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HomeMy WebLinkAboutFOWLER LT 2Onsite File 2L owler ® Municipality of Anchorage I On -Site Water and Wastewater Program (907) 343-7904 5 A Certificate of On -Site Systems Approval Parcel I.D. 002-202-17 1. GENERAL INFORMATION: Complete legal description FOWLER; LOT 2 Location (site address) 613 E 22nd Ave. *Anchorage Expiration Date: / 0 2 2 I Current Property owner(s) Ray Hofmeister Day phone 952-3068 Mailing address Real Estate Agent 2. TYPE OF DWELLING: © Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class_Well ❑ Community ❑ Public Water System ❑ Public Sewer z WaiverNariance request for: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: ------------- COSA Fee $ Waiver Fee $ . Date of Payment b��`iLZ- j Date of Payment Receipt Number 0b�QZ, G Receipt Number COSA # 0 5 C a 113 b D 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: Gayness Engineering Group Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road Suite 101 -Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: '74 In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of .construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE _ System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the followin VN.., 1-7!:: #AECC884 QPoM(UWaq,%�,,�� �= ON-SITE g WATER AND uWA&TE- `'ATER Z PROGRAM c JJJ Original Certificate Date:- Z -21 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_ Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSH e L li Legal Description: FOWLER; LOT 2 Parcel ID: 002-202-17 if more than 1 septic system on lot: COSA Checklist # _—of Structure served by this system A. WELL D A. I M' ❑ iNeil log is filed With Onsite (or attached) Well production at time of test ** gpm --t Date drilled 7959 (?) T— r . N/A � =.��F. �.� �„����..�, � Water storage tank volume gallons 0 Total depth UNKNOWN ft � �� ;' � �� �'; ``�"-� � Well disinfected for coliform test? ❑ Yes © No Cased to UNKNOWN ft 51311 Coliform bacteria is Negative FO -1 Sanitary seal is functioning correctly Nitrate mg/L 0 Nitrate less than MRL (ND) [07 '�Alires are e prorl protected Arsenic 26.9 u /L properly y p }��� g r-1 Arsenic less than MRL (ND) Casing height (above ground) �" in. Collected by GEG, LTD. Date of flow test for COSA 5/8/21 Date of Sample 5/6/21 Static Water level at beginning of test ft. n is nRTL-SIAN - THIS IS A PIT WELL. REPAIRS PERFORMED AS DIRECTED BY MOA (SEE ATTACHED INVOICE) "PUMPED OUT 105U GALLONS IN 200 MINUTES. ASSUMED D.:2* GPM PRODUCTION Com me B. i'ANK DATA A Age of tank(s) years Tank type/material Measured operating fluid level in septic 'tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Ga)14*hs introduced gallons Co,i,)ments/Deficiencies: COSA Checklist yellow sheet If yes, enter date AWWU SEWER D. 'ABSORPTION FIELD DATA A ` x1hich system tested (date installed) 7 Adequacy test date 17 ALL standpipes present per record drawing Results []Pass For bedrooms Total measured depth from grade ft (m Fluid depth prior to test in [measured depth to pipe invert from grade ft (min) Water added gal ❑ N/A — pressurized field New depth in ❑ Monitortubesgo to bottom of fective. If not, state depth into effective Elapsed time min ❑ Code -required soil c er over field Final fluid depth in ❑ System preso ed Absorption rate gpd (Required if vp ant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of tesK Ga)14*hs introduced gallons Co,i,)ments/Deficiencies: COSA Checklist yellow sheet If yes, enter date AWWU SEWER 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' ❑ Yes NSA Community Sewer Manhole/Cleanout > '100' �* ❑ Yes if No ft ❑✓ Yes if No ft Neighboring Tank > 100' P71 Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No NSA ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ❑✓ Yes if No fit 0 Yes if No ft ftsep nk is under driveway comment below * Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑✓ Yes if No ft ✓❑ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No ft Surface Water > 100' ❑ Yes if No t Property Line > 5' ❑ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑ Yes if No ft Private Wells > 100' Yes if No ft Water tvlain > 10' ❑ Yes if No ft Community W > 200' ❑ Yes if No ft !dater Service Line > 10' ❑ Yes if No ftsep nk is under driveway comment below From Absorption Field on Lot to: (Please enter distanc less than required) Building Foundation > 10' (01 Yes if ft If absorption field is under driveway comment below Property Lire > 10' s if No ft Wells on Adjacent Lots: Water Main = 10 ❑ Yes if No ft Private Wells > 100' D Yes if No ft VVater Serv' Line > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No ft , race Water > 100' ❑Yes if No ft F. ENGINEER'S COMMENTS *NO REQUIRED SEPERATION DISTANCE REQUIRED BEFORE 1983 WELL FLOW TEST PERFORMED WITHOUT SOUNDING FOR WATER LEVEL. **SEE ATTACHED DOCUMENTS FROM AWWU G. ENGINEER'S CERTIFICATION I certify that l 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. CASA Checklist yellow sheet #AECC884 _M Arsenic Advisory Certificate of On -Site Systems Approval # OSC211360 Subdivision: Fowler, Lot 2 A water sample revealed an arsenic concentration of 26.9 micrograms per liter (ug/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Ma�lmg Address P O BoX 196650:* Anchorage, Alaska 99519 6650 *www muni org ';jLkTE SCHEDULED TI M E SUDIVISI F0'%fVL7-R BLOCKILOT ITRA LT 1 H,,] DICATE NOR T11,11 if SIZE MAH':TYPE MAIN: DEPTAT MAIN: AT PROP. LINE: CONNECT LOCATION: COMMENTS: III I L,2-- I INSPECTED BY DATE: 74. fo Erik Widger From: Dave <dave@awps.com> Sent: Monday, June 14, 2021 2:49 PM To: Erik Widger Subject: 613 E 22nd Ave. Artesian Well Hi Erik, we were hired recently to replace the well pit cover and install a sump pump at 613 E. 22 d Ave. in Anchorage. This well is a flowing artesian well and has a water -tight seal at the casing top to prevent artesian overflow at the wellhead. With out this seal the artesian well will constantly flow and cause flooding in the well pit. At the time of our visit the seal was not leaking water into the pit. Please let me know if you have any additional questions. Thank you Dave VanWingerden, Owner Anchorage Well & Pump Service, Inc. 7640 King Street Anchorage, AK. 99518 Office — 907-243-0740 Fax — 907-243-0742 1 A:s f"!- Tt:R , S T C R �X :i7llls' TIC Anchorage Bowl WR 1 dr 3 i . 00Cr 00 Administration Facility FQ 50706 C'4 station RKSeptage Receiving Station < co cf) _0 9 C) CY) ':Ic C\1 co 50804 50805 50806— CL, 4 [L In 210i rrp. 16520 % C:) CN 4 C"! 3057 0904 5 0— 906 CY) r DI 0, _8 AC ^tip n 24CN 82 7 1 C\j 02A 1005 5 0 06 1 T BAC 22nd Avenuc .597 51105 _51106 cleanout. Nt'at. 2596 251t' A"onue CIcanouIInf,4anhcla,A%VV;U Joint Base 50709 �X 50_808 i 50809 50905') 1 50909 51007 1 1 51008 51107 1 511 5120 5120 51307 51009 Chugach Stale Par, I E] Administration Facility FQ LRUP.MpStation Mmcwnng station RKSeptage Receiving Station < co .. tr .. I Facility _0 2596 In 16520 - _8 AC ^tip n C\j - -42791 0 -o Legend ClcanoLn.AVMlJ cleanout. Nt'at. 2596 251t' A"onue CIcanouIInf,4anhcla,A%VV;U SAC 0 42792 Dangerous Manhole 7 Across Too, AINWU Manhole. AWWU n 02D 0 Manhole, Private CY) @ Discharge Point AWWU CY)-,.to-) AhRellcf,AMIJ N 41738 AirVaMUMAWWU N 8CIPP 20163 Constructed Pipe 00 < (3—hylfain, All 0- '23340 12 co `fii �AiA RT 1 Casing and Owe, Pip., All Owners 3 00 For- Main. AWWU 38�91 i FormnonAWWU ,\N q)7 21099 COD 401761 c=> Record Draing Lnit Cl) Sewer Basin Cl) co 00 N Joint Base 50709 �X 50_808 i 50809 50905') 1 50909 51007 1 1 51008 51107 1 511 5120 5120 51307 51009 Chugach Stale Par, I E] Administration Facility FQ LRUP.MpStation Mmcwnng station RKSeptage Receiving Station MT .. tr .. I Facility Design Pip. (3—hy Main. AVAIVU C-41>0 Gravely Main. Private 0' Far. Mon, AINWU Oz- For. Klein, Private Retired Pipe Abandoned In Place, All 0—c,s = MOA Grid ILNFORMATION AND DATA CONTAINED ON THIS DOCUMENT 326191, r �S NOT TO BE CONSIDERED ACCURATE AND THE (.) MUNICIPALITY OF ANCHORAGE ASSUMES NO LIABILITY FOR DAMAGES OCCURING AS A RESULT OF USING 03B THIS DOCUMENT. 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