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FOREST VIEW HEIGHTS LT 15
Onsite File Forest View Heights Lot 15 #014-141-22 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201310 PID Number: 014-141-22 Dwelling: ❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑ Upgrade Name John Mathews ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 7305 Lewis Place Anchorage, AK ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 907-244-5271 3 1.2 GPD/SF 9.8 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 5.8 Ft. Gravel depth beneath pipe 4.0 Ft. Subdivision Block Lot Forrest View Heights 15 Fill added above original grade 3.1 Ft. Gravel length 38' Ft. Township Range Section Gravel width 5 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 380 Ft2 1 Ft. Well >100' >1 00' N/A N/A >25' TANK X Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1,000 Gal. Surface Water >100' >100' NIA N/A Material Plastic Number of compartments 2 Lot Line >:5>10' N/A N/A NA Foundation >1 01 >10' N/A N/A LIFT STATIONManufacturer Capacity Gal. Remarks Alarm location Electrical installed by PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield Installer Northern Excavating Drainfield D3034 CO/MT D3034 Inspector L.Tidwell BENCH MARK (Assumed elevation) 100 ft Inspection1st8/12/20 �d 8/12/20 Location and description dates:2 Top of foundation at SE corner of home 3rd 4th ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp 4 FJ Conditional Approval: Date P"""""'°.:qS/��,e ° 49 th .� ........ ,.i..... ..,.........«..................,, L41CHAEL E. ANDERSON Un No. CE-4381 ��6;°=..10/14/19 Septic System�A��� `�,�, Approved �,`�; Date y a Note: this approval does not include well permit requirements. (Kev U5/U1/16) 1"=50' NOTE: CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND PERMIT # OSP201310 PID # 014-141-22 FOREST VIEW HEIGHTS, LOT 15 A B FCO 35.5 MH1 39.8 SV1 41.8 A B 2CO 42.3 CO1 55.9 MT1 56.9 CO2 38.5 4.5 16.2 20.8 22.7 37.7 39.4 53.0LEWIS PLACE12/30/20 FEET 0 50 100 10' UTILITY EASEMENT220215MH1 CO1 FCO CO2 MT2 2CO SV1 TH 38' LONG x 5' WIDE x 4' EFFECTIVE DEPTH ABSORPTION TRENCH3-BDRM HOME ALTERNATE SITE CATIII 15' LONG x 5' WIDE x 3' EFFECTIVE DEPTH ABSORPTION TRENCH EXISTING WELL 1,000 GALLON SEPTIC TANK w/20" MANWAY. PROPOSED WELL EXISTING WELL EXISTING WELL MT1 MT2 35.650.0 PLAN AS-BUILT 9/23/20 38' PROFILE AS-BUILT (NO SCALE) 92.9 88.6 93.5 97.55FCOMH SVFOREST VIEW HEIGHTS, LOT 15 1000 GAL SEPTIC TANK 101.1 FINISH GRADE DRAINFIELD ROCKMT TH#1NO GROUNDWATER 8/11/20 88.2 92.2 COCO82.0 88.2 92.2 98.0 ORIGINAL GRADE MT2CO92.7 PERMIT # OSP201310 PID # 014-141-22 Q DOC CO dba SILL 8c GO LE LLIVAN WATER WELLS -� offe P.O. Box 670269, Chugiak, AK 99567 688-2759 OWNER OF LAND: John Matthews ADDRESS: Bore Hole Data Depth From To LEGAL DESCRIPTION Forest View Heights Lot 15 DATE: 9-28-20 0 2 PERMIT NUMBER: OSP201310 DATE OF ISSUE: 8-12-20 TAX IDENTIFICATION NUMBER 01414122000 Is well located at approved permit location: ❑Yes ❑No Method of Drilling: Nair rotary ❑cable tool Depth of Well: 125' Casing Type: Steel Wall thickness .250 inches Diameter: 6 inches, depth 124 feet Liner type 2 4 4 68 68 90 90 105 105 108 108 111 Static Water Level: 48 feet Recovery Rate 20 ® gpm gph Method of Testing Air Well Intake Opening Type: ❑ open end Fopen hole ❑ Screened Start feet Stopped ❑ Perforations Start feet Stopped Grout Type: Bentonite Volume: 50 lbs Depth: from 2 feet, to 42 feet 111 122 122 125 Well Disinfected Upon Completion: ❑yes ❑ no Method of Disinfection: Chlorine 50 PPM Comments: Casing Stickup Overburden Silty Sand & Gravel Silty Sand & Gravel w/ Clay Silty Sand & Gravel w/ Cobbles Silty Sand & Gravel Wet Clay & Gravel Yellow Silty Sand & Gravel Sand & Gravel 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. www.sullivanwaterwells.com Pump Installation Log Well Drilling Permit Number: SW OSP201310 Date of Issue 8-12-20 Parcel Identification Number: 01414122000 Legal Description Property Owner Name & Address Forest View Heights Lot 15 John Matthews Pump Installation Date: 3-2-21 Pump Intake Depth Below Top of Well Casing: 110 feet Pump manufacturer’s Name: F&W Pump Model: 4F07P05301S Pump Size: 1/2 hp Pitless Adapter Burial Depth: 10 feet Pitless Adapter Installer: Northern Excavation Disinfected Upon Completion? yes no Method of Disinfection: Chlorine 50 PPM Comments: Pitless Manufacturer: Martinson Pump Installers Name: Sullivan Water Wells Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. Received Date/Time 03/23/2021 14:41 03/23/2021 14:10Collected Date/Time 1211244001 Matrix SGS Ref.# Client Sample ID Forest View Heights L15 Client Name Project Name/# Printed Date/Time 03/29/2021 11:22Forge Engineering Inc. Technical Director Stephen C. Ede Forest View Heights L15 Drinking Water Sample Remarks: Parameter Results LOQ Units Method Allowable Limits Prep Date Analysis Date InitContainer ID Metals by ICP/MS ACF03/26/21EP200.8ug/LArsenic 03/25/21ND5.00 (<10)B Waters Department EWW03/26/21SM21 4500NO3-Fmg/LTotal Nitrate/Nitrite-N 0.709 0.200 (<10) C Microbiology Laboratory A.L03/23/21SM21 9223B100mLE. Coli Negative 1 A A.L03/23/21SM21 9223B100mLTotal Coliform Negative 1 A 2 of 5 PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) August 12, 2020 M.O.A. Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Subject: Forest View Heights, Lot 15 – NHN Lewis Place Septic System Design 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 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, septic location and alternate site. No conflicts exist between this proposed system and any other well or septic system on this lot or adj acent lots. A test hole was placed on the lot on August 11, 2020 in close proximity to the test hole placed by First Water Consulting on May 21, 2019. Soils encountered in our test hole varied significantly from First Water Consulting in that distinct and easily identifiable divisions in the subsurface soils was found. Clean sand was found to 5’ below the surface followed by silty gravel (GM) to 9’. The percolation rate of the GM layer was determined to be 2.5 minutes per inch. Sand was then found again to 11’ with GM to the bottom of the hole at 16’. Our design is based on the subsurface soils found in our test hole. Sand encountered in the test hole contains no particle larger than the No. 4 Sieve. It contains little silt and easily absorbs water at a rate greater than 1 minute per inch. A laboratory analysis is unnecessary in this case as the material is easily visually analyzed. This material is identical to that found in the First Water Consulting test hole. A percolation test is included in that document. The new absorption trench will incorporate a portion of the GM layer and the SP layer. Water passing the SP layer will be slowed by the GM layer prior to dispersal into the surrounding strata. No groundwater was encountered in the test holes and none has been noted during the ensuing monitoring period. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201310, Rebecca Carroll, 08/12/20 The ground surface on the lot slopes to the northwest at grades approximating 15%. There are no slopes greater than 25% within 50 feet downslope of either the primary or alternate site. Ground contours are shown on the site plan indicating the grade and direction of flow. Stormwater drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. Wells on this and adj acent lots are shown. The new system will be a minimum of 100’ from all wells and surface water and more than 5’ 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 adj acent properties. Sincerely, Michael E. Anderson, PE 8/12/20 1"=50' 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 FOREST VIEW HEIGHTS, LOT 15 LEWIS PLACE8/10/20 FEET 0 50 100 10' UTILITY EASEMENT220215MH CO FCO CO MT 2CO SV TH 38' LONG x 5' WIDE x 4' EFFECTIVE DEPTH ABSORPTION TRENCH 3-BDRM HOME ALTERNATE SITE PROPOSED WELL 1,000 GALLON SEPTIC TANK w/20" MANWAY. PROPOSED WELL EXISTING WELL EXISTING WELL Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201310, Rebecca Carroll, 08/12/20 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 8/10/20 FOREST VIEW HEIGHTS, LOT 15 DESIGN FACTORS: SYSTEM REQUIREMENTS: 450 GPD PEAK FLOW PERK RATE: 2.5 MIN/IN APPLICATION RATE: 1.2 GPD/SF 5' WIDE TRENCH SYSTEM 1,000 -GALLON SEPTIC TANK 4" PERFORATED PVC (HOLES DOWN) DRAINFIELD ROCK 5' 6" 6" 4' 4' BOTTOM OF TRENCH: 8.5' BELOW GRADE FLOW LINE ELEVATION: 4.5' BELOW GRADE TOP OF TRENCH: 0.5' ABOVE GRADE 450 GPD / 1.2 GPD/SF /5' WIDE * .5 (RED. FACTOR) = 37.5 LF TRENCH REQUIRED (38 LF SPECIFIED) GEOTEXTILE FABRIC Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201310, Rebecca Carroll, 08/12/20 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 1 SLOPE SLOPE SITE PLAN DATE READING GROSS TIME (minutes) NET TIME (minutes) DEPTH to WATER NET DROP PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH) TEST RUN BETWEEN: FT. and FT. COMMENTS: (inches)(inches) Forest View Heights, Lot 15 8/11/2020 J. Millette DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING: IF YES @ WHAT DEPTH?- 2.5 -- 6 7 014-141-22 John Mathews 4:15/4:25 8/11 1 2 3 4 5 6 4/9 6 16 4:28/4:38 4:44/4:54 4:56/5:06 5:08/5:18 5:20/5:30 1' OB Professional Engineers Stamp: 8/12/20 10 - - - CLEAN SAND SW/SP SILTY GRAVEL GM SILTY GRAVEL GM CLEAN SAND SW/SP PERC.RATE <1 MIN./INCH. PERC. RATE 2.5 MIN./INCH. 5 6 16 4/810 16 10 410 16 4/8 6 16 10 4 6 16 4/8 10 4 10 10 4/8 4 4/8 4 DISTINCT DIVISIONS IN SOIL STRATA AS SHOWN. PERCOLATION TEST MEASUREMENTS TO 1 16". PERC. RATE <1 MIN./INCH. PERC. RATE 2.5 MIN./INCH. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201310, Rebecca Carroll, 08/12/20 4661 13030 Sues Way - Anchorage, Alaska 99516 Tel. 907-350 -9566 firstwaterAK@gmail.com SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: FOREST VIEW HTS. L15 PERFORMED BY: FWCS - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 8/1/2020 DEPTH FEET OG SOILS 1 2 ORG/OL 3 4 5 6 7 8 SW/sp 9 10 11 12 13 14 15 16 17 18 BOH 19 20 Reading Date Gross Time Net Time Depth to Water Net Drop 5/21/19 < 2 min 6 6 6 6 6 6 6 6 6 6 6 6 PERCOLATION RATE <1 (MIN / INCH) TEST RUN BEWTWEEN 4 & 5 FT PERC HOLE DIAMETER 6 PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16TH. GROUND WATER ENCOUNTERED: NO IF YES, AT WHAT DEPTH: NA DEPTH TO WATER AT MONITORING: DRY DATE: 5/30/19 TESTHOLE # 19-1 DATE PERFORMED: 5/21/2019 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: Sandy soils readily absorbed water during perc test. Insitu material suitable for filtration VERIFY GROUNDWATER MT AT TIME OF CONSTRUCTION PERFORMED FOR: JOHN MATHEWS 8/1/2020 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201310, Rebecca Carroll, 08/12/20 MUNICIPALITY CH E a41.' R 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. 014-141-22 1. GENERAL INFORMATION Expiration Date: / - Crz, - 2-1 Complete legal description Forest View Heights Sub, Lot 15 Location (site address) 7315 Lewis Place Current property owner(s) SIX M Cedar Homes Day phone (907) 244-5271 Mailing address 15001 Longbow Drive, Anchorage, AK 99516 Real estate agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) t ❑ Pip 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 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: Waiver Fee $ Date of Payment-( -7 ( Date of Payment Receipt Number. C73Z. la Receipt Number COSA # 0 S C 21 1 152- 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 Date 4/5/21 of q�gs�l 49 TH - r 6. DSD SIGNATURE S . ..."' . System #1 Approved for bedrooms �% BenjamiLg,'Schiller / System #2 Approved for bedrooms �i�,X- CE 12592 Disapproved ltll pROFESS104 t\aa11~ Conditional approval for bedrooms, with the following stipulations: ...,, 1 f//— IATER ��� PROGEAM �Ji 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 X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSA Checklist Legal Description: Forest View Heights Sub, Lot 15 Parcel ID: 014-141-22 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 9/28/20 Total depth 125 ft Cased to 124 ft © Sanitary seal is functioning correctly ❑® Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA 9/28/20 Static water level at beginning of test 48 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 Tank installed on 8/12/20 D. ABSORPTION FIELD DATA Wide Trench Which system tested (date installed) 8/12/20 Fmil ALL standpipes present per record drawing Total measured depth from grade 12.9 ft (max) Measured depth to pipe invert from grade 8.9 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 N/A gallons Comments/Deficiencies: COSA Checklist yellow sheet Well production at time of test 20 gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ❑ No FMil Coliform bacteria is Negative Nitrate 0.709 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑® Arsenic less than MRL (ND) Collected by Forge Engineering Date of Sample 3/23/21 C. LIFT STATION 11-1 uired maintenance completed Age of lift sta years Lift station material Comments: Adequacy test date NEW Results ❑✓ Pass For 3 bedrooms id depth prior to test in Water ed gal New depth in Elapsed time in Final fluid depth i Absorption rate god Any, rejuvenation treatment (past 12 m hs) 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' Fv-1 Yes Community Sewer Manhole/Cleanout > 100' Q Yes if No ft FV1 Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' Fv-� Yes if No ft Absorption Field on Lot > 100' M Yes if No ft Holding Tank > 100' F� Yes if No ft Neighboring Absorption Fields > 100' 0 Yes if No ft Water Main > 10' Animal Containment > 50' F/� Yes if No ft Fv-� Yes if No ft Q Yes if No ft Water Service Line > 10' R Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway comment below Community Sewer Main > 75' 0 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' Fv-1 Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5' F-1 Yes if No ft Wells on Adjacent Lots: 0 Absorption Field > 5' Fv-� Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' Q Yes if No ft 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' El Yes if No ft If absorption field is under driveway comment below Property Line > 10' El Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' 0 Yes if No Water Service Line > 10' Rl Yes if No ft Community Wells > 200' R Yes if No Surface Water > 100' Fv-1 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION ���•QF!9kk���� l certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with ®,••TN • • •� MOA COSAguidelines in effect on this date. • w • '' r ..... • ..= ..: . .` Benjarryq,,&hiller �� �'c{�, • , CE 12592 , • �w�� �� /�1F9 • . 04/05/21 , • ti�� PROFiSSOW - COSA Checklist yellow sheet ft ft