HomeMy WebLinkAboutTHE CASCADES TRACT AOnsite File
The Cascades
Tract A
#078-161-13
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP221056 PID Number: 078-161-13
Dwelling: X Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: 0 New ❑ Upgrade
Name
COLONY BUILDERS INC
ABSORPTION FIELD
❑ Dee Trench ❑ Bed 0 Mound
p El Trench
Site Address
2451 West River Dr.
❑ Other
Phone
(907) 345-0371
�Number of Bedrooms
Soil Rating
Total depth from original grade
1.0 GPD/SF
+2.0 / +2.0 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
+2.5/+2.5 Ft.
Gravel depth beneath pipe
0.5/0.5 Ft.
Subdivision Block Lot
The Cascades Tract A
Fill added above original grade
5.3/5.4 Ft.
Gravel length
2 @ 60
Township Range Section
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
600 Ft2
2
>61 Ft.
Well
>50'
>50'
>50'
N/A
>25'
TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑� Other
Manufacturer
Orenco / Advantex
Capacity
1500 Gal.
Surface Water
>50'
>50'
>50'
N/A
Material
Plastic
Number of compartments
2
Lot Line
>5'
>10'
>5'
N/A
NA
Foundation
F>1Q'
> 1 0'
> 10'
N/A
LIFT STATION
Manufacturer
Orenco
Capacity
100 Gal.
Remarks Advantex tank and pump vault are ballasted
per manufacture specs.
Alarm location
Inside Garage
Electrical installed by
Pending confirmation
Installer
PIPE MATERIAL House to tank D3034 Tankto
D3034
Red Dog Masonry
Drainfield D3034 CO/MTD3034
Inspector J. Millette
BENCH MARK (Assumed elevation) 100 ft
Inspection 15` 3/17/22 2nd 4/7/22
Location and description
3rd 4th
Bottom of siding @ point'B'
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
OF A/
Conditional Approval: Date
,a
TH
Septic System%j
Benjamr chiller
•���
Approved Date 5 ��ZZ
Note:
CE 12592
�����s19. 5/4/22 AN"'
tFF, W
l
this approval does not include well permit requirements.
�\�pROFESSIO
THE CASCADES, TRACT A
PERMIT # OSP221056
PID # 078-161-13
ENGINCC RING
TANK IS BALLASTED WITH 12" OF
CONCRETE AROUND CENTER RIM
PROFILE AS -BUILT
(NO SCALE)
Benja i Schiller
��� •. CE 2592
2022
\®_PROFSSIONP `.o
THE CASCADES, TRACT A
PERMIT # OSP221056
i i 1
15' T&E ESEME�T
i
k Ji
100' SEPTICi j
E)EPTH�A�BS�RP�ION� ����
T `^``4NCI"fES cS;
ALTERNATE`}.
E'Q
MH
T1 `
\ !AY`t Fct1
ff
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ENGINEERING
0 lkk
Benja i Schiller
.CE. oz92,•��C�@�.eo
it®a�PROfESS10NP „�
3:1 SLOPE
1,500-W
STANK w/
\ POD & P
a
PID # 078-161-13
,f
�1
}
f
t
cH HILLS A
,1
� e
THREAD OF SOUTHFORK
EAGLE RIVER MEANDER LINE
UMP VAULT
t
WELL
Us
( �Z vX20' DRAINAGE)\ ti. fi
\ EASEMEN\ \ f
'TRACT A',-
126VPAIC ACCES�—,EASEMENT
l -_
\
D040i GREY\L5 �.
PLAN AS -BUILT
0 100 200
FEET
1"=100'
A B
FCO
31.7
6.8
MH
27.4
23.5
POD
25.5
26.7
PV
32.8
24.2
MT1
49.4
30.8
MT2
86.3
86.4
MT3
61.1
37.1
MT4
90.4
84.9
LEGEND
CO - CLEANOUT
PV - PUMP VAULT
FCO - FOUNDATION CLEANOUT
POD - FILTER POD
MH - MANHOLE
MT - MONITORING TUBE
TH - TEST HOLE
THE CASCADES, TRACT A
PERMIT # OSP221056
SOUTH TRENCH
2" INSULATION
98.9 101.7 FINISH GRADE
98.4
96.4
PID # 078-161-13
96.4 ORIGINAL GRADE -�
F—
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98.9
98.4
i- 96.4
1 <" I I` ' " • _ .' ' • DRAINFIEL•D.ROCK..
MOA FILTER SAND
TYPE II GRAVEL
93.9
60'
GROUNDWATER @ 96.4 ON 3/6/18
87.4
N
I --
NORTH TRENCH 94.4 ORIGINAL GRADE
2" INSULATION F-
99.8 FINISH GRADE 3:1
96.9 -I 96.4
96.4 96.4
94.4
_ �._............._, 94.4
DRA N LD.ROCK.
MOA FILTER SAND
TYPEIIGRAVEL
92.9
60'
GROUNDWATER @ 94.4 ON 3/6/18
85.4
N
7k
F—
PROFILE AS -BUILT
[NGIN[e0.1NG (NO SCALE)
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CLEARWATER
:.:k_ �a.. sup•
6830 E Green Glen Dr. well Log Phone: 907-795-2531
Wasilla, AK 99654 PERMIT #R20-2742 E-mail: carin@akclearwaterwells.com
www.alaskaclearwaterwells.com
Date Started: 12/06/21 Date Completed: 12/06/21
Legal Description: The Cascades Tract A - Parcel ID #07816112000
Site Address: 2451 West River Dr., Anchoraqe
Property Owner: Colony Builders Owner Address:
Latitude: 61.24253 Longitude: -149.46315 Meridian: Seward
Borehole Data: Depth (ft)
Soil Type, Thickness & Water Strata From To
Stick up 0
2
Gravel 2
6
Clay 6
45
Gravel/boulders/water 45
60
jTY T OmL
liwm e L
mtrates ug L
Arw TP,
Well Pump Installation: Pump Intake Depth
Brand: Model:
Size: HP
Drop Pipe Type: Drop Pipe Size:
Comments:
Installer: Date:
in.
R
Pump Installation Log Only: ❑
Borough: Anchorage
T: R: Section:
Method of Drilling ❑✓ air rotary ❑ cable tool
Casing type: Steel A53B Well Depth: 60 feet
Wall Thickness: -25
Diameter: 6 inches Casing Depth: 59
Liner Type: Diameter: 6 inches
Liner Start: feet Stop: feet
Casing stickup above ground: 2 feet
Static water level (from top of casing): 28 feet
Pumping level: feet after ❑Artesian Well
hours pumping gpm
Recovery Rate: !L—gpm
Method of Testing: Air
Well intake Opening Type:
❑✓ Open End ❑ Open Hole
❑ Screened Start feet Stopped feet
Type:
❑ Perforated Start feet Stopped feet
Type:
Gravel Packed: ❑Yes ❑No
Grout Type: wen sear Volume: 2-501bbege
Depth: Start feet Stopped feet
Well Disinfected Upon Completion? ❑Yes [—]No
Method of Disinfection:
Comments:
Driller/Installer: Frank Meyer
Signed:
Date: 12/07/21
YELLS;
w.r
Pump Log
6830 E Green Glen Dr. Phone: 907-795-2531
Wasilla,AK99654 E-mail: carin@akelearwatenvells.com
www.alaskaclearwaterwells.com
Date Started: 03(24122 Date Completed: 03124122
Legal Description: The Cascades Tract A Borough: Anchorage
Site Address: 2451 West River Dr.
Property Owner: Colony Builders Owner Address:
Well Depth: 60 ft. Static Water Level: 28 ft.
Recovery Rate:1m
Pump Intake Depth: 53 ft
Pump Brand: Myers Model: 3NFL52-12-P4-02 Size: 112 HP 10
Serial Number, 8752928
Drop Pipe Type: PUC Drop Pipe Size: 1 in.
Comments:
Meyer
Pump Installer: Rusty y Signed:
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: OSP221056
Work Type: WellSeptic Renewal
Tax Code Number: 07816113000
Site Legal Address: THE CASCADES TRACT A G:0959
Site Mailing Address: 2451 WEST RIVER DR, Eagle River
Owner: COLONY BUILDERS INC
Design Engineer: FORGE ENGINEERING
This permit is for the construction of:
Effective Date:
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
cnr
t.�Cl)�I'CRICllf
3/15/2022
3/15/2023
144975
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
Veronica Pope
CiE 2022.03.15
15:12:06 -08'00'
Received By: � �
Issued By: la� I Ka��
Date: 7n
Date: % ,2,Q -2-2
4
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 078-161-13
Property owner(s) SNS Holdings, LLC
Mailing address 375 E. 76th Avenue Anchorage, AK 99518
Site address NHN West River Drive Eagle River, AK
Day phone 345-0371
Legal description (Sub'd., Block & Lot) The Cascades, Tract A
Legal description (Township, Range & Section)
Lot Size 144,975 Sq. Ft. Number of Bedrooms Four
APPLICATION IS FOR:
(® all that apply)
Absorption Field ❑X
Septic Tank
❑X
Holding Tank
❑
Privy
❑
Private Well
❑X
Water Storage
❑
APPLICATION IS AN:
Initial
❑
Upgrade
❑
Renewal
❑X
TYPE OF DWELLING:
Single Family (SF)
(w/wo ADU)
Duplex (D)
Multiple Dwellings
(SF and/or D)
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Distance: 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: 1 L( 5
Date of Payment: �� `� a 09 a
Receipt Number:
Permit No. O S P12a 1
Permit App_::- : :-'.,:c
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
March 11, 2022
MOA Development Services Dept, On -Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: The Cascades, Tract A — NHN West River Drive
Septic System Permit Renewal
Dear On -Site Services Engineer:
The permit for the construction of a well and septic system_ on Tract A, Cascades Subdivision has
expired. A site visit was conducted and other than the house being built, there have been no
substantial changes to this lot or to the surrounding area since the permit was originally issued.
The current design and permit conditions meet all code requirements. We therefore request the
renewal of the permit for the well and septic system on this lot.
Sincerely,
Michael E. Anderson, PE
11.20.20
PO BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
November 19, 2020
MOA Development Services Dept, On-Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: The Cascades, Tract A – NHN West River Drive
Septic System Design
Dear On-Site Services Engineer:
The owner of the above lot intends to build a 4-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 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.
The ground surface on the lot slopes to the northeast at grades approaching. There are no slopes
greater than 25% within 35 feet downslope of either the primary or alternate site. Field
measurements indicate the slopes exceed 25% at 44’ from the edge of the proposed absorption
trench. Ground surface contours are shown on the site plan indicating the grade and direction of
flow. Stormwater drainage will not impact this septic system. The new trenches will be constructed
parallel to the slope as much as possible.
The absorption trench will be constructed utilizing engineered receiving soils in conformance with
Section 15.65.210D3c and the attached design documents. The absorption trench will be utilized
in association with an Advantex Treatment System with an AX-20 pod and pump vault. The
system will be 50’ from the well on this and adj acent lots.
Please refer to the attached test hole logs, soils lab analysis, plan and profile sheets for the septic
design. If this design is followed, there will be no adverse impacts to adj acent properties.
Sincerely,
Michael E. Anderson, PE
11/19/20
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201372, Rebecca Carroll, 11/20/20
1"=100'
NOTE:
NO SLOPES >25% WITHIN 35' 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
THE CASCADES, TRACT A
WE
S
T
R
I
V
E
R
D
R
I
V
E
11/19/20 FEET
0 100 200
20' DRAINAGE EASEMENT
THREAD OF SOUTHFORK
EAGLE RIVER MEANDER LINE
25' PUBLIC ACCESS EASEMENT
15' T&E EASEMENT
100' SEPTIC SETBACK 50'
CREEK MAI
NTENANCE ESMT25'
CROSS COUNTRY SKI
&EQUESTRI
AN TRAI
L ESMT17901785178017751805MT
MT
MT
MT
ALTERNATE SITE
2-60' LONG x 5' WIDE x .5'
EFFECTIVE DEPTH
ABSORPTION TRENCHES
1,500-GALLON ADVANTEX TANK w/ AX20
FILTER POD & PUMP VAULT.
GROUNDWATER IS PRESENT. SECURE
TANK AND PUMP VAULT TO PREVENT
FLOTATION IN ACCORDANCE WITH
MANUFACTURER'S INSTRUCTIONS.
PV
FCO
MH
MH
TOE OF 3:1 SLOPE
1770FOUR BEDROOM
HOME
PROPOSED WELL w/50' RADIUS.
CONSTRUCT A MINIMUM OF 25'
FROM ANY SUBSURFACE DRAIN.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201372, Rebecca Carroll, 11/20/20
THE CASCADES, TRACT A
DESIGN FACTORS: SYSTEM REQUIREMENTS:
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
11/19/20
600 GPD PEAK FLOW
PERK RATE: 80 MIN/IN
APPLICATION RATE: 1 GPD/SF
5' WIDE TRENCH SYSTEM w/ENGINEERED
RECEIVING SOILS
1,500-GAL FAP ADVANTEX TREATMENT SYSTEM
w/AX-20 FILTER POD & PUMP VAULT
DRAINFIELD ROCK
5'
BOTTOM OF TRENCH: 2.0' ABOVE GRADE
FLOW LINE ELEVATION: 2'6" ABOVE GRADE
TOP OF TRENCH: 5.0' ABOVE GRADE
600 GPD / 1 GPD/SF /5' WIDE = 120 LF TRENCH REQUIRED (120 LF SPECIFIED)
6"
2'0"
6"
MOA APPROVED SAND1.0'
15-3/16" DIAMETER HOLES @ 4' SPACING
1.25" PERFORATED PVC (HOLES DOWN)
2" DIRECT BURY INSULATION
4" TOPSOIL & SEED
3:1 SLOPE
4" TOPSOIL & SEED
3:1 SLOPE
OG OG
2'
NOTE:
REMOVE ORGANIC MATERIAL TO UNDERLYING SILT. REPLACE↵
WITH MOA APPROVED SAND.
1.0'
TYPE IIA SELECT BACKFILL↵
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201372, Rebecca Carroll, 11/20/20
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)
T h e C a s c a d e s , T r a c t A
8 /1 9 /2 0 2 0
M a s o n J a k u b i s i n ⌥
DATE OF MONITORING:
WAS GROUND WATER ENCOUNTERED?
DEPTH TO WATER AFTER MONITORING:
IF YES @ WHAT DEPTH? 6 '⌥
80 --
2 3
0 7 8 -1 6 1 -1 3
C o l o n y B u i l d e r s ⌥
11:03
8/19
1
2
3
11:35
12:07
ORGANICS
Professional Engineers Stamp:
11/12/20
30
Y e s⌥
0'
1 0 /1 5 /2 0 ⌥
ML
1 0
16
30 7
16
30 6
16
0 / 1 0
16
0 / 7
16
0 / 6
16
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201372, Rebecca Carroll, 11/20/20
DEPARTMENT OF THE ARMY
ALASKA DISTRICT, U.S. ARMY CORPS OF ENGINEERS
REGULATORY DIVISION
P.O. BOX 6898
JBER, AK 99506-0898
November 3, 2020
Regulatory Division
POA-2020-00469
Colony Builders, Incorporated
Attention: Mr. William F. Taylor
9420 Vanguard Drive
Anchorage, Alaska 99507
Dear Mr. Taylor,
This letter responds to your September 28, 2020, request for a Department of the
Army (DA) jurisdictional determination for Tract A of Cascade Subdivision in Eagle
River. It has been assigned number POA-2020-00469, South Fork Eagle River,
which should be referred to in all correspondence with us. The subject parcel is
located on West River Drive in Eagle River, Alaska, at Latitude 61.2427º N.,
Longitude 149.4632º W.
Based on our review of the information you provided and our October 2, 2020, site
visit, we have determined that although the subject property may contain waters of the
United States (U.S.), including wetlands, the proposed home construction project would
take place within the parcel’s uplands, and would not involve a discharge of fill material
into waters of the U.S. Therefore, a DA permit is not required. However, a permit may
be required if you alter the method, scope, or location of your proposed work. You
should contact us if you make changes to your project.
Section 404 of the Clean Water Act requires that a DA permit be obtained for the
placement or discharge of dredged and/or fill material into waters of the U.S., including
jurisdictional wetlands (33 U.S.C. 1344). The Corps of Engineers (Corps) defines
wetlands as those areas that are inundated or saturated by surface or groundwater at
a frequency and duration sufficient to support, and under normal circumstances do
support, a prevalence of vegetation typically adapted for life in saturated soil conditions.
Section 10 of the Rivers and Harbors Act of 1899 requires that a DA permit be
obtained for structures or work in or affecting navigable waters of the U.S. (33 U.S.C.
403). Section 10 waters are those waters subject to the ebb and flow of the tide
shoreward to the Mean High Water Mark, and/or other waters identified by the Alaska
District.
-2-
Nothing in this letter excuses you from compliance with other Federal, State, or
local statutes, ordinances, or regulations.
Please contact me via email at: roberta.k.budnik@usace.army.mil, by mail at
the address above, by phone at (907) 753-2785, or toll free from within Alaska at
(800) 478-2712, if you have questions. For more information about the Regulatory
Program, please visit our website at: www.poa.usace.army.mil/Missions/Regulatory.
Sincerely,
Roberta K. Budnik
Project Manager
LI V LJ U I! V U P A L� TV OF A !1 V CH O CI U,\ G 77 u5H
Development Services Department -907 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 078-161-13
Expiration Date: D / — ZZ
1. GENERAL INFORMATION
Complete legal description The Cascades Tract A
Location (site address) NHN West River Dr, Eagle River, AK 99577
Current property owner(s) SNS Holdings LLC Day phone (907)345-0371
Mailing address 375 E 76th Ave, Anchorage, AK 99518
Real estate agent
2. TYPE OF DWELLING:
Q 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
Q
Private Septic
Q
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.
COSA Fee $ 75 t '-f 5
Date of Payment �[� Z.
Receipt Number 079; t p
COSA#_ (SSC ZZ I l aO
Date:
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 (M.J.) Phone (907) 522-7773
Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503
Engineer's Printed Name Benjamin Schiller, P.E.
6. DSD SIGNATURE
System #1 Approved for 4
System_#2 Approved for _
Disapproved
Conditional approval for
bedrooms
bedrooms
Date 5/4/2022
4 OFq��i1
, :......
Ben)amin.Schiller %
�� ��� • CE 12592 • A/
��l.�J'Pn�• 5/4/22
bedrooms, with the following stipulations:
Jm WAST'=VVATER ?
SFRvVj\:
BY Original Certificate Date: G%— 27_
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: The Cascades Tract A
If more than 1 septic system on lot: COSA Checklist # of
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled 12/6/2021
Total depth 60 ft
Cased to 59 ft
❑® Sanitary seal is functioning correctly
0 Wires are properly protected
Casing height (above ground) 24 in.
Date of flow test for COSA 12/6/2021
Static water level at beginning of test 28 ft.
Comments Data from time of well drilling 12/6/2021
B. TANK DATA
Age of tank(s) NEW years
Tank type/material Advantex /Plastic
Measured operating fluid level in septic tank N/A
Standpipes/foundation cleanout per record drawing
Date of pumping NEW CONSTRUCTION
D. ABSORPTION FIELD DATA Mound System
Which system tested (date installed) 3/17/22
❑® ALL standpipes present per record drawing
Total measured depth from grade 3.3 /aft (max)
Measured depth to pipe invert from grade ft (min)
R N/A — pressurized field
❑o Monitor tubes go to bottom of effective. If not, state
depth into effective
*1 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
Parcel ID: 078-161-13
Structure served by this system
Well production at time of test 15 gpm
Water storage tank volume N/A gallons
Well disinfected for coliform test? ❑ Yes ❑ N
❑® Coliform bacteria is Negative
Nitrate 0.261 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L M Arsenic less than MRL (ND)
Collected by Forge Engineering
Date of Sample 4/26/2022
C. LIFT STATION
❑® Required maintenance completed
Age of lift station NEW years
Lift station material Plastic
Comments: Pump Vault for Advantex
Adequacy test date New System
ults p Pass For
bedrooms
Fluid d h prior to test in
Water adde gal
New depth
Elapsed time ml
Final fluid depth in
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'
>50
Community Sewer Manhole/Cleanout > 100'
❑ Yes
if No
ft
M Yes
if No ft
Neighboring Tank > 100' ❑✓ Yes
if No
ft
Private Sewer/Septic Line > 25' [✓ Yes
if No ft
Absorption Field on Lot > 100' ❑ Yes
if No
>50 ft
Holding Tank > 100' ❑✓ Yes
if No ft
Neighboring Absorption Fields > 100'
ft
Community Wells > 200'
Animal Containment > 50' ❑✓ Yes
if No ft
❑✓ Yes
if No
ft
if No
ft
If septic tank is under driveway comment below
From Absorption Field on
Manure/Animal Excreta Storage > 100'
if
Community Sewer Main > 75' [D Yes
if No
ft
❑✓ Yes
if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10' ❑✓ Yes if No I ft Surface Water > 100' ❑ Yes if No >50 ft
Property Line > 5'✓❑
Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5'
❑✓
Yes
if No
ft
Private Wells > 100'
❑ Yes if No >50
ft
Water Main.> 1U..
❑
Yes.
Jf No.,
ft
Community Wells > 200'
F71 -Yes if.No
ft
Water Service Line > 10'
❑✓
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.-
ots:Water
WaterMain > 10'✓❑
Yes
, if No
ft
Private Wells > 100'
❑ Yes if No >50
ft
Water Service Line > 10'
❑✓
Yes
if No
ft
Community Wells > 200'
❑✓ Yes if No
ft
Surface Water > 100' ❑ Yes if No >50 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
OF A IL
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• Benjarrir5chiller
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,MUNICIPALITY OFA CHORALE
ADVANCED NN,ASTENN"ATER'I'REAI'iZ1EN'I' SI'STEN't
MAINTENANCE AND REPAIR AGREEMENT
THIS N-1AINTENANCE AND REPAIR AGREEiVIENT, herein the "AGRI I_'\1FN'l"' made and
entered into as of this `� Da} of 141v t of 20 2- L by and between
herein the -'0W\ER.'' and the Nelunicipalivy of.
Anchorage. herein the "MUN1CIPAL.ITY—. in accordance vvIth Anchorage Municipal Code
(AMC) 15.6-5.365. In consideration of the mutual covenants contained herein. the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Svstems. The Municipality grants permission to the
Owner to utilize and operate an Advanced � astcwater Treatment System (AkV\VTS).
described as Advantex Waste Water Treatment
located at (legal description)
The Cascades Tract A
1 Maintenarice, Repairs and Alterations.
((.owner is required to read, understand and initial each section)
Throughout the terns of this Agreement. the Owner shall enter into a service agreement
with an A` Nk"TS service and maintenance provider approved by the Municipality or the
manufacturer's rep1ese111at1ve. The he maintained in a satisfactory
condition capable of performing as designed a.ld producinS-1 treated septic effluent in
accordance with the equipmeriCs approval for operation in the. Municipality.
It shall 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 rr.aintenance fee (typically 5400 to 5600).
rtOwner agrees that only maintenance and repair personnel approved by the l'lunicipality
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 .1W\N, %TS reduces the potential
failure 01'111C system. which could include sewage backup and costly repairs or drainfield
replacement.
(rev. 05/15,12-2018) Page 1 of
Owner ackntnvledges that the Municipality may request records of maintenance and
repairs from the mantrlirctiner's rcpresentative or maintenance provider.
Owner acknowled<zes that the Iine for fading to maintain and repair an :�yl� W TS may be
assessed in accordance with ANIC 1=4.60.030.
Owner agrees to the-Municipaiitw reasonable access to test and inspect the
AkV TS. The \`Iunrc ipality° �� ill 2tve at least ?-4-horn notice.
Owner agrees that ani sale or transfer of title o the property will not occur without a :relw
Certificate of Cin -Site Systems approval.
Owner agrees that the AW117TS installation and maintenance requirements as provided
by the MVll TS vendor/installer and approved by the, ,Municipality are the novernitrg
guidelines for the Construction, maintenance and repair of the 0wner's AWWTS.
Owner agrees to maintain remote monitoring of the AWW7TS as required by the
A11''WTS approval,
Term. The term of this Agreement shall begin on the date of approval bythe
mmlicipality to operate the installed system. oi- upon transfer of title. and shall continue
yvhile the AW W"I'S is operational or until title is transferred.
=4. :Nornvaiver.The failure of the Municipality at any time to enforce a provision of this
Agreement shall lir no «,'aw constitute a waiver of the provisions. nor in any way affect
the validity of the Agreement orally hart hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
�. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and N-lunicipalin=. Any attempt to amend this agreement by either an
urrautllorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice ofLaw. Any civil action arising From this Agreement shall be
brought in the Superior Court for the Third Judicial District of tile State of Alaska at
Anchorage. The laws of the state of Alaska shall govern the rights and obligations ofthe
parties under this A(Yreement.
?. Severabilihr. Argy- provisions of this Agreement decreed invalid by a court of competent
lurisdietion shall not invalidate the remaining provisions of the .Agreement.
(rev. 05/18/2018) Page 2 of 3
OWNER:
Bv:
041'gnaturc) Date:
�j•(O w� (print name)
NOTARY PUBLIC
TAMMY D. WATSON
STATE OF ALASKA ) STATE OF ALASKA
5S. AN COMMISSION EXPIRES January 17.2025
)
THIRD .R.JDICIAL DISTRICT )
The foregoina instrument was acknowledged before me thio ay of Y ,) f 1
0_a2Aby T -mm,,
NOTAM 1BLIC FOR ALASKA
My Commission expires:
MUNICIPALITY: „
����By:
(rev. 05/18/2018)
signature) Date: _
(1)rint name)
Title:
Page 3 of 3