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HomeMy WebLinkAboutGOLDEN VIEW HEIGHTS LT L-1�,;.,; f i ( � .;:.v� w t s i 1 t' � 5U MII Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP131218 PID Number: 020-043-15 Dwelling: 0 Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New N Upgrade Name: RICHARD & ANN MIZE ABSORPTION FIELD ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 6500 E 156TH AVE ANCHORAGE AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original gradeGravel Ft. depth beneath pipe Ft. Subdivision Block Lot GOLDEN VIEW HEIGHTS L-1 Fill added above original gradeGravel Ft. length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Fe Ft. Well >100' >25' TANK ■ Septic Cl S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1000 Gal. Surface water >100' Material Number of compartments Lot Line >5' STEEL 2 NA Foundation >51 LIFT STATION Manufacturer Capacity Curtain Drain >50• Gal. Remarks EXISTING SEPTIC TANK ABANDONED Pump on level at in. Pump off level at in. High water alarm at in. PER UPC REQUIREMENTS DBL CLEANOUTS ADDED PRIOR TO TANK Pump make and model Electrical Inspections performed by Installer PIPE MATERIAL Houseto tank 3034 Tankto drainfield 3034 ISAAC'S CONST. Drainfield COIMT3034 Inspector ANSON MOXNESS BENCH MARK (Assumed elevation) 100 It Inspectiondates: 1'r 8/29/13 Location and description 2w 3"' 4m BOTTOM STEP OF STAIRS TO DECK COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL p Conditional Approval: _� ALq kJJ Date i �Q TH � . RS �. SPURKLAND.;� 150 ���i - ADoroved �0FE"1`NP�= Date/0 II IprJGl.41V11 I�G�JV I l 0-1-1 L..I.IY/IL / oe � VIEW HEIGHT GQ�DEN � INSTALLED NEW 1000 GALLON STEEL SEPW R CONNECTED TO DRAIN FIELD Lot L-1 ABANDONED EXISTING SEPTIC TANK PER MOA COM REQUIREMENTS F B INSTALLED DOUBLE ClFANOUT A 3 8ORM SFR SWING TIES A 8 DBL. C.O. C 30' 7.5' ST. c. o. D 31' 8' ST. C.O. £ 37' 15' Dix C.O. F 39' 17.5' NOT£.• THIS LS NOT A SURV£Y£0 PLAT. WELL & SEPTIC LOCATIONS TAKEN fROM ON-SITE WATER AND WASTE WATER 0£PARTM£NT DOCUMENTATION. ALL LOCATIONS SHOWN ARE APPROXIMATE. 25 0 25 50 75 100 125 150 SCALE) I' = 50 FT, 4 FEET COVER DLNIBLE CLEANIB/TS flfl �flI IqI fl BDUBLE CLEANDUTS CONNECTED TO EXIST BRAINFIELD 1000 GALL17N SEPTIC TANK BENCH MARK BOTTOM STEP OF ASSUMED ELEVATION 100 FEET IJI'UlfALAIVLI tNUINLtH llt, I I GOLDEN VIEF HEIGHTS LOT L-1 I I SEPTIC SYSTEM ASSUILT 203 V 15TH. AVENUE ANCH. AK. 99501 ANN & DICK MIZE LATE: SEPT 25, 2013 (907) 279-3916 5600 E 156TH AVE, ANCHDRAGE AK 99516 SHEET, 1/1 GRIDr 3838 IPERMIT # DSP 131218 PID # 020-043-15 GOLBENVIEVHEIGHTSLLI-ASB.DVG# OSP 131218 PID # 020-043-15 GDLBENVI£VH£IGHTSLLI-ASB.DVGI On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP131218 Tax Code Number: 02004315000 Work Type: Septic Permit Effective Dates: August 01, 2013 to August 01, 2014 Design Engineer: SPURKLAND ENGINEERING Subdivision: GOLDEN VIEW HEIGHTS Site Legal Address: GOLDEN VIEW HEIGHTS LT L-1 G:3238 Owner/Address: MIZE RICHARD N &ANN MACINNES 6500 E 156TH AVENUE ANCHORAGE AK 995165005 Site Mailing Address: 6500 E 156TH AVE, Anchorage This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy Lot Size in Sq Ft: 203623 Total Bedrooms: 3 N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Bv: Issued By: Date: 5 MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 020-043-15 Property owner(s) RICHARD MIZE Day phone Mailing address Site address 6500 E. 156TH AVE., ANCHORAGE, AK 99516 Legal description (Sub'd., Block & Lot) GOLDE IEW HEIGHTS LOT L-1 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field E] Initial ❑ Single Family (SF) (w/wo ADU) Septic Tank Q Upgrade Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: NONE Distance: I certify that the above information is correct. I further certify that this is in accordance with aDDlicable Municipal Codes. of property owner or Permit/Rush Fees: doo— W1gXth41'4 Waiver Fees: _ Date of Payment: -7)>A % a Date of Payment: Receipt Number: 0g'(0010 G Receipt Number: Permit No. O'bP16 LLtg Waiver No. Permit App_9-1-12.doc Spar N afld Eimgonee oflg Environmental Consulting and Design July 19, 2013 Municipality of Anchorage Development Services Department Building Services Division On-site Water and Wastewater Program 4700 Elmore Rd. P.O. Box 196650 Anchorage, AK 99519-6650 Subject: SEPTIC TANK PERMIT APPLICATION Goldenview Heights Lot L-1 Ladies and Gentlemen: We are submitting an application to replace the septic tank for this lot. The existing septic tank serving the above referenced property is 34 years old and has been compromised and the owner would like to replace it. The submittal consists of one (1) drawing showing the present improvements on the lot and the proposed improvements of the lot, of which only the septic tank is subject to this permit application. The installation of this septic tank will not prevent wells and septic systems from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses within 100 feet of the proposed septic tank location. The proposed septic tank will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. If you have any questions or are in need of additional information please contact me at 279-3916. Sincere y, Lars kland, P.E. 203 West 15t" Avenue Suite 202, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEng@gci.net VIEW NEIGH js GG�DEN p INSTAR NEW 1000 GALLON STEEL SEPTIC CONNECT TO DRAIN FIELD - L o t L-1 ABANDON fx157 .� SEPTIC TANK PER MOA CODE REOUIRELIfNTS INSTALL FOUNDATION CLEANOUT 3 BDRM SFR DOUBLE CLEANVUrS NOTE., THIS IS NOT A SURVEYED PLAT. WELL & SEPTIC LOCATIONS TAKEN FROM ON-SITE WATER AND WASTE WATER DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE APPROXIMATE 25 0 25 50 75 100 125 150 SCALE I' = 50 FL 4 FEET COVER ��- FOUNDATION CLEANDUT CaWCT TO EXIST BRAINFIELB 1000 GALLON SEPTIC TANK ISPURKLAND ENGINEERING I I GOLDEN VIE1! HEIGHTS LOT L-1 I I SEPTIC SYSTEM SCHEMATIC 203 W M. AVENUE ANCH, AK,K99501 ANN & DICK MIZE BATE, JULY 17, 2013 (907) 279-3916 5600 E 156TH AVE, ANCHORAGE AK 99516 SHEEP 1/1 GRID, 3238 I PERMIT # OSP 111XXXX PID # 020-043-15 GOLDENVIEVHEIGHTSLLLBVG GRE ,,ER ANCHORAGE AREA BOR dGtt ,~ ':' Department of Environmental Quality ~ 3330 C Street Anchorage, Alaska 99503 LOCATION ~SPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LEGAL DESCRIPTION SEPTIC TANK: DISTANCE FROM WELL- ~ ~' 0 MANUFACTURER, INSIDE LENGTH INSIDE WIDTH MATE R I AL _~-~ NUMBER OF COMPARTMENTS~-~--- LIQUID DEPTH LIQUID CAPACITY ,'/t'~/'~10 GALLONS, ~ DRAIN '~A,,~): I'---"".,L~-~,.. DISTANCE FROM WELL FOUNDATION~) ~_~0_~_~_d~_NEAREST LOT LINE NUMBER OF LINES I DISTANCE BETWEEN LINES TRENCH WIDTH ABSORPTION AREA '~-'~O SQ. FT. LENGTH OF EACFI LINE ........... ,~_ DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE. MATERIAL BENEATH TILE WELL: TYPE _CONST RUCTION DEPTH TOTAL LENGTH OF LINES -;_ 7 IN. TOTAL EFFECTIVE ABOVE TILE DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION__ LO'F LINE __ SEWER LINE .... TANK , SYSTEM CESSPOOL , OTHER SOURCES APPROVED_ __ DISAPPROVE[)__ REMARKS DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: ~ SEWER LINE DEPTH: ,-"~¢- PIPE MATERIAL: LOT SLOPE?- REMARKS: 'it.lEi t..EiNGTH Di[J"ll~iil'.,llili;]iOl'.,I ]iI~:!; 'i'I.IEi J...l~i[l'.,llii~"l"l..I ,'~[J'.,I F:'E!I:ii'I") I[i[IJ:::' 'I'IIEi I"Fi:I:~ii'.,IC:I.I '"iFf [)Fi:I::i~NI:'.I.I..I ~ Fl-lEi [)EZF:"t"il OF FI 'TF:i:IiiilNE:H (')J::?. t::']i't' [[:[i; TI-lEi E:, ]i '.E;'i"I::iI'.,ICEi I!i!',l:ii["i'l.,.llii[l:[l'..I "I'I..~Ei ':::;L t::i'F:'F:IC:Ei Ill)j:: i::!ii:~:i:3Lli",l[i:, I:::IN[)I'l-Ilili: I:~!:CI'I"}"J~)H Ol::: I"Hl'ii: li~:i:':;Cl:::l',,,'l:::l"[][OJ",~ '::]:1",1 'i'i.li!::l:;i:[i: :[:iil; i'-,iO :i.::Ei:"l I.,.I:[[::,"I'H F::i:31:;?. Irk:. I::'t'i.I":I',I:~L. [::'I!:[I:::'TI'I :[:i!i; 'l'ld'!i H]/I",I]:i"ILIH [::'E:I:::'TH OF:: ...... '""""'r" ..... .:lr':.r"~',,_::.~. [i~l!i:'l'l.'~li:E:N 'l'lllli: cILr]'I:::'I:::IL.L. Fii'-,i[::, '1 I.IEi: [i~OT'I'CIH OF: THli!!: [i[ ::.:: c: r:l',,,'l:::l T :1: 01'-,I ,' :1: H I:::E:E:'F ', Performed for Uel)artment of [nvironmen~al O' lity 3330 "C" S~reet Anchorage, Alaska ~9b03 SOII,S hO(i - PI,',I~OI,ATION TI,:ST Legal Description: This form reporLs:'-~ Depth Feet lO- ll - 13- 14- Was ground water encountered? --""NN_(;- If yes, at what depth? Reading Date Gross Time Percolation raLe minute, · Proposed ins~allat-T6h-:----$'e'e~-ge Pit ................. [Irain Field ..,~ l)el)Lh of Inlet ,, Depth to ~ottom of pit or trench Net Time Depth to Watep Net Drop , : - DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ":' '~ ' ii' :' DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date --~ (a) Legal Description (include lot, block, subdivision, section, township, range) (b) Location (address or directions) ,,5' oo Applicant Name_']~l~b ~;:).a4~,f.~4,~ Applicant Address Telephone: Home lq/ > Business (c) Applicant is (check one): Lending Institution []; Owner/builder,~; Buyer []; Other [] (explain); .__ __ (d) Lending Institution ~ L~, ..~..~ . Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family~ Multi-Family [] Number of Bedrooms ~ Other WATER SUPPLY Individual Well,t~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservahon attesting to the legality and status. Page 1 of 2 SEWAGE DISPOSAL OnsiteA Public [] Community [] Holding Tank [] Note:'i'f community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (11/84) ENGINEERING FIRM PROVID. ~3 INSPECTIONS, TESTS, FILE SEARCH, [...~A AND INFORMATION As certified by my seal affixed hereto and as of the Validation date shown below, I verify that my investigation of'this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on Seal DNEP APPROVAL ~ .~ Approved for "~"~ "~_~edrooms by Approved ~ Disapproved Terms of Conditional Approval ~'~'~v~-"b'~/~ Date Conditional CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page2of2 . ;: t , ~, : 72-025 (11/84) ; ' WELL DATA Well Classification Well Log Present (Y/N) _ / Total Depth P Static Water Level ___ Casing Height Above Ground __ Electrical Wiring in Conduit (Y/N) _ _ Y Cas/ed MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 Legal Description: ~'~,~ If A. B, C, D.E.C. Approved (Y/N) Date Completed ~//~ /7~ Yield / Depth of Grouting Pump Set At t~ Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot ""~,,/ ; On Adjoining Lots ; On Adjoining Lots ~>~.~::~' To Nearest Public Sewer' Line ~ To Nearest Public Sewer Cleanout/Manhole '/,~/~__ To Nearest Sewer Service Line on !,.et ~::>_~/ Water Sample Collected by /2' r-~"a~/'.,¢..4/5~/I/ _, ;Date _7/,"//~ Water Sample Test Results ___ ,~ ~_/,:,~/e_.~, - - / / - Comments ___~_Va/Ch' ' B. SEPTIC/HOLDING TANK DATA Air-tight Caps (Y/N) Date Installed Standpipes (Y/N)" / 'y Depression over Tank (Y/N) /~_ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) ~ Separation Distances from Septic/Holding Tank: To Water-Supply Well _ ,)/0¢ / To Property Line ("~'//DO/ To Water Main/Service Line 7/0/ Course __/~_ No. of Compartments _ Y Foundation Cleanout (Y/N)~..~. Date Last Pumped ~_/~'' ; for -'"'-' Temporary Holding Tank Permit (Y/N) To Building Foundation '¥o Disposal Field _____c~ To Stream, Pond, Lake, or Major Drainage Gem ments __~",., Page 1 of 2 C, ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed (~//~//.7,~ Width of Field ~.~(~ Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well ...~./'Cl~ / To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking/Area, or Vehicle Storage Area Comments Type of System Design Length of Field -~7 / Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots "~_'-~ / To Cutbank (if present) LIFT STATION Date Installed //~/~.A.,/~~ Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** ~.~lqic~er,*tiofaY tha~nf~ratTd t~.~2f~=,nd,..______ HAA guidelines in effect on the date of this inspection. Company MOA No. Receipt No. Date of Payment Amount: $ ~ ~ ¢~-~ .' ...... ~:'?~.( . ~,,, Eng neet s Seal Page 2 of 2 t~(~. ANCHORAGE, ALASKA 99501 CONSULTING ENGINEER " rE[ EPHONE: (907) 279-3916 SEPTIC SYSTEM 7 0 U A C Y TEST LEGAL: LOCATION: OWNER: RESIDENCE: WATER SYSTEM: SEPTIC SYSTEM: DATE OF PUMPING: DATE OF TEST: TEST PROCEDURE: LOT 6M, GOLDENVIEW iii:LGIITS 6500 E. 156TH. ROBERT RETHERFORD SINGLE FAMILY, 'P ~': ..I1~ ]3KI)ROOHS ON SITE WELL FROM MUNICIPAL REC S: TANK: GREER STEEL, .n ~ COMP. 1000 GAL. ABSORPTION SYSTEM: i'NC!] ABSORPTION AREA: SO. FT. SOIL RATING: 85 INSTALLATION DATE: .'d/(:US;T i976 JULY 3, 1.986 JULY 1, 1986 SYSTEM WAS INSPECri".:ll, AND HEASURED. TANK WAS FOUND WITH 4 FEET ' ~'- ," '~ AND A LIQUID DEPTII OF 50 INCHES, 'PIIE TRENCH SUMP WAS 9.1 Fl' .'1' I'EI'iP WITII 6 FEET OF LIQUID. COVER OVER TRENCH WAS 3.5 PEET. WATER WAS ADDED TO THE SUMP AT A COx'"' '':T !:L,'Vi'}'i OF 6 GALLONS PER MINUTE. THE WATER LEVELS IN TANK AN!~ ','.q~N?; MONITORED WNILE A TOTAL OF 600 GALLONS OF WATER WAS A' ,A ;, ":'~' ,';ATER LEVEL IN TEIE TANK ROSE 1 INCII WHILE THE; LEVEL IN III .~: ;.1~ !-',OSE A TOTAL OF ]1.5 INCHES. THE INFILTRATION RATE WAS TIIEN MONITOP},' THIS TIME THE WATER LEVELS IN BOTII '".,,~, THOSE PRIOR TO THE TEST. TEST RESULT: THIS SYSTEM HEN THE MUNICIPALITY The operational life of all septic soil conditions, groundwater levels year, and the wate~_ usage of th system. These condiLions are outside of this septic system. We can the}-<~: how long the syshem will continue rements of the Municipality and Stat.~. !.'Old, 20 MINUTES. DURING AND SUMP RETURMED TO ~:~' 2ODE RE0_U]'REMENTS OF ;nds em the lecal tEuake during the no served by [he ef the evaluater ye any estJ. mate of ~erat_ional requi- :,, ,t ANCHORAGE, At~,SKA 99[;01 CONSULTING ENGINEER TELEPHONE: (907) 279-3916 RESIDENTIAL W E ]~ I N S P E C T I O N LEGAL: LOT 6M GOLDENVIEW II!.[G,tlS LOCATION: 6500 E. 156 AVENUE OWNER: ROBERT RETHERFORD TYPE OF WELL: SINGI,E :,':,:!]' v WELL LOG AVAILABLE: YES INSTALLATION REOUIREMENTS MET: YES WELL YIELD FROM WELL LOG: 6-7 GPN. PUMP YIELD: 6 GPM. DATE OF INSPECTION: JULY 1, 1986 TEST PROCEDURE: WELL WAS PUMPED AT A CONSTANT RATE OF 6 GALLONS PER MINUT" i'/!{ILE 'PIIE DRAWDOWN WAS MONITORED WITH AN ACOUSTIC PROBE. THF. '.<JILL WAS PUMPED TILL THE DRAWDOWN STABILIZED. STATIC WATER h!": :h w/\s FOUND AT ]6 FEET BELOW TOP OF CASING. AFTER 30 MINUTEF PU/'!PING AT 6 GPM. THE WATER LEVEL STABILIZED AT 23 FEET. ': · .'.~,L WAS PUMPED FOR 60 MINUTES MORE WITHOUT FURT]IER DRAWDOWN. TEST FOR COLIFORHS: WATER WAS TESTE~, : COl,[FORM BACTERIA ON JULY 2, 1986. Tt.]S'i '. :!I. CATIVE. TEST RESULT: THIS WELL MEE~,:~ ::~ ' N q©UIREHENTS OF THE MUNICIPALITY OF ARC!! The Municipal r,ac ; :-,~ment for well flow is 150 gallons of v. '.~:' For bedroom per 24 hours.This well su~: .:;.;es this requirement. The assessment et ' 'oxdition of this well applies only ! < ' ~: ~]ti. ens as ef this date. The flew ~ ' l,,~ well may change due to subsurfa - ~ u~s that may not be observed from ~ : ' :.' and changes in land use and :,~ : " s that may impact the conditions . {::hfer feeding the well. ® Municipality of Anchorage ` I[' On -Site Water and Wastewater Program (907) 343-7904 5 E T Y Certificate of On -Site Systems Approval Parcel I.D. 020-043-15 1. GENERAL INFORMATION: Expiration Date: /Q _36 —2 I Complete legal description GOLDEN VIEW HEIGHTS; LOT LI Location (site address) 6500 E 156th Ave. *Anchorage Current Property owner(s) Richard & Anne Mize Day phone 242-0267 Mailing address Real Estate Agent 2. TYPE OF DWELLING: X❑ Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 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 ❑ Waiver/Variance request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ 550 Waiver Fee $ Date of Payment �3 o 0.21 Date of Payment Receipt Number. o6q 76 Receipt Number COSA # 05C-2-119 Waiver # 5. STATEMENT OF INSPECTION BY ENGINI=ER 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 33 Engineer's Printed Name: Jeffrey A. Garness Date: 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 system/s on the date/s of the 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 system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system 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 party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE �J System #1 Approved for _ bedrooms System #2 Approved for Disapproved Conditional approval for By 1� bedrooms bedrooms, with the followi #AECC884 4 WSITE T7 p I A17f R AND m vl'A-r E � m PRrnr,4.4 A R Original Certificate Date: T SERVIG'F 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other qI) f�C rsii3'4-s 701 Leg?1 Description: GOLDEN VIEW HEIGHTS; LOT 1 Parcel ID: 020-043-15 If more than 1 septic system on Iot: COSA Checklist # of Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 1979 (?) + U' 6 ( � � tciti� Total depth ft "—' Cased to UNKNOWN ft �'1A t%t Sanitary seal is functioning correctly FOR Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 6/1/21 Static water level at beginning of test 12.6 ft Comments S. Ail K DATA Age of tank(s) 8 years Tank type/material sEPitC"'E Measured operating fluid level in septic tank 48' } F0 Standpipes/foundation cleanout per record drawing Date of pumping 5/12/21 D. ABSORPTION FIELD DATA Which system tested (date installed) $/5/76 ALL standpipes present per record drawing Total measured depth from grade 7.83 ft (max) Measured depth to pipe invert from grade 4.33 ft (min) ❑ N/A – pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective 3.5, . ® Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced N/A gallons Comments/Deficiencies:_'sysreM FULL To INVERT 'COSA Checklist yellovi sheet Well production at time of test 5.7+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes 110-1 No Flffl Coliform bacteria is Negative Nitrate 3.02 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by GEG, LTD. Date of Sample 6/1/21 C. LIFT STA JIOI�,i ❑ Required maintenance completed Age of lift station __ years Lift station material Comments: N/A Adequacy test date 7/2/21 Results [DPass For 3 bedrooms Fluid depth prior to test 21 in Water added 1032 gall New depth *42 in Elapsed time 120 min Final fluid depth 31 in Absorption rate 450+ gpd A,ny rejuvenation treatment (past 12 months) ONE tf yes, enter date N/A Qyi E. oC:PARA.TION DIS AN'CES Porn Private VVell on Loi to: (Please enter distances if less than required or if community well.) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No *5 + Community Sewer Manhole/Cleanout > '100' [7 Yes if No ft ❑✓ Yes if No fi Neighboring Tank > 100' 7 Yes if No ft Private Sewer/Septic Line > 25' Yes if No ft Absorption Field on Lot > 100' F/71 Yes if No ft Holding Tank > 100' Yes if No ft Neighboring Absorption Fields > 100' Water (Main > '10' Q Animal Containment? 50' F/71 Yes if No ft ✓� Yes if No ft Water Service Line > 10' 0✓ Yes if No ft Manure/Animal Excreta Storage > 100' comment below Community Server Main > 75' 0 Yes if No ft [Z] Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No *5 + it Surface Water > 100' E✓ Yes if No 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' Q Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Water Service Line > 10' 0✓ Yes if No ft If septic tank is under driveway comment below F, orn Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Yes if No It If absorption field is Linder driveway comment below Property Line > 10' 0 Yes if 1\10 ft Wells on Adjacent Lots: Water Main > '10' Q Yes if No ft Private Wells > 100: Yes if No ft Water Service Line > 10' 0 Yes if No +** ft Community Wells > 200' Z Yes if No ft Surface Water > 100' P/1 Yes if No it F. ENGINEEWS COPAN1IEi,,iTS *MET CODE AT TIME OF INSTALL **APROXIMATELY 2.5' TO SHED ***ASSUMED 10'+ THERE IS A BOOTLEG TRENCH HOOKED UP TO THE SYSTEM THAT WAS DISCONNECTED BY ARM SERVICES. NO INFO AVAILABLE FOR THIS TRENCH. 5j G. E'NGINEER'S CERTIFICATION 1 certify that I have determined through fleld 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 e; A. rness., CE_ 795 "��9_ MECC884 peplAlparson O =il rLIJ _b3 V J p U V) 0 I'm I I 30.0' 30.0' t I C.: O I N J Qi 4 M C9 NC),.. : V Z Yj 0) Cr)�o' I �. C-) 4d �'ys O��dQQ�4 I p1 O Z p U UC C C C i m C Q 0 m 4 o x O 0 0 0 Q ai Q. LL E D y p, U m Cn c p c O y� m (D U7 U 3 a U -O p m >• y O O E a j�( aDN00 L3`0 0o0 �I _ (a j a V)w� = a Q min M1 �� °v " p In,0hh� (n p p O 0 O p m y .0 C CL I y o m("a p E 0 CD 0 CL I o m000 ovm Cr)o L. rn y a m I 0y ro0•. E y � (�! V) 1'0 V 2 t m I CD�� O ° v"" pro—s aim t7S O" y O (Dl CZ.p 0_ I O IIS 00 a_ppOy to) mho -I (� O f%% smcm��i-f and L'J-t-- c ° m V) -Yt .Q T I m L'i Q C m y w- U U xi J A m f� > p y p LAJ W .y O O C= I w (n >p U U y O > V O i W G o .0 6 N p .r- C c ro I 9—LJ t� °O ar O C7 V) E iYb m. L a L O O � .� y O P`i1 _^ 0 0 m 3 y cn ar O > vl 1] r L. m 7s O woommom m U t. y m to m cc 5 Q r -00 p O a L -t- c 0