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HomeMy WebLinkAboutT11N R2W SEC 28 SE4SE4 N OF CREEK (Lease Area #14)Onsite File AFE Le da -se Area Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201439 PID Number: 090-051-08 Dwelling: ❑■ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ■❑ New ❑ Upgrade Name Alaska Housing Finance Corp. ABSORPTION FIELD ❑ Deep Trench 0 Wide Trench Bed ❑ Mound Site Address 24305 Seward Highway, Anchorage, AK 99540 _❑ ❑ Other Phone Number of Bedrooms Soil Rating ITotal depth from original grade 4 1.0 GPD/SF 4.0 / 4.1 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3.4/3.5 Ft. Gravel depth beneath pipe 0.6 / 0.6 Ft. Subdivision Block Lot Fill added above original grade Gravel length 1.2/1.4 Ft. 60.0 / 60.0 Ft. Township Range Section 11N 2W 28 SE4SE4 Gravel width Beds: Number of Lines Distance between lines 5 Ft. N/A N/A Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 600 Ftz 2 6.4 Ft. Well >100' >100' 'N/A N/A >25' TANK ❑p Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1250 Gal. Surface Water >100' >100' N/A N/A Material Plastic Number of compartments 2 Lot Line >5' >10' N/A N/A NA Foundation >10' >10' N/A N/A L TATION Manufacturer Capacity Remarks Gal. Alarm location Electric ailed by Installer PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield Wilco Construction Drainfield D3034 CO/MTD3034 Inspector L.Tidwell / M.Jakubisin BENCH MARK (Assumed elevation) 100 ft Inspection 151 11/18/20 11/19/20 Location and description 2�a Bottom of log siding 31d 11/20/26 411 ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date ®*:49TH • .....=... i Septic System/ % BenjarliiySchiller % �¢r�FcslF c Approve f -�,. Date - 23 - 3/ 2222 . •���`���� i eiF�pR O S 10N1`�'� � Note: this approval does not include well permit requirements. F F 00:'a E S \�\ �RCV VJ/VL/ IOf CF) CIO C) N 0- M, IM W -..m Phi im OR jf C) co U f J1 w Ul A Z 0 CO F- z >: CO v < 6c) W W 0 z LO ry -j < z OO 60 < F < U) x m /02 < W < C) I-- - 0- Z: 0 CN ED CN / 3: - - -r LLI co CL LL U) Eo w 0 LJ x W U) 0 < Z > w Z: Of LU Liu Z < Ll- W (C) x LL W U) 0 W Lo C140 -j -i 2i Xc0 U LU LLI U) 0 � 0 LL Cj 6i 0 C) 0 C) co � C:) Lo C"! C\! c h pl-: c7i Lo IN 06 F- o00 w m Co m cli � (14 O Mme- CM CO LO C) M Mca �; M 04 Cl) rl- 00 m ol2 > P 2i 0 2E C) o C) :E w Ul A Z 0 CO F- z >: CO v < 6c) W W 0 z LO ry -j < z OO 60 < F < U) x m /02 < W < C) I-- - 0- Z: 0 CN ED CN / 3: - - -r LLI co CL LL U) Eo w 0 LJ x W U) 0 < Z > w Z: Of LU Liu Z < Ll- W (C) x LL W U) 0 W Lo C140 -j -i 2i Xc0 U LU LLI U) 0 � 0 LL Cj 6i 0 C) 0 C) W LU z (j) it f--, LLJ < 0 LU F-- 2<� J =) w LU 0 < Z LU 0 Z3 W, w W < ZD r 0 2: < o LU LL U) FLU - w (D 600 LU C) 0 o -i LL LL U) \ ,�� Cdr -5 C., U) C, w N D z Z W LU z (j) it f--, LLJ < 0 LU F-- 2<� J =) w LU 0 < Z LU 0 Z3 W, w W < ZD r 0 2: < o LU LL U) FLU - w (D 600 LU C) 0 o -i LL LL U) \ ,�� Cdr -5 C., U) C, w N T11 N R2W SECTION 28 SE4SE4 PERMIT # OSP201439 PID # 090-051-08 04 83.2 FINISH GRADE 82.0 ORIGINAL GRADE 1 p ry DRAINFIELD ROCK 78.6 — -r: 78.6 VOA A AN 78.0 76.0 76.0 NO GROUNDWATER -10/9/2-0- 71.0 r F— CY) 0 3- 0 81.8 FINISH GRADE 80.4 ORIGINAL GRADE 2 0 76.976.9 DRAINFIELD ROCK — WOA!A .§AND 76.3 74.3 74.3 60' NO GROUNDWATER 10/9/20 clq 69.4 r F-- PROFILE AS -BUILT lNGIN!l RING (NO SCALE) gp0 lk , F A-W 4,9 na .. ........... 8enin;Echil�ler: #0CE 12592 3/3/22 k� T11 N R2W SECTION 28 SE4SE4 PERMIT # OSP201439 ENGINEERING PROFILE AS -BUILT (NO SCALE) 49 TM Ben ar'T i Schiller CE 125923/3/22 , . •�v� ��V, PROFESSIO�P��� L- • Permit Number: #SW201439 Date of Issue: 11-16-2020 Parcel Identification Number: 09005108000 Date Started: 7-15-21 Date Completed: 7-16-21 Is well located at approved permit location? x Yes ❑ No Legal Description: TI IN R2W Sec 28 SE4SE4 N of Creek Property Owner Name & Address: AHFC % Rainbow Valley Homeowners Association PO Box 112751 Anchorage, Alaska 99511 Borehole Data: Depth (ft) Method of Drillin x air rota Soil Type, Thickness & Water Strata From To g n' ❑cable tool Stick up cobbly gravel gravelly silt silt sandy silt gravelly silt tv/boulders gravelly silt wet silty water sand & gravel 0 2 2 4 4 15 15 27 27 45 45 81 81 99 99 101 Casing type: steel Wall Thickness:.250 inches Diameter: inches Depth: feet Liner Type: Diameter: inches Depth: feet Casing stickup above ground: 2 feet Static water level (from ground level): 46 feet Pumping level: 100 feet after `2 hours pumping 15 gpm Recovery Rate: 15 gpm Method of Testing: air li t Well Intake Opening Type: x Open End ❑ Open Hole ❑ Screened Start feet Stopped feet ❑ Perforations Start feet Stopped feet Grout Type: bentonite granules Volume: 1 bg Pump: Intake Depth feet Pump size hp Brand Name Well Disinfected Upon Completion? x Yes ❑ No Method of Disinfection: chlorine tablets Comments: Well Driller: Alpine Drilling & Enterprises PO Box 110496 Anchorage AK 99511 -yyw: Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: OS P201439 Date of Issue: 1 1 _ 16 _ 20 Parcel Identification Number: 090 _ 051 _ 080 Legal Description Block Lot Property Owner Name & Address: T11 N SEC28 SE4SE4 AFHC % Rainbow Valley HOA Lease Area 14 PO Box 11275, Anchorage, AK 99511 Pump Installation Date: 10 -21 -21 Pump Intake Depth Below Top of Well Casing: 98 Pump Manufacturer's Name: G ru ndfos Pump Model: SQE07-240 Pump Size: 1 hp Pitless Adapter Burial Depth: 10 feet Pitless Adapter Manufacturer's Name: Campbell Pitless Adapter Installer: Wilco Construction Well Disinfected Upon Completion? C2: Yes 0 No Method of Disinfection: Chlorine Tablets Comments: feet Original pump log was lost. This is a recreation using the information available. (Forge Engineering) Pump Installer Name: Company: Arrow Pump and Well Mailing Address: PO Box 110496 City: Anchorage State: AK zip: 99511 Attention: The pump installer- shall provide a pump installation log to On-site within 30 days of pump installation. I CHUGACH STATE PARK EAST 760.56' 1I M M m Q Z. a 0 J CL U V) L- o V l � V °0 Q c - O a U(? J •If)� V ) k}-- c— O OIL I p m c o 10)f.,,G O m 01 v 1jNrnO o +,c3a W c U ��)tn Vv�/Qv1 O m =c p D O O O w>,sL I I a0IDmaoI �< Q U m L 00 -0 i- � O J �-> (D I M M m Q Z. a 0 J CL U V) L- o V l � V °0 Q c - O a U(? J •If)� V ) k}-- c— O OIL I c �- !r p a 0.2 m y C 'p 0.0 0 m ° Uc 72 m w o N U m X m m m t ~- C mo cL p 0a w o '0 00 c Lm o m 3s O U 0 0 U .a y c � 0 CL L w 0 0 U; m c -c p •- c V) > 0 U p m c o O m 01 T L m 6 L m +,c3a W c U ro W -c Q O m =c p D O O O w>,sL I I a0IDmaoI Q U m L 00 -0 i- � O J �-> (D I NL. N°'t°00 m fn E � m ._ j .p Q «- O D1 N m -c y 3� O pI c oZ a M ;-D p m _a C3L 1 00.00 "pU �s mr-r pl 0c spmrn3m c -0 o 7.p >,�yc—oa i jQ p t O X O > m p � 0 r- 0 .c Z.2 m 0 m, QCr 0 ps— O CL I ++- L't N p O I Om�y I m Q n. E c 0 �- U m m> p H y .0 < a, 0 0 mWOcE-2E p £ m m to Q3°cam + 0 c �- !r p a 0.2 m y C 'p 0.0 0 m ° Uc 72 m w o N U m X m m m t ~- C mo cL p 0a w o '0 00 c Lm o m 3s O U 0 0 U .a y c � 0 CL L w 0 0 U; m c -c p •- c V) > 0 U 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: OSP201439 Work Type: WellSeptic Initial Tax Code Number: 09005108000 Site Legal Address: T11 N R2W SEC 28 SE4SE4 N OF CREEK GA147 Site Mailing Address: 24305 SEWARD HWY, Indian Owner: ALASKA HOUSING FINANCE CORP Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date Expiration Date: 1t,cnr 0 c` n t ep<irtment Lot Size in Sq Ft: Total Bedrooms: 11/16/2020 11/16/2021 1306800 Q 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 Received By: Date: Issued By: Date: 11Z17Ao 4 11/17/20 MUNICIPALITY OF ANCHORAGE 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. 090-051-08 Property owner(s) AHFC % Rainbow Valley Homeowner's Ass. Day phone 227-0725 Mailing address P.O. BOX 112751 Anchorage, AK 99511 Site address 24317 Seward Highway Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) T11 N R2W SEC 28 SE4SE4 N OF CREEK Lot Size 1,306,800 Sq. Ft. Number of Bedrooms Four (4) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial ❑X Single Family (SF) ❑X (w/wo AD U) Septic Tank 19Upgrade ElDuplex ❑ (D) Holding Tank ElRenewal ElMultiple 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. (Signature of property owner or authorized agent) Permit/Rush Fees: 6 1 5 coq I b Date of Payment: lOf/6ZZ0 Receipt Number: 0g439 Z.D Permit No. dS Pa C)A `-I 3`"'I Permit App_::- : .-..:c Waiver Fees: Date of Payment: Receipt Number: Waiver No. PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) November 13, 2020 M.O.A. Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Subject: T11N R2W Section 28 SE4 SE4 N of Creek – 24305 Seward Highway Well and Septic System Design Dear On-Site Services Engineer: The owner of the above lot intends to provide sewer service to an existing 4-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 and septic location and alternate site. No conflicts exist between this proposed well and system and any other well or septic system on this lot or adjacent lots. The ground surface on the lot slopes to the west at an approximate 20% grade. There may be slopes greater than 25% for short distances within 50 feet downslope of either the primary or alternate site. The absorption trenches have been designed to comply with the steep slope provisions of the Municipal Code. The distribution lines are set at 3.5’ below the surface and no surface disturbance will occur within 50’ down grade from the absorption trenches. 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. The new system will be a minimum of 100’ from all wells and 100’ from surface water and more than 5’ from the septic tank. Please refer to the attached test hole logs 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 11/13/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201439, Deb Wockenfuss, 11/16/20 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 FD - FLOW DIVERTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND TH1 T11N R2W SECTION 28 SE4SE4 1"=100' 11/13/20 200100 0 FEET 12' GRAVEL ROAD EXISTING FOUR BEDROOM HOME TH2 DECOMMISSION OUT HOUSE PER U.P.C. 2-60' LONG x 5' WIDE x .5' EFFECTIVE DEPTH ABSORPTION TRENCHES. ALTERNATE SITE 1,250 GALLON SEPTIC TANK w/20" MANWAY. 2 0 % CO FS CO CO MT 2COFCO MT SVMHPROPOSED WELL 8208007802 0% 10' MIN. FROM HOUSE FOUNDATION TO TANK. 10' 6' 6' SEPARATION BETWEEN ALL TRENCHES. NOTE: NO WELLS WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM OR ALTERNATE SITE IN ANY DIRECTION. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201439, Deb Wockenfuss, 11/16/20 T12NR2WSEC28 SE4 SE4 N of CREEK DESIGN FACTORS: SYSTEM REQUIREMENTS: 600 GPD PEAK FLOW PERK RATE: <1 MIN/IN APPLICATION RATE: 1.0 GPD/SF 5' WIDE TRENCH SYSTEM 1,250-GALLON SEPTIC TANK 2' MOA APPROVED SAND LINER TYPICAL TRENCH SECTION (NO SCALE) 4" PERFORATED PVC (HOLES DOWN) 5' 6" 6" 3' 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 BOTTOM OF TRENCH:4.0' BELOW GRADE FLOW LINE ELEVATION: 3.5' BELOW GRADE TOP OF TRENCH: 0.5' ABOVE GRADE 600 GPD / 1.0 GPD/SF /5' WIDE * 1.0 (RED. FACTOR) = 120 LF TRENCH REQUIRED (120 LF SPECIFIED) 10/14/20 6" GEOTEXTILE FABRIC DRAINFIELD ROCK MOA APPROVED SAND 2' Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201439, Deb Wockenfuss, 11/16/20 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) T11N R2W SECTION 28 SE4SE4 N of creek 10/2/2020 J. Millette DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING: IF YES @ WHAT DEPTH? - 0.73 6 3 4 090-051-08 Paul Thurman 12:18 10/2 1 2 3 4 5 6 5 8 16 - 11 8 16 12:23 12:28 12:33 12:38 12:44 1' OB Professional Engineers Stamp: 10/15/20 4:18 no None 10/9/20 GW (WELL GRADED GRAVEL W/ 12" MINUS) BOH 6 0 16 5 8 16 - 11 8 164:22 6 0 16 5 8 16 - 11 8 164:21 6 0 16 5 8 16 - 11 8 164:19 6 0 16 5 8 16 - 11 8 164:23 6 0 16 5 8 16 - 11 8 164:23 6 0 16 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201439, Deb Wockenfuss, 11/16/20 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 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) T11N R2W SECTION 28 SE4SE4 N of creek 10/2/2020 J. Millette DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING: IF YES @ WHAT DEPTH? - - - 3 4 090-051-08 Paul Thurman 10/2 1 2 3 4 5 6 1' OB Professional Engineers Stamp: 7/3/19 no None 10/9/20 GW (WELL GRADED GRAVEL W/ 12" MINUS) BOH Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201439, Deb Wockenfuss, 11/16/20 Q 4- VJ Jr P N Z, 5Tv¢y Fri -ANA is 400Se zlr' =8= CAIr. ST4i"e7 ®F- A L45 KA !, 7G0. S-6. yr m LA fel 15 311-s'00 N.44"/Zb8`W, ►5'4.87 / LAW 13 LAAI(� SYMBOLS L^j ERTIFICATiON SURVEY TYPE / Set set El construction, �' DRAINAGE -found G) - NO CORNERS SET loo° ASSUMED ELEV. WOOD DECK Sgt Qk AS - BUILT FENCE � A� pi-iAt.T Lot Survey Certificatioc -LOT SURVEY -TOPOGRAPHY PLOT PLAN - AS-BUIL-9-LOT CHAIN LINK FENCE v:•:d. CONCRETE Q LOT SURVEY NOTE: Fences are shown in their approximate _- r;� r`. iScale `�� `s AS BUILT - NO CORNERS SET locations only. REC It is the responsibility of the builder or owner, prior ro LEGEND hub & tt found O iron rebar -found O Set set El construction, to verify proposed building grade relative -found G) set 0 to finished grade and utility connections and to determine iron pipe brass cap -found Sgt Qk the existence of any easements, covenants o restrictions which do not appear an the recorded subdivision plat. alum. Cap -found e set Gr Lot Survey Certificatioc - �< r m ,,; '-- r; • Prepared by j �+ BENCH IUiARK 1 v Professional Land Surveyors I hereby certify that I have< surveyed the property shown = 1 " = 200' Drawn b;+ DGM and desci bW hereon, and the im ovements situated _- r;� r`. iScale `�� `s thereon are within the ! c oG _ _.. el Date Surveyed: property lines and do not 5 fj�� �j f �' lr r Nov. overlap or encroach on odiocent prol•erty,exceF Date Drown= June /- Douglas G. F.Sihion `, . es indicated -iereon, . Easements o' record, f>'r No. 5781-5 Legal Description'. other than tiose shown on the recorded plat , are not shown hereon. �'�rv�` Y Lease Area 1985 ( checked by. REJ 1987 Grid. w.o. No. 14, Rainbow Valley A parcel of land lying and being in the SZS2 Sec. 28, T.11N., R.2W., Seward Meridian, Alaska, more particularly described by metes and bounds as follows: Commencing at the Sec. Cor. of Secs. 27,28,33 and34, WEST, along the S. boundary of Sec. 28, 200.00 ft; thence NORTH, along the West line of Lease Area No. 18, 600.00 ft., to a Cor. of Lease Area No. 16; thence S.61011'21"W., 913.02 ft., to a Cor. of Lease Areas Nos. 13 and 16; thence N.16000'00"L., along a line common to Lease Areas Nos. 13 and 16, 660.00 ft., to a Cor. of Lease Areas Nos. 13,14,15 and 16, the true point of beginning; thence N.44012108"W., along a line common with Lease Area No. 13, 154.87 ft.; thence WEST, along a line common with Lease Area No. 13, 365.00 ft., to a Cor. of Lease Areas Nos. 13 and 14; thence N.28000'00"E., 470.73 ft., to a point on the S1/16 line of Sec. 28; thence EAST, along the S1/16 line of Sec. 28, 760.56 ft., to a Cor. of Lease Areas Nos. 14 and 15; thence S.44000'00"W., along a line common with Lease Area No. 15, 732.13 ft., to the point of beginning, containing 6.67 Acres, more or less. Located in the Anchorage Recording District, Third Judicial District, State of Alaska, which property is hereinafter referred to as "Lease Area No. 14", as indicated on the Rainbow Valley Homeowners Association Plat dated RUSH MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 090-051-08 Expiration Date: (o —2— J— 2--Z- 1. Z 1. GENERAL INFORMATION Complete legal description T1 1 N R2W S E C28 S E4S E4 N OF CREEK asp il�,, Location (site address) 24317 Seward Hwy, Anchorage, AK 99540 *1y Current property owner(s) Alaska Housing Finance Corp. Day phone Mailing address PO Box 112751, Anchorage, AK 99511 Real estate agent 2. TYPE OF DWELLING: ❑■ Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic ❑� 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 $ 7`7 t y5 Date of Payment l t �r Z c%ZZ Receipt Number y COSA# 0.5622169 Z-2 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 3/17/22 Atq�lil TH �9*�i✓ . 6. DSD SIGNATURE .��. 5.... .. ...:.. l System #1 Approved for bedrooms / BenjammiyrySrySchiller CE ••� r System #2 Approved for bedrooms �1���29,trr•. 3/17/222 .•'���`�� ll`04 Disapproved ltd, pROFES510NaESSIOV Conditional approval for bedrooms, with the following stipulations: OF'QNC���,ipri J g WATER AND J m WASTfv'.'AT o AhA_— JJIJ/ �)VT y: Original Certificate Date: 3-23 -2Z 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 Il 11 t 1111111 Legal Description: T11 N SEC28 SE4SE4 N OF CREEK LEASE AREA #14 parcel ID: 090-051-08 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA FE -1 Well log is filed with Onsite (or attached) Date drilled 7/16/21 Total depth 101 ft Cased to 101 ft Fil Sanitary seal is functioning correctly 0 Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA NEW Static water level at beginning of test 46 ft. Comments Well retested for coliform after disinfectior B. TANK DATA Age of tank(s) 1.3 years Tank type/material Septic/ Plastic Measured operating fluid level in septic tank New 0 Standpipes/foundation cleanout per record drawing Date of pumping N/A D. ABSORPTION FIELD DATA 5' Wide Trench Which system tested (date installed) 11/20/20 ❑® ALL standpipes present per record drawing Total measured depth from grade 5.2 ft (max) Measured depth to pipe invert from grade 4.6 ft (min) ❑ NIA — pressurized field no Monitor tubes go to bottom of effective. If not, state depth into effective n 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 Well production at time of test 15 gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ❑ No ®❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L FR] Arsenic less than MRL (ND) Collected by Forge Engineering Date of Sample LIFT STATION 3/16/22 ❑ Req ' d maintenance completed Age of lift statin years Lift station material Comments: System built but not used since installation Adequacy test date Re is ❑ Pass For bedrooms Fluid dep rior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ✓� Yes Community Sewer Manhole/Cleanout > 100' ✓� Yes if No ft M Yes if No Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' [ Yes if No Absorption Field on Lot > 100' 0✓ Yes if No ft Holding Tank > 100' ❑✓ Yes if No Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' Yes if No ✓0 Yes if No ft if No ft F. ENGINEER'S COMMENTS Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0Yes if No ft ✓� Yes if No ft ft ft ft ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 7✓ Yes if No ft Surface Water > 100' Q✓ Yes if No ft Property Line > 5' ✓� Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Q 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' Q✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Yes if No ft If absorption field is under driveway comment below Property Line > 10' Yes if No ft Wells on Adjacent Lots: Water Main > 10' Yes if No ft Private Wells > 100' Q✓ Yes if No Water Service Line > 10' Yes if No ft Community Wells > 200' Yes if No Surface Water > 100'✓Q Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION OF k.4 1 certify that l have determined through field inspections and review Cj�4' • + . • • fi'g� �$ of Municipal records that the above systems are in conformance with ,o/ 49TH MOA COSA guidelines in effect on this date. 4 ' • ' ' ' �..• Benjarrr>Schiller �ci . CE 12592 slF�� 3/17/22 \:AW COSA Checklist yellow sheet �1������®�►�� ft ft