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HomeMy WebLinkAboutSAND WILLHOLTH BLK 1 LT 1Sand- ��il��� PIK s q. GE aG/ • �-� Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Parcel I.D. 010-105-28 Certificate of On -Site Systems Approval Expiration Date: 1 Z 2 1. GENERAL INFORMATION: Complete legal description Sand Wilholth: Block 1, Lot 1 Location (site address) 1000 W. 32nd Ave. *Anchorage, AK Current Property owner(s) Stanley Bodgan Day phone 907-227-1008 Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex-� ❑ Multiple Dwellings (Single Family and/or Duplex) 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 Water System ❑ Public Sewer WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ oC 1 (� I + 12G(9USH Waiver Fee $ q q lol�Zo — Date of Payment I 1 ��'�� Date of Payment Receipt Number (s Receipt Number, COSA # 0 5 C 2 1 y Waiver # 6. 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: Garness 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: 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 V" System #1 Approved for ' bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms bedrooms, #AECC884 `OF r('�ti��(/� with the following stip ns: ON-SITE m WATER AND WAS rrtvATER By: Original Certificate Date:_)O.Z The Municipality of Anchorag evelopment 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 OA COSA Checklist Legal Description: Sand Wilholth; Block 1, Lot 1 If more than 1 ser Parcel ID: 010-105-28 Jc system on lot: COSA Checklist # of Structure served by this system Pit well was filled in - see attached photos. GEG did not evaluate the suitability of th kh I A. WELL DATA t e wor , suc as Insu atlon over the water service line or need for heat trace. ❑ Well log is filed with Onsite (or attached) Date drilled 1950? Total depth Unk ft Cased to Unk ft H Sanitary seal is functioning correctly ❑Q Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 8/27/20 Well production at time of test 9+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes R No ** 0 Coliform bacteria is Negative Nitrate mg/L R Nitrate less than MRL (ND) Arsenic ug/L R Arsenic less than MRL (ND) Collected by Anchorage Well and Pump Services Date of Sample 7/16/20 Static water level at beginning of test *0 ft. Comments 'Static water level was at top of casing prior to test. Installation of packer may be necessary to prevent overflow thorough conduit and into ground. "Assumed B. TANK DATA Age of tank(s) years Tank type/material Measured operating fluid level in septic tan Standpipes/foundatign e+eatiout per record drawing D. ABSORPTION FIELD DATA Which system tested (date installed) Wil 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 ❑ Monitor tubes go to bottom of effective. If not, stag depth into effective C. LIFT STATION ❑ Required main e>aa��, �ge-af`ti t station years Lift station material Comments: Adequacy test date Results ❑Pass For bedrooms Fluiddepth prior est in Water ed gal New depth in Elapsed time min ❑ Code -required soil cover over fiel Final fluid depth in ❑ System presoaked Absorption rate gpd (Required if vacant f reater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) If yes, enter date Gal Introduced gallons ments/Deficiencies: COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' NSA Community Sewer Manhole/Cleanout > 100' *50 ft ❑ Yes if No ft ❑ Yes if No if No Neighboring Tank > 100' R Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No *Unk ft Absorption Field on Lot > 100' ❑ Yes if No NSA ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' if No Animal Containment > 50' ❑✓ Yes if No ft E] Yes if No ft if No ft If is tank is under driveway comment below 50 Manure/Animal Excreta Storage > 100' —❑✓ Community Sewer Main > 75' 171* 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 ' o ft Property Line > 5' ❑ Yes if No ft Wells on Adjacent Lots: Private Wells > 100' ❑ Yes if No ft Absorption Field > 5' 1771 Yes if No ft Private Wells > 10 ' El Yes if No ft Water Main > 10' ❑ Yes if No ft Commu ' ells > 200' E]Yes if No ft Water Service Line > 10' 171Yes if No ft If is tank is under driveway comment below From Absorption Field on Lot to: (Please enter diss if less than required) Building Foundation > 10' ❑ Yes i ft If absorption field is under driveway comment below Property Line > 10' es if No ft Wells on Adjacent Lots: Water Main > 10' ❑ Yes if No ft Private Wells > 100' ❑ Yes if No ft Water Servi ine > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No ft S ce Water > 100' ❑ Yes if No ft F. ENGINEER'S COMMENTS *Assumed well was drilled in 1950 when house was built and sewer line installed in 1967. In short, met code at time of installation. There is no pump in well. Jet pump is inside of house. G. ENGINEER'S CERTIFICATION OF A _111 o I certify that 1 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. 0 ......., Ve 2 tv e t� {3q Lt � OQ - 7 i JC 53 COSA Checklist yellow sheet ����pr o f e s sio�°6o #AECC884 N Frontier Surveys, LLC Project No: 20-404 6Ordered By: Drew Jones Scale 1" = 25' Date: 8/26/2020 Plat: P-122 I Grid: SW1629 -j--------- W. 32ND AVENUE-------------�---_ 03 N90°"00' 00'W 145.00 6 a 20.0 —�c= I R.O.W. ,�,.. ` `-•-.. . 47 N ) i a GRAVEL w l PARKING Lot 1, Block 1 PAVED:: o Sand-Willholth Subdivision :259 10.9 ^ 10,150 Sq. Ft +/_ '20.6 i o ;u 1000 W. 32nd Avenue nCIS 0 1 Story Wood Frame Nouse I yt g With Detached Garage 7.9 $ M v? 0.4 v GARAGE c �J 44.6 28.9 25.9 U o N90° 00' 00'E 145.00 °w Cn i U r I I� i LOT Y i I � I J Legend X Electric Meter/Outside Power co, Telephone Pole Gas Meter f]f Mailbox A- Fence $ 4 ass Storm Drain `W; Water Well -ft-• Overhead Utility General Notes: 0 12.5 25 50 1. This document is created for the purpose of a single property transaction and is subject to Federal Copyright Laws. 2. Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey. 3. All measurements/setbacks are to the visual/apparent building footprint. Scole in Feet 4. All dimensions to property lines are plustminus 0.1ft. This survey complies with the ASKS Mortgage Location Standards. The survey represents visible improvements and .� OF 111 f conditions at the time of the survey. This document does not constitute a boundary survey and is subject to any Atq t J! J inaccuracies that a subsequent boundary survey may reveal. It Is the responsibility of the Owner to determine the existence of any easements, covenants, or restriction which do no appear on the record plat. Under no circumstances is j �9 JJ should this document be used for construction or for establishing a boundary or fence line. ' ` 4LH* As -Built Survey of: .. �.,. •l J�rf'�....;, 0' ... • : Lot 1 BI 4 ock 1 Sand-Willholth Subdivision I r........ ..... Pie"? M. Aragler �j Ne. 15-" 2 I, Pierre Stragier, hereby certify that this Mortgage Inspection Survey was performed by me, or iJJJ f� • 08/26/2020 un under my direct supervision on August 25th, 2020. f f ff' ' . . / — "-%Y``� Frontier Surveys, LLC JJ 9� 111 tt�t� o ��`` NTIER- 650 W. 58th Ave. Suite E Anchorage, Alaska 99518 �� . Serveyys�. —111--.. -- 907.460.1686-info@frontiersurveys.com _ h rAN 7B TY✓E C N /595 E /7 TOPELE✓' 9 TYPE C O4 .eo ✓� N /S, 91t.eP yw•! © 253. E L7, f.'� ZSd.3 ✓ C0.:7003 0. 0, 0' P/.5 E /], �li'c' Sol/ O Tor Eaev • 9i.9- I 3 <�06Y9.'4B� 9gS5 TpP ELE✓,'i7B 9L,%© �YJ jnv. S PJ.9. ! " 7 /NeN -�. I Lia ft, 'C AC 0 0.30 N-0>o6'W : syr—�Y-6A9-L f. "RC 6030 dObQ `W - 0261 <7_ � I •moi av 86031(0S 0,0- 7,7 1 x :87 ZL B7 L8 , B t00 9t00 /O/BO /MOO/PM _ /3/00 - /¢r00. SOL"' AYE OFsi°fit. V lY 4 u ..ir19t�vS+a g o Y�d Erol CC c FO CO✓YSTR. ° .ala kgPGlSj,£^vFt... w ! �� � � Q � . :.. -ASEM— h 400 no'4y n Nr8_AC " 5 P SBB 2TP Ml `g u /0' 1, rlZll-)- EASEMENT MN 2/8/0-9 MH 21 B/0-/0P/8/O-// T✓pE e NEL 5 True c 5rn P.6t TF z5 _ �"� v i %m snr /er/aoz: Vin. 22r 45 SANDS /Y /G g3Y5 N /6,9393 N /6,939.5 E E /6, r47. 0 E 17 /47,0 Top E/Ev. 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General Information Application Date 5/14/84 (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 1, Block 1, Sandwilhoth Subdivision Location (address or directions) 1000 W. 32nd Ave. (b) Applicants Name Dennis Gladwin Tblephone 346-2566 Applicants Address 6808 Doubletree Ct. (c) Applicant is (check one) Lending Institution F -El ; Omer/builder ; Buyer Other � (explain); (d) Lending Institution Alaska Pacific Mortgage Telephone 562-6100 Address 101 W. Benson Blvd. (e) Peal Estate Co. & Agent Address Telephone 2. jjTe of Fesidence Single -Family ZI Number of Bedroom 3. Water Supply Multi -Family 2 Other (describe Individual X11 r:�ET Commnity Public Note: If ccrrrurity well system, must have written confirmation from the State Department of Environne ntal Conservation attesting to the legality and status. Is the well adequate for the number of bedrocrm specified in this HAA (Y/N) Y 4. Sewage Disposal Onsite r__1 Public Community Holding Tank Is the wastewater disposal system adequate for the number of bedrocros (YM) Y (Page 1 of 21 2-15-84 5. Engineering Firm Providing Inspections, 'tests, Lata and Information. I certify that I ha -,a checked, verified, or cor.fo.nedl to all MGA HAA Guidelirp-s i effect on tN date of this inspection. Signed. Name of Firm / , _ k c>,r_ Address ' ') 6 Signed by 1Y, Date (ENGINEER SEAL) Te Date re Or e.q4,aa'A Rbr,AV � �a v h.DHEP Apj2roval Approved for iedroors By �� Date C� Approved ,Disapproved Conditional � � . `!he Municipality of Anchorage Department of Yieai n ana hmvironmencal .,rc�ec lcr, not guarantee the continued satisfactory performance of the water supply and /or 1 wastewater disposal system. This approval indicates that, as of the validation c sham above, based on the data and information furnished by an ergineer rec;istex� the State of Alaska, the water supply and wastewater disposal system is safe and tional for the number of bedrooms and type of structure indicated, (DHEP SEAL) 7. Mail the HAA to the following address. KB2/d5/s [Page 2 of 21 •°rte-� `esA �.-"• ..: +e+^°Gn\-.rte h.DHEP Apj2roval Approved for iedroors By �� Date C� Approved ,Disapproved Conditional � � . `!he Municipality of Anchorage Department of Yieai n ana hmvironmencal .,rc�ec lcr, not guarantee the continued satisfactory performance of the water supply and /or 1 wastewater disposal system. This approval indicates that, as of the validation c sham above, based on the data and information furnished by an ergineer rec;istex� the State of Alaska, the water supply and wastewater disposal system is safe and tional for the number of bedrooms and type of structure indicated, (DHEP SEAL) 7. Mail the HAA to the following address. KB2/d5/s [Page 2 of 21 . �- OMAN MUNICIPALITY OF ANCHORAGE (MCA) b866 ,lbW HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST -FEBRUARY 1984 N01103108d lViNMNOWAN3 1 H11V3H d0 Id30 SOWOHJNV d0 JU11Vd1D1Nnw A. WELL DATA LEGAL: Lot 1, Blk 1, Sandwilhoth Subd. Well Classification Individual If A, B. or C, D.E.C. Approved(YM) N/A Well Log Present (Y/N) N Date Completed unknown Yield 6 apm Total Depth unknown Cased to unknown Depth of Grouting unknown Static Water Level unknown Pump Set At unknown Casing Height Above Ground 1211+ Sanitary Seal on Casing (Y/N) Y Electrical Wiring in Conduit (YM) N Depression Around kbll1head (Y/N) N Separation Distances from Well: To Septic/Holding Tank on Lot N/A On Adjoining Lots N/A To Nearest Edge of Absorption Field on Lot N/A ; On Adjoining Lots N/A To Nearest Public Sewer Line 100' + To Nearest Public Sewer Cieancut/Manhole 1001+ To Nearest Sewer Service Line on Lot 25' + Water Sample Collected By D. Maney Date 5/14/84 Water Sample Test Results Satisfactory .for Total Coliform Conw ents Very old system, Well head & casing located in 6' x 8' x 4' box below ground surface enclosure (completely enclosed). Sustained yield of 6 gpm for 80 min. (465 gal). No pitless adaptor. B. SEPTIC/HOLDING T_'1NK DATA N/A Date Installed Size No. of Compartments Standpipes (Y/N) Air -tight Caps (Y/N) Foundation Cleanout (Y/N) Depression over Tank (Y/N) Date Last Pumped Pumping/Maintenance Contract on File (Y/N) ; for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) Separation. Distances from Septic/Holding Tank: To'Water-Supply 6b ll To Property Lire To Water Main/Service Line Course Comments public Sewer [Page 1 of 21 To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage 2-15-84 C. ABSORPTION FIELD DATA N/A Soils Rating in Absorption Strata Date Installed Width of Field Type of System Design. Length of Field Depth of Field Gravel Bed Thickness Square Feet of Absorption Area Standpipes Present (Y/N) Depression over Field (Y/N) Date of Last Adequacy Test Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Wsll _ To Building Foundation Lot To Water Main/Service Line To Property Line To Existing or Abandoned System cn on Adjoining Lots To Cutbank(if present) To Stream/Pond/Lake/or Major. Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Convents Public Sewer D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump on" Level at "Pump off" Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes(Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or, conformed to all MOA KAA Guidelines in effect on the date o this inspection. �/ SigDate Company MOA No. i i (jo KB1/d5/s (Page 2 of 21 2-15-84