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HomeMy WebLinkAboutOVERLOOK ESTATES #2 LT 2 Onsite File Overlook Estates #2 Lot 2 #068 - 041 - 34 kmuv uDivu 1 o/ Municipality of Anchorage I- EB 2020 On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191422 PID Number: 068-041-34 Dwelling: 9 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: 9 New ❑ Upgrade Name Steve Letcher ABSORPTION FIELD ❑ Deep Trench ❑s Wide Trench ❑ Bed ❑ Mound Site Address 27313 Vantage Ave. Eagle River, AK ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 602-525-8118 3 1.0 GPD/SF 4.0 / 4.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3.5/3.5 Ft. Gravel depth beneath pipe 0.5 Ft. Subdivision Block Lot Overlook Estates #2 2 Fill added above original grade 0.9 / 1.5 Ft. Gravel length 2 @ 45 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 450 Ft2 2 >6 Ft. Well >100' >100' N/A N/A >25' TANK ❑e Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity er 1,000 Gal. Surface Water >1 00' >100' N/A N/A Material Nu of compartments Lot Line >5' >10' N/A N/A NA Plastic '2 Foundation >10' >10' N/A N/A LIFT STATION Manufacturer Capacity Remarks Gal. Alarm location Electrical installed by PIPE MATERIAL House to tank D3034 Tank to drainfield D3034 Installer Nothern Excavation Drainfield D3034 CO/MTD3034 Inspector J. Mlllette / L. Tidwell BENCH MARK (Assumed elevation) 100 ft Inspdectio 151 10/2/19 10/3/19 Location and description YJ 2�d Top of foundation. 4,h ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp ®®®�®OF Conditional Approval: Date 4,��P�E°"'® �9 �.9..A.:''jy...49th ........ ...5`JY..B.... ................................................ 0 �%•MICHAEL E. ANDERSON Septic System Approve d t._ (` Date 2,'21 -�j *: ®!f �. NO. CE-4381 ••' e®®TFC;°•...,• 2/5/20 •,.•••'F�, PROFESS\ONP�®®® Note: this approval does not include well permit requirements. kmuv uDivu 1 o/ OVERLOOK ESTATES #2, LOT 2 PERMIT # OSP191422 PID # 068-041-34 LOT 3 LOT \2 \ 1 \ EXISTING WELL \ \ \ 100' WELL'RADIUS c� 3-13DR\ \HOME ~� j 1,000 GALLON SEPTIC \ �I �\ TANK w120' MANV�YaY LOT 4 \ \ \ B C l ALTERNATE SITE \ _ FCO �` A B C \ E MH C01 \ FCO �� 22.6 2.1 A l coz S C01 X6.3 10.1 C04 MT2 2C0 \�' �; ' \MH 27:0 13.3 SV 28.8 ` 18.1 \ t \ 1 THA 2CO 30.3 -21:2 ` �THa CO2 24.2 23.9 ` • CO3 ` , 67.6 59.0 2-45'LONG x 5' IDE x.5' \ C05 C 3 M7� `"MT1 69.1 59.5 EFFECTIVE DEPTH ` \ C04 38.6 X46.2 SORPTION TRENCHES 9s MT2 ,.37.9 44.11 10, T&E sEMENT—CQ5 78:3-----,-- 60.2 _._ — 15'GAS ERSE.�AENT OiTAOE A'VENUE 1 ENGINEERING � \ \ A& OF q 46,b LEGEND JAW . CO - CLEANOUT PLAN AS -BUILT 2C0 -DOUBLE CLEANOUT • 49th FCO - FOUNDATION CLEAN( 0 50 100 FS - FLOW SPLITTER VALVE ................................. MICHAEL E. ANDERSON ; ® FEET MH - MANHOLE No. CE -4381 Zsv j� �''• 1/30/20•''® V=50, MT - MONITORING TUBE o ®®��Ott �� ESS\ a®®��� TH - TESTIHOLE T OVERLOOK ESTATES #2, LOT 2 PERMIT # OSP191422 PID # 068-041-34 87.9 87.4 TH-A 84.4 83.9 uon 01 ENGINEERING O� EAST TRENCH o U 92.3 FINISH GRADE 91.4 ORIGINAL GRADE DRAINFIELD ROCK MOA APPROVED FILTER SAND 85.4 85.4 45' �- NO GROUNDWATER 9/23/19 '�- 75.4 O� U� WEST TRENCH 89.4 FINISH GRADE �� 87.9 ORIGINAL GRADE DRAINFIELD ROCK O U MOA APPROVED FILTER SAND 81.9 45' 81.9 i r® NO GROUNDWATER 9/23/19 �- 71.9 PROFILE AS -BUILT (NO SCALE) 87.9 87.4 84.4 83.9 ��: 49gth� a .h.....® 0,1; MICHAEL E. ANDERSON •�� B ��T�No. _ �F•,130/2o 38•,.•'c���'®�� 4144 4"ROTES®ate '®�® /O/z/7 �,L�9AL�)y MUNICIPALITY OF ANCHORAGE / On-Site Water&Wastewater Program ti : Yr/C11s �r f PO Box 196650 , 4700 Elmore Road � ' I Anchorage,Alaska 99519-6650 Phone:(907)343.7904 Fax:(907)343-7997 Q ,:fit http://www.muni.orgtonsite �'' �� '^ ��� epur Mont On-Site Water & Wastewater System Permit Permit Number: OSP191422 Effective Date: 9/24/2019 Work Type: WellSeptic Initial Expiration Date: 9/23/2020 Tax Code Number: 06804134000 Site Legal Address: OVERLOOK ESTATES#2 LT 2 G:0465 Site Mailing Address: 27313 VANTAGE AVE, Eagle River Owner: ATOR KARLENE M FAMILY TRUST Lot Size in Sq Ft: 54689 Design Engineer: FORGE ENGINEERING Total Bedrooms: 3 This permit is for the construction of: 10 Disposal Field Q Septic Tank 0 Holding Tank 0 Privy 10 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 q/ 6141 CO-41&'1 Des n C\1a eci r A bee\root, ha e. )9M4r Received By: it,€i'it�''(,�,e t 1/t4L ) i' • Date: q/A4//q Issued By: a/+ Date: CVWr-1 • MUNICIPALITY OF ANCHORAGE c• Community Development Department ,*,,.1?'' ) , 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. 068-041-34 Property owner(s) Steve Letcher Day phone 602-525-8118 Mailing address 8124 E. Leonora Street Mesa, AZ 85207 Site address 27313 Vantage Avenue Eagle River, AK Legal description (Sub'd., Block & Lot) Overlook Estates #2, Lot 2 Legal description (Township, Range & Section) Lot Size 54,689 Sq. Ft. Number of Bedrooms Three (3) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑X Initial ❑X Single Family (SF) ❑X (w/wo ADU) Septic Tank ❑X Upgrade ❑ Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑X Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. 14/1,_,S,,,Q,, a 0,9----, (Signature of property owner or authorized agent) Permit/Rush Fees: 1/3/2. Waiver Fees: Date of Payment: q/Zoq Date of Payment: Receipt Number: 0({0L30 Receipt Number: Permit No. _ OSP/61 /92,Q Waiver No. Permit App__-:• :....c I`. ) • GE ► ENGI NEERING PO BOX 240773 ANCHORAGE,AK 99524 522-7773 677-7766(FAX) September 25, 2019 MOA Development Services Department On-Site Water& Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Overlook Estates #2,Lot 2 Dear On-Site Services Engineer: The owner of the above lot intends to build a 3-bedroom home on the property. We are submitting this design and 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 location,septic location and alternate site. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. The ground surface on the lot slopes to the west,at an approximate 20%slope. There are no slopes steeper than 25%within 50' down slope of the proposed absorption trenches. Ground contours are shown on the site plan showing the grade and direction of flow. Storm water drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. Test holes on the lot and in the subdivision indicate very coarse gap graded gravel with very few fines. The absorption rate of effluent is much faster than 1 minute per inch. A 2' sand liner is required and has been designed in to the system. Wells on this and adjacent lots are shown. The new system will be a minimum of 100' from all wells and surface water, and more than 5' away from the septic tank. The alternate site is located more than 6' away from the primary site. Please refer to the attached test hole logs, soils lab analysis, plan and profile sheets for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, 44.loOF 4!" . "6, Michael E. Anderson, P.E. • : 49th �� � • 0 7 S •MICHAEL E. ANDERSON • •vS•• No. CE-4381 '�: ��♦��,p'�'••.,9/25/19•,.•••••�`�i 440 ,, :ESS' . OVERLOOK ESTATES #2, LOT 2 \\ \ \ ` -\ N 1 \ \ \ \NCi ' \ \-- N - - — —\' N \ \ , ` N N — \\ 11 `� \ 1 i / \� LOT\2 ', `� \ N \ � \ ` \ \ 1 \ \ 1 1 \ N 1 \\ P OPOSED)VLE \ \\ I 1 \ I I 1 L_ 1 j \\ \\ \\ \ 11 N ® \ \ � 1��. \\ 1 1 \ \ \ \\ \ \ \ \ � � \ \ \ / \ N\ 1 \ \ rill / -, \ \ \ 1 �^. LOT4 \\ 1 1 \ 3- MHOME / \\ \ \\ \\11 N 1 \\ \ \\ \ \ \ \ � � \ 1,000 GALLO 'TIC \-...'. FCC.•• \ ALTERNATE SfTE -'\ \ TANK w120' N AY \ N 1 \ 1 _ �' N \ \ 1 \ NT TH�SV \_— \\ N \ \ �� �THB • \ N \r \ 1 2-45'LONG x 5' E x.5' IN. • 1 �� �\ \ EFFECTIV D P l'H�1 - •RPTION TR N\ � 10'T&ESS •MENT \, ""\ � — \,..., i —\ — \ 15'GAS EAS v1ENT _ � � \ ` \ _ ___— �\ \\ ` VANTAGE A�lENUE N\ �' '\\ \ \ \ \ \ ` - - � N - - \ �� law N bs) ' GE N �N N • CMGI....a NOTE: \ \ � \ N ��.•��•INNNO SLOPES>25%WITHIN 50'OR SURFACE WATER WITHIN 100'OF THE •4�E .qC sive. PROPOSED SEPTIC SYSTEM LEGEND 4"6-) """.. ••� CO-CLEANOUT W • 2C0-DOUBLE CLEANOUT a ° 49th ='�•�s ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS �. „, FCO-FOUNDATION CLEANOUT • PROPERTY ARE SHOWN.NO CONFLICTS WITH WELLS OR SEPTIC :1 -•� FS-FLOW SPLITTER VALVE 0.„..Y...„...„„„.„. . „„„„„„.. , SYSTEMS. •�,•S MICHAEL E. ANDERSON: : MH-MANHOLE %fa,..• No. CE-4381 z'. 0 50 100 ����Fa,�.. 912819 �,r ,f MT-MONITORING TUBE = Mill = FEET v.�.0 pROF[ss)�jD:4 SV-SEPTIC VENT -w,ll,",��� 1”=50' TH-TEST HOLE OVERLOOK ESTATES #2, LOT 2 DESIGN FACTORS: SYSTEM REQUIREMENTS: 450 GPD PEAK FLOW 5'WIDE TRENCH SYSTEM PERK RATE: <1 MIN/IN 1,000 GALLON SEPTIC TANK APPLICATION RATE: 1.0 GPD/SF 450 GPD / 1.0 GPD/SF/5'WIDE *1.0 RED. FACTOR = 90 LF TRENCH REQUIRED (90 LF SPECIFIED) BOTTOM OF TRENCH: 4.0' BELOW GRADE FLOW LINE ELEVATION: 3.5' BELOW GRADE TOP OF TRENCH: .5' ABOVE GRADE 6" III-III-III-III-III- - -111=111=111=111=111=111_ I111111E111EIII 11El1 E-11 II 1=11 I-111=111=111=111=1 3' –I 11-111—_111=111=111=11 IE 1=III=III=III=III=III=1 GEOTEXTILE FABRIC –1 11=111=111=111=111-1 1—III—III—III=III— —1 EIII=111EIII=111—=111] 1-11 I-11 I-11 11E-111E1 4" PERFORATED PVC (HOLES DOWN) DRAINFIELD ROCK 2' MOA APPROVED SAND 5 1 Alri 46,')N NGE TYPICAL TRENCH SECTION (NO SCALE) +• F- '" ..g44. C ��,�� NOTES: kr-�499ttham_ %` °A t 1. GRADE AREA OVER TRENCH TO DRAIN AWAY �� '1-- � �-� 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' •cf, MICHAEL E. ANDERSON WITH 2" OF INSULATION sic s No. CE-4381 _� 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER •jf4%. 9/20119.r,..''0'+. THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY �� o ;;�o:+ ++• 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.: THA SLOPE SLOPE 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) Overlook Estates #2 l2 9/13/19 J. Williams DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING: IF YES @ WHAT DEPTH? - <1 6 4 5 068-041-34 CLIENT 2:33 - 2:34 9/16/19 1 2 3 4 5 6 OB Professional Engineers Stamp: 9/20/19 <1m NO None 9/23/19 POORLY GRADED GRAVEL 6' MINUS GP 2:34 - 2:35 <1m 2:35 - 2:36 <1m 2:36 - 2:37 <1m 2:37 - 2:38 <1m 2:38 - 2:38 <1m ** **Perc rate much faster than 1 mpi. No accumulation of water occurred. Readings to 1/16" could not be taken. ** ** ** ** ** ** ** ** ** ** ** Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191422, Deb Wockenfuss, 09/24/19 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.: THB SLOPE SLOPE 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) Overlook Estates #2 l2 9/13/19 J. Williams DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING: IF YES @ WHAT DEPTH? - <1 6 4 5 068-041-34 CLIENT 3:15 - 3:16 9/16/19 1 2 3 4 5 6 ** OB Professional Engineers Stamp: 9/20/19 <1m NO None 9/23/19 POORLY GRADED GRAVEL 6' MINUS GP <1m <1m <1m <1m <1m **Perc rate much faster than 1 mpi. No accumulation of water occurred. 3:16 - 3:16 3:18 - 3:19 3:19 - 3:20 3:20 - 3:21 3:22 - 3:22 Readings to 1/16" could not be taken. ** ** ** ** ** ** ** ** ** ** ** Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191422, Deb Wockenfuss, 09/24/19 Certified Drilling Log P DOC CO dba BILL 8& COLE ��►ULLIVAN WATER WELLS P.O. Box 670269, Chugiak, AK 99567 688-2759 OWNER OF LAND: Letcher Custom Homes ADDRESS: 27313 Vantage Ave Eagle River, AK 99577 Bore Hole Data Depth From To LEGAL DESCRIPTION Overlook Estates #2 Lot 2 DATE: 10-2-19 0 2 Casing Stickup PERMIT NUMBER: OSP191422 DATE OF ISSUE: 9_24_19 TAX IDENTIFICATION NUMBER 06804134000 Is well located at approved permit location: ®Yes ❑No Method of Drilling: ®air rotary ❑cable tool Depth of Well: 382' Casing Type: Steel Wall thickness .250 inches Diameter: 6 inches, depth 144 feet Liner type Static Water Level: 88 feet Recovery Rate 20 ® gpm ❑ gph Method of Testing Air Well Intake Opening Type: ❑ open end ®open hole ❑ Screened Start feet Stopped ❑ Perforations Start feet Stopped Grout Type: Bentonite Volume: 50lbs Depth: from 2 feet, to 42 feet Well Disinfected Upon Completion: ®yes ❑ no Method of Disinfection: Chlorine 50 PPM Comments: 2 4 Overburden 4 28 Sand Silt & Gravel w/ Cobbles 28 86 Hardpan & Boulderes 86 121 Sand Silt & Gravel w/ Cobbles 121 255 Bedrock Gray 255 309 Bedrock Green Hard 309 322 Bedrock Gray 322 382 Bedrock Gray w/ Quartz Drillers Name: Cole Sullivan ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. Matsu Borough: Department of Environmental Conservation. ® DOC CO dba ULLIVAN WATER WELLS BILL &COLE P.O. Box 670269, Chugiak, AK 99567 688-2759 www.sullivanwaterwells.com Pump Installation Log Well Drilling Permit Number: SW OSP191422 Date of Issue 9-24-19 Parcel Identification Number: 06804134000 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. N Dig RIV99 d0 sisva co W di (Vq),96'66Z(H),62*66Z M„61,t, 4.00S X N .. o ^! 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(•fo tl)U�w �'`• >wcSzntnzto uj ~O m tV,7F� ,�•+`�/+;J� x w w MUNICIPALITY OF ANCHORAGE 0i Development Services Departments Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 068-041-34-000 Expiration Date: Legal description OVERLOOK ESTATES #2 LT 2 Site address 27313 VANTAGE AVE Eagle River AK 99577 Current property owner(s) KARTH BRIAN D 2/2/2024 XThe On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 11/2/2023 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 Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 MUNICIPALITY OF ANCHORAGE ®� Development Services Department R� P p Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 068-041-34 Complete legal description OVERLOOK ESTATES #2 LOT 2 Location (site address) 27313 VANTAGE AVENUNE, EAGLE RIVER, AK 99577 Current property owner(s) BRIAN D KARTH I Day phone 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: ® Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ® Plastic ❑ Concrete ❑ Fiberglass Age 4 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ® Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ 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 $ -5 50 Date of Payment loh- o17-:3 COSA # 05C 231 y 08 Waiver Fee $ Date of Payment Waiver # COSA Application.doc COSA Checklist.docx COSA Checklist Legal Description: OVERLOOK ESTATES #2 LOT 2 Parcel ID: 068-041-34 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 10/2/2019 Total depth 382 ft Cased to 144 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 10/18/23 Static water level at beginning of test 86 ft. Well production at time of test 6+ gpm Water storage tank volume NA 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 Date 10/18/2023 Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank 49” Date of pumping 10/18/23 Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 10/3/2019 ALL standpipes present per record drawing Total measured depth from grade 10.6 ft (max) Measured depth to pipe invert from grade 3.7 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective. (ED) 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 gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date 10/18/23 Results Pass (TESTED LOWER TRENCH ONLY) Fluid depth prior to test 0 in Water added 500 gal New fluid depth <1 in Elapsed time 5 min Final fluid depth 0 in Absorption rate 450 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 6 in (MOA 0.5’ ED) Effective depth used 0 in ( Final Fluid Depth) Effective depth (ED) remaining 6 in Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots & appears approximate. Upper trench was dry & extensive fill / cover has been majority placed over the septic system. COSA Checklist.docx 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’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ 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’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ 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 FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 11/01/2023 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 11/01/23 Epl"s MUNICIPALITY OF ANCHORAGE Development Services Department �� Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 068-041-34 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Expiration Date: n Complete legal description Overlook Estates #2, Lot 2 Location (site address) 27313 Vantage Avenue, Eagle River, AK 99557 Current property owner(s) Karlene Ator Family Trust Day phone 602-525-8118 Mailing address 8124 W. Leonora Street, Mesa, AZ 95207 Real estate agent 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Three Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic El Water Storage ❑ Holding Tank, ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ i Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $J Date of Payment o2Ll g�a�aU Receipt Number COSA # 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 Michael E. Anderson, P.E. 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Date 2/19/20 Conditional approval for bedrooms, with the following stipulations: 6- liflR.,IFIJ� Original Certificate Date: Z., Z!�'-Z-0 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 Septic System Advisory Well Flow Advisory COSA Checklist blue sheet Nitrate Advisory Arsenic Advisory Other Legal Description: Overlook Estates #2, Lot 2 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA WE Well log is filed with Onsite (or attached) Date drilled 10/2/19 Total depth 382 ft Cased to 144 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) >18 in. Date of flow test for COSA 10/2/19 Static water level at beginning of test 88 ft. Comments B. TANK DATA Age of tank(s) <1 years Tank type/material Septic/Plastic Measured operating fluid level in septic tank New ❑ Standpipes/foundation cleanout per record drawing Date of pumping New Construction - 1012/19 D. ABSORPTION FIELD DATA 5' Wide Trench Which system tested (date installed) 10/3/19 ❑ ALL standpipes present per record drawing Total measured depth from grade 4.9/5.5 ft (max) Measured depth to pipe invert from grade 4.4/5.0 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: 068-041-34 Structure served by this system Well production at time of test 20 gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ Nc ❑ 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 2/17/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date New Construction Results El 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' 171 Yes Community Sewer Manhole/Cleanout > 100' 0✓ Yes if No ft M Yes if No ft Neighboring Tank > 100' Q Yes if No ft Private Sewer/Septic Line > 25' ✓� Yes if No ft Absorption Field on Lot > 100' ✓0 Yes if No ft Holding Tank > 100' 0✓ Yes if No ft Neighboring Absorption Fields > 100' ✓] Yes if No ft Water Main > 10'✓Q Animal Containment > 50' ✓Q Yes if No ft ✓0 Yes if No ft ✓V Yes if No ft Water Service Line > 10' ✓0 Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway comment below Community Sewer Main > 75' �✓ Yes if No ft 0✓ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 171 Yes if No ft Surface Water > 100' Q Yes if No ft Property Line > 5' ✓0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' if No Yes if No ft Private Wells > 100' ✓] Yes if No ft Water Main > 10'✓Q ft Yes if No ft Community Wells > 200' ✓V 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' 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'✓Q Yes if No ft Private Wells > 100' 0✓ Yes if No ft Water Service Line > 10' 0 Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' ✓0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I 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 ............................... ..t.......... '.,.MICHAEL E. ANDERSON ♦ �� •. No. CE -4381 2/27/20 .••°� SCC B