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HomeMy WebLinkAboutRIVERPARK VIEW BLK 1 LT 3 Onsite File Riverpark View Block 1 Lot 3 #067 - 041 - 33 Inspection Report_9-1-12.doc Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP171137 PID Number: 067-041-33 Dwelling: 9 Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: 9 New ❑ Upgrade Name: Troy Davis Homes Inc. ABSORPTION FIELD ❑ Deep Trench W Shallow Trench ❑ Bed ❑ Mound Address 1689 S Knik Goose Bay Rd. Wasilla, AK 99654 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade (907) 357-9394 3 1.2 GPD/SF 7.4 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3.4 Ft. Gravel depth beneath pipe 4.0 Ft. Subdivision Block Lot River Park View 1 3 Fill added above original grade 0.2 Ft. Gravel length 38 Ft. Township Range Section Gravel width 5.0 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 From Tank Field Tank Line 380 Ft 1 Ft. Well >100' >100' N/A N/A >25, TANK 9 Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity 11000 Gal. Surface Water >100' >100' N/A N/A Material Number of compartments Lot Line >5' >10' N/A N/A Steel 2 NA Foundation >5' >10' N/A N/A LIFT STATION Manufacturer Capacity Gal. Curtain Drain None Noted Remarks Pump on level at in. Pump off level at in. High water alarm at in. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank Tank to D3034 drainfield D3034 Installer Northern Excavation Drainfield D3034 CO/MT 3034 Inspector Mike Anderson BENCH MARK (Assumed elevation) 100 ft Inspection 151 7/13/17 7/14/17 Location and description 3`° 2nd 4th Bottom of SW door jam. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp OF Al Conditional Approval: Date i /TH&'V I . Benin Schiller .' ��)fiFG ,,• CE 12592 Approved L i m C,H I,J Date J 1 6lir 4 �- , ,i? - .•� Inspection Report_9-1-12.doc RIVERPARK VIEW. BLOCK 1 LOT 3 PERMIT # OSP171137 95.2 PID # 067-041-33 98.8 FINISH GRADE OUB 98.6 ORIGINAL GRADE 91.2 m NO GROUNDWATER 5/28/16 DRAINFIELD ROCK 3 91.2 38' PROFILE AS -BUILT (NO SCALE) O U 95.2 go --or- i4C;q`�l l '9*� mc .......... jSer �'c •• CE 12592 dw lA_ PROFESSI�NP W CID ,; gn c n *—Qb- C:) *> z Iz IF P] c7l �; C2 Fn p C/) 0 x -OU � cn 0 cm 0 Z v C/) cn CD c/) < cf) 0 0 --q (-- m 71, z 2 Z C?cn G) 0 O U) Ccf) ;o -n 5 m>. m m (-) m I i -O I > M*\ 0 i m cl) --I 0 i r z Y) 0C2 8 � 0 0 -n a m --q m ca -0 > m co 0 0 c/) m 0 ;z U) m 0 0 0 o cf) z n c/) ---i r m cn r Z ..C) A //: \ --i w E�: Ez m -n < 0 0 0 M 1 00 G) -rn - m z MMc)>o-n U) -0 0 0 m sc�z > IS o cf) C ::7 IOU Z 0 < r- -0 0 ir- 0 r- m ;:D m > M m Z --I C-) G)0 r - M Z M 0 > z m m 0 < > z m 0 0 zg- C-) - C/) C/) -r, o o 0 <0 0 Cf 0 co Co Ol O N7- — Icn:v, I i -O I M*\ c/) m < m m Z* >Z m > ca z > 41 --4 Cf co x cn 0 cl) m 0 M*\ c/) m < m m Z* >Z m > ca C/7 -mn m cl) 0 r ®chi, m m M z Z ..C) A //: \ m c-0 cn m a: z m CD z > 41 --4 Cf 0 cl) 0 r ®chi, m CA) CLEMENS CIRCLE m --i >90 cf) m m m 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: 3 Block: I Additional: Permit# OSPI71 1317 Well Depth: 121 ft. From: To: Formation: Below Ground: 119 ft.l 0 29 stickup, silty gravel Above Ground: 2 ft. 29 42 wet silty gravel 6al/Min: 10 42 107 107 113 gray wet silt brown wet silt,gravel Static Level: 35 ft 113 121 gravel, water Casing: 121' of 6" ID Steel I I ner Pipe: none Perforated: none Grouted: Bentoniti Depth: 20'-ir none WATER QUALITY TESTING Cofflorm covi oom Nitrates Mg/L 'Arsenic ug/L Pate Drilled: 7-14-2017 Driller: Ben Mattson __7 Development Services Department Building Safety Division GE e4 ® On -Site Water & Wastewater Program ��° 4700 Elmore Road Z. P.O. Box 196650 a c Mark Begich Anchorage, AK 99507 s n E T Y Mayor www.muni.ora/onsite (907) 343-7904 Pump Installation Log Well Drilling Permit Number: SW OSP171137 Date of Issue: 6-28-2017 Parcel Identification Number: 067-041-33-000 Legal Description Property Owner Name & Address: River Park View Lot 3 Block 1 Troy Davis Homes, Inc. 6970 Clemens Circle 1689 Knik Goose Bay Road #400 Eagle River, AK Wasilla, AK 99654 Pump Installation Date: 10-5-2017 Pump Intake Depth Below Top of Well Casing: 113 feet Pump Manufacturer's Name: Goulds Pump Model: 7HS05412CL 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? ✓❑ Yes ❑ No Method of Disinfection: Chlorine tablets Comments: 7 GPM 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. MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Water & Wastewater System Permit Permit Number: OSP171137 Work Type: WellSeptic Initial Tax Code Number: 06704133000 Site Legal Address: RIVERPARK VIEW BLK 1 LT 3 G:0364 Site Mailing Address: 6970 CLEMENS CIR, Eagle River Owner: TROY DAVIS HOMES INC Design Engineer: ANDERSON ENGINEERING This permit is for the construction of: Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date Expiration Date ,l t C - v. Department Lot Size in Sq Ft: Total Bedrooms: 6/28/2017 6/28/2018 44142 Q 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 7 113' I '7 W* I VY1 o Vt S e. ip A -i C S r A-,- rn . Received By: , Date: Zuh Issued By: n Date: b� KI , 189107/ 41/804 MUNICIPALITY OF ANCHORAG wmJUN 12 2017 ti Community Development Department \ , Phone: 907t, .l - 9C) Development Services Division Fax: 907 193;t7 On-Site Water& Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 067-041- 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 6910 C-1/4e--"w.\'' C'rJe) Legal description (Sub'd., Block& Lot) Riverpark View, Block 1, Lot s Legal description (Township, Range & Section) Lot Size 44,142 Sq- Ft. Number of Bedrooms Three (3) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (El all that apply) Absorption Field Q Initial Single Family (SF) D (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. -74,_<L„e, L (Signature of property owner or authorized agent) Permit/Rush Fees: 'ISI + ai5 - W 4 Waiver Fees: Date of Payment: 4 r� Date of Payment: Receipt Number: 0 3530 Receipt Number: Permit No. 05e 11 ‘k31 Waiver No. Permit App_9-1-12.doc ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) June 12, 2017 Municipality of Anchorage Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 3, Block 1, Riverpark View Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 3, Block 1 , Riverpark View Subdivision intends to construct a new three-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 ,000-gallon septic tank and a 38' long by 5' wide by 4' effective depth absorption trench to treat and dispose of the effluent generated in the house. The elevation of the distribution line in the absorption trench will be 3.0' below the surface and the total depth will be 7.0'. 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. The ground surface on the lot in the area of the septic system slopes to the southwest at 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 3, Block 1, Riverview Park June 12, 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, /4J—I 61('`-1127 %.4,10.wark vi OF A •Michael E. Anderson, P.E. . 4 • �' 0 TH-�� ••'g �I Attachments i••• • . „ • •• •••- •• •• •MICHAEL E. ANDERSON. ✓ gir fr •. C -4381 ;•� � #•��ed,.•. -IL-S ,.' ♦.;��, ' S �1� z a ' z a � ��♦�� o A c� 0 c E+ `� ;u iK: 0 cn r- �:5oQ — =-io< m m I I I I G7 N o� �1�,/L�'' Z c e .•' �� I =ort' ° r co 61.9E d 12,00 N O i N 0 a cn C° ° p o m � I xx CA M O m % \\ 0je `o / i O `l� —I = r H r 3 /maw O 19 I o \ �M0 O = I� Vl � O f i � / Z � C TT S/ o// m �+ I � CA 0 i n �i a — 0<0 IV 0 Z 04 o � m D Z C 0 Cr a3 ° o rt S 3 0 01 5. 0 cr C C n3 X00 O C rt L-�t M LOT 3, BLOCK 1 , RIVERPARK VIEW SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Three Bedroom Home 5'Wide Trench System Perc. Rate: 1 -5 Min./Inch 1,000 Gallon Septic Tank Application Rate: 1.2 GPD/SF 4' Drainfield Rock 3 Bedroom4 X 150 GPD/1.2 GPD/SF (Application Rate) = 375 SF Absorption Area 375 SF/5 SF/LF*.5(Red. Factor) = 37.5 LF Trench Length THEREFORE: Construct a 38' 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 3' Below the Existing Ground. Total Depth of Trench to be 7' 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 2'6" Geotextile / Fabric 6" 4" Perforated PVC (Holes Down) Drainfield Rock 4'0" 5' I I TYPICAL DEEP TRENCH SECTION ��•�E of, •, (NO SCALE) +.`A, ............., + NOTE: Grade Area Over Trench to Drain Away. . .t Minimum 6' Separation From Bedrock. x....' ... ... . ..':. s Minimum 4' Separation From Groundwater. s Minimum 100' Separation From Private Wells in the Area. Michael E.Anderson Minimum 100' Separation From Surface Water or Streams. ♦o ; �. Minimum 10' Separation From Water Service Line. �•'tsJ .•, No. CE4381 - QUO 6 L 1;..��<c,41.�� LI/W/ :H.LVQ SIH.L NO .LOH3dH M SHNI'IRGUID H'IdIOINnW QNV H,LV LS "I IV RLIM H3MVQ2I000V NI (19M032I2d SVM SIM, ZVHZ AdI. NU NOSNHQNV 'H'IHVHOIW `I 'JNRIHHNIJNH N0S'dHQNV Ag QHM0J-dHd ZS91 9H1 (INV SHl Ol _MUN301 _IVIb�iVW �13=NnS9nS '1S�11 Ol NMIcl CITWOS ]21d T10H 1S31 'SLN9WW00 L3 s PUB 13 j7 :NHHM.LHEl Nn -a .LSH.L (SHHONI) ��9 'VIQ H'IOH "O2iHd (HONI/NIII) 0•Z:HJ V d NOIJ V'I002IHd NVId 911S 33S Nd -Id I11S :ONl'd011NOiN AO 3IIVQ 0 :DM'dOlINOIN 11313V 'd9lVM d0 HI&M S t.H Ld3a iVHM D SBAJI ON U131i3.LNflODN3'd9lVM QNnO'dD SVM ]dO-iS MO/WJ ONdS H11M _I�IAd2i0 )d_11S 90/80 V 910H IS91 �11�-1-11 W :NVIDINHDH.L :#(Il IHO2IVd :,ON .LOHIO2Id L I/ I I/ L :Hlvcl S-DWOH SlAVC1 ),OH1 :2IOd clam032IHd -anS HAMA 'A�Jdd J�JAI�j `I 'ADO -18 `2 10-1 :NOI.LdIldDSHQ IVOHZ ISH I. NOIZV'IODUHd - JO I STOS -6T -8I -LT .91 -9T tT -£I -ZI TI -0I 6 - 8 L 9 S _ •rj Z -I 0333) H1dga OS99-61 S66 '>IV `�IOd�JOHONV 1�1�]H1S nAeDd�18 OOL-7 1N�]Wl�]Vcl�lQ S�131AH�IS 1N�]WJO_1�]n�JQ �PDVZ1OHONV _�O .11l-lb'dIOINnw "00.S „00.9/„00.1 01 9Z:6/91:6 9 -.00'9 „00'9/„00'1 OT t7T:6/t,0:6 S "00'S „00'9/„oo-1 OT £0W£9:8 1' 1100'S 11009/1100'1 OT ZS:8/Ztb:8 £ 1100* 9 1100'9/1100' 1 01 T t7:8/ T £: 8 Z -.00'9 .00.9/„oo-1 OI 0£VOZ:8 T I 11 JNI1S�1 01 21016cJ GIWOSI&I TIOH 1Sl1 (S�IHONI) dOHG 1IN (SDHONI) HI1bV 01 HldIa (S�i1nNIW) IWI1 _LIN (Sg1nNIW) IWI1 SSOJ JNIGVII IlVG NVId 911S 33S Nd -Id I11S :ONl'd011NOiN AO 3IIVQ 0 :DM'dOlINOIN 11313V 'd9lVM d0 HI&M S t.H Ld3a iVHM D SBAJI ON U131i3.LNflODN3'd9lVM QNnO'dD SVM ]dO-iS MO/WJ ONdS H11M _I�IAd2i0 )d_11S 90/80 V 910H IS91 �11�-1-11 W :NVIDINHDH.L :#(Il IHO2IVd :,ON .LOHIO2Id L I/ I I/ L :Hlvcl S-DWOH SlAVC1 ),OH1 :2IOd clam032IHd -anS HAMA 'A�Jdd J�JAI�j `I 'ADO -18 `2 10-1 :NOI.LdIldDSHQ IVOHZ ISH I. NOIZV'IODUHd - JO I STOS -6T -8I -LT .91 -9T tT -£I -ZI TI -0I 6 - 8 L 9 S _ •rj Z -I 0333) H1dga OS99-61 S66 '>IV `�IOd�JOHONV 1�1�]H1S nAeDd�18 OOL-7 1N�]Wl�]Vcl�lQ S�131AH�IS 1N�]WJO_1�]n�JQ �PDVZ1OHONV _�O .11l-lb'dIOINnw MUNICIPALITY OF ANCHORAGE 4,57.1.(7.7.11..71...4. 1DEVELOPMENT SERVICES DEPARTMENT +♦1♦ 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650,.' % ♦ 49th i SOILS LOG - PERCOLATION TEST * 1 ,�.L c.-��/L,;'1 /, :,MICHAEL E. ANDERSON ;C, LEGAL DESCRIPTION: LOT 3, BLOCK I, RIVER PARK VIEW SUB. ♦♦,/J • No.r E-ase/• ti • PERFORMED FOR: TROY DAVIS HOMES ♦♦+ t •+ DATE: 5/19/16 PROJECT No.: ♦~� � �+ PARCEL ID#: TECHNICIAN: W. ROBERTS Professional Engineers Stamp. DEPTH TEST HOLE 5 (feet) 1 OB/OG SLOPE SITE PLAN 4 2 3 4 . 4 5 — SEE SITE PLAN a y 6 a * 7 — a 8 SILTY GRAVEL WITH SAND 9 —Is :4 GM/GW 1 a WAS GROUND WATER ENCOUNTERED? NO IF YES @ WHAT DEPTH', DEPTH OF WATER AFTER MONITORING; NONE I I DATE OF MONITORING: 5/28/16 l DEPTH TO 1`; DATE READING G(M NUTES)OSS E (MINUTES)NET TIME WATER N(INCT DROP (INCHES) 14 .° TEST HOLE PRESOAKED PRIOR TO TESTING: 15 • 5/28 1 4:00/4:10 10 I.13"/4.50" 3.37" 16— 2 4:11/4:21 10 1.25°/4.63" 3.38" 3 4:22/4:32 10 1.00°/4.38" 3.3 8" 17— a 4 4 4:33/4:43 10 1.25"/4.63" 3.38" 18 BOH @ 18' 5 4:44/4:54 10 1.00"/4.38" 338" 19 6 4:55/5:05 10 1.25"/4.63" 3.38" 20 PERCOLATION RATE:2•96(M1N/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 *�00.+..qrV DEVELOPMENT SERVICES DEPARTMENT ��,`4� '••••.., ..rrf.+` 47QQ BRAGAW STREET ANCHORAGE, AK 99519-6650 ':• ��_ • 9th 1\ SOILS LOG - PERCOLATION TEST (PIIL - • + :MICHAEL E. ANDERSON s LOT 3, BLOCK I, RIVER PARK VIEW SUB. .. '• No. CE-4381 �+ LEGAL DESCRIPTION: .��4r rt-.1.t ,,.' ♦ PERFORMED FOR: TROY DAVIS HOMES �*64 • ' • DATE: 5/19/16 PROJECT No.: irr e��s"�' PARCEL ID#: TECHNICIAN: W. ROBERTS Professional Engineers Stamp: DEPTH TEST HOLE 6 (feet) OB/OG SLOPE SITE PLAN 1 4 2 G l a 4 4 - 5 ,O SLE SITE PLY. • 4 ' i 6 4 - 7 a . a 8 . • SILTY GRAVEL WITH SAND 9 °d 4 GM/GW WAS GROUND WATER ENCOUNTERED? No 10— IF YES @ WHAT DEPTH" S DEPTH OF WATER AFTER MONITORING: NONE L 1 1 DATE OF MONITORING: 5/28116 12 - DEPTH TO 13 DATE READING GROSS MMITES)E NET TIME(MINUTES) WATER N(INCT DROP ., (INCHES) 14 TEST HOLE PRESOAKED PRIOR TO TESTING: 15 5 -'S 1 5:14/5:24 10 0.75"/4.50" 3.75" 4 6 2 5:25/5:35 10 0.75"/4.50" 3.75" 3 5:36/5:46 10 0.63"/4.38" 3.75" 17 `. V 4 4 ' 5:47/5:57 10 0.50"/4.25" 3.75" 18 BOH @ Is' 5 5:58/6:08 10 0.50"/4.25" 3.75" 19 6 6:09/6:19 10 0.75"/4.50" 3.75" 20 PERCOLATION RATE:2•7 (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 PAUM PA U Il Y OF AHCHO "v N GE .:t 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. 067-041-33 Expiration Date: ^ Zg Z 1. GENERAL INFORMATION Complete legal description Riverpark View, Block 1 Lot 3 Location (Site address) 6970 Clemens Cir, Eagle River, AK 99577 Current property owner(s) Paul Lam/ Foxwortil Day phone (405)213-6871 Mailing address 6970 Clemens Cir, Eagle River, AK 99577 Real estate agent 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone 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 $ 5 5 d Waiver Fee $ Date of Payment Date of Payment Receipt Number Receipt Number COSA # 0 S C 2 if (OH 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone (907) 522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503 Engineer's Printed Name Benjamin Schiller, P.E. (M.J.) Date 10/20/21 TH 6. DS_ D,SIGNATURE System #1 Approved for 3 bedrooms Benjam* chiller System #2 Approved for bedrooms�s'•. �oi2oi292 .• �``�`r�/ Disapproved kkF, PROFESSION - Conditional approval for bedrooms, with the following stipulations: k o WAST':v'ATER oz / PROUhAlvl 1 Original Certificate Date: 1 Cn The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: Riverpark View, Block 1 Lot 3 If more than 1 septic system on lot: COSA Checklist # A. WELL DATA ❑® Well log is filed with Onsite (or attached) Date drilled 7/14/2017 Total depth 121 ft Cased to 121 ft ❑® Sanitary seal is functioning correctly R Wires are properly protected Casing height (above ground) 28 in. Date of flow test for COSA 10/18/21 Static water level at beginning of test 32.6 ft. Comments B. TANK DATA Age of tank(s) 4 years Tank type/material Septic/Steel Measured operating fluid level in septic tank 48 Fol Standpipes/foundation cleanout per record drawing Date of pumping 10/24/21 Around The Clock Pumping., D. ABSORPTION FIELD DATA Shallow Trench Which system tested (date installed) 7/14/17 W ALL standpipes present per record drawing Total measured depth from grade 7.7 ft (max) Measured depth to pipe invert from grade 3.7 ft (min) ❑ N/A — pressurized field ❑® Monitor tubes go to bottom of effective. If not, state depth into effective Parcel ID: 067-041-33 of Structure served by this system Well production at time of test 7.7+ gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 1.03 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Forge Engineering Date of Sample 10/13/21 FT STATION ❑ Requir aintenance completed Age of lift station years Lift station material Comments: Adequacy test date 10/18/21 Results O Pass For 3 Fluid depth prior to test 2 Water added 661 gal New depth 7 in Elapsed time 1440 min 3 bedrooms lit ❑® Code -required soil cover over field Final fluid depth in ❑ System presoaked Absorption rate '450 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Yes Community Sewer Manhole/Cleanout > 100' ft 0✓ Yes if No ft M Yes if No ft Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25'✓Q Yes if No ft Absorption Field on Lot > 100' Yes if No ft Holding Tank > 100' Yes if No ft Neighboring Absorption Fields > 100' Surface Water > 100'✓] Animal Containment > 50' ❑✓ Yes if No ft ft F✓ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0✓ Yes if No ft F✓ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' Q✓ Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5'✓Q Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' P- Yes if No ft Private Wells > 100' ❑✓ Yes if No ft Water Main > 10' ✓V Yes if No ft Community Wells > 200'✓0 Yes if No ft Water Service Line > 10' Q✓ 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' Q Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' p✓ Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Surface Water > 100'✓] Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION i certify that 1 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� ^ Benjarr niSchiller d FFG, •. CE 12,592 • c�`�r®"® i�l�• , 10/20/21Aw, PROFESStONt` , COSA Checklist yellow sheet r P '/,'S..411' A J. 'J '1 • • 2 ,Gt •t c_� Municipality of An% ,-age,;‘:..�': `\" _° °.__ On-Site Water and Wastewate :P fog arri \ < ' . (907) 343-7904bl 2�1� ''1 ■:V E i $p f E T Y v A ,,c1 /ti Certificate of On-Site Systerns / pproyal4y ''-•!! ol.__fi°:.! - Parcel I.D. 067-041-33 Expiration Date: •3 —I O/ ( 1. GENERAL INFORMATION Complete legal description Riverpark View Block 1 Lot 3 Location (site address) 6970 Clemens Cir. Current Property owner(s) Troy Davis Homes Inc. Day phone (907) 357-9394 Mailing address 1689 S Knik Goose Bay Rd. Wasilla, AK 99654 Real Estate Agent Day phone 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well D Individual LI Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: `/ii ,v,g)(-y 09 Date: /42//q/17 COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ I (.(p'' Waiver Fee $ Date of Payment 12451(9-(9 Date of Payment Receipt Number OOio9OD Receipt Number COSA# C6Cf 3-(5gO Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, y investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Gui'-.: or this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, tional 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 Benjamin Schiller, PE Date 12/13/17 i *.*49TH *0�i 6. DSD SIGNATURE '• r N System #1 Approved for 3 bedrooms • Be., •in Schiller / System #2 Approved for bedrooms � ;r. E 125,021.7 Nr�/ Disapproved kk. ''Y.40r ,z. ••`"�-+ Conditional approval for bedrooms, with the following stipulations: P\5‘Y OFC ON-SITE 476,,,' c WATER AND r`' n WASTEWATERo�_- PROGRAM Original Certificate Date: ( ^1 C ^1 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: Riverpark View Block 1 Lot 3 Parcel ID: 067-041-33 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Yes Date completed 7/14/17 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 121 ft. Cased to 121 ft. Casing height(above ground) 24 in. FROM WELL LOG AT INSPECTION _ Date of test 7/14/17 New Static water level 35 ft. ft. Well production 10 g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform ND colonies/100 mL Nitrate ND mg/L Arsenic ND ug/L Date of sample: 11/06/17 Collected by: Wheaton Water Wells B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 7/14/17 Tank size 1000 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 7/13/17 Soil rating5-Wide (g.p.d./ft2 or ft2/bdrm) 1.2 GPD/SF System type Length 38 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth 7.6 ft. Eff. absorption area 380 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 (Y/N) "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 X75' Animal containment areas >50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Absorption field >5' Water main >10' Water service line >10' Surface water >100' Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water main >10' Water Service line >10' Surface water >100' Driveway, parking/vehicle storage >1 0' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS G. ENGINEER'S CERTIFICATION ��.. 4i _ ks I certify that I have determined through field inspections and .:�P'••••" :1i •9'f' review of Municipal records that the above systems are in ..0'*�,•49 TM I� •it conformance with MOA COSA guidelines in effect on this date. FA Engineer's Printed Name Benjamin Schiller, PE ;11 „�_�, 12/13/17 � �;•, Ben-;, in Schiller •;a ! Date (� ` ,•• CE 192 .•w � }0 `�ea44".1:3.1!!•'1,\l� ` PRO Ss:4 *� COSA brown sheet 10-10-12.doc Lot 4 ____ L 1 N 893648E 316.71' i J ' ' " z c_ri �; GRAVEL * / �: : DRIVEWAY . v • Lot 3 / . 44,142 s.f. /' i20 .. . . . . /vi) q-0 0 .. c 0 m v2• SEPTIC PIPES rye. 2.0• I. g 0 n . . 1 0 r • • s N HT 2 STORY RESIDENCE 36.8' 1 Lot 2 �� 2.7ss w tTl 1 co 22.o w WELL (01 Z I & a \S m 1 • 0 �4° �p�\ o n_ 2 r- .. \ O 1�� m 47 ` N /^\ 49'19 \ � �� �— � 341.Ss, • • • . I \ ' N 15' T&E EASEMENT I 30.0' Lot 1 , .., ,.. :•..: 1