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HomeMy WebLinkAboutHORIZON ESTATES LT 4Horizon Estates Lot 4 #051-324-24 Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP141297 PID Number: 051-324-24 Dwelling: X Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: X New ❑ Upgrade Name: Troy Davis Homes ABSORPTION FIELD 9 Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 165 E. Parks Hwy #200 Wasilla, AK 99654 ❑ Other Phone 357-9394 Number of Bedrooms Soil Rating Total depth from original grade 3 g GPD/SF 11.3 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3,3 Ft.8 Gravel depth beneath pipe SubdivisionBlock Lot Horizon.Estates 4 Ft. Fill added above original grade 0-1 Gravel length 38 Township Range Section F( Ft. Gravel width 3 Beds: Number of Lines Distance between lines SEPARATION DISTANCES Ft. Ft TO Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 608 Ft2 1 Ft. Well >100' >100' >100' NA >25' TANK (I Septic ❑ S.T.E,P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity 1,000 Gal. SurfaceWater >100' >100' >100' NA Material Number of compartments Lot Line >5 >10' >5' NA Steel Two NA Foundation >5' >10' >5' NA LIFT STATION Manufacturer Capacity Curtain Drain None - Noted Gal. Remarks Pump on level at in. Pump off level at in. High water alarm at in. - Pump make and model Electrical Inspections performed by Installer Tank to PIPE MATERIAL House to tank D3034 dran eld D3034 Northern Excavation Drainfleld D3034 co/MT Inspector A. Harala BENCH MARK (Assumed elevation) 100.0 ft Inspection dates: 1M 8/21 /14 Location and description 2-8/21/14 3r° 9/5/14 41"- Garage Slab. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL 'RPV' !a OF 44 llso Conditional Approval: Date �P' 9 so ' 49TH ± $0.... ....... . . i.................. ................ �MlcHAEL E. ANDERSON �: CE - 4381 Approved Date j a j 1�,,►'a IncncrYYv.n oe.....a o_n_ ,. Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 Permit Number: OSPI41297 LOT 3 LOT 12 S89056'55'E 130.11 _ +UTILITY EASEMENT 17.60 12,40 HORIZON ESTATES LOT 4 40,028 SF 11 Page 2 of 3 PID No. 051-324-24 LOT 5 77 CD 0 9 C5 0 C:) CD TH9A Mi 0 P; TH9 ® C4 51 A S2 Alternate M - CJ Site W CD A B V Co / -4 S7 33.8' 42.2' C4 45.4' 38.6' FCO CS 60.4• 71.4' M7 50.4' 53.8' THREE BEDROOM HOME Well ® LEGEND .�-\E OF ,��♦ ;D(A•r ti� ��jm M1 — FCO Monitor Tube —Foundation .• . ,,... •+ a, o . 1 {•� F` _ Clean Out Test j C1 _ CleanHole ' 15' T & E ESMT, "`�" Out n. N89058'28"W 130.11 MICHAEL E. ANDERSON fs No . CE -4381 I O MULDROW STREET l 2..... /S�.,P�� =ice Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: OSP141297 94.1-I 1,000 Gallon Septic Tank PID No. 051-324-24 rn U I U -I O-'13 36' (Trench Length) PROFILE AS -BUILT No Scale MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 DEPTH (feet) 1- 2 3 4 5 6 7 9 10- 11 12- 13- 14- 15- 16- 17- 18- 19 - SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: LOT 4, HORIZON SUBDIVISION PERFORMED FOR: TROY DAVIS HOMES DATE: 10/10/13 PROJECT No.: PARCEL ID#: TECHNICIAN: A. HARALA TEST HOLE 10 OB/OG A m SILTY GRAVEL WITH SAND d GM �4�xL-4.r9..t.,h,pyr!^Lf •'* ........ICHA............... RS0I...... Q, :• XICXaEL E. aNBERSON y % No. CE -4381 eN' N Professional Eneinee,s Stamo: SITE PLAN SEE SITE PLAN Y S WAS GROUND WATER ENCOUNTERED? NO IF YES @ WHAT DEPTH? DEPTH OF WATER AFTER MONITORING: NONE 2% DATE OF MONITORING: 10/17/13 d O ° DENSE a ° a ° BOH @ 17.5' DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH TO WATER (INCHES) NET DROP (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 10/10 1 14:44 6.56" 2 15:14 30 9.25" 2.69" 3 15:15 6.63" 4 15:45 30 9.75' 2.63" 5 15:46 6.50" 6 1 16:16 30 9.19" 2.69" PERCOLATION RATE:I 1 (MIN/INCH) PERC. HOLE DIA. 611 (INCHES) TEST RUN BETWEEN: 4.5 FT. and 5.5 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 10120113 Sep.10.2024 04:08 PM PAGE. 1j 2 ACE WAVER WELL DRILLING A subsidiary ofACE Yenfures, Inc. P.O. Box 520090 116? N. Knapp Dr Big lake, Ak. 99652 (907) 357.7987 fax (907) 376-7987 (907) 354-1398 cell Well Owner Trop Davis Homes Use of Well: Domestic Locations Lot 4 Horizon Estates — Cagle River Date of Completion: 08126!2014 Job # 14-07 Drilling Method: Air notary Size orCasing; 6" Depth of bole: 215 feet Cased tot 103 reef Static Water Level; 22 feet below mpofoaaing, Finish of Wall ( ) Open End { } GrouYSeal (X) Screer&iner ( X) laarf0rmed Describe screen, seal, or perforation: PVC liner set rtvm 325 to 103 feat Perforated frotn 8S to 63 feet and from $0 to 90 feet Bentonite sutiace greet seal, Well Pumping Test at 2,5 Gallons per ( ) hour (x ) minute. Suggested Pump Setting dopth: 210 feat from top of casing. Method of disinfection: Chlorine tablets Depth in feet from casing to Details of Formationsisizeicolor{ etc 0 to 3 feet Stick u 3 to 53 feet 53 to 60 feet Sit avel Sil sand avel 60 to 92 feet Cemented vet — Wal 92 to 175 feet Sandstone bedrock P75 to 178 feet Coal water 178 to 225 feet Sandstone bedrock Driller Signatl,rL2. LZ—' hate: � %� Ace Water ' t Box 520M Big Lake, Ak. 99652 (9071376-7987 Well Owner: Troy Davis Homes Job# P 14-07 Installation Date: 10/2312014 Legal Description: tot 4 Horizon — Eagle River Pump Intake Depth: 182' feet below top of casing (TOC). Pump Manufacturer: Goulds Well Depth: 225' Model: Bruiser Size: '1x Horse Static: SN: K1353809 GPM: 5 GPM Pitless adapter buried depth, Disinfection method: Chlorine tablets Additional comments: Water Sample taken. ***Pump Saver Added. Well is dirty — needs to be pumped. control box at bottom of stairs in crawlspace on footing, Installer signature, 4 All Date I [ JzkQ 'It -4 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: LOT 4, HORIZON SUBDIVISION PERFORMED FOR: TROY DAMS HOME DATE: 8/21/14 PROJECT No.: PARCEL ID#: TECHNICIAN: A. HARALA DEPTH TEST HOLE 9A (feet) 1 2 3 4 5 6 7 8 9 11 12 13 14 17 1 COMMENTS: OB/OG SILTY GRAVEL WITH SAND GM BOH @ 5' WAS GROUND WATER ENCOUNTERED? NO IF YES @ WHAT DEPTH OF WATER AFTER MOM DATE OF MO HOLE PRE SOAKED PRIOR TO MICHAEL E. ANDERSON Pw&.i... I SITE PLAN SEE SITE PLAN k t z DEPTH? TORING: NITORING: 2% DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH To (INCHES) WATER NET DROP (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 8/21 1 8:12 1.75" 2 8:42 30 4.75" 3.00" 3 8:43 1.63" 4 9:13 30 4.63" 3.00" 5 9:14 1.75" 6 9:44 30 4.75' 3.00" PERCOLATIONRATE:10 (MIN/INCH) PERC.HOLE DIA.. 6�� (INCHES) TEST RUN BETWEEN: 5.0 FT. and 6.0 FT. TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 10/20/13 On -Site Water & Wastewater System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP141297 Tax Code Number: 05132424000 Work Type: WellSeptic Initial Permit Effective Dates: August 14, 2014 to August 14, 2015 Design Engineer: ANDERSON ENGINEERING Subdivision: HORIZON ESTATES Site Legal Address: HORIZON ESTATES LT 4 G:0553 Owner/Address: TROY DAVIS HOMES INC 165 E PARKS HIGHWAY STE 200 WASILLA AK 996540000 Site Mailing Address: 18189 MULDROW ST, Eagle River Lot Size in Sq Ft: 40043 Total Bedrooms: 3 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy Y Private Well N Water Storage All construction must 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 must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By: MUNICIPALITY OF Community Development Department Development Services Division 6 On -Site Water & Wastewater Program e- e � , ON-SITE SEWER/WELL PERMIT APPLICATION t .,. ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 Parcel I.D. 05 �- "-:Zq Property owner(s) Troy Davis Homes Day phone 310-2501 Mailing address 165 E. Parks Highway #200 Wasilla, AK 99654 Site address Fish Hatchery Road Eagle River, AK 99577 Legal description (Sub'd., Block & Lot) Horizon Estates, Lot 4 Legal description (Township, Range & Section) Lot Size 40,028 Sq. Ft. APPLICATION IS FOR: (® all that apply) Number of Bedrooms Three APPLICATION IS AN: TYPE OF DWELLING: Absorption Field ❑x Initial Septic Tank ❑x Upgrade Holding Tank ❑ Renewal Privy ❑ Private Well ❑X Water Storage ❑ ❑X Single Family (SF) ❑ (wlwo ADU) Duplex (D) El Multiple Dwellings SUBMITTA F and/or D) AUG 1 2014 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 Permit/Rush Fees: SbR' 2t5- = 78y' Date of Payment: I 11 y C`` - Receipt Number: O,0co4 t% Permit No. 05 f 14 aAl � sh AAj`«g i21142f Permit App_ ;1L:.:c. Il^7 6 Waiver Fees: _ Date of Payment: Receipt Number: Waiver No. ❑X July 31, 2014 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 4, Horizon Estates Subdivision Septic System Design and Perm it.Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 4, Horizon Estates Subdivision intends to construct a new three- bedroom home on the lot. We are requesting a permit be issued for the construction of a new well and septic system to accommodate the home. The attached Site Plan and backup documentation identify the location and configuration of the proposed well and septic system along with the alternate site. Also identified on the plans are the proposed and existing wells in the area and septic systems on surrounding lots. No conflicts exist between the proposed septic system and the well or septic systems and wells on adjacent lots. Drainage arrows and ground contours are shown on the site plan showing the grade and direction of flow on the lot. The drainage pattern will not be changed as a result of this project. The test holes placed on the lot indicated silty gravel with sand (GM). The percolation rate of the soil was determined to be 6 to 15 minutes per inch. No groundwater was found during the placement of the test holes and none was noted during the monitoring period. An application rate of .8 gallons per day per square foot was used in the design of the absorption system. We are proposing to place a new 1,000 -gallon septic tank and a 36' long by 3' wide by 8' effective depth absorption trench to treat and dispose of the effluent generated in the house. The elevation of the distribution line in the absorption trench will be 2.5' below the surface and the total depth will be 10.5'. A minimum of 3' of fill or 2 of insulation and 2' of fill will be placed over the absorption trench and 4' over the septic tank. The ground surface on the lot in the area of the septic system slopes to the north and northwest at a shallow grade with some cross sloping from the east. The new trenches will be constructed parallel with the contours of the slope as much as possible in conformance with Municipal requirements. The new septic system will be constructed a minimum of 100' from all wells and any surface water and 10' the proposed and existing water services in the area. Lot 4, Horizon Estates August 1, 2014 Page Two If the system is constructed in accordance with our design the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments e 49th MICHAEL E. ANDERSON No. CE -4351 11, 0 0 J IHHZIZS VNIdSVrIVW i z w � I " r 1N3NGSV3 ONIN3380S X �i F ` ( N00°02'30"W 299.72 yI � NpISwQ8 �S8 Gad�J ArpISN�t{p8$ /a �I 6-�l mxaxma.ownx. : a w ♦�� .• ON ; ' a Z Vo LOT 3 CONTOUR INTERVAL — 2' / Proposed Well® / % F �49th W •E ;MICHAEL E. ANDERSON ✓f�:, NO. CE -4381 1 '55"E 130, 1'I1-ITY ESMT. HORIZON TA - OT 4 40,028 SF 0 W Alternate Site ® 36' Long x 3" ide ` THIO 0 x 8' Effec' a Depth \\ TH8 0 Absorpti Trench MT 1,000 ollon SV 2CO LOT 5 Septic ark SV YCD / TH EE BEDROOM / HOME v°tt �s"`;...i5 1 I Prop sed vX,4 , I W I® D_ . T & E ESMT. N 8 9 5y 2 °W 130.11 MU"OW ST EET LEGEND \ MT - Monitor Tube FCO - Foundation Clean Out Hole SITE PLAN CO Clea -Clean Out FSV -Flow Splitter Valve FS SCALE 1" = 40' LOT 4, HORIZON ESTATES SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Three Bedroom Home Deep Trench System Perc. Rate: 6-15 Min./Inch 1,000 Gallon Septic Tank Application Rate: .8 GPD/SF 8' Drainfield Rock 3 Bedrooms X 150 GPD/.8 GPD/SF (Application Rate) = 562.5 SF Absorption Area 562.5 SF/16 SF/LF = 35.16 LF Trench Length THEREFORE: Construct a 36' Long x 3' Wide x 8' Effective Depth Absorption Trench at the Location Shown. Flow Line Elevation in the Trench to be 2.5' Below Original Ground. Total Depth to Be 10.5' Below Existing Ground. Provide 4' of Cover Over Septic Tank and a Minimum of 3' Cover Over Absorpiton Trenches. Maintain 100' Separation from Wells in the Area. Natural Backfill 2'0" Geotextile Fabric 6., O 4" Perforated PVC (Holes Down) 8'0" 1 1 — ------ '-� Drainfield Rock 3' TYPICAL DEEP TRENCH SECTION �,.••oF (NO SCALE) •�p�E••• ^•� NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. �� •,••; „49th y� Minimum 4' Separation From Groundwater. r �vfr Glu Minimum 100' Separation From Wells in the Area. � m, MICHAEL E.nnoEasoN Minimum 100' Separation From Surface Water or Streams. If -p'.... No. CE -ase, MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 DEPTH (feet) I- 2 3 4- 5 - 6- 7 8- 9- 10- 11 12- 13- 14- 15- 16- 17- 18 - SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: LOT 4, HORIZON SUBDIVISION PERFORMED FOR: TROY DAVIS HOMES DATE: 10/10/13 PROJECT No.: PARCELID#: TECHNICIAN: A. HARALA TEST HOLE 9 �m OB/OG m SILTY GRAVEL WITH SAND a GM ° _ a ° DENSE a ° 0 ° BOH @ 17.5' 49th_ .'•. MICHAEL E. ANDERSON SITE PLAN SEE SITE PLAN L, i 9 a WAS GROUNDWATER ENCOUNTERED? —11-u — IF YES @ WHAT DEPTH? S DEPTH OF WATER AFTER MONITORING: NaNE O 2% DATE OF MONITORING: 10/17/13 0 DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH TO WATER (INCHES) NET DROP (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 10/10 1 13:39 5.94" 2 14:09 30 8.81" 2.88" 3 14:11 5.88" 4 14:41 30 8.81" 2.93" 5 14:42 5.81" 6 15:12 30 8.81" 3.00" PERCOLATION RATE: 10 (MIN/INCH) PERC. HOLE DIA.-6L(INCHES) TEST RUN BETWEEN: 4.5 FT. and 5.5 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATF.• 10/20/13 MUNICIPALITY OF ANCHORAGE .a Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-324-24 1. GENERAL INFORMATION Complete legal description Expiration Date:? -20 `2-2 HORIZON ESTATES LT 4 Location (site address) 18139 MULDROW ST Current property owner(s) HOOVER JOANN L Day phone Mailing address 12110 BUSINESS BLVD STE 6 EAGLE RIVER, AK 99577 Real estate agent 2. TYPE OF DWELLING: n Single Family (w/ o AD ) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic FxJ 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 $r5 50 Date of Payment r,- Receipt Number © / (,o- S -q D COSA# 05CP21 Qr73 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 Eklutna Engineering, LLC Phone 907.406.1058 Address 19162 Mountain Rd Chugiak AK 99567 Engineer's Printed Name Curtis Townsend, PE Date �� Z -V Z 2 OF A(q���� 49 TH 6. DSD SIGNATURE A ... ... System #1 Approved for bedrooms t� • wnsaod'W a i`�s�fa ip 1•• Date Z 20Z� O System #2 Approved for bedrooms ��F�,,lF .No.c 11.. ����Aw Disapproved Conditional approval for bedrooms, with the following stipulations: .�►lllltt((((((fi�, By: Original Certificate Date: -6 - Z0 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: HORIZON ESTATES LT 4 Parcel ID: 05132424000 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 drille -2014 Total depth 225 ft Cased to 103 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) ' 24 in. Date of flow test for COSA 6IM022 Static water level at beginning of test 19 ft. Comments B. TANK DATA Age of tank(s) 8 years Tank type/material septic steel Measured operating fluid level in septic tank 50 ❑ Standpipes/foundation cleanout per record drawing Date of pumping 6/8/2022 D. ABSORPTION FIELD DATA Which system tested (date installed) 2014 WE ALL standpipes present per record drawing Total measured depth from grade 10.83 ft (max) Measured depth to pipe invert from grade 3.1 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective 7.7 Well production at time of test 4.2 gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 2.31 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Curtis Townsend Date of Sample W5=22 C. LIFT STATION ❑ Required maintenance com Age of lift stationy rt Lift station materiae Adequacy test date 613/2022 Results E Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 507 gal New depth 7 in Elapsed time 1320 min ❑ Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate '450 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) no date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet 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' if No ft Community Sewer Manhole/Cleanout > 100' ✓0 Yes if No ft M Yes if No ft Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' rv-71 Yes if No ft Absorption Field on Lot > 100' Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' ft Yes Animal Containment> 50' Yes if No ft El Yes if No ft Yes if No ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' M/Yes if No ft r-11 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' [✓, Yes if No ft Surface Water > 100' Q Yes if No ft Property Line > 5' 0✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5'L j✓ Yes if No ft Private Wells > 100' P/1 Yes if No ft Water Main > 10' ft Yes if No ft Community Wells > 200' ✓1 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' ✓D Yes if No ft If absorption field is under driveway comment below Property Line > 10' F/ Yes if No ft Wells on Adjacent Lots: Water Main > 10' Yes if No ft Private Wells > 100' Q Yes if No ft Water Service Line > 10' Yes if No ft Community Wells > 200' 0 Yes if No ft Surface Water > 100'[]✓ Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date.NENGINEERS to, TH ...... ice•,,,.,.,,, COSA Checklist yellow sheet tis L. rtwnsc d ,per• Q2te Is W. CE i'i� }@, 1 ^* hllyi .Mn. • Municipality of Anchorage On -Site Water and Wastewater Program rr� "z t1 (907)343-7904 s ' Certificate of On -Site Systems Approval Parcel I.D. 051-324-24 Expiration Date: Z`s l 1. GENERAL INFORMATION Complete legal description Horizon Estates, Lot 4 Location (site address) 18139 Muldrow Street Eagle River, AK 99577 Current Property owners) Troy Davis Homes, Inc. Day phone 357-9394. Mailing address 165 E. Parks Highway, No. 200 Wasilla, AK 99654 Real Estate Agent ?ay phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDPOOMS: Three 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual I] Individual Water. Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: ""' Received by: Date: COSA to be released to the engineer, unless ctheWse requested by the engineer. mom COSA Fee $ is 01, Waiver Fee $ Date of Payment _ �ZB� Date of Payment Receipt Number 077g76: Receipt Number COSA# o�c.�5/Oz a 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. Name of Firm Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 6. DSD SIGNATURE � 1/ System #1 Approved for 3 bedrooms m:hC"C AnorasoNe.�� a�� �T •o LE-tpi3t31 .� System #2 Approved for bedrooms Disapproved 111ttCOPESS a�4® Conditional approval for bedrooms, with the following stipulations: OF j/ n, / Cor.«t<d�nftti)in,,. By: &MAI .6171 `w f� l ac(drrey Original Certificate Date: The Municipality of Anchorage Devef6pment 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 Stale of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet ( :n c i2a w w t ® Lev i t_ -x®,; VA ® 91 -0 T& 11 E -'1i' Legal Description: `Hol'izon Estates, Lot 4 Parcel"ID:051-324-24 A. WELL DATA "• Well type iPrlUate IfA, B, or C provide PWS # Well Log (Y/N) Y Date completed 8261 Sanitary seal (YIN) y Wres properly protected (Y/N) Y Totaldepth 225 �'ft "" �Cased"to 1.Q ft. Casing height -(above ground) 8 � in. FROMMELL LOG AT INSPECTION Date of test " 8/26/14 Static water level 22 " Well proquciion. 2.5 g:p.m. g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL " Nitrate •436 mg/ Arsenic ND ug/L ' Date of sample: 1/13/15Collected by: 'AndersonEngrg. B. SEPTIC/HOLDING TANK DATA ptic/Steel Se Tank Type/Material! p Date installed 8/21 /1"4 '. Tank size 1,000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation.cleanout (Y/N), Y . Depression over tank (Y/N) High water alarm.(Y/N) N Date of pumpingeW Const. pumper C. ABSORPTION FIELD•DATA 8/21/14 i 8 GPD/SF Dee Trench Date,installed Soil rating (g.p.d./ft cr ft?/bdrm) _ System type P Length 3 "ft. Width 3 ft. Gravel below pipe 8.0 ft. 11=12 608,. z Total depth ft . - Ef . absorption.ar`ea: ft Monitoring tube Y Depression over.field N ` Date of adequacytest "NeV►t COCISt; Results (Pass/Fail). For bedrooms Fluid depth in absorption field before test in.:` Water added gal.New depth in., Elapsed Time min.: Final fluid depth in. Absorption rate >_ g.p.d Any rejuvenation treatment "(past,12 mo.) (Y/N* &type) N ` If yes, give date Lot 4 has PLASTIC CAP DETAIL SCALE: N.T.S ATOP ALL 5/8"X 36" RESAR SET OR FOUNDTHIS SURVEY N89°58'28"W 130.11 MULDROW STREET Recert Update and LotCorners Relreshed 06-15-2017 111109 GRAPHIC SCALE: 1 Inch = 60 Feet i 30 15 0 15 30 60 120 FOR: Joanne Hoover Date Scale Legal Description 10-22-14 1" = 60' FORBES& ASSOCIATES INC Grid AS-BUILT—SURVEY Lot 4 Block NW 453 2170615 HORIZON ESTATES P.O. BOX 232293 Anchorage, Alaska 99523 Drawn by Meld Book SUBDIVISION (90 7) 227-5881 cef 244 1 hereby certify that the property described hereon has been surveyed by me, or at my direction, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto unless otherwise shown. That no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other easements on said property except as shown. It is the responsibility of the owner or builder, prior to construction, to verify proposed building grade relative to finish grade and utility connections and to determine the existence of any easements, covenants or restrictions which do not appear on the recorded subdivision plat. Listed distances prevail over scaling. Reproduction may cause distortion. m ��.OF A�q X16 AM s*: 49TH ®�® ................................... 00 ® ...................................ye CHARLES E. FORBES o10 d�o �, B ®®sf•. LS -7326 ,• ��Ar ® �, •., 06-16-17.'S�� ®�8k ".0%essi0n0\\'_ I%,