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Home My WebLink AboutCHULI LT 2A1Onsite File c h u 11'a PID# 075amI33aw05 Formerly US Survey 3042 Lot 241. MUNICIPALITY OF ANCHORAGE WASTEWATER CONNECT PERMIT 07 - 5317 WATER & WASTEWATER UTILITY DATE OF APPLICATION 3000 ARCTIC BLVD. SCHEDULED COMPLETION DATE PHONE: (907)564-2762 BLOCK/LOT/TRACT LT 2A SUBDIVISION US SURVEY 3042 T1 ON R2E SEC 19 TAX CODE 7513295 GRID SE5012 AS -BUILT STREET ADDRESS OWNER GEORGE L & KATHY S STEWART MAIL ADDRESS 2531 MAYLEN CIR ANCHORAGE, AK 99516 06/06/2007 12/31/2007 X SINGLE FAMILY MULTI -DWELLING No. APTS COMMERCIAL PHONE CONTRACTOR CAT'S EYE EXCAVATING ASSESSMENTS Repair Existing Service $ Main Line Extension X On Property Only City Tap Have Been Levied Hydrant Only 50' or Longer f j,- To Be Levied Main Tap .. To Property Line Only -1 Comments: 5 �Crl� rv/ Main Tap & On Property Connect Row No. Disconnect R & R - Main Tap Only Owner Staff CONNECT SIZE 4 " ISSUED INSPECTION FEE $ 54.00 iAID CASH PERMIT FEE $ 48.00 CHECK # $ 0.00 OTHER DEPOSIT $ 0.00 INSPECTE,I� BY cam} L Y s< REIMBURSABLE TOTAL $ 102.00 NUMBER DATE / E3 / 07 REMARKS PERMITTEE (Please Print) MAIL ADDRESS SIGNATURE fir, tissF�ts i M IN P K If U I UK PHONE POST IN A CONSPICUOUS PLACE AT THE JOB SITE AWWU INSPECTOR Original i.c CA& DATE SCHEDULED 6' 0 -01 TIME 2 :� P�1 INSPECTOR SUBDIVISION US SURVEY 3042 BLOCK/LOT/TRACT LT 2A INDICATE NORTH S7 Kc) v"'----- g 3 , ---i C A$%�F- P'E�• \r.- � Rl�/�wAY � s O-�-ros5 S ��el� F1�+-- -�-°..a�e-� +-1�...� �-4l. �K�Pr-�P..t..�oh I6 SL� I 4� �2 - lP 12v, E� "D SIZE MAIN: TYPE MAIN: DEPT AT MAIN: AT PROP. LINE: �O ' CONNECT LOCATION: COMMENTS: INSPECTED BYt J J DATE: MUNICIPALITY OF ANCHORAGE WATER & WASTEWATER UTILITY 3000 ARCTIC BLVD. PHONE: (907)564-2762 BLOCK/LOT/TRACT LT 2A SUBDIVISION US SURVEY 3042 TAX CODE 7513295 GRID STREET ADDRESS 200 SPROAT RD WASTEWATER CONNECT PERMIT 08 - 5027 DATE OF APPLICATION SCHEDULED COMPLETION DATE SE 5012 AS -BUILT 02/19/2008 12/31/2008 X SINGLE FAMILY MULTI -DWELLING No. APTS COMMERCIAL OWNER GEORGE STEWART PHONE MAIL ADDRESS PO BOX 1714 GIRWOOD, AK 99587-1714 CONTRACTOR REDMOND Repair Existing Service On Property Only Hydrant Only Mair. Tap - To Property Line Only Main Tap & On Property Connect Disconnect R & R - Main Tap Only CONNECT SIZE 4 " REIMBURSABLE NUMBER REMARKS City Tap 50' or Longer Row No. ASSESSMENTS Main Line Extension X Have Been Levied To Be Levied Comments: Owner ISSUED wwmsr Staff INSPECTION FEE $ 54.00 PAID CASH PERMIT FEE $ 48.00 CHECK # $ 0.00 OTHER DEPOSIT $ 0.00 INSPECT BY TOTAL $ 102.00 _ DATE a kv/ PERMITTEE (Please Print) *SAME AS CONTRACTOR PHONE 7f33 MAIL ADDRESS �j, R. iQgZgo�si v�F .oK 991SR7 SIGNATURE POST IN A CONSPICUOUS PLACE AT THE JOB SITE AWWU INSPECTOR Original DATE SCHEDULED �2 - �,TIME ��• INSPECTOR SUBDIVISION US SURVEY 3042 BLOCK/LOT/TRACT LT 2A INDICATE NORTH I )) l _ �a.�y�.e�i p•�C � �� GI �U 1�xcFlla��` 2J 4L-:3 �. CCA-' / 33 Jt•a�4o^ ¢ w � �.L. 12 V M. AC C Lc.•�-�• .s C) 01-1 SIZE MAIN: TYPE MAIN: DEPT AT MAIN: AT PROP. LINE: CONNECT LOCATION: COMMENTS: INSPECTED BY: DATE: 2 -;z IN r4 IN M -W Drilling, Inc. *P.O. Box 110378#Anchorage, AK 99511• •907-345-4000 ♦ 907-345-3287 Fax• Job No.: 07-1o1 Parcel No.: 075-132-06 Permit No. SW060375 Permit Datcd: 11222006 Groundwater Well As -Built & Log, • Well Owner: stews • Legal Description: US Survey No. Construction ♦OseofWell: Domestic * Hole Depth: 101' ♦Casing Sive: 6" ♦Cased TO: 100.35' ♦ Drill Method: 7 Air Rotary ♦ IVall. ♦Alaterlah A 53 Steel Pert. ♦ Well Completion- Open end X ScreenPerforated Method:♦Screen/Perjoration description: None • Grout A'otes: (2) Sack(s)- No. 8 bentonite granules • A'otes: ♦ Dislnjecled Yes No Alethod: Chlorine tablets ♦ 11 ell Development Alethod: Air surge A'otes: ♦Static water level (S111) 65' (above) (below) top of casing (TOC). ♦ 11'e11yleld test at 10 gallons per minute (GPJ1)/ga1"sper-hour{GP1Q for I hour(s) Willi 100% of drawdown (DD)fromstatic level (.S1VL). *Method: Airlift ♦ Date ojstarted. 19 December 2006 ♦ Date ofconhpletion: 19 December 2006 ♦Pump Install. Depth in feet from top of easin 0 TO 2.5 Details of formations penetrated. size of material, color and miscellaneous details. Casing stickup 2.5 TO 4 Oranics 4 TO 32 ty gravel: dark gray 32 TO 76 As above: black 76 94 TO TO 94 _ l0l As above: light brown, damp Water gravel: medium TO -- TO --- TO TO TO -- - — _.-- TO T--0--- ------ _TO-- --- _-- WAYNE-E. WESTBERG P1esldetlt,.MWDrilling,1ac. HGWA CvNed Muter Gmund*atef Col hft - - - TO -- — Corrtrac:torslJcense-- 0 000 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 WATER SUPPLY PERMIT Initial Date Issued: Nov 22, 2006 Expiration Date: Nov 22, 2007 Permit Number: SWO60375 Parcel ID: 075-132-06 Legal Description: US SURVEY 3042 LT 2 T10N R2E SEC 19 Design Engineer: 0855 GARNESS ENGINEERING GROUF Site Address: Owner Name: GEORGE STEWART Lot Size: 65340 SQ. FT. Owner Address: 2531 MAYLEN DRIVE Total Bedrooms: 4 Permit Bedrooms: 4 GIRDWOOD , AK - This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy Q 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. 5. The following special provisions. WHEN THE WELL HAS BEEN COMPLETED AND SATISFACTORY WATER PRODUCTION HAS BEEN DETERMINED, THE WELL DRILLER SHALL PLACE AN APPROVED SANITARY SEAL ON THE WELL HEAD AND NO PITLESS ADAPTER OR PUMP SHALL BE INSTALLED UNTIL AN APPROVED WASTEWATER DISPOSAL SYSTEM HAS BEEN CONSTRUCTED. Received By. r l� Issued By. Date: Date: ZZ D Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw St. P.O. Box 196650 G� Anchorage, AK 99519-6650 EkP L O eA -r\Y�. vvww.ci.anchorage.ak.us 1 (907)343-7904 �v1 �v3I)1�uSIonJ ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. Property owner(s) GWART Day phone 577-1062 Mailing address SEN DRIVE • GIRDWOOD AK Site address h4e sk& Dy,Vf. Zip Code Legal description (Sub'd, Block & Lot) PROPOSED STEWART S11301VIS N- i OT 2A. Legal description (Township, Section & Range) N/A Lot Size 105, NO Sq.Ft. THIS APPLICATION IS FOR ( ®all that apply): Absorption Field ❑ Septic Tank ❑ Holding Tank ❑ ❑ Privy Private Well Water Storage ❑ Number of Bedrooms 4 THIS APPLICATION IS AN: Initial Upgrade ❑ Renewal ❑ 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 GROUP Ltd. PenniURush Fees: 175-00 Date of Payment: 1 o V Receipt Number. CS Ci 0 0 (Rev. 11/05) Waiver Fees: Date of Payment: Receipt Number. GARNESS ENGINEERING GROUP, Ltd. ftrw � _ . l CONSULTANTS & GENERAL CONTRACTORS e November 15, 2006 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragraw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Well permit for U.S.S. 3042; Lot 2, Proposed Stewart Subdivision; Lot 2A, To whom it may concern: The existing Lot 2, USS 3042 is to be subdivided into 3 lots. Our client is proposing to build on proposed Lot 2A, Stewart subdivision. The property is to be served by a private well and public sewer. The well is to be drilled in the approximate location shown on the attached site plan. Also shown on the attached site plan are possible well locations for Lot 2B and Lot 2C, both lots are to be served by public sewer. We request that your department issue a well permit for proposed Lot 2A, Stewart subdivision. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. P.E., M.S. NOTE: Attached is a site plan drawing which is part of the design package for this septic system. (Contact G.E.G. Ltd. for 7 page construction specification letter.) 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507-1259 Ph: (907) 337-6179' Fax: (907) 338-3246' Website: www.gamessengincering.com ALL SURROUNDINGLOTS / SERVED BY PUBLIC SEWER / / Loi 3042 A. \ \.S L / USS 3842 LOT 88E, ^I � NH i USS 3042 LOT BBC. USS 3042 / USS 3042 LOT 88D, LOT J. / PROPOSED ��rc� / 4 BEDROOM 64 � HOUSE / PUBUC �\ of / i.7•r�\ 4 �Yl�� USS 3042 LOT 758, 2C, SKI / PRbf(SSEO STEWART T / SUBDMSION; LOT 2B, / / / USS 3042 / LOT I. I I ROX. N 1 GARNESS ENGINEERING GROUP, Ltd. p ��:• .. CONSULTANTS CONSULTANTS 3 GENERAL CONTRACTORS �+•••�—^••••••� MAIN PREPARED FOR: PHONE NUMBER: PACE NUMBER: (J�✓•••• GEORGE STEWART 522-1062 1 OF 1 �QOp ';� Y A Gor ess. LEGAL DESCRIPTION: DRAWN BY: J E-] •' 0 PROPOSED STEWART SUBDIVISION; LOTS 2A, 28, 2C, C•J•G• gyp. DATE:440�d Pr o! e s s)o�ooc TYPE OF WORK: �O�O� sto SITE PLAN FOR PROPOSED WELL 11/14/2006 (R.,01)05) Municipality of Anchorage On -Site Water and Wastewater Program z (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 075-132-95 Expiration Date: 01- Zq 22 1. GENERAL INFORMATION: Complete legal description US SURVEY 3042: T1 ON R2E SECTION 19 LOT 2A Location (site address) 200 Sproat Road *Girdwood Current Property owner(s) Melissa Larose Mailing address Real Estate Agent 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 382-7024 Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer WaiverNariance request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ a Date of Payment 111 _20 -Z? - Receipt Number e)q -Lj 9 iC COSA # O S Ca 1 a 5 Date: Waiver Fee $ _ Date of Payment Receipt Number Waiver # N 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: 6 �' �-2, In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the systems on the date/s of the J-� (lf �•. f��\: C �} evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, `. ��'.' _ • , groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the implied) the future of (j • • • . system/s; therefore, GEG makes no warranty (express or regarding performance :. ,; + ' the well or septic system. GEG makes no representation whether an alternative well or. septic system tI ^, '.:!' re . - .rr.e s; can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or k!V!,`r,, vt' XE`< fro i �� party (including subsequent property purchasers) is not authorized, nor will it confer any legal right `,�y��\\�ov whatsoever. #AECC884 6. DSD SIGNATURE System #1 Approved for �' bedrooms �llltttttt(«/(� Qi,,\TY OF System #2 Approved for bedrooms\ Disapproved � SIT � Pp gJ ON - Conditional approval for bedrooms, with the f81,byin ftuT16fibMqp �m AST"• VIiA7-ER fro 1 r uUNAM I11)0))) � By: Original Certificate Date: l9 �2 2Z 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 engineers work. 7. ATTACHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other S Legal Description: US SURVEY 3042; T1 ON R2E SECTION 19, LOT 2A Parcel ID: 075-132-95 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 'ti'9'06 Total depth 101 ft Cased to 100.35 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 6/6/22 Static water level at beginning of test 71.4 ft. Comments B. TANK DATA Age of tank(s) years Tank type/material Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA Which system tested (date installed) ❑ ALL standpipes present per record drawing Total measured depth from grade ft (ma Measured depth to pipe invert from grade ft (min) ❑ N/A —pressurized field Monitor tubes go to bottom o ective. If not, state depth into effective ❑ Code -required soil er over field ❑ System pres ed (Required if nt for greater than 30 days prior to date of t introduced _gallons COSA Checklist yellow sheet Well production at time of test 3+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes No Coliform bacteria is Negative Nitrate 0,SV-- mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L [arsenic less than MRL (ND) Collected by GEG, LTD. Date of Sample 6/6/22 C. LIFT STATION ❑ Required maintenance completed Age of lift station years/ Lift station material Comments: /Adequacy test date Results ❑Pass For bedrooms --- Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate and- Any pdAny rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) ❑ Yes if No Septic Tank/Lift Station on Lot > 100' N/A Community Sewer Manhole/Cleanout > 100' Property Line > 5' Q Yes if No ft [D Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No * ft Absorption Field on Lot > 100' ❑ Yes if No NSA ft Holding Tank > 100' Yes if No ft Neighboring Absorption Fields > 100' Q Yes if No ft Animal Containment > 50' ❑✓ Yes if No ft 0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' [DYes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) �HW.WU SCWCK", Building Foundations > 10' ❑ Yes if No ft Surface Water> 100' Yes if ft Property Line > 5' ❑ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑ Yes if No ft Private Wells > 100' ❑✓ Yes if No ft Water Main > 10' ❑ Yes if No ft Communiells > 200' Q Yes if No ft Water Service Line > 10' ❑ Yes if No ft If Ic tank is under driveway comment below From Absorption Field on Lot to: (Please enter dist Building Foundation > 10' ❑ Yes ft Property Line > 10' es if No ft Water Main > 10' ❑ Yes if No ft Water Se ' Line > 10' ace Water > 100' ❑ Yes if No ft ❑ Yes if No ft if less than required) If absorption field is under driveway comment below Wells on Adjacent Lots: Private Wells > 100' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No ft F. ENGINEER'S COMMENTS *SEE GEG LETTER IN MOA DOCUMENTS DATED 3/15/13 G. ENGINEER'S CERTIFICATION 1 certify that l 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. COSA Checklist yellow sheet #AECC884 r"AA Municipality of Anchorage On-Site Water & Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D, 075-152-95 1. GENERAL INFORMATION Expiration Date: Complete legal description Location (site address) USS 3042 LOT 2A (~'~ 5~rV¢~t 5~, L-,,1F~ TI~ ~,~ S~ I~t 200 SPROAT ROAD *GIRDWOOD, AK 99587 Current Property owner(s) Mailing address GEORGE & KATHY STEWART PO BOX 1714 *GIRWOOD, AK 99587 Day phone 522-1062 Real Estate Agent SHARNEE EPLY W/ REMAX OF ALYESKA Dayphone 785-4217 2. TYPE OF DWELLING: · Single Family (w/wo ADU) [] Duptex [] Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4, TYPE OF WATER SUPPLY: Indivic ~al Well · Indiviccal Water Storage [] Community Class__Well [] Public Water System [] TYPE OF WASTEWATER DISFOSAL: Individual On-site [] Individual Holding tank [] Community On-site [] Public Sewer · Received by: /"/ COSA to be release¢ t the engineer, unless othen,vise requeSted by the engineer. Waiver Fee $ Date of Payment Receipt Number 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(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 557-6179 Address .3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. E}ig' "~nd~rs 'Comr'hentsr' ' ;,F~.'''-~; *'~',;I,> ; '¢ 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 repealed 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 sen/ed 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 dght whatsoever. Date DSD SIGNATURE ~ System #1 Approved for System #2 Approved for Disapproved. Conditioh ~1 approval for bedrooms. bedrooms. bedrooms, with the following stipulations: ON-SITE .... R AND WAI ~ WASTEWATER PROGRAM The Municipality or Anchorage Develop, emt Services Division (DSD) issues Certificates of On-Sits Systems Approval (COSA) based only upon the represenatations given in paragraph 5 by an independent professional civil engineer registered in the State sf Ataska. The Municipality of Anchorag~ is not responsible for errors or omissions in the professional engineer's work. 7. ATTCHMENTS: COSA Checklist ~ Septic System Ad visory Well Flow Advisc I ¢ (Rev. 1 lf05) Nitrate Advise_tv , Arsenic Advisory Other /~~_ Original CertifiCa;e I~te~-' '.~ - / ] 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: USS 5042 LOT 2A A. WELL DATA Well type PRIVATE IfA, B, or C provide PWSID# Date completed 12/19/06 Sanitary seal(Y/N) YES Pamel ID: 075-152-95 To~ldepth 101 ff. Cased to 100.55 ft. FROM WELL LOG Date of test 12/19/06 Static water level 65 ft Well production 10 g.p.m. WATER SAMPLE RESULTS: Well Log (Y/N) Wires properly protected (Y/N) Casing height(aboveground) ATINSPECTION 2/t5/ 3 70 ff. Coliform 0 colonies/100 mi. Arsenic: ND ug./L. B. SEPTIC/HOLDING TANK DATA Nitrate 0.518 mg./L. Date of sample: 2/15/15 3.48 g.p.m. Collected by: GEG. Ltd. PUBLIC SEWER YES 12+ in. Date installed Soil rating (g.p.d./f¢or ft2/bdrm)__ System type ,~ Length .ff. Width .ft. Gra~_ft. Total depth .ft. Eft. absorption area ft2 Monitoring ruble/ Depression over field Date of adequacy test Rest__ For bedrooms Fluid depth in absorption f"~ in. Water added, gal. New depth in. Elapsed Time: ~ Final fluid depth in. Absorption rate >= g.p.d. ~eatment (past 12 mo.) (Y/N & type) If yes, give date Tank Type/Material Date installed Tank size gal. Number of Compartme~ ~a~a~t11~ Foundation cleanout (Y/N) De re~k (Y/N) High water alarm (Y/N) ~ Pumper. C. ABSORPTION FIELD DATA YES D. LIFT STATION Date installed. "Pump on" level at.__ in. Size in gallons Manhole/A~_~_.~.~ ...----------------- ~ High water alarm level at .in. Cycles tested. Meets alarm & cimuit requirements? On adjacent lots. 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot N/A Absorption field on lot N/A Public sewer main 75'+ Sewer/septic service line * Holding tank N/A Animal containment areas_ 50'+ Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: 100'+ 100'+ Building foundation Property line. Absorption field Water main Water service line Surface water ~ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORP~TO-: Property line __ __ Bui?~oundation. Water main. Water service line ~ Surface water Driveway, parking/vehicle storage. ~ Wells on adjacent lots. F. COMMENTS *SEE AT[ACHED GEG LETfER DATED 3/15/13 G. ENGINEER'S CERTIFICATION I cerSfy 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 Pfintsd Name JEFFREY A. GARNESS Date (Rev. 11/05) GARNESS ENGINEERING GROUE Ltd. CONSULTANTS & GENERAL CONTRACTORS March 15, 2013 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 Ref: Sewer Line to Water Line Separation Distance for USS 3042 Lot 2A, To whom it may concern: It is not possible to verify the separation distance between the private sewer line, and the water service line with out the lines being professionally located. Per the AWWU connect card for the property and the location of the well it is likely that the sewer line is 25 feet away from the well. It appears that the separation distance between the water amd sewer service lines is unknown. Water sample results indicate nitrate levels at 0.518 mg/L is well below the maximum level of 10.0 mg/L. If:~ have any questions, please contact us at 337-6179. Thank you for your assistance. / P.E., M.S. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com ' I I 1 I I I I I I I I I I I' I I I I I .... HOU,~E O01 3 1 ' 5'~~ 2B , ~ UNDER NO ClRmm~$TANCES ~I(XJLD ~ AS-BUILT ~ U~ F~ ~S~C~ ~ F~ EST~U~ING B~D~y ~ ~ IJ~' LOt ~ SURLY ~E · RESPONSlBIUTY OF TH£ BULDER OR oWNER PROR CONSTRUCTION, TO VERIFY PROPOSED BUiL~iN~N~AOE RELATIVE TO FINISHED ORADtr AND UTIUTY CONNECTIONS TO DETERMINE ~-IE EXISTENCE OP ANY EA~-MENTS, COVENANTS OR RESTRICTIONS t~-IICH DO NOT APIaEAR ON THE RECORDED SUBDIVISION PLAT, SURVEY CER~FICA'I]ON I j >LOT PLaN SYMBOLS s~r Rr-~R AINA~E, ASPHALT Prepared Robert E. Johns, Assoc. Professional Land Surv~yor's~' 1" = 40' t~. Lot S,F, 02/15/13 b~ REJ 02/15/13 ~":SE5012 US SURVEY 3042 LT 2,~ T10N R2E SEC 19 13-43 -*---t :::::::::::::::::::::::: MANHOLE MM-3~ I~ATCH LIME STA, 7+50 SEE LEFT / / MATCH LINE MANHOLE ~ STA, 7+50 4+98 asa SEE RIGHT INSTALL TYPE A MANHOLE STA. 10+10 (DESIGN SUR) ~- STA, 19+68~c (ALYESKA HWY) CONNECT TO EXISTING MANHOLE_ MUNICIPALITY OF ANCHORAGE ANCHORAOE WATER & WASTEWATER U~UTY MONARCH LI.Do 60-10 AWI~LI Work Order Nurfiber(~): 9491-4130-00xx CPR Inse~v[ce Date: CADD File Nome: MONPNP.DW~ DATE SCHEDULED ~' ~ ~ TIM£ :~.~,c,~ ~ I~SPECTOR ~ SUBDIVISION US SURVEY 3~2 BL~LOT~CTLT 2A / ; " ~ ,~N . ~]b~ SI~M~, :! : J ~PE MAIN:, DEPT AT MA N:. rr r~ ATPR~ -- INSPECTED~Y:~ ~ ~ t ~ ~ DATE ~ ~ ' ~ I SUBDIVISION US SURVEY 3042' IBLOCI~/LOT/TRACT LT 2A - NDtCATE NORTH SIZE M~N ~ ~ M~. ' OEPTA, MAIN I AT PROP CON.CT LO~T ON COMMENTS;