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Home My WebLink AboutLINGO LT 2 W 100'Lingo Lot 2 W 100' #001-143-05 9/I1 /201-7 Subject: Abandonment of well at 2009Wildwood ( Lingo `,c, a L01pOr 1) Excavate to pitless 2) Remove existing waterline to existing house 3) Fill w/ Bentonite (42 bags) 4) Install 6" cap 5) Backfill in compacted lifts Municipality of Anchorage On-Site Water and Wastewater Program (907) 343-7904 Certificate of On-Site Systems Approval Parcel I.D. 001-143-05 Expiration Date: / /- / - / ~, GENERAL INFORMATION Complete legal description LINGO LT 2 W 100' Location (site address) 2009 WILDWOOD LN ANCHORAGE AK 99517 Current Property owner(s) ALASKA INTERNATIONAL EDUCATION Day phone Mailing address Real Estate Agent PEGGY FRENCH Day phone 2. TYPE OF DWELLING: [] Single Family (w/wo ADU) [] Duplex [] Multiple Dwellings (Single Family and/or Duplex) U MITTA[, JUL ~ 9 Z014 3, NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual Well [] Individual Water Storage [] Community Class __ Well [] TYPE OF WASTEWATER DISPOSAL: Individual [] Holding Tank [] Community [] P'-.b..c Sewer [] WaiverNariance request for: NONE Received by: /~, ~'/)~ ~'~,. COSA to be released to t~'~ngineer, unless otherwise requested by the engineer. Date: Distance: COSA Fee $ Date of Payment Receipt Number COSA# (~'D/-..~-I ~"~ 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm SPURKLAND ENGINEERING Phone 279-3916 Address 203 W. 15TH AVE.,STE.202A, ANCHORAGE, AK 99501 Engineer's Printed Name LARS SPURKLAND Date 7/28/14 DSD SIGNATURE ~ System #1 Approved for System #2 Approved for __ Disapproved - Conditional approval for bedrooms bedrooms bedrooms, with the following sti~~ Th age 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. ATTACHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory X Nitrate Advisory Arsenic Advisory Other If more than I septic system is on the lot: COSA Checklist # I of 1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: Lingo Lot 2 W 100' A. WELL DATA Well type PRIVATE If A, B, or C provide PWStD # -- Date completed UNK Sanitary seal (Y/N) Y Parcel ID: 001-143-05 Well Log (Y/N) N Wires properly protected (Y/N) Y Total depth 73+ f. Cased to __ FROM WELL LOG Date of test Static water level Well production WATER SAMPLE RESULTS: NEG Coliform colonies/100 mL Arsenic 19.5 ug/L >40 ft. Casing height (above ground) 18+ in. AT INSPECTION 7/22/14 ft. 65 ff. 6.0 g.p.m, g,p.m. Nitrate 0.256 mg/L Date of sample: 7t22/14 Collected by: ANSON MOXNESS B. SEPTIC/HOLDING TANK DATA Tank Type/Material Tank size __ gal. Foundation cleanout (Y/N) Date of pumping Number of Compartments __ Depression over tank (Y/N) __ Pumper Date installed Cleanouts (Y/N) High water alarm (Y/N) C, ABSORPTION FIELD DATA Date installed Length Total depth ft. Date of adequacy test Fluid depth in absorption field before test __ in. Elapsed Time: min. Final fluid depth Any rejuvenation treatment (past 12 mo.) (Y/N & type) Soil rating (g.p.d./ft2 or f~/bdrm) ft. Width ft. Eft. absorption area __ fi2 Monitoring tube__ Results (Pass/Fail) Water added in. System type Gravel below pipe ft. Depression over field __ For bedrooms gal. New depth in. Absorption rate >= g.p.d. If yes, give date D. LIFT STATION Date installed "Pump on" level at __ Datum in. Size in gallons "Pump o~ level at in. Cycles tested Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? in. E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot -- Absorption field on lot -- Public sewer main 100'+ Sewer/septic service line 25'+ 50'+ Animal containment areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation -- Water main Wells on adjacent lots -- ABSORPTION FIELD ON LOT TO: Property line -- Water Service line -- Curtain drain '~ On adjacent lots -- On adjacent lots -- Public sewer manhole/cleanout 100'+ Holding tank NA Manure/animal excrete storage areas 100'+ Property line - Water service line -- Absorption field - Surface water -- Building foundation -- Water main -- Surface water -- Wells on adjacent lots -.- Driveway, parking/vehicle storage -- F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name I-ARS SPURKLAND Date 7/28/t4 COSA brown sheet_l 0-10-12.doc Municipality of Anchorage Community Development Department Development Services Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Arsenic Advisory Certificate of On-Site Systems Approval # 141365 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 2 W 100' of Lingo Subdivision. This inspection revealed an arsenic concentration of 19.5 micrograms per liter (ug/L) for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells m'e 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. Information on arsenic is available from the On-Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. 3B '.% ~ L0'r ~..v~ SURVEY TYPE FILOT PLANS & LOT SURVEYS SURVEY CER'RF!CATION PL3T pLAN SYMBOLS set rEOar ~ ~ DRaINASE ~ ASPHALT O FOUND ERBAR O O 0 WOOD FENCE ~ CONCRETE ~) ASSUMED ELEV, × × X METAL FENCE ~ WOOD DECK NOTE: ONLY THOSE IMPROVEMENTS ABOVE: GROUND AND VISIEILE W1LL BE SHOWN. FENCES, WELLS, SEPTIC CLEANOUT$, $iOEWALKS, D]~IVE:WAY~. ETC., ARE SHOWN IN THEIR APPROXIMATE LOCATION, ONLY. SNOW MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATEO. ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED, Prepared by Robert E. Johns, Jr. & Assoc. Professional Land Surveyors s:or.: 1" ---- 60' R~c. Lot s.e, R~c. PIct File Nm -.....~ ~, s,.~.~: /~. Oate Orawm 07/29/14 ~'": 1428 W.0. 14-355' Lot 2 W 100' LINGO