septic tank and place a new 1,500 -gallon septic tank. The existing
absorption trench will be extended to a total of 60' 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 3' below the surface and
the total depth will be 11'. 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.
Lot 1, Cherokee Ridge Subdivision
July 11, 2016
Page Two
The ground surface on the lot in the area of the septic system slopes to the west at a
shallow grade with some cross sloping. 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 140' 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:
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,
Si� Fjj D
7
Michael E. Anderson, P.E.
Attachments
W�'e,
" 49th _
MICHAEL E. ANDERSON
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LOT 1, CHEROKEE RIDGE SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Five Bedroom Home Deep Trench System
Pere. Rate: 12.6 Min./Inch 1,500 Gallon Septic Tank
Application Rate: .8 GPD/SF 8' Drainfield Rock
5 Bedrooms X 150 GPD/.8 GPD/SF (Application Rate) = 937.5 SF Absorption Area
937.5 SF/16 SF/LF = 58.6 LF Trench Length
THEREFORE: Remove the existing 1,250 gallon septic tank and place a new 1,500 gallon septic tank
at the same location. Extend the existing absorption trench to a total length of 60'x 3' wide x 8' effective
depth. Flow line in the trench to be placed at the same elevation as the existing line. The total depth of
the trench shall be the same depth as the existing trench. Provide a minimum of 3' of cover over the
distribution line and 4' over the septic tank. All components of the septic system must be 100' from all
private wells in the area.
Natural
Backfill
2'6"
Geotextile
Fabric
6, :0:: 4" Perforated
PVC (Holes Down)
M
3'
Drainfield Rock
TYPICAL DEEP TRENCH SECTION -••.�
(NO SCALE)
NOTE: Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock. 49tH
Minimum 4' Separation From Groundwater. �
31.E :...............
Minimum 100' Separation From Wells in the Area. MCNAEL E. ANDERSON
Minimum 100' Separation From Surface Water or Streams. ���; ?:, No. CE4391 ,•'A
Municipality of Anchorage
On -Site Water and Wastewater Program • (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP161013 PID Number: 015-272-94
Dwelling: 0 Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: 0 New ❑ Upgrade
Name:
White Raven Development, Inc.
ABSORPTION FIELD
N Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound
Address
12580 Old Seward Hwy. Anchorage, AK 99515
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
4
.8 GPD/SF
11 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
3 Ft.
Gravel depth beneath pipe
8 Ft.
Subdivision Block Lot
Cherokee Ridge 1
Fill added above original grade
,rj-1 Ft.
I Gravel length
50 Ft.
Township Range Section
Gravel width
3 Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
I
From
Tank
Field
Tank
Line
800 Ftz
One
Ft.
Well
>100'
>100'
>100'
>75'
>25'
TANK IN Septic ❑ S.T.E.P. ❑ Holding ❑ other
Manufacturer
Anchorage Tank
Capacity
1 1,250 Gal.
Surface Water
>100,
>100'
NA
NA
Material
Number of compartments
Lot Line
>5'
>10'
NA
NANA
Steel
Two
Foundation
>5'
>10'
NA
NA
LIFT STATION
Manufacturer
Capacity
Curtain Drain
None
I 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 Housetotank D3034 drainfieldTankto
D3034
White Raven Development, Inc.
Drainfleld-R 0 C0/MT
Inspector W. Roberts
BENCH MARK (Assumed elevation) 100.0 ft
Inspection
1d 5/12/16 5/12/16
Location and description
da es: 2otl
aro 4m
Garage Slab
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
��"Q��
�•�� OF '!4 Rot
Conditional Approval: Date
= �`P• S�®�®
Poo,01
..................................
f�-.MICHAEL E. ANDERSON :C- 0
J : CE -4381
�V'P,fOFr
Arove
Pp i . ✓� Date���
100 �''
Inspection Report_9-1-12.doc
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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: OSP161013
9O W
Page 3 of 3
PID No. 015-272-94
90.5-
LF-_ Drainfield Rock
82.5 ,e,— 76.5
50' (Trench Length)
PROFILE AS -BUILT
No Scale
� 90.5
82.5
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION:
PERFORMED FOR: _
DATE: 5/12/16
PARCEL ID#:
DEPTH
(feet)
1 � OB/OG
2
PROJECT No.:
TECHNICIAN:
TEST HOLE lA
3 Silty Gravel
GM
4
5
6 B.O.H.
7
8
9
W. Roberts
SLOPE
SITE PLAN
See Site Plan
LO
READING
WAS GROUND WATER ENCOUNTERED? No
NET TIME
(MINUTES)
DEPTH TO
WATER
(INCHES)
IF YES @ WHAT DEPTH?
11
TEST HOLE PRESOAKED PRIOR TO TESTING:
0
DEPTH OF WATER AFTER MONITORING: O
It—
1
2:08
DATE OF MONITORING:
I
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH TO
WATER
(INCHES)
NET DROP
(INCHES)
5/12
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
2:08
0.75'
2
2:38
30
2.88^
2.13"
3
2:40
0.88°
4
3:10
30
3.00°
2.12"
5
3:11
0.75^
6
3:41
30
2.88"
2.13"
PERCOLATION RATE: 14.2 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN: 4 FT. and 5 FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST COMPLETED TO VERIFY ABSORPTIVE
CHARACTERISTICS OF SOIL LENSE.
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: 6/24/2016
1
Alpine Drilling & Enterprises
Well Log
Permit Number: #SW 161013 Date of Issue: 2-1-16 Parcel Identification Number: 01527294000
Date Started: 2-15-16 Date Completed: 2-17-16 Is well located at approved permit location? x Yes ❑ No
Legal Description: Cherokee Ridge Lot 1
Property Owner Name & Address: Hultqui t Homes, Inc
12580 Old Seward Highway
Anchorage, Alaska 99515
Borehole Data:
Soil Type, Thickness & Water Strata
Depth (ft)
From To
Method of Drilling x air rotary ❑ cable toot
Casing type: steel
stick-up
0
2
Wall Thickness:.250 inches
organics & sill
silt
2
3
3
4
Diameter. 6 inches Depth: 168 feet
Liner Type:
Diameter: ^ inches Depth: _ feet
gravelly silt
4
20
Casing stickup above ground: 2 feet
Static water level (from ground level): 147 feet
cobblygravel 20 35
silty cobbly gravel
35
58
Pumping level: 167 feet after
gravelly silt
58
95
2 hours pumping 7 gpm
Recovery Rate: 7 gpm
silty gravel
95
145
Method of Testing: air li r
silt
145
160
Well Intake Opening Type:
silty gravel
160
165
x Open End ❑ Open Hole
silty water sand & gravel
165
168
❑ Screened Start _ feet Stopped feet
❑ Perforations Start _ feet Stopped _ feet
Grout Type: bentonite granules Volume: 2 b¢s
Depth: Start 0 feet Stopped ? feet
Pump: Intake Depth _ feet
Pump size _ hp Brand Name
Well Disinfected Upon Completion? x Yes E] No
Method of Disinfection: chlorine tablets
WATERUALITY TESTING
WNorm IN a q C01.1100mi.
Nt Tme 5- 7 R
Comments:
Arsenic IV ug/l
Well Driller: Alpine Drilling &Enterprises
PO Box 110496
Anchorage AK 99511
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box I96650
MadrBegich Anchorage, AK 99507
Mayor wwwmeorofamlte
(907)343-7904
Pump Installation Lo
Well Drilling Permit Number: SW MOO Date ofIssueg�
Parcel Identification Number: 015 Alai
Le cqpuon rragerI OwnerI saptine
�i �t`�i
1.1610 old teiPtl;�
Pump Installation Date: D i f I Zo
Pump Intake Depth Below Top of Wen casing; 1W feet
Pump Manufacturer's Name: {✓f �ti� t [ W'
Pump Model: Z A 601
Pump Size* hp
Pidess Adapter Burial DepthAA feet
Pitless Adapter Manufacturer's Name:
Pittess Adapter Installer: ttt
Well Disinfected Upon Completion? K Yes ❑ No
Method of Disinfection:
Comments: ,
Pump Installer Name:
Aarow Pump & Well Service
P.O. Box 110496
Anchorage, AK 99511-0496
Attention: The pump installer shalt provide a pump installation log to the DSD within 30 days of pump installation.
Please save for your engineer.
This is needed for your COSA.
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:
OSP161013
Tax Code Number:
01527294000
Work Type:
WellSeptic Initial
Permit Effective Dates: February 01, 2016 to January31, 2017
Design Engineer:
ANDERSON ENGINEERING
Subdivision:
CHEROKEE RIDGE
Site Legal Address: CHEROKEE RIDGE LT 1 G:2635
Owner/Address: HULTQUIST HOMES INC
12580 OLD SEWARD HIGHWAY ANCHORAGE AK 995153506
Site Mailing Address: 11448 ELMORE RD, Anchorage Lot Size in Sq Ft: 57246
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.
[approval.
cial Provisions:
proposed system is in a different soil stratum than the strata that was tested. The Engineer
ds to do an additional percolation test in the upper strata prior to the construction of the septic
. Please submit stamped and signed results with the As -built Inspection Report. If the results
uire a design change, construction of the system willstop pending On -Site review and
AMC 15.65.060.B.2
Received
Issued By:
_.ZI(hW
Date:
8 9
MUNICIPALITY OF ANCHORAGE �\
JNV [ i�
Community Development Department Phone: 90 904 5
Development Services Division Fax: 907-3 97s 6 9
On -Site Water & Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 015-272-94
Property owner(s) Hultquist Homes, Inc. Day phone
Mailing address 12580 Old Seward Highway Anchorage, AK 99515
Site address NHN Elmore Road Anchorage, AK 99516
Legal description (Sub'd., Block & Lot) Cherokee Ridge, Lot 1
Legal description (Township, Range & Section)
Lot Size 57,246 Sq. Ft. Number of Bedrooms
Four (4)
APPLICATION IS FOR: APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field 0 Initial Fi
Single Family (SF)
El
(w/wo ADU)
Septic Tank E Upgrade ElDuplex
(D)
ElHolding
Tank ElRenewal 13
Multiple Dwellings
❑
Privy ❑
(SF and/or D)
Private Well
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE I WAIVER REQUEST
FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
Z
owner or authorized agent)
Permit/Rush Fees: S(oI -t A IS = 7tq Waiver Fees: _
Date of Payment: I ht!s-) (o Date of Payment:
Receipt Number: CA Receipt Number:
Permit No. 0001 to Waiver No.
Permit App 9-1-12.doc
January 14, 2016
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 1, Cherokee Ridge Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 1, Cherokee Ridge 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. Also identified on the
plans are the existing wells in the area and septic systems on surrounding lots. No
conflicts exist between the proposed septic system and well or septic systems and wells
on adjacent lots. Drainage 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 hole placed on the lot in the area of the absorption trench and alternate site is
shown on the Site Plan where it was surveyed in and not as shown on the test hole log.
The test hole indicates silty gravel with sand (GM). The percolation rate of the soil was
determined to be 12.6 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 1,250 -gallon septic tank and a 50'
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 3' below the surface and the total depth will be 11'. 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.
Lot 1, Cherokee Ridge Subdivision
November 21, 2014
Page Two
The ground surface on the lot in the area of the septic system slopes to the west at a
shallow grade with some cross sloping. 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' 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:
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
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10'30'
150.00'
LOT 1, CHEROKEE RIDGE SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Four Bedroom Home Deep Trench System
Perc. Rate: 12.6 Min./Inch 1,250 Gallon Septic Tank
Application Rate: .8 GPD/SF 8' Drainfield Rock
4 Bedrooms X 150 GPD/.8 GPD/SF (Application Rate) = 750 SF Absorption Area
750 SF/16 SF/LF = 46.8 LF Trench Length
THEREFORE: Construct a 50' Long x T Wide x 8' Effective Depth Absorption Trench at the Location
Shown. Flow Line Elevation in Trench to be 3' Below Original Ground Surface. Total Depth to be 11'
Below EAsting Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption Trench. Maintain
100' Separation from Wells in the Area.
Natural
Backfill
2'6"
Geotextile
Fabric
6" O 4" Perforated
PVC (Holes Down)
I
3'
Drainfield Rode
TYPICAL DEEP TRENCH SECTION
(NO SCALE)
NOTE: Grade Area Over Trench to Drain Away. : t�
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.- i}
MICHAELE.ANMR N
SOILS LOG - PERCOLATION TEST
TEST HOLE 1
SLOPE
J
OR ORGANICS
2
3—
L
GM TIGHTSILTY
GRAVEL
4-
5
GRADUAL SOIL
X
INTERFACE
TH
7
8
9 —
Al
Ij
10 —
7.
11
GM/SM SILTY SAND
4
12 AND GRAVEL
2
13
WAS GROUND WATER SLOPE
14
ENCOUNTERED? Y
15
IF YES, AT WH TH
DEPTH? NONE' X
16
17BOH
DEPTH TO WATER AFTER
MONITORING? NONE'
18 -
DATE: 4/21/2014
DATE PERFORMED: 4114114
READING DATE CLOCK WATER
TIME NETTIME LEVEL NET DROP
READING
1 4114114 12:36 — 6.67
2 1:06 30 MIN 8.34 2.77
3 1:08 --- 5.42
4 1:38 30 MIN 7.90 2.48
5 1:41 5.42
6 2:11 1 30 MIN I 7.8T 2.39
PEROLATION RATE 12.6 (minlinch) PERC HOLE DIAMETER 6 inches
TEST RUN BETWEEN 5.5 FT AND 6.5 FT
COMMENTS: Test hole excavated by Brian T. Harten. Prec hole was presoaked. Perc test ran for
at least 1.5 hours. Last three readings reported. Bottom of pert hole in GM/SM. Test performed in
representative soil.
PERFORMED BY: Steven R.
Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST.
NOTES:
PANNONE ENG SVC, LLC
?�Vk
Date
SOILS LOG
P.O. BOX 102954 ANCHORAGE, AK 99510
5/27/2014
Scale
PHONE (907) 272-8218 FAX (907) 272-8211
w
.... ..
NTS
P.I.D. NO
T12N R3W, SEC 21 N2SE4SE4NE4
BRIAN T. HARTEN
ELMORE
............ ............
Steven R. Panno ' ne
CE 149
'ef-5-272-222
PERMIT NO.
X
Sheet
SOILS LOG
ANCHORAGE, AK 99516
......
k\�"q?OFESS
2 OF 5
� -- / .1 Cd
n
MUWC�PAUTY OF ANCHORAGE
A
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. 015-272-94 Expiration Date: I" P— Z 0 Z O
1. GENERAL INFORMATION
Complete legal description -CHEROKEE RIDGE LOT 1
Location (site address) 11448 ELMORE ROAD, ANCHORAGE, AK 99516
Current property owner(s)
Mailing address
Real estate agent
& STEVEN SAUDER
Day phone
11448 ELMORE ROAD, ANCHORAGE, AK 99516
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
5
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
®
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 $ Ll 19,56 ( 19) Waiver Fee $
Date of Payment // / -)- d'q 0 Date of Payment
Receipt Number b I q o4 5 Receipt Number
COSA# 0SC),0 1`f0-3
Waiver #
COhGi��rUna $21750 Gc�t/�IJ
P°"� g/Itlzow
'rW14i* 31tvis 1�
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 FIRST WATER CONSULTING Phone 907-350-9566
Address 13030 SUES WAY, ANCHORAGE, AK 99516
Engineer's Printed Name CURTIS HUFFMAN, PE Date 8/1/2020
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
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 in land use,
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
system and maintenance. 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, any estimate of how long a system will function satisfactory /��g�Q: • • . • •!1•,9 ���
for current or future occupants or guarantee that no unseen encroachments, deficiencies or _ J
discrepancies exist can be given by First Water Consulting & FWB * • 9 TH
....:* r
;V1.�
6. DSD SIGNATURE %r Curtis Huffman /
System #1 Approved for _ bedrooms ����F,q�s••. CE 128991
System #2 Approved for bedrooms TF�F�pROFES5O�'
Disapproved
Conditional approval for bedrooms, with the following stipulations:
R,e bA,(y-Q S Vim► c S PaDTI G
WAST'=OVER ?
� )TSER\Arl
Original Certificate Date:'yI�I�`�% Z -U
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
Legal Description: CHEROKEE RIDGE LOT 1 Parcel ID: 015-272-94
If more than 1 septic system on lot: COSA Checklist # _of
A. WELL DATA
® Well log is filed with Onsite (or attached)
Date drilled 2/17/2016
Total depth 168 ft
Cased to 168 ft
® Sanitary seal is functioning correctly
® Wires are properly protected
Casing height (above ground) 24+ in
Date of flow test for COSA 7/22/2020
Static water level at beginning of test 161 ft.
Well production at time of test 5.9 gpm
Comments
B. TANK DATA
Age of tank(s) 4 years
Tank type/material SEPTIC / STEEL
Measured operating fluid level in septic tank 49"
® Standpipes/foundation cleanout per record drawing
Date of pumping 7/22/20
D. ABSORPTION FIELD DATA
Which system tested (date installed) 7/24/2016
® 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
® Monitor tubes go to bottom of effective. If not, state
depth into effective
Structure served by this system _
Water storage tank volume NA gallons
Well disinfected for coliform test? ❑ Yes ® No
® Coliform bacteria is Negative
Nitrate 4.34 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ® Arsenic less than MRL (ND)
WE
Collected by « y°
Date of Sample 7/22/2020 --
C. LIFT STATION
❑ Required maintenance completed
Age of lift station _ years
Lift station material
Comments: See attached letter.
Adequacy test date 7/24/2020
Results Z Pass For 5 bedrooms
Fluid depth prior to test 77 in
Water added 1070 gal
New depth 89 in
Elapsed time 1440 min
® Code -required soil cover over field Final fluid depth 79 in
❑ System presoaked Absorption rate 750 gpd
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N
date of test) If yes, enter date
Gallons introduced gallons FWES
Comments/Deficiencies: See attached letter — field operating in top 2' of the 8' effective depth. � ,.9
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'
® Yes
if No
Community Sewer Manhole/Cleanout > 100'
® Yes
if No
ft
® Yes
if No
Neighboring Tank > 100' ® Yes
if No
ft
Private Sewer/Septic Line > 25' ® Yes
if No
Absorption Field on Lot > 100' ® Yes
if No
ft
Holding Tank > 100' ® Yes
if No
Neighboring Absorption Fields > 100'
if No
ft
Animal Containment > 50' ® Yes
if No
® Yes
if No
ft
ft
If septic tank is under driveway comment below
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ® Yes
if No
ft
® Yes
if No
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
® Yes
if No
ft
Surface Water > 100'
® Yes if No
Property Line > 5'
® Yes
if No
ft
Wells on Adjacent Lots:
® Yes
Absorption Field > 5'
® Yes
if No
ft
Private Wells > 100'
® Yes if No
Water Main > 10'
® Yes
if No
ft
Community Wells > 200'
® Yes if No _
Water Service Line > 10'
® 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'
® Yes
if No
_ ft
Wells on Adjacent Lots:
Water Main > 10'
® Yes
if No
ft
Private Wells > 100' ® Yes if No —ft
Water Service Line > 10'
® Yes
if No
ft
Community Wells > 200' ® Yes if No
Surface Water > 100'
® Yes
if No
ft
F. ENGINEER'S COMMENTS
See attached letter regardinq septic tank / deck supports and field.
G. ENGINEER'S CERTIFICATION
l certify that l 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.
.... .... .....
r • Curtis Huffman
CE 128991 ,• w�
.8/3/202,0. t
��� pROfESS1��A
ft
ft
ft
ft
ft
ft
ft
ft
MUNMWAUTY F
Development Services Department
On -Site Water & Wastewater Section
Parcel I.D. 015-272-94
Certificate of On -Site Systems Approval
1. GENERAL INFORMATION
Complete legal description -CHEROKEE RIDGE LOT 1
Phone: 907-343-7904
Fax: 907-343-7997
Expiration Date: 1- P- Z 0 Z 0
Location (site address) 11448 ELMORE ROAD, ANCHORAGE, AK 99516
Current property owner(s) LISA & STEVEN SAUDER Day phone
Mailing address
Real estate agent
11448 ELMORE ROAD. ANCHORAGE. AK 99516
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
5
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
®
Private Septic
Water Storage
❑
Holding Tank
❑
Community Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Waiver request for: Distance:
Received by:
COSA to be released to the engineer, unless otherwise requested by the engineer.
Date:
COSA Fee $ a, 5 U �C� ! �' `�> Waiver Fee $
Date of Payment y D'q 0 Date of Payment
Receipt Number I q OS 5 Receipt Number
COSA # a SC,� a 1 `-J 0-3 Waiver #
CO�G���ivna� $21750 CvL/14,_)
P°`'d S/I(J2ow
rWA;-Pi* 3 1 t � SIS
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 FIRST WATER CONSULTING Phone 907-350-9566
Address 13030 SUES WAY, ANCHORAGE, AK 99516
Engineer's Printed Name CURTIS HUFFMAN, PE Date 8/1/2020
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
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 in land use,
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
system and maintenance. 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, any estimate of how long a system will function satisfactory
for current or future occupants or guarantee that no unseen encroachments, deficiencies or
discrepancies exist can be given by First Water Consulting & FWCS
6. DSD SIGNATURE
System #1 Approved for
System #2 Approved for
Disapproved
Conditional approval for
_ bedrooms
bedrooms
z
4��11r .
g�P•��TA
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• • ' Curtis Huffman• • •' • •�
It�'F,•. CE 128991 •.•����
dT��• • .Q/1/2Q20'����
lliF�PROFESSOX�
S- bedrooms, with the following stipulations:
e�OfI C 4
WATER AN9 M!::
J0 WAST'_vt'ATER z^
/ J/JJ',f.4SER. \G ,
B 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 engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
Legal Description: CHEROKEE RIDGE LOT 1 Parcel ID: 015-272-94
If more than 1 septic system on lot: COSA Checklist # _of
A. WELL DATA
® Well log is filed with Onsite (or attached)
Date drilled 2/17/2016
Total depth 168 ft
Cased to 168 ft
® Sanitary seal is functioning correctly
® Wires are properly protected
Casing height (above ground) 24+ in.
Date of flow test for COSA 7/22/2020
Static water level at beginning of test 161 ft.
Well production at time of test 5.9 gpm
Comments
B. TANK DATA
Age of tank(s) 4 years
Tank type/material SEPTIC / STEEL
Measured operating fluid level in septic tank 49"
® Standpipes/foundation cleanout per record drawing
Date of pumping 7/22/20
D. ABSORPTION FIELD DATA
Which system tested (date installed) 7/24/2016
® 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
Structure served by this system
Water storage tank volume NA gallons
Well disinfected for coliform test? ❑ Yes ® No
® Coliform bacteria is Negative
Nitrate 4.34 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ® Arsenic less than MRL (ND)
WES
Collected by-=
Date of Sample 7/22/2020 --
C. LIFT STATION
❑ Required maintenance completed
Age of lift station _ years
Lift station material
Comments: See attached letter.
Adequacy test date 7/24/2020
Results M Pass For 5 bedrooms
Fluid depth prior to test 77 in
Water added 1070 gal
New depth 89 in
® Monitor tubes go to bottom of effective. If not, state
Elapsed time 1440 min
depth into effective
® Code -required soil cover over field Final fluid depth 79 in
❑ System presoaked Absorption rate 750 gpd
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N
date of test)
Gallons introduced gallons If yes, enter date
FRES
Comments/Deficiencies: See attached letter — field operating in top 2' of the 8' effective depth. -
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
® Yes
Septic Tank/Lift Station on Lot > 100'
ft
Surface Water > 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'
Community Wells > 200'
® Yes if No ft
Animal Containment > 50' ® Yes
if No ft
® Yes
if No
ft
From Absorption Field on Lot to: (Please enter distances
if
less than required)
Building Foundation > 10'
Manure/Animal Excreta Storage > 100'
if No
Community Sewer Main > 75' ® Yes
if No
ft
® Yes
if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
® 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'
® 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 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'
® Yes
if No
_ ft
Wells on Adjacent Lots:
Water Main > 10'
® Yes
if No
ft
Private Wells > 100'
® Yes if No —ft
Water Service Line > 10'
® Yes
if No
ft
Community Wells > 200'
® Yes if No
Surface Water > 100'
® Yes
if No
ft
F. ENGINEER'S COMMENTS
See attached letter regarding septic tank / deck supports and field.
G. ENGINEER'S CERTIFICATION
1 certify that l 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.
OF A
TH
.... ....•..
• Curtis Huffman
CE 128991 •.����
�F��'PROFEWOL� �
0
F-int
CONSULTING
.
13021 Montego Circle, Anchorage, AK 99516
907-350-9566 / firstwaterAK(a,gmail.com
August 5, 2020
Municipalities of Anchorage
On -Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: CHEROKEE RIDGE LOT 1— ENCROACHING DECK SUPPORTS TO TANK & TESTING
The edge of the septic tank was measured at approximately 2" to the edge of the 4" treated wood deck
support. The tank interior was visually inspected via camera by One Stop Services to verify integrity and no
damage or penetration was observed. As of the date this letter, Mike N. Anderson is to drive or install deck
pilings to the tank bottom elevation prior to closing. We will verify this has been completed and notify you
prior to COSA issuance.
Septic adequacy testing and visual inspection note: Water was initially added to the field cleanouts during
the commencement of the adequacy test. However water immediately began to back into the tank, even
though fluid levels in the monitoring tubes were below the field lateral. Therefore the adequacy test was
conducted via the monitoring tubes with no backing into the tank. Elevations were checked between the
field and post tank inverts and were determined to be as noted on the inspection report. Subsequently, we
had the field lateral line jetted / cleaned. The field is operating in the top 2' of the 8' effective depth
(80%+/- saturated).
Please contact us if you have any questions.
Respectfully,
Curtis Huffman, P.E.
Attachments: COSA Submittal
0
First
r C O N S U L T I N G
rt� ;C ,tC
13021 Montego Circle, Anchorage, AK 99516
907-350-9566 / firstwaterAKngmaii.coin
August 8, 2020
Municipalities of Anchorage
On -Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: CHEROKEE RIDGE LOT 1— ENCROACHING DECK SUPPORTS TO TANK
Per the previously submitted letter — the encroaching deck supports to the existing septic tank are to be
addressed by Mike N. Anderson, PE. Please see attached proposal. There is currently no immediate
public health or safety issues based on visual observations and due to contractor availability request a
Conditional COSA be issued at this time to facilitate the pending closing.
We will submit final COSA once completed. If you want to inspect the installation of the deck supports,
please contact us or Mike directly. Please contact us if you have any questions.
Respectfully,
Curtis Huffman, P.E.
Attachments: Mike N. Anderson Proposal
h A'1
®
Municipality of Anch � ��� 2 gyp`' ° > G
On -Site Water and Wastewater Pro a lv
(907) 343-7904q S A F E T Y ^
62L � 0
LLa66
Certificate of On -Site Systems Approval
Parcel I.D. 015-272-94 Expiration Date: q-2-14-1�o
1. GENERAL INFORMATION
Complete legal description Cherokee Ridge, Lot 1
Location (site address) 11448 Elmore Road Anchorage, AK 99516
Current Property owner(s) Hultquist Homes, Inc. Day phone 522-3204
Mailing address 12580 Old Seward Highway Anchorage, AK 99515
Real Estate Agent
2. TYPE OF DWELLING:
FxFi Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: Four
Day phone
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
F.71
Individual
0
Individual Water Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
WaiverNariance request for:,
Received by: I/ Ul V—V 'VI U 1X/ Date: W 2�W- /(a
COSA to be released to the engineer, unless oth mise requested by the engineer.
COSA Fee $ L 1 /. 0 Waiver Fee $
Date of Payment (a /'AL ilm Date of Payment
Receipt Number ®(f ��$�� Receipt Number
COSA# [lJLl6(JIi7 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.
Phone 522-7773
Date�_
®PSE° OF °!� 0
svarw 49TH�� P�4
...._ -_'.. e n ear ®
6. DSD SIGNATURE. b�- � L� c'4"
°°.°
System #1 Approved for bedrooms �g c MICHAEEL 843;ER50 :��ID
System #2 Approved for bedrooms
Disapproved®a9%nVA%����®
Conditional approval for bedrooms, with the following stipulations:
By:. `� t 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 engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSAbluesheel f S 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: Cherokee Ridge, Lot 1 Parcel ID: 0 15-272-94
A. WELL DATA
Well type Private If A, B, or C provide PWSID # Well Log (YIN) Y
Date completed 2/17/16 Sanitary seal (YM) Y Wires properly protected (Y/N) Y
Total depth 168 ft. Cased to 168 ft. Casing height (above ground) >18 in.
Date of test
Static water level
FROM WELL LOG
2/17/16
147
ft.
Well production 7 g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 colonies/190 mL Nitrate 5.79 mg/L
Arsenic ND ug/L Date of sample: 6/10/16
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
C. ABSORPTION FIELD DATA
AT INSPECTION
ft.
a8
Collected by: And. Engineering
Date installed 5/12/16
Cleanouts (Y/N)
Y
High water alarm (Y/N) N
Date installed 5/12/16 Soil rating (g.p.d./ftZ or ftz/bdrm) .8 GPD/SF System type Deep Trench
Length 50 ft. Width 3 ft. Gravel below pipe 8 ft.
Total depth 11.9 ft. Eff. absorption area 800 ftZ Monitoring tube Y Depression over field N
Date of adequacy test New Const. Results (PasslFail) For -Y— bedrooms
Fluid depth in absorption field before test in. Water added gal. New depth in.
Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date
D. LIFT STATION
Date installed
"Pump on" level at
Datum
Size in gallons _
in. "Pump off' level at
Cycles tested _
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot >100,
Absorption field on lot >100,
Public sewer main >75'
Sewer /septic service line >25'
Animal containment areas >50'
SEPTIC/HOLDING TANK ON LOT TO:
>5'
Building foundation Property line >5f
Water main >10' Water service line >10
_ Manhole/Access (Y/N)
in. High water alarm level at in.
Meets alarm & circuit requirements?
On adjacent lots
On adjacent lots
>100,
>100,
Public sewer manhole/cleanout >100,
Holding tank >75'
Manure/animal excrete storage areas >100,
T
Wells on adjacent lots >100'
ABSORPTION FIELD ON LOT TO:
Property line >10, Building foundation >10,
Water Service line >10,
Curtain drain None Noted
F. COMMENTS
Surfacewater >100'
Wells on adjacent lots >100'
G. ENGINEER'S CERTIFICATION
t 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 6/24/2016
COSA brown sheet 10-10-12.doo
Absorption field >51
Surface water >100,
Water main >10'
Driveway, parking/vehicle storage >10'
E 4; WW\
4AEL E. ANDERSON 0
JW
CE -4381
L -zye-16 c;
''RaFES5l0�p���
Municipality of AnchorageED
, Q
Development Services Department ,
Building Safety Division I
i4,FE7Y' e
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
Nitrate Advisory
Certificate of On -Site Systems Approval # OSC161252
A Certificate of On -Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block , Lot
1 of Cherokee Ridge subdivision. This inspection revealed a nitrate
concentration of 5.79 milligrams per liter (mg/L) was reported for the
property's well water sample. The Environmental Protection Agency (EPA)
has established a maximum contaminant level (MCL) of 10.0 mg/L for
public drinking water systems. While private wells are not subject to this
regulation, EPA standards are based on existing health information and can
therefore be used to gauge the relative quality of water from private wells.
Please see the attached "Nitrate Fact Sheet" for important information
regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
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