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HomeMy WebLinkAboutRIVERPARK VIEW BLK 2 LT 3Onsite File Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP161334 PID Number: 067-011-25 Dwelling: ■❑ Single Family (SF) ❑ Duplex (D) [' Multiple (SF and/or D) Project: ❑■ New ❑ Upgrade Name: Troy Davis Homes, Inc. ABSORPTION FIELD Address El Deep Trench ❑■ Shallow Trench [' Bed ❑ Mound 1689 Knik Goose Bay Rd, Ste 400, Wasilla, AK ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 250-4989 7 1.2 GPD/SF 10.9 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 2.9 Ft. 8.0 Ft. Riverpark View Estates 2 3 Fill added above original grade Gravel length Township Range Section 2.0 Ft. 55.0 Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES 3.0 Ft. Ft. To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist.between trenches From Tank Field Tank Line 880 Ft2 1 Ft. Well >100' >100' N/A N/A >25' TANK m Septic ❑ S.T.E.P. El Holding ❑Other Manufacturer Capacity Surface Water >1001 >100' N/A N/A Anchorage Tank 2000 Gal. Material Number of compartments Lot Line >5' 10' N/A N/A Steel Two NA Foundation >5' >10' N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain None Noted Gal. I I 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 Jake Millette BENCH MARK (Assumed elevation) 100.0 ft Inspection 15, 1/14/171/15/17 d Location and description dates: 2 3°' 4m Finish floor of home i r' lamp COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL �"��'�Arita.OF Conditional Approval: Date a I\I\'.�.. wig,••'Qr,��Oit A • sit • o inni 1 tchiligr.71• • r •19. / r v Apprvxi rg4_____ T1— Date (0 –20'47 get ts$ a• Inspection Report_9-1-12.doc RIVERPARK VIEW ESTATES, BLOCK 2 LOT 3 PERMIT # OSP161323 PID # 067-011 -25 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT: 343-7904 4700 ELMORE RD, ANCHORAGE, AK 99519-6655 WASTEWATER DISPOSAL SYSTEM OR WELL INSPECTION REPORT r O O 5 N> NC - r ,-99.0 - - - 92.95 2000 GAL \ 92.8 SEPTIC TANK l( ! - 96.5 FINISH GRADE OUB M 94.5 ORIGINAL GRADE O / \ . - - - - - ._ .. - -- - __. _.. _.-AM. 91.6 DRAINFIELD ROCK 91.6 83.6 83.6 / JJ 77.5 N = NO GROUNDWATER 5/29/16 H ~' of A‘4kk1 1ATh '•.*f/ CIN PROFILE AS-BUILT �� E4enjami Schiller : • �'•• AEL 12592 ...•�� (NO SCALE) '+�k PROFESS''•-. io \\\t��� PERMIT RIVERPA# OSP1613RK 23VIEW ESTATES, BLOCK 2 LOT 3 PID # 067-011-25 'Sb — _ RNERPARK VIEW ESTATES \ WELL BLOCK 2 LOT 3 —1 \ \ A B C \ FCO 32.6 21.5 \ SV1 9.4 39.6 SV2 9.4 54.0 2C0 17.5 56.3 'O O CO1 29.1 63.3 7-BDRM HOME MT1 29.1 64.7 \ co MT2 FCO CO2 77.8 30.1 \ TH 11® 0 MT2 78.5 29.2 \ • sv,v1 S TH 1\2 0 U MT1 C01 \e4 -,. \ \_ 2000-GAL SEPTIC TANK \ LOT d 9 \— ALTERNATE SITE P of ALq��l 10Avo: * .- TM i� • ....• ••• • // LEGEND ••••• •••• MT-MONITORING TUBE / • Benjami Schiller 01 FCO-FOUNDATION CLEANOUT 0O�(`'• AEL 12592 •',4°/� TH-TEST HOLE 111`\°Ro rssl`_�� 0 = N0 = 100SVSV-SEPTIC VENT ��\" CO CLEANOUT 1"=50' Development Services Department • Building Safety Division • ` • , 1r E eL On-Site Water & Wastewater Program so- I— 4700 Elmore Road P.O. Box 196650 ` a,L] 1 i Mark Begich Anchorage, AK 99507 s " ETY Mayor www.muni.org/onsite (907)343-7904 Pump Installation Log Well Drilling Permit Number: SW 0SP161323 Date of Issue: 11-15-2016 Parcel Identification Number:067-011-04-000 Legal Description Property Owner Name& Address: River Park View Lot 3 Block 2 Troy Davis Homes, Inc. 6831 Clemens Circle 1689 Knik Goose Bay Road#400 Eagle River,AK Wasilla,AK 99654 Pump Installation Date: 2-13-2017 Pump Intake Depth Below Top of Well Casing: 109 feet Pump Manufacturer's Name: Goulds Pump Model: 10HS05412CL Pump Size V2 hp Pitless Adapter Burial Depth: 13 feet Pitless Adapter Manufacturer's Name: Harvard Pitless Adapter Installer: Unknown Well Disinfected Upon Completion? Yes ❑ No Method of Disinfection: Chlorine tablets Comments: 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. Wheaton Water Well, Inc. 1190 N. Wasilla-Fishhook Road Wasilla, AK 99654 (907)376-2041 Name: Troy Davis Homes, Inc. Address: 1689 S. Knik Goose Bay Road City: Wasilla State: AK Zip Code: 99654 Well Site: River Park View Lot: 3 Block: 2 Additional: Well Depth: 128 ft• From: To: Formation: Below Ground: 126 ft. 0 36 sand, gravel Above Ground: 2 ft. 36 44 wet silty gravel 44 96 wet gray silt Gal/Min: 20 96 102 wet silt, gravel Static Level: 19 ft. 102 104 boulder Casing: 128' of 6" ID Steel 104 105 wet gray silt 105 107 brown silt, gravel, water Liner Pipe: none 107 111Y a silt, gravel Screened: none 111 126 fine sand, coarse gravel,water Perforated: none 126 128 gravel, water Grouted: Bentonite Depth: 20'+ Develop. Method: Air V1fA7k:K t�t�glITY TESTING f Cosjrrn f1 Co1/100mL Use of Well: Residential + NJ:tales Drilling Method: Rotary r ug/L Fluids Used: none Pump Installed: none Other: Chlorinated 'Date Drilled: 12-27-2016 Driller: Ben Mattson 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: OSP161323 Tax Code Number: 06701104000 Work Type: Septic Initial Permit Effective Dates: November 15, 2016 to November 15, 2017 Design Engineer: ANDERSON ENGINEERING Subdivision: T14N R1W SEC 24 Site Legal Address: T14N R1 W SEC 24 W2SW4SW4SW4,SE4SW4SW4SW4 G:0364 Owner/Address: TROY DAVIS HOMS INC 1689 S KNIK GOOSE BAY ROAD WASILLA AK 996540000 Site Mailing Address: 6831 CLEMENS CIR, Eagle River This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank C 1 1112316 Lot Size in Sq Ft: 301439 Total Bedrooms: 7 N Privy Y Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: Date: li /G MUNICIPALITY OF ® Community Development Department Development Services Division On -Site Water & Wastewater Program ANCHORAGrE[ ;° MAW OCT 26 2015 �s one: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PER APPLICATION' Parcel I.D. 067-011-04 g ,.' +.a 3 x - 1 Property owner(s) Troy Davis HomesDay phone 310-2501 Mailing address 1689 S. Knik Goose Bay Road #400 Wasilla, AK 99654 Site address 6831 Clemens Circle Eagle River, AK 99577 Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) T14NR1 WSEC24 W2SW4SW4SW4SE4SW4SW4SW4 Lot Size 301,439 Sq. Ft. Number of Bedrooms Seven (7) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) El Absorption Field ❑ Initial El Single Family (SF) (w/wo ADU) Septic Tank 0 Upgrade ❑ Duplex (D) ❑ Holding Tank ❑ Renewal ❑ 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. /-u� 'f a'L' (Signature of property owner or authorized agent) Permit/Rush Fees: 11-29-40 Date of Payment: 101.'�u11(P Receipt Number: O 3q F}� Permit No. osglLu "'23 Permit App_9-1-12.doe Waiver Fees: Date of Payment: Receipt Number: Waiver No. October 25, 2016 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: T14N R1W Section 24, W1/2SW1/4SW1/4SW1/4 SE1/4SW1/4SW1/4SW1/4 Proposed Lot 3, Block 2, River Park View Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The subject parcel is currently being subdivided into 7 new lots. The owner of the parcel intends to construct a new seven -bedroom home on proposed Lot 3, Block 2. The remainder of the tract is currently vacant. 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 the proposed septic systems and wells on adjacent lots. Drainage arrows are shown on the site plan showing the grade and direction of flow on the lot. The drainage pattern will not be changed as a result of this project. The test holes placed on the lot in the area of the absorption trenches and alternate site indicate well graded gravel (GM/GW). The percolation rate of the soil was determined to be 1 to 5 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 1.2 gallons per day per square foot was used in the design of the absorption system. We are proposing to place a new 2,000 -gallon septic tank and a 55' long by 3' wide by 8' effective depth absorption trench to treat and dispose of the effluent generated in the house. The elevation of the distribution line in the absorption trench will be 2' below the surface and the total depth will be 10'. 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. T14N R1W Section 24 October 25, 2016 Page Two The ground surface on the lot in the area of the septic system slopes to the southwest at a grade approaching 20% with some cross sloping from the east. 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 L�7. ' 49th MICHAEL E ANDERSON SECTION 24, T14N, R1 W, S.M., ALASKA W1/2 SW 1 /4 SW 1 /4 SW 1 /4, SE 1 /4 SW 1 /4 SW 1 /4 SW 1 /4 irl S 8 '21 "25"W 33.0 ' J GRAVEL A_ N 4t4 R��FR 't*G OF Arae 440 L7� 49th ...�. ........................................... 9, MICHAEL E. ANDERSON.: (Q r No. CE -4381 N / IO O Proposed N ® Well 01 m w M/ �,e en p Red am q Ho nna ; -'-----' ° c 2,000 Gallon TH13 + TMl 2Ca TM � Sv Septic Tank Alt. O�'-------------------------- - -- -Sc. -------- Go --------'p ----------- - 33' SECTION LINE EASEMENT h^ S 89'25'20'W 352.83' 61.0 nd� 55' Long x 3' Wide x s1.0NOTE: 8' Effective Depth Absorption Trench No Conflicts with Wells or Septic Systems on Neighboring Lots. All Proposed Lots are Currently Vacant. SITE PLAN SCALE 1" = 100' r Z m N O O 0Q W m w ao Z W N N J / M LEGEND L4 0 W / L4 SV — Septic Vent aI CO — Clean Out m (�'� W MT — Monitor Tube r TH — Test Hole rn S 8 '21 "25"W 33.0 ' J GRAVEL A_ N 4t4 R��FR 't*G OF Arae 440 L7� 49th ...�. ........................................... 9, MICHAEL E. ANDERSON.: (Q r No. CE -4381 N / IO O Proposed N ® Well 01 m w M/ �,e en p Red am q Ho nna ; -'-----' ° c 2,000 Gallon TH13 + TMl 2Ca TM � Sv Septic Tank Alt. O�'-------------------------- - -- -Sc. -------- Go --------'p ----------- - 33' SECTION LINE EASEMENT h^ S 89'25'20'W 352.83' 61.0 nd� 55' Long x 3' Wide x s1.0NOTE: 8' Effective Depth Absorption Trench No Conflicts with Wells or Septic Systems on Neighboring Lots. All Proposed Lots are Currently Vacant. SITE PLAN SCALE 1" = 100' N 89'23'56"E 329.95' SECTION 24, T14N, R1 W, S.M., ALASKA W1/2 SW 1 /4 SW 1 /4 SW 1 /4, SE 1 /4 SW 1 /4 SW 1 /4 SW 1 /4 0g.. Proposed Well ® I I I � I 1 TH14 ` TH13 ----CO 0 MT 0 ~ TH11 TH12 It. 0 ------------------------------ _Site ______-- /Z ry/ FCO 2.000 Gallon 0 SV Septic Tank `* SV 2CO o ;A -V °4 33' SECTION LINE EASEMENT ti°M S 89'25'20"W ti0 N 352.83 55' Long x 3' Wide x 8' Effective Depth Absorption Trench NOTE: No Conflicts with Wells or Septic Systems on Neighboring Lots. All Proposed Lots are Currently Vacant. SITE PLAN SCALE 1" = 50' T W W O A O SECTION 24, T14N, R1 W, S.M., ALASKA W1/2 SW1/4 SW1/4 SW1/4, SE1/4 SW1/4 SW1/4 SW1/4 DESIGN FACTORS: SYSTEM REQUIREMENTS Seven Bedroom Home Deep Trench System Perc. Rate: 1-5 Min./Inch 2,000 Gallon Septic Tank Application Rate: 1.2 GPD/SF 8' Drainfield Rock 7 Bedrooms X 150 GPD/1.2 GPD/SF (Application Rate) = 875 SF Absorption Area 875 SF/16 SF/LF = 54.69 LF Trench Length THEREFORE: Construct a 55' Long x 3' Wide x 8' Effective Depth Absorption Trench at the Location Shown. Flow Line Elevation in the Trench to be 2' Below Existing Ground. Total Depth to Be 10' Below Existing Ground. Provide 4' of Cover Over Septic Tank and a Minimum of 3' Cover Over Absorpiton Trench. Maintain 100' Separation from Wells in the Area. Natural Backfill Geotextile Fabric 6 \I PVC (Holes Down) 8'0" 1 Drainfield Rock 3' TYPICAL DEEP TRENCH SECTION •'••� O utit. (NO SCALE) • p� ........•••� X11 NOTE: Grade Area Over Trench to Drain Away. J as n Minimum 6' Separation From Bedrock. ■.....:...... ...... .. ... Minimum 4' Separation From Groundwater. 0 Minimum 100' Separation From Wells in the Area. ��P,', MICHAEL E. ANDERSON ; Minimum 100' Separation From Surface Water or Streams. ��%;:, No. DEL381 _; MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AN, 99519-6650 DEPTH (feet) 1- 2" 3 4 5 6 7 8- 9 10- 11 12 13 14 1 1 1 1 1 2 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: LOT 3, BLOCK 2, RIVER PARK VIEW SUB PERFORMED FOR: TROY DAy15 HOMES DATE: 5/19/16 PROJECT No.: PARCELID#: TECHNICIAN: W. ROBERTS TEST HOLE 11 OB/OG SILTY GRAVEL WITH SAND d GM/GW d WAS GROUND WATER ENCOUNTERED? NO BOH @ 18.0 SLOPE SITE PLAN SEE SITE PLAN 8 IF YES © WHAT DFP'I'H? READING GROSS TIME (MINUTES) DEPTH OF WATER AFTER MONITORING: NONE 0 NET DROP (INCHES) DATE OF MONITORING: 5/29/16 TEST HOLE PRESOAKED PRIOR TO TESTING: 5/29 COMMENTS: TEST HOLE PRE SOAKED PRIOR DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH To WATER (INCHES) NET DROP (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 5/29 1 12:08/12:18 10 0.75^/3.50^ 2.75" 2 12:19/12:29 10 0.63'/3.38" 2.7511 3 12:30/12:40 10 0.75"/3.50" 2.7511 4 12:41/12:51 10 0.50"/3.25" 2.75" 5 12:52/1:02 10 0.75°/3.50^ 2.75'1 6 1:03/1:04 10 0.50/3.25° 2.75" PERCOLATION RATE: 3.6 (MIN/INCH) PERC. HOLE DIA. 611 (INCHES) TEST RUN BETWEEN: 4 FT. and 5 FT. TEST PERFORMED BY ANDERSON ENGINEERING. 1, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: ()/I3/16 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 DEPTII (feet) 1- 2 3 4 5 6 7 8 9 10- 11 12- 13- 14 15 1 1 1 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: LOT 3, BLOCK 2, RIVER PARK VIEW SUB PERFORMED FOR: TROY DAVIS HOMES DATE: 5/19/16 PROJECT No.: PARCEL ID#: TECHNICIAN: W. ROBERTS TEST HOLE 12 OB/OG d d d SILTY GRAVEL WITH SAND d GM/GW 4 WAS GROUND WATER ENCOUNTERED? NO BOH @ 17.0 SLOPE SITE PLAN SEE SITE PLAN IF YES C+WHAT DEHIT' S GROSS TIME (MINUTES) DEPTH OF WA'I'F.R AFTER MONITORING: NONE LO NET DROP (INCHES) DATEOF MONITORING 5/29/16 p 5/29 DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH To WATER (INCHES) NET DROP (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 5/29 1 1:22/1:32 10 1.00^/4.00" 3.00" 2 1:33/1:43 10 1.13^/4.13" 3.00" 3 1:44/1:54 10 l.00„/4.00,, 3.00” 4 1:55/2:05 10 1.13"/4.13,, 3.00" 5 2:06/2:16 10 0.75"/3.75" 3.00" 6 2:17/2:27 10 1.00"/4.00^ 3.00" PERCOLATION RATE: 33 (MIN/INCH) PERC. HOLE DIA. 611 (INCHES) TEST RUN BETWEEN: 4 FT. and 5 PT. 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: 6/15/16 bUU6 4 4 L Form 1860-9 (July 1975) AA -6661-C WHEREAS PACE 0 3 6 0 xbt aniteb Mateo of 21merim QW all to iub m dime presents Mall come, Greeting: Cook Inlet Region, Inc. is entitled to a Land Patent pursuant to Sec. 14(f) of the Alaska Native Claims Settlement Act of December 18, 1971, 85 Stat. 688, 7041 43 U.S.C. 1601, 1613(f) (1976), for the subsurface estate reserved by the United States in the hereinbelow identified patent of the surface estate in the following described lands: Patent Number Seward Meridian, Alaska T. 14 N SW},WRSW SSec. SE}SW}SW}SW}; Sec. 25, SW}NW}NE}NWk, SW}NE}NW}, S}SE}NE}NW}, SEIANW}. Containing 65.00 acres. NOW KNOW YE, that the UNITED STATES OF AMERICA, in consideration of the premises and in conformity with said Act of Congress, HAS GIVEN AND GRANTED, and by these presents DOES GIVE AND GRANT, unto the said Cook Inlet Region, Inc. the subsurface estate in the land above described; TO HAVE AND TO HOLD the same together with all the rights, privileges, immunities, and appurtenances, of whatsoever nature, thereunto belonging, unto the said Cook Inlet Region, Inc., its successors and assigns forever. The grant of the above-described lands is subject to all the easements and rights-of-way reserved in the aforementioned patent of the surface estate, and to valid existing rights, if any, in the said subsurface estate, including but not limited to those created by any lease (including a lease issued under Sec. 6(g) of the Alaska Statehood Act, 72 Stat. 339, 341); contract, permit, right-of-way or easement, and the right of the lessee, contractee, permittee, or grantee to the complete enjoyment of all rights, privileges and benefits thereby granted to him. IN TESTIMONY WHEREOF, the undersigned authorised officer of the Bonner of Land Management, in accordance with the provisions i of the Act of June 17, 1948 (62 Stat. 476), has, in the name of the United States, causal these letters to be made Patent, and the "> Seal of the Bureau to be hereunto affixed. GIVEN under my hand, in Anchorage, Alaska the NINETEENTH day of SEPTEMBER in the year of oar Lord ore thousand nine hundred and SEVENTY—NINE and of the Independence of the United States the two hundred and FOURTH. �04896y Patent Number A .GE f E _. DISTRICT Assistant to the State Director for ANCSA coo .....r. Roo <5_ 89 70 , •_ _ Municipality of Anchorage - On-Site Water and Wastewater Program E OOCT �"� '� sJ ■.iJ'it (907) 343-7904 111. AF (* ` 6 , L '3()h Certificate of On-Site Systems Approval Parcel I.D. 067-011 -25 Expiration Date: I Zd 1. GENERAL INFORMATION Complete legal description River Park View, Block 2, Lot 3 Location (site address) 6831 Clemens Cir Current Property owner(s) Troy Davis Home Inc. Day phone (907) 357-9394 Mailing address 1689 S Knik Goose Bay Rd #400, 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: 7 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 111 Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: (I1 f.'i L i e Date: /0/24/ I COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ (pg t 4 t 1--v+s4 -111.W Waiver Fee $ Date of Payment 101 ►l fri Date of Payment Receipt Number O$ Fb7 ' Receipt Number COSA# VcDC( 1 \'W 1 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 1399 W. 34th Ave. Suite 203 Anchorage, AK 99503 Engineer's Printed Name Benjamin Schiller, PE Date 1 0/1 5/1 7 �dr;tiv, �� .^ 'i,4* 152 41,9 • l4?i'S. '49 ,,• �. • s.F �t 6. DSD SIGNATURE . ..- _ ,� oe System #1 Approved for 7 bedrooms ."• System #2 Approved for bedrooms -; . a das Disapproved •• ° •' Conditional approval for bedrooms, with the following stipulatia m'v ;T,Y o�F,� ;, ON-SITE o -ct- WATER AND v".: WASTEWATER o cTN 6 PROGRAM 40 �Nr SER\1CC"5 Original Certificate Date: tO Y 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 ; 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: Riverpark View, Block 2 Lot 3 Parcel ID: 067-011 -25 A. WELL DATA Well type Private If A. B. or C provide PWSID # Well Log (YIN) Y Date completed 12/27/16 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 128 ft. Cased to 1 28 ft. Casing height (above ground) 24 in. FROM WELL LOG AT INSPECTION Date of test 12/2 7/16 N e w Static water level 19 ft. ft. Well production 20 g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform ND colonies/100 mL Nitrate ND mg/L ND 211 4 � Wheaton Water Wells Arsenic ug/L Date of sample: Collected by: 1,1E,,,) sAmp A+cet.! 014-7 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Sepic / Steel Date installed 1 /15/17 Tank size 2000 gal. 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 Pumper New Construction C. ABSORPTION FIELD DATA Date installed 1/14/17 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.2 GPD/SF System type Trench Length 55.0 ft. Width 3.0 ft. Gravel below pipe 8.0 ft. Total depth 12.9 ft. Eff. absorption area 880 ft2 Monitoring tube Y Depression over field N Date of adequacy test New 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 >100On adjacent lots >1001 Absorption field on lot >100On 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: >5' >5' >5' Building foundation Property line Absorption field Water main >10'10' Water service line >10'10' Surface water >100' Wells on adjacent lots >100 ABSORPTION FIELD ON LOT TO: Property line >1Building foundation Water main>10' >1 0 >10' >100' Water Service line Surface water Driveway, parking/vehicle storage >10' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS G. ENGINEER'S CERTIFICATION Or ,Ae..;....t li. I certify that 1 have determined through field inspections and sr 07_. --- s .V review of Municipal records that the above systems are in •* • . • r►+ ; '.9 d+ conformance with MOA COSA guidelines in effect on this date. I ..' Engineer's Printed Name Benjamin Schiller, PE 012,,_____ m,,, .. o • • '" j /1 5 Date 10/15/2017 �• . 16• wh ( s/i o or �'Ii. a.+� o R COSA brown sheet 10-10-12.doc -1 0 9,0 dt z 9 o v) n rCLEMENS CIRCLE - -1 p; m 0 i(8 O J Il' z -7 'o. O - / co o -I / D z / Z U) / yo M o -A/ E bf / m Pi .Zi a / `': / o -1 N1 CO 5.0I / ( / ,v1 g _ _ N13 Adv I 1.5'•x• ��� "s+ �• / o� i \ C / cto —z o60.9' o, ill r co 4747 Q bi 9. N p to ui 'Do rn toToy ru'l� cr- Iv 0 NO W �� rn in m S 01'36'16"E 179.16' I Tract C-1 A 1-2A o Z / NOTE: FOUNDATION. WELL & SEPTIC ONLY PLOT PLAN AS BUILT x SCALE 1" = 100' GRID SW 0363 Project No. 16-304/86 11500 Daryl Avenue. Anchorage, Alaska 99515-3049 Lang & Associates , inc . (907) 522-6476 Phone _ (907) 522-4625 Fax O'0 A / don Professional Land Surveyors kenOlangsurvey.com a `.9 p JonathanOlangsurvey.com v'` �nnpp • I hereby certify that I have surveyed the following described property: Ofl�/ "- �yvp LOT 3. BLOCK 2. RIVERPARK VIEW SUBDIVISION Q e• .' 49� /" OD 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 lying adjacent thereto encroach on the surveyed le KENNETH G. LAIV premises and that there are no roadways, transmission lines or other visible Q¢r^�, 1� easements on said property except as indicated hereon. Q ,p �(S 520Z J O Dated this the Day of :5,..i.1--I . at Anchorage, Alaska Qp1 ,oR L'•••••••• Ooh A �SSIONAI o it Is the responsibility of the owner to determine the existence of any easements, �4pppooa covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963