HomeMy WebLinkAboutDALZELL-SCHNEITER BLK 1 LT 2I ol
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015-291
-11
MUNICIPALITY OF ANCHORAGE
f DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME~ PHONEI Jq'NEw
MAILING ADDRESS
LEGAL DESCRIPTION
NO. OF BEDROOMS
Well ~ A~sorPtion area Dwelling PERM It NO.
~ ~ Manufacturer ~~ Material ~g N°' of compartments ~
~ Liq. capacity in gallons, o ~ IF HOMEMADE: Insidelength ~ ~ Width ~ ~ Liquid depth ~ ~
~ ~ DISTANCE TO: Well Dwelling
O Z ~ Manufacturer ~
~--~ ~ ~. , Material Liquid capacity in gallons
Q~ DISTANCE TO: Well Foundation Nearest lOt line PERMIT NO. ..~ ~ ~ ~
~ Distance between lines J
~_ No. oflines ~ Length of each lin~ q total length of lines~ ~ Trenchwid ,~Oinches 0 ~
~ Top of tile to finish grade 1 ,, Material beneath tile ~' O inches ~r~i
Q ~ O II Total effective on area
Length Width Depth PERMIT NO.
Type of crib i meter Crib depth Totel effective absorption area
m WelF ' Building foundation Nearest lot line
~ DISTANCE TO:
~~s~ss~[~ Depth Driller Distance to lot line PERMIT NO.
~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
OTHER
SCI L TEST RATING
.... 505 ~
A~O~ED ~ DATE LEGAL
72-013 /. 3/78)
PERMIT NO.
I'-llJ[-.I I L--: I L I T"r' ,zl,,F. RI%lC:
DEF'ARTMENT AF HEALTH AND EN",,IRONMENTRL F~.:OTECTION
825 "'L" STREET., ANCHORAGE AK. 99501
264-472~
( ?804?_-< )
AF'PL I CANT
LF,]:AT I ON
LEGAL
JAMES 8UMGARDNER SRA BOX 474E 9950?
MILROB AVE
L2 Bi DALZELL-SCHNEITER SUB LOT SIZE
TYPE OF SOIL ABSORBTION ~-,,c; IS
--.z_TEM · TRENCH
]:44-19Z.':3:
........ .-"._, SQUFIRE FEET
MANIMUM NUMBER OF BEDROOMS = 4 SCIIL RATING (SQ FT,-."BR',=
,..-.%
THE REQLIIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS- /./~.- //:7 ./~
[:'EF'TH= 12 LEI'-.IGTH= "~-"~' . 6RR'-..'EL [:'EF"f-H =
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE 80TTOM OF THE E~CAVBTION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET).
F.:Em_-~.m_m I F-:E[) SEF'T I m]: TAI'-II<: '---- I ZE= 125~J
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS [:,EPARTMENT [:,URING THE
TNSTALLATION ]NSPECTILN~ OF ANY 14ELLS ADJACENT TO THIS PR_F'ERT~ AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
TL-J~]' ( 2 :) I I'-ISF'E,]:T I ,]NS ARE F-:E~;!I_I I F~:E[:.
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAl_ E:'T' THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN R WELL AND RNY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR 8 PRIVATE WELL; OR
i50 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC NELL
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
PEI:~:r"I I T E::-f,F' I RE'_-] [:,EE:Er-IBEF.'
I CERTIFY THAT
1: I Afl FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND NEL[_S RS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
~: I UNDERST~, THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE
ENLARGEMENT IF THE
CUSTOMER
i EHKiNS WELL DRILLING
PHONE 344-3]92
DR I LLER~S WELL
Ja~e~ B~m..~Lrdner dba ~un Construction
L'0 G
Oeo 78
Box 474-E SRA
Anchorage, AK 99507
LOCATION Lot 2, Block 1, Dalzell-Schnoider Subdivision off Birch Rd
6~
SIZE DEPTH 45' CASING DEPTH~45' GROUTING DEPTH NA
YIELD
STATIC WATER LE-VEL~ HOW TESTED
PUMP INSTALLED 1/3 hp TYPE Red Jacket
FORMATIONS ENCOUNTERED AND APPROPRIATE DEPTHS
__ TO 25 Loose Sand and gravel ~,ater seeoage at 18'
25 TO 44 Gravel and brown clay
44 TO 46 Sand, Gravel water 8-9 gpm
46 TO 48 grs. y clay
~TO
~TO
TO
TO
TO
~ TO
· /
' APPLI( IT HAIL NLY
, FILLS OUT UPPER
?re, party Owner ~2-d.~,- ~ ~../~__.. ~.~.~ ~ ~/~ Phone
M~iling Addre~ ""~
Buyer /~p~
Address ~_~.~ ~./~, /y ~,-,/~ ~,~ )ZiP Code
/ ~ _ ~/~ Phone
Lending Institution
Address ~/~/-
Realty Co. & A~nt ~7 ,~ / .Z,~,'~.~. ~/7 ~' ~-~F~ 7~ ~5~ ~'~ ~ Phone
Auure s
Legal Descript~n ~
Street Locatim r~~
Type of Resi~nce
~inole Family
~ Multiplo [amilg ~o. o~ ~odroo~
~ Other
W~e~pply
~lndividual A~ACH WELL LOG. A w~l log is required for all wells drilled since June 1975.
g Community For wells drilled prior to that date, give well depth (attach log if available).
~ Public Utility
Se~er ~sposal
~dividual Year Indiv~ual Installed:
~ Public ~ility When Connected to Public Utility:
~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED.
T~/~ __~.,...~O Time Time Time
Date Date Date Date
Inspector Inspector Inspector Inspector
Field Notes: -- --
(~'APPROVED BEDROOMS *CONDITIONS OF APPROVAL
( ) DISAPPROVED
( ) CONDITIONAL APPROVAL*
By:DATE /--,.~__ ~__ ~ ,
Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received
72-023 (3/82)
DEPARTMENT OF HEALTH & ENVIRO~ENTAL PRO{ECTI~ MENT,~L P:.:OI'ECTION
825 L Street-Anchorage, Alaska 99501 JAN 2 9 1979
ENVIRONMENTAL ENGINEERING DIVISION
~a ~ ~~ Telephone 2644720 RECEIVED
flE~UEST FOB APPROVAL OF INDIVIDUAL WATEB AND $EWEfl FACILITIES
DIRECTION~: Complele all parts on page ~. Incomplete reques~ will not be pro~eg. Please allow ten (~0) daVs ~or processing.
1. PROPERTY OWNER ~O~
MAILING ADDRESS
PROPERTY R ESI DENT (., ~,n~from~o~)
2. BUYER PHONE
3. LENOING INSTITUTIO~ [ PHONE
MAI LING ADDRESS
...........
5. LEGAL DESCRIPTION
STREET LOCATION
6. TYPE OF RESIDENCE
[~'~'1NG LE FAMILY
[] MULTIPLE FAMILY
One D Four ~ Other
Two ~ Five
Three ~ Six
7. WATER SUPPLY
[~'NDIVI DUAL*
[] COMMUNITY
[] PUBLIC UTILITY
* ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth ('attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
[[;;}/ INDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
**If individual/on-site, give installation date ~/ )~
If system is over two (2) years old an adequacy test is required
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78)
�� 7 8 S Ip • .
3 rr E_ 8
•; ,_ Municipality of Anchor e'"' = '.' 1r {
On-Site Water and Wastewater Prog JUN d 5 am
(907)343-7904 2W . ��S A ETY
Q
Certificate of On-Site Systems Ap `o o a L"_+9' ")1�
Parcel I.D. 015-291-11 Expiration Date: —2(51 -1 7
1. GENERAL INFORMATION:
Complete legal description Dalzell-Scheiter; Block 1, Lot 2
Location (site address) 5460 Milrob Ave. *Anchorage,AK
Current Property owner(s) Vivian Bowman Day phone 748-4748
Mailing address 5640 Milrob Ave. *Anchorage,AK
Real Estate Agent Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
El Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ® Individual El
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
Received by: Date: & A 1//. ---
COSA to be released to the gineer,unless otherwise requested by the engineer.
COSA Fee $ 524 Waiver Fee $
Date of Payment (WV/9 Date of Payment
Receipt Number 6I558C9 Receipt Number
COSA# (35C///22/ Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179
Address: 3701 East Tudor Road, Suite 101-Anchorage,Alaska 99507 _
Engineer's Printed Name: Jeffrey A. Garness Date: ] /s' '('?_"
o�oopp‘
In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system oQ A / 0
in accordance with the guidelines and regulations established by the Municipality of Anchorage and 4:=,,,, .•'' .••. `-9 c 1j
industry practices. The reported results describe the condition of the system/s on the date/s of the Q v uqn
evaluation. Separation distances were measured to readily identifiable features. Hidden defects or ��..• 9 Li
�;( U/�
encroachments may exist that were not identified during the evaluation. The operational life of all wells Q ¢ � 1 % VD
and septic systems depend upon a variety of variables, including but not limited to, soil conditions, g •Q
groundwater levels (that may fluctuate during the year), quality of construction (materials and / i VA
workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and �.�.-� . V {{
are outside the control of GEG. Satisfactory test results do not guarantee future performance of the nV '.J ffq • Gornless:
system/s; therefore, GEG makes no warranty(express or implied) regarding the future performance of 0O _7. _ `��
the well or septic system. GEG makes no representation whether an alternative well or septic system v 9 ••. r • •�cg'4
can be installed on the property in the event either of the current systems fail to perform adequately in 0� c''e .f.3f •I.l ��°p
the future. The content of this report is for the sole benefit of the person/party that retained GEG to �•,%,,,,,,r a po f e s s1 0\c=,
perform the evaluation. Reliance upon the information provided in this report by any other person or '. pgpQQ
party (including subsequent property purchasers) is not authorized, nor will it confer any legal right
whatsoever.
#AECC884
6. DSD SIGNATURE ‘\,.. OF A!'UCyO
/41
System #1 Approved for __S bedrooms = SITE G'
System #2 Approved for bedrooms = Wp,TER AND
Disapproved WASTEVUATER o
'�' PROGRAP�
Conditional approval for bedrooms, with the following st xlatlons: c-,
�/7CIU7 nr17\1,f'c:
IS ,l
S rvtel
[ G `rd� �kL 1 S - p�Q ✓`c lCh c
r
A� e .sct13..ii iza evs e- d
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By: t- -- " /' \ Original Certificate Date: i� —2-01
`
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The
Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's wolk' '•
7. ATTACHMENTS: ` • .ti
COSA Checklist _ Nitrate Advisory=
Septic System Advisory Arsenic Advisory 4:, , .y
Well Flow Advisory Other
COSA blue sheet_10-10-12.doc
•
If more than 1 septic system is on the lot:
COSA Checklist # of
Structure served by this system
Certificate of On-Site Systems Approval Checklist
Legal Description: Dalzell—Schneiter; Block 1, Lot 2 Parcel ID: 015-291-11
A. WELL DATA
Well type Private If A. B. or C provide PWSID# N/A Well Log (YIN) Yes
Date completed 12/3/1978 Sanitary seal (YIN) Yes Wires properly protected (YIN) Yes
Total depth 45 ft. Cased to 45 ft. Casing height (above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test 12/3/1978 5/4/2017
Static water level 20 ft. 28.5 ft.
Well production 8-9 g.p.m. 6+ g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 ml. Nitrate 5-25 mg./L. Collected by: GEG. Ltd.
Arsenic: ND<5 ug./L. Date of sample: 5/4/2017
*39 year old steel septic tank is approaching the end of its useful life.
B. SEPTIC/HOLDING TANK DATA Septic tank is located under parking area, advisory notice recommended.
Tank Type/Material *Septic/Steel Date installed 8/21/1978
Tank size 1,250 gal. Number of Compartments 2 Cleanouts (YIN) Yes
Foundation cleanout (Y/N) Yes Depression over tank (YIN) No High water alarm (Y/N) N/A
Date of pumping 5/1/2017 Pumper Around the Clock Pumping
C. ABSORPTION FIELD DATA *Below Existing Grade at Sump
Date installed 8/21/1978 Soil rating (g.p.d./ft''o ft'/bdn ) 110 System type Trench
Length 39 ft. Width 4 ft. Gravel below pipe **6 ft.
Total depth *8.75 ft. Eff. absorption area 468 ft Monitoring tube Yes Depression over field NO
Date of adequacy test 5/4/2017 Results (Pass/Fail) Pass For 3 bedrooms
Fluid depth in absorption field before test ***0 in. Water added1.025 gal. New depth ***4 in.
Elapsed Time: ***0 min. Final fluid depth ***4 in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) None Known If yes, give date —
**MT/Sump only extends appoximately 4 feet into 6 feet of drainrock.
***264 gallons of water was introduced into the drainfield during the first 40 minutes of the
test, resulting in a 4 inch rise in liquid level in the sump. An additional 761 gallons was
introduced over the remaining 90 minutes of the test, causing no rise in liquid level.
D. LIFT STATION
Date installed Size in gallons Manhole/Access (YIN)
"Pump on" level at in. "Pump off" level at .• wa er alarm level at in.
I- •• Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main 75 + Public sewer manhole/cleanout 100'+
Sewer/septic service line 25'+ Holding tank 75'+
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5+ Property line 5'+ Absorption field 5'+
Water main 10'+ 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 10'+ Water main 10'+
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage *0'+
Curtain drain None Known Wells on adjacent lots 100'+
F. COMMENTS
*Drainfield is located under driveway — Met code in 1978
G. ENGINEER'S CERTIFICATION ,,,'5''7C-.--- F A, ','N
o . S0�
o, . .. X00
1 certify that I have determined through field inspections and G ' • ' •,
review of Municipal records that the above systems are in
I IA
conformance with MOA COSA guidelines in effect on this 1/
O4_ 0
date. f -, •. Garn-ss, c
Engineer's Printed Name JEFFREY A. GARNESS 0Q aski CE • - Z-1
d��rer •c.3.L. ,c o
0°
Date j/ � °pr0fessio °o�
�lD000��-a
#AECC884
(Rev 11'05)
•
• Municipality of Anchorage
•,f Development Services Department
Building Safety Division 5. E
On-Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
Nitrate Ad's ism-kr
Certificate of On-Site Systems Approval # OSC 171221
A Certificate of On-Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block 1, Lot 2 of
Dalzell-Schneiter subdivision. This inspection revealed a nitrate
concentration of 5.25 milligrams per liter (mg/L) was reported for the
property's well water sample. The Environmental Protection Agency (EPA)
has established a maximum contaminant level (MCL) of 10.0 mg/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.
Please see the attached "Nitrate Fact Sheet" for important information
regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On-
Site Systems Approval.
Nitrate Fact Sheet
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble
in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass
rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is
in the form of ammonia or protein first, which through contact with oxygen and certain
bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from
wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also
result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or
three years, but is associated with a potentially fatal infant disease called
methemoglobinemia. In the digestive system of young children, nitrate converts to
nitrite, which can pass through the intestinal wall into the blood stream. There it
combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The
EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The
standard has been lowered from a previous level of 45 mg/L set by the US Public Health
Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and
other common home water treatment systems such as softening or iron filtration does not
readily remove nitrate. The best method for limiting nitrate in well water is source
control. This can include avoiding overdosing of fertilizer near the well and maintaining
good separation distances between septic tank leach fields and the well. A special anion
exchange filter that contains a media with a strong affinity for negatively charged ions in
water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical"
methods using a spectrophotometer to read the final color endpoint. Specific ion
electrodes also can be used to detect the activity of nitrate in water. This laboratory uses
several different wet chemical methods approved under the public water supply
laboratory certification program. They also have test kits available, which the laboratory
uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test
kit results against a certified analysis from the lab occasionally to verify the accuracy of
the kit. We recommend using a specially prepared bottle that has been rinsed in
hydrochloric acid for collecting samples.
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i '•:Thomas H.(i.t</reyer.: tp,
tree house 1,6f LS-7625 •' A°�J
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25' Drainage & Utility Easement
N89'54'39"E 200.00'
34 Legal Description: Legend:
Asbuilt
Lot 2, Block 1Found Rebar
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Well
G ro u Dalzell-Schneiter Subdivision septic
pOverhang
Land Surveying Survey Certification: I hereby certify that a Mortgagee's Wood Deck /r���fj
Land Development Consultants Inspection was performed on the described property. Concrete
Subdivision Specialists Notes: It is the owner's responsibility to determine the
Construction Surveying existence of any easements, covenants, or restriction
which are not on the recorded subdivision plat. This
Tom H Dreyer, P.L.S. osbuit shall not be used for construction or for
124 E 7th Avenue establishing property lines.
Anchorage, Alaska 99501 Checked by: THO Drawn by: CB Scale 1" = 50' Grid 2537
(907) 306-8104
mail@S4AK.com Job 2017-26 Field Book: 141 Plat 77-260 Dote: 5/17/2017