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HomeMy WebLinkAboutSYLEA LT 3Onsite File Sylea Lot 3 #051-732-38 (Rev uotuzi -its) Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201074 PID Number: 051-732-38 Dwelling: ❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: © New ❑ Upgrade Name Troy Davis Homes Inc ABSORPTION FIELD ❑ Deep Trench © Wide Trench ❑ Bed ❑ Mound Site Address 22980 Sheltering Spruce Ave, Chugiak, AK ❑ Other Phone Number of Bedrooms Soil Rating ITotal depth from original grade 310-2501 3 1.2 GPD/SF 5.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3.0 Ft. Gravel depth beneath pipe 2.0 Ft. Subdivision Block Lot Sylea 3 Fill added above original grade 1.5 Ft. Gravel length 54 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 1 Dist. between trenches From Tank Field Tank Line 385.7 Ft2 Ft. Well >100' >1 00' N/A N/A >25' TANK ❑ Septic © S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Greer 1250 Gal. Surface Water >1 > 100' N/A N/A Material Plastic Number of compartments 2 Lot Line>5' >10' N/A NIA NA Foundation >1 0' >1 0' N/A N/A LIFT STATION Manufacturer Greer Capacity 250 Gal. Remarks Alarm location Inside garage Electrical installed by Elek-Tek PIPE MATERIAL House to tank F628 Tank to D1785 drainfield Installer Alex Enterprises Drainfield D1785 CO/MTD3034 Inspector J. Mlllette BENCH MARK (Assumed elevation) 100 ft Inspection 1v 12/7/20 12/8/20 Location and description dates: 3rd 12/9/20 4nd " 12/9/20 Bottom of siding @ point B ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp �; Conditional Approval: Date • • ',,�. r... �_.. :•• BenCE 592iller Septic System ` Approved SAA o _����e�' Date � 3/2/21 Note: this approval does not include well permit requirements. �11Fll pROFESStONA. �� (Rev uotuzi -its) ? � (�� �iA ar% a .k � .• "aia. y.. �u i i �.-; a i 6 Wasilla, AK 99654 (9071376-2041 Name: Troy Davis Homes Address: 1689 S Knik Goose Bay Rd. #400 City: Wasilla State: AK Zip Code: 99654 Well Site: Sylea Lot/Block: 3 Additional: Well Depth: 181 ft. From: 70: Formation: topsoil Below Ground: 179 ft. 7 18 silt/gravel Above Ground: 2 ft. 18 20 bolder Gal/Min: 10 20 39 silt/gravel 39 41 bolder Static Level: 160 ft. 76 76 92 sand Casing: 181ft. of 6 in. x .25 in. steel 92 110 gravel 110 150 gravel/silt Liner Pipe: N/A 150 158 damp silt/gravel 158 164 gravel/water Screened: N/'4171 164 171 wet silt/sand 181 gravel/sand/water Perforated: N/A Grouted: Yes Depth: N/A Develop. Method: Air WATER QUALITY TESTING cofformbse� t Col/100mL Use of Well: Residential Ntrates _ ='-0.02 mg/L ArseNc 0. 76 f ug/L Drilling Method: Rotary 12 lel ,2vb Misc: Other: Chlorinated to 50ppm The well was pumped 5' off the bottom with 100% draw down for 2 hours and recovered at 10. Date Drilled: 5/28/2020 Driller: Ben Mattson Mark Begich Mayor Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907) 343-7904 Pump Installation Log Well Drilling Permit Number: SW Date of Issue: Parcel Identification Number: Legal Description Property Owner Name & Address: Pump Installation Date: Pump Intake Depth Below Top of Well Casing: feet Pump Manufacturer’s Name: Pump Model: Pump Size hp Pitless Adapter Burial Depth: feet Pitless Adapter Manufacturer’s Name: Pitless Adapter Installer: Well Disinfected Upon Completion? Yes No Method of Disinfection: Comments: Pump Installer Name: Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. Inorganics Analysis Description Analysis Results MDL LOQ MCL Dilution Factor Qual Analysis Units Method Analysis Date/Time Analysis Technician Nitrate/Nitrite as N <0.0280 0.0280 0.0730 10.0 1 U mg/L ARS-WCH-010/SM4500-NO3E 12/29/20 14:10 ASEBA ARS Sample Delivery Group: Client Sample ID: Sample Collection Date: Sample Matrix: Percent Solids: ARS5-20-00897 Lot 3 Sylea Sub 12/17/20 9:45 Drinking Water N/A N/A ARS5-20-00897-001 12/17/20 01/12/21 Request or PO Number: ARS Sample ID: Date Received: Report Date: Microbiology Analysis Description Analysis Results MDL LOQ MCL Dilution Factor Qual Analysis Units Method Analysis Date/Time Analysis Technician E. Coli Absent N/A N/A 1.00 1 Present/Absent ARS-BIO-002/SM9223B 12/17/20 16:18 EMAHER Total Coliform Absent N/A N/A 1.00 1 Present/Absent ARS-BIO-002/SM9223B 12/17/20 16:18 EMAHER Preparation Method:ARS-154/EPA 200.8 Analysis Method:ARS-155/EPA 200.8 CAS# Analyte Analysis Result MDL PQL CRDL Dilution Factor Qual Analysis Units Analysis Date/Time Analysis Technician 7440-38-2 Arsenic 0.761 0.200 1.00 NP 1 J ug/L 01/04/21 15:07 KCROCHET Inorganics ARS Sample Delivery Group: Client Sample ID: Sample Collection Date: Sample Matrix: Percent Solids: ARS1-20-03373 ARS5-20-00897-001 12/17/20 9:45 Drinking Water N/A 15600 ARS1-20-03373-001 12/22/20 01/08/21 Request or PO Number: ARS Sample ID: Date Received: Report Date: 000000pp M 3°2 ">J s mI M p Q: 'g W N 2�YZ N p M aQ: N: zOW oII r,o o�� ,O.op� ojm O0: W Jad6N N Q Z M o Y O Y O 280 0 i o p4��6���0000 00 0 e a ��ps 24 Z 0 i U LU 0o L ° x ° m E m W m o m o N w ----- \ / v°iij m)o v)°91 60oma «fpm r mn Q I S Ic 09I c c m> ¢ m m z Cq C11 0 DO 441 I/ N N C C L '° o L °_ J J U)a0 c0 / �7(n0 me a C£oa X41 mm C) toNo �\ Ia oam-n -k C14 I �m 6 to (AlJ K o / rye +,C) // �, L v m N lm. +w O�2f'. / IIS ._ O m..m �« EL I c Al _j U) O� / I �'` E'o o- m I m o 2 \ `v � 2y / . J o 0 ��- __, \8!•!�2 h� \ ,OHO tD U N c o o c v o (Vv / �\ \ \ tF S y\ ao E�z)vE RP�)�5 x • U z a a �o o 00 wo ; z J O q Z«� m m O m 0 N \�w¢ / \ °o ac�m o` wn \ \. rSPNE"P / a _ \ J I N tcnm Eco :E 0- o \ \ \ aRv �' �♦ \ \ \ Z W 0 m m>° w m p \ d u) Q) TM OX 00 m C + m C 2830 \\ o O E00 E N h m a J a3cam c° 00 O \ /�\\ \ N \\ \ 0 �a 3 N w I V) \ .d QNM¢U T W J O> W Q Z Z \ V) O N J w W Uw> W a~ a¢> J Z w w N W O a- 0 J Z Ww W W Z Q 0 W w 0 w w U C U wKUWd w - \ in (NiJ Q rn � Q � r < 4d g Z 4 W V) J < O Z h MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Water & Wastewater System Permit Permit Number: OSP201074 Work Type: WellSeptic Initial Tax Code Number: 05173238000 Site Legal Address: SYLEA LT 3 G:1459 Site Mailing Address: 22980 SHELTERING SPRUCE AVE, Chugiak Owner: TROY DAVIS HOMES INC Design Engineer: FORGE ENGINEERING This permit is for the construction of: Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date: Expiration Date: nom. t n'F. r. ------------------- Department Lot Size in Sq Ft: Total Bedrooms: 4/30/2020 4/30/2021 55894 2 Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing 3 1 , vJ iSe� � i , n clue ��71� Wr0 wvk� wZ� rQ-01d`k v� Lt) ti-\ # 'I t }-t Z J�- -, w,Q c) � Cb n s r u cA� b a- -- Ir -4'x'1 C 5/11 2,1D2 t I Received By: � %f Date: Issued By: ��l 1 "� 1 Date: y �D q%0"?0 EPU4NS MUNICIPALITY OF ANCHORAGE Community Development Department ` Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWERM/ELL PERMIT APPLICAT[ON Parcel I.D. 051-732-38 Property owner(s) Troy Davis Homes Day phone 310-2501 Mailing address 1689 Knik Goose Bay Rd #400, Wasilla, AK 99654 Site address NHN Sheltering Spruce Avenue Chugiak, AK Legal description (Sub'd., Block & Lot) Sylea, Lot 3 Legal description (Township, Range & Section) Lot Size 55,894 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (M all that apply) Absorption Field ❑X Initial ❑X Single Family (SF) ❑X (w/wo ADU) Septic Tank ❑R Upgrade ❑ Duplex (D) ❑ Holding Tank ❑ Renewal F-1Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑X E Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST%'FOR: Distance: I certify that the above information is correct. I further certify that this is' in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 96'Z0 (0/5. Waiver Fees: Date of Payment: 1 «/oKl oC0 Date of Payment: Receipt Number: *1119?,0 Receipt Number: Permit No. �� Waiver No. 0 51Pa0I0 7�{ Permit App_-'-:- :_."c. f e PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) April 17, 2020 MOA Development Services Department On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Sylea, Lot 3 – NHN Sheltering Spruce Avenue Septic System Design Dear On-Site Services Engineer: The owner of the subject 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 northwest 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. Storm water 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, Michael E. Anderson, PE 4/17/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201074, Rebecca Carroll, 04/30/20 / LOT 20 / \ fro ��• c/ o _,`• LOT 19/ 2 \ \ �� MT / 40' MT MT �P � J�H1 S!D L1 k? ;O FA ►1I SYLEA, LOT 3 cot -1 ' 1 — _LOT 2 EXISTING WELL \ 100' WELL RADIUS \ / TH#2Q5 / i �i / O LOT 1 PROPOSED WELL / FCO viT ®� 3-BDRM HOME- \\ FCO _ SV hH MT INSTALL 1250 -GAL STEP TANK w/ 2-20" MANWAYS. TH2 S/D L19A / LOT 4 54' LONG x 5' WIDE x 2' EFFECTIVE DEPTH ABSORPTION TRENCH (MAINTAIN MIN. 10' SEPARATION FROM PROPERTY LINE AND HOUSE FOUNDATION). s ENGINCE0.ING LOT 3 00' RADIUS ALTERNATE SIT . CATEGORY YSTEM �� LOT 7 w/15' L G x 5' WIDE x 2' ECTIVE DEPTH BSORPTION TREN APP. RATE 6.0. LOT 6 NOTE: t / ! NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. 0 50 100 �m Em Ism FEET 1"=50' LOT 8 LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEAN( FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE SYLEA, LOT 3 C,ot 1 DESIGN FACTORS: SYSTEM REQUIREMENTS: 450 GPD PEAK FLOW 5' WIDE TRENCH SYSTEM PERK RATE: 1-5 MIN/IN 1250 -GAL STEP TANK APPLICATION RATE: 1.2 GPD/SF 450 GPD / 1.2 GPD/SF / 5' WIDE * 0.7 RED. FACTOR = 52.5 LF TRENCH REQUIRED (54 LF SPECIFIED) BOTTOM OF TRENCH: 4' BELOW GRADE FLOW LINE ELEVATION: 2' BELOW GRADE TOP OF TRENCH: 6" ABOVE GRADE NOTE: 30- 6' DIAMETER HOLES @ 1.8' SPACING. TYPICAL TRENCH SECTION (NO SCALE) NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY 2" INSULATION TEXTILE FABRIC RFORATED PVC =S DOWN) IELD ROCK E N G I N E E R I N G.. ®�P.E �F SOILS LOG AND PERCOLATION TEST `, 49th *� ENGINEERING ®" ,+ •• •//� a.....I.............. u. .. as a � MICHAEL E. ANDERSON •�® LEGAL DESCRIPTION: _ P �•. NO. C1120 : Z� SYLAE SUBDIVISION LOT 19A ®1 �F y..• mina �•,••`1 PERFORMED FOR: TROY DAMS HOMES 444ft� ES;�0�,'6®' DATE: 02/08/18 PROJECT No.: PARCEL ID#: TECHNICIAN: C. J O H A N S E N Professional Engineers Stamp: DEPTH ( TEST HOLE #1 1 11 OB SLOPE SITE PLAN ++++ ++++ 2 + + + + +++ + ++++ ++++ ++++ ++++ ++++ ++++ 4++++++++ ++++ ++++ 5 —++++++++ GM (SILTY SAND FILL MIXED ++++++++ W/ ORGANICS) 6-+++++++ + ++++ ++++ ++++++++ ++++ ++++ 8++++++ ++ ++++ ++++ 9++++ ++++ ++++ ++++ 10 ++++++++ WAS GROUND WATER ENCOUNTERED? NO ++++++++ IF YES r WHAT DEPTH? NONE L 11 +++ + + + + DEPTH TO WATER AFTER MONITORING: 15.5' 0 + DATE OF MONITORING: 5/28/18 P E 12 13 14 15 16 17 18 19 20 PERCOLATION RATE: I. I (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 5 FT. and 6 FT. COMMENTS: GROSS TIME NET TIME DEPTH To NET DROP DATE READING (MINUTES) (MINUTES) WATER (INCHES) (INCHES) 3/09 1 11:20/ 11:26 6:22 471"'-10 �' s �' 2 11:27/ 11:34 6:30 4 � o �' s �' 3 11:35/11:42 6:30 4,�'-�o�' s�' 4 11:43111:50 6:33 481"-1081" s �' 5 11:51/11:58 6:44 4�'-�0�� s„�' 6 11:59/12:06 6:44 4�'-�0�� s�' DEPTH (feet) 1 - 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 12 13- 14- 15- 16- 17- 18- 19- 20 - MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 ELMORE ROAD ANCHORAGE, AK 99519-6650 SOILS LOG AND PERCOLATION TEST LEGAL DESCRIPTION: SYLAE SUBDIVISION — LOT 19A PERFORMED FOR: TROY DAVIS HOMES DATE: 02/08/18 PROJECT No.: PARCEL ID#: TECHNICIAN: C. JOHANSEN TEST HOLE #2 ++ +++ READING GROSS TIME (MINUTES) +++ +++ DEPTH To WATER (INCHES) NET DROP (INCHES) +++ +++ TEST HOLE PRESOAKED PRIOR TO TESTING: +++ +++ 12:38/12:48 10 +++ +++ 3 +++ +++ 12:49/12:59 10 +++ 317 3 1:00/1:10 10 +++ 3,0 +++ +++ 1:11/1:21 10 +++ + + + SILTY SAND ++++++ 1:22/1:32 FILL MIXED ++++++, W/ ORGANICS + + + 10 as' -7,6" 3,0 +++ +++ +++ +++ + + + i +++ 6" OB PEAT SILTY CLAY • 'S •4 COMMENTS: -- SLOPE WAS GROUND WATER ENCOUNTERED? No IF YES n WH S DEPTH OF WATER AFTER MO DATE OF MO SITE PLAN SEE SITE PLAN AT DEPTH? NONE L NITORING: 15.5' NITORING: 5/28/18 DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH To WATER (INCHES) NET DROP (INCHES) 3%09 TEST HOLE PRESOAKED PRIOR TO TESTING: 1 12:38/12:48 10 4 "" 8 '" 3 2 12:49/12:59 10 11186" - 716" 317 3 1:00/1:10 10 4,6"-776" 3,0 4 1:11/1:21 10 a,6'-76" 3,°-� 5 1:22/1:32 10 a6"-716" 3,°� 6 1:3311:43 10 as' -7,6" 3,0 PERCOLATION RATE: 3.3 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 4 FT. and 5 FT. DEPTH (feet) 1- 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20 - LEGAL DESCRIPTION: SYLAE SUBDIVISION - LOT 18A PERFORMED FOR: TROY DAVIS HOMES DATE: 02/08/18 PROJECT No.: PARCEL ID#: 051-732-38 TECHNICIAN: C. JOHANSEN TEST HOLE # 1 1' OB COMMENTS: GM (SILTY SANDY GRAVEL) SLOPE WAS GROUNDWATER ENCOUNTERED? YES GROSS TIME (MINUTES) IF YES a WHAT DEPTH? 12' L 2/08 DEPTH TO WATER AFTER MONITORING: 8' 0 1:35 DATE OF MONITORING: 5/08/20 P 2 2:35 E 51110" DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH To WATER (INCHES) NET DROP (INCHES) 2/08 1 1:35 4-1"1 2 2:35 30 51110" 11100" 1s 3 2:36 4710" $ 3:06 30 51,g" 1 M' 5 3:07 4-106" 6 3:37 30 51160" 1 110" PERCOLATION RATE: 18.5 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 3 FT. and 4 FT. DEPTH (feet) 1- 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19 - SOILS LOG AND PERCOLATION TEST ENGINEERING LEGAL DESCRIPTION: SYLAE SUBDIVISION — LOT 184, PERFORMED FOR: TROY DAVIS HOMES DATE: 02/08/18 PROJECT No.: PARCEL ID#: 051-732-38 TECHNICIAN: C. JOHANSEN TEST HOLE 42 COMMENTS: 1' OB GM (SILTY SANDY GRAVEL) WAS GROUNDWATER ENCOUNTERED? YES GROSS TIME (MINUTES) IF YES rt WHAT DEPTH? 12' L 2/08 DEPTH TO WATER AFTER MONITORING: 7.5' 0 4:05 DATE OF MONITORING: 5/08/20 P 2 4:35 E 516" DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH To WATER (INCHES) NET DROP (INCHES) 2/08 1 4:05 416" 2 4:35 30 516" 116" 3 4:36 4 16" 4 5:06 30 5 16" 1 6' 5 5:07 48" 6 5:37 30 512 16' PERCOLATION RATE: 24.0 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 4 FT. and 5 FT. MUNICIPALITY E Development Services Departmeht Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-732-38 1. 'GENERAL INFORMATION Expiration Date: <,:? - L/_ ?_ D Z 2 - Complete legal description Lot 3, Svlea Subdivision Location (site address) _22980 Sheltering Spruce Ave, Chugiak, AK 99567 Current property owner(s) Frank Jr & Camille Biro Day phone Mailing address 22980 Sheltering Spruce Ave, Chu iak, AK 99567 Real estate agent Dar_ Botts /Realty Sample Day phone ( 907) 885-2350 2. TYPE OF DWELLING: Q Single Family (w/%-vo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑X Private Septic � ] Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for Received by COSA lobe released '10 the engineer, unless otherwise requested by the engineer. COSA Fee Date of PaemientLl�2 9 Receipt Number—Z 7ti CASA # OSC- 22 117.6 Date: Waiver Fee S Date of Payment Receipt Number Waiver Distance: 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my sea] 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 andlor 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 tiles 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 acknovAedge that On -Site staff may visit the site to verify the information submitted. Name of Firm _ Pinard Engineering Phone ( 907) 232-1347 Address PO Box 871347, Wasilla, AR 99587 P Engineer's Printed Name Paul E. Pinard Date DSD SIGNATURE rtc°�° L '� co°o�ccoeoaaoeocGo System #1 Approved for--3—bedrooms ¢, C f t R , pi aTe System =f2 Approved for Disapproved Conditional approval for bedrooms _ bedrooms, with the following stipulations: [22- ` (, li3Okkttk((((((( �OF �i,, `J ON-SITEkin C ,STF (WATER o Jm� F)ROGRPM o\�� �3 4 �JJ)���/ T SERI\,���� 3y: Original Certificate Date: The Municiaality of Anchorage oevelopment 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 Stage of Alas'_ The P ;unicipaUtyof Anchorace is not responsble for errors or omissions in the professional engineers woek. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other eose crez'v C� �� Legal description: Lot 3, Sylea Subdivision Parcel lt). 051-732-38 If more than I septic system on lot: COSA Checklist # of A_ WELL DATA Well log is filed with Onsite (or attached) Date drilled 5/8/20 Total depth 181 ft Cased to $i it Sanitary sea] is functioning correctly Wires are properly protected Casing height (above around) 24 in. Date of flow test for COSA 4/25/22 Static water level at beginning of test 150.3t_ Comments 8_ TANK DATA Age of tank(s) 12_ years Tank typelmaterial Plastic Measured operating fluid level in septic tank 4-4' N Standpipesffoundation cleanout per record drawing Date of pumping 4/27/22 D- ABSORPTION FIELD DATA Structure served by this system _ Well production at time of test 4.0 qpm `Pater storage tank volume gallons Well disinfected for coliform test? EJ Yes E No 0 Coliform bacteria is Negative Nitrate2. 26 mglL [—J Nitrate less than MRL (ND) Arsenic ugJL [XArsenic less than NIRL (ND) Collected by Pinard Engineering Date of Sample 3 23 22 C. LIFT STATION 2 Required maintenance completed Age of lift station <2 years Lift station material Plastic Comments: Which system tested (date installed) 12 / /20 Adequacy test date a_ 25/22 �g ALL standpipes present per record drawing Results MPass For 3 bedrooms Total measured depth from grade 6.5 ft (max) Fluid depth prior to test 3.5 in Measured depth to pipe invert from grade ft (miry) Water added 480 gal a NIA — pressurized field New death 7 in Monitor tubes go to bottom of effective. If not, state depth into effective Elapsed time 20 min Code -required soil cover over field Final fluid depth 3.5 in ® System presoaked Absorption rate 450+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) None date of test) Gallons introduced gallons If yes, enter date Comments,/Deficiencies: COSA ChecUk st �--Hcw shee_ E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if communily well) Septic TanklLift Station on Lot > 100' Yes if No Community Sewer Manhole/Cleanout > 100' Yes if No ft 12 Yes if No ft Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25'a Yes if No f# Absorption Field on Lot > 100' Yes if No ft Holding Tank > 100' Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' Yes if No ft M Yes if No ft ft if septic tank is under driveway comment Belo ,7 Manure/Animal Excreta Storage > 100' Community Suver Main > 75' Yes if No ft MY Yes if No ft From Septicll-folding T ank on Lot to: (Please enter distances if less than required) Building Foundations > 10' Yes if No it Surface Water >' 100 _ � Yes if No ft Property Line > 5' Yes if No ft Wells on Adjacent Lots: Yes Absorption Field > 5' Yes if No ft Private Wells > 100' ® Yes if No ft Water Main > 10' ® Yes if No ft Community Wells > 200' [ Yes if No ft Water Service Line > 10' Yes if No ft if septic tank is under driveway comment Belo ,7 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 drive:^ray comment below Property Line > 10' Yes if No ft Wells on Adjacent Lots: zl'Jater Main > 10" Yes if No ft Private Wells > 100' D'Yes if No ft i!'Vater Service Line > 10' Yes if No ft Community Wells > 200' [XYes if No ft Surface Water > 100' Yes if No It F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that t 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. C©SA Check3st yes tie. sheet MUNICIPALITY OF ANCHORAGE Deveiopment Services Department Phone- 907-3143-7904 later & Wastewater Section On -Site ',Ala'tP Fax: 907-343-79097 Lift Station/Pump Vault Maintenance Log Owner?C)4� StreetI Address Septic `T`ank;: -Sludge level lnches -Pumping: requir<,;eW'Pumping complete,( Aesno Lift station: -Pump basket cleaned kyaA no >Effluent filter cleaned (2ge�no -Control floats cleaned 141Ra no Proper float settings confirmed @ no ,Operation satisfactory 0 no Alarm System: ,Dedicated electrical alarm circuit es no -Audible and visual alarm inside dwelling aeno -Alarm system operatic, satisfacto not sati isfactoni Manhole Riser -Ground,vvater intrusion at riser to tank connection ves,11no ; -Ground water intrusion around pipe penetrations hole furictiona(Ze-L no -Manhole lid: Functional GLno Insulated ly Secured 6_e no Other -All manufacturer required inspections and maintenance completees po Comments: r' Qualified Maintenance Provider: - Technician �a� 1Ef Company 7T�� I Ced ki, F XF—M Date N MUNICIPALITY OF ANCHORAGE 0 s -� 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 -732-38 Expiration Date: (v " 1'" Z( 1. GENERAL INFORMATION Complete legal description Sylea Sub, Lot 3 Location (site address) 22980 Sheltering Spruce Ave Current property owner(s) Troy Davis Homes, Inc Day phone (907) 357-9394 Mailing address 1689 S Knik Goose Bay Road #400, Wasilla, AK 99654 Real estate agent Day phone 2. TYPE OF DWELLING: FE -1 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Q Private Septic ❑s 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 $ 12-0 Date of Payment -'( ('—Z Receipt Number (9 _ COSA# 05C_211103 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. Date 3/8/21 TH 4 N • 1 b. 6. DSD SIGNATURE ... System #1 Approved for bedrooms % Benja SchillerQz / System #2 Approved for bedrooms �;c,�TF� CE 12592 n� Disapproved 1k��, PROFESSIO�4 Conditional approval for bedrooms, with the following stipulations: '_- AST` /v0 M = SERVIC•E�CN-',�, By. Original Certificate Date: "21 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 Legal Description: Sylea Sub, Lot 3 Parcel ID: 051-732-38 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 05/28/20 Total depth 181 ft Cased to 181 ft FOR Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA 5/28/20 Static water level at beginning of test 160 ft. Comments B. TANK DATA Age oftank(s) �1 years Tank type/material Plastic Measured operating fluid level in septic tank New ❑ Standpipes/foundation cleanout per record drawing Date of pumping Tank Installed 12/8/20 D. ABSORPTION FIELD DATA Shallow Trench Which system tested (date installed) 12/9/20 X ALL standpipes present per record drawing Total measured depth from grade 6.5 ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field FM-il 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 Structure served by this system 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 0.028 mg/L ❑ Nitrate less than MRL (ND) Arsenic 0.761 ug/L ❑ Arsenic less than MRL (ND) Collected by Wheaton Water Wells Date of Sample 12/17/20 C. LIFT STATION ❑® Required maintenance completed Age of lift station <1 years Lift station material Plastic Comments: Lift station installed 12/8/20 Adequacy test date New System Results Q✓ Pass For 3 bedrooms Fluid depth prior to test in added gal New de in Elapsed time min Final fluid depth Absorption rate gpd Any rejuvenation treatment (past 12 If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' 0 Yes if No Community Sewer Manhole/Cleanout > 100' Q Yes if No ft Q Yes if No Neighboring Tank > 100' Fv-1 Yes if No ft Private Sewer/Septic Line > 25' Fv-1 Yes if No Absorption Field on Lot > 100' 7 Yes if No ft Holding Tank > 100' 0✓ Yes if No Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' E✓ Yes if No F-1 Yes if No ft if No ft F. ENGINEER'S COMMENTS Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 7 Yes if No ft Fv� Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' ft ft ft ft ril E✓ 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' r✓ Yes if No Water Main > 10' El Yes if No ft Community Wells > 200' M✓ Yes if No_ Water Service Line > 10' R 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' U Yes if No ft If absorption field is under driveway comment below Property Line > 10' F-1 Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' Yes if No Water Service Line > 10' 0 Yes if No ft Community Wells > 200' D Yes if No Surface Water > 100' rv-1 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that I 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 co -TH .......... • Be njarrkrrvSchiller �� �F� •, CE 12592 • w��� ��lF • . 03/08/21 , • '� Aw, PR4FESS\Q# ft ft ft 10