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HomeMy WebLinkAboutDENALY ESTATES BLK 2 LT 8AM .fir �".: � ,�:� �:� v �="r. �.,�. y� ;� � • y"Fill ' Municipality of Anchorage On-Site Water and Wastewater Program • (907)343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181319 PID Number: 067-062-15 Dwelling: 0 Single Family(SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: 0 New ❑ Upgrade Name: ABSORPTION FIELD Troy Davis Homes Address 9 Deep Trench 0 Shallow Trench 9 Bed 9 Mound 1689 Knik Goose Bay Rd 400 Wasilla, AK 99654 9 Other Phone Number of Bedrooms Soil Rating Total depth from original grade 310-2501 4 1.0 GPD/SF 6.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 4.0 Ft. 0.2 Ft. Denaly Estates 2 8 Fill added above original grade Gravel length Township Range Section 0-.5 Ft. 2 @ 60 Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES 5 Ft. Ft. To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist.between trenches Lift Station From Tank Field Tank Line 600 Ft2 2 >6 Ft. Well >100' >100' N/A N/A >25' TANK l l Septic 0 S.T.E.P. 0 Holding 0 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 2 NA LIFT STATION Foundation >10' >10' N/A N/A Manufacturer Capacity Curtain Drain None Noted Gal. Pump on level at Pump off level at High water alarm at Remarks A 1,500-GAL tank was installed in place of the 1,250-GAL for possible future upgrade. in. in. in. 2" of Insulation over Tank. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank D3034Tank to drainfield D3034 Installer Northern Excavation Drainfield D3034 CO/MT D3034 Inspector J. Millette BENCH MARK (Assumed elevation) 100 ft Inspection 151 10/8/18 2.'d 10/9/18 Location and description dates: 3'2 4`h Bottom of siding on NW corner of home. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp 0:31T-sill II 44 4. Conditional Approval: Date ••,P� i�q �i• 49th • A1. •, 0 MICHAEL •E. ANDERSON J : • ' No. CE-4381 :#• ��1♦���' 4117119 .••''••F��� F • gppr• . `�A / — Date u"{� x.04 PROF : DENALY ESTATES BLOCK 2 LOT 8 PERMIT # OSP181319 PID # 067-062-15 sa T&E EASEME � LOT 9 �\ n, • LOT 9 �. _. 38�f l 2C0 1,500 GALLON �� FS' T1-,3V2 -SEPTIC TANK O �� —� MTz T� HA CT3 \ \\\ \� 7 MT4p�/� � XISTINO WELL \ �j�, O , FCO __-. .� S5 --"----..N..„` 2-60'LONG x 5'WIDE x.5 EFFECT E --‘,,_,DEPTH ABSORPTION TRENCH .® 4-BDRM HOME , \ \ ALTERNATtSITCATEGORY ��,- -\ \� \ SYSTEM W/25'LONG,x 5'WIDE x.III 5' _ ---- _� . N. \ EFFECTIVE DEPTH ABSORPTION ,/ N \ SYSTE . APP.RATE 5 GPD/SF. , \ \ �\ \\ -- /' - \ / \ _ / 15'SLOPE EASEMENT / - / / TRACT A ,- VACANT VACANT A' B C FCS'- 9.1 3.2 ••M •,141 SV1 39.6 + 37.4 .••-7 ,..P1::.. .,q 11� SV2 48.5 44.8 LEGEND LEANOUT :. -...,' � '••&••• 2C0 50.8 . 46.1 �'���• • PLAN AS-BUILT CO1 44.4 - 37.2 2C - DOUBLE �;� � �. ��i 2C0-DOUBLE CLEANOUT / 6: 4-9th .. MT1 46.5 39.5 " 1� Z "� 'j CO2 61.7 68.8 FCO-FOUNDATION CLEANOUT �0• MT2 63.3 70.5 FS-FLOW SPLITTER VALVE �,:MICHAEL E. ANDERSON .,• MT-MONITORING TUBE •n 1, - 4,. 0 50 100 CO3 31.4 _ 22.4 _ t-j-,, No. CE-4381 i �_� FEET , MT3 28.9 20.1 SV-SEPTIC VENT 111�,�`'+..4//17/19; P�<-, � C04 61.4 59.6 TH-TEST HOLE • .OFESS • ,,SGL. 1"=50 MT4 62.1 61.8 CONTOUR INTERVAL-2' DENALY ESTATES B2 L8 PERMIT # OSP181319 PID # 067-062-15 o > > o U- CV - - Ar- 98.7 - - - - ` 96.6 2" INSULATION 1:--,c......''.....: 87.7 96.0 1500 GAL 95.8 I SEPTIC TANK V `� 91.8 TRENCH #1 ..O98.3 ORIGINAL/ FINHO AL GRADE -- 94.8 ��"_ DRAINFIELD ROCK 94.8 94.3 �r . MOA APPROVED SAND • 94.3 I '-- 92.3 60, 92.3 - H �- GROUNDWATER @ 89.3 9/25/18 86.3 = TRENCH #2 ,O 98.8 FINISH GRADE ---........i._ f 98.3 ORIGINAL GRADE 2� Clik. 94.8 -�.1- DRAINFIELD ROCK 94.8 94.3 -- • MOA APPROVED SAND • 94.3 --'---- 92.3 60' 92.3 H `4.� �E.OF. q(.4 •♦♦ 4. 49th )\ •••°1.4 Com-i MICHAEL E. ANDERSON'S '� PROFILE AS-BUILT '•-=`�NO . CE-4381 ,:s . ) GE (NO SCALE) .�f,0�'ROFESS. � .• �� 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: 8/2 Additional: McIntyre Road, Eagle River,AK Well Depth: 126 ft From: To: Formation: 0 11 silt&gravel Below Ground: 124 ft. 11 17 sand,gravel,water Above Ground: 2 ft. 17 56 sitl&gravel Gal/Min: 20 56 106 clay,wet 106 123 . wet clay&gravel Static Level: 0 ft 123 126 gravel&water Casing: 126 ft.of 6 in. x .25 in.steel Liner Pipe: N/A Screened: N/A Perforated: N/A Grouted: Bentonite Depth: 20' plus Develop. Method: Air Use of Well: Residential Drilling Method: Rotary WATER QUALITY TESTING Collfo m e° CoI/100mL Misc: Flowing Artesian Nitrates 1 2Z mg/L Arsenic Z•0 ug/L Other: well disinfected with chlorine 50 ppm 6 bags of chips The well was pumped 5'off the bottom with 100%draw down for 2 hours and recovered at 20 gpm. Date Drilled: 10/9/2018 Driller: Ben Mattson Development Services Department Building Safety Division • i"e On-Site Water & Wastewater Program • �' as 4700 Elmore Road P.O. Box 196650 < MLS' i Mark Begich Anchorage, AK 99507 ' ` F T 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 Lot 8 Block 2 Troy Davis Homes 1689 Knik Goose Bay Rd,Suite 400 Pump Installation Date:2/22/19 Pump Intake Depth Below Top of Well Casing:115 feet Pump Manufacturer's Name:Goulds Pump Model:10HS05-412 Pump Size 1/2 hp Pitless Adapter Burial Depth:13 feet Pitless Adapter Manufacturer's Name:Harbor Pitless Adapter Installer: Brian Wille \%'ell Disinfected Upon Completion? ✓E Yes No Method of Disinfection:Resirculation Comments: Pump Installer Name: Brian Wille 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: OSP181319 Work Type: Wel]Septic Initial Tax Code Number: 06706215000 Site Legal Address: DENALY ESTATES BLK 2 LT 8 G:0362 Site Mailing Address: 25294 MC INTYRE RD, Eagle River Owner: TROY DAVIS HOMES INC Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date Expiration Date Lot Size in Sq Ft: Total Bedrooms: llehartIII ell t 9/12/2018 9/12/2019 81339 2 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 Special Provisions: 1. The Engineer needs to do a test hole prior to the construction of the septic field. Construction may proceed at your own risk before the 7 day water monitoring is complete. Please submit stamped and signed results with the As -built Inspection Report. If the results require a design change, construction of the system will stop pending On -Site review and approval. 2. If soils perc faster than 1 min/in, a sieve analysis is required. GD 4 1 91-2%I`6 Peces�'y-french .0 )vCC'+'Vrl, Received By: / Date: Issued By: Date: 4 MUNICIPALITY OF ANCHORAGE j�Fi 9 �n Community Development Department �,`" 91 - 3-7904 Development Services Division tifiiime 907 -7997 On-Site Water & Wastewater Programui6 a SEP 10 ..L ON-SITE SEWER/WELL PERMIT APPLI 6 ION ;'\> a 6 $ I'9� Parcel I.D. 067-062-15 Property owner(s) Troy Davis Homes Day phone 310-2501 Mailing address 1689 Knik Goose Bay Rd #400, Wasilla, AK 99654 Site address 25294 McIntyre Rd. Chugiak, AK 99567 Legal description (Sub'd., Block & Lot) Denaly Estates, Block 2, Lot 8 Legal description (Township, Range & Section) Lot Size 81,339 Sq. Ft. Number of Bedrooms Four (4) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (E all that apply) Absorption Field X Initial Single Family (SF) X (w/wo ADU) Septic Tank n Upgrade n Duplex (D) i Holding Tank I I Renewal IMultiple Dwellings Privy n (SF and/or D) Private Well Water Storage U 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. � .L... E (Signature of property owner or authorized agent) Q,usk �a yo Permit/Rush Fees: 569f 915-I�'�k :710L7 Waiver Fees: Date of Payment: "- It)-6 Date of Payment: Receipt Number: OQ 11°1 Receipt Number: Permit No. OSP Ig131e1 Waiver No. Permit App_:-:•:....:c 4 ' GE ENGINEERING PO BOX 240773 ANCHORAGE,AK 99524 522-7773 677-7766(FAX) September 9, 2018 MOA Development Services Dept, On-Site Water& Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Denaly Estates, Block 2, Lot 8—25294 McIntyre Road Septic System Design Dear On-Site Services Engineer: The owner of the above lot intends to build a 4-bedroom home on the property. 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 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 west. Ground contours and drainage arrows 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. We are relying on the test hole information for Lot 9 to the north and the test hole completed during the subdivision phase of the project. The assumed application rate is 1.2 gallons per day per square foot. A test hole will be completed prior to construction of the septic system. If subsoil conditions vary from our assumption a complete redesign will be submitted. 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 6' from the primary site. Or fwl« f6 a e 61111e. '1'7* *P%, MCA Please refer to the attached test hole logs, soils lab analysis, plan and profile sheets for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, 1, *: 49 TH A\ ••*r% Michael E. Anderson,PE C Michael E.Anderson . / Attachments f+f1e,.Fl 43o1-4,c ��iFDPROFESSI0N� "' W F- 0 J N / ` i U O M W U) LLI F— F— U) — F— U) W J Z W M Li - LU Pil \\ W \ co \ w S \ O w O / \ z H / N \ \ :f Z F— Z3 O W 0 W W N OQZ U > m w:;, Z w H Q FF---cD> I- U 1- Z Z W EDW' W Q - W H — O o° p> O z Z m Z CO - U S— z U 0 0 w w 0 L U F LOU 0 0 0 w > S O I / / I ( / I ( / i / r LU w oLL M 0LO 0 LO % w / ¢w0 \ wU 0- LL- w • U 'fib' • .. . • ` ` ,• / O co Q) M W U LLJ S (n Q r Cl) n z 0 LL. p O a W J o\ z Z -3: p \ 0 ui O z \ a w \ O Cl) a Q / z Q LL. ¢ a W "- O / z = oowco I I o I II O 'w Q m U a( I I a N WI ( 1 I I' \ 0 z it - / O z rj) LL // / I LU W co / Z F- U) U) / ILO Z:) 2 U / ( " O LU U) LU CO Gf 0 O LU / VU Z Q > I / / I ( / I ( / i / r LU w oLL M 0LO 0 LO • WAN • U 'fib' • .. . • ` ` ,• DENALY ESTATES, BLOCK 2 LOT 8 DESIGN FACTORS: 600 GPD PEAK FLOW PERK RATE: <1 MIN/IN APPLICATION RATE: 1.0 GPD/SF SYSTEM REQUIREMENTS: 5' WIDE TRENCH SYSTEM 1,250 -GAL SEPTIC TANK 2' MOA APPROVED FILTER SAND 600 GPD / 1.2 GPD/SF / 5' WIDE * NO RED. FACTOR = 120 LF TRENCH REQUIRED (120 LF BOTTOM OF TRENCH: 4' BELOW GRADE FLOW LINE ELEVATION: 3.5' BELOW GRADE TOP OF TRENCH: .5'ABOVE GRADE �5'� RATED PVC (HOLES LD ROCK ,COVED SAND TYPICAL WIDE TRENCH SECTION (NO SCALE) NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE T 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 IFIED) logo.jpg •• A.. .1 •. A. •.• ...w ... Michael E. nderson'. �'F••,483 -E 4i �'s� . •ii �t11Fp0 FOPp��� ���NP��•� 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: LOT 8, BLOCK 2, DENALY ESTATES PERFORMED FOR: TROY DAVIS HOMES, INC. DATE: 9/17/2018 PROJECT No.: PARCEL ID#: TECHNICIAN: J. MILLETTE TEST HOLE #A 1' OB COMMENTS: SLOPE WAS GROUNDWATER ENCOUNTERED? YES IF YES @ WHAT DEPTH? 9' DEPTH OF WATER AFTER MONITORING: 9' DATE OF MONITORING: 9/25/18 of ACq��li Michael E. nderson . 483 E 1lliF�' 80 SIONP��� SEE SITE PLAN 54 DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH To WATER (INCHES) NET DROP (INCHES) 9/19 TEST HOLE PRESOAKED PRIOR TO TES ING: 1 POORLY GRADED GRAVEL 2:01 WITH COBBLES 6 GP 2 3:03/3:05 2:10 4-10 6 COMMENTS: SLOPE WAS GROUNDWATER ENCOUNTERED? YES IF YES @ WHAT DEPTH? 9' DEPTH OF WATER AFTER MONITORING: 9' DATE OF MONITORING: 9/25/18 of ACq��li Michael E. nderson . 483 E 1lliF�' 80 SIONP��� SEE SITE PLAN 54 DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH To WATER (INCHES) NET DROP (INCHES) 9/19 TEST HOLE PRESOAKED PRIOR TO TES ING: 1 3:00/3:02 2:01 4-10 6 2 3:03/3:05 2:10 4-10 6 3 3:06/3:08 2:08 4-10 6 4 3:09/3:11 2:05 4-10 6 5 3:12/3:15 2:11 4-10 6 6 3:16/18 2:09 4-10 6 PERCOLATION RATE: <1 (MIN/INCH) PERC. HOLE TEST RUN BETWEEN: 3 FT. and 4 FT. ®Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 E Certificate of On -Site Systems Approval Parcel I.D. 067-062-15 1. GENERAL INFORMATION: Expiration Date Complete legal description DENALY ESTATES- BLOCK 2 LOT 8 Location (site address) 25294 Mc Intyre *Eagle River Current Property owner(s) Troy & Marcy McGill Day phone 854-8104 Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) a 3 , 12 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual 0 - famc Individual Water Storage ❑ Holding Tank ❑ Community Class_Well ❑ Community ❑ Public Water System ❑ Public Sewer "-NC. Waiver/Variance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5 5 0 Date of Payment '� M2_02 i Receipt Number 69 r7 Q g G COSA# OSC�113`-Iq Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: ' ZI In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE V System #1 Approved for 7 bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms bedrooms, with the fol /. *r ................ ., ter';: SE.: . . Va.;E— #AECC884 \QY OF (6-1 i `g ON—SITE �v WAT r P" gR sAIVD L WATER z ; loollnr:... C7 By: Original Certificate Date: (,/"g 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 Legal Description: DENALY ESTATES; BLOCK 2, LOT 8 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 10/9/18 Total depth 126 ft Cased to 124 ft ❑ Sanitary seal is functioning correctly W Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 6/10/21 Parcel ID: 067-062-15 Structure served by this system Well production at time of test 4.2+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes OR No %coiiform bacteria is Negative Nitrate 1 -_ mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L , Arsenic less than MRL (ND) Collected by GEG, LTD Date of Sample 6110/21 Static water level at beginning of test ft. Comments *ARTESIAN WELL (PER WELL LOG) : DID NOT REMOVE SANITARY SEAL B. TANK DATA Age of tank(s) 3 years Tank type/material SEPTICWEE Measured operating fluid level in septic tank 50" X Standpipes/foundation cleanout per record drawing Date of pumping 4/20/21 D. ABSORPTION FIELD DATA Which system tested (date installed) 10/8/18 0 ALL standpipes present per record drawing Total measured depth from grade 4.66 ft (max) Measured depth to pipe invert from grade 2.75 ft (min) ❑ N/A — pressurized field C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: N/A Adequacy test date 6/10/21 Results Q✓ Pass For _ Fluid depth prior to test _ Water added *889 gal New depth 2 in 4 bedrooms 0 in 0 Monitor tubes go to bottom of effective. If not, state Elapsed time 20 min depth into effective ❑ Code -required soil cover over field Final fluid depth 0 in Absorption rate 600+ gpd ❑ System presoaked NONE (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) N/A Gallons introduced N/A gallons If yes, enter date Comments/Deficiencies: "TESTED NORTH TRENCH ONLY -SOUTH TRENCH WAS DRY UPON ARRIVAL & STAYED DRY THROUGHOUT TESTING 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' r✓ Yes if No ft Q Yes if No ft Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' F71 Yes if No ft Absorption Field on Lot > 100' Q✓ Yes if No ft Holding Tank > 100' 0 Yes if No ft Neighboring Absorption Fields > 100' F✓ Yes if No ft Water Main > 10'✓0 Animal Containment > 50' 0 Yes if No ft ✓� Yes if No ft Yes if No ft Water Service Line > 10' P/ Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway Community Sewer Main > 75' Q Yes if No ft 0 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' Yes if No ft Property Line > 5' F✓ Yes if No ft Wells on Adjacent Lots: ✓1 Absorption Field > 5' Q✓ Yes if No ft Private Wells > 100' F✓ Yes if No ft Water Main > 10'✓0 ft Yes if No ft Community Wells > 200'✓] Yes if No ft Water Service Line > 10' P/ 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' 2✓ 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' ✓1 Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' FV� Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS SEE EMAIL FROM OWNER REGARDING NO FREEZING G. ENGINEER'S CERTIFICATION 1 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. COSA Checklist yellow sheet MIN #AECC884 ... . Y/A­­ 3 .... ess: •cG Ofesslo Erik Widger From: Mcgill Troy <Troy.Mcgill@hcahealthcare.com> Sent: Monday, June 14, 2021 12:20 PM To: Erik Widger Subject: 25294 McIntyre Road Regarding our property at 25294 Mcintyre Road, ER, AK 99577 a We have not had any issues with the septic freezing. e Respectfully, Troy Board -Certified Sports Clinical Specialist Director Therapy/Health Management Services Alaska Regional Hospital P 907.264.1759 1 NA, 907.205.9304 1 ePANS - Ros# ! MUNICIPALITY OF ANCHORAGE 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. 067-062-15 Expiration Date: 7' 22- —1 9 1. GENERAL INFORMATION Complete legal description Denaly Estates, Block 2, Lot 8 Location (site address) 25294 McIntyre Road Chugiak, AK 99567 Current property owner(s) Tory Davis Homes, Inc Day phone 957-9394 Mailing address 1689 Knik Goose Bay Rd #400 Wasilla, AK 99654 Real estate agent Day phone 2. TYPE OF DWELLING: C, Single Family (w/wo ADU) E Duplex n Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic U Water Storage ❑ Holding Tank ❑ Community Well ❑ Community n Public Water System ❑ Public Sewer n Waiver request for: Distance: Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ /2•d Waiver Fee $ Date of Payment q I t Dl14 Date of Payment Receipt Number QQU. b Receipt Number COSA# OSCfq l f«o 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 4/17/19 Z 4-9tn :s • 6. DSD SIGNATURE ; .... • • System #1 Approved for bedrooms •�," N.�cnALL E. ANDERSON V `,�tn,•'•. No. CE-4381 S•�.4'- System #2 Approved for bedrooms • .................. ...al17l1s,,. � .• • Disapproved ‘f PROF -3; Conditional approval for bedrooms, with the following stipulations: `llllll(Wfuo�� \AY OF ri, ON-SITE WATER AND WASTEWATER PROGRAM a �S� O jij) SER\1\' •`/110 , Original Certificate Date: `(I 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: Denaly Estates Block 2 Lot 8 Parcel ID: 067-062-15 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 20 gpm Date drilled 10/9/18 Water storage tank volume N/A gallons Total depth 124 ft Well disinfected for coliform test? El Yes ❑■ No Cased to 126 ft ❑■ Coliform bacteria is Negative 0 Sanitary seal is functioning correctly Nitrate 1.22 mg/L ❑ Nitrate less than MRL(ND) ❑■ Wires are properly protected Arsenic 2.0 ug/L ❑Arsenic less than MRL (ND) Casing height(above ground) 24 in. Collected by Wheaton Water Wells Date of flow test for COSA 10/9/18 Date of Sample 4/9/19 Static water level at beginning of test 0 ft. Comments Well is 124' below ground and 2' above ground. Flowing artesian well. B. TANK DATA C. LIFT STATION Age of tank(s) 0 years ❑ Required maintenance completed Tank type/material Septic/Steel Age of lift station years Measured operating fluid level in septic tank New Lift station material 12 Standpipes/foundation cleanout per record drawing Comments: No lift station. Date of pumping N/A D. ABSORPTION FIELD DATA Shallow 5-Wide Which system tested (date installed) 10/8/18 Adequacy test date t❑ ALL standpipes present per record drawing Results ❑Pass For bedrooms Total measured depth from grade 6.0/6.5 ft(max) Fluid depth prior to test in Measured depth to pipe invert from grade 4.014.5 ft(min) Water added gal ❑ N/A—pressurized field New depth in ❑� Monitor tubes go to bottom of effective. If not, state Elapsed time min depth into effective Final fluid depth in EICode-required soil cover over field ❑ System presoaked Absorption rate 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:New septic system. 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' m Yes if No ft El Yes if No ft Neighboring Tank > 100' L7(Yes if No ft Private Sewer/Septic Line > 25' ®Yes if No ft Absorption Field on Lot> 100' Z Yes if No ft Holding Tank > 100' ©Yes if No ft Neighboring Absorption Fields > 100' Animal Containment> 50' p Yes if No ft ®Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ®Yes if No ft ®Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' Z 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' m Yes if No ft Private Wells> 100' Q Yes if No ft Water Main > 10' iii Yes if No ft Community Wells >200' [] Yes if No ft Water Service Line > 10' Z 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' 71 Yes if No ft Wells on Adjacent Lots: Water Main > 10' 7] Yes if No ft Private Wells> 100' El Yes if No ft Water Service Line > 10' ®Yes if No ft Community Wells > 200' ® Yes if No ft Surface Water> 100' ® Yes if No ft F. ENGINEER'S COMMENTS 4 440 G. ENGINEER'S CERTIFICATION •",P.. .....'�'.04• arc-, v1 1 certify that I have determined through field inspections and review Jr / 1,-- ••••s of Municipal records that the above systems are in conformance with A ;' 49th t` MOA COSA guidelines in effect on this date. •.. .,ii, .... ..•• ••� e• MICHAEL E. ANDERSON t'i ki' I. �j• �"J,% ' No. CE-4381 .. COSA ♦ ••. 4117119 .•• C� 1 COSA Checklist yellow sheet v. CO pRpi ESS. \\\, ..• ,,11111swaS11 4 \ \\�\ l \ \ HOUSE DETAIL \ \\ \ '' Seale: 1• - 30' \ \ \ v • 1.5'x8.3' CANT A, /3 CI‘ • --,--. \Oo cD Rio Lot 9 15' T&E EASEMENT 0 90 '' \ 1 STORY WAL RESIDENCE _ — .to \ w/ WALKOUT BSMT i/,%ip,'�// OF�k q •,' E 553•'1 ,,,,,,,--"- SI 'N \ a. 61546 22 SEPTIC �-L- -� i • N `r PIPES . / S. . yo \ �� •fi •Gs inn/ % • �/ 41111111014, tOiltst4P' aP \\ 4404000:940 `\ Lot H WELL \ �` \ 81.338 e.f. stip I i< \\ \ �� ��' \ H 15' SLOPE EASEMENT. < 9pP /�/ \ i BT77 / \ i / `� 77 / -� X647 / �� / `��� Tract A / \ ��� / i / TBM - TOP OF r REBAR i ELEVATION = 367.95 L-108.48 R-120• ,. � \` / i \ � Tract B ` 5/ PLOT PLAN _ AS BUILT K SCALE _1-3r_ GRID _2(...11.0.2_ Project No. 18-406/85 . -... .. i11500 Daryl Avenue, Anchorage. Alaska 99515-3049 Lang & Associates, inc. ( ) 522-6476 Phone i 907(907) 522-4625 FaxF\ s` 1 Professional Land Surveyors k.nolan9=ary.ycam -c- AC ` jeaathanOlangsurvey.com � ........ .. . SI�, 14'7...' 4, I hereby certify that I have surveyed the following described property: •• '� LOT 8. BLOCK 2, DENALY ESTATES SUBDIVISION (PLAT No. 2018-29) '*�' 49� \ '�*t r Anchorage Recording District, Alaska, and that the Improvements situated thereon are i within the property lines and do not encroach onto the properly adjacent thereto, that KnmT,ii _ I ' i no improvements on the property lying adjacent thereto encroach on the surveyed ... .... -. 3 premises and that there are no roadways. transmission lines or other visible iy . % e easements on sold property except as indicated hereon. i S ��(L% 520 / Dated this the oih Day of /.Yd u-- , '"'`' . al Anchorage, Alaska 4 \ . N 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