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HomeMy WebLinkAboutSEIDLER #2 BLK 5 LT 8idl r' lock Lo1' 8 050-151 -61 QGRE "ER ANCHORAGE AREA BOf 'IGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME William Peissig LOCAI'ION MAILING ADDRESS 511 S. Lane Street PHONE 333-8382 LEGAL DESCRIPTION Lot 8, Block 5, Seidler Sub, SEPTIC TANK: DISTANCE FROM WELL 150' INSIDE LENGTH UL fJ1852OO MANUFACTURER Stack Steel MATERIAL . INSIDE WIDTH LIQUID DEPTH __ NUMBER OF Steel COMPARTMENTS_ 2 .LIQUID CAPACITY 7250 GALLONS. SEEPAGE PIT: Concrete rings NUMBER OF PITS ] LINING MATERIAL Gravel BUILDING FOUNDATION ADDITIONAL ABSORPTION DIAMETER 69' ORWIDTH 12', LENGTH26~, DEPTH 6' CRIB SIZE: DIAMETER 4~ DEPTH 6' DISTANCE FROM: WELL 150' TOTAL EFFECTIVE NEAREST LOT LINE 12' . ABSORPTION AREA (WALL AREA) 414 _sq. FT. WELL: TYPE Drilled CONSTRUCTION BUILDING NEAREST FOUNDATION __ LOT LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED Standard DEPTH 267' DISTANCE FROM: NEAREST SEPTIC SEEPAGE SEWER LINE TANK 140' SYSTEM 150' REMARKS DISTANCES: INSTALLED BY: _ R~R~ Wood~ PIPE MATERIAL: Cast Iron LOT SLOPE: REMARKS: Form No, EQ-031 DIAGRAM OF SYSTEM GREATER ANC:HORAGE AREA BOROUGH BEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4961 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO. NAME OF APPLICANT _//~}/1~ INSTALLATION LOCATION LEGAL DESCRIPT,ON & ~C PHONE INSTALLATION OF: TYPE AND SIZE OF FACILITY TO BE SERVED SOIL TEST RESULTS - COMPLETION DATE ANTICIPATED TO BE INSTALLED BY cS - NOT£: THIS PERMIT I~ NOT VALID WITHOUT SOIL FINAL INSPECTION: 24 HOUR NOTICE REQUIRED, BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTI TYPE f/ SEEPAGE AREA SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS / FOUNDATION TO SEPTIC TANK ~ SEPTIC TANK TO seEPAGE PIT WALL SEPTIC TANK ~ . SEEPAGE PIt TO NEAREST LOT LINe. WELL TO SEPTIC TANK ///~ ~) DRAIN FIELD /~L'~ t SEEPAGE Pit /~') ~ , ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK DRAIN FIELD SEPtiC TANK, ., SEEPAGE PIT TO RIVER, LAKe, STREAM. . SEEPAGE PIT CAST IRON INTO AND OUT OF SEPtiC TANK AND INTO CRIB CROSSING GaP Of EXCAVATION S PEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT rEMOVABLE CAPS. DIAGRAM OF SYSTEM GRAVEi nAC, KFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. LICENSED DESIGNER [ CERTIFY THAT i AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCH/~RAge /~REA BOROUGH ORDrNANCE NO. 28-6S AND THAT THE ABOVE DATE { ' RE GREATER ANCHORAGE AREA BOROUGH Depar'~e. nt of Environmental Quality 3330 "C" Street anchora9e, Alaska 99503 Performed for ~,~] L\ ~ ~x~-~:~ m' ~L ~ Date performed Legal Description: ']lids form reports: Soils log ? Pe~c61ation test Depth Feet l- 3- 4- 5- §- ?- 8- 9- tO- 14- Was ground water encountered? If yes, at what depth? Reading Date Percolation rate minute, GroSs Time Net Time Depth to H2O Net Drop Proposed installation: Seepage Pit .... Drain Field " Depth of Inlet ~ . Depth to bottom of pi~ or trench . COMMENTS: '/.~---~'~-~_~.~..~ ~.~ .,?'.,]Z~ 0_~.~-~ ..~'_,~.~0'.~~~.:_ ........... Performed By~.~-"-~~ ~'C~ By: Date: .......... Time Q~_~D/1 Date ~ -__~77,.~.5. InsP ~__. '\ MUNICIPALITY OF ANCHORAGE i'1 DEPARTME~ OF HEALTH AND ENVIRONMENT PROTECTION 82~5 ~ Street, Anchorage, Alas~.~t 99501 ,~6~Dbk 279-2511, ext. 224 or 225 -~ [\P -~ '/ . ~ May ].6, 1977 ~.~~1~ -~- Date Received: #2: #3: Time Time ~(Sf~) D~,. _ Date Insp ~9~_~ Date Insp REQLEoT FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Home Federal Savings and Loan Association Mailing Address: 535 D Street Phone: 272-1451 2. Property Owner: William Peissig Mailing Address: Post Office Box 455 99577 Phone: 694-9918 3. Legal Description: 4: Single Family Residence: (~ Multiple Family Residence: ( ) Lot 8 Block 5 Seidler Subdivision ~12 Number of Bedrooms: Number of Bedrooms: o Well System: Individual Well k ) Permit ~ -'~ Depth ~ell Construction Sewage Disposal S~S'~em: On-site System Permit ~ ~/'/ Ins'hal led ~- 1974 Septic Tank Size [ ~ ~ ~ ~Manufacturer Absorption Area Community/Public System ( ) 267' Well Log on File Bacterial Analysis __ Public Utility Material Distances: Well to Septic Tank / ~z~v/~/ to Absorption Area to Sewer Line (~l, ~' Nearest Lot line ~ Absorption Area / to Nearest Lot Line /~ Page .' Two Department of Health and EnvJronmen[al Projection Request for Approval of Individual Sewer and War:er ~acll~tx_s Legal Description: Lot 8~Block 5 Seidler Subdivision ~. Comments: Disapproved: Letter Attached: ( ) Date: Date: Department Worksheet: .MUNICIPALITY OF ANC ¢O' DF_P1'. O!: III!Al IH ,?: HUN I C I PALI TY OF ANCHORAGE EhlVl~.oi, .: ,,,i 99501 i,l/~'l I 825 L Street, Anchorage, Alaska "~' ~." ' 279'-25171., ext.. 224, 225 Property Owner: Mailing Address: 0 Name of Buyer: Mailing Address: Phone: Se Lending Institution: Mailing Address: Phone: Realtor/Agent: Mailing Address: Legal Description Street Location: Phone: Single Family Residence: (~ Number of Bedrooms: Mu].tiple Family Residence: ( ) Number of Bedrooms: Water Supply: *IndJ. vidua]. Well If Individual Well., well depth (t~ Public/Co~nunity System If Co~aunity System, name of system ( ) Sewage Disposal System: On-site System (/ Public System ( ) / / If On-site System, date of installation: ~/~_~/?~___ *NOTE: A well log is reguired on ALL wells drilled since 6/75. 3/77 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.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 05°~131-61 COSA # (~--~ Expiration Date: GENERAL INFORMATION Complete legal description Seidler #2 S/D, Block 5, Lot 8 Location (site address) 11928 Devils End, Eagle River, Alaska Current Property owner(s) William and Patricia Peissig Mailing address 735 s. Los Topacios, Green Valley, AZ 85614 Day phone (907) 351-3165 Lending agency Mailing address Real Estate Agent Mailing Address Day phone Audrey Mason of ReMax of Eagle River 11525 Old Glenn Hwy., Eagle River, AK 99577 Day phone 622-3344 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual Well [] Individual Water Storage [] Community Class __ Well [] Public Water System [] TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding Tank [] Community On-site [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I vedfy 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 Douglas T. Kenley, P.E. Address 9806 E. Northstar Circle, Palmer, AK 99645 Engineer's Pdnted Name Douglas T. Kenley DSD SIGNATURE Approved for ~ Disapproved. Conditional approval for bedrooms. Phone (907) 746-1073 Date bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory (Rev. 11/05) X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date:, ~/0-' /'7/-// Municipality of Anchorage Development Services Department Building Safety Division On-Sita Water & Wastawatar Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www. mUni.org/onsita (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Setd~ #2 S/D, Block 5, Lot 8 Parcel ID: 050 131 61 000 A. WELL DATA Well type P~vae If A, B, or C provide PWSID # Data completed ?,~,,2~4 Sanitary seal (Y/N), ,Y, Total depth 267 ,ft. Cased. to 46 ,ft. FROM WELL LOG Data of tast 8/12/74 Static water level 36.5 f. Well Log (Y/N) Y VVires properly protected (Y/N) Y Casing height (above. grOund) ..... 12 AT INSPECTION 8/2/11 70.8 fL in. Well production 2.5 g.p.m. WATER SAMPLE ,,RESULTS: Coliform Negative COIOnlas/100 mL Nitrate ,0,.10~ mg/L Arsenic: NO ug/L · ~ date of sample:~.~ -: T~nk Type/Mat~,. Sept,C/Steel Tank size $25o gal; Number of Compartments 2 Foundation cleanout (Y/N) Y* Data .of. Pumping 8/24/11 C. ,A~EK)~FIO~ FIELB INtTA Datai~talled :9/21/74 S~l rating (g.p.d./ft~ orft~/bdrm) 103 Length 26 ff. Width 12 fL Total depth 10.5 ff. Eft. absorption area,. 4,14 ft2 Monitoring tube ,, Y, Date of adequacy test 9/22/11 Results (Pass/Fail) Pass,~, 1.4 g.p.m. by: F. Kenley Date ~instaled ' .9/21/74 Cleanouts (Y/N) Y Elapsed Time: 868 min. Final fluid depth 2~1/2 in. Absorption rate >= 600 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) y/,State Wide Blasting ff yes, give data 8/24/11 c ravet N/A Crib Depression over field N ~' , For, 4, ,bedrooms ' New depth 3~, ,~8 in. VVater added 622 ge'L Fluid depth in absorption field before test ~3-~/2 in. Depression over tank (Y/N) N High water alarm (Y/N) Pumper , JRs Pumping D. LIFT STATION Data installed "PUmp on" level at ~ in. aatam- E. SEPARATION DISTANCES SEPARATION DISTANCES FROM V~ELL ON LOT TO: Septic tank/lift station on lot Absorption field on lOt Public sewer main N/A Sewer/septic service line 25+ ff. Animal containment areas 50+ f. Size in gallons Manhole/Access (Y/N) m "Pump o~ level*at ' ' r alarm level at Cycles tested Meets alarm & circuit requirements? 100+ff. 100+ff. 100+ ft. On adjacent lots On adjacent lots 100+ ft. Public sewer rrmntml~cleanout Holding tank N/A Manure/animal excrete storage areas N/A 100+ f. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ ft. Water main 1 0+ ft. VVeils on adjacent lots 100+ ft. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: vva~r set,ce line 10+ ft. ~field Surface water 5+ fl:. r COSA Fee $ ~-~q 0 ~- Waiver Fee $ Date of Payment q /~-~J/1[ Date of Payment (Rev. 4110) Property line 12 ff. Building foundation 10+ ft. VVater main 1 0+ ft. Water ServiCe line 10+ f. Surface water 100+ ft. Curtain drain None Known Wells on adjacent lots 100+ ff. I certify that I heve determined through f*~ld inspections and ,, review of Municipal records tlmt t/Ye. above..systems em in Engineer's Printed Name Douglas T. Kenley P.E. Date ' "i/~0 g'l Douglas T. Kenley, P.E. 9806 E. Northstar Circle, Palmer, Alaska 99645 (907) 746-1073 September 28, 2011 Municipality of Anchorage On-Site Services 4700 South Bragaw Anchorage, Alaska Re: William Peissig, Owner Seidler #2 S/D, Block 5, Lot 8 11928 Devils End Eagle River, Alaska COMMENTS TO TAN COSA CHECKLIST *Foundation clean out is inside house in downstairs laundry room. At the start of the well and septic test on August 2, 2011, the crib had a water level of 56-3/4". The test was stopped because the water in the well was depleted after only 458 gallons had been pumped out. At that time the water level in the crib was at 71-3~4". The effective depth of the crib is 72". It was decided to hire State Wide Blasting to loosen up the sewer rock in the crib, which was done on August 24, 2011. On September 22, 2011, a new test was performed with the well yielding 1 ..4 G.P.M. in four hours. The crib had 13-1/2" of water at the begining of the test and after 622 gallons of water was introduced into the system, the new level was at 36-1/8". After 868 minutes, the level was 24-1/2". The system is capable of absorbing 600 gallons in 24 hours. Douglas T. PE #8176 PROPOSED FINISHED FL~ LOT 7 UNDER NO CIRCUMSTANCES SHOUm AN AS-BUILT BE USED FOR CONSmUC~ON OR FOR ESTABLISHING BOUNDARY OR FENCE UNES. ~E SUR~YOR TAKES RESPONSIBIU~ FOR ~E INI~AL ~ANSAC~ON ONLY AND ASSUMES FINANCIAL LIABILITY ONLY FOR ~E COST OF ~E SURLY. LIS~D DISTANCES PREVAIL O~R SCAMNG. REPRODUC~ON MAY CAUSE ERRORS IN SCALE. ~ LOT m.~ SURVEY TYPE SYMBOLS F~NDA~ AS-BUILT ~ RNAL SmUCmRE ~-BUILT ~ SET REBAR ~ DRAINAGE  o FOUND REBAR WOOD FENCE ~ CONCRE~ PLOT ~N , . . AS-BUILT . . . LOT SURLY . . . T~O~HY ~ AS-BUILT . . . NO C~S ~T ~ ~CA~ON AS-BUILT . . . NO C~NERS ~T ~ ASSUMED E~V. X X % METAL ~NCE I//[~l WOOD DECK PLOT PLANS A LOT SURVEYS NOTE: IT IS THE RESPONSIBILITY OF THE BUILDER OR O~ER, PRIOR TO ONLY ~OSE IMPROVEMENTS ABOVE GROUND AND ~SlBLE ~LL BE CONSTRUC~ON, TO ~RIFY PROPOSED BUILDING GRADE RELA~VE SHO~. FENCES, ~LLS, SEP~C CLEANOUTS, SIDEWALKS, DRI~WA~, TO FINISHED GRADE AND U~LI~ CONNEC~ONS AND TO DE~RMINE ETC., ARE SHO~ IN THEIR APPROXIMA~ LOCA~ON, ONLY. SNOW ~E EXIS~NCE OF ANY EASEMENTS, COVENANTS OR RES~IC~ONS MAY PRE~NT SOME IMPRO~MENTS FROM BEING SEEN AND LOCA~D. WHICH DO NOT APPEAR ON ~E RECORDED SUBDIVISION PLAT. ALL DISTANCES ARE RECORD UNLESS OTHERWISE NORD. SURLY CER~FICATION _~~.~ Prepored by OF 47"%. Robert E. Johns Jr. & Assoc ~,~ ~. ~, ~ h~. ~, ~.,, ...... .~** Professionol Lond Surveyors os ~ ~ ~e ~ md to ~, ~ of my ANCHORAGE, ALASKA 9950~ ~ ~emd ~ ~./ ~0 ' ~ ~L~ Scale: Rec. Lo~ S.F. Rec. Plat File No. RNAL S~UC~RE AS-BUILT SGS Reft# 1 113577001 Client Name Douglas Kenley P.E. Printed Date/Time 08/10/2011 7:59 Project Name/# Seidler S/D, BK 5, LT 8 Collected Date/Time 08/02/2011 15:40 Client Sample ID Hose Bib Received Date/Time 08/03/2011 11:15 Matrix Drinking Water Technical Director Stel~hen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID L/mits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 B (<10) 08/04/11 08/05/11 NRB Waters Department Total Nitrate/Nil~ite-N 0.107 0.100 mg/L SM204500NO3-F C (<10) 08/04/11 AYC Microbiolog~r Laboratory E. Coli Total Coliform Negative I 100mL SM20 9223B A 08/03/1 l DLC Negative I 100mL SM20 9223B A 08/03/11 DLC