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Home My WebLink AboutALPINE VILLAGE BLK 5 LT 16Alpin Village Block 5 Lot #014-132-25 Parcel I.D. 014-132-25 Mumc~pahty of AnchCr)(~ ~I On-Site Water and Wastewater (907) 343-7904 C .TI C^T O.-S T SYST . .OV Fxpiration Date: //- 7-/5' 1. GENERAL INFORMATION Complete legal description ALPINE VILLAGE BLOCK 5, LOT 16 Location (site address) 7427 BERN STREET, ANCHORAGE, AK 99507 Current Property owner(s) Mailing address Real Estate Agent KURT COLTON & KANSUDA LEONARD Day phone 7427 BERN STREET, ANCHORAGE, AK 99507 Day phone 2. TYPE OF DWELLING: [] Single Family (w/wo ADU) [] Duplex [] Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3~ TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class __ Well Public Water System [] [] [] [] TYPE OF WASTEWATER DISPOSAL: Individual [] Holding Tank [] Community [] Public Sewer [] WaiverNariance request for: COSA ,o be released~o th,; engineer,"/unl;ss oth/e~u;sted by the engineer. Date: COSA Fee $ Date of Payment ~;¢/¢~ Receipt Number Waiver Fee $ Date of Payment Receipt Number Waiver # Distance: STATEMENT OF ~NSPECTION BY ENGINEER As certified by my~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 wastewai.er disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify thai. 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 ARCTERRA CONSULTING, INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 7/30/15 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations 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 obsenced from the sudace, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being senced by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how iong a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. DSD SIGNATURE \j System #I Approved for .~ bedrooms. System #2 Approved for __ _ bedrooms. Disapproved. Conditional approval for _ bedrooms, with the following stipulations: Original Certificate Date: .~_- T - / -.~' ' / '~--"~) -- 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 lhe professional engineer's work. ATTACHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory X Nitrate Advisory Arsenic Advisory Other COSA blue sheet 10-1C~12.dcc If more than I septic system is on the lot: COSA Checklist # of Structure s~rved by this system _ Certificate of On-Site Systems Approval Checklist Legal Description: ALPINE VILLAGE BLOCK 5, LOT 16 A. WELL DATA Well type PRVT Date completed 2006 Total depth ff. IfA, B, orC provide PWSID #__ Sanitary seal (Y/N)_Y Cased to f. FROM WELL LOG Parcel ID: 014-132-25 Date of test Static water level ft. Well production g.p.m. Well Log (Y/N) N Wires propedy protected (WN) _Y Casing height (above ground) 12 AT INSPECTION 7/231t$ 64 ff. 2.5 g.p.m. in. WATER SAMPLE RESULTS: Coliform /~/'~. coloniesll00 mL Nitrate Arsenic:/~-~,,.~' ug/L Date of sample: ?123115 mg/L Collected by: ARCTERRA B. SEPTIC/HOLDING TANK DATA - PUBLIC SEWER 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. Soil rating (g.p.d./ft2 or ft2/bdrm) _ ft. Width ft. Eft. absorption area _~ Monitoring tube Date of adequacy test ,, Results (Pass/Fail) Fluid depth in absorption field before test in. Water added Elapsed Time: min. Final fluid depth in. Any rejuvenation treatment (past 12 mo.) (YIN & type) System type Gravel below pipe Depression over field gal. Absorption rate >= If yes, give date For New depth 'bedreoms in. g.p.d. LIFT STATION Date installed Size in gallons "Pump on" level at __ in. "Pump o~ level at _ in. Datum Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot NA Absorption field on lot NA Public sewer main 75'+ Sewer/septic service line 25'+ Animal containment areas 50'+ SEPTIC/HOLDING TANK ON LOT TO: PUBLIC SEWER Building foundation Water main Wells on adjacent lots Property line__ Water service line ABSORPTION FIELD ON LOT TO: PUBLIC SEWER Property line Water Service line Curtain drain Building foundation Surface water Wells on adjacent lots F. COMMENTS Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? in. On adjacent lots NA On adjacent lots NA Public sewer manhole/cleanout 100'+ Holding tank NA Manure/animal excrete storage areas 100'+ Absorption field Surface water Water main Driveway, parking/vehicle storage 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 KENNETH M. DUFFUS Date 0713012015 COSA canary sheet_2-6-15.doc UJ 30' T t30,00~ WELL 0 X 48.0' 37.0~ EXISTING HOUSE ~ 28,0' 130.00' N89~ 59' 00"E 15 N89" 59' 00"E ~E ~R~R TA~$ ~0N$1~[~Y FOR ~ )N)~ ~AN~C~0N ONLY ~O ~S ~N~ ~bl~ ~Y ~ ,~ ~T ~ ~ S~, ~oz ~ SURLY TYPE SY~OLS SURVEY CERT[FICA~ON Prepared Robert E. Johns, b~r. & Assoc. Professional Land Surveyors Municipality of Anchorage Community Development Department Development Services Division On-Site Water and Wastewater Program 4700 EImore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Arsenic Advisory Certificate of On-Site Systems Approval # 151407 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 5, Lot 16 of Alpine Village Subdivision. This inspection revealed an arsenic concentration of 14.2 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 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. Information on arsenic is available from the On-Site Water and Wastewater Program website (www.muni.or~onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval.