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
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Wheaton Water Well, InA
1190 N. 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,
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Ben)am�niSchiller
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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
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L15' UTILITY
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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