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HomeMy WebLinkAboutCHANDELLE ACRES LT 28Onsite File Chandelle Acres Lot 28 #051-822-07 tKev ub/uznts) Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211488 PID Number: 051-822-07 Dwelling: ❑■ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑■ New ❑ Upgrade Name David & Gayle White ABSORPTION FIELD ❑■ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 23915 Chandelle Drive ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 0.45 GPD/SF 6.5 / 9.5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 1.0/4.1 Ft. Gravel depth beneath pipe 5.5/5.5 Ft. Subdivision Block Lot Chandelle Acres 28 Fill added above original grade 3.6/0.5 Ft. Gravel length 61 / 61 Ft. Township Range Section Gravel width 3 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 1342 Ft2 2 14 Ft. Well >100' >100' N/A N/A NIA TANK X Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1250 Gal. Surface Water >1 00' >100' N/A N/A Material Number of compartments Lot Line >5' >10' N/A N/A NA Plastic 2 Foundation >10' >10' N/A N/A LIFT STATION Manufacturer Capacity Remarks Gal. Alarm location Electrical installed by PIPE MATERIAL House to tank D3034 Tank to drainfield D3034 Installer Little Dipper Excavating Drainfield D3034 cO/MTD3034 Inspector L. Tidwell BENCH MARK (Assumed elevation) 100 ft Inspdection 15` 8/3/22 8/4/22 Location and description 2nd 3'° 8/10/22 4`h Bottom of siding ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp OF ! q kk� Conditional Approval: Date .�,� ���Q�.•' 49 •* ��� imUr Septi S stem � ;• Benja Schiller Approved \ �-�—�;;d Date q_ 1�P -2Z +Ok��sjF9�, sii5z? • .����� lily PROFESSI0� Note: this approval does not include well permit requirements. ®�\®�1 tKev ub/uznts) CHANDELLE ACRES. LOT 28 MT4 C04 .c\ 1250 -GAL SEPTIC TANK W/ 20" MANWAY PID # 051-822-07 ',LONG x T WIDE, 5.5' ECTIVE DEPTH ABSO t I l t NEIGHBORING ON SEPTIC i LOT 29 NEW WELL !--- M D-- LLE D -RIS - `� r J / LOT 14 \ , NEIGHBORING SEPTICS NOT I,NiVIEW AND > 100' FROM WELL LOT 15 A B C ENGINEERING' ® v• f .49 TH '•.9 ` Benja i Schiller CE 2592 29� PLAN AS -BUILT 0 50 100 FEET 111=50' FCO 1.7 27.4 - MH1 33.2 15.0 66.0 SV1 38.2 17.5 66.5 2CO 41.0 19.2 66.6 FS 55.7 30.8 69.3 MT1 1 71.1 50.8 1 91.0 C01 70.7 51.0 92.4 MT2 - 30.8 35.8 CO2 - 32.1 34.9 MT3 - 53.6 47.0 CO3 - 5 . 1 45.6 MT4 87.4 65.0 98.8 C04 86.3 63.9 98.1 LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE CHANDELLE ACRES, LOT 28 PID # 051-822-07 U 89.8 FINISH GRADE 86.2 ORIGINAL GRADE 85.2 DRAINFIELD ROCK 85.2 79.9 79.7 80.3 61' TRENCH1 NO GROUNDWATER 11/30/21 69.2 ~ Ol- I- O U� 83.5 FINISH GRADE 83.0 ORIGINAL GRADE 2� U 79.0 79.0 DRAINFIELD ROCK 4 73.3 73.5 73.1 61' TRENCH 2 NO GROUNDWATER 11/30/21 1.9&. ��i1' 66.0 LN6INLERIHG PROFILE AS -BUILT (NO SCALE) '* 4®TM .��.. �• ••'•.B .• enja' Schiller ,•'•• '®�Fc CE 12592 VJhaz L'0n Wear AVYee �g'j54CC. 1190 N. Wasilla-Fish hook Road Wasilla, AK 99654 (907)376-2041 Name: Hultquist Homes, Inc Address: 12570 Old Seward Hwy #204 City: Anchorage State: AK Zip Code: 99515 Well Site: Chandelle Acres Lot/Block: L28 Additional: 23915 Chandelle Dr, Chugiak Well Depth: 208 ft. From: To: Formation: 0 55 silt/gravel/cobble Below Ground: 206 ft. 55 106 sand/gravel w/clay streaks Above Ground: 2 ft. 106 117 clay Gal/Min: 7117 121 gravel/silt 121 148 pea gravel Static Level: 172 ft. 148 155 sand 155 164 silt/gravel Casing: 208ft. of 6 in. x .25 in. steel 164 177 wet gravel/silt 177 199 clay/silt/sand Liner Pipe: N/A 199 203 gravel/sand/water 203 205 sand/water/gravel Screened: N/A 205 208 gravel/water/sand Perforated: N/A Grouted: Yes Depth: 20'+ WATER T'ES'1'9N0 Develop. Method: Air VITY ColsfOrm 4 C01/100ML Nitrates (V L Use of Well: Residential A'rseNc —ug/' Drilling Method: Rotary Misc: Other: Chlorinated to 50ppm The well was pumped 5' off the bottom with 100% draw down for 2 hours and recovered at 7gpm . Date Drilled: 2/9/2022 Driller: Brandon Moore Development Services Department Building Safety Division 7 tin -Site Water & Wastewater Program ggun 4700 Elmore Road P.O. Box 196650 d �� Mark Begich Anchorage, AK 99507 S A F E T Y Mayor www.muni.org/onsite (907)343-7904 Pump Installation Log Well Drilling Permit Number: SW OSP211488 Date of Issue: 12/14/2021 Parcel Identification Number: 051-822-07 Legal Description Property Owner Name & Address: Chandelle Acres Lt28 Hultquist Homes 23915 Chandell Dr 12570 Old Seward Hwy #204 Chugiak, AK Anchorage, AK 99515 Pump Installation Date: 8/25/22 Pump Intake Depth Below Top of Well Casing: 180' feet Pump Manufacturer's Name: Meyers Pump Model: 3NFL102-8-P4 Pump Size 1 hp Pitless Adapter Burial Depth: 13 feet Pitless Adapter Manufacturer's Name: Cambpell Pitless Adapter Installer: Unknown Well Disinfected Upon Completion? ✓❑ Yes ❑ No Method of Disinfection: Sterilene Comments: Pump Installer Name: Wheaton Water well, Inc. 1190 N. Wasilla-Fishhook Road Wasilla, AK 99654 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. 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 hftp://www.muni.org/onsite On -Site Water & Wastewater System Permit Permit Number: OSP211488 Work Type: WellSeptic Initial Tax Code Number: 05182207000 Site Legal Address: CHANDELLE ACRES LT 28 GA 560 Site Mailing Address: 23915 CHANDELLE DR, Chugiak Owner: WHITE DAVID L & GAYLE L Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date Expiration Date: i»en� O U ♦h t�epartrne�lt Lot Size in Sq Ft: Total Bedrooms: 12/14/2021 12/14/2022 49312 Q Disposal Field Cif 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 Com 1 c 1_Q . — - 1/31ZZ Received By: Date: _ Issued By:Date: 1:2 0 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 051-822-07 Property owner(s) Eklutna Inc. Day phone 907-310-2501 Mailing address 16515 Centerfield Drive #100, Eagle River, AK 99577 Site address NHN Chandelle Dr. Legal description (Sub'd., Block & Lot) Chandelle Acres Lot 28 Legal description (Township, Range & Section) Lot Size 49,312 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: (N all that apply) Absorption Field ❑X Septic Tank Q Holding Tank ❑ Privy ❑ Private Well ❑X Water Storage ❑ APPLICATION IS AN: Initial 0 Upgrade ❑ Renewal ❑ TYPE OF DWELLING: Single Family (SF) Q (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) 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. k (Signature of property owner or authorized agent) Permit/Rush Fees: 4 a 2 0 Waiver Fees: Date of Payment: I )-o� I Date of Payment: Receipt Number: 05; 1 014b Receipt Number: Permit No. 03 R2 11 ya3' Waiver No. Permit App_'-'- :- December 2, 2021 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 12/2/21 Subject: Chandelle Acres Lot 28 – NHN Chandelle 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, so we are submitting this permit application for the construction of a new well and septic system. The attached site plan identifies the location of the home as well as the proposed well, septic location and alternate site. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. The ground surface on the lot slopes toward the north. The slopes on the property within 100’ downgrade of the proposed absorption trenches do not exceed 46% and comply with the steep slope provision. The absorption trenches have been designed with steep slope guidelines in mind. Drainage arrows on the site plan show 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. Wells on this and adjacent lots are shown. The new system will be a minimum of 100’ from all wells and surface water, and more than 5’ away from the septic tank. The alternate site is located more than 12’ away. Please refer to the attached test hole logs, plan and profile pages for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211488, Rebecca Carroll, 12/14/21 CHANDELLE ACRES, LOT 28 W-41 ALTERNATE SITE: 20' LONG x 5' WIDE, 4' EFFECTIVE DEPTH CATIIIADVANCED TREATMENT ABSORPTION TRENCH 1250 -GAL SEPTIC L-,,�' TANKW/20" MANWAYQTR TRACT A I 28 I s NEIGHBORING 2-61LONG x -T WIDE, 5.5' SEPTIC \MT EFFECTIVE DEPTH ABSORPTION 3 5 CO TRENCHES Co \. �J 3'0 FS LOT 29 N#2� y litw i �. X10\ FCOFCO NEJG HBORING ( 4 BDRM HOME SEPTIC \, \ EXIS� ING WELL ` ;\ 10' UTILITY EA ES MEN - PROPOSED WELL / HANDI _ ---- i N GHBORING SEPTIC dT IN VIEW AND > 100' FROM WELL \ — _ LOT 15 \ // 1pGEIN[l RING NOTE: LOT 14 NO SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC LEGEND SYSTEM ��P••' �9,+ CO - CLEANOUT 491N •.'•,* �� ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS 2CO - DOUBLE CLEANOUT "' • • • • • • PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC FCO -FOUNDATION CLEAN( • SYSTEMS. FS - FLOW SPLITTER VALVE Benja i Schiller / MH - MANHOLE ' ��� •.• CE 2592 0 50 100 MT -MONITORING TUBE �sl marslao:, . •''� r FEET �I�F�F�pROFESSION•' SV - SEPTIC VENT 1 —50 TH -TEST HOLE 46 % ANG L E OF EF F L U E N T INFLU E N CE EXI STI NG GRAD E PROPOSED TRENCH 1 PROPOSED TRENCH 2 1"=10' 2010 0 FEET SLOPE CROSS SECTION Benjamin Schiller CE 12592R EGISTEREDPROFE S S I O N ALENGINEER12/9/21 >12' 2' CHANDELLE ACRES, LOT 28 355 350 345 340 335 330 325 320 5 10 15 20 25 30 35 40 45 50 55 60 65 7570 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211488, Rebecca Carroll, 12/14/21 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 Benjamin Schiller CE 12592R EGISTEREDPROFE S S I O N ALENGINEER4" PERFORATED PVC (HOLES DOWN) DRAINFIELD ROCK 3' 6" 3' 5'-6" DESIGN FACTORS:SYSTEM REQUIREMENTS: 600 GPD PEAK FLOW PERK RATE: 24 MIN/IN APPLICATION RATE: 0.45 GPD/SF 5.5' DEEP TRENCH SYSTEM 1250-GAL SEPTIC TANK BOTTOM OF TRENCH: 10.5' BELOW GRADE FLOW LINE ELEVATION: 4.5' BELOW GRADE TOP OF TRENCH: 0.5' ABOVE GRADE 600 GPD / 0.45 GPD/SF / 5.5' DEEP / 2 SIDES = 121.2 LF TRENCH REQUIRED (122 LF SPECIFIED) 12/9/21 GEOTEXTILE FABRIC 4'6" 6" CHANDELLE ACRES, LOT 28 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211488, Rebecca Carroll, 12/14/21 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST TECHNICIAN: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DEPTH (feet) PROJECT No.: TEST HOLE 1 SLOPE SLOPE SITE PLAN DATE READING GROSS TIME (minutes) NET TIME (minutes) DEPTH to WATER NET DROP PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH) TEST RUN BETWEEN: FT. and FT. COMMENTS: (inches)(inches) L.TIDWELL DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING: IF YES @ WHAT DEPTH?- 24 6 4 5 11/23/21 1 2 3 GM (SILTY SANDY GRAVEL) Professional Engineers Stamp: N/A DRY 11/30/21 CHANDELLE ACRES L28 11/23/21 051-822-07 HULTQUIST HOMES 11:481 2 3 0-1 6 16 12:33 12:34 1' OB 30 Benjamin Schiller CE 12592R EGISTEREDPROFE S S I O N ALENGINEER12/2/21 30 30 0-1 416 0-1 416 1 6 16 1 416 1 416 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211488, Rebecca Carroll, 12/14/21 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) L.TIDWELL DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING: IF YES @ WHAT DEPTH?- 24 6 4 5 11/23/21 1 2 3 GM (SILTY SANDY GRAVEL) Professional Engineers Stamp: N/A DRY 11/30/21 CHANDELLE ACRES L28 11/23/21 051-822-07 HULTQUIST HOMES 12:181 2 3 0-1 6 16 12:49 1:20 1' OB 30 Benjamin Schiller CE 12592R EGISTEREDPROFE S S I O N ALENGINEER12/2/21 30 30 0-1 416 0-1 416 1 6 16 1 416 1 416 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211488, Rebecca Carroll, 12/14/21 - ~ [~ SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: SLOPE DATE PERFORMED: '2- / ~;,/q- ~ ~/ SITE PLAN lO 11 12 13 14 15 16 17 18 19 2o COMMENTS PERFORMED BY: /~O~.7~i~4 ~ 1L~d~_ WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Reading Date ~-/~ ~-/¢ CE ~ 2-/¢ 0 P E 7-/'~ Gross Net Net Time Time Drop Depth to Water PERCOLATION RATE ~ ~ ,.~..~/~,~TEST RUN BETWEEN '~O (minutes/inch) ~ FT AND ~' FT DATE: ?-/¢. 72-008 (6/79) 700 "H" STREET, SUITE I ANCHORAGE, ALASKA 9950I TELEPHONE (907) 272-9151 PAN A MERICAN CONSULTING ENGINEERS ARCHITECTURAL, CIVIL, ELECTRICAL, MECHANICAL STRUCTURAL ENGINEERING December 28, 1978 The Blue Max Corporation 411 E. 36th Avenue Anchorage, Alaska 99503 Attention: Mr. Robert Ohrt Subject: Soil Investigation for '!'Chandelle A~re$'I Subdivision, Peters Creek, Alaska. Dear Mr. Ohrt: On December ll, 12, and 13, 1978, we conducted a subsurface soils investigation to determine the suitability of this proposed subdivision for on site sewage dis- posal systems, for satisfactory road and runway subgrades, and for supporting the foundations of residential structures. The investigation complied with the requirements of the Department of Health and Environmental Protection, Municipal- ity of Anchorage. A backhoe was utilized to excavate five (5) test holes. Soil samples were taken at depths as indicated on the Test Hole Logs for sieve analysis and two samples located in planned roadways were taken for hydrometer analysis for an accurate determination of frost susceptibility. The test samples show the soils to be SM, silty gravelly sand or GM, silty sandy gravel generally and tend to become more impervious with depth. This indicates that the preferred leaching system on most of the lots will probably be trenches rather than leaching pits. Probably, as indicated by T.H. #1, there will be some pockets of sand and gravel but it is not predicted that these will be extensive nor frequent. Also, there will prob- ably be some silt pockets which are more impervious than that indicated by the percolation tests which were made at each of the test holes. Again, it is not felt that these silt pockets will be large nor widespread and can be compensated for by the engineer making the soils inspection at the location of the particular leaching field. Percolation tests were performed on ledges located within the test holes at the depths indicated on the Test Hole Logs, see Figures 3, 5, 7, 10, & 13 for the logs and the results of the percolation tests. Holes approximately 10" in diameter and with a depth of 18 inches were dug into undisturbed soils. Procedures described in Public Health Service Publication No. 526, "Manual of Septic Tank Practice", were followed in making the percolation tests. No ground water was encountered in any of the test holes and is not expected to pose any problems for on site sewage disposal systems nor for subgrades in road, runway, or residential construction. Soil In ~tigation, Chandelle Acre~ Page 2. Frost had penetrated approximately one foot below the ground surface at the time of 'the investigation but no permafrost was encountered in any of the testl. holes. The majority of the soils which will be serving as subgrades for the roads, runway, and residential construction will be either F1 or F2 for frost susceptibility. Commonly accepted design and construction techniques should limit.frost movements to tolerable levels with the types of soils which were 2~-~'~'found during this investigation. Since the soils analyses show that the soils become more frost susceptible with depth except for the thin layer of hUmus soil at the surface which will be stripped for all construction over excava- tion is not expected to improve the quality of the soils as subgrades for the roads, runway, or house foundations. Although it is felt that this soil investigation has shown the general nature of the soils and conditions for this proposed subdivision, soil conditions can vary between the test holes without any surface indication. Therefore, tech- .~.~~:.~nical assistance should be. utilized to evaluate the soi,.l~conditions during the ~ 'development construction of this subdivision. Sincerely yours, L. 0. Mathis, . . ~A~Pa~ Ame~.i can~¢onsu ]~t;i ng.~ Eng i neers :....,,,. ::,~ ....... . .~ ,~ r~ % It,S- z2 - z 3 - 7<3 i2~'<~ p t0 I0 t0 iH~p ~t tt ? Im -1 I M U) CN 2 'D 0 `vim C � < =o-0 (i C; 0- 0 my (Dm Z 0 S- 0 E& > Q 0 CD 0— 0 (D 0 0. To A 0 Lo o 0 O-0 0 0 a0, E o_ c (D — 0 % > M (D (D 0 16. cn 0, 4v 0 C C x .00 E:� 0 C; o E r -t-. 0. r r 0 0(L ma Z"o Lo CL 0 0 c -C V) 0 (D 0)), -0> .,S -o 0 0 — r (D 0 0 0 >�v L- >�M_X C _ =) 9) >�0L. CL 0 0 C'o tn 13 0 o '0 -<'o o r- X cn 0. 4v >. 0 0 0 W.2 c L* > > 0 CL 0 -t 0— .< .r- N 0 v c 40 L 4- 0 c Uj 0 -jL. 0- '- .2 _j LOLJ 0 -0 z T < o 4D -a U, 0- cx a. E c 0 o 0 CO 0, > 0 O -C 2 0 'c 0 >�C'4 .0t_ El Q.ID 0 — _C I 0 E -I- E E o -o S w 0 0 0 > 0 r - CL 0 In a MUNICIPALITY OF ANCHORAGE �Jft� 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. 051-822-07 Legal description Chandelle Acres Lot 28 Site address 23915 Current property owner(s) Chandelle Dr. Anchorage Expiration Date: 12-16-22 X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Bye Original Certificate Date: q —1 C —2:2> This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA ApprovWjune 2022 PV1UH0C� F A L0 u Y OO F A H CCH0R%„ r. �l � e Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 051-822-07 Complete legal description Chandelle Acres, Lot 28 Location (site address) 23915 Chandelle Drive, Anchorage, AK 99567 Current property owner(s) Hultquist Homes, Inc 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS Day phone (907) 522-3204 3. TYPE OF WATER SUPPLY: 0 Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: 0 Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑® Plastic ❑ Concrete ❑ Fiberglass Age 1 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed 0 Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ®❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee 12-0 Waiver Fee $ Date of Payment S 03Z -Wo -0 Date of Payment COSA # (D S L 2 7,( Waiver # COSA Application_ June 2022 COSA Checklist Legal Description: Chandelle Acres, Lot 28 Parcel ID: 051-822-07 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 2/9/22 Total depth 208 ft Cased to 208 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA 2/9/22 Static water level at beginning of test 172 ft. Comments B. TANK DATA Measured operating fluid level in septic tank Date of pumping New Installation ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 8/3/22 ❑ ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced N/A gallons N/A date Any rejuvenation treatment (past 12 months) N/A If yes, enter date Comments/Deficienci COSA Checklist June 2022 Well production at time of test 7 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L On Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Wheaton Water Wells Date 9/1/22 C. LIFT STATION L uired maintenance completed Age of lift sta i _ years Lift station material Comments: Adequacy test date NEW Results on Pass N d depth prior to test in Wat added gal New flui epth in Elapsed time min Final fluiddepth in Absorption rate gpd FIELD STATUS — POST ECOVERY Effective depth (per recordwings) in Effective depth used in Effective depth remaining iri E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' O Yes if No Community Sewer Manhole/Cleanout > 100' DYes if No ft EYes if No ft Neighboring Tank > 100' ❑® Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' Fu_1 Yes if No ft Holding Tank > 100' QYes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' R Yes if No ft Q Yes if No ft ft If tank or field is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Q Yes if No ft Q Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' O Yes if No ft Surface Water > 100' Q Yes if No _ Tank to Property Line > 5' ❑® Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' 0 Yes if No ft Private Wells > 100' FE -1 Yes if No Water Main > 10' E Yes if No ft Community Wells > 200' 0 Yes if No _ Water Service Line > 10' M Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS ft ft ft G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Forge Engineering Engineer's Printed Name Benjamin Schiller, P.E. COSA Checklist—June 2022 Phone (907) 522-7773 Date 9/13/22 "R • *fir WWI �... Benjaan g chiller :4 F� CE 12592 �k�F, PROFESSO . ~o~ ti]Nit /0 /P 4% UJd /:-/o L/id /fo '~4 ~ /~.?- ~/ /?o? :/ ~C I015- /4/7 /bo 0 103 /;l,~ fifo2 Z,,¢ F, ^/ /3. /_.q5-8 3 /Z /5-13 z7 ~?/" /Z' /~o7 0 .I L o ~