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HomeMy WebLinkAboutRABBIT CREEK VIEW & HEIGHTS BLK 4H LT 1AOnsite File Rabbit Creek View & Heights Block 4H Lot 1A #020-551-15 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201151 PID Number: 020-551-15 Dwelling: ❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: 0 New ❑ Upgrade Name Deas & Karlena Bode ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed 0 Mound Site Address 7800 Marino Drive Anchorage, AK 99516 ❑ Other Phone 250-4989 JNumber of Bedrooms 4 Soil Rating JTotal depth from original grade 4.0 GPD/SF +2.0 to +3.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade +2.5 to +3.5 Ft. Gravel depth beneath pipe 0.5 Ft. Subdivision Block Lot Rabbit creek V&H 4H 1A Fill added above original grade 5.6 to 6.6 Gravel length 40 Township Range Section Ft. Ft. 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 200 Ftz 1 Ft. Well >50' >50' >50' N/A >25 TANK ❑ Septic ❑ S.T.E.P. ❑ Holding 0 Other Manufacturer Orenco/Advantex FAP Capacity 1500 Gal. Surface Water >50' >50' >50' N/A Material Fiberglass Number of compartments 2 Lot Line >5' >5' >5' 1 N/A NA Foundation >1 0' >10' >10' N/A LIFT STATION Manufacturer Orenco Capacity —100 Gal. I Remarks Trench is insulated Alarm location Inside Garage Electrical installed by Lineside Elec Installer PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield Owner Install Drainfield D3034 Co/MT D3034 Inspector J. Millette / L. Tidwell BENCH MARK (Assumed elevation) 100 ft Inspection fisc 8/27/2020 8/28/20 Location and description 2�a da:3`d Bottom of siding @ point C 4th ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: DateAw ': • :q�Q��� 19 �•. BenjaI Schiller Septic System, Date��.C$v222Approved 2 1 .•'c,�``+ ROFES S10NPL�..® F� pROFE0.,,�® Note: this approval does not include well permit requirements. � k ev VJlVL/ 10) PERMIT # OSP201151 PID # 020-551-15 EXISTING WELL MARINO DRIVE � \ EXISTING WELL w/!0 RADIUS EXISTINGLL TH#1 W/ 50'R, DIUS 1500—GALLON ADVANTEX TANK w/ AX20 POD / PV NOTE: MH2 GROUNDWATER LEVEL IS 1.5' BELOW GRADE ! A SEPTIC TANK AND PUMP VAULT SECURED IN MH1 1 ACCORDANCE WITH MANUFACTURER'S //o I 1255 F ENGINEERING ( ALTERNATE SITE i TH2 �� LMT2 MT1 % ....1265...... a i LOT 1A 10' UTILITY EASEMENT 1 LOT 10A LOT 9A PLAN AS -BUILT RECOMMENDATIONS TO PREVENT FLOTATION 40' LONG x 5' WIDE x 0.5' EFF DEPTH ABSORPTION TRENCH A B C D 0 50 100 WE ME 00 FEET 1 "=50' LEGEND 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT PV - PUMP VAULT MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE ' 0 50 100 WE ME 00 FEET 1 "=50' LEGEND 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT PV - PUMP VAULT MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE i � i i • � . I � • PERMIT # OSP201151 PID # 020-551-15 VJ.V 111.0 FINISH GRADE 107.9 3:1 r' 3:, 107.4 ", --- 2" FOAM INSULATION 105.4 ORIGINAL GRADE GROUNDWATER 102.9 96.4 1 Ark PROFILE AS -BUILT /'l® ' Benja 'Schiller r.r �F •• CE 12592 •moi (� 1 %Pf�c • annozz ••�G�,d ENGINEERING (NO SCALE) FpP'••• 'p�, „m. \`_ ROFESSION MUNICIPALITY OF ANCHORAGE o ,A Development Services Department 1 Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Well Log Permit Number: #_201151 Date of Issue: Parcel Identification Number: Date Started: 7-22-20 Date Completed: 7-24-20 Legal Description: Rabbit Crk View Iot1A blk4H G:3340 Property Owner Name & Address: Deas Bode 7800 Marino Dr. Anchorage, AK Borehole Data: Depth (ft) Soil Type, Thickness & Water Strata From To Is well located at approved permit location? Yes X No ❑ casing stick up 0 3 fill 3 5 silt & gravel 5 22 wet silt & gravel 22 23 dry silt & gravel 23 80 moist clay 80 100 clay 100 142 boulder 142 144 clay w/ gravel 144 180 wet clay w/ gravel 180 190 gravel w/ H2O 190 195 well location N 61 04.295' W 149 44.225' Water Sample Results: Arsenic: ND ug/L Nitrates: 1.29 mg/L Total Coliform Bact ria: ND colonies/100mL l ($/-40z5 Method of Drilling ■❑ air rotary ❑ cable tool Casing type: steel Wall Thickness: •250 inches Diameter: 6 inches Depth: 195 feet Liner Type: Diameter: inches Depth: feet Casing stickup above ground: 3 feet Static water level (from ground level): 31 feet Pumping level: feet after hours pumping gpm Recovery Rate: 7.5 gpm Method of Testing: airlift Well Intake Opening Type: ❑ Open End ❑ Open Hole ❑ Screened Start feet Stopped feet ❑ Perforations Start feet Stopped feet Grout Type: bentonight Volume: 2 bass Depth: 20' Start 0' feet Stormed 20' feet Well Disinfected Upon Completion? Yes No Method of Disinfection: tabs Comments: Well Driller: Johnny Kay Company: Hefty Drilling, Inc. Mailing Address: po box 112130 Anch AK 99511 Attention: The well driller shall provide a well log to the On-site Water and Wastewater Section within 30 days of completion. MARINO DRIVE o N89°31'44"E � "••• 4 ��• ❑F • q��1� RABBIT CREEK VIEW & HEIGHTS (2004-91) 119.04 LOT 1A, BLOCK 4H r�;� ;9 49T"•••• •mak ®/ was made on January 3, 2023 and that the improvements �............ ............. situated thereon are within the property lines and do not overlap or ow a�a. encroach on the property lying adjacent thereto, that no /•-,'.;,•Lee•Karabelnikoff:00 /improvements on the property lying adjacent thereto encroach on I« �, No 3143-Sg�s the premises in question and that there are no roadways, transmission lines or other visible easements on said except e� ••'••• + property as indicated hereon. Easements other than those shown on the rn Anchorage Alaska, this 3rd day of January 2023. ao �9A 0 4 Well Lift Station MH .. 16.0' 016, 3' L cv Wood Stairs•MH � Covered Y N Landing 2—Level 6.1 C/0 Wood Frame ' 14 0, 32.6' Residence -t 33.7' Cantilever C\4 w 52.3' N_ o N 15.3' r CO O N Z N I . O V) c N N a W O o Riser I O Riser L— — 10' utility Easement 124.82' S88-18'1 1 "W LOT 10A N OTE: Dimensions are measured to the wood trim. LOT 9A 5/8" Rebar W/Red Plastic (Typical) Sewer Treatment POD LOT 2A N SCALE 1 " = 30' 0' 15' 30' 60' I hereby certify that an accurate survey of the following described property: "••• 4 ��• ❑F • q��1� RABBIT CREEK VIEW & HEIGHTS (2004-91) `P:.• •..J`�+` AW • ®® LOT 1A, BLOCK 4H r�;� ;9 49T"•••• •mak ®/ was made on January 3, 2023 and that the improvements �............ ............. situated thereon are within the property lines and do not overlap or ow a�a. encroach on the property lying adjacent thereto, that no /•-,'.;,•Lee•Karabelnikoff:00 /improvements on the property lying adjacent thereto encroach on I« �, No 3143-Sg�s the premises in question and that there are no roadways, transmission lines or other visible easements on said except e� ••'••• + property as indicated hereon. Easements other than those shown on the record plat may not appear on this drawing. Anchorage Alaska, this 3rd day of January 2023. LOT 2A N SCALE 1 " = 30' 0' 15' 30' 60' MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program 0 S� PO Box 196650 4700 Elmore Road 7' Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 n http://www.muni.org/onsite 71 v Uepartment On -Site Water & Wastewater System Permit Permit Number: OSP201151 Effective Date: 6/10/2020 Work Type: WellSeptic Initial Expiration Date: 6/10/2021 Tax Code Number: 02055115000 Site Legal Address: RABBIT CREEK VIEW & HEIGHTS BLK 4H LT 1A G:3340 Site Mailing Address: 7800 MARINO DR, Anchorage Owner: BODE IDEAS & KARLENA R Lot Size in Sq Ft: 32919 Design Engineer: FORGE ENGINEERING Total Bedrooms: 4 This permit is for the construction of: 10 Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Q Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: 1. During tank install, engineer shall confirm continuity of accepting soil (1-3 ft below original grade) for ERS design. 2. On the record drawing, the alternate site shall be relocated so that the edge of the mounded fill is at least 2 ft from the property line (in compliance with Fill & Grade requirements). 3. The AWWTS Maintenance Agreement shall be notarized prior to inspection report approval. co,o u , c� Received By: Date: Issued By: �j� / Date: � r I��/�I MMMP A UTY OF ° MC HO . GE 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. 020-551-15 Property owner(s) Stevens David & Deloris Mailing address 8521 Golden Street #4 Anchorage, AK 99502 Site address 7800 Marino Drive Anchorage, AK 99516 Day phone 250-4989 Legal description (Sub'd., Block & Lot) Rabbit Creek View & Heights, Block 4H, Lot 1A Legal description (Township, Range & Section) Lot Size 32,919 Sq. Ft. Number of Bedrooms Four (4) APPLICATION IS FOR: APPLICATION IS AN: (® all that apply) Absorption Field ❑X Initial Septic Tank ❑X Upgrade El Holding Tank ❑ Renewal ❑ Privy NJ Private W II ❑X ? ���✓ Water Sto TYPE OF DWELLING: Single Family (SF) ❑X (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) 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: /�����-�� Date of Payment: �c �`;LO.16 Receipt Number: ci-4&g -o Permit No. 65 P-2®11`—% Waiver Fees: 5 f Date of Payment: i (a v �d Receipt Number: Waiver No. COV ID_19 Permit App_'-'-:- :."c� �25% DISCOUNT APPLIED PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) June 4, 2020 MOA Development Services Department of On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Subject: Rabbit Creek View & Heights, Block 4H, Lot 1A – 7800 Marino Drive Septic System Design Dear On-Site Services Engineer: The owner of the subject property intends to build a four bedroom home on the lot. 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 proposed home and the proposed well and septic system locations. 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 to the northeast at 15% in the area of the proposed trench. There are no slopes greater than 25% within 50 feet down slope of the trench. Ground surface contours 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 septic system will include a Category III treatment tank and pod with a minimum of 50’ 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 log and plan and profile sheets for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Michael E. Anderson, PE 6/4/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201151, Rebecca Carroll, 06/10/20 10050 0 FEET 1"=50' 4-BDR M HO M E NOTE: NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND TH2 RABBIT CREEK VIEW & HEIGHTS, BLOCK 4H, LOT 1A SLOPES > 25% SLOPES > 46% MARINO DRIVE DECK 10' UTILITY EASEMENT TH#1 1265 1260 1255 1250 1245 1240 1235 1230 ALTERNATE SITE PROPOSED WELL EXISTING WELL 50' RADIUS 1500-GALLON ADVANTEX TANK W/ AX20 POD PUMP VAULT MT MT MH MH FCO 6/9/2020 30' LONG x 5' WIDE x 0.5' EFF. DEPTH ABSORPTION TRENCH. 50' RADIUS EXISTING WELL GROUNDWATER LEVEL IS 1.5' BELOW GRADE. SEPTIC TANK AND PUMP VAULT MUST BE SECURED IN ACCORDANCE WITH MANUFACTURER'S RECOMMENDATIONS TO PREVENT FLOTATION. NOTE: Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201151, Rebecca Carroll, 06/10/20 W44- DESIGN FACTORS: SYSTEM REQUIREMENTS:� 600 GPD PEAK FLOW 5' WIDE TRENCH SYSTEM PERK RATE: 7 MIN/IN 1,500 -GALLON ADVANTEX TREATMENT TANK APPLICATION RATE: 4 GPD/SF w/AX-20 POD AND PUMP VAULT 600 GPD / 4.0 SF / 5' WIDE = 30 LF TRENCH REQUIRED (30LF SPECIFIED) BOTTOM OF TRENCH: V ABOVE GRADE FLOW LINE ELEVATION: 1.5' ABOVE GRADE TOP OF TRENCH: 4.0' ABOVE GRADE TOP 6" MUST BE TOPSOILED & VEGETATED GEOTEXTILE FABRIC & NATURAL BACKFILL 2" INSULATION IN SITU ML MOA APPROVED SAND \ � MOA APPROVED SAND NOTE: 30 - 3/16" HOLES IN LATERAL @ 1' SPACING ENGINEERED RECEIVING SOIL *1' DEPTH MINIMUM MEASURED FROM LOW SIDE. REMOVE ALL ORGANICS UNDER MOUND PERIMETER TO UNDERLYING ML. REPLACE WITH ENGINEERED RECEIVING SOIL AND MOA APPROVED SAND TO LIMITS SHOWN. 5' 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 E N G I N E E R I N G'. OF 4 - 49th MICHAEL E. ANDERSON No. CE -4387 �F•.,,••6/10/20 ,.•'''( 4 !'ROFEll IS, IS,� ®�` LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST TECHNICIAN: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DEPTH (feet) PROJECT No.: TEST HOLE 1 SLOPE SLOPE SITE PLAN See Site Plan DATE READING GROSS TIME (minutes) NET TIME (minutes) DEPTH to WATER NET DROP TEST HOLE PRESOAKED PRIOR TO TESTING: PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH) TEST RUN BETWEEN: FT. and FT. COMMENTS: (inches)(inches) RABBIT CREEK V&H B4H L1A 10/26/18 J. Millette DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH OF WATER AFTER MONITORING: IF YES @ WHAT DEPTH? YES 2' 2' 48 6 1 2 020-551-15 DEAS BODE 4:22 10/26/18 1 2 3 4 5 6 30 30 30 3 8 16 4 3 16 11 16 4 1 16 9 16 3 4 16 3 14 16 10 16 4:52 4:53 5:23 5:28 5:58 1' OB CL (CLAY W/ COBBLES) 11/26/18 Professional Engineers Stamp: ML (SANDY GRAVELLY CLAYEY SILT) 3 8 16 11/27/18 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201151, Rebecca Carroll, 06/10/20 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST TECHNICIAN: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DEPTH (feet) PROJECT No.: TEST HOLE 2 SLOPE SLOPE SITE PLAN See Site Plan DATE READING GROSS TIME (minutes) NET TIME (minutes) DEPTH to WATER NET DROP TEST HOLE PRESOAKED PRIOR TO TESTING: PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH) TEST RUN BETWEEN: FT. and FT. COMMENTS: (inches)(inches) RABBIT CREEK V&H B4H L1A 10/26/18 J. Millette DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH OF WATER AFTER MONITORING: IF YES @ WHAT DEPTH? YES 2.5 2.5 7 6 1 2 020-551-15 DEAS BODE 4:37 2/21 1 2 3 4 5 6 30 30 30 6 10 4 16 4 4 16 6 10 4 16 5 12 16 10 5:07 5:10 5:40 5:42 6:12 1' OB CL (CLAY W/ COBBLES) 11/26/18 Professional Engineers Stamp: ML (SANDY GRAVELLY CLAYEY SILT) 4 4 16 4 4 16 11/27/18 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201151, Rebecca Carroll, 06/10/20 MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this Day of r' of 20-, by and between .041yLLL/10�vLY- SA , herein the "OWNER," and the Municipality of A4rchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (.Amc) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: I . Advanced Wastewater Treatment Systems. The Municipalit<= grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as Advantex System located at (Iegal description) Rabbit Creek View & Heights, Block 4H Lot 1A 2. Maintenance Re airs and Alterations. (Owner is required to read, understand and initial each section) Tluotighout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shat] be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment s approval for operation in the Municipality. fes' It shal l be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). �,2 Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system; which could include sewage backup and costly repairs or drainfield replacement. (re,k 05/I8/2018) Page I of 3 �IvC- Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. !)t(__ Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. Q y2:r- _ Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS, Q' Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. 1 onwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions. nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (Tev. 051181201$) Page 2 of 3 I � B': (signature) Date: (print name) ATE OF AI-ASKA ) Ss. [IRU R.?DICIAL DISTRICT ) The foregoing instrument was acknowledged before me this day of 20Z3, by grl�ar��nDf� I ZV= NOTA PUBLIC FOR ALASKA My Commission expires:�3 signature) F vPsrint name) 0 Icol Seal _ x STATE OF ALASKA Notnry Public 13rittaoy' ' ` --T'smnA 30103012 Co mm Me, Ms.0_ tf?P027 Date: ,Z/,/ 20 Z� Title: c t / C-- 05/13/2018) Page 3 of 3 Page Development Services DepartmentPhone: 907-343-7904 =' On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 020-551-15 Certificate of On -Site Systems Approval Expiration Date: 15 Zo Z Legal description RABBIT CREEK VIEW & HEIGHTS BLK 4H LT 1A Site address 7800 Marino Dr Anchorage Current property owner(s) Deas and Karlena Bode X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for Comments or advisories: :1 bedrooms, with the following stipulations: Original Certificate Date: 2 z 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 ApprovaLJune 2022 U ICI'ALIT �F A �HC)'A E i —I Development Services Department Phone: 907-343-7904 On -Site Water 9- IN Section—� Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 020-551-15 Complete legal description Rabbit Creek View & Heights Block 4H Lot 1 A Location (Site address) 7800 Marino Drive, Anchorage, AK 99516 Current property owner(s) Deas & Karlena Bode Day phone (907) 250-4989 2. ON-SITE SYSTEMS SIZED FOR 4 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 2yrs - See advisory if steel older than 20 years 6. ABSORPTION FIELD: i❑ 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 $ i �) Date of Payment '2 J"? COSA# l�3 �ga.D Waiver Fee $ Date of Payment Waiver # COSA Application_June 2022 February 6, 2023 MOA Development Services Department of On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Subject: Rabbit Creek View & Heights, Block 4H, Lot 1A – 7800 Marino Drive Testing for COSA Dear On-Site Services Engineer: The septic system for this new residence was installed in August of 2020. However, the home was not finished and the system was unused until the owners moved in, March 19 of 2021. We are confident that the system can be considered within the 2-year usage window and does not require further testing for a COSA. On Jan 30 we checked the levels of fluid in the trench and found it dry. All indications are that the system is working as designed. Sincerely, Benjamin Schiller, P.E. Legal Description: Rabbit Creek View & Heights Block 4H Lot 1A Parcel ID: 020-551-15 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 7/24/20 Total depth 195 ft Cased to 195 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 36 in. Date of flow test for COSA 7/24/20 Static water level at beginning of test 31 ft. Comments B. TANK DATA Measured operating fluid level in septic tank _ Date of pumping New Installation JZ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 8/28/2020 ❑ ALL standpipes present per record drawing Total measured depth from grade 3.6 ft (max) Measured depth to pipe invert from grade 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/Deficienci COSA Checklist June 2022 Well production at time of test 7.5 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 1.29 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Forge Engineering Date 1/18/23 C. LIFT STATION Required maintenance completed Age of lift station 2 Yrs years Lift station material Fiberglass Comments: Adequacy test date New Installation Results ❑ Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate ' gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) in Effective depth used in Effective depth remaining in 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 FE Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No ft Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' [j] Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' ❑ Yes if No ft Q Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' EYes if No ft � 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' Q Yes if No ft Surface Water > 100' ❑® Yes if No ft Tank to Property Line > 5' FE] Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' Q Yes if No ft Private Wells > 100' r -E-1 Yes if No ft Water Main > 10' FEI Yes if No ft Community Wells > 200' R Yes if No ft Water Service Line > 10' Z 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 Engineer's Printed Name COSA Checklist—June 2022 Benjamin Schiller, P.E. Phone (907) 522-7773 Date 1/31/23 ,.� ©F !4tq�ll� Benjarr chiller CE 12592 �klF�pR4FESS10NP .�