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Home My WebLink AboutWILLOW CREST TR 3Willow ere t Tract 3 #010-215-19 Municipality 'of Anchorage On-Site Water & Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEHS APPROVAL Parcel I.D. 010-215-19 I. GENERAL INFORMATION Expiration Date: Complete legal description Location (site address) Current Property owner(s) Mailing address Real Estate Agent WILLOW CREST TRACT 4303 COPE STREET *ANCHORAGE, AK 99503 FRANK MILLER Day phone 4303 COPE STREET *ANCHORAGE, AK 99503 RICK JARVIS W/ REMAX Day phone C/O AGENT 244-3590 2. TYPE OF DWELLING: · Single Family (w/we ADU) [] Duplex [] Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 2 4. 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 · COSA to be released to the engineer, unless olhetwise requested by the engineer. Date: COSA Fee $ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number Waiver# 0% 5. 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(am) 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 357-6179 Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 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 DaD 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. Satisfactoo/ 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 previde any warranty orfuture estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DaD. 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. DSD SIGNATURE 'L/~ System #1 Approved for System #2 Approved for bedrooms. bedrooms. Disapproved. Conditional approval for ~ ON-SITE ~.~_ E ~ WASTEWATER bedrooms, with the following stipulations: ~ The Municipality or Anchorage Develop, emt Services Division (DAD) issues Certificates of On-Site Systems Approval (COSA) based only upon the represenatations 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 engineeFs work. 7. ATTCHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Other .,/--'~ Original Certificate Date: If more than t septic system is on the lot: COSA Checklist # of Structure served by this system __ Certificate of On-Site Systems Approval Checklist Legal Description: WILLOW CREST TRACT 5 Parcel ID: 010-215-19 A. WELL DATA Well type PRIVATE *PER AAROW PUMP & WELL SERVICE (SEE ATTACHED) IfA, B, orC provide PWSID# N/A Well Log (Y/N) NO Date completed 19507 Sanitary seal (Y/N) YES Wires propedy protected (Y/N) YES Totaldepth '155 ft. Cased to '100'+ ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test Static water level Well production NO WELL LOG ~ g.p.m. 9/28/12 22 .ft. 4.41 g.p.m. WATER SAMPLE RESULTS: Coliform 0 coloniesll00 mi. Nitrate ND mg./L Collected by: GEG. Ltd. Arsenic: ND ug./L. Date of sample: 9/26/12 & 10/4/12 B. SEPTiC/HOLDING TANK DATA PUBLIC SEWER Tank Type/Material Date installed Tank size gal. Number of Compartments (Y/N) High water alarm (Y/N) ~Pumper C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ft2or ft2/bdrm)__ System type .ft. Width .fl. Gra~. Length Total depth ft. Eft. absorption area ft2 Monitoring tub~ / Depression over field Date of adequacy test Rest__ For bedrooms Fluid depth in absorption ~ in. Water added _ gal. New depth in. Elapsed Time: ~ Rnal fluid depth in. Absorption rate >= g.p.d. ~raatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed "Pump on" level at in. Datum ~ Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Size in gallons Manhole/A~__~._~) ~ "Pump off' leve~, High water alarm level at n Meets alarm & circuit requirements? Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer/septic service line ***UNKNOWN Animal containment areas. 50'+ On adjacent lots On adjacent lots N/A Public sewer manhole/cleanout '50'+ Holding tank N/A Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line Absorption field Water main Water service line Surface water ~ Wells on adjacent lots ~ SEPARATION DISTANCE FROM ABSORPT~ TO: Property line ~ndation Water main Water service line / Surface water Driveway, parkingNehicle storage ~ Wells on adjacent lots F. COMMENTS *MEETS CODE AT TIME. **SEE ATTACHED WAIVER REQUEST. ***SEPARATION DISTANCE IS UNKNOWN. THERE WAS NO DISTANCE REQUIREMENT FOR PRE-1959. 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 (Rev. 11/05) M~unicipality of Anchorage P.O. Box 196650 · 4700 Elmore Road Anchoracqe, Alaska 99519-6650 · (907) 343-_7904 · Fax (907') 343-7997 http:llwww.muni.orRlOnsite Development Services Division On-Site Water and Wastewater Proqram **** VARIANCE/WAIVER REVIEW **** Waiver& OSP12t367 COSA#: OSC121472 PID#: 010-215-19 Legal Description: Willow Crest, Tract 3 Engineer: Garness En.qlneerin.q Group Permi¢: Applicant: Frank Miller Your request for a waiver of the required 50 feet horizontal separation from the public sewer trtmk to the private well has been approved. The approved separation distance is 20.0 feet. This waiver approval applies to the existing systems only. Any future upgrade will require all separation distances be met or another approval from this department. [] The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. [] Notarized letter(s) of non-objection have been received from the owner(s) of the affected adjacent property. [] Adjacent properties are not affected by this waiver. Waiver is Granted: X Waiver is not Granted: Rec~4: N/A Amount: $0.00 Date Paid: N/A **** VARIANCE/WAIVER REVIEW **** GARNESS ENGINEERING GROUP, Ltd. CONS~JLTANTS & G~NERAL CONTRACTO[RS ~:~:~ ~ ~ October 11,2012 Municipality of Anchorage Development Service Department On-Site Water & Wastewater Program 4700 Elmore Rd. P.O. Box 196650, Anchorage, Ak 99519-6650 (907) 343-7904 Reft Waiver Request for Well to Public Sewer Main (Willow Crest Tract 3) The existing 2 bedroom house is served by a private well and public sewer· We request you grant a 20' foot separation distance waiver from the well on the referenced property to the public sewer main located near the east property line. The following items are justification for the waiver: * The encroactunents have existed for over 51 years. · Recent water sample results indicated nitrate levels were non detectable, mad no coliform bacteria. Based upon the aforementioned facts, it appears that there is minimal risk associated with the granting of the 20' foot waiver. If you have any/7 Y~ tions, 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: garnessengineering.com Aarow Pump & Well Service, LLC P.O. Box 110496 Anchorage, AK 99511 Office: (907) 346-9355 · Fax (907) 345-0202 Eagle River: (907) 622-9335 No. 9568 CUSTOMER _.,,,. / F JOB SITE LABOR HOURS RAT~ AMOUNT TOTAL MATERIAL ~ ~ Thank You SIGNATURE (I Hereby Acknowledge the Satisfactory Completion of the Above Described Work and agree that if above work is nol palcl for in 90 days I agree to allow Aarow L.L,C, the right to remove unpo, ld for equipment and charge for labor already performed & labor to remove unpaid ~r equipment.) SE~ICE CHARGE AT RATE OF 1,5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. SGS SGS Ref.# 1124652001 Client Name Garness Engineering Group, Ltd Printed Date/l'ime 10/02/2012 15:55 Project Name/# Willow Crest Tract 3 Collected Date/Time 09/26/2012 10:00 Client Sample ID Willow Crest Tract 3 Received Date/Time 09/26/2012 10:12 Matrix Drinking Water Technical Director Stephen C. Erie Samplc Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date [nit Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10') 09/28/12 10/01/12 NRB Waters Department TotalNitrate/Nitrite-N ND 0.100 mg/L SM21 4500NO3-F B 09/27/12 CMA Microbiology Laboratory E. Coli Negative I 100mL SM21 9223B A 09/26/12 DLC Total Colifbrm Positive 1 100mL SM21 9223B A 09/26/12 DLC SGS Ref.# ! 124869001 Client Name Aarow Pump & Well Service Printed Date/Time 10/10/2012 9:20 Proiect Name/# 4303 Cope St Collected Date/Time 10/04/2012 ! 1:35 Client Sample ID 4303 Cope St Received Date/Time 10/04/2012 11:46 Matrix Drinking Water Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Resuks LOQ Units Method Container ID Limits Date Date Init Microbiolog~ Laboratory E. Col/ Negative I 100mL SM21 9223B A 10/04/12 DLC Total Coliform Negative I 100mL SM2i 9223B A 10/04/12 DLC OF FENCE LINE~ OR ~R E~LISHIN~ ~ND- ~N:~ 11/0772012 23:30 '9072430742 AWPS, iNC. PAGE 01/01 Pu~ Well Drilling Permit Number: SW Pared Identification Number: Installation Log Date of lssue: ~ Legal Description I l[ Prop.erty Owner Name ~g Addr~s: ..... Pump ~ntake D~p~h Below Top of W~II ~a~p Size ~ hp ~/tles~ Adapter Barial Depth: ~ Altention: Ti~e pm~lp i~ala!le~ si/al/ } Lnstallation log to t?xe DSD withJ~ 30 days ot' pump