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HomeMy WebLinkAboutSYLEA LT 2Onsite File Sylea Lot 2 #051-732-37 trcev 05/02-ho) Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191421 PID Number: 051-732-37 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑s New ❑ Upgrade Name Troy Davis Homes ABSORPTION FIELD ❑ Deep Trench ❑■ Wide Trench ❑ Bed ❑ Mound Site Address 23000 Sheltering Spruce Ave. Chugiak, AK ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 310-2501 3 1.2 GPD/SF 2.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 1.0 Ft. Gravel depth beneath pipe 1.0 Ft. Subdivision Block Lot Sylea 2 Fill added above original grade 1.7 Ft. Gravel length 2 @ 34 Ft. Township Range Section Gravel width 5.0 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 390 Ft z 2 >6 Ft. Well >1 QQ' >1 00' N/A N/A >25' TANK 0 Septic ElS.T.E.P. ❑ Holding El Other Manufacturer Greer Capacity 1,000 Gal. Surface Water >1 00' >1 00' N/A N/A Material Number of compartments Lot Line >5' >10' N/A N/A NA Plastic 2 Foundation >1 0' >1 0' N/A N/A LIFT STATION Manufacturer Capacity Remarks Trench, tank, and all septic lines are insulated. Gal. Alarm location Electrical installed by PIPE MATERIAL House to tank D3034Tank to D3034 drainfield Installer Whitters Excavating Drainfield D3034 CO/MTD3034 Inspector J. Millette BENCH MARK (Assumed elevation) 100 ft Inspe tion 15` 5/$/20 5/11/20 Location and description r 2�d Garage slab. 3 4th ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp OF ' Conditional Approval: Date ' . •'®�� ff ' 49th .............................................. o Vin? MICHAEL E. ANDERSON p Q 00. �® Septic System Approved Date /1( 20®®�F,'••..•5/14/20 0 %• No. CE -4381 Z� �® •'<<� ik,"ROSS Note: this approval es not include well permit requirements. ®®� trcev 05/02-ho) 100500 FEET 1"=50' 3-BDRM H O M E CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND 2CO PERMIT # OSP191421 PID # 051-732-37 SYLEA SUBDIVISION, LOT 2 A B FCO 23.6 MH 28.0 SV 30.6 A B C C 7.5 14.4 18.2 2CO 33.1 CO1 CO2 21.6 39.1 39.0 MT1 37.3 18.0 48.2 48.0 SHELTE R I N G S P R U C E A V E 5/12/20 15' UTIL I T Y E A S E M E N T 40' WATER EASEMENT (BK. 1214, PG. 585) TH1 TH2 SEPTIC AREA SV MH FCO ALTERNATE SITE: CATEGORY III TREATMENT SYSTEM w/ 20' LONG x 5' WIDE x 1' EFFECTIVE DEPTH ABSORPTION TRENCH. APP RATE 5 GPD/SF. 2-34' LONG x 5' WIDE x 1' EFFECTIVE DEPTH ABSORPTION TRENCHES 1,000 GALLON SEPTIC TANK w/20" MANWAY EXISTING WELL MT1 MT2 CO1 CO4 CO3 CO2 PLAN AS-BUILT PROPOSED WELL CO3 CO4 48.5 50.1 MT2 51.3 50.5 26.4 28.2 FS PROFILE AS-BUILT (NO SCALE) 5/14/20 34' DRAINFIELD ROCKMT TH#2GROUNDWATER @ 92.6 10/24/19 95.6 97.6 COCO81.6 95.6 97.6 98.6 ORIGINAL GRADE 98.2 94.1 98.75 101.0 FCOMHSV1000 GAL SEPTIC TANK 2CO98.05 PERMIT # OSP191421 PID # 051-732-37 SYLEA SUBDIVISION, LOT 2 MOA APPROVED FILTER SAND96.6 96.6 2" INSULATION 2" INSULATION NORTH TRENCH 34' DRAINFIELD ROCKMT TH#2GROUNDWATER @ 92.6 10/24/19 95.6 97.6 COCO81.6 95.6 97.6 98.6 ORIGINAL GRADE MOA APPROVED FILTER SAND96.6 96.6 2" INSULATION SOUTH TRENCH 100.3 100.3 H Jw H � ooc IflQ N w wa I_t Im 13 o_ Zm m° ° c Q L O m 0_4 Nj 0toN Y > n N —1aato 31 Z ° N N 0 N N J U N J_ 5 m E O O ° Y m � L Q o+ V m m m O m 0 m �t Nd L m G m m L> Q m a O + > ooa p m ° CL . 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Wasil la -Fish i • Roal Wasilla, AK 99654 (907)376-2041 Name: Troy Davis Homes Address: 1689 S Knik Goose Bay Rd. #400 City: Wasilla State: AK Zip Code: 99654 Well Site: Sylea Lot/Block: L2 Additional: Well Depth: 161 ft. From: To: Formation: 0 2 fill Below Ground: 159 ft. 2 6 silt/gravel/cobble Above Ground: 2 ft. 6 34 silt/gravel Gal/Min: 10 34 37 wet sand/silt 37 55 silt/gravel Static Level: 141 ft. 55 68 silt/gravel/cobble 68 70 silt/gravel/water Casing: 161 ' of 6" steel casing 70 84 fine silty sand/dry 84 88 dry gravel Liner Pipe: N/A 88 147 gravel/silt 147 155 damp silt/gravel Screened: N/A 155 161 gravel/water Perforated: N/A Grouted: Yes, 2 bags Depth: N/AWATER QUALITyTESTING C01/,100 Develop. Method: Air i Golfer rn 1.i�itrates L I Arsenic �� LV'L Use of Well: Residentialw Drilling Method: Rotary Misc: Other: Chlorinated with Sterilene The well was pumped 5' off the bottom with 100% draw down for 2 hours and recovered at 10 . Date Drilled: 10/7/2019 Driller: Ben Mattson 11 s' I s`3 z ti.i 0 R"n c'' f C C" I� Mark Begich QC11")-' Mayor i-ww.mur;i.nrc'/Ansi%e (cwrt7) 343` 904 Pump Installation Log Well Drilling Permit Number: SW OSP191421 Date of Issue: 09/20/2019 Parcel Identification Number:051-732-37 Legal Description Property Owner Name & Address: SYLEA LOT 2 Troy Davis Homes, Inc. 1689 Knik Goose Bay Road #400 Wasilla, AK 99654 Pump Installation Date: 04/22/2020 Pump Intake Depth Below Top of Well Casing: 145 Pump Manufacturer's Name: MEYERS Pump Model: 3NFL2-8-P4-01 Pump Size 3/4 hp Pitless Adapter Burial Depth: 15 feet Pitless Adapter Manufacturer's Name: CAMPBELL Pitless Adapter Installer: unknown Well Disinfected Upon Completion? F� Yes ❑ No Method of Disinfection: Sterilene Comments: Pump Installer Name: Wheaton Water Well, Inc. 1190 N. Wasilla-Fishhook Road Wasilla, AK 99654 feet Attention: The pump installer shall provide a pump installation lob to the DSD within 30 days of pump installation. . /1/2_6k7 °""f,. . MUNICIPALITY OF ANCHORAGE ,,.....—_o> >1�L'nt ,;,,....-..........<,,,,, � \ On-Site Water&Wastewater Program \e , S�,f j ; . . PO Box 196650 4700 Elmore Road �" • 1 Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 e. •-• ;"� 1 http:!/www.muni.orgionsite Q '9.:7,4?-1 ».'' H / 7;s1- ':.J I s epartment 4"cyoar6* On-Site Water & Wastewater System Permit Permit Number: OSP191421 Effective Date: 9/20/2019 Work Type: WeliSeptic Initial Expiration Date: 9/19/2020 Tax Code Number: 05173237000 Site Legal Address: SYLEA LT 2 G:1459 Site Mailing Address: 23000 SHELTERING SPRUCE AVE, Chugiak Owner: TROY DAVIS HOMES INC Lot Size in Sq Ft: 41063 Design Engineer: FORGE ENGINEERING Total Bedrooms: 3 This permit is for the construction of: E1 Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy E1 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 L * &\O I ccl Cey(. c)Ic e. awe '+b h97cr 9(01A.441Votter. t Received By: Of: .t %`l'.0 /i`t `q -e ')- Date: q Issued By: beiai 0 Date: q t /6 EPLAMS MUNICIPALITY OF ANCHORAGE n , r.•.. Community Development Department Phone: 907-343-7904 Development Services Division = Fax: 907-343-7997 On-Site Water& Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 051-732-37 Property owner(s) Troy Davis Homes Day phone 310-2501 Mailing address 1689 Knik Goose Bay Rd #400, Wasilla, AK 99654 Site address 23000 Sheltering Spruce Avenue Chugiak, AK Legal description (Sub'd., Block & Lot) Sylea, Lot 2 Legal description (Township, Range & Section) Lot Size 41,063 Sq. Ft. Number of Bedrooms Three (3) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑X Initial Single Family (SF) I (w/wo ADU) Septic Tank Upgrade [ Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings n Privy ❑ (SF and/or D) Private Well n Water Storage LJ 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: 1312- Waiver Fees: Date of Payment: �`�a /q Date of Payment: Receipt Number: 0�'"S/ J SO Receipt Number: Permit No. O3 P 17 j L a/ Waiver No. Permit App_ :• ::...c I� GE ENGINEERING PO BOX 240773 ANCHORAGE,AK 99524 522-7773 677-7766(FAX) September 19, 2019 MOA Development Services Dept, On-Site Water& Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Sylea, Lot 2—23000 Sheltering Spruce Avenue Septic System Design Dear On-Site Services Engineer: The owner of the above lot intends to construct a 3-bedroom home on the property. We are submitting this permit application for the construction of a new well and septic system to serve the home. The attached site plan identifies the location of the home and the proposed well, septic system 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 northeast at shallow grades. There are no slopes greater than 25% within 50 feet downslope of either the primary or alternate site. Contours and 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 trenches will be constructed parallel to the slope as much as possible. The new system will be a minimum of 100' from all wells and surface water, 10' from any water service and more than 5' away from the septic tank. Please refer to the attached test hole logs and plan and profile pages for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, � OF •-14,-./L12.. aA-Ts---n �• • 29_- Michael E. Anderson, PE `t' .49th d, tr • rm.rw....wrsw..n,.r..,un.a.,., w+ r• MICHAEL E. ANDERSON f Nc. CE-4381 s 41 •1 TF` 9/19/19 a04‘54r� SYLEA SUBDIVISION, LOT 2 S) SHELTERI NG SPRUCE AV �� ,/,......177RTERNATE S ATEGORY III --- E / TM2NT SYSTEPATH' w/2 F ! G x 5' 4_ EFFECT • PTH ABSOR' • // REQ H. AP• 5G'D/SF � MEN 2-33+ / / • EFFf LONG1E DEPT VVIDE x ' / • ORf'ii@N-TRENCHES / / TH10 • MT . teit t \ / / / Sys�TH2 • LOT / / / � / // -- — — R onMH •• \- 3-BDRM HOM. / / // / / 1,250 l.ALLON S.T.E.' \ / // / LOT 2 T,e,NK /20"MANW 4 LJ ` / / \ O \ //// 40'WA ER EASEMENT SEPTIC AREA // (BK. K. 1214. PG.585) \ \ / / / / 2 /r:/// // // / PROPOSED WELL \ LOT1 \ / / / \ / N / LOT 3 \ ' � _ _ _ _ � ' / GE �I � iliiii* RING NOTE: 1 .4.00 aa44_ NO SLOPES>25%WITHIN 50'OR SURFACE WATER WITHIN 100'OF THE LEGEND �••\P� .........q•.., ••• PROPOSED SEPTIC SYSTEM CO CLEANOUT �.s i S� �i 2C0-DOUBLE CLEANOUT ?' - ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS + 49th �� • FCO FOUNDATION CLEANOUT �• •••••• ••• •� •�••••i PROPERTY ARE SHOWN.NO CONFLICTS WITH WELLS OR SEPTIC ���►-•� FS-FLOW SPLITTER VALVE SYSTEMS. 00, MICHAEL E. ANDERSON MH-MANHOLE t��-,,yy� NO. CE-4381 -'� 0 50 100 MT-MONITORING TUBE v.A .",,••.:0/24/19 _...04 4, Ell = = FEET SV-SEPTIC VENT .� OFESSt7 i 1"=50' TH-TEST HOLE • SYLEA, LOT 2 DESIGN FACTORS: SYSTEM REQUIREMENTS: 450 GPD PEAK FLOW 5' WIDE TRENCH SYSTEM PERK RATE: 4 MIN/IN 1,000-GAL SEPTIC TANK APPLICATION RATE: 1.2 GPD/SF 450 GPD/ 1.2 GPD/SF/5'WIDE * .87 (RED. FACTOR) = 65.25 LF TRENCH REQUIRED (66 LF SPECIFIED) BOTTOM OF TRENCH: 2.0' BELOW GRADE FLOW LINE ELEVATION:1.0' BELOW GRADE TOP OF TRENCH: 1.5' ABOVE GRADE TOPSOIL & REVEGETATE MOUND GEOTEXTILE FABRIC & 2" INSULATION 1=111=111-1 1 h 111 -1 =ME-111E111- 111E111-1-11 -111=111= 1'6" 11 1111=111=11- 11 =111.111=111-111-111=111 111=111=111-111-1 11- _I I I 11�11-11111E-111E111-111111 111 l'=111-_7_1111 M 111=111=111=111- 6" 1' PERFORATED PVC (HOLES DOWN) „ ,,,;,;;,;,;,;:;,;:,:;:;,;:;;;, 15 -13fi DIA. HOLES PER LATERAL 1' : : ::::::::::::::::::::::::. @ 2.2' SPACING. DRAINFIELD ROCK {- 5 { eft. ) •NGEN TYPICAL TRENCH SECTION 0,1i "111 4 (NO SCALE) .tsP *„ .;�q ♦♦♦ NOTES: -/ '\ •', � i«« 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' jATNICHAEL •E. ANDERSON f • WITH 2" OF INSULATION •♦��r•.�,.�No.CE-14381 ff ; 3. THAN PREVIOUSLY OBSERVED, COALL EONGINEER IMMEDIATELY IS HIGHER ,j+4'.� �5���• t••.• Municipality of Ai wi 1ut aye On-site Water and Wastewater 41,(44.4.21, " ' _1421, 0-71,tk : r • kfGE SOILS LOG AND PERCOLATION TEST Q49ti . (N0I NE ERI N4 • O MICHAEL E. ANDERSON f : ♦C•. �. ' No. CE-4381 .4•' = LEGAL DESCRIPTION: S Y LAE SUBDIVISION - LOT 17 A ,AV's. 9119/19 M,,.., '•• PERFORMED FOR: TROY DAVIS HOMES +*h Ess c::•4° DATE: 02/07/2018 PROJECT No.: PARCEL ID#: P I D TECHNICIAN: C . J O H A N S E N Professional Engineers Stamp: DEPTH TEST HOLE# 1 (feet) 1' OB SLOPE SITE PLAN 2 ,r 3 4 5 ~ ✓ SILTY SAND W/GRAVEL 6 .-:`. GETS SILTIER W/DEPTH 7 ,;r' 8 9 1 0 y,•'.` WAS GROUND WATER ENCOUNTERED? N %•i• IF YES 1%WHAT DEPTH? NONE S 1 ] DEPTH OF WATER ATTER MONITORING: 8 DATE OF MONITORING: 5/28/18 E 12 DATE READING GROSS TIME NET TIME NATER NET DROP 13 °: .:c (MINUTES) (MINUTES) (INCHES) (INCHES) 14 2/08 TEST HOLE PRESOAKED PRIOR TO TESTING: 1 10:11 / 10:21 10 416"-10 6" 5 is `�;';: '`•:::` 2 10:22 / 10:32 10 4,6"-10 i" 5 is 3 10:33 / 10:43 10 4 6"-10 6" 5 17 4 10:44 / 10:54 10 416"- 916 54 18 5 10:55 / 11:05 10 4 s"- 9 W 5 is 19 6 11:06 / 11:16 10 46"- 9 s" 5 20 PERCOLATION RATE: 1.8 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 4 FT. and 5 FT. • COMMENTS: • • OF q • t ♦♦ SOILS LOG AND PERCOLATION TEST t i` 6'= .• � GE 49th ENGIN E[RI N6 _ t. 7e:r O F;MICHAEL E. ANDERSON= CK dim C-13. No.\ No. CE-4381 /2: LEGAL DESCRIPTION: SYLAE SUBDIVISION — LOT 17A ♦ F 1onale PERFORMED FOR: TROY DAVIS HOMES h��H.ESS •4 DATE: 02/07/2018 PROJECT No.: PARCEL ID#: PID TECHNICIAN: C. JOHANSEN Professional Engineers Stamp: DEPTIII TEST HOLE #2 (feet) 1 1' OB SLOPE SITE PLAN •2 3 4 •..• 5 SANDY GRAVEL 6 • • " 7 8 9 . , . I O WAS GROUND WATER ENCOUNTERED? N0 IF YES WHAT DEPTH? NONE S 1 1 DEPTH OF WATER AFTER MONITORING 6' . DATE OF MONITORING. 10/24/19 12 ; • • •• DEPTH TO 13 • DATE READING GROSS TIME NET TIME WATER NET DROP (MINUTES) (MINUTES) (INCHES) (INCHES) 14 2/08 TEST HOLE PRESOAKED PRIOR TO TESTING: 15 1 12:10/ 12:20 10 516°' 8,611 3A 16 2 12:21 / 12:31 10 516 �s "-7 ' 2is 3 12:32/ 12:42 10 5A" -7is1 2 17 4 12:43/ 12:53 10 5,6 -7A11 2-A 18 5 12:54/ 1:04 10 516" -7 s11 2A 19 6 1:05/ 1:15 10 516"'71611 2 s 20 PERCOLATION RATE: 4.0 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 4 FT. and 5 FT. COMMENTS: MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 051-732-37 Certificate of On -Site Systems Approval z F Expiration Date: / _ S Legal description SYLEA LT 2 Site address 23000 SHELTERING SPRUCE AVE Current property owner(s) BONAHOOM X The On -site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: c Original Certificate Date: 6/20/2024 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory _ Absorption Field Advisory Nitrate Advisory X Tank Age Advisory Arsenic Advisory _ Other COSA ApprovaLJune 2022 11111111 li 11 1 q k Development Services Department -343-7904 Phone:907 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 051-732-37 Complete legal description Sylea Lot 2 Location (site address) 23000 Sheltering Spruce Ave, Chugiak, AK 99567 Current property owner(s) Patrick & Becky BonahOOM Day phone 619-977-8064 2. ON -SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: RE Private Well R Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units El Community Well or Public R Water Storage 4. TYPE OF WASTEWATER DISPOSAL: rb� Private Septic Fj Private Septic serving 2 dwelling units F-1 Holding Tank El Community Septic or Public Sewer 5. SEPTIC TANK: RE Steel E] Plastic E] Concrete R Fiberglass Age 4 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: n AWWTS [:1 Bed F] Deep Trench nN Wide Trench n Seepage Pit Waiver request for: Expedited review requested: M Distance: By applying for this entitlement, this property is subject to inspection by municipal On -site staff to verify the accuracy of the information provided. COSA Fee $ 57t) Waiver Fee $ Date of Payment Date of Payment COSA # S C71 Waiver # COSA Application —June 2022 COSA Checklist Legal Description: Sylea L2 Parcel ID: 051-732-37 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA 0 Well log is filed with Onsite (or attached) Date drilled 10/7/2019 Total depth 161 ft Cased to 161 ft Fol Sanitary seal is functioning correctly ❑■ Wires are properly protected Casing height (above ground) >18 in. Date of flow test for COSA 6/4/2024 Static water level at beginning of test 133 ft Comments B. TANK DATA Measured operating fluid level in septic tank 4811 Date of pumping 6/19/24* ❑ Required maintenance completed, if AWWTS Comments: *Alaska Quality Septic D. ABSORPTION FIELD DATA Which system tested (date installed) 5/8/2020 ❑■ ALL standpipes present per record drawing Total measured depth from grade 4.0/4.3 ft (max) Measured depth to pipe invert from grade 3.0/3.3 ft (min) ❑ N/A — pressurized field. ❑■ Per record drawings, field is insulated. ❑■ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced N/A gallons N/A date Any rejuvenation treatment (past 12 months) N/A If yes, enter date Comments/Deficiencies: Trenches listed South / North Well production at time of test 5.0 gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes R No 0 Coliform bacteria is Negative Nitrate 7.80 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L❑ Arsenic less than MRL (ND) Collected by Forge Engineering Date 5/22/24 C. LIFT STATION stair d maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 6/4/2024 Results ❑■ Pass Fluid depth prior to test 0/0 in Water added 575 gal New fluid depth 0/4 in Elapsed time 1440 min Final fluid depth 010 in Absorption rate >450 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 12/12 in Effective depth used 0/0 in Effective depth remaining 12/12 in COSA Checklist June 2022 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' Yes if No ft [E Yes if No ft Neighboring Tank > 100' ❑o Yes if No ft Private Sewer/Septic Line > 25' FEJ Yes if No ft Absorption Field on Lot > 100' Fm� Yes if No ft Holding Tank > 100' Q Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' Q Yes if No ft ❑o Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' DYes if No ft Q Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' Fm� Yes if No ft Surface Water > 100' ❑■ Yes if No ft Tank to Property Line > 5' ❑■ Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' g Yes if No ft Private Wells > 100' Yes if No ft Water Main a 10' o■ Yes if No ft Community Wells > 200' n Yes if No ft Water Service Line > 10' M Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS G. CERTIFICATION & 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, indicates that the on -site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Forge Engineering Phone (907) 522-7773 Engineer's Printed Name Benjamin Schiller, P.E. Date 6/6/2024 COSA Checklist —June 2022 OF A4, kk1 C7P��� Benjarrn Schiller C E 12592 s �PRO*FiS*00am.. MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT I 907-343-7904 On -Site Water and wastewater Section Fax: 343-7997 www.muni.org/onsite Nitrate Advisory Certificate of On -Site Systems Approval # OSC241184 Subdivision: SYLEA , Block: , Lot: 2 A water sample revealed a nitrate concentration of 7.80 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Nitrate Fact Sheet From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. Maiiing'Atltlress:.P. O. Box 9665i0'* Anchorage; Alaska 99519 6650 !:, www.muni org °' MUNICIPALITY OF ANCHORAGE Development Services Department p p =-` � Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-732-37 1. GENERAL INFORMATION Expiration Date: 2 0-2 Z - v Complete legal description Sylea Lot 2 Location (site address) 23000 Sheltering Spruce Ave, Chugiak, AK 99567 Current property owner(s) Jacoby & April Bruner Day phone (907)726-3621 Mailing address PSc 80 Box 14971, Apo, AP 96367 Real estate agent 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑■ Private Septic Q 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 $ 550 Date of Payment 61Z2 Receipt Number 069670 COSA # OSC 22 I I 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone (907) 522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503 Engineer's Printed Name Benjamin Schiller, P.E. 6. DSD SIGNATURE System #1 Approved for 3 bedrooms System_#2 Approved for bedrooms Disapproved _ Date 4/13/22 OF A W, �1 TH ��.... ...tis:..,.. . Ben)am�niSchiller �FGj•.. CE 12592 ,• c�`v�� 11. JPI. • , 4/13/22 .lop" Conditional approval for bedrooms, with the following stipulations: ,OF 111T1- `� WATER AND m nnf-w-t AKAWAST-VATER oz By:_ I �•—\ Original Certificate Date:—! Z7 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: Sylea Lot 2 Parcel ID: 051-732-37 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA W Well log is filed with Onsite (or attached) Date drilled 10/7/2019 Total depth 161 ft Cased to 161 ft 0 Sanitary seal is functioning correctly 0 Wires are properly protected Casing height (above ground) >18 in. Date of flow test for COSA 10/7/2019 Static water level at beginning of test 141 ft Comments B. TANK DATA Age of tank(s) 2 years Tank type/material Septic/Plastic Measured operating fluid level in septic tank 49 ❑® Standpipes/foundation cleanout per record drawing Date of pumping Alaska Quality Septic 5/19/21 D. ABSORPTION FIELD DATA Shallow 5' Wide Trench Well production at time of test 10 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ No ®❑ Coliform bacteria is Negative Nitrate 7.34 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L 0 Arsenic less than MRL (ND) Collected by Forge Engineering Date of Sample 4/12/22 FT STATION ❑ Require aint� Age of lift station Lift station material Comments: nance completed Which system tested (date installed) 5/$/20 Adequacy test date *Site visit 4/12/22 no ALL standpipes present per record drawing Results ❑ Pass For bedrooms Total measured depth from grade 3.0 ft (max) Fluid depth prior to test in Measured depth to pipe invert from grade 2.0 ft (min) Water added gal ❑ N/A — pressurized field W Monitor tubes go to bottom of effective. If not, state New depth in depth into effective Elapsed time min ❑ Code -required soil cover over field Final fluid depth *0 / 2 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 gallons If yes, enter date Comments/Deficiencies: 'System < 2 yrs old, measurements taken during site inspection 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' ft Q✓ Yes if No ft M 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' F/ Yes if No ft Holding Tank > 100' F Yes if No ft Neighboring Absorption Fields > 100' Surface Water > 100'✓Q Animal Containment > 50' Yes if No ft ft [D 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' P( Yes if No ft Surface Water > 100' 0 Yes if No ft Property Line > 5' r✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Q✓ Yes if No ft Private Wells > 100' Yes if No ft Water Main.> 10.'.. _ Yes if No ft Community Wells > 200' _ r7l Yes if No ft Water Service Line > 10' �✓ 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' 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' ❑✓ Yes if No ft Community Wells > 200' QQ Yes if No ft Surface Water > 100'✓Q Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION OF l certify that 1 have determined through field inspections and review : • TM , of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. • �- njaatfSchiller �� ?'FG, • CE 12592 • �`v�i 4/13/22 • •V�� � � PROFESSIONP ., � COSA Checklist yellow sheet ���&-1�24 210 May 17, 2022 PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) FORGECIVIL.COM MOA Development Services, On -Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Sylea, Lot 2 — 2300 Sheltering Spruce Ave Nitrate mitigation Dear On -Site Services Engineer: We were recently hired to recertify the water well and septic system for the subject lot. A water sample take from the well on 4/12/2022 reflected a climb in nitrate concentration from 0.02 mg/L to 7.34 mg/L. The sudden increase in nitrates is thought to be the potential result of surface water contamination due to a low area around the well collecting seasonal breakup/runoff water. To initigate .the surface water concern, bentonite was placed around the well casing at about 3' below the surface in an attempt to intercept any water that may be traveling down the outside of the well casing. Additionally, about 8 yards of fill was spread around the well to help sheet water away from the well and keep water from collecting near it. The efficiency of this repair may not be measurable until similar runoff circumstances occur later in the year or during the next breakup season. The intention of this repair is to take steps toward mitigation in an economical and incremental manor, as it is difficult to guarantee the level of effectiveness of any action taken concerning aquifer or well contamination. Sincerely, 4 sk ' Benjamin', hiller, PE 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. 051-732-37 1. GENERAL INFORMATION Expiration Date: 'i' Complete legal description Sylea, Lot 2 Location (site address) 23000 Sheltering Spruce Avenue Chugiak, AK Current property owner(s) Mailing address Real estate agent Troy Davis Homes, Inc Day phone 310-2501 1689 S. Knik Goose Bay Rd #400, Wasilla, AK 99654 2. TYPE OF DWELLING: ❑■ Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: Private Well 0 Water Storage ❑ Community Well ❑ Public Water System ❑ Day phone TYPE OF WASTEWATER DISPOSAL: Private Septic R Holding Tank ❑ Community ❑ Public Sewer'. ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. i COSA Fee $ 12,6 / qG• Waiver Fee $ Date of Payment '5-11q ! ;to po Date of Payment Receipt Number Receipt Number. COSA # Waiver # CO,ID-1 9 25% DISCOUNT APPLIED 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 Civil Engineering Phone 907-522-7773 Address P.O. Box 340773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 5/13/2020 6. DSD SIGNATURE _ System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: ° %f1F?fiii141� `' Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory COSA Checklist blue sheet X Nitrate Advisory Arsenic Advisory Other Legal Description: Sylea, Lot 2 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 10/7/2019 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 10/7/2019 Static water level at beginning of test 141 ft. Comments B. TANK DATA Age of tank(s) `1 years Tank type/material Plastic Measured operating fluid level in septic tank New ❑ Standpipes/foundation cleanout per record drawing Date of pumping New Construction - 5/11/20 D. ABSORPTION FIELD DATA Shallow 5' Wide Trench Which system tested (date installed) 5/8/20 ❑ ALL standpipes present per record drawing Total measured depth from grade 3.0 ft (max) Measured depth to pipe invert from grade 2.0 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: 051-732-37 Structure served by this system Well production at time of test 10 gpm Water storage tank volume None gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic •515 ug/L ❑ Arsenic less than MRL (ND) Collected by Wheaton Water Wells Date of Sample 4/20/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date New Construction Results ❑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' [✓ Yes Community Sewer Manhole/Cleanout > 100' ✓Q Yes if No ft / Yes if No ft Neighboring Tank > 100' F/ Yes if No ft Private Sewer/Septic Line > 25' Q✓ Yes if No ft Absorption Field on Lot > 100' P/ Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' Yes if No ft Water Main > 10'✓] Animal Containment > 50' 17 Yes if No ft F/ Yes if No ft Yes if No ft Water Service Line > 10' ED Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway comment below Community Sewer Main > 75' ✓Q 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' [✓ Yes if No ft Surface Water > 100' ❑✓ 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'✓❑ Yes if No ft Water Main > 10'✓] ft Yes if No ft Community Wells > 200'✓� Yes if No ft Water Service Line > 10' ED 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' 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' M Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100'✓Q Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that / 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 SPRUCE AVENUE Q I 0 0 1— — L15' UTILITY EASEMENT I01F9 r i r 1 j PLOT PLAN _-- AS BUILT —X SCALE 1==30' GRID NW —145-9— Project No. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, inc. (907) 522-6476 Phone Q000000� (907) 522-4625 Fax o OF A t ` ok ors 4 Professional Land Surve kenOlangsurvoy.com Y jonathanOlongsurvey.com o X, S 1 herebycertifythat 1 have surveyed the followingdescribedproperty: 0 P..-0 O LOT 2, SYLEA SUBDIVISION (PLAT No. 2019-69) p 49?H* Q� Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that w Improvements on the property lying adjacent thereto encroach on the surveyed �" 1: KENNETH- . premises and that there are no roadways, transmission lines or other visible DO�c .' 00 easements on said property except as Indicated hereon.S(13 'L62cO t S'61 Yin__ 2 > b 9� '..l -S— 202.•'* g�p� Dated this the _ Day of _.L`; at Anchorage, Alaska 4�40pROSSiounL��o� It is the responsibility of the owner to determine the existence of any easements, 044poo�t' covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963