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Home My WebLink AboutHIGHLAND TERRACE LT 6Highland Terrace Lot 6 #050-312-13 Municipality_ of Anchorage - - — -Ory-Site Water and Wastewater Program (907) 343-7904 Page ` of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: 05P13y3311 PID Number: 050 31Z-13 Dwelling: 2 Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ( New ❑ Upgrade Name: EW H a ABSORPTION FIELD Address Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound 1073r)r, N 1: 81_3L P: nR ❑ Other 7.2 GPD/SFJ 30 D pipe invert from original grade Gravel depth beneath pipe "1 cr h i Ft.] 'I Z SEPARATION DISTANCES I z Ft. — Ft. To From Septic Tank Absorption Field Lift Station Holding Tank Sewer Line Total absorption area 5X F1' Number of trenches I Dist. between trenches Ft. well 106+ JW4 TANK I@ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer 2 /�WIK Capacity 3S Gal. Surface Water NA Material FbL'rMf LEVE Number of compartments Z Lot Line 5 r (Ji 1 FoundationS* q 10} LIFT STATION Manufacturer /VA Capacity Gal. Curtain Drain 1 50+ 1 Sp+ 1 Remarks Pump on level at Pump off level at High water alarm at make and model jElectrical Inspections performed by PIPE MATERIAL Housetotank '"""`° Installer Ata$ drainfield 46$ S6NuETrER TTZrnGKi/✓6 Drainfield�� CO/MT °" Inspector PE7E7rhfE6/ky� BENCHMARK (Assumed elevation) ft Inspection Location and description dates: I";.-:? Zia Z—% 1 N c�C GO/�Nclz �� l ��ItiCj� 3id JO -j.4 0 COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Approval: Approved Date Date /1-3-/q CLEANOUT 1 (FOUNDATION) TANK CLEANOUT 1 MONITORING TUBE 1 TANK CLEANOUT 2 CLEANOUT 2 \ DOUBLE CLEANOUT 3 I CLEANOUT 5 MONITORING TUBE 2 CLEANOUT 4 �P2JALG(tADE 0 I � 0 I fo V fl7�.iGiNALGRRDE - 4-:70 2" INSULATION TRENCH PER DESIGN 6�}7 T i3oT�innOF: 7ES14C(E INVERT ELEVATION POINT I.E. DEPTH CLEANOUTI 97'-0" TANK INLET 99E" TANK OUTLET 96'-5"M0NITORING WELl1 CLEANOUT2 96'J" CLEANOUT3 96'-3"CLEANOUT4 78'-0" MONITORING TUBE 2 10'-0" CLEANOUTS 76'-0 NOTES: 1. REFERENCE ELEVATION IS 100'-0" AT SE CORNER OF HOUSE. 2. NO GROUNDWATER WAS PRESENT IN EITHER MONITORING TUBE. 3. DRAWING IS NOT TO SCALE. TITS DESIGN DRAWING No. HEWKO HOUSE DRAWN HIGHLAND TERRACE, LOT 6 AB2 AS-BUILTPROFILE PH DATE 10-31-2014 " 100' WELL RADIUS - WELL CLEANOUT 1 TANK CLEANOUT 1 POINT 1 MONITORING TUBE 1 POINT TANK CLEANOUT 2 CLEANOUT 2 - - - CLEANOUT 3 MONITORING TUBE 2 TH 2A 0.� TEST HOLE #1 TH 2 CLEANOUT 4 CLEANOUT 5 FUTURE ALTERNATE DRAINFIELD SWING TIES POINT MT1 metz TPNHG NGUT1 YO'd` 19'd' TMK CLE DIJT2 me za'.rc GI MT2 .I WT3 B1'-0' 3V-V CLEMWT• 73'ti' 81--V MONNCRINGTUW2 PW 19B'd' ML MT fl9'd` 111$ XWL Ill N9E94IX6 ASE N MEIFA@ e. O TIRE: DESIGN DRAWING No. HEWKO HOUSE DRAWN HIGHLAND TERRACE, LOT 6 q AB AS-BUILTPLAN PH 1 DAT 10-31/2014 ARCTIC PUMP & WELL INC. R r- Jim Sullivan PO sox 770197 eruusvn as Eagle River, AK 99577 crus e tt - (907) 688-2510 (907) 243-2282 Pump Installation Log Well Drilling Permit Number: osp121205 Parcel Identification Number: 05031213000 Date Of Issue: 9/2112012 Tuesday, September 10, 2013 Legal Description Highland Terrace L6 Property Owner Name Address: Peter Hewko Lot: 6 3831 Boek Cir Block: Anchorage AK 99507 Pump Installaion Date: 8/26/2013 Pump Intake Depth Below Top of Well Casing: 390 Feet Pump Manufacturer's Name Franklin Pump Model: 10JS1P4-2W230 Pump Size: 1 Pitless Adapter Burial Depth: 12 Feet Pitless Adapter Manufacturer's Name Harvard Pitless Adapter Installer: ulk Well Disinfected Upon Completion? Yes Method of Disinfection: Chlorine Comments: Pump Installer Name: Arctic Pump & Well, Inc. Tuesday, September 10, 2013 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: OSP131334 Tax Code Number: 05031213000 Work Type: Welseptic Permit Effective Dates: September 20, 2013 to September 20, 2014 Design Engineer: HEWKO" PETER D. Subdivision: HIGHLAND TERRACE Site Legal Address: HIGHLAND TERRACE LT 6 G:0155 Owner/Address: HEWKO PETER 3831 BOEK CIRCLE ANCHORAGE AK 995073059 Site Mailing Address: 19355 HIGH BLUFF DR, Eagle River Lot Size in Sq Ft: 74899 Total Bedrooms: 4 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. Special Provisions: The permit includes waiver OSP121317, allowing the drainfiled to be constructed on a 30 percent slope. Special Provisions: C01 revises the septic tank location. Special Provisions: PRIOR TO CONSTRUCTION: At least one of the test holes shall be deepened to substantiate there is no impermeable soil within 6 vertical feet of the bottom of the drainfield and 7 -Day groundwater monitoring shall be completed. If the results require a design change, an approved chnge order shall be issued prior to constructing the drainfield. '�Th:S ii a. vicetntwa) rlf t7S�1al�Of, Received By Issued By: I MUNICIPALITY OF ANCHORAGE e0k.-C 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 Parcell.D. 050-31_2-J3 Property owner(s) _I C� 9EWK0 Day phone 3q6 —1 Vit Mailing addre Site address Legal description (Sub'd., Block & Lot) �1T/i�� ,1 a 6 Legal description (Township, Range & Section) Lot Size _77W �W Sq. Ft. Number of Bedrooms APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field 91' Initial Single Family (SF) ❑ (wlwo ADU) Septic Tank Ell'Upgrade ElDuplex (D) ElHolding Tank ElRenewal Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Weil 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. of property owner or authorized agent) Permit/Rush Fees: NUFeP PPti I-og , Date ofd: �i I Ile 113 Receipt Number: Permit No. os i°13133`� Permit App_"-: - Waiver Fees: Date of Payment: Receipt Number: Waiver No. September 13, 2013 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Watewater Program PO Box 196650 Anchorage, Alaska 99519 Subject: Renewal of sewer/well permit for Highland Terrace, Lot 6 Dear Sir or Madam: I would like to request a renewal of the well and septic permit for Lot 6, Highland Terrace. There are no changes to the proposed system. If you have any questions, please contact me at 346-1616. Respectfully, Peter Hewko, PE 3831 Boek Cir Anchorage, AK 99507 Certified Drilling Log BILL Sc COLE OC CO dba �P.O.Box 670269, ULLIVAN91WATER WELLS, AK 99567 GBII-2759 OWNER OF LAND: Peter Hewko ADDRESS: 3831 Boek Circle Anchorage 99507 Bore Hole Data Depth From To LEGAL DESCRIPTION Highland Terrace Lot 6 DATE: 7/1/13 0 2 Casing Stickup PERMIT NUMBER: 121205 DATE OF ISSUE: 9/21/12 TAX IDENTIFICATION NUMBER 05031213000 Is well located at approved permit location: ® Yes ❑ No Method of Drilling: Zair rotary ❑ cable tool Depth of Well: 400ft Casing Type: Steel Wall thickness ,250 inches Diameter: 6 inches, depth 44ft Static Water Level: 42 feet Recovery Rate 5 ® gpm ❑ gph Method of Testing Well Intake Opening Type: ❑ open end ® open hole ❑Screened Start feet Stopped Grout Type: Bentonite Chip's Volume: Depth: from 0 feet, to 20 feet Well Disinfected Upon Completion: ® yes ❑ no Method of Disinfection: Chlorine 50PPM Comments: Well Hydrofraced 2 4 Overburden 4 21 Hardpan 21 43 Silty Sand & Gravel Tight 43 140 Bedrock Gray 140 260 Bedrock Green 260 307 Bedrock Gray w/ Quartz 307 320 Bedrock Green 320 345 Bedrock Gray w/ Quarts 345 400 Bedrock Gray 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. 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: OSP121205 Tax Code Number: 05031213000 Work Type: WellSeptic Initial Permit Effective Dates: September 21, 2012 to September 21, 2013 Design Engineer: HEWKO` PETER D. Subdivision: HIGHLAND TERRACE Site Legal Address: HIGHLAND TERRACE LT 6 G:0155 Owner/Address: HEWKO PETER 3831 BOEK CIRCLE ANCHORAGE AK 995073059 Site Mailing Address: 19355 HIGH BLUFF DR, Eagle River Lot Size in Sq Ft: 74899 Total Bedrooms: 4 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. Special Provisions: PRIOR TO CONSTRUCTION: At least one of the test holes shall be deepened Q to substantiate there is no impermeable soil within 6 vertical feet of the bottom of the drainfield and 7 -Day groundwater monitoring shall be completed. If the results require a design change, an the drainfield to be constructed on a 30 percent slope. Received Issued By: OIV406Q Kl- �j'3/�a Ctl+e 1c� s%evid kA q p dated }/3/i3•i.f- July 3, 2012 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Watewater Program PO Box 196650 Anchorage, Alaska 99519 Subject: Special Provisions of Permit OSP 121205 Dear Sir or Madam: In accordance with the special provisions of Permit OSP121205, an additional test hole was excavated adjacent to test hole 2. This test hole was excavated on June 25, 2013, to a depth of 16' (6' below bottom of drainfield). No impermeable layers were encountered, and no groundwater was observed. Ground water monitoring was conducted for 7 days from June 25 through July 2; no ground water was observed in the hole during this time. This additional information should satisfy the requirements of this special provision associated with this permit. If you have any questions, please contact me at 346-1616. Respectfully, Peter Hewko, PE 3831 Boek Cir Anchorage, AK 99507 Attachments: Soil Log Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www. ci.anchorage, ak.us (907) 343-7904 Soils Log - Percolation Test . . 6 W ././µ"1 V. y PCIER DAVID HIEV;10 �j�• NO. 1'aE'JJWT • �'w, Performed For: Peter Hewko Date Performed: 6/25/201 Legal Description: Lot 6, Highland Terrace Township, Range, Section: __2A Depth �1�t1<� DIZG't7VTy o 5rn w/G KAVEL 0 0 I 12- 13- 14- 15- 16 - 2-13- 14- 15- 16- a 17- 18- 19- L36 -10F FOO Site Plan WAS GROUND WATER ENCOUNTERED? NO 5 IF YES, AT WHAT DEPTH? N/A L Depth to Water After P P Monitoring? NONE E Date: 7/2/2013 PERCOLATION RATE (minuteslinch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS Test hole 2A excavated to verify separation to groundwater and impermeable layers. See test hole 2 for percolation test. PERFORMED BY: Peter Hewko i Peter Hewko CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 7/2/2013 Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http://www.muni.oM/Onsite Development Services Division On -Site Water and Wastewater Program pent 000"t""'10 **** VARIANCE/WAIVER REVIEW **** Waiver#: OSP121317 COSA#: Permit#:OSP121205 PID#:050-312-13 Legal Description: Highland Terrace, Lot 6 Engineer: Peter David Hewko, P.E. Applicant: Peter Hewko Your request for a waiver of the required 50 feet horizontal separation from the absorption field to the 25% or greater slope has been approved. The approved separation distance is 0.0 feet. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of non -objection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. ..................................................................... a......... Waiver is Granted: X Waiver is not Granted: Date: Cia 1/u Approved by: 'A_ Name of Reviewer ............................................•.................................. Rec#: 01558C Amount: $200.00 Date Paid: 9120/2012 **** VARIANCE/WAIVER REVIEW **** MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program Mayor Dan Sullivan ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel l.D.fp.W —3q-2 -y-5 +SY"'�\iC YOAAGd.Ct� Propertyowner(s) tlaETER HEwKO Dayphone 3H616f6 Mailing address 3632 r30EK LL2 A1i6µolzq6,, 4k 9951D9t Siteaddress 1.932-6 otK 9R- Lc !zWL_7-e Legal description (Sub'd., Block & Lot) N-LGHI-AAID Mm f;) A _ LoT f2 Legal description (Township, Range & Section) Lot Size jgjg9 Sq. Ft. Number of Bedrooms_ THIS APPLICATION IS FOR: THIS APPLICATION IS AN: (® all that apply) Absorption Field ® Initial Septic Tank [itj Upgrade ❑ Holding Tank ❑ Renewal ❑ Privy ❑ Private Well Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or Permit/Rush Fees: Waiver Fees: O =� Date of Payment: �`� Date of Payment: ct Receipt Number: Receipt Number: 0 1 5' S` C Permit No. 5 /�� (aUS Waiver No. OSpot I 13 f i G:\Building\On Site\Forms\Client Forms\Permil App_010411.doc (Rev. 1/11) September 20, 2012 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Watewater Program PO Box 196650 Anchorage, Alaska 99519 Subject: New sewer/well permit for Highland Terrace, Lot 6 Dear Sir or Madam: On June 10, 2011 two test holes were excavated on the subject property. Percolation test were performed at these locations on June 13, 2011. The results of these tests and water monitoring are attached. No groundwater has been observed in either hole at any point. We propose to install a 2' wide deep trench septic system on this property. The percolation rate for the test hole adjacent to the proposed primary drainfield is 5 min/inch, which is within the range allowed for a deep trench system. For the proposed 4 bedroom house and a 6' deep trench, a length of 42' is required ((4xl50/l.2)/(2x6)--41.7'). The system will have a minimum cover of 4'-0". The proposed site slopes 30%; a request for a slope waiver is attached. Due to system depth, we request a special provision to probe the test holes to 16' (6' below drainfield) prior to construction to verify separation to groundwater and impermeable layers. Probed holes will be monitored for groundwater for 7 days in accordance with AMC 15.65.06084. Based on well logs and test holes documented on Lot 5 (South), Lot 7 (West), and Lot 12 (East) of the site which show the nearest impermeable layer 20.5 to 37 feet below grade and no groundwater encountered to at least 15' below grade (the deepest test hole is on Lot 5 at 15' with no groundwater encountered), we do not anticipate encountering either groundwater or impermeable layers, however we understand that proceeding under a special provision is at our risk. The septic tank for the system will be a 1250 gallon insulated polyethylene tank. The system will be inspected by a registered engineer 1) when all excavation is completed, and 2) when the septic system is installed and the system is ready to be backfilled. The proposed well is West of the house and Northwest and uphill from the septic drainfield. There are no public or private wells or surface water within a 100' radius of the proposed location. There are no known curtain drains near the site. We do not expect that there will be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 346-1616. Respectfully, �V F '1� Peter Hewko, PE 3831 Bock Cir Anchorage, AK 99507 Attachments: On -Site Well and Sewer Application Request for Slope Waiver for Septic Disposal Field Site Plan and Absorption Field Detail Soil Log/ Percolation Test September 20, 2012 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Watewater Program PO Box 196650 Anchorage, Alaska 99519 Subject: Request for Slope Waiver for Septic Disposal Field at Highland Terrace, Lot 6 Dear Sir or Madam: We propose to install a 2' wide deep trench septic system on this property. The slope conditions on the site will not allow the wastewater disposal field to be located 50' horizontally up gradient from a change in slope to greater than 25%. We propose to install the disposal field in accordance with MOA memorandum dated April 7, 2004. Per this memorandum, a line at a 25% slope beginning 2.5' above the distribution pipe invert must intersect actual grade a minimum of 35' horizontally from the point 2.5' above the pipe invert. The proposed site slopes at 30%. We propose to locate the pipe invert 4'-0" below grade, which will cause the hypothetical line at 25% slope to intersect the actual slope 36'-0" horizontally from the point above the invert. This is shown on the wastewater disposal field trench section of the drawing. Based on the above, we request a slope waiver of zero (0) feet. If you have any questions, please contact me at 346-1616. Respectfully, F;tr_4�� Peter Hewko, PE 3831 Bock Cir Anchorage, AK 99507 i /. Tract C ^\\-,.Basis of Bearing �N8V56'00 -� "•'- / 300.02' PP C`40'_UTES� I =T', jN,� zea „53 I .; -250 • �- PROPOSED �•1.� `"• �`"�^-'t\I HOUSE 1 1 I � 540' 15 I -•, a _ I Lot? L PROPOSED 3 = A '�,� '" �• 8 GRAVEL t i •�.. �.� 1-. 1 i \ },� DRIVEWAY. `�pROPOSED SEPTIZ,"\ ALTERNATE SEPTIC `.Lot 6 � � •,..� �- _ \_ 6"y.SlA t, 78,222 S.F. 182.3'1 1.80 AC. Lot 12 PP 246,97, 50°00.1§•W LUFF E PP �OHE M _ O Finish Floor Elevation Upper-914.00' LEGEND Lower--902.00' O FOUND PLASTIC CAP ON REBAR �_ g / • FOUND 5/8- REBAR ='s Zone R-S Setback TEST PIT LOCATION -- comer Lot 0 50' 100' OF A� /1111 Front 50' Sides 25' Back 25' Vertical Datum is NAVD88 CORS(98), Geoid12 Survey Date Sept. 2012 • i * • lli Plot Plan Lot 6, Highland Terrace Subd., SE 1/4, NE 1/4, S 7, T14N, R1W, S.M. !.-'� I hereby certify that 1 have surveyed the i ..••• •• ••• . Del Norte Surveying, Inc. property shown and described hereon and that i9g • G GREER a`4- no visible encroachments exist except as i°i LS-8033 indicated. 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No Dense Depth -- Water Depth After Monitorino.None Datej 6/13/11 # Date Gross Time Net Time Depth Net Drop 1 6/13 0 -- 5.0' -- 2 6/13 10 10 min. 7,0' 2' 3 6/13 12 -- 5.0' -- 4 6/13 22 1 10 min. 7.0' 2' 5 6/13 25 -- 5.0' -- 6 6/13 35 10 min. 7,0' 2' 7 6/13 37 -- 5.0' -- 8 6/13 47 10 min. 7,0' 2' 9 6/13 1 50 -- 5.0' -- 10 6/13 1 60 1 10 min. 1 7,0' 1 2' 21 Percolation Rate 5 min./inch Perc Hole Diameter 6' Test Run Between 3' and 4' Comments PrPsnaked. Measurements made to nearest 1/16 inch. Performed By NorthRim Eng, I CERTIFY THAT THIS TEST WAS Performed in Accordance with All State/Municipal Guidelines in Effect ON THIS DATE. DATE; 6/10/11 NOR THRI M ENGINEERING PO Box 770724 Eagle Rlx .. Alaska 99577 907.694. 7025 'TESTH❑LE LOG GEOTECHNICAL T, H, 2 DOW 6/10/11 S❑ILS .a �N INEERING LOG - PERCOLATI❑N TEST Performed For; Peter Hewko Date Performech 6/10/11 Legat Descriptions Highland Terrace S/D, Lot 6 DEPTH (FEET) 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10 - 11 - 12 - 13 - 14 - 15 - 16 - 17 - 18 - 19 - 20 - Organic SM Silty Sand w/ Gravel Dense T,H, Location; East Test Hole Groundwater? No Depth -- Water Depth After Monitorina,None Date; 6/13/11 # Date Gross Time Net Time De th Net Drop 1 6/13 0 -- 5.5' -- 2 6/13 10 10 min. 7,0' 1.5' 3 6/13 12 -- 5,5' -- 4 6/13 22 1 10 min. 7,0' 1.5' 5 6/13 25 — 5.5' -- 6 6/13 35 10 min, 7,0' 1.5' 7 6/13 37 -- 5.5' -- 8 6/13 47 10 min. 7.0' 1.5' 9 6/13 50 -- 5.5' -- 10 6/13 60 10 min. 7.0' 1.5' 21 Percolation Rate 7 min./inch Perc Hole Diameter 6' Test Run Between 3' and 4' Comments; PrPsnakPd. MPasurementa made to nParPst 1/16 Inch, Performed By NnrthRim Fng, I igf CERTIFY THAT THIS TEST WAS Performed in Accordance with All State/Municipal Guidelines in Effect ON THIS DATE, DATE; 6/10/11 NOR THRIM syP�E..... '"�, TESTH❑LE LOG ENGINEERING•i •*• T, H. 1 PO Sox 770724 i'i '9'."''w'•'( .... Eagle fttwr, Alaska 99577 - 9O7.694.702B GEOTECHNICAL DOW' 6/10/11 r EPIRAI MUNICIPALITY OF ANCHORAGE Development Services Department ` Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 050-312-13 Certificate of On -Site Systems Approval Expiration Date: _1(-7-19 1. GENERAL INFORMATION Complete legal description Highland Terrace, Lot 6 Location (site address) 19355 High Bluff Drive, Eagle River, AK Current property owner(s) Peter HeWkO Day phone 907-691-5688 Mailing address 11935 Broadwater Dr, Eagle River, AK 99577 Real estate agent Day phone 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic 0 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 $ 515D Date of Payment V/ G Q Receipt Number d0LI690 COSA# 05Cl9135q 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 Michael E. Anderson, P.E. Date 7/31/19 6. DSD SIGNATURE 4— System #1 Approved for �' bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: ITY<<r(�(6i Com% WqTSITE c SrF� p -- m ter' p� GRAM r� GRA •J M �o )110 By: i �'`' Original Certificate Date: 17— The — 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: Highland Terrace, Lot 6 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 7/1/13 Total depth 400 ft Cased to 44 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 26 in. Date of flow test for COSA 7/24/19 Static water level at beginning of test 17 ft. Comments B. TANK DATA Age of tank(s) 5 years Tank type/material Septic/Plastic Measured operating fluid level in septic tank 55 ❑ Standpipes/foundation cleanout per record drawing Date of pumping 7/30/19 - JRs Pumping D. ABSORPTION FIELD DATA Deep Trench Which system tested (date installed) 1/7/14 ❑ ALL standpipes present per record drawing Total measured depth from grade 9.9 ft (max) Measured depth to pipe invert from grade 3.7 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 2,030 gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 050-312-13 Structure served by this system Well production at time of test 5.4 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 ❑ Arsenic less than MRL (ND) Collected by Forge Engineering Date of Sample 7/23/19 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: N/A Adequacy test date 7/24/19 Results ❑✓ Pass For 4 bedrooms Fluid depth prior to test 26.5 in Water added 1,169 gal New depth 54 in Elapsed time 1200 min Final fluid depth 24 in Absorption rate '600 gpd Any rejuvenation treatment (past 12 months) No 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' 0 Yes if No Community Sewer Manhole/Cleanout > 100' ✓Q Yes if No ft r7,/ Yes if No Neighboring Tank > 100' F/� Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No Absorption Field on Lot > 100' M Yes if No ft Holding Tank > 100' F,71 Yes if No Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' 0 Yes if No 7 Yes if No ft if No ft F. ENGINEER'S COMMENTS Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' F/� Yes if No ft 21 Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' F-/� Yes if No ft Surface Water > 100' ft ft ft ft ft F Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' El Yes if No ft Private Wells > 100' Fv Yes if No _ Water Main > 10' 0 Yes if No ft Community Wells > 200' 0✓ Yes if No_ Water Service Line > 10' F✓ 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' E] 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' 0 Yes if No ft Private Wells > 100' Yes if No Water Service Line > 10' Q✓ Yes if No ft Community Wells > 200' ❑✓ Yes if No Surface Water > 100' ✓� Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION certify that l have determined through field inspections and review '�;;:•" °i., of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date."`s` 49th MICHAEL E. ANDERSON No CE -4381 7/31/19 .*•°°Ct�r COSA Checklist yellow sheet •...,"'°"°°Y, f'VESSySt®. ft ft ft ft T/1 I'0=PI1jLda; ussaw�yI=lolaafoad�xoqu!/t/o/n/I!Lw/woo•a13oo2•lieuT//:sduq -51 t ISE � ;�` _`"' •r'� ! ' P p \ IN tion ot the Structure('s 8�00 n n this mord dr,a r $hilt a?l EES i I Sl thT' By; i� � ASSUILi SUTARD & ASSOCIATES LAI\TD SURVEYING 694--0829 1 HEREBY CEwniry THAT I HAVE SURVEY€`L) THERAT�L SCALE.� FOLLOWING DESCRIBED PROPERTY: OF A AND THAT €it6 EI�CR6ACH 6,V-"S, E)CIST iD(CEP1 A» � �� • •ter x INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER is RETE i�iEk tE Ti f EXISTENCE (P EKY d K Y , 4- W EASEMEf� TS, COVENANTS.. CR RESTRICTIONS GREP�' � y s WHICH DO NOT A FE R 0�� THE RECv^i�Dt� Si1Si7E- VISION PLAY". UNDER No CIRCUNESTANCES SE�iULb 'EB ANY DATA HEREON BE USED �'oR COEtit ai1�UCTEC}i� %x?� i� �? �� J LS 5 ,? z, OFFENCE LIMES; Cts FOR ES`�AE3LI rf-1IEt(G 80UI�ED- —D ARY LINES. RAWN, h, A'i�uo-•.+dm.d...,.....�.�,�,�m...wrw,�sz., ..w,..;�.�ar..maa�-..� 2df• I00 jpngsL-llnlq-g2iq 6l OZ/6i/L • Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 0-50-5J2-1-3 1. GENERAL INFORMATION Expiration Date: .2 - � /_�- Complete legal description F4_10IL-Ii D `ter L'. Location (site address) 1"%35C, iiSff130,iFF' L>r'? Current Property owner(s) Day phone _3 r1;; -ye?v Mailing address Real Estate Agent '3G - .5i l3OF K r i 1� f}n/LNORA . A K f /,W)l 2. TYPE OF DWELLING:. [�J' Single Family (w/wo ADU) ❑ Duplex ❑ Multiple. Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public M1 f, System ❑ Public Sewer ❑ WaiverNariancerequestfor: 5LoPE (>Z� T�r,2 �r-rI}N Zr5°'a Distance: " Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ 6' 'AD Waiver Fee $ _ Date of Payment Ct 2�l y C Date of Payment Receipt Number Receipt Number COS A# O aCAWi 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 add State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Phone Address Engineer's Printed Name BI t;L-11kO Date OFAt 6. DSD SIGNATUREi�'° t`d, System #1 Approved for bedrooms •* �// u a!_ l rt�yFi i; System #2 Approved for _bedrooms � • , � • � r, Disapprovedj _a,rNO.t..l..,t:...r Conditional approval for bedrooms, with the following �4+' jpions: o i r hi41";iiC;•;f ;i; :: jTi...... u. OF MTC :g WATER AND BY7 �ii/ / Original Certificate Date:_ 3 Th " uni pal7t of Drage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSH) 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 blue sheet ( - : c 6 If more than 1 septic system is on the lot: . COSA Checklist # 1 of 2 . Structure served by this system = Certificate of On -Site Systems Approval Checklist Legal Description: 41-6141 410n 71Z rM irk t.QTti Parcel ID: 050 A. WELL DATA Well type T171 V If A, B, or C provide PWSID # Well Log (Y/N) Date completed Sanitary seal (YIN) Wires properly protected (Y/N) Y _ Total depth �_ft. Cased to Casing height (above ground) ? `t . in. FROM WELL LOG AT INSPECTION Date of test -1-23 Static water level q'2- ft. ft. Well production 5 g,p.m, g.p.m. WATER SAMPLE RESULTS: Coliform A59Wcolonies/100 mL Nitrate V,: %% mg/L Arsenic 0433 ug/L Date of sample: &t Collected by: -fes !' PFwkO B. SEPTIC/HOLDING TANK DATA Tank Type/Material F7LVE7NV/ ENE Date installed 7--7 -2 q Tank size -1250 . gal. Number of Compartments z Cieanouts (Y/N) Foundation cleanout (YIN) rlonroccinn nvcr tanL NlAll w H1g t I (Y'N) Al ( ) �_ �r ��.� - -rte. • k •i i h wa er a arm , Date of pumping IVA -niBti Pumper C. ABSORPTION FIELD DATA Date installed rating (g.p.d./ftZ or ftZ/bdrm) -1,i System type TC6NCH Length k 2 ft. Width a ft. Gravel below pipe 6 ft Total depth 2 W ft. Eff. absorption area 200 ftZ Monitoring tube r Depression over field N Date of adequacy test ryR-1v6i✓ Results (Pass/Fail) For H 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) If yes, give date D. LIFT STATION Date installed 1v,4 - NONE Size in gallons Manhole/Access (YIN) "Pump on" level at in. "Pump off" level at in. High water alarm level at' in. Datum Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 10D* Absorption field on lot 100'r Public sewer main SVA Meets alarm & circuit requirements? On adjacent lots VO It On adjacent lotsO t Public sewer manhole/cleanout N'A Sewer /septic service line -100 1" Holding tank VQ Animal containment areas 49-106-t- Manurelanimal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 51 Property line 5-r Absorption field S t Water main A'A Water service line 0* 10- . Surface water 10a -f' Wells on adjacent lots 100 t ABSORPTION FIELD ON LOT TO: Property line 10 t Building foundation 10f Water main IV14 Water Service line Aft Surface water 100 4, Driveway, parking/vehicle storage 50 Curtain drain SOY. Wells on adjacent lots j0Q F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that t 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. Engineer's Printed Name tPl� Ht;Wkt? Date %-20 -1't COSA brown sheet 10-10-12.doc • 49TH sE•^ PETERDAVI :Eda q tffB F n cosy .n 4 ,9z