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HomeMy WebLinkAboutEAGLE RIVER VALLEY RANCHETTES LT 33BEagle River Valley Ranc hettes Lot 33B #050 -224 - 14 MUNICIPALITY OF ANCHORAGE 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 MAILING ADDRESS LEGAL DESCRIPTION PHONE E~EW []UPGRADE LF' ----. ~ DISTANCE TO: J Well Manufacturer J~',~) ~'~ H ~ ~ Ibiq. capacity ingallons I. HOMEMADE: DISTANCE TO: We NO. OF BEDROOMS IAbsorption area Dwelling Material Width ,3 PERMIT NO. No. of compartments ~nside length Liquid depth Dwelling PERMIT NO. Manufacturer Material Liquid capacity in gallons Foundation Nearest lot line g PERMIT NO. DISTANCE TO: [ Well~:~O / Length of each line Tota[ length of lines Material beneath tile Top of tile to finish grade Trench wi~.~h~_~, inches Distance between lips,. / Total effective absorption area Length Width Depth PERMIT NO. Crib depth Total effective absorption area Well DISTANCE TO: Building foundation Class Depth Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Absorption area(s) Nearest lot line Septic tank OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS 72~)~[~ (Rev. 3/78} ~ DATE LEGAL PERMIT NO. APPLICANT CHARLES BARR PO BOX 541E.R LOCATION ~ LEGAL LOT SIZE TYPE OF SOIL ABSORPTION SYSTEM IS': TRENCH MUN I C I PRLI T¥ OF RNCHORRGE DEPARTMENT I HEALTH AND ENVIRONMENTAL~OTECTION 10~ ~O 7[$ 825 ~ ~TREET, ANCHORAGE, ilK. ~ffii 264-4720 3; t~ 7/~ Ot~--S I TE SEWER PERM I T ~ 694-90i0 22580 SQUARE FEET t~XIMUM NUMBER OF BEDROOMS SOIL RATING (SQ FT?BR)= 28~ THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEPTH= 10 LENGTH= 105 GRAVEL DEPTH= 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 BOTTOM OF THE EXCAVATION (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). REQU I RED SEPT I C TANK S I ZE= 1000 GRLLO~S PERMIT RPPLICRNT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. ------ TWO < 2 > INSPECT I Otis ARE REQU I RED 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 i00 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM 8 PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERM I T EXP I RES DECEMBER I CERTIFY THAT l: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. ~: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENC~EMODELED TO INCLUDE MORE THAN ~ BEDROOMS. APPLICANT CHARLES BARR ISSUED B ATE--- V4.0 BLOCK ADDRESS .LOT(S) Kevbox As-Bu111 J Date - 7/5* )*"? /oh)f- fr/r-Jn Work Performed Afr- -r>7 y7'^^K'U^!2-/t-^' * --S-AZ^-eV-n&e^f Condition of Kevbox/Comments 6ooj| /   MUNICIPALITY ©( Development Services Department �ct Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I. D. 050-224-14 Certificate of On -Site Systems Approval Expiration Date: 1 a 0 � o 1. GENERAL INFORMATION Complete legal description EAGLE RIVER VALLEY RANCHETTES LOT 33B Location (site address) 18619 TWENTY GRAND ROAD, EAGLE RIVER, AK 99577 Current property owner(s) JOEL ROBERT SIMPSON Day phone Mailing address Real estate agent 18619 TWENTY GRAND ROAD. EAGLE RIVER. AK 99577 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑ Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ® Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 550 Waiver Fee $ Date of Payment Lf 2 "Z 1 Receipt Number 2 q COSA # 0 SC a l lL 5 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 (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On=Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY ANCHORAGE AK 99516 Engineer's Printed Name CURTIS HUFFMAN PE Date 4/9/2021 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject toA/ these various and dynamic characteristics and are outside the control of the evaluator of the •� • 4 � well and septic system. Therefore, any estimate of how long a system will function satisfactory ,0.�'���• • 9, $�� for current or future occupants or guarantee that no unseen encroachments, deficiencies or TM ' _• discrepancies exist can be given by First Water Consulting & Fl�rS . 6. DSD/ SIGNATURE ' • Curtis Huffman System #1 Approved for -3 bedrooms �00�29% . CE128991 .����.a►� FESSIOHP System #2 Approved for bedrooms ��1,� '°RO Disapproved Conditional approval for bedrooms, with the following stipulations: SOF .�U N- xN9ER AND WAST` v''ATER o� PKOGr AKA �� J�%iFNT SER��G By: Original Certificate Date: 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 work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist Legal Description: EAGLE RIVER VALLEY RANCHETTES LOT 33B Parcel ID: 050-224-14 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA – PUBLIC WATER Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date of Sample Comments __________________________________________________________________________________ B. TANK DATA Age of tank(s) 48 years Tank type/material SEPTIC / CONCRETE Measured operating fluid level in septic tank 58” Standpipes/foundation cleanout per record drawing Date of pumping 4/6/2021 C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 7/9/1980 ALL standpipes present per record drawing Total measured depth from grade 11.7 ft (max) Measured depth to pipe invert from grade 5.5 ft (min) N/A – pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective *6’+/- ED MEASURED OF 5’ED Code-required soil cover over field System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Adequacy test date 4/6/2021 Results Pass For 3 bedrooms Fluid depth prior to test 45 in Water added 500 gal New depth 55 in Elapsed time 1380 min Final fluid depth 44 in Absorption rate 450 gpd Any rejuvenation treatment (past 12 months) N If yes, enter date Comments/Deficiencies: *PER ELEVATIONS BETWEEN POST TANK CO AND MT. FIELD OPERATING IN THE TOP 1-2’ OF THE EFFECTIVE DEPTH. E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Property Line > 5’ Yes if No ft Absorption Field > 5’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10’ Yes if No ft Property Line > 10’ Yes if No *0 ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft 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 F. ENGINEER’S COMMENTS *MOA WAIVER. 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. 4/9/21 t •` Municipality of Anchorage On-Site Water and Wastewater Program QVC �(/� (907) 343-7904 , , ,Y Certificate of On-Site Systems Approval Parcel I.D. 050-224-14 Expiration Date: 5-2S---Ig 1. GENERAL INFORMATION Complete legal description Eagle River Valley Ranchettes lot 33B Location (site address) 18619 Twenty Grand Current Property owner(s) Brian Stigerwalt Day phone 242-4236 Mailing address Real Estate Agent Day phone 4 ]] 2. TYPE OF DWELLING: `� ti WM 4' -o ❑ Single Family (w/wo ADU) ' 5- ❑ Duplex a JUN 1 'J.) , ❑ Multiple Dwellings (Single Family and/or Duplex) K,..__ ti c,3. NUMBER OF BEDROOMS: 3 a 6 8 L 9 5n 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System 0 Public Sewer ❑ WaiverNariance request for: none Distance: Received b Date:60, L/( COSA to be rele to the engineer,unless otherwise requested by the engineer. COSA Fee $ 62(0- Waiver Fee $ Date of Payment (p--1441 Date of Payment Receipt Number 00co t Receipt Number COSA# MC-11 12-41 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 C&M Engineering Phone 854-5558 Address 30840 Prudhoe bay Engineer's Printed Name Charles Balzarini Date 6/11/17 r• rzi acv.• *: 4 9TH, 6. DSD SIGNATURE 'r ? . . • , T� System #1 Approved for 3 bedrooms ;� System #2 Approved for bedrooms f .. 'LES G BALZARI aT• Q • Disapproved 0k,eiRi (/� ,,•%. Conditional approval for bedrooms, with the following li4,44 � Vs( (") nj�in e--) ON -SITE WATER AND WASTEWATER PROGRAM 1 ' E3j(7=Z Original Certificate Date: V —162"II 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 work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory _ Other COSA blue sheet r • If more than 1 septic system is on the lot: COSA Checklist# 1 of 1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: Eagle River Valley Ranchettes Lot 33B Parcel ID:050-224-14 A. WELL DATA Well type None If A, B, or C provide PWSID# na Well Log (Y/N) na Date completed na Sanitary seal (YIN) na Wires properly protected (Y/N)na Total depth na ft. Cased to na ft. Casing height (above ground) na in. FROM WELL LOG AT INSPECTION Date of test na na Static water level na ft. na ft. Well production na g.p.m. na g.p.m. WATER SAMPLE RESULTS: Coliform na colonies/100 mL Nitrate na mg/L Arsenic na ug/L Date of sample: na Collected by: na B. SEPTIC/HOLDING TANK DATA Tank Type/Material septic/concrete Date installed 8/28/1973 Tank size 1000 gal. Number of Compartments 1 Cleanouts (YIN) yes Foundation cleanout(Y/N) yes Depression over tank (Y/N) no High water alarm (Y/N) no Date of pumping 5/25/17 Pumpersanitary pumpers C. ABSORPTION FIELD DATA Date installed 7/9/1986 Soil rating (ggoislifiLler ft2/bdrm) 289 System typetrench Length 110 ft. Width 3 ft. Gravel below pipe 5 ft. Total depth 12 ft. Eff. absorption area 1 100 ft2 Monitoring tube yes Depression over field no Date of adequacy test 06/02/17 Results (Pass/Fail)pass For 3 bedrooms Fluid depth in absorption field before test 36 in. Water added 450 gal. New depth 44 in. Elapsed Time: 1440 min. Final fluid depth 36 in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) none known If yes, give date n/a D. LIFT STATION Date installed no lift Size in gallons na Manhole/Access (Y/N) na "Pump on" level at na in. "Pump off' level at na in. High water alarm level at na in Datum na Cycles tested na Meets alarm&circuit requirements? na E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot na On adjacent lots na Absorption field on lot na On adjacent lots na Public sewer main na Public sewer manhole/cleanout na Sewer/septic service line na Holding tank na Animal containment areas na Manure/animal excrete storage areas na 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 ABSORPTION FIELD ON LOT TO: Property line 0* Building foundation +10 Water main +10 Water Service line+10 Surface water +100 Driveway, parking/vehicle storage +10 Curtain drain +50 Wells on adjacent lots +100 F. COMMENTS LINE 4/41 Vi'./ 0,1/ /'TtZ G. ENGINEER'S CERTIFICATION 11." oF kt Amp- I certify that I have determined through field inspections and , r Q`• • ,� 14 ,r, review of Municipal records that the above systems are in /f •• •�'9 l� conformance with MOA COSA guidelines in effect on this date. • ` : ••+ Engineer's Printed Name Charles Balzarini • ° Date06/12/17 • • • ' • ° • • ° ° • • CHARLES G BALZARINI Alf ck- C,E-1.3854, .7 .4 4'D P>OFES51i3 � :- ` ' COSA canary sheet_2-6-15.doc