HomeMy WebLinkAboutSUMMIT ESTATES BLK 2 LT 9Summit
Estates
Block 2
Lot 9
#015-072-10
MUNICIPALITY of
Development Services Department
On -Site Water & Wastewater Section
Parcel I.D. 015-072-10
Certificate of On -Site Systems Approval
1. GENERAL INFORMATION
Expiration Date:
Complete legal description SUMMIT ESTATES BILK 2 LT 9
Location (site address) 5428 E 97TH AVE, ANCH AK
Current property owner(s) BRADLEY J & COURTNEY MCCONNELL
Mailing address SAME
Real estate agent
2. TYPE OF DWELLING:
Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 5
Day phone
Day phone
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER
Private Well
E
Private Septic
0
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
Date of Payment 1 `� 0 1
Receipt Number 1C( 9 I
COSA # CiSGZ11 Q L-/7 _.
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
hone: 907-343-7904
Fax: 907-343-7997
II /qr Z
DISPOSAL:
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify t
on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this
on-site water supply and/or wastewater disposal system is (are) safe, functional and a
bedrooms and type of structure indicated herein. I further verify that based on the infc
Municipality of Anchorage files and from my investigation and inspection, the on-site wate
disposal system is (are) in compliance with all applicable Municipal and State codes, ord
effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify
Name of Firm MIKE N ANDERSON, P.E.
Address 4661 NATRONA AVE ANCH AK
Engineer's Printed Name MIKE N ANDERSON, P.E.
at my investigation, based
pplication, shows that the
equate for the number of
'nation obtained from the
supply and/or wastewater
ances, and regulations in
e information submitted.
Phone 72 -8864
Date 2-1
6. D1IGNATURE �;•-•-••
System #1 Approved for 5 bedrooms t =" l
System #2 Approved for bedrooms `•
Disapproved y =r
Conditional approval for bedrooms, with the following stipulatil
21
A as
? T t-!
HAEL N. AND[RXN;_=ti J
AX
Original Certificate Date: may{-- l q-2
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approv 1 (COSA) based only upon the
representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. e 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 blue sheet
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TATER
r z�
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Original Certificate Date: may{-- l q-2
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approv 1 (COSA) based only upon the
representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. e 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 blue sheet
Legal Description: SUMMIT ESTATES BLK 2, LOT 9
If more than 1 septic system on lot: COSA Checklist #
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled 913/14
Total depth 76 ft
Cased to 76 ft
❑ Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ground) 24°+ in.
Date of flow test for COSA 1/29/21
Static water level at beginning of test 50 ft.
Comments
B. TANK DATA
Age of tank(s) 6 years
Tank type/material *
Measured operating fluid level in septic tank 49"
❑ Standpipes/foundation cleanout per record drawing
Date of pumping *steel/septic, pumped 2/9/21
of Structure served by this
Well production at time of test
Water storage tank volume 0
Well disinfected for coliform to
❑ Coliform bacteria is Negati-
Nitrate 6.99 mg/L ❑ Nitr
Arsenic ug/L ❑ Ars
Collected by MNA
Date of Sample 1/29/21
C. LIFT STATION
❑ Required maintenance comr
Age of lift station years
Lift station material
Comments:
D. ABSORPTION FIELD DATA
-Which system tested (date installed) 1O1514
Adequacy test date 3128121
NO ALL standpipes present per record drawing
Results EDPass For 5
Total measured depth from grade * ft (max)
Fluid depth prior to test 0/0
Measured depth to pipe invert from grade 5.25-4, ft (min)
Water added 750+ gal
❑ N/A - pressurized field
OR Monitor tubes go to bottom of effective. If not, state
New depth 10/10 in
depth into effective
1440
Elapsed time min
❑ Code -required soil cover over field
Final fluid depth 0/0 in
❑ System presoaked
Absorption rate 750 gpd
(Required if vacant for greater than 30 days prior to
Any rejuvenation treatment (pas
date of test)
Gallons introduced gallons
If yes, enter date
Comments/Deficiencies: 11.75'-10.5'. All septic pipes installed per the engineering
asbuit.
COSA Checklist yellow sheet
ID: 015-072-10
gallons
❑ Yes ❑ No
less than MRL (ND)
less than MRL (ND)
m
bedrooms
12 months) N
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'
0
Yes
Community Sewer Manhole
r✓ Yes
if No
ft
✓Q
Neighboring Tank > 100' El Yes
if No
ft
Private Sewer/Septic Line >
Absorption Field on Lot > 100' 0 Yes
if No
ft
Holding Tank > 100'
Neighboring Absorption Fields > 100'
Private Wells > 100'
Water Main > 10'
Animal Containment > 50'
El Yes
if No
ft
Community Wells > 200'
Water Service Line > 10'
'✓D
Yes
Manure/Animal Excreta Stor
Community Sewer Main > 75' FV� Yes
if No
ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
0
Yes
if No
ft
Surface Water > 100'
Property Line > 5'
✓Q
Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5'
1-71
Yes
if No
ft
Private Wells > 100'
Water Main > 10'
✓0
Yes
if No
ft
Community Wells > 200'
Water Service Line > 10'
'✓D
Yes
if No
ft
If septic tank is under driveway I
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10'
P-
Yes
if No
ft
If absorption field is under d
Property Line > 10'
0
Yes
if No
ft
Wells on Adjacent Lots:
Water Main > 10'
Q
Yes
if No
ft
Private Wells > 100'
Water Service Line > 10'
[/✓
Yes
if No
ft
Community Wells > 200'
Surface Water > 100'
0
Yes
if No
ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION
l 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
anout > 100'
[,,
Yes
if No ft
ED
Yes
if No ft
[)
Yes
if No ft
Q✓
Yes
if No ft
> 100'
✓,/ Yes if No ft
Q✓ Yes if No ft
21 Yes if No
ft
0 Yes if No
ft
:omment below
vay comment below
Yes if No
ft
Yes if No
ft
* -----------
,......:<........
.
• MICHAEL N
Jit• r„ �
ANDLRSC:N ,� n
CL -
4/,A
Nitrate Advisory
Certificate of On -Site Systems Approval # OSC211047
Subdivision: Summit Estates, Block: 2, Lot: 9
A water sample revealed a nitrate concentration of 6.99 milligrams per liter (mg/Q.
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. Since nitrates are known to slowly increase, we recommend
you monitor the water quality. 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.
7Vla�lmg Address O Box 196650 *Anchorage, Alaska 99519 6650 *www muni org
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.
ER*AJI,
MUNICIPALITY OF ANCHORAGE
;i
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 015-072-1
1. GENERAL INFORMATION
Expiration Date: _ 1� h 1 a, o--) D
Complete legal description SUMMIT ESTATES BLOCK 2 LOT 9
Location (site address) 5428 E 97TH AVENUE ANCHORAGE, AK 99507
Current property owner(s) MATTHEW & JENNIFER COAR Day phone
Mailing address
Real estate agent
5428 E 97TH AVENUE, ANCHORAGE, AK 99507
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
5
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 $ 556 Waiver Fee $
Date of Payment /19 -I Date of Payment
Receipt Number 061 3�QU Receipt Number
COSA # n oQ /'5'�(j 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 ANDERSON CONSTRUCTION & ENGINEERING Phone 345-3377
Address 4661 NATRONA AVENUE ANCHORAGE, AK 99516
Engineer's Printed Name MICHAEL N. ANDERSON, PE Date 11/1/2019
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, AW or
local soil characteristics, groundwater levels that may fluctuate during the year, quality of AW? .
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 to ,� V
these various and dynamic characteristics and are outside the control of the evaluator of the Of
well and septic system. Therefore, any estimate of how long a system will function satisfactory
for current or future occupants or guarantee that no unseen encroachments, deficiencies or
discrepancies exist can be given by FUN and Anderson Construction & Engineering.
„•
6. DSD SIGNATURE4 &
11/1/19 .,• �,
System #1 Approved for bedrooms'
System #2 Approved for bedrooms
Disapproved
Conditional approval for bedrooms, with the following stipulations:
XV
OAI,S/TE
INZnp.,'
m
OGRTFR =
Ail �0
RVIC
B C_J�Lxud Y• �i�� �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 blue sheet
Legal Description: SUMMIT ESTATES BLOCK 2 LOT 9 Parcel ID: 015-072-10
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 9/3/2014
Total depth 76 ft
Cased to 76 ft
® Sanitary seal is functioning correctly
® Wires are properly protected
Casing height (above ground) 24+ in.
Date of flow test for COSA 10/1/2019
Static water level at beginning of test 49 ft.
Well production at time of test 3.1+ gpm
Comments
B. TANK DATA
Age of tank(s) 5 years
Tank type/material SEPTIC / STEEL
Measured operating fluid level in septic tank 50"
® Standpipes/foundation cleanout per record drawing
Date of pumping 10/1/2019
D. ABSORPTION FIELD DATA
Which system tested (date installed) 10/15/2014
® ALL standpipes present per record drawing
Total measured depth from grade 11.75 -10.5+ ft (max)
Measured depth to pipe invert from grade 5.25 - 4 ft
(min)
❑ N/A — pressurized field
® Monitor tubes go to bottom of effective. If not, state
depth into effective
® Code -required soil cover over field
❑ System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced gallons
Comments/Deficiencies:
Water storage tank volume NA gallons
Well disinfected for coliform test? ❑ Yes ® No
® Coliform bacteria is Negative
Nitrate 6.61 mg/L
Arsenic ug/L ® Arsenic less than MRL (ND)
WE
Collected by �' .
Date of Sample 10/9/2019
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments:
Adequacy test date 10/1/2019
Results R Pass For 5 bedrooms
Fluid depth prior to test 0 / 0 in
Water added 830 gal
New depth 11 / 22 in
Elapsed time 1050 min
Final fluid depth 0 / 0 in
Absorption rate 750 gpd
Any rejuvenation treatment (past 12 months) N
If yes, enter date
FUN
14z ,
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
Wells on Adjacent Lots:
Community Sewer Manhole/Cleanout > 100'
® Yes
if No
ft
® Yes
if No
Neighboring Tank > 100' ® Yes
if No
ft
Private Sewer/Septic Line > 25' ® Yes
if No
Absorption Field on Lot > 100' ® Yes
if No
ft
Holding Tank > 100' ® Yes
if No
Neighboring Absorption Fields > 100'
Surface Water > 100'
® Yes
Animal Containment > 50' ® Yes
if No
® Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ® Yes
if No
ft
® Yes
if No
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10' ® Yes if No ft Surface Water > 100
ft
ft
ft
ft
ft
® 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 _
Water Main > 10'
® Yes if No ft
Community Wells > 200' ® Yes if No .
Water Service Line > 10'
® 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
If absorption field is under driveway comment below
Property Line > 10'
® Yes
if No
ft
Wells on Adjacent Lots:
Water Main > 10'
® Yes
if No
ft
Private Wells > 100' ® Yes if No ft
Water Service Line > 10'
® Yes
if No
ft
Community Wells > 200' ® Yes if No
Surface Water > 100'
® Yes
if No
ft
F. ENGINEER'S COMMENTS
Southern trench is along the edge of the driveway and the very eastern portion is slightly under drive with no known
G. ENGINEER'S CERTIFICATION
l certify that / 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.
MICHAEL N. ANDERSON: •
Sri... No. CE 9-9 {v
10/10/19.• o
AOr
�FESSI021�'S'
ft
ft
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT 907-343-7904
On-Site Water and Wastewater Section Fax: 343-7997
www.muni.org/onsite
Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519-6650 * www.muni.org
Nitrate Advisory
Certificate of On-Site Systems Approval # OSC191524
Subdivision: Summit Estates, Block: 2, Lot: 9
A water sample revealed a nitrate concentration of 6.61 milligrams per liter (mg/L).
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. Since nitrates are known to slowly increase, we recommend
you monitor the water quality. 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.
Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519-6650 * www.muni.org
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.