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HomeMy WebLinkAboutT15N R1W SEC 18 LT 32 Onsite File T15N R1W Sec 18 Lot 32 #051 - 171 - 09 Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP171351 PID Number: 051-171-09 Dwelling: ❑ta Single Family (SF) ❑ Duplex(D) ❑ Multiple(SF and/or D) Project: I■❑ New ❑ Upgrade Name: ABSORPTION FIELD Troy Davis Homes Inc. Address 11 Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound 1689 Knik Goose Bay Rd Suite 440 Wasilla, AK [' Other Phone Number of Bedrooms Soil Rating Total depth from original grade (907) 310-2501 4 0.8 GPD/SF 10 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 3.0 Ft. 7.0 Ft. 32 Fill added above original grade Gravel length Township Range Section 1.0 Ft. 54 Ft. 15N 1W 18 Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES 3.0 Ft. Ft. To Septic AbsorptionHolding Sewer Total absorption area Number of trenches Dist.between trenches Tank Field Lift Station Tank Line From 756 Ft2 1 Ft. Well >100' >100' N/A N/A >25' TANK D Septic 0 S.T.E.P. ❑ Holding ❑Other Manufacturer Capacity Surface Water >100' >100' N/A N/A Anchorage Tank 1,250 Gal. Material Number of compartments Lot Line >5' >10' N/A N/A Steel 2 NA LIFT STATION Foundation >10' >10' N/A N/A Manufacturer Capacity Curtain Drain None Noted Gal. 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 D3034Tank to D3034 Installer drainfield Northern Excavation Drainfield D3034 CO/MT D3034 Inspector C. Johansen, J. Millette BENCH MARK (Assumed elevation) 100 ft Inspectionect1st 2/07/18 2nd 2/07/18 Location and description es: Sd 4th Bottom of siding at East wall. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date iP.s%••....q/gsw.j ,.*: 49TH / vI • 0,A, •MICHAEL E. ANDERSON r `' ' CE-4381 �.. Approve.' v..., �- i Date 7—' - 1��/o•4 i o....•�p�,:�� Inspection Report_9-1-12.doc T15N R1W SEC 18 L32 PERMIT # OSP171351 PID # 051-171-09 N 0 O (n (n N 98.6 - - - 2"40 PSI INSULATION 95.7 94.8 95.1 74.111250 GAL 94.9 SEPTIC TANK r 1 90.8 98.6 FINISH GRADE 0 97.6 ORIGINAL GRADE 94.6 94.6 DRAIM It ROCK 87.6 87.6 54' 81.6 NO GROUNDWATER 10/16/17 H * 49TH \-57*#0 s -O�,..MICHAEL E. ANDERSON : CE-4381 41'3: PROFILE S PROFILE AS-BUILT • ,44,- (NO ;(NO SCALE) ilop ...... �;0FElOQr• T15N R1W SEC18 LOT 32 PERMIT # OSP171351 PID # 051-171-09 % ) iii ' •I ,\ f / AR1S \�A�RES /, / P 4. . r / __ — _ - I , Lot 2 I ; Lot 3f' / �� ,,i . • !ASPFIALT •• . • \ I I i 0 Lot 2 , fr \ , / 1,: • / , c__ , , , / c' ,/ , , , , . . / / ``� a SRN /' O \\�� // .�+'q y •- . TH#2 Lot 32 �► �/ I 0 al (!1 _ �3 I - — pp, 4-BDRM HOME. I 01 " / FC��• Sv. MT1 - �� �' S4'LONG x3'WIDE x7' C) 0 2C0 EFFECTIVE DEPTH � � \ • ABSORPTION TRENCH 1,250 GALLON TH10 \ p / Q/ \ SEPTIC TANK 111 0 // ...'•. M CO.2: N \` il/ EXISTING SE- IC Lot 35 _ ��N.`AN��\ A B _ LEGEND i�p8���� FCO 15.3 23.9 CO-CLEANOUT Q). .9 �� SV1 24.5 26.7 2C0-DOUBLE CLEANOUT *; 491H 1\ , "*, _ SV2 29.9 33.2 FCO-FOUNDATION CLEANOUT g :W 2CO 32.4 35.9 FS-FLOW SPLITTER VALVE / C01 41.8 36.3 FA . Michael E.Anderson.��/ 0 50 100 MT1 42.7 37.0 MH-MANHOLE r#,11,"•.k4".7 C E4 '.•1 ' AO MT2 54.7 80.8 MT-MONITORING TUBE illFoROFESS\0Na+ FEET CO2 56.5 82.9 SV-SEPTIC VENT \\X.N`��` 1"=50' TH-TEST HOLE , Wheaton Water Well, Inc. 1190 N. Wasilla-Fishhook Road Wasilla, AK 99654 (907)376-2041 Name: Troy Davis Homes, Inc. Address: 1689 Knik Goose Bay Road, Suite 400 City: Wasilla State: AK Zip Code: 99654 Well Site: T15N, R1 W, S18 Lot: 32 Block: Additional: Permit #OSP 171351 19907 Juhnke Drive; Chugiak Well Depth: 245 ft. From: To: Formation: Below Ground: 243 ft. 0 53 stickup, silt, gravel Above Ground: 2 ft. 53 69 silt 69 76 sand, silt Gal/Min: 12 76 84 sand, silty water Static Level: 81 ft. - 84 . 115 silt Casing: 134' of 6" ID Steel 115 130 silt, gravel 130 133 soft sandstone Liner Pipe: 120 ft. 133 245 hard sandstone Screened: none Perforated: none Grouted: Bentonite Depth: 20' + 180' fracture, 1 gpm Develop. Method: Air 210' 230' fractures, 11 gpm Use of Well: Residential Drilling Method: Rotary WATER QUALITY TESTING j Conform Ne Co1/100mL Misc.: Well disinfected with Nitrates ,J mg/L Misc: chlorine 50 ppm Arsenic 2. gL Other: none pate Drilled: 2-13-2018 Driller: Ben Mattson Development Services Department Building Safety Division • Vi; ,;%,;; ' ' p, t e< z < ,:.,: On-Site Water & Wastewater Program o ::,ii, 4700 Elmore Road , P.O. Box 196650 ` 'IA N.i c Mark Begich Anchorage, AK 99507 SiFEY Mayor www.muni,org/onsite (907)343-7904 Pump Installation Log Well Drilling Permit Number: SW OSP171351 Date of Issue: 11-27-2017 Parcel Identification Number:051-171-09 Legal Description Property Owner Name& Address: T15N,R1 W,S18;LOT 32 Troy Davis Homes,Inc. 19907 Juhnke Drive 1689 Knik Goose Bay Road#400 Chugiak,AK Wasilla,AK 99654 Pump Installation Date: 4-25-2018 Pump Intake Depth Below Top of Well Casing: 213 feet Pump Manufacturer's Name: Myers Pump Model: 3NFL72-8-P4-01 Pump Size 3/4 hp Pitless Adapter Burial Depth: 11 feet Pitless Adapter Manufacturer's Name: Harvard Pitless Adapter Installer: Unknown Well Disinfected Upon Completion? 17] Yes ❑ No Method of Disinfection: sterilene Comments: 8 gpm pump Pump Installer Name: Wheaton Water Well,Inc. 1190 N.Wasilla-Fishhook Road Wasilla,AK 99654 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. ciP %.1'k A"r 00 MUNICIPALITY OF ANCHORAGE On-Site Water& Wastewater Program PO Box 196650 4700 Elmore Road _ f. . 4 Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 " http://www.muni.org/onsite 111161-1 .. 1)chartnuenl 4hCH ON pVE On-Site Water & Wastewater System Permit Permit Number: OSP171351 Effective Date: 11/27/2017 Work Type: WellSeptic Initial Expiration Date: 11/27/2018 Tax Code Number: 05117109000 Site Legal Address: T15N R1W SEC 18 LT 32 G:1155 Site Mailing Address: 19907 JUHNKE DR, Chugiak Owner: TROY DAVIS HOMES INC Lot Size in Sq Ft: 81457 Design Engineer: FORGE ENGINEERING Total Bedrooms: 4 This permit is for the construction of: Er Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy 0 Private Well ❑ Water Storage All construction shall 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 shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: (,)/A f(,{, � A , Date: I I Issued By: RiJt4QcL GDOLtrQS JJJ Date: 11 . 01 Co MUNICIPALITY OF ANCHORAGE 13 2017 ti Community Development13 2017 t 46 Phone. 907-343-7'eir Development Services Division Fax: 907-343-799 On-Site Water& Wastewater Program ON-SITE SEWERNVELL PERMIT APPLICATION Parcel I.D. 051-171-09 Property owner(s) Troy Davis Homes, Inc. Day phone 310-2501 Mailing address 1689 Goose Bay Road No. 400 Wasilla, AK 99654 Site address 19907 Juhnke Drive Chugiak, AK 99567 Legal description (Sub'd., Block& Lot) Legal description (Township, Range & Section) T15N R1W Section 18 Lot 32 Lot Size 81,457 Sq. Ft. Number of Bedrooms Four (4) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field 0 Initial Single Family (SF) 0 (w/wo ADU) Septic Tank Upgrade ❑ Duplex (D) ❑ Holding Tank ❑ Renewal ❑ 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. E (Signature of property owner or authorized agent) Permit/Rush Fees: ff`1 Waiver Fees: Date of Payment: 11/1 4/7' Date of Payment: Receipt Number: 65 A Receipt Number: Permit No. USPfl'L351 Waiver No. Permit App__-: : ..:c; v) ' GE N G I N [ E NIM G PO BOX 240773 ANCHORAGE,AK 99524 522-7773 677-7766(FAX) November 16, 2017 Municipality of Anchorage Development Services Dept- On-Site Water& Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: T15N R1W SECTION 18 Lot 32 Septic system design and permit application Dear On-Site Services Engineer: The owner of the above lot intends to build a 4-bedroom home on the property, so we are submitting this permit application for the construction of a new well and septic system. The attached site plan identifies the location of the home as well as the proposed well, septic location and alternate site.No conflicts exist between this proposed system and any wells, whether on this lot or adjacent lots. Drainage arrows and ground surface contours are shown on the site plan showing the grade and direction of flow. The drainage pattern in general will not be changed by the construction. The test holes placed on the lot indicate silty sand (SM). No groundwater or bedrock was found down to 16'. The percolation rate was determined to be 3.5 to 10.9 min/in. An application rate of 0.8 gpd/sf was used in the design of the absorption system. We are proposing to place a new 1250- gallon septic tank with a deep absorption trench 3' wide x 54' long x 7' effective depth. The elevation of the distribution line will be 3' below the surface for a total depth of 10'. Soil will be mounded 0.5' above the trench. A minimum of 3' of fill or 2" of insulation and 2' of fill will be placed over the absorption trench and 4' of fill over the septic tank. The ground surface on the lot is fairly flat, between 5-8%, and slopes to the southwest in the area where the trench will be placed. The new trench will be constructed parallel to the slope as much as possible. It will be a minimum of 100' from all wells and surface water, and more than 5' away from the septic tank. The alternate site is located more than 14' away. If the system is constructed as designed, it will have no adverse impact: • On the wells in the area or those to be constructed in the future. • On existing septic systems in the area or those to be constructed in the future. • On reserve space on any lots located in the area. • On drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Benjamin Schiller, PE oF IA Ben in Schiller : frctts•. Cq 12592 .•'zr-/ l `,0 ROFESSIW�� T15N R1 W SEC18 LOT 32 /� ( / } i / ; 1 c ACRS i / r P R 1 . - ---__ 1 / L 1 Lot 2 I,- , , Lot 3 - / �_ —e � . I 11 -'\ _----c-7I j I i 0 Lot 2 \ / I I �\ 7 \\ / 252•5 �� 1,� `\c. \ , , 255.09----- j--\ 6\ 1 •\ .....,_____76-... 7_--- , <6 , N / 252' I PROPOSED / '.�/ ril 54'LONG x 3'WIDE x 7' WELL 1 t. _ Ttt2 i EFFECTIVE DEPTH x /--. — • i ABSORPTION TRENCH J (-4/i Lot 3 - �. 1 :I-7/ / -_- __ / 250.0 CO- 1 I-/-- SV SV FCO �-1 ,• /• \ \ 4-BDRM HOME � .� 1,250 GALLON / 1/) � • 2y 2 4 SEPTIC TANK / z /( —2SSo \ •1y°I° 11 TH# ,\ 1 ( 2 p . \ < l. h / \I \ i. < _ o --- O / h0. ,tip. ti ALTERNATE SITE EXISTING SEPIC j Lot 35 I ,,`F Al NOTE LEGEND i gyp � Itg NO SLOPES>25%WITHIN 50'OR SURFACE WATER WITHIN 100'OF THE PROPOSED SEPTIC SYSTEM CO-CLEANOUT TM• i */� 2CO DOUBLE CLEANOUT ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH FCO FOUNDATION CLEANOUT WELLS OR SEPTIC SYSTEMS. NO CONFLICT WITH SEPTIC SYSTEM ON LOT 2,JUHNKE. FS FLOW SPLITTER VALVE •.•• Beniarnj Schiller 0 9•'. 0 50 100 MH MANHOLE �+�slF• "°""z'°s2 '•���� - — _ FEET MT-MONITORING TUBE +I‘VPROris.V \• SV-SEPTIC VENT \\X\`-:,� 1"=50' TH-TEST HOLE T15N R1W SEC18 LOT 32 DESIGN FACTORS: SYSTEM REQUIREMENTS: 600 GPD PEAK FLOW 3' WIDE DEEP TRENCH SYSTEM PERK RATE: 10.9 MIN/IN 1,250-GAL SEPTIC TANK APPLICATION RATE: .8 GPD/SF 600 GPD/ .8 GPD/SF I 7' DEEP /2 SIDES = 53.57 LF Trench Length THEREFORE: CONSTRUCT AN ABSORPTION TRENCH 54' LONG x 3'WIDE x 7' EFFECTIVE DEPTH. FLOW LINE ELEVATION IN TRENCHES TO BE 3' BELOW ORIGINAL GROUND SURFACE. TOTAL DEPTH TO BE 10' BELOW EXISTING GROUND. PROVIDE 3' COVER OVER TRENCHES AND 4' COVER OVER SEPTIC TANK, OR INSULATION WITH 2' COVER. 6" JJ_C-E— I►— I ll= . . I -i—�E�k1 ifi11EE1fTfIT -1L-i1 _ _ - 1 - - -Lk-1,ITLITT 2'-6" —111=111—.111—I=11 1� TTT 7f 1TI- 17 IHT11±' 111 L1—I —LII- 6" r'"'�'-=•--'-'--'="''-'`-'-' '' 4" PERFORATED PVC(HOLES DOWN) ltwre ;fAt ezee "" DRAINFIELD ROCK /�It;I.I_��/_I_I�I�az• 7 -Tit-reireTeri� VeZAI X1'1-0-.'.,;1'1.1'1 r-. ��I�I_.�1�11_I .�1�•�1�.�I�1 r._..................... .� '-'-•-•-'='='='='='='=!y �i 4' TO GROUNDWATER '��% =y=am4 6'TO BEDROCK OR IMPERMEABLE LAYER f 3' -� TYPICAL DEEP TRENCH SECTION -'oFl (NO SCALE) i � ' NOTES: ' 49TM '*,, GRADE AREA OVER TRENCH TO DRAIN AWAY „t.. MIN 6' SEPARATION FROM BEDROCK / • Be rin Schiller • MIN 4' SEPARATION FROM GROUNDWATER �+ s , HE 12592 •. �� MIN 100' SEPARATION FROM NEARBY WELLSliF-;•..... • 4 MIN 100' SEPARATION FROM SURFACE WATER OR STREAMS w1/430.100".... MUNICIPALITY OF ANCHORAGE ��� \\\, ' DEVELOPMENT SERVICES DEPARTMENT ,` r��.4.7. ��4-- ,9+, 4700 ELMORE ROAD ANCHORAGE, AK 99519-6650 SOILS LOG AND PERCOLATION TEST %7.4 .2,4yit:, ,k,_-1 M'I'CHAEL E.ANDERSOA,�f LEGAL DESCRIPTION: T 15N RIW SEC 18 L32 �f+!` � C® ..::s r PERFORMED FOR: kvPROFESSION 4 DATE: 8-04-2017 PROJECT No.: , ��� i PARCEL ID#: 051-171-09 TECHNICIAN: J. M ILLETTE Professional Engineers Stamp: DEPTH TEST HOLE 1 (feet) i I SLOPE SITE PLAN 4 SEE SITE PLAN k 6 SILTY SAND SM 8 ' 9 - WAS GROUND WATER ENCOUNTERED? NO 1 O IF YES @ WHAT DEPTH? — DEPTH OF WATER AFTER MONITORING: NONE 11^ ' '' "�' DATE OF MONITORING: 10/16/17 12 ., .i•; DEPTH TO 13 DATE READING GROSS TIME NET TIME (NATER NET DROP (MINUTES) (MINUTES) {INCHES) (INCHES) 14 .:'::" 8/04 I 10:16 0 15- 2 10:46 30 3 3 16 3 10:47 0 11:17 ., 2.75 2.75 17 5 11:18 0 18 6 11:48 30 2.75 2.75 19 l 20 PERCOLATION RATE:10.9 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 3 FT. and 4 FT. COMMENTS: TEST HOLE WAS PRE SOAKED. MUNICIPALITY OF ANCHORAGE ,_G����OF,\ANk DEVELOPMENT SERVICES DEPARTMENT .$,;‘,....• P-*.. `1 . �� 4700 ELMORE ROAD ANCHORAGE, AK 99519-6650 �*:�TtFi �� *���101 / SOILS LOG AND PERCOLATION TEST F Ben in Schiller • of LEGAL DESCRIPTION: T 15N R I W SEC 18 L32 ��(�`� '•. CNE 624592 • �`' �� F�E�PROFESSlO��'�'�� PERFORMED FOR: �\ _ DATE: 8-04-2017 PROJECT No.: ,,~« 4 PARCEL ID#: 051-171-09 TECHNICIAN: J. M I LLE T T E Professional Engineers Scamp: DEPTH TEST HOLE 2 (feet) 1 SLOPE SITE PLAN h: 2 — 3 ` ~ � 4 ' 5 - SEE SITE PLAN sc SILTY SAND 7 —':.-;:.....I.••• • SM 8 — . 9 10 WAS GROUND WATER ENCOUNTERED? NO IF YES @ WHAT DEPTH? - S DEPTH OF WATER AFTER MONITORING: NONE 11 '=..' DATE OF MONITORING: 10/16/17 12 --:: :.' • � DEPTH To 13��=. '•N DATE READING GROSS TIME NET TIME WATER NET DROP (MINUTES) (MINUTES) (INCHES) (INCHES) 14—� :.'�..'::v 8/04 1 10:24 0 15 2 10:45 21 6 6 16 3 10:46 0 4 11:07 21 6 6 17- 5 11:08 0 18— 6 11:29 21 6 6 19 20 PERCOLATION RATE: 3.5 (MIN/INCH) PERC.HOLE DIA. 6 (INCHEc) TEST RUN BETWEEN: 3 FT. and 4 FT. COMMENTS: January 5, 197~ Willis Patterson 4220 East 8th Avenue Anchorage, Alaska 99504 Subject: T15N R1W Section 18 Lot 32 Permit %77452 A permit issued by this department for well and/or sewer system has expired. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal ordinance. If you have drilled the well~ a well log should be sent to this department to document the installation date. If there are any further questions~ please contact this office at 264-4720. Sincerely, Health and Environmental Protection Sewer and Water Section Ji,,,.J~ J!:iiil] Il, JL tl:::::l! !J'"-,,lJ l!iiii::'~ I~iiiiiill Ii"",,!! 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[[i: :l: 'l'l..tl!ii:l::i: I:::1 i::::J i:::l:iii:'.iii: :[ C:iI:~[: ]']: f.,!tiii:J::: F:IF'F:'[i~:OVFi:E:' I:::'1 F:ff.,t"l I','ff::lh.' lii~l!ii: (::1 C:lZhl'.,li']]h,Jl.J(])lJ!ii:: I,'}f::lZl[l'.,l'T[i:l'.,tl:::tl'-,}l::::iii: I:::l(iil::i:l!i[:lili:l',ll:EN'J' Z[:i~; J:;i:jiii:(i:!l..l[l:f;;:}i!:}:]:,. :[}::: l:::l t:::IG!:;i:Iii:EEh'Ii[F,IT :[:!!i; NO'r I.:::Ei:i:::"l C:l.tl:;i:l:iiTE!Jq'r J.l.'l::)l.I I','tt:::1'.~.' IE',E: I:;i:IEJ:i:[I.t[[Fi:Ii!:[3 D:3 iiZ'.,II..F:II:i~:GliE "}Hliii: i:::l[ii::!!i;17[ll:;i:!:::"T]Ol'.,! :i!i;'.~.':!~;'}'li!:}'"l F:!t'.,JE:,,--'(31:;~: ~.i.~(::lJ.J I,/F:lh.' [i!:[ii: :ii!;I..lli!:..]l'liii3]:[:"l' 'Il::) 0 8- E GEO ECHNICAL 8- DEVEL Box 90, Davis St., Eagle River, Alaska 99877 694-2774 or 688-2280 PMENT CO. Earl Ellis Russell Oyster 688-2280 694-2774 S0]L L0~, Land Development Soils 8 Foundations Performed for: Legal Description: Depth (feet) Name: ~\¥~-,,~ ~"~. "'~'<~<~ Tel. No. ~t~- Mailing Address: ~"'~ '~-.~,,'~ k~,c~ Soil Characteristics 2 10 12 . Ground Water [ncountered: Yes Proposed Installation: Seepage Pit Performed by: No ~ If yes, what depth Drain Field ~ • • 6 I 8 9 10 77 •'t Municipality of Anchor. ®g { On-Site Water and Wastewater Progr..rW t/ " �' _ ail I . x (907) 343-79040_ jU 0 9 2018 xi SAFETY Certificate of On-Site Systems A . +val 051-171-09 °lg9 �S iL- 1 Parcel I.D. Expiration Date: 1. GENERAL INFORMATION Complete legal description T15N R1 W SEC 18 Lot 32 Location (site address) 19907 Juhnke Drive Eagle River, AK Current Property owner(s) Troy Davis Homes Inc. Day phone (907) 310-2501 Mailing address 1689 Knik Goose Bay Rd Suite 440 Wasilla, AK Real Estate Agent Day phone 2. TYPE OF DWELLING: 0 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 El Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: (/.Qi lt./1 �� ' Date: i/i 1/F1/ COSA to be released to the engineer,unless othe ise requested by the engineer. COSA Fee $ f/I . Co 0 Waiver Fee $ Date of Payment -lin 12ot 0 Date of Payment Receipt Number 01Le( 21) Receipt Number • COSA# O S C 14 1%25 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 Forge Engineering Phone (907) 522-7773 Address PO Box 240773, Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 7/10/18 ...1-4 if:*. 49TH f`� •.:* ' *7 d1000 6. DSD SIGNATURE r�••••• ••• •••• •••..°. • 0 ©•�!ke f "--' —0, System #1 Approved for 4' bedrooms 0 7{ 0 r`'.MICHAEL E. ANDERSON •�� System #2 Approved for bedrooms �'m%�•°° CE-4381 •;-my ® c^,p •°7-i Ch-ib •°• >G cr Disapproved ®d Fo p'•°°•°°°p�:`�® 9e irOFEsSIO ®® Conditional approval for bedrooms, with the following stipula io'M: .� �F N, .1 16, p\ .SC� �.1Q �1 0RP c 4 PRG \c Gr`.' By: G-N... _ Original Certificate Date: 7-if Z X10 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 blue sheet_f. '• 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: T15N R1 W SEC 18 Lot 32 Parcel la 051-171-09 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 2//13/18 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth VS. Cased to 134 ft Casing height (above ground) 24 in. FROM WELL LOG AT INSPECTION Date of test 2/130//18New Static water level 8 I ft. ft Well production V i 2- g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform As1;66 1 colonies/100 mL Nitrate , IC mg/L p t _n Arsenic •9 ug/L Date of sample: IfI lh 15 Collected by: A RS A l i�YU(.lvtl�'�X re5f 4 51 -/1s B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 2/07/18 Tank size 1 ,250gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N Date of pumping New Const. Pumper C. ABSORPTION FIELD DATA Date installed 2/07/18 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.8 GPD/SF System type Deep Trench Length 54 ft. Width 3.0 ft. Gravel below pipe 7.0 ft. Total depth 11 ft. Eff. absorption area 756 ft2 Monitoring tube Y Depression over field N Date of adequacy test New Constr. 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.) (Y/N &type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access(YIN) "Pump on" level at in. "Pump off' 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/lift station on lot X100' On adjacent lots X100' 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 X75' Animal containment areas >50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line >5 Absorption field >5 >100' Water main >10 Water service line >10 Surface water Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: 10' ' Property line Building foundation > 10 Water main Water Service line >10 Surface water >100 Driveway, parking/vehicle storage Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and 4�• OF tl review of Municipal records that the above systems are in dit• . A°•:<16\t 0 conformance with MOA COSA guidelines in effect on this date. r C',P �• 4.- A vve Michael E. Anderson, P.E. r*: 49 Engineer's Printed Name /•••• •••• •..• ..r„•• • ••.: ... C .•.o Date 7/10/18 I��, MICHAEL E. ANDERSON :,c,....° J; CE-4381 �`�- *ti>.. y-iv-/4..•. v`.4. -14rs E :: • '� COSA brown sheet 10-10-12.doc ii ` \ 1 _ o I likt ,INLET V £w R/V �. 0 2.g4. \ .._-4-2,� - ` • � ,. / \ / Z . ...4:— .-\ , , / D otn � ` I mr " ^ � 2 --- r 1 0 0o� N D I \1y� Z� oA 59.8' / o \ c, —i / �T o \ app Z • O 1 Dmm / (D Ln 57.4 / .9— — — — CII '1/4"------. / oo o ab CO o �m p o) m A IV N _ v ' J O m O IPO CO n Z I H L O N3 20.9 -o IV 0N DOo -L-+ rifinuallar:: ,8.7 v7 C -o 6- D (n rn CO 4.6 m rrl ;UN 0 (m!)U) 5.3' a 0 -z-) _ m--1 II N - — rn In - v D 4 38.9' r Co O low H'-'1- D W o N gi IV w O 0 D Z -41 I i ,00.g91. 3„00,90.00 S L CI- = aeNs ��NNnc ° Z t.) A ri 0 m PLOT PLAN AS BUILT X SCALE 1" = 50' GRID NW 1155__ Project No. __ 17-302/66 _ 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lan & Associates inc . . (907) 522-6476 Phone �oo�pp40 g (907) 522-4625 Fax o 0 A / Op4 Professional Land Surveyors kenOlangsurvey.com p c .. . ' p JonathanOlangsurvey.com „:57,.(c...... s�oo0 I hereby certify that I have surveyed the following described property: Q�..' 49TH{ %\ •�*QO BLM LOT 32, SECTION 18, T15N R1W SEWARD MERIDIAN, ALASKA Anchorage Recording District, Alaska, and that the improvements situated thereon are VA within the property lines and do not encroach onto the property adjacent thereto, that a J no improvements on the property lying adjacent thereto encroach on the surveyed (O'er KENNETH G. LA :premises and that there are no roadways, transmission lines or other visible �c ( Q easements on said property except as indicated hereon. �r� Oki ``,P S-52O O .M,�(•%' , at Anchorage, Alaska 4QtN`,Pip �-•-•-•-' xa�o Dated this the _ Day of — VQO' SSI0NA��o It is the responsibility of the owner to determine the existence of any easements, D�pO�ooa covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963