HomeMy WebLinkAboutRIVERPARK VIEW BLK 1 LT 2Onsite File
Municipality of Anchorage
On-Site Water and Wastewater Program •(907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: QSP171053 PID Number: 067-041-32
Dwelling: ■❑ Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑■ New ❑ Upgrade
Name:
Troy Davis Homes, Inc. ABSORPTION FIELD
Address ❑ Deep Trench [' Shallow Trench El Bed ❑ Mound
1689 Knik Goose Bay Rd, Ste 400, Wasilla, AK El Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
250-4989 5 1.2 GPD/SF 8.4 Ft
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot 4.2 Ft. 4.2 Ft.
Riverpark View Estates 1 2 Fill added above original grade Gravel length
Township Range Section 0.5 Ft 63.0 Ft.
Gravel width Beds: Number of Lines 'Distance between lines
SEPARATION DISTANCES 5.0 Ft. Ft
To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist between trenches
From Tank Field Tank Line 630 Ft2 1 Ft
Well >100' >100' N/A N/A >25' TANK O Septic ❑ S.T.E.P. ❑ Holding ❑Other
Manufacturer Capacity
Surface Water >100' >100' N/A N/A Anchorage Tank 1,500 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.
Remarks Pump on level at Pump off level at High water alarm at
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 Ben Schiller BENCH MARK (Assumed elevation) 100.0 ft
Inspection 1s' 5/9/175/10/17 5/10/17 Location and description
Gates: - 4„ Finish floor, NE garage door
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Fig_
e ��
Conditional Approval: Date �� '•• A•,� •. 1.or �
i . : 4 •'• :*
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Of ..... ciE Ty .e r
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Approved f il`e-C4' ? Date 1 0/307 �t1,11..1%
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Inspection Report_9-1-12.doc
RIVERPARK VIEW ESTATES, BLOCK 1 LOT 2
PERMIT # OSP171053 PID # 067-041-32
.--1 LOT 2
/
-.-, LOT 5
/
--, 1500-GAL SEPTIC TANK
LOT
—_, RIVERPARK VEW ESTATES
—_,
..• . • •• " .•.. —_, BLOCK 1
ALTERNATE SITE .. '• ----i_ _,
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/ p LEGEND
,1111",--....1 ef MT-MONITORING TUBE
r % Benjami ' chiller : if,
AEL 12592 .•.4-.e, FCO-FOUNDATION CLEANOUT
TH-TEST HOLE
iro,.‘/(0;!..0,127,2017 .'',..4.,.. 0 50 100 SV-SEPTIC VENT
FEET CO-CLEANOUT
1"=50'
RIVERPARK VIEW ESTATES, BLOCK 1 LOT 2
PERMIT # OSP171053 PID # 067-041-32
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT: 343-7904
4700 ELMORE RD, ANCHORAGE, AK 99519-6655
WASTEWATER DISPOSAL SYSTEM OR WELL INSPECTION REPORT
CV O
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— — ,-91.9 — — —
86.9
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87.7 �-86.1
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SEPTIC TANK
90.5 FINISH GRADE
0g 90.0 ORIGINAL GRADE O0
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85.8DRAINFIELD ROCK - 85.8
81.6 81.6
63'
72.0
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= NO GROUNDWATER 5/28/16
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PROFILE AS—BUILT oifp�;�l.. AL1p592 .�
(NO SCALE) +ik��``"`l*..
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: Riverpark View Lot: 2 Block: 1
Additional: Permit #OSP171053
Well Depth: 141 ft. From: To: Formation:
Below Ground: 139 ft. 0 3 stickup, silt
Above Ground: 2 ft. 3 17 wet brown silt, gravel
17 122 wet gray silt
Gal/Min: 15 122 127 silt,
gravel
Static Level: Artesian 127 141 gravel, water
Casing: 141' of 6" ID Steel
Liner Pipe: none
Screened: none
Perforated: none
Grouted: Bentonite WATER QUALITY TESTING
CoI$bTm Abse 1 _Co1/100mL
Depth: 20'+ Nitrates 1. a _ mg/L
Arsenic <m R Lupit
Develop. Method: Air `' V-1
Use of Well: Residential
Drilling Method: Rotary
Fluids Used: none
Pump Installed: none
Other: none
pate Drilled: 5-25-2017 Driller: Ben Mattson
Development Services Department
Building Safety Division
• 7.4
'"e On-Site Water & Wastewater Program e' <o
4700 Elmore Road
P.O. Box 196650 ` ■ll 1 fi
Mark Begich Anchorage, AK 99507 s . ETY
Mayor www.mur,i.orq/onsite
(907) 343-7904
Pump Installation Log
Well Drilling Permit Number: SW OSP171053 Date of Issue: 4-19-2017
Parcel Identification Number:067-041-32-000
Legal Description Property Owner Name& Address:
River Park View Lot 2 Block 1 Troy Davis Homes, Inc.
Clemens Circle 1689 Knik Goose Bay Road A400
Eagle River,AK Wasilla,AK 99654
Pump Installation Date: 10-13-2317
Pump Intake Depth Below Top of Well Casing: 93.5 feet
Pump Manufacturer's Name: Myers
Pump Model: 3NFL52-12
Pump Size 1/2 hp
Pitless Adapter Burial Depth: 12' feet
Pitless Adapter Manufacturer's Name: Harvard
Pitless Adapter Installer: Unknown
Well Disinfected Upon Completion? Z Yes ❑ No
Method of Disinfection: Chlorine tablets
Comments: 12 GPM
Pomp 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.
JKLIPALITFO MUNICIPALITY OF ANCHORAGE
mint S
• On-Site Water&Wastewater Program
' s
r Anchorage,Alaska 99519-6650 Phone: (907)343-7904 Fax:(907)343-7997 °'
'r http://www.muni.org/onsite , .;
_ Department
NMOCRp'
On-Site Water & Wastewater System Permit
Permit Number: OSP171053 Effective Date: 4/19/2017
Work Type: WellSeptic Initial Expiration Date: 4/19/2018
/�
Tax Code Number: 06704132000 d d"` 5--9_ 17
Site Legal Address: RIVERPARK VIEW BLK 1 LT 2 G:0364 TO 5(10 f 11
Site Mailing Address:
Owner: TROY DAVIS HOMES INC Lot Size in Sq Ft: 69740
Design Engineer: ANDERSON ENGINEERING Total Bedrooms: 5
This permit is for the construction of:
0 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: /; / M/a )'v 6 pOU Date:
Issued By: I ' ,� Q - $1j2
Date: .20
F6�B9lp
`'v
MUNICIPALITY OF ANCHORAGE AH i 7 211
Community Development Department Phone: 907-3, g
Development Services Division Fax: 907-343-7997
On-Site Water& Wastewater Program
ON-SITE SEWERNVELL PERMIT ;G ` ICATION
067-041-
Parcel I.D. ,/.zu
Property owner(s) Troy Davis Homes Day phone 310-2501
Mailing address 1689 S. Knik Goose Bay Road #400 Wasilla, AK 99654
Site address 21371 Conley Avenue Chugiak, AK 99567
Legal description (Sub'd., Block & Lot) Riverpark View, Block 1, Lot 2
Legal description (Township, Range & Section)
Lot Size Sq. Ft. Number of Bedrooms Five (5)
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(El all that apply)
Absorption Field 14 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 El
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.
14-c-d.4zie z
LeL
(Signature of property owner or authorized agent)
Permit/Rush Fees: sse
' ! g 4- Waiver Fees:
Date of Payment: 41// -- 1?' Date of Payment:
Receipt Number: 6S Receipt Number:
Permit No. OSP/7/653 Waiver No.
Permit App_9-1-12.doc
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
April 16, 2017
Municipality of Anchorage
Development Services Department
On-Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 2, Block 1 , Riverpark View Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 2, Block 1, Riverpark View Subdivision intends to construct a new
five-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 the existing septic systems and
wells on this and adjacent lots. Drainage arrows and ground surface contours are
shown on the site plan showing the grade and direction of flow on the lot. The drainage
pattern will not be changed as a result of this project.
The test holes placed on the lot in the area of the absorption trenches and alternate site
indicate gravel (GM/GW) with varying amounts of sand and silt. 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 found in either test hole during the
monitoring period. An application rate of 1 .2 gallons per day per square foot was used
in the design of the absorption system. We are proposing to place a new 1,500-gallon
septic tank and a 63' long by 5' wide by% 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 4.0' below the surface and the total depth will be 8.0'. 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.
1
The ground surface on the lot in the area of the septic system slopes to the southeast-
at
outheastat a shallow grade. The new trench will be constructed parallel to the ground contours
in conformance with Municipal requirements. The new septic system will be
constructed a minimum of 100' from all wells and any surface water and 10' the
proposed and existing water services in the area.
Lot 2, Block 1, Riverview Park
April 16, 2017
Page Two
If the system is constructed in accordance with our design the following statements
apply:
1. The system, if constructed as designed, will have no adverse impact on the wells
in the area or those to be constructed in the future.
2. The system, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
3. The system, if constructed as designed, will have no adverse impact on reserve
space, either surface or subsurface, on any lots located in the area.
4. The system, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
Sincerely,
74-4--L4.1
Michael E. Anderson, P.E.
Attachments
••• OF
•
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NCI-SAFIE. ANDERSON
0 J,'.. CE-4381 4`?
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RIVERPARK VIEW ..•-\F.-, � ��,��,
SUBDIVISION .�P.••••'••"""' • � . _
69,740 s.f. i G7 r _ •
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i. • 49th iN `, I.
AREA MAP .. -.
♦,VI;MICHAEL E. ANDERSON !• i%
SCALE 1' = 100' �,
�1 NO, CE-4381 -
•♦.44.° ROFESSI''�''•
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No Conflicts with Wells I . )1 — .. •
or Septic Systems on `\ ti 1°3' �� 1 BB40.�a .
Neighboring Lots. \` ` 'gm , 1 // r ly
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,fl ,'/ \� LOT 1
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.\� dp
\\ I��/ Proposed
i•• ' '49th • `•f \ 0q0 . 'i • Well
...ev4Li. ... .......
`� -- — LEGEND
f9 ci.-•MICHAEL E. ANDERSON 4't p N.
SV — Septic Vent
�' '••'�"''-'7•• BLOCK 1 , LOT 2 CO — Clean Out
•jj .... ����� �\ \
MT
— Test�tHole
ube
�;;;5�;;'• RIVERPARK VIEW
SUBDIVISICN CONTOUR INTERVAL — 4'
SITE PIAN 69.740 sf_ ��,\
SCALE 1' = 50' \ `
LOT 2, BLOCK 1 , RIVERPARK VIEW SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Five Bedroom Home 5'Wide Trench System
Perc. Rate: 1 - 5 Min./Inch 1,500 Gallon Septic Tank
Application Rate: 1.2 GPD/SF 4' Drainfield Rock
5 Bedroom4 X 150 GPD/1.2 GPD/SF (Application Rate) = 625 SF Absorption Area
625 SF/5 SF/LF*.5 (Red. Factor) = 62.5 LF Trench Length
THEREFORE: Construct a 63' Long x 5'Wide x 4' Effective Depth Absorption Trench at the Location
Shown on the Site Plan. Flowline Elevation in the Trench to be Placed at 4' Below the Existing Ground.
Total Depth of Trench to be 8' Below Existing Ground. Place a Minimum of 4' of Cover Over the Septic
Tank and 3'of Cover Over the Trench or Place 2" of Insulation and 2' of Cover. All Elements of the
Septic Sytem Must be a Minimum of 100' From All Private Wells in the Area.
Natural
Backfill
3'6"
Geotextile
Fabric
6.. O 4" Perforated
— - PVC (Holes Down)
Drainfield Rock
4'0"
5'
I I
TYPICAL DEEP TRENCH SECTION
(NO SCALE) �:
MUNICIPALITY OF ANCHORAGE 4031 _rtti�
DEVELOPMENT SERVICES DEPARTMENT .�PSE O.. 44/..
99519-6650 c'• 1 �•
4700 BRAGAW STREET ANCHORAGE, AK4• 49th 7� ';*.
SOILS LOG - PERCOLATION TEST
MICHAEL E. ANDERSON = j
LEGAL DESCRIPTION: LOT 2, BLOCK I, RIVER PARK VIEW SUB. ��.:�:o No%c-gat�C�-•ti.'
PERFORMED FOR: TROY DAVIS HOMES •'" .. P •0
DATE: 5/19/16 PROJECT No.: •,l� �s0 ��•
PARCEL ID#: TECHNICIAN: W. ROBERTS Professional Engineers Stamp
DEPTH TEST HOLE 3
(feet)
OB/OG SLOPE SITE PLAN
1
d
2
3
a
4
5 SEE SITE PLAN
• A
d
6 4 A
7
4
8 SILTY GRAVEL
WITH SAND
9 a a GM/GW
WAS GROUND WATER ENCOUNTERED? No
1 a
IF YES @ WHAT DEPTH',
• DEPTH OF WATER AFTER MONITORING: NONE LE
11 a DATE OF MONITORING: 5/28/16
•12 L
GROSS TIME NET TIME DEPTH TO NET DROP
13 d DATE READING (MINUTES) (MINUTES) (NATER (INCHES)
(INCHES)
14 .' TEST HOLE PRESOAKED PRIOR TO TESTING:
15 5/28 1 1:06/1:16 10 0.75"/3.25" 150"
2 1:17/1:27 10 0.50"/3.00" 2.50"
16
3 1:28/1:38 10 0.75"/3.25" 2.50"
17
4 1:39/1:49 10 0.88"/3.38" 2.50"
18 BOH @ 18' 5 1:50/2:00 10 0.75"/3.25" 2.50"
19 6 2:01/2:11 10 0.75"/3.25" 2.50"
20 --
PERCOLATION RATE: 4.0 (MIN/INCH) PERC.HOLE DIA. 6" (INCHES)
TEST RUN BETWEEN: 4 FT. and 5 FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. I,MICHAEL E.ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 6/13/16
MUNICIPALITY OF ANCHORAGE �t>.>t��,,
DEVELOPMENT SERVICES DEPARTMENT �� �� •• 1
•
4700 BRAGAW STREET ANCHORAGE, AK 99519-6650V)''•
,..
i 49th
SOILS LOG - PERCOLATION TEST
MICHAEL E. ANDERSON
f G1 :
LOT 2, BLOCK I, RIVER PARK VIEW SUB. `♦r Na. CE-4381 �� i
LEGAL DESCRIPTION: s .Y:�7�7,.• ° '•••
PERFORMED FOR: TROY DAVIS HOMES �1+,�`p ••
DATE: 5/19/16 PROJECT No.:
PARCEL ID*. TECHNICIAN: W. ROBERTS Professional Engineers Stamp
DEPTH TEST HOLE 4
(feet)
OB/OG SLOPE SITE PLAN
1
d
2
3
4
5 a SEE SITE PLAN
(. Q
7
e
8 SILTY GRAVEL
WITH SAND
9 —R •4 GM/GW
d '
10— V WAS GROUND WATER ENCOUNTERED? NO
IF YESgi WHAT DEPTH'
DEPTH OF WATER AFTER MONITORING: NONE
1 1 DATE OF MONITORING: 5/28/16
12
GROSS TIME NET TIME DEPTH To NET DROP
13 DATE READING (MINUTES) (MINUTES) WATER (INCHES)
(INCHES)
14 TEST HOLE PRESOAKED PRIOR TO TESTING:
15— • • 5/28 1 2:33/2:43 10 0.75"/4.88" 4.13"
2 2:44/2:54 10 0.75'75.00" 4.25"
16— •
3 2:55/3:05 10 0.63'74.88" 4.25"
17— ea 4
3:07/3:17 10 0.50"/4.63^ 4.13"
18— BOH @ 18' 5 3:18/3:28 10 0.75"/5.00" "
4.25
19 6 3:29/3:39 10 0.63"74.88" 4.25"
2O
PERCOLATION RATE: 2.2 (MIN/INCH) PERC. HOLE DIA. 6" (INCHES)
TEST RUN BETWEEN: 4 FT. and 5 FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST 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: 6/13/16
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 2, BLOCK 1, RIVERVIEW PARK VIEW
GENERAL:
1 . The scope of this project includes the procurement and placement of a new
1,500-gallon septic tank at the location shown on the Site Plan. Work also
includes the construction of a new 63' long x 5' wide x 4' effective depth
absorption trench at the location also shown on the Site Plan. The
distribution line in the trench will be placed at 4.0' below the existing ground
surface. Total depth of the trench will be 8.0' below the existing ground
surface. The new absorption trench and septic tank must be placed a
minimum of 100' from all private wells and any surface water in the area. A
minimum of 2' of cover with insulation is required over the absorption trench
and 4' of cover over the septic tank.
2. Construction shall be in accordance with the approved site plan, design
drawings, Municipal Permit with any special provisions or conditions, and all
applicable State and Municipal Wastewater Disposal Regulations.
3. The Contractor shall be responsible for obtaining all underground utility
locates and for the layout of the septic system and verification of the location
of all lot lines. The Contractor must also verify the location of wells in the
area and assure that the separation distances are met.
4. Unless specifically agreed otherwise, the contractor shall be responsible for
final grading areas subsequently depressed from soil settling. Property owner
shall be responsible for revegetation of affected areas unless specifically
agreed otherwise.
5. Contractors installing wastewater disposal systems must be certified by the
Municipal Building Safety Division On-Site Water and Wastewater Program
for system installations. Owners installing their own systems must receive
prior approval from the On-Site Water and Wastewater Program before
beginning system installation.
SEPTIC TANK INSTALLATION
1 . A new 1,500-gallon septic tank must be procured from an approved source
and installed at the location shown.
2. A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shall include two 4" cleanouts for pumping access.
3. The septic tank shall be sufficiently bedded to prevent settling or shifting of
the tank.
4. All standpipes on the septic tank shall extend a minimum of 12 inches above
final grade.
5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial
insulation.
6. A foundation cleanout shall be installed one to four feet from the building
foundation. Two cleanouts are required between the tank and the drainfield.
7. Final grading over the tank shall be such that a positive slope exists away
from the septic tank.
DRAINFIELD CONSTRUCTION:
1. The drainfield shall be constructed to the dimensions shown on the design.
The bottom of the trench shall be within 2" of level.
2. Distribution piping must be placed level with perforations down atop a level
bed of drainfield rock. Rock should then be placed over the pipe to provide a
minimum of 2" of cover.
3. A silt barrier or geotextile fabric must be placed between the drainfield rock
and the natural soil backfill.
4. Monitor tubes must be 4" in diameter and installed at the locations shown on
the design. The portion below ground must be perforated.
5. Contractor shall verify the septic tank and drainfield are a minimum 100' away
from any private water wells in the area, 150' from a Class "C" Well or 200'
from any community well.
6. Direct bury insulation must be placed over the distribution system if less than
3' of backfill depth is available. Finish grade over the trench must be
mounded to prevent settlement or depressions.
7. The area surrounding the absorption trench must be graded to drain away
from the trench.
8. A minimum 2' of accepting soil is required below the drainfield rock for a 5'
wide trench. All pockets of unacceptable materials must be removed and
replaced.
MATERIAL SPECIFICATIONS:
1. Septic tanks must be constructed by a municipally approved septic tank
manufacturer.
2. The following pipe materials are approved for use in septic system
installations in the Municipality of Anchorage:
Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and
solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or
A.B.S. (perforated and solid).
3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow
Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder,
Fernco, or equal).
5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed
between the final drain rock layer and the native soil layer.
6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the
#200 sieve.
INSPECTIONS:
Municipal Ordinance requires a minimum of two inspections. These inspections
must be conducted under the supervision of a professional engineer registered in
the State of Alaska. The first inspection must be conducted after the excavation
of trenches, beds or pits and before the installation of any gravel. A septic tank
may be set in place, but may not be backfilled.
The second inspection must be conducted after the placement of the geotextile
fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No
backfill should be in place at the time of inspection.
Contractor shall provide a copy of all field survey layout and construction notes
for use in preparing the certified as-built of the completed system.
R• g910 Uf a
• !r--- Municipality of Anchor. ti 0.1z, A
On-Site Water and Wastewater Pro. - iiia"=: :. z
(907) 343-7904
OCT 26 2017 ID 5a < <TY
Certificate of On-Site Systems A 6 oval }/\'
067-041 -32 G'[ 6s
Parcel I.D. Expiration Da e: Jan 30 oZQ ig
1. GENERAL INFORMATION
Complete legal description River Park View Block 1 Lot 2
Location (site address) 6900 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:
n Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 5
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well Individual ❑
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
Received by: Date: kJ e r(7
COSA to be released to the eng er,unless otherwise requested by the engineer.
COSA Fee $ ///4Y Waiver Fee $
Date of Payment 4Q/a?1/9 Date of Payment
Receipt Number 0 L Receipt Number
COSA# 0607-/ Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER s.
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, fuhctional 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, he 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 Date 10/25/17
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6. DSD SIGNATURE �- Ifo,, . • ,,.....•..
5 System #1 Approved for bedrooms {{'�" / p .`�
o t �.• in J a:T y °'
System #2 Approved for bedrooms e,,
Disapproved �'� °�o°•!1`1� i?-••.E�0�
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Conditional approval for bedrooms, with the following stipura ibbs.T.-:^-�
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?41ENTS � -
By: 616Y,(1/()A Original Certificate Date: U .3�J/201
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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 -
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: River Park View Block 1 Lot 2 Parcel ID: 067-041 -32
A. WELL DATA
Well type Private If A, B, or C provide PWSID# Well Log (YIN) Y
Date completed 5/25/1 7 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y
Total depth 141 ft Cased to 141 ft. Casing height (above ground) >18 in
FROM WELL LOG AT INSPECTION
Date of test 5/25/17 New
Static water level Artesian ft ft.
Well production 15 g.p.m. g.p.m
WATER SAMPLE RESULTS:
Coliform ND colonies/100 mL Nitrate 1 .23 _ mg/L
Arsenic ND ug/L Date of sample: 10/17/17 Wheaton Water Wells
Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Steel Date installed 5/10/17
Tank size 1 500 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
1.2 GPD/SF
Date installed 5/9/17Soil rating (9Pd./ft2 or ft2/bdrm) System type 5 Wide
Length 63 ft. Width 5 ft Gravel below pipe 4.2 ft.
Total depth 8.9 ft. Eff. absorption area 630ft2 Monitoring tube Y Depression over field N
Date of adequacy test New Const Results (Pass/Fail) For bedrooms
Fluid depth in absorption field before test in. Water added gal. New depth in.
Elapsed Time: min. Final fluid depth in. Absorption rate >= g p.d.
Any rejuvenation treatment(past 12 mo.) (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 >100' On adjacent lots >100'
Absorption field on lot 100' On adjacent lots 100'
Public sewer main >75' Public sewer manhole/cleanout >100'
Sewer/septic service line >25' Holding tank >75'
Animal containment areas >50' Manure/animal excrete storage areas >100'
SEPTIC/HOLDING TANK ON LOT TO:
>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:
>10'
Property line 1 Building foundation 1 Water main
Water Service line Surface water Driveway, parking/vehicle storage
Curtain drain None Noted Wells on adjacent lots >100'
F. COMMENTS
G. ENGINEER'S CERTIFICATION ,, �Vsy+�li!
/ certify that I have determined through field inspections and
p1 C1 F g qiI,
review of Municipal records that the above systems are in a.4SP ?•;• -r ��'•.sf.1l
conformance with MOA COSA guidelines in effect on this date. *• 4 T'� :9 Is
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Engineer's Printed Name
Benjamin Schiller, PE • _ � ••••••:...;
Date 10/25/17 �IK...4i,31 Sc "
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COSA brown sheet 10-10-12.doc
Lot 5
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PLOT PLAN AS BUILT X SCALE 1" = 100' GRID SW 0363 Protect No. 17-053/B5
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & Associates , inc . (907) 522-6476 Phone oopCOp 0
ke(9O7)nOlan22-4625 su ey comax .=71.,Q�r .q L 4%�
Professional Land Surveyors g ....•• •....:11/4s,1:1
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jonathanOlangsurvey.com O ...".'f.
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I herebycertif that I have surveyed the followin described property: QOCP �'\ �oo
LOT 2, BLOCK 1, RIVERPARK VIEW SUBDIVISION (PLAT2017-23) y 49TH /\ � ��
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 1 , ...4"---
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no improvements on the property lying adjacent thereto encroach on the surveyed ��o 1 KENNETH GS LANG 4�
premises and that there are no roadways, transmission lines or other visible �,
easements on said property except as indicated hereon. �n J'� �' i3f L"7 Q�
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Dated this the Day of :.%�-T La ry , ___�, at Anchorage, Alaska 41144,0 '•••••• X .
/PortSSIONA1-�o
It is the responsibility of the owner to determine the existence of any easements, ���00000a
covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963