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Home My WebLink AboutLAKE O THE HILLS BLK 1 LT 7Onsite File Lake O The Hills Block 1 Lot 7 #015-331-14 Municipality of Anchorage -' On-Site Water and Wastewater Program • (907) 343-7904 Orii aof 3 ON-SITE WASTEWATER INSPECTION REPORT Y Ai Permit Number: OSP191137 PID Number: 015-331-14 2019 41 Dwelling: g Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ■❑ New ❑ Upgrade Name: ABSORPTION FIELD Chistopher Crosta & Randi Jo Gause Address El Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound 11501 Rockridge Dr. Anchorage, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 907-841-6249 4 0.8 GPD/SF 10.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 3.0 Ft. 7.0 Ft. Lake 0 The Hills 1 7 Fill added above original grade Gravel length Township Range Section 0.6 Ft.' 54 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 1 Tank Field Tank Line 756 Ft2 1 Ft. Well >100' >100' N/A N/A >25' TANK 0 Septic ❑ S.T.E.P. ❑ Holding ❑Other Manufacturer Capacity Surface Water >100' >100' N/A N/A Anchorage Tank 1,250 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 1 Curtain Drain None Noted Gal. Pump on level at Pump off level at High water alarm at Remarks Pitless adapter manufactured by Campbell, installed 10' below grade by in. in. in. Red Dog Masonry. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank D3034 Tank to D3034 Installer drainfield Red Dog Masonry Drainfield D3034 CO/MT D3034 Inspector J. Williams BENCH MARK (Assumed elevation) 100 ft Inspection 1s, 11/8/19 2"d 11/11/19 Location and description 3rd 4`h Garage slab. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp 4000,aim•,isi4 Conditional Approval: Date a ji` .t's. i 49th om ♦/ • ..MICHAEL E. ANDERSON • • a t.0�.... No. CE-4381 . �� - T........ 11/25/19 �.........�� Approved _� Date X2/3% ,.446 PROFESS\................ ... ,,4� Inspection Report_9-1-12.doc / LAKE 0 THE HILLS, BLOCK 1 , LOT 7 PERMIT # OSP191137 PID # 015-331-14 - f LOT6 // \ , � - - - Jam , �/////j%//�%//%//�%// / // / //j///j� ` \ / \\ //1//Z/ 1 , \ \ I 54'LONG x 3'WIDE x 7' • EFFECTIVE DEPTH EXISTING WELL 1 ALT.ERNATE SITE ABSORPTION TRENCH I I T� t ` — — LOT 7 ` 1 100'SETBACK i FROM LAKE %1 1 1 /� N \\ I • TN2 Cot \ /�� 4-BDRM HOME / N MT1 • 1 - C0 \ /• `„ / \\ • \ / .� � // \ .2C0 .\2__Mp / \ /� - I — - - \ 1,250 GALLON I 1 / �O .'� SEPTIC TANK �fr,Q� I Gco .s c1ei b ® I '1 o(Fo a I 5k-ft1 51au _.1 1 1P2�, 5e wl- c yp, ;.at/ LOT 8 LOT 3 A, eg"..EXISTING WELL BLOCK 4 \ \ / ,1 \ / ` \ / WELL ON THIS LOT>100'FROM PROPOSED \ / SEPTIC SYSTEM AND ALTERNATE SITE. N / ��aaaaa ••�.P�EwOF. ,q��+�.. A B C LEGEND 2�'�J, `'`'�;�/�� FCO 5.2 27.1 CO-CLEANOUT isl 4/ 49th i\ %*$ PLAN AS-BUILT SV1 105.4 129.2 2C0-DOUBLE CLEANOUT SV2 111.9 136.5 FCO-FOUNDATION CLEANOUT i7� ��— �t 2C0 115.7 . 140.7 FD-FLOW DIVERTER VALVE •c+s MICHAEL E ANDERSON 7�a 0 50 100 CO1 105.3 h. , 136.7 MH-MANHOLE •�C'�J, NO. OE-4381 a,' m I♦ = FEET MT1 109.2 140.0 v141c` 1125ne .4 4. �-± CO2 , 157.8 186.5 MT MONITORING TUBE "� o "'—" P •. GE 1"=50 MT2 153.6 182.6 SV-SEPTIC VENT toi �SS1-4•� �a � ■ •a TH-TEST HOLE LAKE 0 THE HILLS, BLOCK 1 , LOT 7 PERMIT # OSP191137 PID # 015-331-14 o > > 0 u_ w CNJ - - 80.45 - - - 75.8 V°r 75.15 r 1250 GAL 75.35 SEPTIC TANK �'''- 70.9 73.9 FINISH GRADE "/- o OH 73.3 ORIGINAL GRADE -o l \ 70.3 �- 70.3 DRAINFIELD ROCK 63.3 63.3 54' 58.3 56.3 NO GROUNDWATER 4/17/19 NO GROUNDWATER 4/17/19 I _ H H •isliaui,' t C9j i °�1� ••• •:241'49th �� , 111 eriaj, 16 f 7TMICHAEL E. ANDERSON I L E A -B I •.�-.. No. C0-4381 :� : s [iit'GE .-e...... 11,25,19 e.4-4- N61N[[[ING (NO SCALE) ..•, F* ".ESS‘00i•• ,1Art\ars- Alpine Drilling & Enterprises Well Log Permit Number: #SW191137 Date of Issue: 4-30-19 Parcel Identification Number: 01533114000 Date Started: 7-20-19 Date Completed: 7-21-19 Is well located at approved permit Iocation?x Yes ❑ No Legal Description: Lake 0 The Hills Blk 1 Lot 7 Property Owner Name&Address: Christopher Crosta Colony Builders 9420 Vanguard Unit A Anchorage, Alaska 99507 Borehole Data: Depth (ft) Method of Drilling x air rotary ❑ cable tool Soil Type,Thickness&Water Strata From To Casing type: steel stick-up 0 2 Wall Thickness: .250 inches silt 5 Diameter: 6 inches Depth: feet Liner Type: gravelly silt 5 33 Diameter: inches Depth: feet silty gravel 33 84 Casing stickup above ground: 2 feet sandy gravelly silt wet 84 141 Static water level (from ground level): 76 feet gravelly silt wet 141 156 Pumping level: 155 feet after silty water sand and gravel 156 161 2 hours pumping 40 gpm Recovery Rate: 40 gpm Method of Testing: air lift Well Intake Opening Type: x Open End ❑ Open Hole ❑ Screened Start feet Stopped feet ❑ Perforations Start feet Stopped feet s WATER QUALITY TESTING Grout Type: bentonite granules Volume: 2 by Conform A4 Col/100mL Depth: Start 0 feet Stopped ? feet Nitrates ,U/7 L Pump: Intake Depth feet Arsenic ND ug/L 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 -pleo6eJ saIL (7, ( 605A MUNICIPALITY OF ANCHORAGE • Development Services Department 'f}: Q Phone: 907-343-7904 On-Site Water& Wastewater Section - Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: 191137 Date of Issue: 4 -30 _19 Parcel Identification Number: 015 331.1400 Legal Description Block Lot Property Owner Name& Address: I Christopher Crosta/Colony Builders Lake'0 the Hills - 1 7 94____ 2 guard 9r., Unit A Anchorage,AK 99507 ---- Pump Installation Date: 9 -30 _2019 Pump Intake Depth Below Top of Well Casing: 152 feet Pump Manufacturer's Name: Goulds Pump Model: 7HS07 Pump Size: 3/4 hp Pitless Adapter Burial Depth: N/A feet Pitless Adapter Manufacturer's Name: N/A Pitless Adapter Installer: N/A Well Disinfected Upon Completion? f4 Yes ❑ No Method of Disinfection: chlorine tablets Comments: PLEASE SAVE FOR COSA. Pump Installer Name: Company: Aarow Pump & Well Service, LLC Mailing Address: P.O. Box 110496 City: Anchorage State: AK Zip: 99511 Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. GRAVEL DR. A5 �� \ AS -BU PLAT NO. 72-236 I HEREBY CERTIFY THAT I HAVE SURVEYED THE LAKE 0' THE HILLS SUBDIVISION GASTALDI LAND ENCROACHMENTS EXIST EXCEPT AS INDICATED. SURVEYING, LLC LOT 7, BLOCK 1 DETERMINE THE EXISTENCE OF ANY EASEMENTS, 2000 E. DOWLING RD., SUITE 8 COVENANTS OR RESTRICTIONS WHICH DO NOT ANCHORAGE, ALASKA 99507 54,657 S.F. PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR GRID DATE LAKE 0' THE HILLS ESTABLISHING BOUNDARY OR FENCE LINES. SW2639 � S �4°30pp„E E 314 — �� 100 0 , 30” Oq 0 441 �SeM N Wq� gNCE N 79°3g'37 WAY ESMT' 20, RIGHT OFPG 1781 — 19-03 \ — (BK120'_---- _ SYSTEMS WILD OF — ON O BE \ 2S•\ EDGE OF — — — — NO SEWERp HE EREPIAT) — — ALLOW THIS UNE �P WELL \ ' �Y,yT' FReOOYS�eq LAKE 0 _ — 0 0 o� — 0 \ --------- K ° ---- - 0 0 0 z z �' • ,p\ —_ • SEPTIC SYSTEM 10' UTIL/TY �9 GRAVEL DR. A5 �� \ AS -BU I LT I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO GASTALDI LAND ENCROACHMENTS EXIST EXCEPT AS INDICATED. SURVEYING, LLC IT IS THE RESPONSIBILITY OF THE OWNER TO JEFF A. GASTALDI, R.L.S. DETERMINE THE EXISTENCE OF ANY EASEMENTS, 2000 E. DOWLING RD., SUITE 8 COVENANTS OR RESTRICTIONS WHICH DO NOT ANCHORAGE, ALASKA 99507 APPEAR ON THE RECORDED SUBDIVISION PLAT. PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR GRID DATE ESTABLISHING BOUNDARY OR FENCE LINES. SW2639 11/19/2019 ANCHORAGE RECORDING DISTRICT, ALASKA F.B. JOB NO. NOTE: NO CORNERS SET THIS DATE 19-03 LOH71 .,**ILIL■1\ OF A4# i * : 49TH : * 0 rQ �0c�at� . o :Jeffery A. Gastaldi o . s. LS-6091AIF .sP •. 11/19/2019 0`J� • • 0 lass 11 m MAto] BUILDING DETAIL SCALE. 1 —20 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://wv,w.muni.org/onsite On -Site Water & Wastewater System Permit Permit Number: OSP191137 Work Type: WellSeptic Initial Tax Code Number: 01533114000 Site Legal Address: LAKE O THE HILLS BLK 1 LT 7 G:2639 Site Mailing Address: 11501 Rockridge DR, Anchorage Owner: CROSTA CHRISTOPHER & Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft Total Bedrooms: c ,. �;. �elt�t•rCntcttC 4/30/2019 4/29/2020 54657 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 Received By:OtHluf�wfirrv') Date: 'f _ Issued By: Date: T �D % 4 TERMS MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWERNVELL PERMIT APPLICATION Parcel I.D. 015-331-14 Property owner(s) Colony Builders Mailing address 9420 Vanguard Drive Anchorage, AK 99507 Site address NHN Rockridge Drive Anchorage, AK Day phone 345-0371 Legal description (Sub'd., Block & Lot) Lake O The Hills, Block 1, Lot 7 Legal description (Township, Range & Section) Lot Size 54,657 Sq. Ft. Number of Bedrooms Four (4) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (M all that apply) Absorption Field ❑X Initial ❑X Single Family (SF) ❑X Septic Tank ❑X Upgrade El(w/wo ADU) Duplex (D) ❑ Holding Tank ElRenewal ElMultiple 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. .Wl"� aat'4� (Signature of property owner or authorized agent) Permit/Rush Fees: V-6 Waiver Fees: Date of Payment: �l �U �� Date of Payment: Receipt Number: 045 -00 Receipt Number: Permit No. 0,51014 037 Waiver No. Permit App_.;- :- ,...mac PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) April 25, 2019 MOA Development Services Dept, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Lake O The Hills, Block 1, Lot 7 – NHN Rockridge Drive 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 on this lot or adjacent lots. The ground surface on the lot slopes gently to the south at grades approximating 10%. There are no slopes greater than 25% within 50 feet downslope of either the primary or alternate site. Drainage arrows are shown on the site plan indicating 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. 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, Michael E. Anderson, PE 4/25/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191137, Rebecca Carroll, 04/30/19 54' LONG x 3' WIDE x 7' EFFECTIVE DEPTH ABSORPTION TRENCH NOTE: NO SLOPES >25% WITHIN 50' 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 FD - FLOW DIVERTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND CO LAKE O THE HILLS, BLOCK 1, LOT 7 1"=50' FEET 0 50 100 4-BDRM HOME 1,250 GALLON SEPTIC TANK MT 4/25/19 A. C . D R I V E 10'UTILITY ESM T. RO C K RID G E DRI VE30' DAM MAINTEN A N C E EASE M ENT & WALKWAY S L O P E = 8. 0 % PROPOSED WELL 100' SETBACK FROM LAKE EXISTING WELL CO CO 2CO SV SV 2CO FCO 10%TH1 TH2 10%10%4" INSULATION OVER LINE UNDER DRIVEWAY ALTERNATE SITE WELL ON THIS LOT >100' FROM PROPOSED SEPTIC SYSTEM AND ALTERNATE SITE. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191137, Rebecca Carroll, 04/30/19 LAKE O THE HILLS, BLOCK 1, LOT 7 DESIGN FACTORS: SYSTEM REQUIREMENTS: 600 GPD PEAK FLOW PERK RATE: 6-15 MIN/IN APPLICATION RATE: .8 GPD/SF 7' DEEP TRENCH SYSTEM 1,250-GAL SEPTIC TANK TYPICAL TRENCH SECTION (NO SCALE) 4" PERFORATED PVC (HOLES DOWN) DRAINFIELD ROCK 3' 6" 6" 3.5' 7' 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: 11.0' BELOW GRADE FLOW LINE ELEVATION: 4.0' BELOW GRADE TOP OF TRENCH: 0.5' ABOVE GRADE 600 GPD / .8 GPD/SF /7' DEEP / 2 SIDES = 53.57 LF TRENCH REQUIRED (54 LF SPECIFIED) 4/25/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191137, Rebecca Carroll, 04/30/19 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) LAKE O THE HILLS, BLOCK 1, LOT 7 4/10/19 J. Millette DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH OF WATER AFTER MONITORING: IF YES @ WHAT DEPTH? NO - NONE 2 6 5 6 COLONY BUILDERS 11:20/11:30 4/11 1 2 3 4 5 6 10 10 10 0/5-4/16 0/5-3/16 5-3/16 0/5-2/16 0/5-2/16 5-2/16 0/5-1/16 0/5-1/16 5-1/16 11:31/11:41 11:42/11:52 11:53/12:03 12:04/12:14 12:15/12:25 ORGANICS SANDY SILTY GRAVEL 4/17/19 Professional Engineers Stamp: 4/25/19 & FILL GM 5-4/1610 10 10 5-2/16 5-1/16 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191137, Rebecca Carroll, 04/30/19 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 2 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) LAKE O THE HILLS, BLOCK 1, LOT 7 4/10/19 J. Millette DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH OF WATER AFTER MONITORING: IF YES @ WHAT DEPTH? NO - NONE 15 6 5 6 COLONY BUILDERS 1:34 4/11 1 2 3 4 5 6 30 30 30 0 2-1/16 2-1/16 0 2 2 0 2 2 2:04 2:05 2:35 2:36 3:06 ORGANICS SANDY SILTY GRAVEL 4/17/19 Professional Engineers Stamp: 4/25/19 & FILL GM Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191137, Rebecca Carroll, 04/30/19 PLAT NO. 72-236 LAKE 0' THE HILLS SUBDIVISION LOT 7, BLOCK 1 54,657 S.F. s1o' 11 5 37..E 3A4.54 - t4 -7 9 14.84.N79 775' 3 0O , O r LAKE 0' THE HILLS S ,4113p,00 £ /00 I 3p, 0q Op £AS£M£lV MAIIVr£Nq NO AICE- S£ & WALKWAY ALSO E. p/SPOSq °oH S0ovc H CCAON KE S�S WCL B \ \ +� £R PLA S p£ of £ BG�O,oO �°O \ �O�YCFO } 60 \O•+ p o S�9 70 y �, 600• ° Q, 4r EFI— ELEVATIONS BASED ON MOA AERIAL TOPO PLOT PLAN I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT GASTALDI LAND THE PROPOSED IMPROVEMENTS AND DRAINAGE SURVEYING, LLC PATTERNS ARE AS SHOWN HEREON. IT IS THE JEFF A. GASTALDI, R.L.S. 2000 E. DOWLING RD., SUITE 8 RESPONSIBILITY OF THE OWNER, PRIOR TO ANCHORAGE, ALASKA 99507 CONSTRUCTION, TO VERIFY THE PROPOSED PHONE 248-5454 BUILDING LOCATION ON LOT, BUILDING DIMENSIONS GRADE AND UTILITY CONNECTIONS GRID DATE SW2639 4/4/2019 AND TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED F.B. JOB NO. LOH71 SUBDIVISION PLAT. 0� r ,Lg`L C ,....o OF 1♦ 49TH •: * � ��. / m : Jeffery A. Goslold LS -6091 AV sP •• 4/4/2019 �• �� • •♦ Pap •••.•••.•••• 411* Ofessiono\\-G�\ ♦ 11\ \*��•� 7m] 1 11=40' BUILDING DETAIL SCALE: 1"=20' MUNICIPALITY OF ANCHORAGE 0 Awl, Development Services Department Iz Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-331-14 1. GENERAL INFORMATION Expiration Date: Complete legal description Lake O The Hills, Block 1, Lot 7 Location (site address) 11501 Rockridge Drive Anchorage, AK Current property owner(s) Randi Jo Gause and Christopher Crosta Day phone 907 541-6249 Mailing address 2912 Kingfisher Drive Anchorage AK 99502 Real estate agent 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone CAuSk ll -z1 -1q 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well El Private Septic 0 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. 121/L COSA Fee $ S + = 120 Waiver Fee $ Date of Payment ) I - Date of Payment Receipt Number (?-I3-01L6 Receipt Number COSA # CXDU t 5 7 2 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 11/26/19 es!G ®OF IL A �oe�. AW Ar Ar 49th 6. DSD SIGNATURE ®Zy�;"" 0 .............0........ a ... got ...... I ........ a V System #1 Approved for bedrooms MICHAEL E. ANDERSON •�� NO. CE -4381 ••�_ System #2 Approved for bedrooms �e`f�F'••.•• 11/26/19 ��: Disapproved ♦o soes�i;;so;; s��•• Conditional approval for bedrooms, with the following stipulations: �WASTE,NATER o^ �� PRO"Am By: / Original Certificate Date: �2 / The Municipality of Anch ge 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 Septic System Advisory Well Flow Advisory COSA Checklist blue sheet X Nitrate Advisory Arsenic Advisory Other E Legal Description: Lake O The Hills, Block 1, Lot 7 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 7/21/19 Total depth 161 ft Cased to 161 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) >18 in. Date of flow test for COSA 7/21/19 Static water level at beginning of test 76 ft. Comments B. TANK DATA Age of tank(s) <1 years Tank type/material Septic/Steel Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping New Construction - 11/11/19 D. ABSORPTION FIELD DATA Deep Trench Which system tested (date installed) 11/08/19 ❑ ALL standpipes present per record drawing Total measured depth from grade 10.6 ft (max) Measured depth to pipe invert from grade 3.6 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 015-331-14 Structure served by this system Well production at time of test 40 gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by FORGE ENGINEERING Date of Sample 11/15/19 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date New Construction Results 1❑ Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date 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' 0 Yes Community Sewer Manhole/Cleanout > 100' M Yes if No ft 0 Yes if No ft Neighboring Tank > 100' ✓0 Yes if No ft Private Sewer/Septic Line > 25'✓0 Yes if No ft Absorption Field on Lot > 100' ✓0 Yes if No ft Holding Tank > 100' F71 Yes if No ft Neighboring Absorption Fields > 100' Fv� Yes if No ft Water Main > 10' Animal Containment > 50' 0✓ Yes if No ft 0✓ Yes if No ft Yes if No ft Water Service Line > 10' ✓0 Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway Community Sewer Main > 75' 0 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' 0 Yes if No ft Surface Water > 100' 0✓ Yes if No ft Property Line > 5' ✓0 Yes if No ft Wells on Adjacent Lots: ✓0 Absorption Field > 5' 0 Yes if No ft Private Wells > 100' Fv� 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' Yes if No ft Water Service Line > 10' 0 Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' El Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION"iflf I certify that I have determined through field inspections and review , ,� o.A,,. ','!,; of Municipal records that the above systems are in conformance wither° °+ ' MOA COSAguidelines in effect on this date.4*� ugh W#'1. COSA Checklist yellow sheet :n MICHAEL E. ANDERSON G No. CE -43$1 •" 0i 6 /.f ROF.ESSi' 'O , 4ice