HomeMy WebLinkAboutCROSS VIEW ESTATES BLK 2 LT 10Cross Vi
IN
Estates
Block 2
Lot
#01§-221-72
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program, 4700 Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.cLanchorage.ak.us (907) 343-7904 Page 1 of
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number:. SW070021 PID Number:. O15--221 --72
NaT':COLONY BUILDERS Wastewater System: · New rl Upgrade
9420 VANGUARD DR. UNiT A * ANCHORAGE, AK 99507 ABSORPTION FIELD
Phone: NO, of Bedrooms:
(907) 345-0371 5 · Deep Trench n Shallow Trench ri Bed 13Mound riOther
LEGAL DESCRIPTION 0.8 c..o/s~... 10' MAX
2 10 CROSS VIEW ESTATES SEE DWG. r~ 6.12/5.82
- - - SEE DWO. n. 106 (2
WELL: · New ri Upgrade 2.5 n. 2I 15
PRIVATE 272 ~ 268 n. 1265+ s~, n. D 3034/ F-810
ALPINE DRILLING 4/9/2007 216 ~ RED DOG 4/3-6/2006
9 c.~. 268 ,, 2 ,, TANK
SEPARATION DISTANCES = s.p~cr'l Hold~ng D S.T.[.P. D other
Tank Reid Station Tank S..,~ U~, ANCHORAGE TANK 1500
we, 100'+ lO0'+ - 25'+ STEEL 2
Surface Wote, 100'+ 100'+ - - LIFT STATION
FoundoUon
~emorXs: BENCH MARK
TOP OF CMU BLOCK ON NORTHEAST CORNER OF
THE HOUSE.
Inspections performed by: GEG, Ltd. Dates: 1st 4/3/2007
Development Services Department Approval
R~viewed
,c..~...sE,: AS BUILT DRAWING ,,~cc,,o
SW070021 - 015-221-72
,' A s c~-%-~ ~, ~X
I ST2 57.9 26.0 ~9.0 ~ ~ .~ 7~ ~
/',/~/ ~ ~s~ o~ .~
~ ,~¢~::1 /
/
. ~... co, ~o~ / ~ - I
~- . ', ' /
I X ~~,--o.
,
GARNESS ENGINEERING G~OUP, Ltd. ~ ~ ~[~T~y~
,, CONSULTANT' & GEN E~L CONT~CTOR8 ~
COLONY BUILDERS 345-0371 2 OF 3
CROSS v,~w ESTATES SU~D,V,S,O,: LOT ~0. ~LOCK 2. J.L.~.
~s-Bu~L~ o~[ WILL ~ S[PZm SVSZ[~ ~/~/200~
ST1 55.5 19.9 29.8
$T2 57.9 26,0 39.0
FO 65.8 36.7 51.5
COl 84.6 51.5 55.4
&~l'l 83.5 51.0 55.5
C02 60.4 45.7 68,7
MT2 58.7 40.8 64.6
C03 75,5 60.5 82.5
MT3 77.7 60.1 80.4
C04 96.0 64.5 71.6
MT4 91.9 61.0 70.4
DBL2 62.,32 ,31.95 45.91
TOP OF TANK
INV[RT OF BUNG
AT INLET w 96.B0
f"":7
FI t PI
AT 07 97.41
' ' 7~ (PER CO~0R)
N~ 1500 GALLON
SEPTIC TANK J J
~1 AT O~- 96.62
FINN. GRADE-
- 97,02+
'/H141B
GRADE
95.50
FABRIC
FINN. GRADE-
- g8.45+
- ORIGINAL GRADE - 98.17
F~RIC
TH141B
OF' PIPE
91.52
OF PIPE
- 94,29
12'+'
OF
TRENCH ""
8,5.50
IOTTOM OF
TRENCH -
88.17
OF BOTTOM OF
HOlE - 76.50 (NO H20)
REt~TIV[ D.L"VAT~ON OF BOTTOM OF
HOlE - 79.07 (NO
I DESIGN OF PROPOSED SEPTIC SYSTEM
(Rev. 0~)
G.A__.R_U..E..S__S ENGINE~'"RING GR..OUP, Ltd. ~
..... · ~ ~ . CONSULTANTS & GENERAL CONTRACTORS ,,- /~r~.
COLONY BUILDERS 345-0571 I 5 OF ,.'3 \v~
CROSS VIEW ESTATES SUBDIVISION, LOT 10, BLOCK 2 I J.L,Id,%
I 8/23/2007
G ARN ESS ENGINEERIN G GROUP, Ltd. ~?~H '"
SOILLOG- PERCOLATION~~.. ,.,~'~ ..... ~..I.//.IJ. ....... .~ ........ .;t
PERFORME, FO,: ~0~0~ ,U,~. ~.,~~~;~.r~'.~'~~''~-'~' ~
~L~._ '.~.~...u ~J
DEPTH ~
(feet) o~cs I IEST HOLE ~41BI
LO~ SOIL C~SSIFICATIONS
~ ~w ~ ORO
~ GP ~ ML
~c o~ S~E ATTACHED
% ~, SW MH
SP CH
SH OH
SC
.~. ~o SITE PLAN
GROUNDWATER D~TE
~Rr ~/aO/200~
D~Y 4/2/2007
DRY 4/6/2007 ~- s~:
I0 SM/ML
11 DATE READING CLOCK NET TIHE WATER LEVEL NET DROP
TIME (HINUTES) READING (INCHES)
4/~/~0o7 ~ 2:30 - s' -
12
2 3:00 30 2" 4'
13 3 3:00 - 6- _
4 3:30 30 2" 4"
14 5 5:50 - 6- -
6 4:00 50 2" 4"
15
16
17
18
19 PERCOLATION RATE 7.5 (HIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 6 FT. AND 6.5 FT.
20 A FOUR HO~ PRESOAK WAS PERFORHED: ~ YES ~ NO
SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORHED BY: ~LE MAUS
COHHENTS:
PERFORMED BY CEG, Ltd. I, JEFFR~ A. CARNESS, CERTI~ T~T THIS WAS PERFORMED IN ACCORDANCE
ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE:
WITH
Ruc O! 200?
Colon~ Builder~,Ino. 80?3456934 p.2
ALPINE DRILLING & ENTERPRISES
. permit Number: #SW070~21 Date of Issue: 3-fC.~-O7
Date Started; '4-8-07 Date Completed: ~-~07
. ~gal D~eH~o.:
P~pe~ ~ner N~e & Add.ss:
Bore. hole Data:
'Soil TyI~, TM~loaess & Wa~' Strata
=tick;u~
,dlt ..............
gravelly silt
sandY
gravel
ssndy silt
,silty gravel
si~y ffmvel
~ffY water sand & g~vel .
~1~ wa~er sand & grovel
bedrock
Cross View Estates Block
Coloney Builders
0420 Vanguard Drive
Anchorage, Alaska 09507
Depth (ft)
From To
0
38
58
86
174
226
242
261
268
2
i21
174
226
242
245
261
268
· 272
parcel Identification Numbcr:~
Is well 16cared et approved permit location? [] Yes [] No
Method of Drilling [] eir rotary [] cable tool
Casing iype:
Wall Thtclm'~ss: ,~Q inches
Diameter: _6 inch~ Depth: ~ feet
' ~iner Ty-~ae: ............. ,.
D|amet~: inches ' D~pth: feet
Casinl stlckup above ground: 2 feet
Static water level (from ground level): 2'/6 feet
Pumping leveh, ~68 feet after
2 hours pumping t gpm
Recovery Rate: t~ gpm
lVlcthod of ~esting: air lit~
.Well Intake Opening Type:
[] Open End [] Open Hole
[] Screened Stsn f~et StopPed fcct
[] Perfor~ons Start' .fe~ Stoppcd
Grout Type: be~r, nt~e .~'an,/e~ Volume:
Depth: Sart 0 f¢~ Stopped ? f~et.
Pump: Intake Depth feet
Pump size _ . hp Brand Name
Well Dlsin~ccted Upo~ Com~'l;~loni'[~] Yes []
Method of Disinfection:. ~hlorlne tablet~
Comments:
Well Driller: Alpine Ddlling & Enterpdsc~
PO Box
Anchorage Alaska
Attention: The well driller shell provide a well log to the property o~¢r within 30 days of completion and the property
owner or the well driller shall provid¢ a well log to the D~,¢lopment Services D .elag-~znt within 60 diys of completlon. ·
::: 08/27/2007 10:14 FAX 907 343
3UN-1~-~7 01:5~
ON SITE
~001
P.1/1
Pump Ip).~llmtton L.ol
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT
Initial
Date Issued: Mar 15, 2007
Expiration Date: Mar 14, 2008
Permit Number: SW070021
Legal Description: CROSS VIEW ESTATES BLOCK 2 LOT 10
Design Engineer: 0855 GARNESS ENGINEERING GROUI~
Owner Name: COLONY BUILDERS
Owner Address: 9420 VANGUARD DRIVE
ANCHORAGE, AK 99507-
Parcel ID: 015-221-72
Site Address: NHN HERITAGE HEIGHTS DRIVE
Lot Size: 47915 SQ. FT.
Total Bedrooms: 5 Permit Bedrooms: 5
This permit is for the construction of:
[] Disposal Field [] Septic Tank [] 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 ( 18AAC72 ) 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.
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Bragaw St.
P.O. Box 196650
Anchorage, AK 99519-6650
www.cLanchorage,ak.us
(907) 343-7904
ON-SITE SEWER/WELL PERHIT APPLICATION
FOR A SINGLE FAHILY DWELLING
ParcelI.D.
Property owner(s) COLONY BUILDERS
Day phone 345-0371
Mailing address 9420 VANGUARD DRIVE * ANCHORAGE. AK
Zip Code
Legal description (Sub'd, Block & Lot ) CROSS VIEW ESTATES SUBDIVISION: LOT 10. BLOCK 2.
Legal description (Township, Section & Range)
,or S..Ft.
N/^
Number of Bedrooms
THIS APPLICATION IS FOR ( ~3 all that apply): THIS APPLICATION IS AN:
Absorption Field [] Initial
Septic Tank [] Upgrade
Holding Tank E] Renewal
Privy
Private Well []
Water Storage []
[]
[]
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 GROUPI Ltd.
PermitJRush Fees:
Date of Payment:
Receipt Number:
(Rev. 11/05)
Waiver Fees:,
Date of Payment:
Receipt Number:
GARNESS ENGINEERING GROUP, Ltd.
: " - : .... ;~. ........ :: CONSULTANTS & GENERAL CONTRACTORS
March 12, 2007
Municipality of Anchorage
Development Service Department
On-Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907) 343-7904
Ref: Proposed Well and Septic System for Cross View Subdivislon; Lot 10, Block 2,
To whom it may concern:
The proposed 5 bedroom house will be served by a private well and septic system. We are proposing to
install a new 1500 gallon septic tank and a dual deep 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:
I. 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 WATERS: There are no surface waters within 100 feet ofthe proposed septic system.
4. TOI'OGRAPIIY: As can be seen on the attached topography drawing the average topography below
the drainfield is a 10-15 percent slope running approximately east to west. In short, there are no slope
concerns.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems.
If you have an~ uestions, please contact us at 337-6179. Thank you for your assistance.
Pres
NOTE: Attached is a site plan drawing, a design drawing, one soil log, which are all part of the design package for
this septic system. (Contact G.E.G. £td. for 7page construction specification letter.)
3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com
"P'j',.,/.~. / LOT 24. BLOCK 1. / \
--'"~'-./d~; / X
.... ~. ~ ~./ / h CROSS V1L'W EST.
/
· ~~, ~-~2~ ....
· -~ t E~=~ I /~ / ',/:
..... ~ .... ( NN /
'-~ ~~' ~
~,, --.~.~.::~
~ LOT 7, BL~K 2. / i
GAYNESS
CONSULTANTS & GENERAL CO~RACTORS ~-,~--~../~
SITE P~N FOR PROPOSED WELL AND SEPTIC SYSTEM 5/8/2007
LETTER THAT P[RTNNS TO THIS DESIGN. ~',~%, ~\ ~
TO OBTAJN A COPY OF' THE LETTER ~./~. ~ ~ ~ NUMBER OF' BEDROOMS:
CONTACT GEG. BY PROCEEDING FORWARD ~ ~ ~ ~, GALLONS PER DAY (GPO): 750
WiTH THIS INSTALLATION. THE ENGINE[R, ~ ~'~Y/'I ~' PERCOLATION RATE/S: 5 MIN./INCH
WELL DRILLER, CO~OR AND ~ ~' ~'% ~ PROPOSED APPUCA~ION RA1[: 0.6
PROPERTY OWNER AGREE THAT THEY )~. ~ ~'. ~'~ MINIMUM DRAJNF1ELD SO.FT.: 1250
Pave R~O TH[SE SP[C~nCXTIONS MD ~, / \ ',,~y,,~ ',~
AGREE TO AGCEPT THE TERMS AND ~, \ nm
/ / '~. \ ~. ~'~1"//_ LENGTH:106 F~ET (2 ~P 53)
/ // \ \ ~ ~ I M.0.'.~PR~OSANDnL?ER:"/^
/ / ' ~, ~ ~ ~ I REDUCTION FACTOR:N/A
,,,'ii -- ...... - { ./
~, PROPOSED
i/ ~ / -,, ~~,~'--~~c°~'o~ /
I EXC~YAT[ 0 PRIOR / / \ \
~, % ' THE USE OF AN ADVANCED ~1" m 40' [
G AIl N ESS ENG I NEEII I NG G I1OUP' Lt¢I' ~ '4~"!' !"~'"!7' ii~! I\ ~ '~'
....... CONSULTANTS & OENERAL CONTRACTORS ........ ·
COLONY BUILDERS 545-0571 2 OF' 2 t~A~_~..}~.,
LEGAL DESCRIPTION: DRAWN BY: ' '"
TY~EDESIGNCROSSoF WORK:VIEWoF PROPOSEDESTATES SUBDIVISION;sEPTiC SYSTEMLOT 10, BLOCK 2, D^~[:5/9/2007C'J'G' ~,~~~
Rev. Ol~0S)
53 FEET LONC
55 fEET LONC
GRADE
GRA~E
G~ADE
F1L1[R FABRIC-~
6' OF
MAX
6' OF'
PREPPED FOR: iPHONE NUMBER: } PAGE NUMBER:
COLONY BUILDERS I 345-0371
CROSS VIEW ESTATES SUBDIVISION; LOT 10, BLOCK 2 ~ C,J,G,
2/2007
TYPE OF WORK:
DESIGN OF' PROPOSED SEPTIC SYSTEM
GARNESS ENGINEERING GROUP, Ltd. ~~'""~'.?~!0~
..... CONSUlTANTS&GENERAL. CONTRACTORS
· . , . . ~..-..':'.. 7.F./t.,.. 2 ......
SO~L LO( -PE:RCOL~T~OS TEST ~7~..tfJ:.{. ,-, ..... ~ ......... .,~
LEGAL DESCRIPTION' HERffAGE HILLS SUBDMSION ~1 T~CT C&O (PROPOSED LOT 41)
' ~Ae ' I/C~7953 -" &~f
, ~h~:,¢_.~../.,... o~
~EPTH ~
~fl~ LOAM SOIL C~SSIFICATIONS
G~ i~ CL
GC OL
~ ,, SW HH
SP CH
s. o.' SEE A~ACHED
, sc SITE P~
DEPTH TO
GROUNDWATER DAlE
DRY 9/2/2005
DRY 9/19/2005
11 DAlE EE~DI~G CLOCK ~ET IIHE W~IEE LEVEL NET DROP
TIHE (HI~UIES) EE~DI~G (I~CHES)
~2 9/7[os ~ 2:1o - s' -
2 2:40 ~0 O" 6'
15 5 2:40 - 6- _
4 5:10 50 O" 6"
14 5 5:10 - 6- _
6 3:40 50 0" 6"
15
16
17
18
19 PERCOLATION RATE '5 (HIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 5 FT. AND 6 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: ~ YES D NO
SOILS LOGGED BY:. JODY MAUS PERCOLATION TEST PERFORHED BY: CALEB CALL
COMMENTS: * RECOMMEND USING A 0.6 APPLICATION
PERFORMED BY GEG, Ltd. I, JEFFR~ ~ GARNESS, CERTI~ THAT THIS W~ P~FORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: ~/t~/o~
DEPTH TO
GROUNDWATER DATE
DRY 9/2/2005
DRY 9/19/2005
1 '< i
; L
II
L , I
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.muni.org/onSite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 015-221-72
1. GENERAL INFORMATION
Expiration Date:
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
CROSS VIEW ESTATES, BLOCK 2, LOT 10
5758 HERITAGE HEIGHTS DRIVE *ANCHORAGE, AK 99516
MICHAEL & MARGARET SMITH
5758 HERITAGE HEIGHTS DRIVE
Day phone 281-827-6957
*ANCHORAGE, AK 99516
Day phone
BETHANY STAMPER W/ COLDWELL BANKER Day phone 265-9169
5000 "C" STREET SUITE 101 *ANCHORAGE, AK 99505
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 5
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. STATE.~¥!ENT OF !NSPECT~ON _Y ENGINEER
As certified by my sea/affixed hereto and as of the validation dates,uwn"~' ........................ u~o~/, I v~,,y ,.,~L ,,u'
invest~ation, based on procedures outlined in the Ce~ificate of On-Site Systems Approval Guidefines for this appfication,
shows ~ ~ ' '
for the number of bedrooms and t~¢e of structure indicated herein. I fu~,~er verify t,~at based on the
~ .......... s~ files ~nd ~"om my i~vestigatic~~,~,~ ,,i~sp~+~,~ ~.,~, ,, .,*~e,
on-site water supply and/or wastewater disposal system is(are) in compliance with ail 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
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Date
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 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 following stipulatio.~.,..%~.~?,
.,,
Arsenic Adv.sow
Septic System Advisory
Weft Fiow Advisory
Ni~!..:-~i!~7~e Advisory / ....
Maintenance Agreements
Supplemental Engineer's Report
L)tner
Originat Certificate Date: ~,,,,//~ /,/ /' _
(Rev. 11105)
Municipality of Anchorage
Development Services Department
CERTIFICATE
Legal Description:
WELL DATA
Well type PRIVATE
Date completed 4/9/07
Total depth 272 .ft.
Building Safety Division
On-Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
OF ON-SITE SYSTEMS APPROVAL CHECKLIST
CROSS VIEW ESTATES, BLOCK 2, LOT 10 Parcel ID: 015-221-72
If A, B, or C provide PWSID# N/A
Sanitary seal (Y/N) YES
Cased to 268 ft.
FROM WELL LOG
4/9/07
216 ft.
g.p.m.
Nitrate 0.659 mg./L.
Date of sample: 4/8/11
Date of test
Static water level
Well production 9
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mi.
Arsenic: ND ug./L.
SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL
Tank size 1500 gal. Number of Compartments
2
Pumper A+
I'BELOW EXISTING GRADEI
Soil rating (g.p.d./ft2o~ 0.8
Width 2,5 ft.
Well Log (Y/N)
Wires properly protected (Y/N)
Casing height (above ground)
AT INSPECTION
~/15/11
214 ft.
4.g+ g,p.m.
YES
YES
24+ in.
Collected by: GEG, Ltd.
Date installed 4/5-6/07
Cleanouts (Y/N) YES
High water alarm (Y/N) N/A
HOMKE SERVICES
System type DEEP TRENCH
Gravel below pipe 5.82/6.12 ft.
Depression over field NO
For 5 bedrooms
New dePth 23 in.
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO
Date of pumping 8/6/10
ABSORPTION FIELD DATA
Date installed 4/3-6/07
Length 106 (2@55) ft.
Total depth * 10.85 ft. Eft. absorption areal 265+ ft2 Monitoring tube YES
Date of adequacy test *'4/15/10 Results (Pass/Fail) PASS
Fluid depth in absorption field before test 10 in. Water added 760 gal.
Elapsed Time: 180 min. Final fluid depth 19 in. Absorption rate >= 750+ g.p.d.
Any rejuvenation treatment (past 12 mo,) (Y/N & type) NONE KNOWN If yes, give date -
**TESTED EAST TRENCH ONLY. WEST TRENCH WAS DRY ON 4/25/11.
D. LIFT STATION
Date installed
"Pump on" level at__
¸in.
Size in gallons Manhole/Access ~ ~
"Pump off" level_a~. High water alarm level at
Cycles tested, Meets alarm & circuit requirements?
SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
100'+
Septic tank/lift station on lot
Absorption field on lot 100'+
Public sewer main N/A
Sewer/septic service line 25'+
Animal containment areas. 50'+
in.
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout
Holding tank N/A
Manure/animal excrete storage areas
N/A
100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+
Water main N/A Water service line 10'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation, 10'+
Water service line 10'+
Curtain drain NONE KNOWN
Absorption field 5'+
Surface water. 100'+
Water main N/A
Driveway, parking/vehicle storage 10'+
Surface water 100'+
Wells on adjacent lots. 100%
F. COMMENTS
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.
Engineer's Printed Name JEFFREY A. GARNESS
Date
COSA Fee $ q
Date of Payment
Receipt Number
(Rev. 11105)
Waiver Fee $
Date of Payment
Receipt Number
z
-q
c
N O0'~l 7'52"W 95.50'
20' STORM DRAIN ES
/
/
/
/
0
Z
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.orglonsite
(907) 343-7904
Parcel I,D,
1. GENERAL INFORMATION
Complete legal description Lot 10; Block 2; Cross View Estates
Location (site address) 5738 Heritage Heights
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Ol~"~l- ~j,O. COSA# O~OPlP'
Expiration Date:
Current Property owner(s) Thomas M. Uffie
Mailing address
Day phone
Lending agency
Mailing address
Real Estate Agent Dar Walden
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 5
Day phone
Day phone 257.0409
3. 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 dvil
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 (ara) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further vedfy that based on the information
abtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(ara) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm s & s Engineering
Address 15861S. BirchwoodLoopChugiak, AK99567
Engineer's Pdnted Name J~0~¢4~' C,
5. DSD SIGNATURE
f Approved for ~
Disapproved.
Conditional approval for
Phone 694-2979
Date ~ / 3
.-o t.~. ~:~..-. ......
~' ./' i..
~'~*~ [ ROBERT C, COWAN
bedrooms. , ';cs ?~':,.,:'::.'.,':.
It¥~_/',,..,
bedrooms, with the following stipulations:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
X
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-79O4
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
LegalDescription: LO"/- IO /~/--oc~: ~.. CP,,~J V/~r~ ~7'. ParcellD:
A. WELL DATA
Well type (~ V~ r (. IfA, B, or C provide PWSID # ~ Well Log (~3/N) ¥,~
Date completed ¥/q/o 7 Sanita~ seal ~N) ~ ~ Wires properly protected ~/N)
Totaldepth ~fl. Casedto ~E~fl. Casing height (a~ve ground) /~ +in.
FROM WELL LOG AT INSPECTION
g.p.m.
Date of test
Static water level ft.
Well production ~' g.p.m.
WATER SAMPLE RESULTS:
Coliform colonies/100 mL
Arsenic: ~J¥) mg/I
B. SEPTIC/HOLDING TANK DATA
Nitrate O, ~0,~mg/L
Date of sample:~.~_/0~
TankType/Material 5,;,~rt c.- / £T£
Tank s~e I~0 ~ gal Number of Compa~ments
Foundationcleanout~/N) Y~ Depression over tank
Date of pumping" ~ ~, ~ ~ Pumper
C. ABSORPTION FIELD DATA
Date installe~ d/~ /; 7 Soil ra{ing ~p.d.l~r ~2~drm)
Length J ~ ~ ~ Width
Other bacteria
Collected by:
Date installed
Cleanouts (~"~N) V ~'-
High water alarm ~
I colonies/100 mL
7
System type T~ ~ ,v c/-/
Gravel below pipe. 5", ~-~./I,,IZ ft.
Total depth/°'t/~ ft. Eft. absorption arealPd-'~'ft2 Monitoring tube 'Y( J Depression over field
Date of adequacy test ~/~.S'Jo ~ Results(PassiFail) ~'~J'J' For ,_,c- bedrooms
Fluid depth in absorption field before test ~"~ in. Water added'7~'~/gal. New depth 3 ~ in.
Elapsed Time:]~'3~. min. Final fluid depth ]~ in. Absorption rate >= "TJ'-c --/- g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) /~&' ~ ~- ~<: ~'o~,,/ If yes, give date
D. LIFT STATION
Date installed .S, ize in gallons ~R,t)--'-'--~'
'Pump on' level at__ in. Pump off' level at / High water alarm level at
Datum ~d Meets alarm & circuit requirements?
E. S E PARA-T~S
in.
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/rift stafion on lot JO0 /-~
Absorption field on lot
Public sewer main
Sewer/septic service line ;)- 5- I _~.
Animal containment areas ~-'O
On adjacent lots
I O o -/- On adjacent lots
Public sewer manhole/cleanout
Holding tank /'"
Manure/animal excrete storage areas I C' 0 .-/
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation
Water main
Wells on adjacent lots
Property line 5"
Water service line
Absorption field
Surface water
IOO "-.,/.,
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line ~ o '--t- Building foundation
Water Service line ~ o '-,'- Surface water
Curtain drain tv~,~ K~'u~/vVellsonadjacentlots
Water main /'//4
Driveway, parking/vehicle storage
F. COMMENTS
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.
Engineer's Printed Name /~ I~ ~'~P-7' ~ , C'o,~.,/;~
Date G /~ C,/~
COSA Fee $
Date of Payment
Receipt Number
(Rev. 11/05)
,::, I q q b
Waiver Fee $
Date of Payment
Receipt Number
SGS Kef.#
Client Name
Project Name/#
Client Sample ID
Matrix
1082904001
S & S Engineering
LIOB2 Cross View Est.
LI0 B2 Cross View Est.
Drinking Waler
All Dare,Times are Alaska Standard Time
Printed Date~'flme 07/01/2008 13:42
Collected Date/Time 06/20/2008 16:00
Recelved Date/Time 06/20/2008 16:35
Technical Directnr Stephen C. £de
PWSID 0
Sample Remarks:
AIIo~able Prep Analysis
Parameter Result. POL Units Method Container ID Limits Date Date li~il
~atals bg ZCV/~tS
Arsenic
ND $.00
ug~L EP200.8 C (<10) 06/27/08 06/30/08 NRB
Waters Depar~nt
Total Nitratc/Nitrite-N
0.805 0.100 mg/L SM20 4500NO3-F B (<10) 06/27/08 JDZ
l~.crobiolog~ Laborator~
Colony Count I
Total Coliform Ncgative
Fecal Coliform Negative
col/100mL SM20 9222B A (<200)
col/100ml. SM20 9222B A (<1)
col/100mL SM20 9222B A (<l)
06/20~8 DLC
06/20/08 DLC
06/20/08 DI.C
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program ¢\
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.munl.org/onsite
(907) 343-7904
( ERTIFICATE OF 0N-SITE SYSTEHS ,b, PPROVAL
FOR .b, SINGLE FAHILY DWELLING
Parcel I.D. /~,,..~/- 5o3/- C~c
1. GENERAL INFORMATION
COSA. 0 0. 5'1
Expiration Date:
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
.............. Mailin{]-~-ddress _~-~'.~- ...............
Real Estate Agent
Mailing address
CROSS V~EW ESTATES, LOT 10, BLOCK 2
I'{HN HERITAGE HEIGHTS DRIVE
COLONY BUILDERS Day phone
9420 VANGUARD DRIVE UNIT A * ANCHORAGE~ AK 99597
Day phone
Day phone
Unless othen~ise requested, COSA will be held by DSD for pickup.
2. NUMBEROF BEDROOMS: 5
345-0371
t
3. TYPE OF WATER SUPPLY:
Individual Well ~r~
Individual Water Storage
Community Class Well Q
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 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 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 GARNESS ENGINEERING GROUP. Ltd.
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE. AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Phone 357-6179
Date
Engineer's Comments:
In conducb'ng this evaluation, GEG, LtD. attempted to previde a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of tho
system under the conditions encountered at the time of the test, and separetion
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condib'on, groundwater levels that may
fluctuate dufing 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 guarentee future performance of the system, nor do they guarentee 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 .........
operetional 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 fight whatscover.
5. DSD SIGNATURE
~ Approved for ,~
Disapproved.
Conditional approval for __
bedrooms.
bedrooms: with the fllowing stipulations:
Attachments:
COSA Checklist
Septic System AdvisoP/
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Reort
· Other
Original Certificate Date:, -- .3 1 - o 7
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-665O
www.muni.org/o~site
(9O7) 343-7904
CERTIFICATE OF ON-SITE SYSTEHS APPROVAL CHECKLIST
Legal Description: CROSS VIEW ESTATES~ LOT 10, BLOCK 2
Parcel ID: O~A--/-,~ ~ I' 7.,~....
A. WELL DATA
Well type Iq~VAT~ If A, B, or C provide PWSID~ N/A
Date completed 4/9/20Q. 7 Sanitary seal (Y/N) YES
Total depth 272 ft. Cased to 268 ft.
Well Log (Y/N)
Wires properly protect~l (Y/N)
Casing height (above ground)
YES
YES
24 in.
FROM WELL LOG
Date of test 4/9/2007
Static water level 216 ft.
Well production 9 g.p.m.
WATER SAMPLE RESULTS:
AT INSPECTION
Coliform 0 colonies/100 mi.
Arsenic: ND ug.lL.
Nltmta 0.4.12 mg.lL. Other bacteria 0 colonies/100 mi.
Date of sample: 8/1/2007 Collected by: GE(; Ltd.
SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL
Tank size 1500 gat. Number of Compartments 2
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO
Data of pumping NEW Pumper
Date i~stalled 4/5-6/2007
Cleanouts (Y/N) YES
High water alarm (Y/N) N/A
Ce
ABSORPTION RELD DATA
Date installed
Length 106 (2053) ft.
Total depth .loJ/t 1.5 ff. Eft. absorption areal265+ ff~ Monitoring tube YES
Date of adequacy test NEW Results (Pass/Fail). -
Fluid depth in absorption field before test - in. Water added - gal.
Elapsed Time: - min. Final fluid depth - in.
Any rejuvenation treatment (past 12 mo.) (YIN & type)
**USE0 APPLICATION RATE OF 0.6 GPD/SQ.FT.
Soil rating (g.p.d./ftJo~**0:8 System type DEEP TRENCH
Width 2.5 .lt. Grovel below pipe 5.82/6.12 ft.
Absorption rote >=
Depression over field NO
For 5 bedrooms
New depth - in.
- g.p.d.
If yes, give date -
D. UFT STATION
Date installed. ' .,, Size in gallons ~
.Pump on- le~,lghwater_a,rm level at __ .in.
~ ~ Cycles tested Meets alarm & circuit requimments'~
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
Absorption field on lot 100'+
Public sewer main N/A
Sewer/septic se~ice line 25'+
Animal containment ames 50'+
100'+
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cteanout N/A
Holding tank N/A
Manure/animal excreta storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+
Water main N/A Water service line 10'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation. 10'+
Water service line 10'+ Sudace water 100'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
Absorption field
Surface water
5'+
100'+
Water main N/A
Driveway. pinking/vehicle storage 10'+
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.
Engineer's Printed Name JEFFREY A. GARNESS
Date ~
Waiver Fee $
Date of Payment
Receipt Number
SGS Ref.#
Client Name
Project Name/#
Client Sample Il)
Matrix
1073810001
Gamess Engineering Group, Ltd.
Cross View 'Est L10 B2
Cross View -Em LI0 B2
Drinking Watcr
All DatestTlmes are ALaska Standard Time
Printed Date/Time 08/I 5/2007 16:21
Collected Date/Time 08/01/2007 16:34
Received Date/Tim e 08/02/2007 12:45
Technical Director Stephen C?. Ede
PWSID 0
Sample Remarks:
Allov. uhle Prep Analysis
Parameter Results PQL Units Method Container ID Limits Date Date Init
Metals b~ ICP/MS
A~nic
ND 5.00 ug/L EP200.8 C (<10) 08/08/07 08115/07 hill
Waters Department
Toul Nitmtc/Nitrite-N
0.412 0.100 mg/L SM204500NO3-F B (<10) 08/07/07 JDS
14icrobiolo~z Laboratory,
Total Coli£orm 0 col/100mL SM20 9222B A (<1) 0?02/07 SDP
Z
0
