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Home My WebLink AboutBELL LT 1Bell Lot 1 #050-781-35 4 UN GRF`TF-0`\ ANCHORAGE AREA BO"n1"-H Department of Environmental Quality , 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME- I'!Clc'lllkr 13ftl- MAILING ADDRESS51A��YA�PHONE LOCATION YkAf1iZM Sr 4 tlZC 1 LEGAL DESCRIPTION & SEPTIC TANK: DISTANCE (j r NUMBER OF FROM WELL r 1 MANUFACTURER �/V�LLAC MATERIAL ��lC�i� COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH I IQUID CAPACITY �GALLONS. SEEPAGE PIT: �q(� Q ��i / NUMBER OF PITS DIAM ER LOR WIDTHS LENGTH]'_ DEPTH —&J' LINING MATERIAL Ce71CK�t. CRIB SIZE: DIAMETER —DEPTH— DISTANCE FROM: WELL yycI r TOTAL EFFECTIVE y��[l BUILDING FOUNDATION, NEAREST LOT LINE Go ABSORPTION AREA (WALL AREA)�SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE _A-41! —CONSTRUCTION -Ct'lSlN4 �C(�ia� 9Wu+•Cl DEPTH DISTANCE FROM: BUILDING/ NEAREST NEAREST SEPTIC 97r SEEPAGE 4/ FOUNDATION, LOT LINE SEWER LINE TANK—,SYSTEM CESSPOOL , OTHER SOURCES APPROVED DISAPPROVED REMARKS�''•'� DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: �� ;t• � 'r/v^• ' aldla4G PIPE MATERIAL: �fS y Sort;,, 4w( LOT SLOPE: Abut 1 REMARKS: DATE APPROVED k' k LU 1 Z G..A.A. Fo,m No. EO -031 �i0� pkk6wtSM. SC�'t J log owmraor LAND ............. ....... :....... ....... DEPTH Or wuL _._..... ___._....J.... ..._. .__... ADDRESS .. � p �- •� .. .... STATIC LEVEL of WATER 2T..._�J...._.............. • WELL 5 v Ph?•K__•`<!.,<..E•_i2ivi�e••ESf!vtr D AW DOWN FT........... �........__._.�... 41 DATE --STARTED _......._..,....--...-.--...........___........_._.....__._ GALS. PER HR. ....... % D -...--y...... n / (I 7 ivy // DATE—ENDED __,y-..?.__. Ac L..--.-�••..-_•-_.--^—.^....-.._. KIND OF CASING .__V._ . 0_ .._.�.._......_..._.. KIND OF FORMATIONS - FROM._F _N .-_FI'. ro_3.3/_.___._:••r_(N�gRr%...JJPAN FROM—._....._..M. To-----.FT..-.._.r...._..�. iROM......___-__..iT. TO._...____..__.FT...._.._.._._._.___. FRONL N. M TO. Lv'' tT+ i __... FROM. _-� FROM 6-4 FT. To_G Z...�....FT.�! �:-'•1J•-•-_. FRoMTO..,._.__._...FT FROM_ J-:: -". TO_ V ��.._.FT. / n. --.- FROM. iT. TO i7..._. FSCM.��77._.//W�...i:'.TO 7��. /�._..i'I' fil'%�cG•�••P!%nJ FROM sT. TO rr FROM_1_1_._..YFT. TO �'7. s�• A •i�/� • nG FROM._... FT. To rT _. M&15 iE1G TIN7' � 7 �s �' ��. N re s 8• D)R�ILLEWS . � d�.z�-a,�J�yKi✓� r. l5ee 1jr77 swr 5E°Nwykwy Sic �� `�° Requested by Wallace CPrysp', Co. Located off Eagjt River Road (Klondike 1 ra) / r` 6"onsE Ezuction Jif -fag RECEIVED "One test is worth a thousand opinions" UL i ;; 1973AM RO2O TUDOR ROAD. ANCHORAGE. ALASKA 00007 • TKLEPHO"e]22.O472 Performed For Merriam Bell Date PerOJJW6C," 4E3 OOROUGH Legal Descrintion: Lot Block Subdivision This Form Reports Soils Log yes Percolation Test neo th 1 2 it Cha gL,�-j . Silt -Sand -Gravel Mixture N .. g 1n GM -225 Was Ground Water Encountered? No If Yes, At what Depth? H Reading Date_ Gross Time Net Time Depth to H,0 Net Dron' Percolation Rate Hinute Proposed Insta 1—i ation: Seenaae Pit y8s Drain Field Deoth of Inlet Dept TT o Bottom Of Pit Or Trenc COMMENTS: 225 sq. t. ra nage:,area required per bedroom no edroc or water table t: below seepage bit Test Performed By Jim Mack Data Certified By:Construction Testla Lab anager Date: 7-9-73 0__14- Municipalityof Anchorage -• Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 Y� www.muni.orglonsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.-'x-81- 5,15- fi1S iI tiTfe7i X%EarI Complete legal description 6E:L.I_ L-er I COSA # DV 1 I to Expiration Date: % - ; Q % Location (site address) L03, -1 -PTA -MIC-K k1 Oi-va . Current Property owner(s) F+A-K-vEY -ptn Lt_cN Day phone Lf +0 - CIO 1 -1 - Mailing address Lending agency Mailing address Real Estate Agent Mailing Address V o - 13ox 'a 109 (e, I , F�YC_TLE re -(VE -r-, AW_ '91S -4 -1 - Day phone pW 4DJ STK o 0 C -r Day phone '351- 4 3(, Fe T��1DCT1'TI/4�t— Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 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 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. DSO 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, 1 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 Flan Eagle River Engineering Services Phone (,)94-5195 494.21 V 1N f{d-6uite £ Address Eagle River, AK 99577 Engineer's Printed Name LttKISTor°++ 1;1-. WcoD Dade `(1 P9 / d-4- 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory 'Maintenance Agreements Supplemental Engineer's Report Other By 4Original Certificate Date: _25 - 0 7 (flay. nAs) Municipality of Anchorage • i` 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)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: BELL L-0 Z Parcel ID: 05�O – -78 1 – -3.5' A. WELL DATA Well type fMdiiC Date completed Lit - Total depth }eft. If A. B, or C provide PWSID # _ Well Loge` yL� 's Sanitary seal &4TYS5 Cased to f Z ft. FROM WELL LOG Date of test 2 /27 / 70 Static water level -5s ft. Well production e». 6 9— p.m- WATER SAMPLE RESULTS: Coliformcolonies/100 mL Nitrate 3.3r0 mg/L Arsenic: AA00AJpt5' ug/LtL(_ �Ddate of sample: �610� B. SE TIC/HOLDIN9T VK DATA /L Tank Type/Material 4y^CRt %4�_ZhL4L! hof Wires properly protected 64 6'S Casing height (above ground) I_in. AT INSPECTION Li 13/0 52 ft. 1'.1.°1 g.p.m. Other bacteria _4L( colonies/100 mL Collected by: C#R1S I.Jal9� Date installed ? A Z&3 Tank size LI(20 gal. Number of Compartments Cleanouts (Y/N) 1/6'S Foundation cleanout &) Yo Depression over tank (Y6 A& High water alarm eoo Mo Date of pumping 1170107 Pumper nz I'S C. ABSORPTION FIELD DATA Date installed 2aL13 Soil rating (I+AWW or ft2/bdrm) 22y System type 5kWP446 PTT - Length S6 ft. Width 4 ft. Gravel below pipe 6 ft. Total depth –7—ft. Eff. absorption area laft" Monitoring tube _V Depression over field Date of adequacy test `/ Result (as ') ed SS For_!Yfbedrooms Fluid depth in absorption field before test _3_in. Water added2,i,�agall.. New depth in. Elapsed Time: / Pmin. Final fluid depth __3 in. Absorption rate >= 400 g.p.d. Any rejuvenation treatment (past 12 mo.) (i'C3 type) NO If yes, give date AJ14 D. LIFT STATION Date installed Size in gallons 'Pump on" level at _in. 'Pu 7r<iev Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: r Septic tank/lift station on lot 91 r Absorption field on lot it r Public sewer main +7 S r Sewer /septic service line + 7 - Animal Animal containment areas + So r (Y/N) in. High water alarm level at Meets alarm & circuit requirements? On adjacent lots On adjacent lots + /yO / Public sewer manhole/cleanout +lav r Holding tank 4100 f Manurelanimal excrete storage areas Irx� r SEPARATION DISTANCES FROM SEPTIC/M QI=13 16 TANK ON LOT TO: Building foundation S 4 Property line _I Z6 Absorption field G Water main +I,-, r Water service line + 1 b r Surface water 4- loth r Wells on adjacent lots 'f It -9.0 / in. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: r Property tine I Z r Building foundation 4"/0 Water main 4"I0 Water Service tine f" /d r Surface water '+' 100 r Driveway, parking/vehicle storage 4-10 � Curtain drain >s SD r Wells on adjacent lots + 'IoO r F. COMMENTS Nay-•c,(Tt t/ g�pQq�rtS. fyf7�w� be'&'AN& Fo23 eQ, gkt r�srcar»»RH. ;i 7',+ARczveb5 iE' v hC•t� S tri„ C hF�FR I.t� w( Zeye 411- oAZA 70 LOY. G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name 41+yx3yAbe R• t oy t> Date ti COSA Fee $ q?kb- -t If q5 Waiver Fee $ _ Date of Payment '112-47 Date of Payment Receipt Number 95u )q Receipt Number (Rev. 11/05) WQIFPAI SCS Rer.# 1071430001 Client Name Eagle River Engineering Project Name/# Bell Lot 1 Client Sample ID Bell Lot 1 1lratrir Drinking Water PWSID 0 Sample Remarks: All Dates/rimes are Alaska Standard Time Printed DateMme 04/19/2007 14:05 Collected DateMme 04/062007 14:13 Received Dale/rime 04/062007 15:46 Technical Director Stephen C. Ede Allowable Prep Analysis Parameter Results PQL Units Medwd Container ID Limits Date Date Init Metals by SCP/M9 Arsenic ND 5.00 ug/L EP200.8 C (<10) 04/11/07 04/18/07 TK Waters Department Total Nitratc/Nittite-N 3.38 0.100 Microbiology Laboratory Total Colirorm 0 mg/L EPA 353.2 B (<IO) 04/09/07 JDS col/IOOmL SM209222B A (<I) 04/06/07 DPT Municipality of Anchorage -- *,. Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage. AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. gno o - 77'1 - i:2 HAA# bpi- c) Lws Expiration Date: 1 /�A� 1 1. GENERAL INFORMATION Complete legaldescription �PP�v F.abcc .�✓sr�.onc+ P3� �� Location (site address or directions) a-70,;2 a 7 64 un . 2;;te t� .✓?✓fes �9 t 9vS?P Current Property owner(s) 1,4,y e- Day phone 1995-1- 9is --Y— Mailing Mailing address ajrD9 ? ;7 i3., .+.c.ry 5_yn 1r.*r�,ce A,t 9srpL7 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 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 Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Authority 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 verify that my investigation, based on procedures outlined in the Health Authority 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 254ax,r Phone Gly— S� Address 1iru/ ea Wi e5, z., c Engineer's Printed Name Date 7 /27L0'/ 5. DSD SIGNATURE _ Approved for 1_ bedrooms. Disapproved. Conditional approval for bedrooms, with the following CMMTovfmt d 11 CE:10 37 Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other _ By: L a'0*. 2 an Original Certificate Date: (Rev. 01N2) P i Municipality of Anchorage • Development Services Department ' t; Building Safety Division ' On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196850 Anchorage, AK 99519.6650 www.ci,anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: .gF'%.,.A,1- Parcel ID: ESQ 162 .«. A. WELL DATA Well 4",P e,✓.trz If A, B, or C prove PWSID # _ Well Log (Y/Q 4'D Date completed.,d1C Sanitary seal 49N) -;iWz� Wires properly protacted&) )640 Total depth; S2 ft. Cased to _i sZ *7t. Casing height (above ground) _[min. FROM WELL LOG Date of test O�µ Static water level Well production g.p.m. WATER SAMPLE RESULTS: Coliform _42_coloniesl100 ml. Nitrate S. & .3 mg.A. Arsenic:"'IA mg.A. Date of sample: i� rf oy B. SEPTIC/FGTANK DATA Tank Type/Materialye s>e' Tank size �~ gal. Number of Compartments / AT INSPECTION •5/ % g.p.m. Other bacteria QcoloniesH00 ml. Collected by: 4''.rl.? Date installed &94 4S 1 CleanoulsaN) Y,4 --s Foundation cleanout®N) yAo Depression over tank (Y® -!f:� High water alarm (Y$)-) .Vz) Date of pumping Pumper I R 5 C. ABSORPTION FIELD DATA Date installed &" 3 Soil rating (g.p.d./fe oreg�) »r System type -ZZyd*mg piv- Length :rte ft: Width a' ft. Gravel below pipe ft. Total depth ft. Eli. absorption area &Zfe Monitoring tube _Yjfj Depression over field 1L Date of adequacy test /D st/s.s Resuftq2as ail) '-Sg� For --$' bedrooms Fluid depth in absorption field before test1�'m. Water added gal. New depth p7? in. Elapsed Time:fD1'min. Final fluid depth if- in. Absorption rate >= &e2L9 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y4%;k type) .two If yes, give date N 4 D. LIFT STATION Date installed 'Pump on" level at _ in. Datum E. SEPARATION DISTANCES Size in gallons _ T 'Pum at _ in. Cvcles tested SEPARATION DISTANCES FROM WELL ON LOT TO: (Y/N) High water alarm level at Meets alarm & circuit requirements? Septic tank/lift station on lot 97 On adjacent lots 7-,-04 Absorption field on lot //'1 ' On adjacent lots >ie o ' Public sewer main Public sewer manhole/cleanout 7' id0' Sewer /septic service line Holding tank SEPARATION DISTANCES FROM SEPTIC/HeLVM TANK ON LOT TO: Building foundation sof' Property line IAbsorption field 6 ' Water main t64 ' Water service line rie ' Surface water +' iWe ' Wells on adjacent kits f e,�OD ' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: in. Property line 3 -/' Building foundation PS' Water main do ' Water Service line 1'44 ' Surface water /rs0 ' Driveway, parking/vehicle storage Curtain drain fsO ' Wells on adjacent lots ao' for .r ewwS . erg✓.*/ 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 HAA guidelines in effect on this date. Engineer's Printed Nam ri=ziftwc .h eap Date -7-7 --PA LY 2 voN HAA Fee $ Waiver Fee $ _ Date of Payment -2/7 7 IJ4 Date of Payment Receipt Number Receipt Number (Rev. 12101) JUL-24-04 SRT 08:0T SEWARD 8 ASSOC LAND SURV 90T 6940830 �YB9'!ro� c^ /79 ro �'rB«Q ol ASBUIL7 SEWARD & ASSOCIATES LAND SURVm I HEREBY CERTIFY THAT 1 HAVE SURVEYED THE SCALES FOLLOWING DESCRIBED PROPERTY+ AND THAT 90 ENCRR645 NTS EXIST EXCEPT AS DATES �!Q'��.��• A: INDICATED. 17 IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY GRID= iH " EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI_ fids-! P.01 I„M VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB' • V Du.n. MeA S.w.rd • ,� ANY DATA HEREON BE USED FOR CONSTRUCTION /��-r2 �� '•,• 15-4918 i OF FENCE LINES, OR FOR ESTABLISHING BOUND- DRAW� ARY LINES. 1�N�ZN• rrZ "•��