HomeMy WebLinkAboutPARADISE VALLEY BLK 1 LT 8Onsite File
Municipality of Anchorage
On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP181337 PID Number: 020-424-28
Dwelling: 0 Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: 0 New ❑ Upgrade
Name: ABSORPTION FIELD
Steven & Adrean Czajkowski
Address ■❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound
5889 Big Bend Loop Anchorage, AK 99502 ❑ Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
350-1860 5 0.6 GPD/SF 11.5 Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot 3.5 Ft. 8.0 Ft.
Paradise Valley 1 8 Fill added above original grade Gravel length
Township Range Section 4.1 / 2.1 Ft. 81 Ft.
Gravel width Beds:Number of Lines Distance between lines
SEPARATION DISTANCES 3.0 Ft. Ft.
To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist.between trenches
From Tank Field Tank Line 1296 Ft' 1 Ft.
Well >100' >100' N/A N/A >25' TANK 0 Septic 0 S.T.E.P. 0 Holding 0 Other
Manufacturer Capacity
Surface Water >100' >100' N/A N/A Greer 1500 Gal.
Material Number of compartments
Lot Line >5' >10' N/A N/A Plastic 2
NA
Foundation >10' >10' N/A N/A LIFT STATION 't
Manufacturer Capacity
Curtain Drain None Noted Gal.
Pump on level at Pump off level at High water alarm at
Remarks
in. in. in.
Pump make and model Electrical Inspections performed by
PIPE MATERIAL House to tank D3034Tank to D3034
Installer drainfield
Sanders & Sanders Drainfield D3034 CO/MT D3034
Inspector J. Millette BENCH MARK (Assumed elevation) 100 ft
Inspection
1st 9/28/18 2nd 9/28/18 Location and description
3,d 4th Bottom of siding @ point A.
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp
voissusik 4.4
Conditional Approval: Date ,p:...•••" "••••:9, ...
•
i 9 �• .g9th -A\ .4
.et * ..- .:3
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•
•70" MICHAEL E. ANDERSON L,•
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1•� %• No. CE-4381 .•'Z'`
•• TF`••40•••.• 6/11/19 '••<,, ,
4.
Approved 61- 4)44/....,,,i_.— Date 6 .9 ��h44P;oFESS\ 44.
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Inspection Report_9-1-12.doc
PARADISE VALLEY, BLOCK 1 , LOT 8
PERMIT # OSP181337 PID # 020-424-28
/ \ N // BLOCK 2
—If
/
ics LOT 8
100'WELL RAQII \� �� `//
\ IN \ ROCELL
I /� ' ' \ \ STEM
I\ / // VC,�i -\--- -\•-•-.
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\ \ \
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\ EXISTING VI/ELL ) / / ` \ I
II \ \ ,
\\ LOT 7 I ` r/ //� // � li \ \\ \\ \\ /\\ 1,500 GALLON SEfITIC TA�JK L \ /% I / VA/I \I EXISTIN\WELL\ )c \, \\
\ / /\i � I \ \ I \
O I
`\ I / / Sv2d;' l a'p / �2i,. \ \ 1 \ j `\ \1
- - - 4 2C. Tt 4 ' 'L!
ALTERNATE SITE CAT III SYSTEM I / coi \ T2 ,O \�\ /, I ®`\ / /
20 LONG x 3 WIDE X 8'EFFECTIVE I \ / h
DEPTH ABSORPTION TRENCH ` \ \
N.✓'� /� I ki \ 50'RADIUS/
\14.6T8 / / v + — /
I\ \\ \
T2 T \ EXISTIGWELL/ /
/\ 0\' I / /
\ I / /
r `\ \ \ \ � LOT 91\I � �/ //
30'ANCHOR EASEMENT \ . \\ 1 \\\ /
T3
\\ I CO2 \ \ RTH ABS PID ONTRENCH EFFECTIVE ///
\ \TIE INTO Ad1 iPOINT
/
---
� - _ 10'UTILITY EASEMENT \ \'I -
- -
\ I PF�RK TEST#fY3
/ N\ \
/ \\ >\ A B C
/ \ FCO 4.6 21.1
LOT 18 \\// \ SV1 15.9 36.3
\ / \\ SV2 20.6 40.0
\ MT1 18.9 37.2
\ 2C0 22.7 38.6
EXISTING WELL C01 26.5 37.8
GE \ MT2 27.3 32.3
„G,N„R,„G \ CO2 94.6 77.0
I MT3 90.6 75.8
�*4.7 _ OF q� iy LEGEND
:LSP••••••••..•.. ..a*..... ..
..,.� CO CLEANOUT
• ?•'' PLAN AS-BUILT 2C0 DOUBLE CLEANOUT
. 9th
_ FCO-FOUNDATION CLEANOUT
�
y � S �
• .f ^- FS-FLOW SPLITTER VALVE
�,: MICHAEL E. ANDERSON t,:
PARADISE VALLEY BLOCK 1 LOT 8
PERMIT # OSP181337 PID # 020-424-28
O
NO
LL (J) 2 Cl) N
- - / 97.3 - - -
— — 1 93.3
v
71
92.7 1500 GAL 925
SEPTIC TANK
Il _ 1
''''''`-- 86.0
97.5/95.5 FINISH GRADE
i/-
02 93.4 ORIGINAL GRADE g0
l
- h
89.9 89.9
DRAINFIELD ROCK
""------- 81.9
81' 81.9 —
--.775.9
.\-= NO GROUNDWATER 5/12/14
F-
a : 49th "� • •i
az i
•
7.F:MICHAEL E. ANDERSON : a
�G� PROFILE AS-BUILT ''•;; F yrs:11413
w ,N 4,N e,.,N G (NO SCALE) .ei pROFESS..�i.
4'
1,3 �rIIII•.♦
MUNICIPALITY OF ANCHORAGE 4l'\S Or,,,�4 •,
DEVELOPMENT SERVICES DEPARTMENT =G)..• `'••os�♦♦♦
L.700 BRAGAW STREET ANCHORAGE, AK 99519-6650 ' ♦
a • 49th /\ ; 1�
SOILS LOG - PERCOLATION TEST ���tljol C
ill
II MICHAEL E. ANDERSON 1 10
• �B
0� ' N O. CE-4381 •'� _
LEGAL DESCRIPTION: LOT 8, BLOCK I, PARADISE VALLEY SUBDIVISION %JJ'•.• C�•
♦ F '•• 6/4/19 ct
PERFORMED FOR: HARDING HOMES OF ALASKA ♦1�FQ P�- 4.
DATE: 9/28/18 PROJECT No.: 4•11 PROFESS\ ,4.
PARCEL ID#: 020-424-28 TECHNICIAN: J. MILLETTE Professional Engineers Stamp:
DEPTH PERK #3
(feet)
1 SLOPE SITE PLAN
2
3
4
5 SEE SITE PLAN
6
7
8
9
1 0 WAS GROUND WATER ENCOUNTERED?
IF YES(d WI1AT DEPTH? _
S
DEPTH OF WATER AFTER MONITORING:
11 DATE OF MONITORING:
12
GROSS TIME NET TIME DEPTH To NET DROP
13 DATE READING (MINUTES) (MINUTES) WATER (
(INCHES) INCHES)
14 TEST HOLE PRESOAKED PRIOR TO TESTING:
15 9/28 1 8:25 516"
16 2 8:55 30 7 16" 2 16"
3 8:57 56"
17 4 9:27 30 716 216"
18 5 9:29 5 6"
19 6 9:59 30 7 16" 2 k"
20
PERCOLATION RATE:14.2 (MIN/INCH) PERC. HOLE DIA. 6" (INCHES)
TEST RUN BETWEEN: 4 FT. and 5 FT.
COMMENTS:
TEST PERFORMED BY ANDERSON ENGINEERING. 1, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE:
Alpine Drilling & Enterprises
Well Log
Permit Number: #SW181337 Date of Issue: 9-27-18 Parcel Identification Number: 02042428000
Date Started: 2-09-19 Date Completed: 2-11-19 Is well located at approved permit location? x Yes ❑ No
Legal Description: Paradise Valley Block 1 Lot 8
Property Owner Name& Address: Steven &Adrean Csajakowski Harding Homes
Borehole Data: Depth (ft) Method of Drilling
Soil Type, Thickness & Water Strata From To x air rotary ❑ cable tool
Casing type: steel .
slick-up 0 2 Wall Thickness: .025 inches
silt 2 4 Diameter: 6 inches Depth: 196 feet
gravelly silt 4 116 Liner Type:
Diameter: inches Depth: feet
silty sand 116 123 Casing stickup above ground: 2 feet
gravelly silt 123 135 Static water level (from ground level): 95 feet
silt 135 141 Pumping level: 190 feet after
gravelly silt 141 159 2 hours pumping 30 gpm
Recovery Rate: 30 gpm
silty water sand&gravel 159 170 Method of Testing: air lift
gravely silt 170 192 Well Intake Opening Type:
water sand&gravel 192 196 x Open End ❑ Open Hole
❑ Screened Start feet Stopped feet
❑ Perforations Start feet Stopped feet
Grout Type: bentonite granules Volume: 2 hgs
Depth: Start 0 feet Stopped ? feet
Pump: Intake Depth feet
- Pump size hp Brand Name
Well Disinfected Upon Completion? x Yes ❑ No
Method of Disinfection: chlorine tablets
Comments:
Well Driller: Alpine Drilling& Enterprises
PO Box 110496
Anchorage AK 99511
plegy, ooYe `,Or
11/14/2019 02:44 907-345-0202 ALPINE DRILLING PAGE 11/03
MUNICIPALITY OF ANCHORAGE
(7.----,.Development Services Department l �f`I.. °l Phone: 907-343-7904
On-Site Water& Wastewater Section Ai.r / Fax: 907-343-7997
Pump Installation Log
Wen Drilling Permit Number: 181337 Date of Issue: 09 _27 18
i— ____
Parcel Identification Number: 02Q42428
Legal Description Block Lot Property Owner Name&Address:
Paradise Valley 1 $ Herding Nornes
P.U. Sox 110689
Anchcrabe,AK 9911-06 i
--- ,.�.. -- - --
Pump Installation Date: 03 _03 -2ot9
Pump Intake Depth Below Top of Well Casing: 1 92 feet
Pump Manufacturer's Name: Goulds
Pump Model: 7HS07
Pump Size: 3I4 _. hp
Pitless Adapter Burial Depth:N/A feet
Pitless Adapter Manufacturer's Name: N/A
Pltless Adapter Installer: N/A
Well Disinfected Upon Completion? .3 Yes 0 No
Method of Disinfection: chlorine tablets
Comments:
PLEASE SAVE FOR COSA
.. ... -=-------
Pump Installer Name:
Company: Aarow Pump & Well Service, LLC
l Mailing Address: P.O. Sox 110496
City: Anchorage State:AK Zip: 99511- J
Amemummk
Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation.
A X E- n
PLAT NO. 87- 16
PARADISE VALLEY SUBDIVISION
LOT 8, BLOCK 1
19,636 S.F.
c,9FFee
990•
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00
.00
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F
(o oe °•Pc,o
Ni,, p, 1 p,o
1,.
ul 33 4 4o
oLF
N 'so. 0,,Q` 0
A �` WELL
t�sT 9S,
4'C
9
• o•
6 le
O
o .9.
• `O �
.
SEPTIC SYSTEM �9i
N!""""'� MUNICIPALITY OF ANCHORAGE ,,,,,,,,
' On-Site Water&Wastewater Program :\c, "`'' `,-.�S,..
awe\ PO Box 196650 4700 Elmore Road —
' .
Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 ,te
httpa/www.muni.org/onsite IlirF ..
I)c Iiar tIll c tt1
4hCX OHO'.
On-Site Water & Wastewater System Permit
Permit Number: OSP181337 Effective Date: 9/27/2018
Work Type: WellSeptic Initial Expiration Date: 9/27/2019
Tax Code Number: 02042428000
Site Legal Address: PARADISE VALLEY BLK 1 LT 8 G:3538
Site Mailing Address: 5920 GREECE DR, Anchorage
Owner: CZAJKOWSKI STEVEN &ADREAN Lot Size in Sq Ft: 19636
Design Engineer: FORGE ENGINEERING Total Bedrooms: 5
This permit is for the construction of:
0 Disposal Field 0 Septic Tank ❑ Holding Tank 0 Privy 0 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: A portion of the primary and alternate drainfields are not within a 30 ft radius of a
percolation test. An additional percolation test is required prior to construction in location shown on site plan
confirm. If results require a design change, construction shall stop pending On-site review and approval of a
change order. Please submit results with inspection report.
Received By: //i L/I/ILA—lei'/ L;/2i Date: Z I
Issued By: C coi r[ Date: . a 7 1g
MUNICIPALITY OF ANCHORAGE
il
Community Development Department ,16: 0,..,.)1
FA Phone: 907-343-7904
Development Services DivisionFax: 907-ill ;19_ 77
On-Site Water & Wastewater Program y
ON-SITE SEWERNVELL PERMIT APPLICATION (Nia:' OW*
I SEP 17
20t8 I
Parcel I.D. 020-424-28
t.
Steven & Adrean Czajkowski
Property owner(s) 1 Day phone . ."^i/
Mailing address 5889 Big Bend Loop Anchorage, AK 99502
Site address 5920 Greece Drive Anchorage, AK 99516
Legal description (Sub'd., Block & Lot) Paradise Valley, Block 1, Lot 8
Legal description (Township, Range & Section)
Lot Size 19,636 Sq. Ft. Number of Bedrooms 1 v e (5
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(®all that apply)
Absorption Field X Initial n Single Family (SF) X
(w/wo ADU)
Septic Tank ❑X Upgrade ❑ Duplex (D) ❑
Holding Tank I I Renewal
Multiple Dwellings
Privy ❑ (SF and/or D)
Private Well X
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.
(Signature of property owner or authorized agent)
Permit/Rush Fees: ?Ft Waiver Fees:
Date of Payment: Q 11 Q 117 Date of Payment:
Receipt Number: Qlltia7lb Receipt Number:
Permit No. OSA/gi 337 Waiver No.
Permit App_ ' :: c
' GE
rENGINEERING
PO BOX 240773
ANCHORAGE,AK 99524
522-7773 677-7766(FAX)
September 27, 2018
MOA Development Services Dept,On-Site Water&Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: Paradise Valley,Block 1,Lot 8—5920 Greece Drive
Septic System Design
Dear On-Site Services Engineer:
The developer of the subject lot intends to construct a 4-bedroom home on the property. We . e
submitting this design and permit application for the construction of a new well and sep c
system. The attached site plan identifies the location of the home and the proposed well, sept c
location and alternate site.No conflicts exist between this proposed system and any other well lir
septic system,whether on this lot or adjacent lots.
The ground surface on the lot slopes moderately to the southwest. Ground contours are shown •
the site plan showing the grade and direction of flow. Storm water drainage will not impact th s
septic system. The new trench will be constructed parallel to the slope as much as possible.
Well radii on the surrounding lots are shown. The new septic system will be a minimum of 101'
from all wells and surface water, and more than 5' away from the septic tank. The alternate si e
is located more than 16' from the primary site. A test hole and percolation test will be requir,d
prior to the construction of the new system. We request this condition be added to the permit.
Please refer to the attached test hole logs, and plan and profile sheets for the septic design. If s
design is followed,there will be no adverse impacts to adjacent properties.
Sincerely,
OFA\\ N
Michael E. Anderson,PE E
Michael E.Anderson
���'F• 4381-E ••• /
Attachments c�sfF• . •••
�4�
�i� 44:PROFESSP".. 1,'
•
•
PARADISE VALLEY, BLOCK 1 , LOT 8
` \ /
/
,� .\ BLOCK 2
- - - - - y - - `� -- LOT 8
, . 1 ,ifii‹. I •.< -..
�t N
akt
i1/
1 L —
EXISTING WELL ' //if . c \
7 `3, °2 \ \ N. \
/ (,
LOT 7 / / \ \
PROPOSED WELL TGkBE STAKED
1.500 GALLON SEPTIC TANK BY A REGISTERED LAND
SV CO
SURVEYOR TO ENSURB 100'
SEPARATION TO SEPTIC\SYSTEM
2C0 V 5-BDRM HOME AND ALTERNATE SITE ON\BLOCK
79'LONG x 3'WIDE x 8'EFFECTIVE 2,1,OT 8 OF PARADISE VALLEY
DEPTH ABSORPTION TRENCH SUBQIVISION
TIE INTO MID-POINT Co.•-:: \
'••;LOT.8
• TH#2
•
TH#1. •
EXISTING WELL
f '` • •t•• LOT 9
30'ANCHOR EASEMENT •
MT es ALTERNATE SITE
Co
10'UTILITY EASEMENT
\
\
\ PROPOSED PERK
// \ TEST
LOT18 / \
/ N
/ N
/ \
7 EXISTING WELL
NOTE:
•_1�sytv►iai4�� NO SLOPES>25%WITHIN 50'OR SURFACE WATER WITHIN 100'OF THE LEGEND
.•• ��..`�f � ��� PROPOSED SEPTIC SYSTEM
••�,q.• ., •j CO-CLEANOUT
,� iN 1\*% ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS 2CO DOUBLE CLEANOUT
• 49th FCO-FOUNDATION CLEANOUT
"•' i1_ r .Z IZITt %
• ZL •
PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC FS FLOW SPLITTER VALVE
i ,S MICHAEL E. ANDERSON d 4�
SYSTEMS. 50 100 MT-MONITORING TUBE
•• ' •• No. CE-4381 '....___al SV-SEPTIC VENT
0.J • r• mi im NI FEET
TH-TEST HOLE
F .•
�� OFESS��P�. 1"=50'
•
PARADISE VALLEY, BLOCK 1 , LOT 8
DESIGN FACTORS: SYSTEM REQUIREMENTS:
750 GPD PEAK FLOW 8' DEEP TRENCH SYSTEM
PERK RATE: 16-30 MIN/IN 1,500-GAL SEPTIC TANK
APPLICATION RATE: .6 GPD/SF
750 GPD/ .6 GPD/SF/8'DEEP /2 SIDES = 78.13 LF TRENCH REQUIRED (79 LF SPECIFIED)
BOTTOM OF TRENCH: 11.5' BELOW GRADE
FLOW LINE ELEVATION: 3.5' BELOW GRADE
TOP OF TRENCH: .5' ABOVE GRADE
6"
_ -I(1=1 I la 1=f I(_
1E1 I HI l= I --
_ TI-1 I I-1 I 1=1TI=1 I f—I
M=11.1 Tl��-.I II I
3, =1I 1=1 11=n= -IT
NTI=
1=!11F-I I-11-
1 I= I0_--1 111=1
1 I1=I 11=1 1=
1 H 11- '!'-!
6" zwz
,100='=';;I! 4" PERFORATED PVC (HOLES DOWN)
'�`�`•`�`�'�`•'�'•`� DRAINFIELD ROCK
8' •
I- 3
RGE
ENG EERING
TYPICAL DEEP TRENCH SECTION �.•��'o
(NO SCALE) � ••••
.kP:..•••• ..••• ••1
•
i 41
NOTES: 4 9th •••• ♦♦11
,�
1. GRADE AREA OVER TRENCH TO DRAIN AWAY
� c �--!
„
•
2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' j ;MICHAEL E. ANDERSONL,.
WITH 2" OF INSULATION ti s'• No. CE-438.1 .•`���
3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER �•jF ''•• 5°°Z'.�'8......•'••''''
THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY � h pR�;.SS1CNPi.•�
MUNICIPALITY OF ANCHORAGE .♦♦♦♦n�si, •
DEVELOPMENT SERVICES DEPARTMENT •♦•`P •••••"•• s-i co a.�
4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 :�:. :�
. . $
• 49th h SOILS LOG — PERCOLATION TEST ( pzr11
•la• •� MICHAEL E.ANDERSON 0 jj=
11.4::••• NO. CE-4381 •��/
LEGAL DESCRIPTION: LOT 8, BLOCK I, PARADISE VALLEY SUBDIVISION � � '
PERFORMED FOR: RAYMOND STARZEC �•�Fb••'�_/�� �•••
DATE: 5/1/14 PROJECT No.: ••'-� sw5a•.\C"11•4.♦•
PARCEL ID#: 070-474-78 TECHNICIAN: A. HARALA Professional Engineers Stamp:
DEPTH TEST HOLE 1
(feel)
OB/OG SLOPE SITE PLAN
1
2
3
°
e
4
•5 .4• o SEE SITE PLAN t
4
6
4 e.
7
a: 4
•
8 SILTY GRAVEL
• ',E. WITH SAND
9 GM
'
10 ' WAS GROUND WATER ENCOUNTERED? NO
. A IF YES @ WHAT DEPTHS
DEPTH OF WATER AFTER MONITORING: NONE 2%
1 1 • 5/12/14
•' DATE OF MONITORING:
12 e. . d:.
• A. GROSS TIME NET TIME DEPTH To NET DROP
13 DATE READING (MINUTES) (MINUTES) WATER (INCHES)
(INCHES)
14 ' .a TEST HOLE PRESOAKED PRIOR TO TESTING:
15 5/2 1 12:38 5.12"
d2 13:08 30 6.44" 1.31"
16— •
3 13:11 5.06"
17
BOH @ 17.5' 4 13:41 30 6.31" 1.25"
18 5 13:42 5.00"
19 6 14:12 30 6.25" 1.25"
20
PERCOLATION RATE: 24 (MIN/INCH) PERC. HOLE DIA. 6" (INCHES)
TEST RUN BETWEEN: 4.5 FT. and 5.5 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: 5/12/14
MUNICIPALITY OF ANCHORAGE .soga iiv>,o,,
DEVELOPMENT SERVICES DEPARTMENT ������ •••••. •f1
4700 BRAGAW STREET ANCHORAGE, AK 99519-6650
'••49th •°: .
SOILS LOG - PERCOLATION TEST •
all)
MICHAEL E.ANDERSON
•C��••. No. CE-4381 .'_'
LEGAL DESCRIPTION: LOT 8, BLOCK I, PARADISE VALLEY SUBDIVISION
��...(<4....4
s��:,•• ° �
PERFORMED FOR: RAYMOND STARZEC �1 AFD •�Y„{fS\cY S`���
DATE: 5/1/14 PROJECT No.: ••,-� isswo.4••
PARCEL ID#: 0W0-424-28 TECHNICIAN: A. HARALA Professional Engineers Stamp:
DEPTH TEST HOLE 2
(feet)
OB/OG SLOPE SITE PLAN
1
2 •
d e
3
a
4
•4 N
5 SEE SITE PLAN
6 • 1
de.
7 •
a; . .a
•
8 . SILTY GRAVEL
•r
e a' WITH SAND
9 .' GM
• ' WAS GROUND WATER ENCOUNTERED? NO
1 0 a • e
a IF YES @ WHAT DEPTH? S
DEPTH OF WATER AFTER MONITORING NONE 2%
11 • a • DATE OF MONITORING: 5112/Id
12 a. . d'..
GROSS TIME NET TIME DEPTH TO NET DROP
13 DATE READING (MINUTES) (MINUTES) WATER (INCHES)
(INCHES)
• °
14 4 .a TEST HOLE PRESOAKED PRIOR TO TESTING:
15 '.. ` 5/2 1 12:40 4.75"
16 •
2 13:10 30 6.50" 1.75"
• e. e<
17 3 13:11 4.81"
BOH @ 17.5' 4 13:41 30 6.50" 1.69"
18 5 13:43 4.69"
19 6 14:13 30 6.38" 1.69"
20
PERCOLATION RATE: 18 (MIN/INCH) PERC. HOLE DIA. 6" (INCHES)
TEST RUN BETWEEN: 4.5 FT. and 5.5 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: 5/12/14
epuwus
MUNICIPALITY OF ANCHORAGE RI14544
Development Services Department a ft
Z--)1Phone: 907-343-7904
On-Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On-Site Systems Approval
Parcel I.D. 020-424-28 Expiration Date:
1. GENERAL INFORMATION
Complete legal description Paradise Valley Block 1 Lot 8
Location (site address) 5920 Greece Drive, Anchorage, AK 99516
Current property owner(s) Steven & Adrean Czajkowski Day phone
Mailing address 5920 Greece Drive, Anchorage, AK 99516
Real estate agent Day phone
2. TYPE OF DWELLING:
0 Single Family (w/wo ADU)
Duplex RUSW
Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 5
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Private Well [ Private Septic
Water Storage [ Holding Tank LJ
Community Well n Community
Public Water System [ Public Sewer
Waiver request for: Distance:
Received by: am: !,h r,� tt Date: ‘;:////'‘-‘1.
COSA to be released to the engineer.unless othe sbythe engineer.
9 requested 9
COSA Fee $ $ /2D Waiver Fee $
Date of Payment 60/51/63 Date of Payment
Receipt Number [)gq 25D Receipt Number
COSA# Q d3«Q 120 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 6/4/19
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6. DSD SIGNATURE • •l C .0
•
V System #1 Approved for 5 bedrooms o MICHAEL E ANDERSON /
• •• No. CE-4381 • � •
System #2 Approved for bedrooms I� 6i4i19 •
Disapproved 414. ESS‘T,k 44�
Conditional approval for bedrooms, with the following stipulations:
By: LA airrAm Original Certificate Date: ,6A,q
The Municipality of Anchor‘Development 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: Paradise Valley, Block 1, Lot 8 Parcel ID: 020-424-28
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 30 gpm
Date drilled 2/11/19 Water storage tank volume NA gallons
Total depth 196 ft Well disinfected for coliform test? ❑ Yes ❑� No
Cased to 196 ft ❑l Coliform bacteria is Negative
■❑ Sanitary seal is functioning correctly Nitrate 1.94 mg/L ❑ Nitrate less than MRL (ND)
❑■ Wires are properly protected Arsenic ug/L ❑� Arsenic less than MRL (ND)
Casing height (above ground) >24 in. Collected by Forge Engineering
Date of flow test for COSA 2/11/19 Date of Sample 5/16/19
Static water level at beginning of test 95 ft.
Comments
B. TANK DATA C. LIFT STATION
Age of tank(s) <1 years ❑ Required maintenance completed
Tank type/material Septic/Plastic 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
D. ABSORPTION FIELD DATA Deep Trench
Which system tested (date installed) 9/28/19 Adequacy test date New
• ALL standpipes present per record drawing Results ❑Pass For bedrooms
Total measured depth from grade 11.5 ft (max) Fluid depth prior to test in
Measured depth to pipe invert from grade 3.5 ft(min) Water added gal
❑ N/A—pressurized field New depth in
❑1 Monitor tubes go to bottom of effective. If not, state Elapsed time min
depth into effective
UI Code-required soil cover over field Final fluid depth in
[' 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 NA 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 n Yes if No ft
Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' M Yes if No ft
Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' 0 Yes if No ft
Neighboring Absorption Fields > 100' Animal Containment> 50' 0 Yes if No ft
0 Yes if No ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ❑✓ 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' 0 Yes if No ft Surface Water> 100' p✓ 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' 0 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' 0 Yes if No ft
Surface Water> 100' 0 Yes if No ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION ��.�sOr si4
�E........,,414.144
.�
I certify that I have determined through field inspections and review i�'�P,•••'• wj
of Municipal records that the above systems are in conformance with �1�- *** %.
MOA COSA guidelines in effect on this date. w : 49th i'‘ •
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•
•
�•Tn MICHAEL E. ANDERSON J�Er
..0;a:. No. CE-4381 '�•'�_=
•,4%.:**...���6/10/19,•••��Ct 1
COSA Checklist yellow sheet �w f, PROFESS\ 4•4
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