HomeMy WebLinkAboutT12N R4W SEC 10 LT 34 N2T12N R4W
Sec 10
Lot 34 N2
#011-161-01
r-�
GREti R ANCHORAGE AREA BOR.JGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM I
NAME ��7A�-i)o E, �cmmE_ MAILING ADDRESS87020ftr?e-t d tM_VEI' PHONE' 3� -6.9 S
LOCATION h F CE21idi LEGAL DESCRIPTION T/?N R4 -&j 152C, IB._d/r� rev 1.3f�
SEPTIC TANK: � fV �nQrTQ f.%a�-Lk St7LL fftf ULM . � �"c4 Ve'«eedS 98D5
DISTANCE NUMBER OF
FROM WELL MANUFACTURER 6rLFl-- MATERIAL _Sn'-e'-47!�COMPARTMENTS
Z779 -MNK Q19Pk1c+U -� �009cL(.,
INSIDE LENGTH INSIDE WIDTH %QUID DEPTH LIQUID CAPACITY GALLONS.
TOTAL LENGTH r
DISTANCE FROM WELL 114D FOUNDATION ` O NEAREST LOT LINE OF LINES' n
NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTH.�§'IN. TOTAL EFFECTIVE
ABSORPTION AREA 422 SO. FT. LENGTH OF EACH LINE �0
DEPTH OF FILTER �}
DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE �11Y. ABOVE TILE IN.
WELL: r p�� IXIXnn
TYPE iN04 CONST RUCTION�i,219 TH DISTANCE FROM:
BUILDING / NEAREST f NEAREST / SEPTIC, SEEPAGE
JL.is
FOUNDATION �, LOT LINE .L0 SEWER LINE IKO't, TANK_L, SYSTEM //0 ,
i
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED REMARKS ._.
DISTANCES: DIAGRAM OF SYSTEM
INSTALLED BY: J N 4-0 eX(S7�
�pU tR' �f0
SEWER LINE DEPTH: 2 - 3
e,c�sn�yrcvJ�
C — e.
PIPE MATERIAL:
�tc)�1c 0,°'
LOT SLOPE: fir
—
�AR-f1 %p
REMARKS:
Form EQ -032
DATE��_1110 APPROVED
G.A.A.B.
t•i u t•J I C I F+ L_ I T'r• Cl F- r , r,F ��� �_ F=f r� E
f DEPARTMENT/" HEALTH AND ENVIRONMENTAL ,OTECTION
2516 E. (UDOR RD. , ANCHORAGE, AK. 5,,507
276-2221
I TE cE4JEFs FIEF -•tl I T
PERMIT NO. C 76506 )
APPLICAFJT WALDO E REMME 5720 EMERALD 99502
LOCATION E:=:TH ANDri ,c.
LEGAL T12N 841.1 SEC 10 N112 GOV L34 LOT SIZE
i
�j r9l -7
i44-6983
52000 SQUARE FEET
TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING (SQ FT/SR)= 100I'
THE REQUIRED SIZE OF THE SOIL ABSORPTjLIFJ�SYSTEM IS:
C•EF'TH= 12 LEt�FGTH= 2� CiF R'ti EL C•EFJTH=1 r
i
THE LENGTH DIMENSION IS THE LENGTH (IFJ FEET) OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET). i
THERE IS NO SET WIDTH FOP. TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IFJ FEET).
F zEG!L1 I F [-= r-- SEF='T I C TF 1r4K I 2f EZ 12!Srn iCFiLL_10r-JS.
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION. j
MINIHUM DISTANCE BETWEEN A WELL AND ANY OM -SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL.
SPECIFICATION'= AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER
INSTALLATION. i
I
F='ERt•7 I T 'ti•'�FL I G F4Ft' ORFE '4'Er-its F= Fz��M I S~5= ISE
I CERTIFY THAT
1: I AM FAMILIAR WITH THE REQUIREMENTS FOR OH -SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE. i
2: I 14ILL INSTALL THE SYSTEM IFJ ACCORDANCE WITH THE CODES.
_: I UNDERSTAND THAT THE OM -SITE SEWER. SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. i
--____--
APPLICAFJT 14ALDO E REMME
ISSUED BY__1 '� --------- GATE- 7=Ia _76--.
(:I -'CATER AIICIIfa;net. ARLA MIMPO— 1,
Department of Lnvironmeutal OL Ly
3330 "(." "trout
Anchorage, Alaska 97Si)3
SOILS LOG -- PI:ROLA•t'ION TEST
Performed �o _ Date Perfo
for. ..LL..S�:'�:al c_ e
Le,lal Descrlpt7Ut1:--M_123 4•i����xS
This form reports: So Is log_—yPercolation test__
Depth
Feet
I - XL (275) . -.._ .._.. --
2 - ML (275)
3 - 'L (275), 15 - SY (110)
4 - S:'. (25 0)
s:' (25G)
6 -
G:•t
(95)
7
DcpGl to lyater
-a•-
G.;
(95) —
10
1
11
12
13 -
3"'
(110)
14 -
S.;
(110)
S/ opt,
-71� 1175
Was ground water encountered? 110 _ If yes, at what depth?
• I •
Reading
Uate
�
Not Time
DcpGl to lyater
WON
:•
C
Was ground water encountered? 110 _ If yes, at what depth?
• I •
Reading
Uate
Gross Time
Not Time
DcpGl to lyater
Percolation rate minute.
Proposed installa r. Seepage Pit Drain Field
Iflet Urop
Depth of Inlet —_—_ -- Depth to bottom of pit or trenci,
C01-44ERTS.
PrrformuJ Cyc s �,� .Certified By � Datel: 702475•.
r.� n: :.2iir� ncr:i-3 i. ]rah^ P.-. I
EQ -040 (G/74)
Municipality of Anchorage >.,
Development Services Department
Building Safety Division
—
On -Site Water B Wastewater Program n ^
4700 Bragaw Street
P.O. Box 196650 C)!& S CJ AAJ
Anchorage, AK 99519-6650 1u1
www.muni.org/onsfte
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 011-1(01-01 CosA# QCPDX561
1. GENERAL INFORMATION Expiration Date: Jr— A 0 — 07
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
T12N R4W SEC. 10 N2 OF LOT 34
8720 EMERALD STREET • ANCHORAGE AK 99502
GRACE REMME Day phone 248-0316
8720 EMERALD STREET • ANCHORAGE AK 99502
Day phone
MARYANN HAMILTON w/DYNAMIC PROPERTIES Day phone 261-7600
3111 "C" STREET ' ANCHORAGE AK 99503
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site IN
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 B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers 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 withal/ applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Finn GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179
Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date
Engineers Comments:
In conducting this evaluation, GEG, LID. attempted to provide a thorough,
conscientious engineering analysis of the system In accordance with ADEC and MOA
DSD Guidelines 8 Regulations. The reported results described the performance otthe
system under the conditions encountered at the time of the test, and separation
distances measured to readilyldentirtable 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 Ihls 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
__LZ Approved for
Disapproved.
Conditional approval for
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
bedrooms.
Z'Islo-4
bedrooms, with the Glowing stipulations:
L�
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Reort
Other
By:
7%
(Rw. 11105)
0%Y OFA,&,
�\Qp ••.....• yo:
ON-SITE
WATER AND
WASTEWATER :
PROGRAM '
L.�
Original Certificate Date: 2. - 2,— O
Municipality of Anchorage .
• Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Bragew Street
P.O. Box 196650
Anchorage, AK 99519.6650
www.muni.org/onske
(907)943-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: T12N R4W SEC. 10, N2 OF LOT 34, Parcel ID:
A. WELL DATA
Well type PWATE If A, B, or C provide PWSID# N A
Date completed —1958 Sanitary seal (YIN) YES
Total depth 112 fl. Cased to 40+ fl.
FROM WELL LOG
Date of test
Static water level -
Well production 9•P•m•
WATER SAMPLE RESULTS:
Coliform 0 oolonies/100 ml. Nitrate DAD-mg./L.
Well Log (YIN) NO
Wires properly protected (YIN) YES
Casing height (above ground) 12+ in.
AT INSPECTION
5/12/2006
96 fl.
5.8 g.p.m.
Other bacteria _0 colonies/100 ml.
Arsenic: 27.8 ug./L. Date of sample: 5/12/2006 Collected by: GEG Ltd.
2/7/2007
B. SEPTICIHOLDING TANK DATA UNKNOWN
Tank Type/Material CONCRETE Date installed 7/28/1976
700+ YES
Tank size 700 gal. Number of Compartments UNKNOWN Cleanouts (YIN)
Foundation clesnout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) N/A
Date of pumping5/20/2006 Pumper ISAAC'S PUMPING
c. ABSORPTION FIELD DATA PBELOW EXISnNG
Date installed 7/28/1976 Soil rating (g.p.d./12o4!�iio 100 System type TRENCH
Length 30 ft. Width 2 ft. Gravel below pipe 7 ft.
Total depth *1 0.66 ft. Eff. absorption area 420 fe Monitoring tube YES Depression over field NO
Date of adequacy test 5/12/2006 Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before testDE in. Water added 603 gal. New depth 51 in.
Elapsed Time: 15 min. Final fluid depthDE' in. Absorption rate >= 600+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date
D. LIFT STATION
Date installed
"Pump on" level at —in.
E. SEPARATION DISTANCES
Size in gallons
High water alarm level at in.
Cycles tested Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/ltft station on lot
•50't
On adjacent lots
100'+
Absorption field on lot
100'+
On adjacent lob
100'+
Public sewer main - N/A
Sewer /septic service line 25'+
Animal containment areas 50'+
Public sewer manhole/cleanout N/A
Holding tank N/A
Manure/snimal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 100'+
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 10'+ Building foundation 109+ Water main N/A
Water service line 10'+ Surface water 100'+ ng/vehide Driveway, rki g
y pa storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
1 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. rness
Engineer's Printed Name JEFFREY A. GARNESS �O� CE– 53
Date J . A.�"'��
`1t �p�of�seW�d
COSA Fee S Waiver Fee $
Date of Payment Date of Payment
Receipt Number Receipt Number
(Rev. 11/05)
MTM
SGS ReEN
1070499001
Client Name
Gamess Engineering Group, Ltd.
Project Name/H
TI 2N Row Scc 10 NI/2 of L34
Client Sample ID
T12N Row Sec 10 NI2 of L34
Matrix
Drinking Water
PWSID 0
All Dates/rimes are Alaska Standard Time
Printed Date/time 02/142007 14:01
Collected Date/rime 02/07/2007 15:00
Received Dale/rime 02/072007 15:13
Technical Director Stephen C. Ede
Sample Remarks:
353.2 - The MS for Total Nitrate/Nitrite recovered below the QC criteria. The batch LCS is withing QC limits.
Allowable Prep Analysis
Parameter Results PQL Units Method Container ID Limits Date Date Inst
Waters Department
Total Nitrate/Nitritc-N 0.115 0.100 mg/L EPA 353.2 D (<10) 02/08/07 1DS
Microbiology Laboratory
Total Coliform 0 col/100ml- SM2092226 A (<I) 02/07/07 DPT
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.muni.org/onsite
(907) 343-7904
.Arsenic Advisory -
Certificate of On -Site Systems Approval # HA060357
A Certificate of On -Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on N2 of Lot 34, of
T12N R4W SEC 33 Subdivision. This inspection revealed an arsenic
concentration of 27.8 micrograms per liter (ug/L) for the property's well
water sample. 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/onsitg) or at 343-7904.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water 8 Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.orglonsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. V/ I — /&/— 6 I
1. GENERAL INFORMATION
Expiration Date: l /!y
Complete legal description
712N. R4W, SEC. 10, N2 OF LOT 34,
Individual On-site
I
Location (site address)
8720 EMERALD STREET • ANCHORAGE, AK
99502
❑
Community Class Well
❑
Community On-site
2481 0316
Current Property owner(s)
GRACE REMME
Day phone
❑
Mailing address
8720 EMERALD STREET • ANCHORAGE,
AK 99502
Lending agency
Day phone
Mailing address
244L4440
Real Estate Agent
CHERI MARSTON w/PRUDENTIAL J.W.
Day phone
Mailing address
3801 CENTERPOINT DRIVE #200 • ANCHORAGE, AK
I
99503
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
0
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-Sitd 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 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. 1 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 337-6179
Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE. AK 99507 ..
Engineers Printed Name JEFFREY A. GARNESS, P.E. Date *6/`} I°b
Engineers 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 8 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 focal 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 lost
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 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
Approved for bedrooms.
Disapproved.
Conditional approval for bedrooms, with the (flowing
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
L/
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Reort
Other
OF AN�y.,r
Q 0'�^
• ON-SITE . ���Gla
• WATER AND : m-
WASTEWATER ; z
By: Original Certificate Date: ),q
w.,, ,1
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water 6 Wastewater PMram
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 995198650
www.murd.orglonske
(907)343.7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Lagal Desrxlption: T12N. R4W. SEC. 10. N2 OF LOT 34. Parcel ID:
A. WELL DATA
Well" PRIVATE ff A, B, or C provide PWSIDN N/A
Date completed "1958 Sanitary seal (YIN) YES
Total depth 112 ft. Cased to 40+ ft.
FROM WELL LOO
Date of test
Static water level ft.
Well production
WATER SAMPLE RESULTS:
Col form 0 colonies/100 ml.
Arsenic: 27.8 ugJL.
B. SEPTICIHOLDING TANK DATA
i
Well Log (YIN) NO
Wires properly protected (Y/N) 'IES
Casing height (above ground) I 12+ in.
AT INSPECTION
5/12/2008
96 ft.
5.8 O.P.M.
Nitrate ND mgJL. Other bacteria 0 col6nlea/100 ml.
i
Date of sample: 5/12/2006 Collected by: GEG Ltd.
Tank Type/Material CONCRETE/STEEL Data Installed 7/28A19 8
700+
Tank sae 700 gal. Number of Compartments UNKNOWN Cleanouta (YIN) YES
Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) N/A
Date of pumping 5/20/2006 Pumper ISAAC'S PUMPING
I
C. ABSORPTION FIELD DATA i
Date Installed 7/28/1970 Soil raft (g.p.dJfttbrd%iirr1 100 System type TRENCH
Length 30 ft. Width 2 ft. Gravel below pipe 7 ft.
Total depth X10.66 ft. Eff. absorption area 420 ft' Monitoring tube YESi
Depression over field NO
I
Date of adequacy test 5/12/2005 Results (Pass/Fell) PASS For 4 bedrooms
Fluid depth In absorption field before test DRY In. Water added623 gal. New depth 51 in.
i
Elapsed Tone:110 min. Final fluid depth DRY In. Absorption rate >a 600+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date —
0. LIFT STATION
Date installed
'Pump on" level at _in.
Datum
E. SEPARATION DISTANCES
Size in gallons
High water alarm level at m.
Cycles tested Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAift station on lot 052'
Absorption field on lot 100'+
Public sewer main N/A
On adjacent lots 1000+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Sewer /septic service fine 25'+ Holding tank N/A
Animal containment areas 50'+ Manurelan" excrete storage areas 1001+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property Une 5'+ Absorption field 100'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent kris 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 104 Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water 100'+ Driveway. parking/vehicle storage 10'+
Curtain dram NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
• SEE WAIM REOUEST LETTER
0. ENGINEER'S CERTIFICATION
I certify that t have detem*wd through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines im etTed on this
date.
Engineer's Printed%eme JEFFREY A. GARNESS
Date �I�/GL
COSA Fee I 430 �
Date of Payment
Receipt Number I
M". r>O)
Waiver Fee $
Date of Payment
Receipt Number
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.muni.org/onsite
(907) 343-7904
Arsenic Advisory
Certificate of On -Site Systems Approval # HA060357
A Certificate of On -Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on N2 of Lot 34,E of
T12N R4W SEC 33 Subdivision. This inspection revealed an arsenic
concentration of 27.8 micrograms per liter (ug/L) for the property's well
water sample. 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 Ion
arsenic is available from the On -Site Water and Wastewater Program
website (www.muni.org/onsit ) or at 343-7904.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
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9Z 101 I ££ 10-1 MN (W)6£L'49L 3..9ti,L£.00N I 17 101 uyo�
Metals by 1CP/MS
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Waters Department
Nitrate -N ND 0.100 mg/L EPA 353.2 D (<-10)
Microbiology Laboratory
Total Coliform 0 col/100ml- S%12092226 A (<-i)
05/15106 05/18.'06 WAW
05/12/06 ALR
i 05/12/06 TLF
- All Dalesffimes are Alaska Standard Time
SGS Retq
I062411001
Gamess Engineering Group, Ltd.
Printed Date/time
05/192006', 10:04
Client Name
Project Name/tl
T12N R4W See 10 N2 of Lot!
collected collectedDale?ime
05/122006'113:50
Client Sample ID
T12N R4W Sec 10 N2 of L 33
Received Date/time
OS/12J200G 14:35
Alatri:
Drinking Water
Technical Director
Stephen C. Ede
PWSID
0
Sample Remarks:
!
353.2 - The NIS
for Total NO2/NO3 failed to meet QC criteria. The batch LCS is within QC limits.
Alto"ble Prep
Analysis
Results PQL
Units Mcthod Container ID
Limits Date
Date Ini[
Paramcicr
i
Metals by 1CP/MS
Arsenic 27.8 • 5.00 ug/L EP200.8 C (<-10)
Waters Department
Nitrate -N ND 0.100 mg/L EPA 353.2 D (<-10)
Microbiology Laboratory
Total Coliform 0 col/100ml- S%12092226 A (<-i)
05/15106 05/18.'06 WAW
05/12/06 ALR
i 05/12/06 TLF
SGS ReEM
1062747001
All DatesMints an Alaska Standard Time
Client lame
Remme, Steve
Printed Date/time
06/082006 13:28
Project Nsme/B
T12N, R4W, SEC 10
Collected Date/time
05/302006 14:32
Client Sample ID
T12N, R4W, SEC 10
Recehed Date/rime
05/302006 14:59
Slatris
Soil/Solid
Technical Director
Stephen C. Ede
Sample Remarks:
Surrogates
1,4-Di0uorobcnzcnc<stur> 95.8
Semivolatile Organic Fuels Department
Diesel Range Organics ND 20.5
sucrogataa
5a Androstane <surr> 96.4
Solids
Total Solids 95.8
%
SW80210
mg/Kg
AK102
%
Allowable
Prep
Analysis
Parameter
Results
PQL
Units
Method
ContaiwID Limits
Date
I Date
Init
I
Volatile Fuels Department
Benzene
ND
17.5
ug/Kg
SW8021B
A
05/30/06 06/07/06
IIM
Toluene
ND
70.0
ug/Kg
SW8021B
A
05/30/06 06/07/06
IIM
Ethylbcvcne
ND
70.0
ug/Kg
SW8021B
A
05/30/06 06107/06
IIM
P&M-Xylcnc
ND
70.0
ug/Kg
SW8021B
A
05/30/0606/07/06
IIM
o-Xylcnc
ND
70.0
ug/Kg
SW8021D
A
05/30/06 06/07/06
IN
Surrogates
1,4-Di0uorobcnzcnc<stur> 95.8
Semivolatile Organic Fuels Department
Diesel Range Organics ND 20.5
sucrogataa
5a Androstane <surr> 96.4
Solids
Total Solids 95.8
%
SW80210
mg/Kg
AK102
%
AK102
%
SM20 2540G
A 81-108
L
D 50-150
19
05/30/06 06/07/06 IIM
06/02/06 06/03106 JE
I
06/02/06 06103/06 JE
06/06106 JC
SGS ReEB
1062747002
Client Name
Rcmme, Steve
Project Name/M
T12N, R4W, SGC 10
Client Sample ID
Trip Blank
Matrix
Soil/Solid
All Dates/fimef are Alaska Standard Time
Printed Daterrime
06/082006 13:28
Collected Date/fime
05/302006 14:32
Received Datelrime
05/302006 14:59
Technical Director
Stephen C. Ede
Sample Remarks:
I
Allowable
Prep I Analysis
Parameter
Results
POL
Units
Method
Container ID Limits
Date i Date
Inil
I
Volatile Fuels Department
Benzene
ND
12.5
ug/Kg
SW8021B
A
05/30/'06 06/07/06
II.M
Toluene
ND
50.1
ug/Kg
SW8021B
A
05/30/06 06/07/06
IIM
Lthylbctvcnc
ND
50.1
ug/Kg
SW8021B
A
05/30/06 06/07/06
1IM
P 3 M •Xylcnc
ND
50.1
ug/Kg
SW8021B
A
05/30/06 06/07/06
IIM
c-Xylcnc
ND
50.1
ug/Kg
SW8021B
A
05/30106 06107/06
I
IIM
Sursogaua
1,4-Dillwrobcnzenc<sun>
99.7
%
SW8021B
A 81.108
05/30/06 06/07/06
IIM
Solids
Total Solids 100 % Sh120 254OG A 06/06/06 JC
Municipality of Anchorage
1'0. Ikrs 1!M-51) • Anchomgc, Alaska V9.519.66R) • Telephone (107) 343.&M • ra.. (N)7) 34:1.3200
4700Iknlmw• Sl reel • Anchorage, Alaska 91.607
�� a���e.munLorg
Mayor Mark Begich I3trilding Snfcty Di%islon
August 14, 2006
Jeffrey Garness, P.E.
Garness Engineering Group
3701 E. Tudor Road, Suite 101
Anchorage, AK 99507
Subject: Waiver Request for T12N R4W SEC 10, N2 OF LOT 34
Waiver Request WR#: 060046
Parcel ID # 011-161-01
IIA060357
Dear Jeffrey Garness, P.E.:
Your request for a waiver of the required 100 feet horizontal separation from the
septic tank to the private well has been approved. The approved separation distance is
50.0 feet.
This waiver approval applies to the existing septic tank to private well 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. i
Sincerely,
J oodall
vil Engineer
On -Site Water & Wastewater Program
Community, Security, ProsperiCy
State of Alaska:
Separation Distance Waiver Guidelines for S.C.R.O.
(State of Alaska Memorandum to District Office Engineers dated January 3,1985)
Waiver Request for: T12N R4W SEC 10, N2 OF LOT 34
Parcel ID#: 011-161-01
Waiver Request Number WR#: 060046
Waiver Requested: so foot horizontal separation waiver from well on -lot to septic tank on -
lot
Engineer: Jeffrey Gamess, P.E.
IIA060357
Septic Tank Data
The original septic tank is a concrete tank and has been in use since
before 1958. There was a new steel septic tank installed in 1976
adding compacity to the original concrete tank. The concrete tank
and the newer steel tank was permitted and approved in 1976, but
was not formally waived by the On-site department. The total depth
of the tanks is 10 feet for purpose of calculating points.
Well Data
The well was installed some time before 1958. The total depth of the
well is unknown. There is casing to a depth of 40+ feet determined
by Garnees Engineering. For the purposes of calculating waiver
points the well log from Lot 35 sec 10 was used. The well depth of
this well is 245, and is one of the shallower well logs provided. The
well logs submitted by the Gayness Engineering Group shows there
to be a consistent soils strata in the area. This well to septic tank
encroachment has existed for more than 30 years and the water
sample results are with in municipal standards.
Municipality of Anchorage ...r
y ,
Development Services Department c
Building Safety Division ;
On -Site Water and Wastewater Program
4700 Bragaw Street r
i
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchoragc.ak.us
(907) 343-7904
Waiver Review Worksheet
WR#:060046 PID#:011-161-01 HA/Permit# IIA060357
Date Received: August 14, 2006
Legal Description: T12N R4W SEC 10, N2 OF LOT 34
Engineer:
Jeffrey Garness, P.E.
Garness Engineering Group
3701 E. Tudor Road, Suite 101
Anchorage, AK 99507
Applicant: Grace Remme
Waiver Requested: 50 foot horizontal separation waiver from well ondot to septic tank on -lot.
Criteria: Geology
Points:
A. Water Table
7'72
B. Soil Sorption
2'61
1.34
C. Permeability
D. Water Table Gradient
5.00
E. Horizontal Separation
1
Total: . _ 17.662 --7
..........................................................................
Waiver is Granted: X
List Conditions or Reasons for above:
Waiver Is not Granted:
Date: 8114106 By: Joe Goodall
Name of Reviewer
Rec#: Amount: $0.00 Date Paid: 8114!2006
State of Alaska:
Separation Distance Waiver Guidelines for S.C.R.O.
(State of Alaska Memorandum to District Office Engineers dated January 3,1985)
Waiver Request for: T12N R4W SEC 10, N2 OF LOT 34 -
Parcel ID#: 011-161-01 _
Waiver Request Number WR#: 060046 ~'
Waiver Requested: 50 foot horizontal separation waiver from well on -lot to septic tank on -
lot
Engineer: Jeffrey Gamess, P.E.
IIA060357
Water Table Points ,..
Depth of well: 245 7.72
Depth of septic system: 10
235
Distance from the bottom
Point
of the system to the highest
Value
water table in feet
1
0
0
8
1
17
2
24
3
30
4
40
5
85
6
100
7
290
8
1000
9
10
' Straight line Interpolation Is permitted between any two values
Soil Sorbtion Points ,,..
2.61
Soil Type I
Point Value
Clean Gravel
0
Fractured Rock
1
Course Clean Sand
1.5
Sand w/ Small Amt of Clay
2.5
Silt
3.5
1-235 3511.5 +1235 35 ,2.5 + 1235 10 6 +
+ 1 25 l 235, 6 + r 50 l 235,1.5 + `r 235 15 , 6 +
Clay and Sand Equal 4.5 0.4 + 0.4 + 0.3
Clay 6 0.6 + 0.3 + 0.4
-Use the predominant soil type but values can be averaged for a mixture
25 1.5
`235
i
[51 1.5
235
1
0.2
0
Permeability
Soil Type
I Point Value
Clay(will channel)
0
Silt and Sandy Clay
2
Clayey Sand
3
Fine Sand
1.5
Sandy Gravel
1
Fractured Rock
0.9
Course Sand (30 grit)
0.4
Clean Gravel
0
Points „«
1.34
(251.4 + 25,3 +(2513 +r251.4
+ r2 3-5 1j 3 +[ 23550 , .4 + 2 15 5, 3 + l 235, .4
0.12 +0.45 +0.13 + 0.04
0.32 +0.09 +0.19 + 0.01
*Use the predominant soil type but values can be averaged for a mixture
Gradient Points „«
5.00
-30%
0.3
Separation
-20°/,
0.7
slopes toward well
-10%
1.2 J}
25
-5%
2
1
0%
2.93-
Oat
5%
4.5
5
10%
6
slopes away from well
60%
7
*If the gradient is unknown, assume the worst case
Horizontal Points „«
50 1
Horizontal
Point
Separation
Value
In Feet
0
0
25
0.7
50
1
75
2
100
3
150
5
200
6
300
7
'Linear Interpolation between two point value Is acceptable. Horizontally means
straight line distance to the well not the contaminate travel distance to water table
which may be greater.
Conclusion: Grant Waiver Total Points: 17.662
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GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
June 12, 2006
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On -Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Waiver Request for: T12N, R4W, SEC. 10, N2 of Lot 34,
I
The existing 3 bedroom house is served by a private well and septic system. We request you
grant a 50 foot separation distance waiver from the well on the referenced property to th i septic
tank. The following items are justification for the waivers:
• The lots are generally flat in the area. There is a slight slope traveling from the well on the
subject property to the septic system. If the septic system was to overflow, it appears that the
effluent would not travel toward the well head. The house is also between the well and the
septic tank. Which would also prevent it to run towards the well, if the tank began to leak.
• The location of the septic system is in a very visible area so that if any effluent was to
surface, it would be noticed and the problem corrected.
The other path of contamination is subsurface migration wastewater should the tank begin to
leak. Recent water sample results indicated nitrate levels and coliform bacteria results to be
satisfactory. Attached are well logs from surrounding properties showing that the average depth
of the wells are relatively deep, ranging from 230 to 442 feet, with many layers of gravel and
silty sands, which would prohibit a septic leak. Based upon the aforementioned facts, it i ppears
that there is minimal risk associated with the 50 foot separation distance waiver.
If you have any questions, please contact us at 337-6179. Thank you for your assistance.
.E., M.S.
3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507
Ph: (907) 337-6179 • Fax: (907) 338-3246 • Website: gamessengineering.com
I
t, .. ..
0.' i` -'j wFT..I, DIIII.LING I OG
Drilling Co.
Driller -.L t
7 e of well Cq/ Use well owner
Location (address of,' Township, flanReo. sectidn, if known,
or distance from rain road
completed
Sire of casing Depth of hole 2 o feet.. Cased to 2 -?r- feet.'.
Static. water 5l.evel feet (above) (below) land surfoc6. Finish of
well (check one) Open end (3(), Screen ( ). Perforated
Describe screen or perforations ........
Well pumping test at " gals. per (hour) (minute) for—//Z_—hours
2
with reet of drawdown'from static level...
Give details of formations pe
Depth in feet from
surface size of ma ter orond hnrdenss.
around
t6
2.<--, .—to
.Y -Y. to
to 76
.)..-.--.to
to 3
.—to
to
`� -to
JLL-20-2n01 20130
t11LLInt1 J. HILLS tID P.01
!: drilling CO.—'Si/ �. { 1 �%.. usm ec-� . __— .
PrillYT
!
:Call ones^ �� 1/pY us. aY.li
I Location (eddrus Of. Township, 1000. i Section (i! known)1 distant* from roads ,
ss .0al .t, Cases to leoe.
Size of Cssinl�,nspth of Mol. .. _ate
Static vstsr lsv.l l#at (abovs) (belY`w) land surface, finish o!'ve31
....(check one) open end (4fs �Sercen ( )s Perforated (:)t
1
Joseribe Screen or porta caun.: • oure w th ," ,
Uell 7"'■p!n! tett at all, per ar eau . or
to o arautown from staite level. t I. ••
Seoarkr
Date c,A■ilewtad LILk IAG
lorutlons penetrated, site of
"wad Surface color. and It
3r7' 0j(Nce '171. ()or J � ObVx .
to
.p elto
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j.
to
to
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to
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3.�L�7•y� Crile&.. depth�7 1t. dlan. `�� In. crvvm.+�M.W •••_ ._-.._
Depth e1 well +�
��•—�' 2 21977,
Static water t+rel.l.S1.�--It• (�+'�• Oelo■) lend turlaee. Date1gx_77 NOV
Finish Of reit: en -en notion, perforated, OPen-11018• other)
Describe intervals RECEIV.fEQ
and size: �
�� Qat/Oto.
Qell yield tooled by (pumPinQ, 6alling, sir) at i
t!
for r
Acorn with It. of drawdown from static level.
�i—
DRILLERS VA)ERIAL LOS
Depth below lend
Dive description a1 strata penetrated
surface In lent (nl:e of Oaletlel, calor, hardness of drllllnQ, and rater content)
to
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WATER WELL RECORD '
STATE OF ALASKA I '
OEPARTMENT OF NATURAL RESOURES
I
•�'' iDivlsion of Geological 8 Geophysical Surveys
.. - Drlllin0 Permit No.
LOCATION OF WELL Ipleose aomplolo either to, le or it.).
A.D.L. Ne.
la. Borough Subdivision let Sle<s Is. '1/e el fs. Section No. Te.neniPsg Bob c W❑ Maldian�
f 1 •• .30104%
YX _ef�ef�ot�
`
1. OWNER OF WEL t
A L. • I
i I1. 013TANCE AND DIRECTION FROM ROAD INTERSECTIONS
Addno:
slte,I Addle6e and Al el well Loco nen '
Fool Below ' 4• WILL DEPTH: (11001) 5. DATE OF COOIAPLETIO
2. WELL L00 Sorlece .j'6 Q_ ft. /�--. �'�•0-_
• to lal Type Too Setts«
S• XCOble tool ORelarp OOrivoa OOup
0Au0•r Odelted Oaend OOfhert
7.IH[4 Deposits O Public 11 O Industry
S Q IntOellon O Ro<herpe O CemmoAael
O Two, Well OOlher'
S. CA)INO, 'O Thee dud W Welded ( tbs. ft.
Z .
dig.
/..TIn.
tot. Depth walant1� tbs./
ft.
dlep.�In. 1, ft. Da0tn en<taPl
T1. Fill ISN OF WCLIt '
TYPe. Dlasocial
$lot/M h sin: 1.6netn: I .
.Set Nlwean 11. and
I 1t• �•
—'' !..
6 S0ott1111n0 Ora•et pet I
' •: 10. STATIC .WATER LEVELI JIPD— I f)
( 0010
((( .'t) O Above or E209110. load furl co
EedlPal0644• K-
I, Il • Pp �MP,lNO LEVEL Belo. end eurlaeo end YIELD
117L_u, oft.r goal. Pupplogi.—a.P.p.
'MUNIOPALI Y OF fj[HORAO
& eft. after��-hn. Puppine��O.P. p.
I
12.OROUTING Wall Grouted: O Yet JO No
1 Malarial: O Neat Cep6n1 O Dthar: i
� 17. PUMPS (Ir ero1100t6) XP <�
. �•.
Length of Drop Pipe ft. 60PaCly 0•P•m• «
ir
l r _ O Bob.. O jet O C6nlrllleel (O OUu n
A IL RE ARNS: I �
AVAI IS ill
t8. WATER WELL CONTRACTOR'S CERTIFICATION: 10. Water Temperature
OF I OD
This .all GOA drill d dada( Y rl'Alt to and Is repoll is love to Ina bestOfGo wlidbe and belief; ;
Registered Su6lnou Nam
Coal, of 1.1167!44426 Number
Dmf' '�•u
Signed •
Aa26or1[N 4Pnunlelir6
Form 02•WWR (11/81) Copt Dlslri►ulien: WNITL•Slate DOGS, ►INN-DrDla. CANARY-C•elepe1
... � ' MUNICIPALITY OF ANCHORAGE
DEPT. OF I!`_nLT'd L
ENVIRONMENTAL P::O I:CT1ON .
00i 2 1981
.Dotten .Drilling Co. �
. BOY 1006! 'SOUTH STATION' 12061 JOHNS ROAD ANCHORAGE. ALASKA ii611 RPC��.'�7 �
WELL TA(_
For: Wallace Cathcart III. Location: Lot 36B, Jewel'Lake HgtBe
AE+te
:,August, 1981 DI'pth 0 ell 442' i•
Static 71, from ground Pr<;duction: 6 GPM.from
xr• *rN
G i 16
.Sandy silt 16 76.
bark brown sandy silt; fluid 76'.I A3.
Gray sandy silt, fluid 93.. 136:
:.Gray sandy clay t.36.: i ,. 144
Graay silty• sand144 242:
Gray clay 258
Gray till 258 329.
Gray silty clay 329 333 ;
Gray till, fine grained ,- 333 1 366
Gray clay 366 387
Fine grained gray till 387 .409
'j weak
..
Gray till with water sand &gravel; 409 .
..427
Water sand; .very weak &dirty 4�7 441 '
s3 Gray clay 442
Water sand
" .. Drilled by:
V-4..
K.;;: .
uy
3 ,• •�S, MUNICIPALITY OF ANCHOXA,,E
DEPS. OF HE'1LLI
€ GREATER ANCHORAGE AREA BOROUGH ENVRcN•V,ENTAL
Department of Environmental Quality FnO;;C ION
3330 "C" St., Anchorage, Alaska 99503 - 274-455,1 ,,
1976
REQUEST FOR APPROVAL OF RECEIVED
INDIVIDUAL SEWER & WATER FACILITIES
1. Type of Inspection: CMRO VA FNA CONV x
2. Property Owner: Waldo F. _& Grace A. Re_�F•
Mailing Address: 8720 Emerald Day Phone 4L4�oA�
3. Name of Buyer: Refinance
Mailing Address:. _ Day Phone
4. Name of Lending Institution: Alaska_MLtual Savings Bank
Mailing Address: P. 0. Box 1120 Phone 2T4-3561 Ext 239
5. Name of Realtor or Agent: €r/A
Mailing Address: Phone
6. Legal Description: N 1/2 of Government Lot 34 Sec. 10 T121N R4W S.Df.
Location: 8720 Emerald Street
7. Type of Facility to be inspected: SFR Duplex No. Bdrms. 4
8. Water Supply
Type of Supply: Public Utility Individual x
If Individual, number of dwellings presently served
If Individual, depth of well
9. Sewage Disposal System
Type of System: Public Utility Individual (on-site) x
If Individual, date of installation
EQ -037 (1/74)
Page 2 of two pages - Rem%st for Approval of Individual ^^er & Water Facilities
Leal Description m12N uaw section 10 Nk of rot 34
Comments
Approved X rm Disapproved Date—?L2-4f—?9
Appro
ned
Greater Anchoragelid for o
Department ofne year from Enviroate nmental
Quality
DIAGRAM OF SYSTEM
I certify that the information contained in this reouest for aonrnval to ha a *Nilo and
=N1=benLacion or the suD3ect sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
EQ -034 (1/74)
Date
