HomeMy WebLinkAboutFOUR SEASONS CHALET LT 2AFour Seasons
Chalet
Lot 2A
#075-031-24
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On-Site Water & Wastewater Section Fax: 907-343-7997
Pump Installation Log
Well Drilling Permit Number: _______________ Date of Issue: ____-____-____
Parcel Identification Number: ____-____-____
Legal Description Block Lot Property Owner Name & Address:
Pump Installation Date: _____-_____-_____
Pump Intake Depth Below Top of Well Casing: __________ feet
Pump Manufacturer’s Name: ___________________________ Pump
Model: _____________________________________
Pump Size: ____________hp
Pitless Adapter Burial Depth: _________ feet
Pitless Adapter Manufacturer’s Name: _________________________
Pitless Adapter Installer: ____________________________
Well Disinfected Upon Completion? XX Yes No
Method of Disinfection: _____________________________
Comments:
Pump Installer Name: __________________________________
Company: ___________________________________________
Mailing Address: ______________________________________
City: ___________________ State: __________Zip: _________
Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation.
\ Municipality of Anchorage
Development Services Department
1
-
Building Safety Division—
On-Site Water 8 Wastewater Program, 4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number. SW060098 PID Number. 075-031-24
Nome: RICHARD EVANS
Wastewater System: O New' ■ Upgrade
Address:
2239 SUSITNA DRIVE a ANCHORAGE, AK 99516
ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 230-7266 4
i] Deep Trench ■ Shallot Trench O Bed 0Mound Gather
LEGAL DESCRIPTION
Sod Roteq:
1.2
rota Depth Dam a" goal.:
8.5 MAX
cm/sq. R
R
Block: Lot: Subdivision:
Depth to pipe settee, Van original gra..:
Gravel depth beneoth pipe.
— 2A FOUR SEASONS CHALET
SEE DWG. R
2.95 R
Tcenship: Range: Section:
!M spew aright god
Grovel length:
— — —
SEE DWG. R
60 R
WELL: 0 New p Upgrade
Ga of eiallHe
5
Number otdere:
1
Petarc. O.t...n save:
—
R
R
CY,wlrotrn priest.. 40.0; Taal Depth: Loeeal To
iota obooroon ores:awe
patent
D 3034/ F-810
R
50 8 So.R
Dn .. wleal: Stade Motor Level:Mader.
REDMOND EXC.
Gate Yet
5�1-6/1/2006
R
yNW:
pump set At:
caW,p Height Abovo Growrk:
TANK
Dpi„
R
R
SEPARATION
DISTANCES
■Septic 0Holding aS.T.E.P. anther
To
Septic
Absorption
Lift
Holding
/Pnvats
Manutaotaer:
GREER TANK
Copor,ty In goaahc
1250
From
Tank
Field
Station
Tank
see« Lines
Well
too'+
too'+
—
—
25'+
torten":
STEEL
lJ,enb.r at caeYathrse:
2
Surface water
too'+
too'+
—
—
—
LIFT STATION
Lot Line
5'+
et'+
—
—
—
Sig. In gasar:
Ma ufactwer.
Foundation
5'+
10'+
—
—
—
an Hovel al p ell eve aL or slam aL
pump IlaYe !
Vkol Mperbor, penamed by:
Curtain Groin
NONE KNOWN
BENCH MARK
Remarks:
Location orW Deecripto
"LOT LINE WAIVER GRANTED
BOTTOM OF SIDING NEAR FCO
OLD SEPTIC TANK PUMPED CRUSHED AND
COMPLETELY ABANDONED.
100.00 R
ENGINEEA•„EAL
4odo40
oA' of �4
.
Inspections performed by: GEG, Ltd. Dates: 1st 5/31/2006
9 .'• 37
........... .
2nd 5/31/2006
0
3rd 6/1/2006
�Q r y A. Corness:
Development Services Department Approval
00 CE -79153
Reviewed and approved by: Date: (o - l S DG
404p°prate„fa°Oo��
(ale.. 12/01)
PERMrrNUMBER: AS -BUILT DRAWING PARCEL ID NUMBER:
SW0 -
SW060098 075-031-24
NEW
1 �
f
L / /
/
/ALTEIRNATE SITE WILL REQUIRE \US
/ THE USE OF AN ADVANCED
WASTEWATER SYSTEM
NEW 1250 GALLON
/ SEPOC TANK
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS 6 GENERAL CONTRACTORS
5101 L TL'M 0DW 1111[ 101 . MCHMAM M 00501 • RIOIL (.05)S.T) l" . FY (.0»]. "
PREPARED FOR: PHONE NUMBER: PACE NUMBER:
RICHARD EVANS 230-7266 (AGENT) 2 OF 3
LEGAL OESCRIPT)ON: DRAWN BY:
FOUR SEASONS CHALET SUBDIVISION; LOT 2A. C.J.G.
TYPE OF WORK: DATE:_
(R... 01105)
A
B
STI
63.34
41.50
ST2
66.62
48.76
DBL1
69.41
54.24
DBL2
70.21
55.68
C01
77.79
73.63
MT1
73.80
72.15
20235.83
59.75
MT2
33.86
62.80
NEW 1250 GALLON
/ SEPOC TANK
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS 6 GENERAL CONTRACTORS
5101 L TL'M 0DW 1111[ 101 . MCHMAM M 00501 • RIOIL (.05)S.T) l" . FY (.0»]. "
PREPARED FOR: PHONE NUMBER: PACE NUMBER:
RICHARD EVANS 230-7266 (AGENT) 2 OF 3
LEGAL OESCRIPT)ON: DRAWN BY:
FOUR SEASONS CHALET SUBDIVISION; LOT 2A. C.J.G.
TYPE OF WORK: DATE:_
(R... 01105)
PERMMNUMBER: PARCEL ID NUMBER:
SW0 AS—BUILT DRAWING I
SW060098 075-031-24
TH# I
TOP OF TANK Al
INLET - 93.61
INVERT OF BUN(
AT INLET - 93.1
OF
FINAL GRADE
ORIGINAL -100. GRADE / 99.73-101.28
(00.28 A /
HIGHEST POINT
rFlLTER FABRIC
00
TION OF
87.26 BOTTOM
IRLNCH
91.76 (A]
OF BOTTOM
63.76
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS t GENERAL CONTRACTORS .
lAl L TUDM 1410. ]III[ 101 • XCmDW4L 711 "W7 11UIS (W7)177 In • FM Mn]] 0 emRl[ e.e.rery�ew
PREPARED FOR: PHONE NUMBER: PACE NUMBER:
RICHARD EVANS 230-7266 (AGENT) 3 OF 3 0
LEGAL DESCRIPTION: DRAWN BY: OQaO J
FOUR SEASONS CHALET SUBDIVISION; LOT 2A, C.J.G. e
TYPE OF WORK: DATE:
PROFILE AS—BUILT OF SEPTIC SYSTEM UPGRADE 6/5/2006
Rev. cim5)
TANK AT
95.58
OF BUNG AT
ET - 94.90
A. GGT ss:
�1
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water 6 Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Permit Number: SW060098
Legal Description: FOUR SEASONS CHALET LT 2A
Design Engineer: 0855 Gamess Engineering Group, LTD
Owner Name: RICHARD EVANS
Owner Address: 2239 SUSITNA DR
ANCHORAGE, AK 99516 -
Date Issued: May 18, 2006
Expiration Date: May 18, 2007
Parcel ID: 075-031-24
Site Address:
Lot Size: 25439 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit Is for the construction of.
❑✓ Disposal Field [D Septic Tank E] Holding Tank ❑ Privy Private Well 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 (1 BAAC72 ) and Drinking Water Regulations (18AAC80 ).
3_ The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
5. The following special provisions.
1. The subsurface disposal field is not within a 30 foot radius of a test hole. The Engineer needs to do an additional
lest hole during the construction of the septic field. Please submit stamped and signed results with the As -built
Inspection Report. If the results require a design change, construction of the system will stop pending Onsite review
and approval.
2. Please submit well documentation with the inspection report.
Received By.
Issued By.
Date: —/ el, 'd c
Date: -5- Is -O(-;
Municipality of Anchorage
Development Services Department
/ Building Safety Division '
On -Site Water & Wastewater Program '
4700 South Bragaw St.
n' P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.enchorage.sk.us
(907) 343-7904
ON—SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcell.D. -- - DW -031 -
Property owner(s) RICHARD EVANS c/o ERIN EKER Day phone 230-7266
Mailing address _ 2239 SUSITNA DRIVE a ANCHORAGE. AK
Site address Zip Code 99516
Legal description (Sub'd, Block & Lot) FOUR SEASONS CHALET SUBDIVISION: LOT 2A.
Legal description (Township, Section & Range) N/A
Lot Size c7? -5V39 Acres/Sq.Ft. Number of Bedrooms 4
THIS APPLICATION IS FOR( ®all that apply):
Absorption Field
❑
Septic Tank
123
Holding Tank
❑
Privy
❑
Private Well
❑
Water Storage
❑
THIS APPLICATION IS AN:
Initial
❑
Upgrade
Renewal
❑
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal codes.
GARNESS ENGINEERING GROUP, Ltd.
Permit/Rush Fees: 0_
Date of Payment: S-&C,to&
Receipt Number. 33 (Y, t
(Rev. 11/05)
Waiver Fees:
Date of Payment: -1-71b6D6
Receipt Number. 33! 11
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
May 15, 2006
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907)343-7904
Ref: Proposed Septic Upgrade for Four Seasons Chalet Subdivision; Lot 2A,
To whom it may concern:
The existing 4 bedroom house is served by a private well and an undocumented septic system. We are
proposing to install a new 1250 gallon septic tank and 5 -wide trench type drainfield. One test hole was
excavated on the property. The drainfield will be designed around the 30 foot radius of this test hole.
Comments regarding the design are summarized as follows:
1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the
percolation test results.
2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications.
3. SURFACE RATERS: There are no surface waters within 100 feet of the proposed septic system.
4. TOPOGRAPHY: As can be seen on the attached design drawing the average topography around the
proposed drainfield is relatively flat. In short there are no slope concerns.
5. LOT LINE RAIVER: We request a 1 foot lot line waiver from the proposed drainfield to the north
and west lot line. We are unaware of any adverse impacts with the granting of this waiver.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems.
If you have any questions, please contact us at 337-6179. Thank you for your assistance.
NOTE. -Attached is a site plan drawing, a design drawing, one soil log, which are all part ofthe design package for
this septic system. (Contact C.E.G. Ltd. for 7 page construction specification letter.)
3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507
Ph: (907) 337-6179' Fax: (907) 338-3246' Website: gamessengineering.com
/
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LOT 47
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SEWER
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HEMLOCK S/0; /
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If
PROPOSED SEPTIC UPGRADE /
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(SEE DESIGN PACE 2 OF 2) /
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\HEMLOCK S/D; /
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LOT 2.
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GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS E GENERAL CONTRACTORS
fMl L IIIOCM Nlb, fl[I[ 101 � fMdORY[ AI( N501 fllbi ,U] -[1T fiVl b 1L -5]N � 1�50[mow.
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
RICHARD EVANS 230-7266 (AGENT) 1 OF 2
LEGAL DESCRIPTION: DRAWN BY:
FOUR SEASONS CHALET SUBDIVISION; LOT 2A. I C.J.G.
C OF WORK:
SITE PLAN FOR SEPTIC SYSTEM
(KO,. OlN5)
5/15/2006
�...�.y.............
rey A. Gorness.:
C 7953
1..11ASY"1
USS 3045
LOT 47
r
SEWER
SERVICE L
AWWU
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS E GENERAL CONTRACTORS
fMl L IIIOCM Nlb, fl[I[ 101 � fMdORY[ AI( N501 fllbi ,U] -[1T fiVl b 1L -5]N � 1�50[mow.
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
RICHARD EVANS 230-7266 (AGENT) 1 OF 2
LEGAL DESCRIPTION: DRAWN BY:
FOUR SEASONS CHALET SUBDIVISION; LOT 2A. I C.J.G.
C OF WORK:
SITE PLAN FOR SEPTIC SYSTEM
(KO,. OlN5)
5/15/2006
�...�.y.............
rey A. Gorness.:
C 7953
:g'
TO OBTAIN A COPY OF THE LETTER
CONTACT CEG. BY PROCEEDING FORWARD
WITH THIS INSTALLATION, THE ENGINEER.
WELL DRILLER. CONTRACTOR AND
PROPERTY OWNER AGREE THAT THEY
HAVE READ THESE SPECIFICATIONS AND
AGREE TO ACCEPT THE TERMS AND
PROPOSED
DRAINFIELD
1' LOT LINE M
REOUESTE
NOTE: THE CONTRACTOR SHALL
HAVE THE 100' WELL RADIUS
AND THE NORTH AND WEST
LOT LINES FLAGGED BY A
REGISTERED LAND SURVEYOR
PRIOR TO CONSTRUCTION.
V LOT LINE WAIVER
REQUESTED
)NFIRMATION TESTHOLE TO BE
DUG WRING CONSTRUCTION
NUMBER OF BEDROOMS:4
GALLONS PER DAY (GPD): 600
PERCOLATION RATE/S: <1 MIN./INCH
PROPOSED APPLICATION RATE: 1.0
MINIMUM DRAINFIELD SO.FT.: 600
MAXIMUM DEPTH:8.5 FEET
mOTH:5 FEET
LENGTH:70 FEET
M.O.A. APPROVED SAND FILTER: N/A
EFFECTIVE:3 FEET
REDUCTION FACTOR: .58
ACTUAL SO.FT.: 603
—PROPOSED 1250
GALLON SEPTIC TANK
/ EXISTING SEPTIC SYST
BE PUMPED, CRUSHEI
COMPLETELY ABAND(
/ a INSTALL
FOUNDATION
CLEANOUT
I
QA0 0��
GARNESS ENGINEERING GROUP, Ltd. gr ....... • •• •••••• ......•••••
]AI C TA'M A'YD. 1UR 101 • II.O.[A.0( Wf •p0) • I..S[ (001I31]MIT • /N (M1J3Y-]tN • OEKIL �w.pwr•/wM1p••.•
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: •• •••• ••• ••••••
RICHARD EVANS 230-7266 (AGENT) 2 OF 2 OQ v '•• fT Ga ness.:
LEGAL DESCRIPTION: DRAWN BY: QO r CE -7 .�Fo
FOUR SEASONS CHALET SUBDIVISION; LOT 2A. C.J.G.
TYPE oWORK: DATE: proie;'Io�o4�0
0
DESIGN FOR PROPOSED SEPTIC UPGRADE 5/17/2006 ��Oppp000
IRw. OLDS)
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS C 4
A, E T.00N MMD, SuIE 101 • MKaMnOC. NC iY•A) • P1LV4: i07 ],(Y r (.Y: 907 -]1N • WYIG V>^•••q+••M tan
SOIL LOG — PERCOLATION TEST .......
LEGAL DESCRIPTION: FOUR SEASONS CHALET SUBDMSION; LOT 2A, r y
CE_
79/5grness. Qp
PERFORMED FOR: RICHARD EVANS DATE: 5 a 2006 o e'• c�Fop�
7/ iS14.6'
DEPTHO�0O'Pofessio"°oma
(feet) _=== ORGANICS TEST HOLE # 1 r
�Do fesslo
LOAM SOIL CLASSIFICATIONS
GW ==== ORG ---
3 L+'+�Z GP ML
GM CL A
a +,
», G a GC OL
••.• SW MH /
Og 0.•'0 '0, SP CH
SM ; OH / _ —
6 �S SC
i
a� A
8»
9 '+ MORE SILT sc LE.
c
•» w/ DEPTH
11 '`
. L•qL
12
Lwt
14 R {
• L•M_
�•
.L
16 >w':
R•
17
18
19 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 3.5 FT. AND 4.0 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES ENO
SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: JODY MAUS
COMMENTS: THE INSITU SILTY SOILS WILL ACT AS A SAND FILTER
PERFORMED BY GEG, Ltd. 1, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PE FORMED IN ACCORDANCE
Z
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: / O4
DEPTH TO
GROUNDWATER
DATE
13'
5/4/2006
13'
5/13/2006
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Municipality of Anchorage •. ••
�`,� CO. IMx� 19(iGiO •
Al. 1i19fiGiO •Telephone (907) 31.1 )ii01 •1'u�
370(1 ISmgnw S:ncl • :lnehnmgc, :Uackn 99507
atm munLorg
Mayor Dlark Ilcgich
Building Safety Division
May 18, 2006
Jeffrey Garness, P.E.
Garness Engineering Group
3701 E. Tudor Road, Suite 101
Anchorage, AK 99507
Subject: Waiver Request for Four Seasons Chalet Lot2A
Waiver Request WR#: 060019
Parcel ID # 075-031-24
SW060098
Dear Jeffrey Garness, P.E.:
Your request for a waiver of the required 10 feet horizontal separation from the
absorption field to the propertyline has been approved. The approved separation
distance is 1.0 foot. The 1 foot horizontal separation applies for septic absorbtion field to
north and west property line waiver.
This waiver approval applies to the existing absorption field to property line separation
only. Any future upgrade to the on-site wastewater disposal system will require all
separation distances be met or another approval from this department.
If there arc any further concerns or questions regarding this waiver, please call our office
at 343-7904.
Sincerely,
J e oodall
Civil Engineer
On -Site Water & Wastewater Program
Community, Security, Prospeiity
Municipality of Anchorage
Development Services Department
• +� Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519.6650
www.ci.anchorage.ak.us
(907)343-7904
Waiver Review Worksheet
WR#:060019 PiD#:075-031-24 HAIPermit# SW060098
Date Received: May 18, 2006
Legal Description: Four Seasons Chalet Lot2A
Engineer.
Jeffrey Garness, P.E.
Garness Engineering Group
3701 E. Tudor Road, Suite 101
Anchorage, AK 99507
Applicant: Richard Evans & Erin Eker
Waiver Requested: l foot horizontal separation from septic absorbtion field to north and west
property line waiver.
Criteria: Geology Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Total:
Waiver Is Granted: X Waiver is not Granted:
List Conditions or Reasons for above:
Date: 4/18106 By: Joe Goodall
Name of Reviewer
.°...°..°...°°.°..........a...............................................
Rec#: 33181 Amount: $M Date Paid: 5/18/2006
Municipality of Anchorage
Development Services Department
• '� Building Safety Division : `a
Onsite Water and Wastewater Program =. _
4700 South Bragaw St. s r
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET
To: Jeff Gorness
Legal description: Four Seasons Chalet. Lot 2A
The attached paperwork has been reviewed and Is being returned for the following reasons:
❑ Original signature or stamp missing on
® Calculation error in design. 1.0 6PD should be used when existing soils act es a sand filter
® Additional soils information needed. Provide perculation tests so that the system is within a
30' radius. Tests may be done during system excavation and installation
❑ Water monitoring results Inadequate.
❑ Discrepancy in Information submitted. _
❑ Topographic information missing or inadequate. _
❑ Incomplete; missing
❑ Incomplete; missing
❑ Additional adequacy test information needed. _
❑ Water sample unacceptable. _
❑ Measured/proposed distances/dimensions missing.
❑ Locations of all soils, percolation and water monitoring tests not shown. _
❑ Proposed system too deep for soils information submitted.
® Well log required. Provide well log for existing well.
❑ Omission in narrative.
❑ Insufficient fill over tank or field._
® Other. Please note on the plans that the existing system will be abandoned per code
Name of reviewer. Deb Wockenfuss
Date: 05/17/06
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK
NUMBER OF BEDROOMS:4
TO OBTAIN A COPY CE THE LEITER NOTE: THE CONTRACTOR SHALL
CONTACT GEC. BY PROCEEDING FORWARD HAVE THE 100* WELL RADIUS GALLONS PER DAY (CPD1 800
WITH THIS INSTALLATION, THE ENGINEER, PERCOLATION RATE/S: <1 MIN./INCH
WELL DRILLER. CONTRACTOR AND AND THE NORTH AND WEST PROPOSED APPLICATION RATE: 1.2
PROPERTY OWNER AGREE THAT THEY LOT LINES FLAGGED BY A MINIMUM DRAINFIELD SO.FT.: 500
HAVE READ THESE SPECIFICATIONS AND REGISTERED LAND SURVEYOR
AGREE TO ACCEPT THE TERMS AND PRIOR TO CONSTRUCTION. DRAINFIELD DESIGN:
CONDITIONS OUTLINED.
MAXIMUM DEPTH:8.5 FEET
WIDTH: S FEET
LENGTH:58 FEET
W.O.A. APPROVED SAND FILTER: N/A
EFFECTIVE:3 FEET
PROPOSED REDUCTION FACTOR: .58
DRAINFIELD ACTUAL SO.FT.: 500
INSTALL DOUBLE — - CLEANOUTS
PROPOSED 1250
GALLON SEPTIC TANK
(CO
1'
RNATE SITE WILL REQUIRE
E USE OF AN ADVANCED
TREATEMENT SYSTEM
EXISTI
BE CL
INSTALL
FOUNDATION
CLEANOUT
is
Ail
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS&GENERAL CONTRACTORS ......• • •••••• ............••
3T31 L TCM 11010. Ill 101 • NICIILVUI! W MSO) • Ill (ill • fm (fOY)S.Y-JON • Anil w .0AFmn
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ••• ••• ••.••.......•.
RICHARD EVANS 230-7266 (AGENT) 2 OF 2 QQ P hey Carl
LEGAL DESCRIPTION: DRAWN BY: O�'P, •.•�7—� .• • F`a
FOUR SEASONS CHALET SUBDIVISION; LOT 2A, C.J.G. ��'�..•
4ed
TYPE OF WORK: DATE: QOO4Op�QOProfessloo&oa
DESIGN FOR PROPOSED SEPTIC UPGRADE 5/15/2006
nay. OlNal
• Municipality of Anchorage
U3 G
On -Site Water and Wastewater Program -
(907)343-7904 sa ETY
Certificate of On -Site Systems Approval
Parcel I.D. 075-031-24 Expiration Date: 6P ` 2- Z 2 z
1. GENERAL INFORMATION:
Complete legal description FOUR SEASONS CHALET; LOT 2A
Location (site address) 150 Snowmass Circle *Girdwood 99587
Current Property owner(s) Kristina Fritz
Mailing address
Day phone 382-0750
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
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 $ 5 5 O Waiver Fee $
Date of Payment Date of Payment
Receipt Number Receipt Number,
COSA # O S C a-'1 1 1 O 1 Waiver #
10
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: Gamess 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: -2-1 Z 7 -
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 datels of the r)�
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, Cl)
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 j ""' (/
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 ..(1 • • • • •�/
the well or septic system. GEG makes no representation whether an alternative well or septic system (r efl y
can be installed on the property in the event either of the current systems fail to perform adequately in CE- 795 `C
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 rightrzss+ t°o
6. 7IGNATURE
System #1 Approved for bedrooms
System #2 Approved for bedrooms
Disapproved
Conditional approval for bedrooms, with the fol
#AECC884
ON-SITE -mom
WATER AND _
r0"tip I�n91rs_v'ATER01 o
PROGRAM 6
SE?\\J .
1,
�/✓�V Vq-d Original Certificate Date: -2 % 7
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
Legal Description: FOUR SEASONS CHALET; LOT 2A
If more than 1 septic system on lot: COSA Checklist # of
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled 1172(?)
Total depth *68+ ft
Cased to *50+ ft
❑ Sanitary seal is functioning correctly
On Wires are properly protected
Parcel ID: 075-031-24
Structure served by this system _
Well production at time of test 6.7+ gpm
Water storage tank volume N/A gallons
Weydisinfected for coliform test? ❑ Yes MM No
`�� qk ® Coliform bacteria is Negative
Nitrate _— 6/1- ❑ Nitrate less than MRL (ND)
Arsenic ug/L & Arsenic less than MRL (ND)
Casing height (above ground) 18+ in. Collected by GEG, LTD.
Date of flow test for COSA 2/22/22 Date of Sample 2/23/22
Static water level at beginning of test 55.2 ft.
Comments *PER ARROW WELL &.PUMP SERVICE CAMERA INSPECTION IN 2012
B. TANK DATA
Age of tank(s) 16 years
Tank type/material STEEL
Measured operating fluid level in septic tank 50"
❑ Standpipes/foundation cleanout per record drawing
Date of pumping _ ! I i
D. ABSORPTION FIELD DATA TRENCH
Which system tested (date installed) 8/1/06
❑ ALL standpipes present per record drawing
Total measured depth from grade *8.75 ft (max)
Measured depth to pipe invert from grade *6.75 ft (min)
❑ N/A — pressurized field
❑ Monitor tubes go to bottom of effective. If not, state
depth into effective 2.41'
C. LIFT STATION
❑ Required maintenance
Age of lift station
Lift station materi�
Adequacy test date 2/22/22
Results MV Pass For 4 bedrooms
Fluid depth prior to test 6 in
Water added 616 gal
New depth 19 in
Elapsed time 120 min
❑ Code -required soil cover over field Final fluid depth 13 in
❑ System presoaked Absorption rate 600+ gpd
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NONE
date of test) N/A
Gallons introduced N/A gallons If yes, enter date
Comments/Deficiencies: 'FOR NORTH SIDE OF TRENCH -C/O a MT ON SOUTH SIDE OF TRENCH NOT FOUND
rJ
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'
21 Yes
if No
Community Sewer Manhole/Cleanout > 100'
E] Yes
if No
ft
Q Yes
if No ft
Neighboring Tank > 100' Yes
if No
ft
Private Sewer/Septic Line > 25' M Yes
if No ft
Absorption Field on Lot > 100' Yes
if No
ft
Holding Tank > 100' 0 Yes
if No ft
Neighboring Absorption Fields > 100'
if No
ft
Animal Containment > 50' Yes
if No ft
[D Yes
if No
ft
ft
If septic tank is under driveway comment below
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' 0 Yes
if No
ft
0 Yes
if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
21 Yes
if No
ft
Surface Water > 100'
Yes if No ft
Property Line > 5'
21 Yes
if No
ft
Wells on Adjacent Lots:
R Yes
Absorption Field > 5'
R Yes
if No
ft
Private Wells > 100'
Yes if No ft
Water Main > 10'
0 Yes
if No
ft
Community Wells > 200'
M Yes if No ft
Water Service Line > 10'
21 Yes
if No
ft
If septic tank is under driveway comment below
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10'
[Q Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
❑ Yes
if No
*1'+ ft
Wells on Adjacent Lots:
Water Main > 10'
R Yes
if No
ft
Private Wells > 100' 0 Yes if No ft
Water Service Line > 10'
F-11 Yes
if No
ft
Community Wells > 200' El Yes if No ft
Surface Water > 100'
0 Yes
if No
ft
F. ENGINEER'S COMMENTS
*WR#060019
F.C.O. IS PRESENT, BUT NOT SHOWN ON AS -BUILT SURVEY
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.
COSA Checklist yellow sheet
Volt
I x -N isx-N
IV
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J ff ess.
QQ49. —79 3
n
�4 dPr0fessio�o\c�
#AECC884
8
Municipality of Anchorage
' Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
343-7ge.ak.us
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING �1
Parcell.D. 075-031-24 COSA# ose,la1.1-act
1. GENERAL INFORMATION Expiration Date:
Complete legal description FOUR SEASONS CHALET LOT 2A
Location {site address) 150_SNOWMASS CIRCLE *GIRDWOOD, AK 99587
Current Propertyowner(s) KELLER & MICHELE LAGING Day phone C/O AGENT
Mailing address
Lending agency
Mailing address
Real Estate bent
Mailing address
150 SNOWMASS CIRCLE *GIRDWOOD, AK 99587
Day phone
BRYAN EPLEY W/ REMAX OF ALYESKA Day phone 783-2010
PO BOX 1029 *GIRDWOOD, AK 99587
Unless otherwise requested, COSA wilt be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community -Class Well
Public Water System'
4
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 samples. (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 13 wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
0
❑
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 samples. (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 13 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 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. Phone
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineer's Comments
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
- DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
-there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benerit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever
5. DSD SIGNATURE
Approved for bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following
337-6179
Date 2 S 2
ON-SITE
Attachments: /
COSA Checklist Arsenic Advisory
Septic System Advisory Maintenance Agreements
Well Flow Advisory Supplemental Engineer's Report
Nitr Advisory Other
8y: fry Original Certificate Date: .�
(Rev. 11M)
Municipality of Anchorage
' Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: FOUR SEASONS CHALET LOT 2A Parcel ID: 075-031-24
*PER ARROW PUMP & WELL SERVICES
A. WELL DATA (WELL CAMERA'D)
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) NO
Date completed -1972 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth * b& ft. Cased to *50 ft. Casing height (above ground) 12+ in.
FROM WELL LOG
AT INSPECTION
Date of test NO WELL LOG 4/12/12
Static water level ft. 56 ft.
Well production g.p.m. 4.8 g.p.m.
WATER SAMPLE RESULTS:
Coliform —0—colonies/100 ml. Nitrate 0- 4 mg./L. Collected by: GEG. Ltd.
Arsenic: 00 ug./L. Date of sample: 4/12/12
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL
Tank size 1250 gal. Number of Compartments 2
Date installed 5/31-6/1/2006
Cleanouts (Y/N)
YES
Foundation cleanout (Y/N) YES Depression overtank(Y/N) NO High water alarm (Y/N) N/A
Date of pumping i a Pumper /V `e Oe n a /,J -y /:�L AN '0'
C. ABSORPTION FIELD DATA
Date installed 5/31-6/1/2006 Soil rating (g.p.d./ft2or /bdrm 1_2 System type SHALLOW TRENCH
Length 60 ft. Width 5 ft. Gravel below pipe 2.95 ft.
Total depth *8.5 ft. Eff. absorption area 508 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test 4/12/12 Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test 2 in. Water added 600 gal. New depth 3_5 in.
Elapsed Time: 10 min. Final fluid depth E in. Absorption rate >= 600+ g,p,d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date
COZ& MTZAT SOUTH END OF TRENCH COULD NOT BE LOCATED DUE TO SNOW. TEST WAS
PERFORMED USING CO & MT AT NORTH END OF TRENCH. PER JEFF POET CO & MT AT SOUTH
END OF TRENCH DID NOT HAVE TO BE LOCATED.
D. LIFT STATION
Date installed Size in gallons Manhole/Access Q /N
"Pump on" level at in. "Pump oft' level High water alarm level at in.
Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
100'+
On adjacent lots 100'+
Absorption field on lot
100'+
On adjacent lots 100'+
Public sewer main
N/A
Public sewer manhole/cleanout N/A
Sewer /septic service line
25'+
Holding tank N/A
Animal containment areas
50'+
Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+
Property line
5'+ Absorption field 5'+
Water main N/A
Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD
ON LOT TO:
Property line *1'
Building foundation
10'+ Water main N/A
Water service line 10'+
Surface water
100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
i�1
G. ENGINEER'S CERTIFICATION o OF..A
I ceftify that t have determined through field inspections and * N
review of Municipal records that the above systems are in """""' ... """"""'
conformance with MOA COSA guidelines in effect on this
date. ....... .......
Q f r A. ess.
Engineer's Printed Name JEFFREY A. GARNESS QQ @ E—J79513 m�
�0 lZ�i
Date �f �ZS j Z d n ofessio0
40''e l— �° o
COSA Fee $ (JqL)/. W
Date of Payment
Receipt Number U q
(Rev. 11105)
Waiver Fee $
Date of
Receipt Number
AAROW PUMP & WE[[ SERVICE, LLC
P.O. Box 110496
Anchorage, AK 99511
Office: (907) 346-9355 • Fax (907) 333-8976
Eagle River: (907) 622-9335
CUSTOMER
rQ�9
L 7�F '�-/- -I
No. 9344
JOB SITE A-
L J
INVOICE DAATEWELL
�2
DEPTH
b
SWL
5-c
CHLORINATED
PUMP DEPTH
SALESPERSON /
QU ITY
DESCRIPTION
PRICE
AMOUNT
/ S
/A.5,
G
Z2��3J J-
LABOR
HOURS
RATE
AMOUNT
TOTAL MATERIAL
TOTALLABOR
WORK ORDERED BT
DATE COMP.
TOTAL
LABOR
f
PAY THIS AMOUNT
y�G
Thank You
SIGNATURE
(I Hereby Acknowledge the Satisfactory Completion of the Above Described Work and agree that if above work is not paid for in 90 days I agree to allow Aarow
Pump & Well Service, L.L.C. the right to remove unpaid for equipment and charge for labor already performed & labor to remove unpaid for equipment.)
TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE.
SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS.
Municipality of Anchorage
1 Development Services Department
— i Building Safety Division
Onsite Water & Wastewater Program \
4700 Bragaw Street
P.O. Box 196650
Anchorage. AK 99519-6650
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcell.D. 06-6,51-94 COSA#
1. GENERAL INFORMATION Expiration Date: 9 0 G
Complete legal description FOUR SEASONS CHALET: LOT 2A.
Location (site address) 15� NOWMASS CIRCLE • GIRDWOOD. AK
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
RICHARD EVANS Day phone C/O AGENT
2239 SUSITNA DRIVE
Day phone
ERIN EKER w/ DYNAMIC PROPERTIES Day phone 230-7266
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
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 samples. (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 verity 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 riles 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.
Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance oflhe
system under the conditions encountered at the time of the lost, and separation
distances measured to readily identifiable features. The operational filo of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden detects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
VGNApproved for bedrooms.
Disapproved.
Phone
337-6179
Date
Conditional approval for bedrooms, with the fllowing stipulations:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory.
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Reort
Other
p
nN•cITF ••: Nr_ ii
WATER AND ; m=
PROGRAM
By: &C -,t Original Certificate Date: S- O
1R.v 111 1
Municipality of Anchorage ,
' Development Services Department '
Budding Safety Division .
On -Site water & Wastewater Program
47W Bragaw street
P.O. Box 1966W
Androrege, AK 995198650
www.muni.arg/onafte
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: FOUR SEASONS CHALET: LOT 2A Parcel ID: 0 7.r - 031 ' 2 it -
A. WELL DATA
Well type PRIVATE If A. B, or C provide PWSID# N/A
Data completed � 1972 Sanitary seal (Y/N) YES
Total depth 75 ft. Cased to 40+ ft.
FROM WELL LOG
Date of test pG
Static water level _ ���� ft.
Well production N� g.p.m.
WATER SAMPLE RESULTS:
Web Log (Y/N) NO
Wires properly protected (Y/N) YES
Casing height (above ground) 18+ in.
AT INSPECTION
5/4/2006
47 ft,
5.5 g.p.m.
Colffor 0_ colonies/100 ml. Nitrate 0,536 mgJL. Other bacteria 0 colonies/100 mi.
Arsenic: _ ND ug./L. Date of sample: 5/4./2006 Collected by: GEG Ltd.
B. SEPTICfHOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL Data installed 5/31-6/l/2006
Tank sae 1230 9ht, Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alar (Y/N) N/A
Date of pumping NEW Pumper
C. ABSORPTION FIELD DATA
Date installed 5/41-e/1/200e Sob rating 4EOWft9bdr) 1_2
Length 60 ft. Width S ft.
System type SHALLOW TRENCH
Gravel below pipe 2.95 ft.
Total depth 074-9.5 ft. Eff. absorption area 508 ft' Monitoring tube YES Depression over field NO
Date of adequacy test NEW Results (Pass/Fall) PASS For 4 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) NONE KNOWN If yes, give date -
D. LIFT STATION
Date installed
"Pump on" level at _in.
Datum -
E. SEPARATION DISTANCES
Size In gallons
"Pump ofP
High water alarm level at
Cycles tested Meets alar 8 circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100,+ On adjacent lots 1
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main N/A
Sewer /septic service line 25'+
Public sewer manhole/cleanout N/A
Holding tank N/A
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Properly line '1' Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
060019
G. ENGINEER'S CERTIFICATION
I cerdYy that I have determined through fleld inspections and V0,90 review of Municipal records that the above systems are in conformance with MOA COSA guidelinesin effect on this
date.
Engineers Printed Name JEFFREY A. GARNESS
Date 6 2 06
COSA Fee S /?a . O O
Date of Payment 6 j .i - n C
Receipt Number
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
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