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HomeMy WebLinkAboutTIMBERLUX #3 BLK G LT 12Timberlux #3 Block G Lot 12 #018-271-66 GRE,,.ER ANCHORAGE AREA BORv.JGH • - sC��� Department of Environmental Quality ^� 3330 C Street Anchorage, Alaska 99503 ItiSPECTION REPORT ON-SITESSEWAGE DISPOSAL SYSTEM NAME ____ _ _ __._ AILING ADDRESS4 9—q..2D/-7Zzl._ _._ IPHONE LOCATIOgeVA'�t1=��� _ LEGAL DESCRIPTION.J� �a B��i �,,,/I, u�2�u SEPTIC TANK - DISTANCE ��� ��^^ �T NUMBER OF FROM WELL A20 / MANUFACTURER,�[]UA15e—MATERIAL /�s�i-L_—COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY,sL GALLONS. / TOTAL LENGTH DISTANCE FROM WELL (1_FOUNOATION.�, NEAREST LOT LINE NryOF LINES 7� NUMBER OF LINES Q_ DISTANCE BETWEEN LINES TRENCH WIDTZk- IN. TOTAL EFFECTIVE ABSORPTION AREA 1/ y� /,-' SQ. FT. LENGTH OF EACH LINE 7,2/ DEPTH: TOP OF TI WELL:O Dr- TYPE...( BUILDING FOUNDATION CESSPOOL APPROVED DEPTH OF FILTER r7 :TO FINISH GRADE _uS / MATERIAL BENEATH TILE _7 IN. ABOVE TILE c _CONSTRUCTION �c..ac.� DEPTH DISTANCE FROM: NEAREST NEAREST SEPTIC SEEPAGE LOT LINE , SEWER LINE , TANK . SYSTEM , OTHER SOURCES DISAPPROVED—REMARKS-U61 ('.O/7L�_1�Q,7'� AT' -r'111C- "l-JLY21 - DISTANCES: Af�_� t4e.,17- 19C-1�o � INSTALLED BY: SEWER LINE DEPTH: PPIIIPPEEE MMATERIAL:-Iy� LOT SLOPE:i�, REMARKS:e: :w Form EQ -032 w nnwu r ' 1 111u r0. LO � N 140U,SC, ,0 Ci DATE APPROVED G.A.A.B. r•1 LJ r4 I C HL I TY C3 F' Ftr4ClV0t0RF IC3 ANl DEPARTMENTT: HEALTH AND ENVIRONMENTAL _ROTECTION I1 t/'% 2516 E. TUDOR P.D.. ANCHORAGE, AK. 99587 276-2221 LJEFLL Fit4E> Ot t—E• I TE SELJEF<: FJERry I T PERMIT NO. C 76818 ) In -M -76o 3:w PnL�uc�f APPLICANT ROBERT BERNHARDT 2420 TAGALAK 337-6254 &LOCATION MANYTELL AVE LEGAL L12 BG TIMBERLUX ADD#3 LOT SIZE 61500 SQUARE FEET TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4• SOIL RATING CSQ FT/BP.)= 210 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: G•EF'TF-F= ZS. L-Emsirvi= 7"1. GRF3%"EL F>EFll fA= C' THE LENGTH DIMENSION IS THE LENGTH CIN 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). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE,PUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). REG!LJ I REG 'SEF}TIC TANK 'SIZE= '*>-c��GFiLLOt,J� TLJO C 2 ] I tJSF=ECT I Ot-dS FiFZE FZEGlIJ I F2EG� BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER. INSTALLATION. F•EF-cM I T ',PHL I F> F= 01 F QrJE YEFiF<_ FROM I :.�IJE I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. I UNDERSTAND THAT THE ON-SITE SEWER. SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. SIGNED CANT ROBERT BERNHARDT ISSUED , 2k-7�7 TIME DRILL LOG CASING C.H. ``LFeDR1L.41NG 914 East 78th Avenue 2 �L; ll ANCHORAGE, ALASKA Z 344.9242 START COMPLET�� DATE NAME p / ADDRESS No. 1 `:� CITY D Z HO JOB LOCATION J TIME WELL LOG DEPTH WELL LOG 0 ?eA-vety 02 _, •, O STATIC LEVEL GPM - YIELD •-4. 1' DeA4rtment of health and Environment-4�,Protection 2516 E. Tudor Road Anchorage, Alaska 99507 276-2221 Perfunxd forF2dy/G �ti Date. Perfun.r.A a..... -- ..._ Legal Uescriptiun:G i_�_ /3_ � _ This form repurts: Soils log _—_ v _--_ Percolation test � _- — Depth Feet I - ;:— � 2- G29U[cY SQd.� (So) 3 - [ Fn.S rS 4- r _ S/ SA M 7 -S- 6 7 ,S67 B- / S�cTY GRAOE6�% ` 9 - sA.vQ G 17-5-r7 10 - 11 .� 12 - 13 - 14 /f Was ground water encountered? If yes, at what depth?', Itcadin9 Date Gross Time Net Time Dep -------------- - - — - - - - 7 t✓.(117 ------- -•-------•- -1�'da Ah-'------- - -j-°--rye~-� _L :h to hater Ilct it Percolation rate /,.#�/g— Minute. - Proposed installatiun: Seepage Pit rAen�e/f Drain field Depth of Inlet _ — _ _. Dcpth to Lottom of pit or trenci. `— COI1MOTS:----------------------------------- --'--- - - `— Prrfonncd liy:---- - CcrtifcJ By: cocri� �csc—,_iiite:_J jg_7c FQ-0.10 (6/74):��5 - -- • 11(1C, a1-Ic��- � .� ►-�c,� � o'� CSS � b J &Ottv L ��o L,5, Municipality of Anchorage Development Services Department a �. Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. OIB- 2"11- Wo COSA # 102W7q Expiration Date: I I— a Q '- a s 1. GENERAL INFORMATION Complete legal description 1^6%1�x *3 gm rr LT 12 Location (site address) q& -.)l M-„ a i( Aye - Current Property owner(s) Vo%tA A2r"6AA Day phone 345-1034 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Unless otherwise requested, COSA will be held by DSD forpickup. 2. NUMBER OF BEDROOMS: -1_ 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water 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 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 SDI C115in rtrin< Address 203 W 6A Ay,. -S& Zai AK 17501 Engineer's Printed Name t! A r5 Sv 5. DSD SIG ATURE Approved for _� bedrooms. Disapproved. Phone 2a4 -37/b Date elillce i le. of q�qs10 lit �� I AAS E. SPURKtgNo ; 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: &/, � Original Certificate Date: (R., 11105) Municipality of Anchorage Development Services Department Building Safety Division -- On -Site Water & Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Ti I)e,%I"x 113 NIc F LT I'Z Parcel ID: 016-211- UP A. WELL DATA Well type PrAe- Date completed Total depth [39 ft. Date of test Static water level Well production If A, B, or C provide PWSID # = Well Log (Y/N) Y Sanitary seal (Y/N) L Wires properly protected (Y/N) Y Cased to '7 y0 ft. FROM WELL LOG WATER SAMPLE RESULTS: Coliform —0—Colonies/100 mL Nitrate A/D mg/L Arsenic: NZtO ug/L date of sample: 1 oQ, B. SEPTIC/HOLDING TANK DATA Tank Type/Material MaST%(, Tank size I S o0 gal. - Number of Compartments 2 Foundation cleanout(Y/N) ,Depression over tank (Y/N) Casing height (above ground) +12 in. AT INSPECTION 31 os g.p.m. Other bacteria _0 colonies''/1100 mL Collected by: LAOS wJ Date installed 10 - 28 -19 T fo Cleanouts(Y/N) Y High water alarm (Y/N) Al Date of pumping DQi Pumper At Vome Scrum C. ABSORPTION FIELD DATA 1 Date installed fo to Soil rating (g.p.d./ftZ ft2/bdrm 'ZIO System type _ DE�1+ Tre^J Length ft.! Width ft. Gravel below pipe (0 ft. Total depth 10 ft. Eff. absorption area 840 ft= Monitoring tube Depression over field Date of adequacy test 31 O Results (Pass/Fail) R SS For 4 bedrooms Fluid depth in absorption field before lest C]_ in. Water added -gal. New depth 9 in. Elapsed Time: 1W min. Final fluid depth 6 in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type)doneyvwv�n If yes, give date — D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) ' 'Pump on" leve _ in. 'Pump off" level _ in. High water alarm level in. Datum Cycles t d Meets alar ti uit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 1001+ On adjacent lots coI+ Absorption field on lot 100 {" On adjacent lots loo `+ Public sewer main 1>71601 Public sewer manhole/cleanout 17 too t I Sewer /septic service line 90 r + Holding tank NIA Animal containment areas N.O. Manure/animal excrete storage areas N.O. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5,+ Property line 5l+. Absorption field 5 + Water main 77 foo r Water service line 15014- Surface water Al. 0. Wells on adjacent lots 100r+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: >7 1 Property line 10 t'f' Building foundation 10 r t' Water main too r Water Service line 50 + Surface water MO, Driveway, parking/vehicle storage iSol Curtain drain N,O, Wells on adjacent lots Its 11- F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and C2, l� review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. /r ' { KtP�DaY� Engineer's Printed Name LArs S aw, �TARS E!. Date bill 08 (1`,OPfip$�ESID�P`�—r—� COSA Fee $ 4:�,D Date of Payment 911 a /OR - Receipt Number (090 (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number LOT /4 LOT /3 205.07 ?.s 4o M641.40r- A 6 SHED VC4J.1 Bi ,3' LAS ei I Lot . %Z , Block ~.�7 T mr er/ux SUbLl Add No.: Anchorage Recording District, Alaska +t h I -C • . SEPnC S.R'e • 2e 7' ,. .edNEa°.raJt wE[4. J 005.00' LOT �� R A S89e56'36"WzV-'X .. s _ a< ; Q AIANYTELL9 l MI AVE• ♦ .• Ron :.�o LSi4 ma Eassenls of record other than those shown an I,I19Fap••...«....•PaOra�rr too plat of record are sot shown hereon unless 1 ROFESSIONA�� otherwise noted. LOT SURVEY CERTIFICATION LEGEND �d C25 I h..ey witty that Ihave a sysd the property shown and described 0 &ace or Aluminum capped monument recovered hereon, and that the impownents situated thus" are within the prop- O Iron pipe and/or labor recovered. orty lines and do cot overtop or encrdoch on adjacent property and that 0 2 x 2 hub 6 tack recovered no anprovemerNs an adjacent property overlap or onoroaeh on the promises 0 5/8"x 90" rebor set this Survey In a+.eetion and that Men we so roadways. utility line, or other visible —N Fence Lirie (Approx. Location) casements an said property except w Indicated hereon. Date Prepared by: R. L. BUTTON e R Registered Land Surveyor Scale /ft �/^l © 08— 2" 08 (907)279-6200 5/9 W. Eighth Ave. Anchorage A/asto99501 IRet 3136 I F.B. No. 05-055 I Property of: pbber.,c Bern L,. Y&f /V OV -0c .yes c CUD.w I SNEO LOT /4 WI LOT /3 • . SEPnG d.R'd • Lot 12 , Block "G7 7 mr erlux Subd Add No Anchorage Recording District, Alaska .dsr,a•, .WEO LOT 205.Cb, i MARE." • `• pp pp�� y .N1. ...� S 89eY0r,36" W'L L Button s• ——MANYTELL AVE. ��tr�9�o LS -1192 -0 [asenente of rosard other than mora shown on ��\\F" the plat of reseed ore Mot shown here" anion. otherwise Noted. LOT SURVEY CERTIFICATION LEGEND 1 hereby ownfy that I have surveyed me property shown and desorlbed 0 Brass or Aluminum capped monument recovered hereon, one that the imprwveoonts situated theeeoa We within the prop. o IronDipe and/or robot recovered. arty uses and do Mot overlap or encroach on adjacent property and that O 2 x ?hub G tack recovered Ms briprovenwnts on adjobenf "" oveeiap or enoroaoh On the pnwisee • 5/8 x V tabor set this survey In question and that then are Me roadway., utility lin«, or ern« visible _ Fence Urie (Approx. Location) eanwente on sold property oeaept a Indicated harass. - Date Prepared by: R. L. BUTTON e Registered Lord Surveyor Scale /r/ //n' © 08-2-08 (9O7)279-6200 5/9W.Eighth Ave. AncharoyeWashe9950/ Ref. 3/3`67' F.B. No. 05_085 Property of:Roberf Bernfx�r�f