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HomeMy WebLinkAboutDENALY ESTATES BLK 2 LT 13 Onsite File benaly Estates Block 2 Lot 13 #067 - 062 - 20 Municipality of Anchorage On-Site Water and Wastewater Program• (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181270 PID Number: 067-062-20 Dwelling: ❑ta Single Family(SF) El Duplex(D) ❑ Multiple(SF and/or D) Project: 0 New El Upgrade Name: - Troy Davis Homes ABSORPTION FIELD Address El Deep Trench ❑■ Shallow Trench ❑ Bed ❑ Mound 1689 Knik Goose Bay Rd #400 Wasilla, AK ❑ Other Phone Number of Bedrooms Soil Rating 'Total depth from original grade 310-2501 3 1.2 GPD/SF 6.7 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 2.7 Ft.4.0 Ft. Denaly Estates 2 13 Fill added above original grade Gravel length Township Range Section 0.7 Ft. 40 Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES • 5.0 Ft. Ft. To Septic Absorption I Holding Sewer Total absorption area Number of trenches Dist.between trenches From Tank Field Lift Station Tank Line 400 Ft2 1 Ft. Well >100' >100' N/A N/A >25' TANK Septic 0 S.T.E.P. 0 Holding 0 Other Manufacturer Capacity Surface Water >100' >100' N/A N/A Anchorage Tank 1000 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. Pump on level at Pump off level at High water alarm at Remarks No insulation was used. in. in. in. Pump make and model Electrical Inspections performed by Installer PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield Northern Excavation Drainfield D3034 CO/MT D3034 Inspector J. Millette/J. Williams BENCH MARK (Assumed elevation) 100 ft Inspec es 1" 9/6/18 2nd 9/6/18 Location and description d3rd 9/7/18 4th Bottom of siding + COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date • .••�P,� .OF ���9���. • 6);' 41 • , �a ' 49th �. �• � � (3L11 .wnx.nauw.uu..u.•m•n..u...••• u•R •?Pn 1 MICHAEL E. ANDERSON • a 00 • vii ♦ !f•S• No. CE-4381 /p' : A rove (y •s e,pF• 2/20/16 • Appr--- 1-1,t =C7a�t.Cl t�L Date 3"'� 17 ♦ p"•••••.........••••�`4, Inspection Report_9-1-12.doc DENALY ESTATES, BLOCK 2, LOT 13 PERMIT # OSP181270 PID # 067-062-20 LOT 11 - -- - LOT18 30'T&E EASEMENT f 1 LOT_13 / -, 20' T&E EASEMENT LOT 12 . 1,000 GALLON SEPTIC TANK 100'WELL RADIUS / 40'LONG x 5'WIDE x 4'EFFECTIVE DEPTH ABSORPTION TRENCH 'E12 ALTERNATE SITE EXISTING WELL 15'x15'T&E CO2MTz \ EASEMENT • �2COZ FC•0 \ TH1 S • \ 3 BORM HOME LOT 14 \ MZ 01 ,Q \ TH2 . • N. 0 • dq0 ',� \ oq 0 1111ORGE MGiw[!lIMG \ \� N .��P��M,......OF ••1�♦♦ A B LEGEND ?6..••. •y.._ �• FCO 24.1 7.9 CO-CLEANOUT 1 ♦ SV1 30.0 19.9 4 ' =*• 2C0-DOUBLE CLEANOUT i • 49th �`». .3—..' SV2 33.6 25.6 FCO-FOUNDATION CLEANOUT 2C0 35.8 28.6 iu» »»•••»•»••»»•-»»»•-»• ' CO1 16.2 31.9 MT-MONITORING TUBE •,.,-, ,MICHAEL E. ANDERSON j= � 0 50 100 MT1 17.6 33.6 SV-SEPTIC VENT r-,f,s, NO. CE-4381 e ._: CO2 54.2 46.8 TH-TEST HOLE •+0••e,p,°O.,!2/20/19N,.•�F '•ir = = I• MI FEET MT2 54.7 46.0 CONTOUR INTERVAL-2' ,6,,� isskv 4 9 1"=50' PROPERTY LEGAL DESCRIPTION PERMIT # OSP181270 PID # 067-062-20 0 > N 00 - - - 99.3 - - - — — i 94.3 :� 86.1 93.7 1000 GAL 9:---.5 3.5 SEPTIC TANK J ! - 89.4 96.8 FINISH GRADE ,/- � 2 96.1 ORIGINAL GRADE O l \ 93.4 c''''`- 93.4 DRAINFIELD ROCK ' - 89.440, 89.4 J.- 80.1 =-..7\- NO GROUNDWATER 8/15/18 I- i C).•• *..... • s ; a 49th �- • •O A MICHAEL E. ANDERSON a cu GE PROFILE AS-BUILT No. CE-4381,•,_= (NO SCALE) ♦•je,p*•'•...2/20/19."eir iiii MOINE EE IMO •••• 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: Denaly Estates Lot/Block: 13/2 Additional: 25345 McIntyre Road, Eagle River,AK Well Depth: 133 ft From: To: Formation: 0 2 Stick up Below Ground: 131 ft 2 9 Brown sand/silt&gravel Above Ground: 2 ft. 9 51 Grey silt&gravel,hard Gal/Min: 30 51 65 Dry silt 65 70 Wet silt 70 76 Wet heaving sand.Do not pert0 ft Static Level: 76 81 Wet clay Casing: 133 ft. of 6 in. x .25 in. steel 81 128 Clay 128 130 Clay&gravel Liner Pipe: N/A 130 133 Gravel&water Screened: N/A Perforated: N/A Grouted: Bentonite Depth: 20' plus Develop. Method: Air Use of Well: Residential Drilling Method: Rotary WATER QUALITY TESTING 1 Coliform 0\0.e 9 CoI/1 O0mL Misc: Flowing Artesian Nitrates f\(k• mg/L Other: well disinfected with chlorine 50 ppm Arsenic 2 5 ug/L 6 bags of chips The well was pumped 5'off the bottom with 100%draw down for 2 hours and recovered at 30 gpm. Date Drilled: 8/30/2018 Driller: Ben Mattson Development Services Department • Building Safety Division • • On-Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Mark Begich Anchorage,AK 99507 Mayor www.muni,org/onsite (907)343-7904 Pump Installation Log Well Drilling Permit Number: SW Date of Issue: Parcel Identification Number: Legal Description Property Owner Name&Address: Denaly Estates Troy Davis Homes, Inc. Lot 13 Block 2 1689 Knik Goose Bay Road,Suite 400 Wasilla,AK 99654 Pump Installation Date:NIA Pump Intake Depth Below Top of Well Casing:N/A feet Pump Manufacturer's Name:N/A Pu nip Model:N/A Pump Size N/A hp Pitless Adapter Burial Depth:N/A feet Pitless Adapter Manufacturer's Name:NIA Pitless Adapter Installer: N/A Well Disinfected Upon Completion?0 Yes 0 No Method of Disinfection:Chlorinated after drilled Comments:No submersable pump,shallow well jet pump installed in house due to artesian. Pump Installer Name: Wheaton Water Well, Inc Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. •NAL. MUNICIPALITY OF ANCHORAGE nr S On-Site Water&Wastewater Program • rPO Box 196650 4700 Elmore Road �r Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 .� tijar http://www.muni.org/onsite C I partmcnt NCHONPGE On-Site Water & Wastewater System Permit Permit Number: OSP181270 Effective Date: 8/22/2018 Work Type: WellSeptic Initial Expiration Date: 8/22/2019 Tax Code Number: 06706220000 Site Legal Address: DENALY ESTATES BLK 2 LT 13 G:0362 Site Mailing Address: 25345 MC INTYRE RD, Eagle River Owner: TROY DAVIS HOMES INC Lot Size in Sq Ft: 46752 Design Engineer: FORGE ENGINEERING Total Bedrooms: 3 This permit is for the construction of: Disposal Field El Septic Tank 0 Holding Tank 0 Privy IZI Private Well 0 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 Special Provisions: The recorded plat for this subdivision notes that artesian wells are common and that special drilling methods may be required to prevent waste of water via surface discharge. Received By: Date: S 3? I l3 Issued By: evvrii bet Wocke44SS Date: g®iep NNW G4' ‘-° , . MUNICIPALITY OF AN e 101:v. G4' F ��.d i. J 0,:- .._.., : SHI. I, Community Development Department aAUG 1 5 MAh•": 907-343-7904 Development Services Division 'a. : 907-343-7997 On-Site Water & Wastewater Program 4d �A ON-SITE SEWER/WELL PERMIT AP'' r• rt ' e .., US I .......... Parcel I.D. 067-062-20 Property owner(s) Troy Davis Homes Day phone 310-2501 Mailing address 1689 Knik Goose Bay Rd #400, Wasilla, AK 99654 Site address 25286 McIntyre Rd. Chugiak, AK 99567 Legal description (Sub'd., Block & Lot) Denaly Estates Block 2 Lot 13 Legal description (Township, Range & Section) Lot Size 46,752 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field 0 Initial X Single Family (SF) n (w/wo ADU) Septic Tank [J Upgrade I IDuplex (D) Holding Tank ❑ Renewal ❑ Multiple Dwellings Privy n (SF and/or D) Private Well X 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. -114-4-1-AL ,(..<-1 , (Signature of property owner or authorized agent) Permit/Rush Fees: 4 //16R,4 '1 b Waiver Fees: Date of Payment: iL t1/45L�6_ Date of Payment: Receipt Number: aJ `l Ti Receipt Number: Permit No. a.51)&109(5 Waiver No. Permit App_ • :: c 411 Moo v, ) • GE ENGINEERING PO BOX 240773 ANCHORAGE,AK 99524 522-7773 677-7766(FAX) August 15,2018 MOA Development Services Dept, On-Site Water& Wastewater Program 4700 Elmore Rd Anchorage,AK 99507 Subject: Denaly Estates Block 2 Lot 13 -23545 McIntyre Road Septic System Design Dear On-Site Services Engineer: The developer of the subject lot intends to construct a 3-bedroom home on the property. We are submitting this design and permit application for the construction of a new well and septic system. The attached site plan identifies the location of the home and 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 moderately to the south. Ground contours are shown on the site plan showing the grade and direction of flow. Storm water drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. The adjacent lots remain vacant and undeveloped. The new septic 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' from the primary site. Please refer to the attached test hole logs, and plan and profile sheets for the septic design. If this design is followed,there will be no adverse impacts to adjacent properties. Sincerely, _ `144-d—el, 4.01;A *-• ----•144.11/ 1 . *'49 TH %\ *.j Michael E. Anderson, PE rA ME.Anderson Attachments ���`o 4381-E is EY�•\s!, i,�i,,,;pROFEssio - DENALY ESTATES, BLOCK 2, LOT 13 S' PERMIT # OSP181XXX PID # 067-062-20 . r — — — L •N 0.b.,- ' -'1N\ 4...4,, 4 ii I IN„Ili g h i I 4 4,01,N 4,t...4,1/4 4 4 4 4 11,,NI r ,,N,1‘11„- , 30'T&E •A-.M s "Iltbk LOT 12 20' : ,, ► .E♦ \ VACANT •OPOS , . . ♦it 1,000 G•LLON • \ 38'L•NG x WIDE x 4'EFFECTIVE 4 D 'TH AB •• 'T ON TREN H 4 \ 1 1 15'T&E AN `E T % , .*A \\ Ville. co 3e6Rtij6,o / N\ V 6 � It2 ,4111ti LO • , • r z i N : -. .;\. VAC• T 114h.‘11 1 1411* 1 ti ®, jam. )' Ilit ------N-k �- l O c • . G ) q0 ' EN GINFERIM \ \ NOTE: �- ��etku, NO SLOPES>25%WITHIN 50'OR SURFACE WATER WITHIN 100'OF THE LEGEND . .9.F-174- LI kk PROPOSED SEPTIC SYSTEM CO-CLEANOUT /tett.• •• J 77 2C0-DOUBLE CLEANOUT /*:49TH i� *7 ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS 04•4:2...zt• •••••,� PROPERTY ARE SHOWN.NO CONFLICTS WITH WELLS OR SEPTIC FCO-FOUNDATION CLEANOUT SYSTEMS. MT-MONITORING TUBE 4� : Michael E.Anderson : / 0 50 100 SV SEPTIC VENT t0 1•• CE 4381 ��' % TH-TEST HOLE vki ,F,9•$•-14:::*:;" IIIII = FEET CONTOUR INTERVAL-2' lk FDPROFESSIO '.. 1"=50' DENALY ESTATES, BLOCK 2, LOT 13 DESIGN FACTORS: SYSTEM REQUIREMENTS: 450 GPD PEAK FLOW 5' WIDE TRENCH SYSTEM PERK RATE: 1-5 MIN/IN 450-GAL SEPTIC TANK APPLICATION RATE: 1.2 GPD/SF 450 GPD / 1.2 GPD/SF /5' WIDE * .5 RED. FACTOR = 37.5 LF TRENCH REQUIRED (38 LF SPECIFIED) BOTTOM OF TRENCH: 7' BELOW GRADE FLOW LINE ELEVATION: 3' BELOW GRADE TOP OF TRENCH: .5' ABOVE GRADE 6" - —111=111=111=111-111= — 111=111—I I I-111111—I I I 1=1 I I-1 I-1 I I-III-III-I I I 1=1 I I-III-I_I-III-I I I EWE-7_1117=-1i I-111-111-1 11= I 1-1 2'-6' III-III-I 11=�=1 I I-I I I 1=1 I I-1 11=1 I I-III-III-I III-III-III-I I 1=L1=1 I I 1=111=1 I I-111-J.I I-111—I III-III-I 11=J1=1 11=1 I I — 6" �'='='='='='='''-`='=•'='="•'=' 4" PERFORATED PVC (HOLES DOWN) ;•:•:•;•;•:•:•:•;•;•;•.:::•;•:.. ..'.`•`•'.".`".. DRAINFIELD ROCK 5' 1 G 1M41HYl4 iNf4 TYPICAL WIDE TRENCH SECTION F (NO SCALE) ore. NOTES: 0•*��.ff 49��TM �. •* . GRADE AREA OVER TRENCH TO DRAIN AWAY r"'`` ' Z .�,s�4 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' / . Michael E.Anderson WITH 2" OF INSULATIONlF9, E4381� ?/ 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER lj`ED PRO FESSIOHP� THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY N\N�����1` MUNICIPALITY OF ANCHORAGE �� r, 4FAC.gsli1 DEVELOPMENT SERVICES DEPARTMENT /olto.•••••• I .v A 4700 ELMORE ROAD ANCHORAGE, AK 99519-6650 *••49T—" i` •:* �f SOILS LOG AND PERCOLATION TEST .. Michael E.Anderson; j LEGAL DESCRIPTION: DENALY SUB LOT 13kiFDPROFESSiONP�' PERFORMED FOR: TROY DAVIS \�N����'~ Professional Engineers Stamp: DATE: 8/0 8/18 PROJECT No.: PARCEL ID#: 067-062-20 TECHNICIAN: J. MILLETTE N. SHAFER DEPTH TEST HOLE 1 (feet) 1 ,J1 11 11' OB SLOPE SITE PLAN BROWN DIRT W/COBBLES 2 ,• '•;•::::: 4 .'T 5 �:: SEE SITE PLAN �, r, y 6 � i `s;;' 7 •r::=;�'' '. SANDY SILTY GRAVEL GM • • 10 , '::, WAS GROUND WATER ENCOUNTERED? NO IF YES @ WHAT DEPTH? - • ;'1..',;' DEPTH OF WATER AFTER MONITORING: NONE 1 1 ''_.;```' DATE OF MONITORING: 8/15/18 12 •.i,'-.::;. -.::": NET TIME DEPTH To NET DROP GROSS TIME DATE READING 13 :':.7'..;.':',; (MINUTES) (MINUTES) (WATER INCHES) (INCHES) 14 '•'':":...d 8/11 TEST HOLE PRESOAKED PRIOR TO TESTING: . 15 1 12:20/12:24 4:39 4"/ 10" 6" ' ; ;s:.;.": : 2 12:26/12:31 5:19 4"/ 10" 6" 16 -.—- ..... 3 12:32/12:37 5:30 4"/ 10" 6" 17 4 12:39/12:45 6:00 4"/ 10" 6" 18 5 12:46/12:52 6:59 4"/ 10" 6" 19 6 12:53/13:00 7:09 4"/ 10" 6" 20 PERCOLATION RATE: 1.2 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 4 FT. and 5 FT. COMMENTS: MUNICIPALITY OF ANCHORAGE 'E'' AyrDEVELOPMENT SERVICES DEPARTMENT j O• -JA-.7175A, 4700 ELMORE ROAD ANCHORAGE, AK 99519-6650 *'��9TH i\1� -*�' �/�L SOILS LOG AND PERCOLATION TEST �q •. Michael E.Anderson : j ��',`.e*- CEI r-(��� i/ LEGAL DESCRIPTION: DENALY SUB LOT 13 k PROFESSION �, PERFORMED FOR: TROY DAVIS ,`����+~ Professional Engineers Stamp: DATE: 8/11/18 PROJECT No.: PARCEL ID#: 067-062-20 TECHNICIAN: J. MILLETTE DUG ON N. SHAFER DEPTH 8/08/18 TEST HOLE 2 (feet) 1' OB SLOPE SITE PLAN BROWN DIRT W/COBBLES . .,,- ;: 5 .1. SEE SITE PLAN til.;d ., q ' ' �•f.',•.. 6 ai»iii 7 :' ;,` ' SANDY SILTY GRAVEL 8 '} GM .;.,::.Y ' 10 ..3.i . ,.._, WAS GROUND WATER ENCOUNTERED? NO ... , •,;::. ;,:..;:'?7J, IF YES @ WHAT DEPTH? .:: . .,... DEPTH OF WATER AFTER MONITORING: NONE 11 '...'s`::. DATE OF MONITORING: 8/15/18 ...::..f. 4-: .; v. 12 6.:;,;;. -:. DEPTH DEPTH To 1`:�t DATE READING GROSS TIME NET TIME WATER NET DROP 13 ',.Y..::::•;.....:.; (MINUTES) (MINUTES) (INCHES) (INCHES) 14 ` '''': 8/11 TEST HOLE PRESOAKED PRIOR TO TESTING: k '• 1 13:32/13:42 10 4"/7" 3" 15 �:� ::; ': 2 13:43/13:53 10 4"/6 is" 241 3 13:54/14:04 10 4" /6 6" 2;6" 17 4 14:05/14:15 10 4"/7" 3" 18 5 14:16/14:26 10 4"/6150 216" 19 6 14:27/14:37 10 4"/6W 2is 20 PERCOLATION RATE: 3.4 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 3.5 FT. and 4.5 FT. COMMENTS: \ k \ \ L1 \ • Lot 11 \\ \ 449. \ Lot 18 S \\ •-....„. e�vO• \ \ ,??20 -....:„<<:72 --...„ _ 4 o.0 20' T&E EASEMENT -.2.' \ 30' T&E EASEMENT \ \ \ \ \ Lot 12 \ \ \ \ .4 \ \ \ \ y> \ \\ \ • Lot 13�'� *, \ \ \ \\\\ 0 .. 7 / ^. 0 'h a \ \ '*.p.pp 4.0 ryp \ 15'05' T&E lk ti co \\ASEMENT ._4'Ivp• 4 5'Sf. y'� Lot 14 \ X00 \\\ .( ' TBM - TOP OF' $. r REBAR X ' ELEVATION: 388.0 401.' T //_ 0p 2Sk �. 46/� 'S, SPOT ELEVATION TABLE T EXISTING PROPOSED 403.4 A 401.8 YRF /.'4. 403.2 6 401.8 1P0 404.3 C 401.8 'l6 404.3 0 401.8 Jg 403.3 E 401.8 \<0 403.5 F 401.8 HOUSE DETAIL 403.7 G 401.8 403.2 H 401.8 Scale: 1' - 30' •\ 400.0 J 402.0 401.8 I 401.8 x1 10.0' 6.0' DECK 399.6 K 402.0 399.4 L 402.0 399.0 M 402.0 / \ 399.4 N 401.8 R/ 3c 399.2 0 401.8 1 398.8 P 401.8 /. •O gyp\ 400.3 0 401.8 a/'y �'� J L 402.2 R 401.8 e/ 419�E\F 140.p 2 \ ti'60,. .0. Sc k*,„° '4 / LEGEND NOTES: +p2 1) LOT COVERAGE w 4.0% 4.0'x8.0' PORCH u\\9.0, p /� 104.8 EXISTING ELEVATION 2) SEE ENGINEER'S PLANS FOR w/ BALCONY ABOVE 4 103.0 PROPOSED ELEVATION WEU. & SEPTIC LOCATIONS / ROOF OVERHANG' ,,./ SURFACE DRAINAGE PLOT PLAN X AS BUILT_ SCALE 1 . 40' GRID...._0_2.4.6.2-- Project No. 18-299/81 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lan & Associates, inc,. (907) 522-6476 Phone a. g (907) s22-46y. Fax .-- F A SU TA Professional Land Surveyors kentangsian curve ;v•M k nOl anOhngsurvey.com /'P, ...16 I hereby certify that I have surveyed the following described properly: -V: 4,9g{A ...1-1/ �*I', J U L 0 2 2018 S 1, LOT 13, BLOCK 2. DENALY ESTATES SUBDIVISION (PLAT No. 2018-29) Anchorage Recording District, Alaska, and that the Improvements situated thereon an , • within the property lines and do not encroach onto the property adjacent thereto, that i =~eNy (''-V i ^ no Improvements on the property lying adjacent thereto encroach on the surveyed / K h�yA premises and that then are no roadways, transmission lines or other visible 2 l lC v lI•l '�< < $ easements on said properly except as Indicated hereon. Q j„$z-Itib ' .. �/ >'pJk,. , at Anchorage, Alaska 'q" Dated this the Day of '-t ‘1‘ o- It Is the responsibility of the owner to determine the existence of any easements. ‘,\`....,�_--_ covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963 MUNICIPALITY OF ANCHORAGE Development Services Department 1_7)� Phone: 907-343-7904 On-Site Water & Wastewater Section ', Fax: 907-343-7997 Certificate of On-Site Systems Approval Parcel I.D. 067-062-20 Expiration Date: V� I. Z `C Cri 1. GENERAL INFORMATION Complete legal description Denaly Estates Block 2 Lot 13 Location (site address) 25345 McIntyre Rd. Eagle River, AK 99577 Current property owner(s) Troy Davis Homes Day phone 310-2501 Mailing address 1689 Knik Goose Bay Rd #400, Wasilla, AK 99654 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: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Q 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 $ 12 © Waiver Fee $ Date of Payment 3/ 7/ /r Date of Payment Receipt Number 03 7' / D Receipt Number COSA# 0 SC— JR 1 0 b2 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 Michael E. Anderson, P.E. Date 2/25/19 444-317'144 '144 ' 49th W ..: . 6. DSD SIGNATURE ,V �two• i( System #1 Approved for 3 bedrooms �� MICHAEL E. ANDERSON System #2 Approved for bedrooms 0�.'r,'.,, No. CE-4381 ,:C.3 it Disapproved •♦1v11id"`pF Sc9'\0444 Conditional approval for bedrooms, with the following stipulations: 3, /' .sV 41,1. z WATER ANS 7 t4. WASTEWRAp�j1R Q PRoG a* "ANT SERA ' ( By. k--E-�'� Original Certificate Date: I —'('7 The Municipality of Anchorage Development Services bivision (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: Denaly Estates Block 2 Lot 13 Parcel ID: 067-062-20 If more than 1 septic system on lot: COSA Checklist# of Structure served by this system A. WELL DATA ❑l Well log is filed with Onsite (or attached) Well production at time of test 30 gpm Date drilled 8/30r18 Water storage tank volume N/A gallons Total depth 133 ft Well disinfected for coliform test? El Yes 0 No Cased to 133 ft ❑t Coliform bacteria is Negative El Sanitary seal is functioning correctly Nitrate mg/L It Nitrate less than MRL (ND) El Wires are properly protected Arsenic 2.50 ug/L El Arsenic less than MRL (ND) Casing height(above ground) 24 in. Collected by ARS Date of flow test for COSA $/30n8 Date of Sample 1/10/19 Static water level at beginning of test 0 ft. Comments B. TANK DATA C. LIFT STATION Age of tank(s) 0 years El Required maintenance completed Tank type/material S"G`ds' Age of lift station years Measured operating fluid level in septic tank New Lift station material ❑■ Standpipes/foundation cleanout per record drawing Comments: Date of pumping N/A D. ABSORPTION FIELD DATA 5 -WIDE Which system tested (date installed) 9/7/18 Adequacy test date New El ALL standpipes present per record drawing Results ❑Pass For bedrooms Total measured depth from grade 7.4 ft(max) Fluid depth prior to test in Measured depth to pipe invert from grade 3.4 ft(min) Water added gal El N/A—pressurized field New depth in Monitor tubes go to bottom of effective. If not, state depth into effective Elapsed time min ■❑ Code-required soil cover over field Final fluid depth in ElSystem 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 N/A 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' ❑✓ Yes if No ft ElYes if No ft Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line>25' ❑✓ Yes if No ft Absorption Field on Lot> 100' El Yes if No ft Holding Tank > 100' p✓ Yes if No ft Neighboring Absorption Fields > 100' Animal Containment> 50' E✓ Yes if No ft ✓❑Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ElYes if No ft —❑✓ 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' El Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ElYes if No ft Private Wells > 100' p✓ Yes if No ft Water Main > 10' ✓0 Yes if No ft Community Wells>200' El Yes if No ft Water Service Line> 10' ElYes 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' p 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' ✓❑ Yes if No ft Private Wells> 100' ❑✓ Yes if No ft Water Service Line> 10' ElYes if No ft Community Wells > 200' ElYes if No ft Surface Water> 100' ✓0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION ��4�� OF ,1 'te• I certify that I have determined through field inspections and review • e _ Y�. of Municipal records that the above systems are in conformance with �! 49th 4;• i\ •%'f- MOA COSA guidelines in effect on this date. AI, t. t h ' �� • • -2`30-AMICHAEL E. ANDERSON J if ♦ Gi ••(1i 1� al N O. CE-4381 ••.•C�- COSA Checklist yellow sheet ♦ 4. ♦���F�•'••••,`„••,••••P���� ,,,1At\\SS -1\'',,' j