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HomeMy WebLinkAboutVALLEY LT 1Onsite File Valley Lot 1 PID# 051-105-35 Formerly T15N R1W SEC 9 LT 43 Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http:/Avww.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP151101 PID Number: 051-105-04 Q✓ New El Upgrade Troy Davis Homes 165 E. Parks Hwy, Suite 200 Wasilla, AK 99654 357-9394 1 3 43 Township Range Section 15N 1W g 'v From Septic Tank Absorption Field Lift Station Holding Tank Sewer Line well >100' >100' >100' >75' >25' Surface Water >100' >100' N/A N/A Lot Line >5' >10' N/A N/A Foundation >5' >10' N/A N/A NA Curtain Drain I None I Noted Remarks 3SORPTION FIELD ❑ Deep Trench 0 Shallow Trench ❑ Bed ❑ Mound 1.2GPD/SF )th to pipe invert from original grade Gravel depth 3.8 Ft. added above original grade Gravel length 0-1 Ft. vel width Beds: Number of Lines Dista 5 Ft. rl absorption area Number of trenches Dist. 400 Ft' One NK O Septic ❑ S.T.E.P. ❑ Holding ❑ Other ufacturer Capacity ichorage Tank ;vial Number of compa Steel on level at IPUmp off level at and model )I grade 7.8 eath pipe 4.0 40 between line 1 trenches Two at performed by PIPE MATERIAL Housetotank lankto D3034 Installer D3034 drI nfield Northern Excavation Drainfield F810 CO/MT D3034 Inspector W Roberts BENCHMARK (Assumed elevation) 100.0ft Inspection �•' 516/15 Location and description dates: 2nd 517/15 p 3'd 4`h Bottom of Siding SE Corner of House. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL I Engi"ra IStamp Approval: Date s is 49TH MICHAEL E. ANDERSON •: 0 CE -4381 , _�� Approved �O✓�/% Date 0 33 C 4� v 4, n vE se�q i L 33A ® 34 B C4 + - ------- ----- ' sem' � ' w 33 B ExieGn9 '� 34 A w i weu i i `66l/ Mea H Q /44 A > J w Li I� E'seinq \ MICHAEL E. ANDERSON NO, CE -4381 VaUev Avenue IV l\ I VACANT 44 i B '0 T15N R1W SECTION 9 BLM LOT 43 NOTE: No Conflicts with well or septic systems on this lot. T15N R1W SECTI❑N 9 BLM LOT 43 AREA MAP SCALE V = 100' CIO 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: OSP151101 PID No. 051-105-04 s9.4 U n y UU Final Grace Gr�oun� 2'Insulation 1,000 Gallon Septic Tank 96.75 6 _ a 100.2 Finished Grace Existing Grace 2" Insulation & Geotextile Fabric 96.4 Drainfield Rock 96.4 92.4 40' (Trench Length) 84.3 No Groundwater 4-15-15 OF !!4 .............. ..........49th... . ..... PROFILE AS -BUILT ...�......... . �pMICHAEL E. ANDERSON'_';j .i►. f :, No. CE -43 % - No Scale !!1'••�� Certified_Dr .fling Lag it r OWNER OF LAND: Spencer & Caralyn Lyman ADDRESS: PO SOX 79 Crooked Creek, AK 99575 LEGAL DEStPIPT10N T15N RiW SEC 9 LOT 43 DATE: 5-8-15-- RERlu13T NUMBER: OSPI51101� DATE OF ISSUE 5-4-15 TAX I©ENTIFICATIC j NUMBER 05110504000 Is well located at approved permit location yes Nowa Method of Drilling: lair rotary ❑cable tool Depth of Well: 53' Casing Type: Steel Wallthickness ,250 inches Diameter: 6 3nshes, depth 53 feet Liner type Static Water Level; 10feet Recovery Rate 15�a 9pm gph Method of Testing _Ai'r'_ Well Intake Opening Type- M open end (,.#open hole Screened Start feet Stopped Perforations Startfeet Stopped Grout Type: BentonJte __ Volume: 50 lbs Depth: from 2 _ feet, to 42 feet Well Disinfected Upon Completion: Myes �no Method of Disinfection: Chlorine 50 PPIM Comments: -11 Depth From To 0 2 casing Stickup 2 �4T Overburden 4� 15.. Silty sand and gravel 15 41 Silty sand and gravel with clay 41„ 53 Sand and gravel-...�....._...._..�.._._ 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. , BILL & COLE DOC CO dba ULLIVAN WATER WELLS g www.suilivanwaterwells.com Pump Installation Log Well Drilling Permit Number: SW OSP151101 Parcel Identification Number: 05110504000 Legal Description T15N R1W SEC 9 LOT 43 Pump Installation Date: 6-4-15 Pump Intake Depth Below Top of Well Casing: 50 Pump manufacturer's Name: GOULDS Pump Model: 10SBOS412CL Pump Size: 1/2 Pitless Adapter Burial Depth: 10 Pitless Adapter Installer: NORTHERN EXCAVATION Disinfected Upon Completion? ® yes ❑ no Method of Disinfection: CHLORINE 50 PPM Comments: Pitless Manufacturer: MARTINSON B10X Pump Installers Name: SULLIVAN WATER WELLS Date of Issue 5-4-15 Property Owner Name & Address SPENCER & CAROLYN LYMAN PO BOX 79 CROOKED CREEK, AK 99575 feet hp feet Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. 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: OSP151101 Tax Code Number: 05110504000 Work Type: WellSeptic Initial Permit Effective Dates: May 04, 2015 to May 03, 2016 Design Engineer: ANDERSON ENGINEERING Subdivision: T15N R1W SEC 9 Site Legal Address: T15N R1 W SEC 9 LT 43 G:1358 Owner/Address: LYMAN SPENCER W & CAROLYN M PO BOX 79 CROOKED CREEK AK 995759999 Site Mailing Address: 21982 VALLEY AVE, Chugiak This permit is for the construction of: Lot Size in Sq Ft: 108900 Total Bedrooms: 3 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. 1%11s was not lhsta(kec{kP Sec -/45%u; if-4ee-t$ Received By: Issued By: Date: l MUNICIPALITY OF Community Development Department Development Services Division On -Site Water & Wastewater Program ANCHORAGE ON-SITE SEWER/WELL PERP Parcel I. D. 051-105-04 Property owner(s) Troy Davis Homes Day phone 310-2501 Mailina address 165 E. Parks Highway #200 Wasilla, AK 99654 Site address 21982 Valley Avenue Chugiak, AK 99567 Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) T15N R1 W Sec 9 Lot 43 Lot Size 108,900 Sq. Ft. Number of Bedrooms Three APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial Single Family (SF) ❑X (w/wo ADU) Septic Tank ❑X Upgrade ❑ Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑X Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: 1 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: Jri:9' al5 �/?b•�� ( Waiver Fees: Date of Payment: S%r Receipt Number: 614 314� G Permit No. 65 M 5J 1101, Permit App_:: :::..:c: Date of Payment: Receipt Number: Waiver No. 'ANDERSON ENGINEERING,-: P.O. BOX 240773 ANCHORAGE, AK 99624 622-7773 677-7766 FAX April 30, 2015 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: BLM Lot 43, Section 9, T1 6N, R1 Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of BLM Lot 43 intends to construct a new three-bedroom home on the lot. We are therefore 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 septic system along with the alternate site. No existing wells are closer than 100' from the proposed septic system. Drainage arrows and ground surface 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 tract in the area of the absorption trench and alternate site indicated silty gravel with sand (GM) material. The percolation rate of the soil was determined to be 4-5 minutes per inch. Groundwater was found at 14' beneath the surface during the placement of the test holes and remained at that level during the monitoring period. An application rate of 1.2 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 38' long by 5' wide by 4' 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 3' below the surface and the total depth will be 7'. 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 absorption trench slopes from the southeast to the northwest at shallow grades. The new trench 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' BLM Lot 43, Section 9, T1 SN, R1 W April 30, 2015 Page Two from all wells and any surface water and 10' from the proposed and existing water services in the area. 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, w✓'i'd . r C'J, Michael E. Anderson, P.E. Attachments 33 C ) ' � v +' s_ 33A ® �� i 34 B 33 B�;� -- 34 A Valtey Avenue -C I ' ------ G� ------ VACANT O ;;'44 A D 1 44 '.B = 16 S� � I T15N R1W SECTION 9 r � HLM LOT 43 NOTE: No Conflicts with well or septic systems on this lot. ,.•��"'�,, T15N R1W SECTION 9 BLM LOT 43 imp 49th `:•� ................. . ........AREA MAP. i...... }� ���=.MICHAEL E.•ANDERSON cE-+38Ii SCALE 1" = 100' 33A 34C m w m ` \ 30.00 VALLEY AVE. 30.00 S89'59'00"E 350.07 \\ ELM R.O.W. & UTI Y EASEME \ .00 1 1 w,aee.E mz a .a.er 6; Proposed ` well \ I p O TH1 I i i in O N ® c0 `SU _ — W 43 ® a1,000 Gallon vii Septic Tank m p O rn CO o 8' Long x 5' Wide x ' Effective Depth Absorption Trench 44B \ NoAreasof Excessive ape are Within 50' Downslope o Surface Water Within 100'of A y Part of the New Septic Syste . T15N RIW CTION 9 BLM LOT 43 IN N89'59'39"W 330.12 50 51 .............. AV 1� ''� CONTOUR INTERVAL — 2' AV 49th a LEGEND �.• •... ••••• � �..` �:-, I............................................ . SITE PLAN Mf — Monitor Tube FCO — Tee TH —teat Hole Hole Clean Out s MICHAEL E. ANDERSON �: j ��� CO — peon Out 200 — Double Clean Out ,/+, ���2?��••, • 1 ;3...... •. .. ,���� S-Stv. SCALE _ 1" 50' T1 5N R1 W SECTION 9 BLM LOT 43 DESIGN FACTORS: SYSTEM REQUIREMENTS: Three Bedroom Home 5' Wide Trench System Perc. Rate: 1-5 Min./inch 1,000 Gallon Septic Tank Application Rate: 1.2 GPD/SF 4' Drainfield Rock 3 Bedrooms ` 150 GPD/Bedroom = 450 SF Absorption Area 450 SF/1.2 GPD/SF/5 SF (Width) *.5 (Red. Factor)= 37.5 LF Trench Length THEREFORE: Construct a 38" Long x 5' Wide x 4' Effective Depth Absorption Trench at the Location Shown. Distribuiton Line to be Placed 3' Below Ground. Total Depth to be 7' Below the Surface. Provide 3' Cover Over Absorption Trench and 4' Cover Over Septic Tank. Construct System a Minimum of 100' From All Wells in the Area. TYPICAL 5' WIDE TRENCH SECTION (NO SCALE) OSP.••............ NOTE: Grade Area Over Trench to Drain Away. 4MMinimum 6' Separation From Bedrock. �.....:............ . . Minimum 4' Separation From Groundwater. 1 ........................... S .. Minimum 100' Separation From Private Wells in the Area. ��; MicrwE� e.nNoeasor, Minimum 100' Separation From Surface Water or Streams. �, ; No. CEs l 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- 1 1 1 1 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION. BLM LOT 43, T15N, RIW, SECTION 9 PERFORMED FOR: TROY DAVIS HoMEs. INC. DATE: 2/27/15 PROJECT No.: PARCEL ID#: TECHNICIAN: L. BETTS OB/OG TEST HOLE 1 v SILTY GRAVEL d WITH SAND GM a ri d - O d O d BOH @ 16' SLOPE MICHAEL E. ANDERSON SITE PLAN SEE SITE PLAN WAS GROUND WATER ENCOUNTERED? YES IF YES @ WHAT DEFTHR A" )4t1�5- D= OF WATER AFTER MONITORING 2% DATE OF MONITORING: 4/15/15 DATE READING G OSS TIME MINUTES) NET TIME (MINUTES) DEPTH To ATER(INCHES) (INCHES) INET DROP TEST HOLE PRESOAKED PRIOR TO TESTING: 2/29 1 2:14 0.75" 2 2:44 30 8.00" 7.25" 3 2:45 0.63" 4 3:15 30 7.88" 7.25" 5 3:16 0.75" 6 3:46 30 8.00" 7.25" PERCOLATION RATE:4.2 (MINANCH) PERC. HOLE DIA. 6�t (INCHES) TEST RUN BETWEEN: 4.0 FT. and 5.0 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: 4/30/15 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 DEPTH (feet) 1- 2- 3- 4- 5- 6- 7- 8- 9- 10- 11 1 1 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: BLM LOT 43, T15N, RIW, SECTION 9 PERFORMED FOR: TROY DAvis HOMES. INC. DATE: 2/27/15 PROJECT No.: PARCEL ID#: TECHNICIAN: L. BETTS TEST HOLE 2 OB/OG SILTY GRAVEL WITH SAND GM BOH @ 16.5' SIRE PLAN SEE SITE PLAN WAS GRODND WATER ENCOUNTERED? YES IF YES @ WHAT DEPTH?-2`J�14'�L DEPTH OF WATER AFTER MONITORING: .2,�' feI 2% DATE OF MONITORING: 4/15/15 DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH To WATER (INCHES) NET DROP (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 2/29 1 2:30 1.38" 2 3:00 30 8.00" 6.75" 3 3:02 1.50" 4 3:32 30 8.13" 6.75" 5 3:33 1.25" 6 4:03 30 8.00" 6.75" PERCOLATION RATE:4.4 (MIN/INCH) PERC. HOLE DIA. 6" (INCHES) TEST RUN BETWEEN:: 4_0 FT. and 5_0 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: 4/30/15 DEPTH ( feet) 1 - 2- 3- 4 - 5 - 6 - 7 - 8 — 9 — 10- 11 12- 13- 16 17 18 19 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: BLM LOT 43, 1-15N, RIW, SECTION 9 PERFORMED FOR: TROY DAV15 HOM G INC. DATE: 2/27/15 PROJECT No.: PARCEL ID#: TECHNICIAN: L. BETTS TEST HOLE 3 OB/OG SLOPE d a d' ° a SILTY GRAVEL o0 ° WITH SAND q GM d BOH @ 16' WAS GROUND WATER ENCOUNTERED? - YES r9� 49th MICHAEL E. ANDERSON fF YES @ WHAT DEPTH? NO DEPTH OF WATER AFTER MONITORING: DP.Y 2% DATE OF MONITORING: 4/15/15 E DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH ro WATER (INCHES) NET DROPi (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 2/30 1 10:09 2.2511 2 10:39 30 8.25t1 6.00" 3 10:40 2.1311 4 11:10 30 8.13" 6.00" 5 11:12 2.2511 6 11:42 30 8.25" 6.00" PERCOLATION RATE:4.4 (MIN/INCH) PERC. HOLE DIA. 6" (INCHES) TEST RUN BETWEEN:: 4_0 FT. and 5_0 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY ANDERSON ENGINEERING. 1, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 7/14/15 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: BLM LOT 4.3, T15N, RIW SECTION 9 PERFORMED FOR: TRoY DAVISHOMES. IN DATE: 2/27/15 PROJECT No.: PARCEL ID#: TECHNICIAN: L. BETTS DEPTH TEST HOLE 4 (feet) 1 2 3 4 5 6 7 8 9 1a 11 12 14 15 16 17 18 19 OB/OG ° I SILTY GRAVEL ° 1 WITH SAND a GM FA N SITE PLAN FF SEE SITE PLAN 9 i ° neo �nvwL H, cic R' t 'um' bKhU? les IF YES @ WHAT DEPTH? No DEPTH OF WATER AFTER MONITORING: DRYO 2% ° DATE OF MONITORING 4/15/15 P ° E BOH @ 15.5' DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH TO WATER NET DROP INCHES) (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 2/30 1 1:07 0.38" 2 1:37 30 7.75" 7.37" 3 1:38 0.25" 4 2:08 30 7.50" 7.25" 5 2:09 0.25" 6 2:39 30 7.50" 7.25" PERCOLATION RATE:4_1 (MINANCH) PERC. HOLE DIA. 6„ (INCHES) TEST RUN BETWEEN:: 4_0 FT. and 5_0 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY ANDERSON ENGINEERING. 1, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 7/14/15 • Municipality of Anchorage R On -Site Water and Wastewater Program (907)343-7904 kv 41 Certificate of On -Site Systems Approval Parcel I.D. 051-105-04 1. GENERAL INFORMATION Complete legal description Location (site address) Expiration Date: /" T1 5N R1 W Section 9, Lot 43 21982 Valley Avenue Chugiak, AK 99567 Current Property owner(s) Troy Davis Homes Day phone 357-9394 Mailing address 165 E. Parks Highway Wasilla, AK 99654 Real Estate Agent Day phone 2. TYPE OF DWELLING: Fx] Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Three 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System Waiver/Variance request for:. TYPE OF WASTEWATER DISPOSAL: El Individual ❑ Holding Tank ❑ ❑ Community ❑ ❑ Public Sewer ❑ Received by: Date: COSA to be released to the engineer, unless otheNVse requested by the engineer. COSA Fee $b��f Y/// Waiver Fee $ Date of Payment t 011911fr Date of Payment Receipt Number O qg(o Receipt Number COSA#— 0,50-1,S) 156 (- 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 wifh all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE //f 3 b d Phone 522-7773 Date 10/12/2015 �P�E•OF.ACgs�®e i 49TH System #1 Approved or a rooms MICHAEL E:' ANDERSON ; System#2 Approved for _ bedrooms0, ff.•• CE -4381 Fy •: i Disapproved `®8... Conditional approval for bedrooms, with the following stipulation. By: /�(crr�z�ic Original Certificate Date: �a S The Municipality of Ancho e Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representation 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 � If more than 1 septic system is on the lot: COSA Checklist # Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: T15N R1 W Section 9 Lot 43 A. WELL DATA Well type Private If A, B, or C provide PWSID # _ Date completed 5-8-15 Sanitary seal (Y/N) Y Total depth 53 ft. Cased to 53 ft. FROM WELL LOG Date of test 5-8-15 Static water level 10 ft. Well production 15 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate 3.13 mg/L Arsenic ND ug/L Date of sample: 9130/15 B. SEPTIC/HOLDING TANK DATA Parcel ID: 051-105-04 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) >18 in. AT INSPECTION It# Collected by: And. Engineering Tank Type/Material Septic/Steel Dateinstalled 5-6-15 Tank size 11000 gal. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (Y/N) Y Depression over tank (YIN) N High water alarm (Y/N) _ Date of pumping Pumper C. ABSORPTION FIELD DATA Date installed 5/6-7/15 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.2 GPD/BDRM System type 5' Wide Length 40 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth 7.8 ft. Eff. absorption area 400 fe Monitoring tube Y Depression over field _N Date of adequacy test 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 D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump of " level at in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot >100, Absorption field on lot >100' On adjacent lots > 100' On adjacent lots >100' Public sewer main - ` " Public sewer manhole/cleanout >100' Sewer /septic service line >25' Holding tank >75' Animal containment areas > Manure/animal excrete storage areas >100 SEPTIC/HOLDING TANK ON LOT TO: Building foundation > Property line > Absorption field >5 Water main > Water service line > Surface water >100 Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line >10, Building foundation >10' Water Service line >10' Surface water >100' Curtain drain None Noted Wells on adjacent lots >100' F. 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. Engineer's Printed Name Michael E. Anderson, P.E. Date 10/13/2015 COSA brown sheet 10-10-12.doc Water main >10' Driveway, parkingivehicle storage >10' IAEL E. ANDERSON CE -4381 PROFES510�a o00 N89059'10"E 330.03 UPUHLe Det)L1C to—ln—ln D FOR: Troy Davis Homes GRAPHIC SCALE., I Inch= 40 Feet 20-01 O 20 40 80 N89059'10"E 330.03 UPUHLe Det)L1C to—ln—ln D FOR: Troy Davis Homes Date 10-02-15 Scale 1" = 40' Legal Description FORBES & ASSOCIATES. INC Lot BLM LOT 43 Grid NW 1358 As -Built Survey 2150177 SECTION 9 P.O. BOX 232293 Anchorage, Alaska 99523 T 15 N. R 1 W Drawn by Field Book (997) 227-5881 CEF 246 S.M. , ALASKA I hereby certify that the property described hereon has been surveyed�nyAs` by direction, n ut me, or at my and that the improvements situated thereon are within the property lines and do not �►t ..OF 44 �t 4 + 4 overlap or encroach on the property lying adjacent thereto unless otherwise shown. That no hh\, is �.,C: « •�rr « improvements on the property lying adjacent thereto encroach on the in that there M '"J• T 49TH premises question and are no roadways, transmission 74 lines or other easements on said property except as shown. /.•.«r«« «+« +.s++� It is the the responsibility of owner or builder, prior to construction, to /'�+.................�+«, verify proposed building grade relative to finish grade and utility 0 I=. CHARLES �, fQjjBE$ y q�/1 connections and to determine. the exis Lence of any easements, covenants, s « LS -7326 or restrictions which do not appear on the recorded subdivision plat. t 10-15- Listed distances prevail ovrr scaling. 444�',fessi9na}t�,�.�! Reproduction may cause distortion.