HomeMy WebLinkAboutKENO HILLS #6 BLK 6 LT 12 Onsite File
Keno Hills # 6 •
Block 6 •
Lot 1 2
#020 - 141 - 42
Municipality of Anchorage
On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP181239 PID Number: 020-171-42
Dwelling: [' Single Family (SF) ❑ Duplex(D) ❑ Multiple(SF and/or D) Project: ❑■ New ❑ Upgrade
Name:
Crown Pointe, Inc. ABSORPTION FIELD
Address ❑ Deep Trench ❑■ Shallow Trench ❑ Bed El Mound
P.O. Box112313 Anchorage, AK 99511 ❑ Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
(907) 229-1886 4 1.2 GPD/SF 5.0 Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot 3.0 Ft.2.0 Ft.
Keno Hills #6 6 12 Fill added above original grade Gravel length
Township Range Section 0.8 / 1.2 Ft. 70 Ft.
Gravel width Beds:Number of Lines Distance between lines
SEPARATION DISTANCES 5.0 Ft. Ft.
To Septic Absorption Holding i Sewer Total absorption area Number of trenches Dist.between trenches
Lift Station
From Tank Field Tank I Line 500 Ft2 Ft.
Well >100' >100' N/A N/A >25' TANK E Septic ❑S.T.E.P. ❑Holding ❑Other
Manufacturer Capacity
Surface Water >100' >100' N/A N/A Anchorage Tank 1250 Gal.
Material Number of compartments
Lot Line >5' >10' N/A N/A Steel 2
NA
Foundation >10' >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
No insulation needed.
in. in. in.
Pump make and model Electrical Inspections performed by
PIPE MATERIAL House to tank D3034 Tank to D3034
Installer drainfield
Sanders & Sanders Drainfield D3034 CO/MT D3034
Inspector J. Millette BENCH MARK (Assumed elevation) 100 ft
Inspection 151 9/17/18 2"d 9/17/18 Location and description
3,J 49, Top of foundation @ point B.
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp
OF A�q�<<
Conditional Approval: Date X47.•.•• . j
.#10)
.49TH %\ •*9• 9
i
6 .Benja.' . chiller : j
��?'F• CE 12592 ••i4/
��Jl�;. 5/6/19 •''
Ap•roved �t� >_.i`Da Date 1719 '1l%,.:... S10Na\4=
Inspection Report_9-1-12.doc
KENO HILLS #6 BLOCK 6 LOT 12
PERMIT # OSP181239 PID # 020-171-42
\ \ / z
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\\ f �� LOT 12 \.
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o.o.c, , , o o / Q Q o o Q co 00 0 o o\ o 0 0 Q. 0 0 O. c»
t9 co,...0, O �j ed O �.' a' O O Q' ry'V CO co O N d co a0 0 N d c0 O O�O�
0 0 - 2 y q N N N Q t•-7 M co d d d \d d N U) U) O a fl
0 0 0 � •O .O O O / ^O ^O O O N. ^O 00 0 O 0 0 0 O Cr) O O O 0 0 .()(,
•
( EXISTING WELL j
,' 1) .,... .r.- ..-
1
Imo.-:-.-\\ Cr
\\ \ 1/ / w o
\ gyp \ �, \ o
p���o� // cow a.
\\ \ /• ., TH#CO2 / 1 oe
LI-
\ 2 \ /• . • 11 MT 0\ ( // / ►_ o
\ FCO ( .i I i o ^
\ " ' SVl Y •
I 1 i j ' .
G SVq - -- ` r 1 1 .
. • 0
® \ I. .' -hitt. 2C0 1250-GAL SEPTIC LOT 7
\ i - • I 1 TANK
BLOCK 2 \ 1 1
II
.� ` ; i- '
II
LOT 9 , \ • 1 L C01 70'LONG x 5'WIDE,2'EFFECTIVE --
\
`
1 \ DEPTH ABSORPTION TRENCH/ / - ' -, \
1 �� / '
\ \ / \ / \
\ 8ALTERNATE'SITE LCYT 13 \ LOT 6
1 \
4`�"\�,t\ LEGEND
�,`p �'95,�1'' A B C CO-CLEANOUT
j co•• Ni.‘• '� •..y +� PLAN AS-BUILT FCO _ 11.2 22.0 2C0-DOUBLE CLEANOUT
*. 49 TH i� �, •,*y/ SV1 26.1 18.6
. .kX^.. 0 _SV2 34.2 21.7 FCO-FOUNDATION CLEANOUT
f-, ..,_. --.::.
2C0 40.2 25.1 FS FLOW SPLITTER VALVE
/I *- Benja m Schiller . j 0 50 100 CO1 83.9 65.6 MH-MANHOLE
Oi es •. CE 12592 / MT 17.8 23.1 MT MONITORING TUBE
'srF •^'�16'�079 k*.;*--Ir
= = FEET CO2 . 20.1 23.8 SV SEPTIC VENT
Ill1����t =4' ,....,..E
1"=50' TH TEST HOLE
KENO HILLS #6 B6 L12
PERMIT # OSP181239 PID # 020-171-42
o N 0
LUL. U) CO N
- 100.6 - -
F — i 96.6
ii\ v,
96.0 1250 GAL 95.8
SEPTIC TANK
V I
''''''''- 91.8
_ 98.5 198.9 FINISH GRADE _
o� /- 97.7 ORIGINAL GRADE 0
94.7 ,.:• .:,,,,r..:..�{.v. :..t .. 1F ., .��. �:� >.%;�;�•� � tea•,:, 94.7
,' '• .15-t:r7'4. 4' LRXb tai:-.vim � L �^ ::4.}.'.,C..,11:r '-S.,4, s "`�,Y•.:+..,.?,47:
,K•1}X*!:t:;;.. 2x' ,. .! •<; ,,i' i :afi ) ,',_S,' >1,.i,.+t.::' *A't +•F 5$.ori•'
;.'F�:�'('-'a:�ty,i!+'�"R'q;y.e:::��:.w����c�•1 i•{3.vr�`r,/' ;�,�.`�::!;:.�'J9�i6:•,s.°;s�s% t�.":,t:•:'%.ria'�':�!O;�a,;n1;;,��%
92.7 92.7 �-
1- 70' -I
86.7
N
= NO GROUNDWATER 7/20/18
1-
......,.��\\\\\
ikP•'•• • !f'
'49 TM i\ *+?,
-g3.:-.-*•'• In Schiller t✓0 1... CrE,1e 092 �'///
PROFILE AS—BUILT �oil0Fio •• ..,.=
�4„�, E„' (NO SCALE) ��\\\`•••••••
MUNICIPALITY OF ANCHORAGE . . : ,q 111
DEVELOPMENT SERVICES DEPARTMENT *oAlrk.. �; q*�,I
4.700 ELMORE ROAD ANCHORAGE, AK 99519-6650
SOILS LOG AND PERCOLATION TEST .
Benja in Schiller /
$fie•
. CE 162592
LEGAL DESCRIPTION: KENO H ILLS #6, BLOCK 6 LOT 12 i14i.•......•'`+�
PERFORMED FOR: CROWN POINTE HOMES `•\\���~~
Professional Engineers Stamp:
DATE: 7/9/18 PROJECT No.:
PARCEL ID#: 020-171-42 TECHNICIAN: J. MILLETTE
DEPTH TEST HOLE 1
(feet)
1 j 1' OB SLOPE SITE PLAN
2
3 ..1::::.....,:.....:
4 '
5 -4
SANDY GRAVEL W/SILT(SP) SEE SITE PLAN
6
8
1 Q WAS GROUND WATER ENCOUNTERED? NO
D%% ' IF YES(a,WHAT DEPTH? - S
/�j/��/ HARD PAN DEPTH OF WATER AFTER MONITORING: NONE b
11- /' ///` DATE OF MONITORING: 7/20/18 P
„„,
12 E
GROSS TIME NET TIME DEPTH TO NET DROP
13 DATE READING WATER
(MINUTES) (MINUTES) (INCHES) (INCHES)
14 7/20 TEST HOLE PRESOAKED PRIOR TO TESTING:
15 1 13:00/ 13:02 1:50 4i- 10�°i 6i
16 2 13:06/ 13:08 2:01 4- 10 6
3 13:10/ 13:12 2:10 4- 10 6
17
4 13:14/ 13:16 2:14 4- 10 6
18 5 13:17 /13:19 2:13 4- 10 6
19 6 13:21 / 13:23 2:15 4- 10 6
20
PERCOLATION RATE:0.38 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN: 5 FT. and 6 FT.
COMMENTS:
07/12/2013 21: 29 907--345-a2U2 ALPINE DRILLING PAGE 01/0.1
Alpine Drilling & Enterprises
Well Log
Permit Number: 4SW181239 Date of Issue: 8-8-18 Parcel Identification Number: 020117142000
Date Started: 10-25-18 Date Completed: 10-27-18 Is v;ell located.at approved permit location?x Yes 'Milo
Legal Description: Keno Hills#6 Block 6 Lot 12
Property Owner Name&Address: Gown Point
POB 112313
Anchorage, Alaska p951 I
Borehole Data: Depth (ft} —Method of Drilling x air rotary ❑cable tool
Soil Type,Thicki:eis Fi Water Strata From Tor---------�._�_____._.__--�.-----
i Casing type:steel
stick-up 0 Wall Thickness:.250 inches
gravelly coht+ly silt ,l Diameter: 6 inches Depth: 45 feet
Liner Type:
bedrock 4 416 Diameter: inches Depth: feet
{ Casing stickup above ground: 2 fee-.
Static water level(from ground level):41 feet
Pumping level: 416 feet after
2 bows pumping I gem
Recovery Rate: 4 gpm
Method of Testing:air lift
Well Intake Opening Type:
❑ Open End N.Open Hole
•
0 Screened Start _feet Stopped 6 bgs feet
(� Perforations Start feet Stepped _feet
Grout Tyne:t1eittonile chips Volume:
WATER ITY TESTING Der4h: .4 feet Stopped 4.5 feet
Coliform ► CoU100mL Pump: Intake Depth feet •
Nitrates mg/L _ Pump size hp Brand Name
Arsenic ugiL
Well Disinfected Upon Completion? x Yes! No
Method of Disinfection: cidarinuaithal
Comments:
j Well Driller: Alpine Drilling&Enter,irises
PO Box 110496
Anchorage AK 99511
to'? 1 L!/
54,51T1-7
01/02/2013 01:0I 907-345-3202 ALPINE DRILLING PAGE 01/01
MUNICIPALITY OF ANCHORAGE
..�..r AimomminplowriallIMINNIII
+1 Phone. 907-343-7904
Development Services Department
On-Site Water& Wastewater Section ,, Fax: 9J7-343-7997
Pump Installation Log
Well Drilling Permit Number: 181239 Date of Issue: -8 1$__
Parcel identification Number: 02Q171.4211c`-'
Legal Description Blockoto Property avi tier Name&Address:
Kano Hills-A3 E 12 Crown Points
P.O,Box 112513
An&°rage,AK !:8511.2313
Pump Installation Date: ba 19
Pump Intake DepthBelow Top of Well Casing: 397 meet
Goulds
Pump Manufacturer's Name:_ _—__. .—_
Pump Model: ''` 1
Pump Size: hp
Pitless Adapter Burial Depth:NIA_ feet
Pitless Adapter Manufacturer's Name: NIA __ ---
Pitless Adapter installer: N/A
,r
Well Disinfected Upon Completion? yl;ii Yes f2 No
Method of Disinfection: chlorine tablets
Comments:
PLEASE SAVE FOR COSA.
Pump Installer Name:
Company: Alpine Drilling & Enterprises
Mailing Address: P.O. Box 110496
Anchorage State: AK zip: 99511
City:
Attention: The 7 • i tier shall provide a p►xnp mstellation lob;to On-lite within 33 days of primp installation.
eix
;i
N""""r� MUNICIPALITY OF ANCHORAGE
— _ a�
r On-Site Water & Wastewater Program "'0
j ate' PO Box 196650 4700 Elmore Road :C_
4) Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 �^`
http://www.muni.org/onsite I t.
E
0R"VE
On-Site Water & Wastewater System Permit
Permit Number: OSP181239 Effective Date: 8/8/2018
Work Type: WellSeptic Initial Expiration Date: 8/8/2019
Tax Code Number: 02017142000
Site Legal Address: KENO HILLS #6 BLK 6 LT 12 G:3438
Site Mailing Address: 17801 Spain DR, Anchorage
Owner: JOHN HAGMEIER HOMES LLC Lot Size in Sq Ft: 103430
Design Engineer: FORGE ENGINEERING Total Bedrooms: 4
This permit is for the construction of:
Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy 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
Lo -*--:1 q/I718
Received By:
��1311 VA
T# Z I
T1' ii
I I' deel-
Date:
Date: v g
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Division \ Fax: 907-343-7997
On-Site Water& Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 020-171-42
Property owner(s) John Hagmeier Homes LLC Day phone
Mailing address 2204 Cleveland Ave, Suite 201 , Anchorage, AK 99507
Site address NHN Spain Drive
Legal description (Sub'd., Block & Lot) Keno Hills #6, Block 6 Lot 12
Legal description (Township, Range & Section)
Lot Size 103,430 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(®all that apply)
Absorption Field ❑X Initial ❑X Single Family (SF) lXI
Septic Tank 0 L]Upgrade (w/wo ADU)
Duplex (D) H
Holding Tank ❑ Renewal [l
Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well U
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.
�J
(Signature of property owner or authorized agent)
Permit/Rush Fees: % .0D Waiver Fees:
Date of Payment: 1 3I ,II `b Date of Payment:
Receipt Number: ®SO 5(0 I) Receipt Number:
Permit No. 01/419 l5�d�g1 Waiver No.
Permit App__ ..:c b \.-J ) v )
PO BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
July 27, 2018
MOA Development Services Dept- On-Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: Keno Hills #6 Block 6 Lot 12 – 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 other well or septic
system, whether on this lot or adjacent lots.
The ground surface on the lot slopes toward the road moderately from the back to the front,
between 5-15%. There are a few short slopes that run steeper than 25%, for just a few feet. There
are no slopes greater than 25% within 20 feet downslope of either the primary or alternate site, and
the layout meets the requirements for section 15.65.210.B.1.e. Drainage arrows are shown on the
site plan showing the grade and direction of flow. Stormwater drainage will not impact this septic
system. The new trench will be constructed parallel to the slope as much as possible.
Wells on this and adjacent lots are shown. The new system 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 10’ away.
Please refer to the attached test hole logs, soils lab analysis, plan and profile pages for the septic
design. If this design is followed, there will be no adverse impacts to adjacent properties.
Sincerely,
Benjamin Schiller, PE
7/27/18
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP181239, Deb Wockenfuss, 08/08/18
10.5%
15.6 %
11.8%
10.8%
9.3%1010.01020.01030.01040.01050.01060.01006.01008.01
0
1
2
.
0
1
0
1
4
.
0
1
0
1
6
.
0 1018.01022.01024.01026.01028.01032.01034.01036.01038.01042.01044.01046.01048.01052.01054.01056.01058.01062.01064.0
FCO
70' LONG x 5' WIDE, 2' EFFECTIVE
DEPTH ABSORPTION TRENCH
4-BDRM HOM E
PROPOSED WELL
1250-GAL SEPTIC
TANK
NOTE:
NO SLOPES >25% WITHIN 20' OR SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM
ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH
WELLS OR SEPTIC SYSTEMS.
CO - CLEANOUT
2CO - DOUBLE CLEANOUT
FCO - FOUNDATION CLEANOUT
FS - FLOW SPLITTER VALVE
MH - MANHOLE
MT - MONITORING TUBE
SV - SEPTIC VENT
TH - TEST HOLE
LEGEND
CO
TH#1SPAIN DRIVEKENO HILLS #6 BLOCK 6 LOT 12
Aug 07, 2018
SLOPES > 25%
SLOPES > 46%
1"=50'
FEET
0 50 100 10' UTILITY EASEMENTWELL >100' FROM PROPERTY LINETH#2
CO
MT
ALTERNATE SITE (MIN 6' SEPARATION)
10.0
2CO
15.0
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP181239, Deb Wockenfuss, 08/08/18
DESIGN FACTORS: SYSTEM REQUIREMENTS:
600 GPD PEAK FLOW
PERK RATE: <1 MIN/IN
APPLICATION RATE: 1.2 GPD/SF
5' WIDE DEEP TRENCH SYSTEM
1250-GAL SEPTIC TANK
TYPICAL DEEP TRENCH SECTION
(NO SCALE)
4" PERFORATED PVC
(HOLES DOWN)
DRAINFIELD ROCK
5'
6"
6"
1'-6"
2'
Jul 27, 2018
NOTES:
1. GRADE AREA OVER TRENCH TO DRAIN AWAY
2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2'
WITH 2" OF INSULATION
3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER
THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY
BOTTOM OF TRENCH: 4' BELOW GRADE
FLOW LINE ELEVATION: 2' BELOW GRADE
TOP OF TRENCH: 0.5' ABOVE GRADE
600 GPD / 1.2 GPD/SF / 5' WIDE * 0.70 REDUCTION = 70.0 LF TRENCH REQUIRED (70 LF SPECIFIED)
KENO HILLS #6 BLOCK 6 LOT 12
INSULATION
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP181239, Deb Wockenfuss, 08/08/18
DEPTH
(feet)
1-
2
3-
4-
5-
6-
7-
8-
9-
10
11-
12-
13-
14-
15-
16-
17-
18-
19-
20 -
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 ELMORE ROAD ANCHORAGE, AK 99519-6650
SOILS LOG AND PERCOLATION TEST
LEGAL DESCRIPTION: KENO HILLS #6, BLOCK (D LOT 12
PERFORMED FOR: CROWN POINTE HOMES
DATE: 7/9/18 PROJECT No.:
PARCELID#: 020-171-42 TECHNICIAN: J. MILLETTE
TEST HOLE 2
SANDY GRAVEL W/ SILT (SP)
10=612
SITE PLAN
SEE SITE PLAN
COMMENTS:
DATE
READING
WAS GROUND WATER ENCOUNTERED? NO
NET TIME
(MINUTES)
DEPTH To
WATER
(INCHES)
NET DROP
(INCHES)
IF YES a) WHAT DEPTH? -
L
1
15:13/15:14
DEPTH OF WATER AFTER MONITORING: NONE
0
616
-
2
DATE OF MONITORING: 7/20/18
P
4-10
,I
HARD PAN
3
E
1:12
COMMENTS:
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH To
WATER
(INCHES)
NET DROP
(INCHES)
7/20
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
15:13/15:14
1:07
4.1-100
616
2
15:15/15:16
1:09
4-10
6
3
15:17/15:18
1:12
4-10
6
4
15:19/15:20
1:16
4-10
6
5
15:21/15:22
1:18
4-10
6
6
15:23/15:24
1:18
4-10
6
PERCOLATION RATE: 0.22 (MIN/INCH) PERC. HOLE DIA.--L-fINCHES)
TEST RUN BETWEEN: 5 FT. and 6 FT.
LEGAL DESCRIPTION:
PERFORMED FOR:
DATE:
PARCEL ID#:
SOILS LOG AND PERCOLATION TEST
TECHNICIAN:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
DEPTH
(feet)
PROJECT No.:
TEST HOLE 1
SLOPE
SLOPE
SITE PLAN
See Site Plan
DATE READING GROSS TIME
(minutes)
NET TIME
(minutes)
DEPTH to
WATER NET DROP
TEST HOLE PRESOAKED PRIOR TO TESTING:
PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH)
TEST RUN BETWEEN: FT. and FT.
COMMENTS:
(inches)(inches)
Keno Hills #6, Block 6 Lot 12
7/9/18
J. Millette
Development Services Department
4700 Elmore Road Anchorage, AK 99519-6650
Municipality of Anchorage
DATE OF MONITORING:
WAS GROUND WATER ENCOUNTERED?
DEPTH OF WATER AFTER MONITORING:
IF YES @ WHAT DEPTH?
NO
-
None
0.38 6
5 6
020-171-42
Crown Pointe Homes
Professional Engineers Stamp:
Jul 27, 2018
13:00 / 13:02
7/20
1
2
3
4
5
6
1:50
13:06 / 13:08
13:10 / 13:12
13:14 / 13:16
13:17 /13:19
13:21 / 13:23
1' OB
7/20/18
SANDY GRAVEL W/ SILT (SP)
HARD PAN
2:01
2:10
2:14
2:13
2:15
4 0
16 - 10 0
16
4 - 10 6
6 0
16
4 - 10 6
4 - 10 6
4 - 10 6
4 - 10 6
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP181239, Deb Wockenfuss, 08/08/18
NORTHERN GEOTECHNICAL ENGINEERING, INC../ TERRA FIRMA TESTING
a
PROJECT CLIENT:
Forge Engineering
PROJECT NAME:
I{eno Hills
PROJECT NO.:
4914-18
SAMPLE LOC.:
TH-2
NUMBER/ DEPTH:
Lot 12 Block 6
DESCRIPTION:
Poorly -graded sand w/ gravel
DATE RECEIVED:
7/11/2018
TESTED BY:
CH
REVIEWED BY:
RJPC
100
90
80
70
60
50
co 40
c4
Wz 30
w
20
10
0
145
140
135
F
Z 130
Q
125
Q
%GRAVEL 43.8
%SAND 53.7
% SILT/CLAY 2.5
%MOIST. CONTENT 4.6
USCS
USACOEFC
%PASS. 0.02 mm
%PASS. 0.002tnm
SP
N/A
N/A
N/A
UNIFORMITY COEFFICIENT (Cj
15.2
COEFFICIENT OF GRADATION (Ce)
1.0
ASTM DI 557 (uncorrected)
N/A
ASTM D4718 (corrected)
N/A
100
OPTIMUM MOIST. CONTENT. (corrected) N/A
3/4"
PARTICLE SIZE ANALYSIS ASTM D422 / C136
100 10 1 0.1 0.01 0.001
GRAIN SIZE (min)
GRAVEL SAND
COBBLES SILT or CLAY
Coarse Fine Coarse Medium Pine
MOISTURE -DENSITY RELATIONSHIP ASTM DI557
t20
115
0 2 4 '6 8 10 12 14 16
MOISTURE, CONTENT (%)
SIEVE ANALYSIS RESULT
SIEVE
SIZE(mm)
SIEVE
SIZE (US.)
TOTAL% SPECIFICATION
PASSING 0/. PASSING)
N/A
(ASTM D2434)
152.40
6"
76.20
3"
38.10
1.5"
100
19.00
3/4"
87
12.70
1/2"
78
9.50
3/8"
72
4.75
#4
56
2.00 1
#10 1
37
0.85
#20
21
0.43
#40
11
0.25
#60
6
0.15
#100
4
0.075
0200
2.5
HYDROMETER RESULT
ELAPSED DIAMETER TOTAL%
TIME(MIN) (mm) PASSINO
0
0.5
1
2
4
8
15
30
60
250
1440
HYDRAULIC CONTI.
N/A
(ASTM D2434)
DEGRADATION
N/A
(ATM T-313)
PLASTICITY INDEX
N/A
ASTM 4318
The testing services reported herein have been performed to recognized industry standards, unless otherwise noted. No other warranty is made. Should engineering
interpretation or opinion be required, NGE-TFT will provide upon written request.
11301 Ohre Lane - Anchorage, Alaska 99515 Phone: 907-344-5934 Fax: 907-344-5993 tvlrm.age-tJGcom
, P1A JS
MUNICIPALITY OF ANCHORAGE
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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. 020-171-42 Expiration Date: C.— 17—t9
1. GENERAL INFORMATION
Complete legal description Keno Hills #6 Block 6 Lot 12
Location (site address) 17895 Spain Drive
Current property owner(s) Crown Pointe, Inc Day phone 727-5259
Mailing address P.O. Box 112313, Anchorage, AK 99511
Real estate agent Day phone
2. TYPE OF DWELLING:
• Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Private Well n Private Septic H
Water Storage n Holding Tank ❑
Community Well ❑ Community ❑
Public Water System LJ Public Sewer
Waiver request for: Distance:
Received by: Date:
COSA to be released to the engineer,unless otherwise requested by the engineer.
COSA Fee $ `t/X)1 Waiver Fee $
Date of Payment 5-1/57/1 Date of Payment
Receipt Number (J 600-1 ,00 Receipt Number
COSA# 050q /M, 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. Date 5/1 5/1 9
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6. DSD SIGNATURE
/ ...�!. . .
System #1 Approved for 4 bedrooms �/ •. Benja ' •hiller : j
!Os'. CE 12592 •
System #2 Approved for bedrooms slF•,5!15/19 •' V
Disapproved �l �F:ROFESS1014^
Conditional approval for bedrooms, with the following stipulations:
ON-SITE 111
WATER AND
WASTEWATER
pRpGRAM \`
i�))l))))11IV O
— [ �_-• �1-�= Original Certificate Date:
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the
representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is
not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA Checklist blue sheet
COSA Checklist
Legal Description: Keno Hills#6 Block 6 Lot 12 Parcel ID: 020-171-42
If more than 1 septic system on lot: COSA Checklist# of Structure served by this system
A. WELL DATA
•Well log is filed with Onsite (or attached) Well production at time of test 4 gpm
Date drilled 10/25/18 Water storage tank volume NA gallons
Total depth 416 ft Well disinfected for coliform test? ❑ Yes ❑ No
Cased to 45 ft 0 Coliform bacteria is Negative
❑■ Sanitary seal is functioning correctly Nitrate mg/L 0 Nitrate less than MRL (ND)
0 Wires are properly protected Arsenic ug/L 0 Arsenic less than MRL (ND)
Casing height (above ground) 24 in. Collected by Forge Engineering
Date of flow test for COSA 10/25/18 Date of Sample 5/2/19
Static water level at beginning of test 41 ft.
Comments New construction
B. TANK DATA C. LIFT STATION
Age of tank(s) <1 years D Required maintenance completed
Tank type/material Septic/Steel Age of lift station years
Measured operating fluid level in septic tank N/A Lift station material
• Standpipes/foundation cleanout per record drawing Comments: N/A
Date of pumping New construction
D. ABSORPTION FIELD DATA Shallow Trench
Which system tested (date installed) 9/17/18 Adequacy test date New
0 ALL standpipes present per record drawing Results ID Pass For bedrooms
Total measured depth from grade 5.$/6.2 ft (max) Fluid depth prior to test in
Measured depth to pipe invert from grade 3.8/4.2 ft(min) Water added gal
E N/A—pressurized field New depth in
0 Monitor tubes go to bottom of effective. If not, state Elapsed time min
depth into effective
Code-required soil cover over field Final fluid depth in
E System presoaked Absorption rate gpd
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months)
date of test)
Gallons introduced gallons If yes, enter date
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' Community Sewer Manhole/Cleanout> 100'
p Yes if No ft ❑✓ Yes if No ft
Neighboring Tank> 100' 01Yes if No ft Private Sewer/Septic Line >25' El Yes if No ft
Absorption Field on Lot> 100' ✓❑Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft
Neighboring Absorption Fields> 100' Animal Containment> 50' ✓❑ Yes if No ft
El Yes if No ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ❑✓ Yes if No ft LI Yes if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10' ❑✓ Yes if No ft Surface Water> 100' 0✓ Yes if No ft
Property Line > 5' 0✓ Yes if No ft Wells on Adjacent Lots:
Absorption Field > 5' 0✓ Yes if No ft Private Wells> 100' 0✓ Yes if No ft
Water Main > 10' 0 Yes if No ft Community Wells>200' 0 Yes if No ft
Water Service Line> 10' 0 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' 0 Yes if No ft Wells on Adjacent Lots:
Water Main > 10' ✓0 Yes if No ft Private Wells > 100' 0 Yes if No ft
Water Service Line> 10' 0 Yes if No ft Community Wells >200' E Yes if No ft
Surface Water> 100' ✓0 Yes if No ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION OF I�g6\1k,
I certify that/have determined through field inspections and reviewr.
��
of Municipal records that the above systems are in conformance with j*'49 TH i\ •*9
MOA COSA guidelines in effect on this date. g le... . e. . . . .
.. .. .. . ....
/ Benja,• chiller j
O fie•• CE 12592 • `�/
J�: •
•p4on, 5/15/19 ,••�G ,�
�il ", PROFESSIOw.-��
COSA Checklist yellow sheet ���\\"`-.."�