HomeMy WebLinkAboutT12N R3W SEC 9 LT 15 E2TI2N
W
#014-172-10
Municipality of Anchorage
On-Site Water and Wastewater Program
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 014-172-10
1. GENERAL INFORMATION
Expiration Date: ~-/~///'~ ~
Complete legal description T12N R3W SEC 9 LOT 15 E2
Location (site address) 2748 LORE ROAD, ANCHORAGE, AK 99507
Current Property owner(s) DONALD & ETHEL CHRSTENSEN REV. TRUST Day phone
Mailing address 2748 LORE ROAD, ANCHORAGE, AK 99507
Real Estate Agent Day phone
2. TYPE OF DWELLING: [] Single Family (w/woADU)
[] Duplex
[] Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
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 release~ t~o the en~ineer,"unles$ ot,~r r~q uested by the engir~eer.
Distance:
Date: ?/-
COSA Fee $ ,~ '~
Date of Payment /0/~///,-.~/
Receipt Number ~ <2m~ ~::~
cosA 0 c ¢1¢q¢
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
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 ARCTERRA CONSULTING, INC.
Phone 868-3791
Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577
Engineer's Printed Name KENNETH M. DUFFUS
Date 10-19-2015
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 observed from the surface, changes in[and use, local soil charectedslics, groundwater levels that may fluctuate
during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are
subject to these various and dynamic characteristics and are outside ff~e control of the
evaluator of lhe well and septic system. Therefore,
AmTerra can not give any estimate of how long a
sysiem will function satisfactory for current or future
occupants or can AreTerra guarantee that no unseen
encroachments, deficiencies or discrepancies exist.
DSD SIGNATURE
System #1 Approved for
System #2 Approved for
Disapproved.
bedrooms.
bedrooms.
Conditional approval for
bedrooms with the following sti~H~gtions:
-. ~f OF*"
WASTEWAfER ~
By: ,~_~¢~//0/r¢.~.~~ Original Certificate Date: ]'/I/-~~/'''~
The Municipality of Anchor~ Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only
upon th~ rep~'esentations given fo 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
Septic System Advisory
Well Flow Advisory
X
Nitrate Advisory
Arsenic Advisory
Other
If more than 1 septic system is on the lot:
COSA Checklist # of
Structure served by this system _
Certificate of On-Site Systems Approval Checklist
Legal Desodption: T12N R3W SEC 9 LOT 15 E2
A. WELL DATA - see attached docs
Well type PRVT
Date completed cima 1959
Total depth 1~5+ ft.
IfA, B, or C provide PWSID # __
Sanitary seal (WN) _Y
Cased to f25+ ft.
FROM WELL LOG
Parcel ID: 014-172-10
Date of test
Static water level ft.
Well production g.p.m.
Well Log (Y/N) N
Wires propedy protected (Y/N) _Y
Casing height (above ground) 12
AT INSPECTION
9.30.15
57 ff.
4 g.p.m.
in.
WATER SAMPLE RESULTS:
Coliform NEG colonies/lO0 mL Nitrate 0.56 mg/L
Arsenic: ND ug/L Date of sample: 9.30 & 10-8-2015
Collected by: ARCTERRA
B. SEPTIC/HOLDING TANK DATA - see attached docs
Tank Type/Material SEPTIC I CONCRETE
Tank size 1500+ gal.
Foundation cleanout (Y/N) Y*
Date of pumping 4-17-15
Number of Compartments _1
Depression over tank (Y/N) N
Pumper Denali Sewer& Drain
Date installed circa 1959
Cleanouts (Y/N) Y
High water alarm (Y/N) N
C. ABSORPTION FIELD DATA - see attached docs (Length, Width .... are assumed)
Date installed circa f959 Soil rating (g.p.d./~ or ff2/bdrm) 1.2
Length 29 ft. Width 8
Total depth 10 ff. (Measured 9/30/15) Eff. absorption area 500+ ft2
System type CRIB
ft. Gravel below pipe $ ff.
Monitoring tube _Y Depression over field _N
Date of adequacy test 9-30-15 Results (Pass/Fail) PASS For_4bedrooms
Fluid depth in absorption field before test 48 & 41 in. Water added $00 gal. New depth 68 & 43 in.
Elapsed Time: 1440 min. Final fluid depth 48 & 41 in. Abs;3rption rate >= 600+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date
LIFT STATION
Date installed
"Pump on" level at __ in.
Datum
Size in gallons
"Pump off' level at __ in.
Cycles tested
Manhole/Access (Y/N)
High water alarm level at
Meets atarm & circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 50'+ (1059 Req.)
Absorption fiel~d on lot 50'+ {1959 Req.)
Public sewer main 75'+
Sewer/septic service line 25'+
Animal containment areas 50'+
SEPTIClHOLDING TANK ON LOT TO:
Building foundation 5'+
Water main 10'+
Wells on adjacent lots 100'+
ABSORPTION FIELD ON LOT TO:
Property line t0'+
Water Service line 10'+
Curtain drain 50'+ (NONE KNOWN)
Property line 5'+
Water service line
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout 100'+
Holding tank 100'+
Manure/animal excrete storage areas
10'+
Building foundation 10'+
Surface water 100'+
Wells on adjacent lots 100'+
100'+
Absorption field 5'+
Surface water 100'+
Water main 10'+
Driveway, parking/vehicle storage 10'+
F. COMMENTS
See attached letters & sketches for undocumented systems. Dimensions are based on visual observations and are assumed.
*Foundation cleanout via interior plumbing immediately inside foundation on .ground floor.
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipa! 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 10119/2015
COSA canary sheet_2-6-1§.doc
ARcTERRA
CONSULTING~ INC
212 E. 51 st Ave, Anchorage, AK,
99503
Office (907) 868-3791, Fax (907) 868-
3793
November 6, 2015
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: COSA - Undocumented System - T12N R3W SEC 9 LOT 15 E2
We submitted as per previous discussion and instructions from James "Jay"
Crewdson, P.E. the requested items to document the on-site water and
wastewater systems to obtain COSA approval. Please refer to previously
submitted letter. It assumed these on-site systems were installed prior to July 28,
1959.
Per your additional request from today, we have attached an inspection report
and an additional wastewater sketctL of the existing wastewater system. As
stated previously, the tmdocumented septic tank is assumed to be made of
concrete given the time it was instructed (circa 1959) and has a capacity of over
1500 gallons based on information provided by Denali Sewer & Drain Service.
Based on visual observations and measurements of the undocumented septic
absorption field - it appears to be an absorption crib / pit of approximately 20'
long x 8' wide x 6' effective depth. It appears to be a two chambered "crib" with
two monitoring tubes and two cleanouts as shown.
TiLe actual size, material and configuration of the undocumented septic tank are
unknown. Based on the recent as-built survey tile existing septic tank sto2Ldpipe
is 51'+/- from the well and is assumed to meet the separation requirement of 50'
at time of construction. The well is uphill from the septic tank and located
inside the house. The septic system slopes away from the well and based on the
testhole performed on October 12, 2015 the soils encountered were good sandy
filtrating soils with no groundwater observed. Water sample results for nitrates
were very minimal at 0.56 mg/L and demonstrate no impact from the septic
system.
20441 PTARMIGAN BLVD · EAGLE RIVER, AK 99577-8736 · PH (907) 868-3791 · FAX (907) 868-3793
T12N R3W SEC 9 LOT 15 E2
November 6, 2015
Page 2 of 2
Based on this investigation we do not expect there to be any adverse effect on
adjacent lots by the continued operation of this system - a system that his been in
operation for close to 60 years. We therefore request approval of these on-site
water and wastewater systems and issuance of the COSA. If you have any
questions, please contact me at 868-3791 / FAX 868-3793.
Respectfully submitted,
ArcTerra Consulting, Inc.
Attachments: Inspection Report w/Wastewater Absorption System Sketch
Municipality of Anchorage
On-Site Water and Wastewater Program · (907) 343-7904 Page of
ON-SITE WASTI:WATER INSPECTION RI=PORT
Permit Number: PID Number: 014-172-10
Dwelling: [] Single Family (SF) [] Duplex (D) [] Multiple (SF and/or D) Project: [] New [] Upgrade
Donald & Ethel Christensen ABSORPTION FIELD
Address [] Deep Trench [] Shallow Trench [] Bed [] Mound
2748 Lore Road, Anchorage, AK 99507
[] Other
~hone Number of Bedrooms Soil Rating Total depth from original grade
4
1.2 GPD/SF 1 0 Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot 4 +J- Ft. 6+/- Ft
15 E2 Fill added above original grade Gravel length
Township Range Section 0 Ft 20+/- Ft
12N 3W 9 3ravel width Beds: Number of LinesDistance between lines
SEPARATION DISTANCES 8+/- Et. Et
To Septic Absorption Lift Station Holding Sewer Fotal absorption area Number of trenches Dist. between trenches
From Tank Field Tank Line 500+ Ft; Ft.
we, *50' *50'+ NA NA 25'+ TANK [] Septic [] S.T.E.P. [] Holding [] Other
Manufacturer Capacity
Surface Water 100'+ 100'+ NA NA '1250+ Gal.
Material Number of compartments
Lot Line 5'+ 10'+ NA NA
NA
Foundation 5'+ 10'+ NA NA LIFT STATION
Manufacturer Capacity
Curtain Drain NA *50'+ NA NA Gal
Remarks *None known. *See attached letter Pump or~ level at Pump off level at -ligh water alarm at
pertaining to this undocumented system, in. in in
This IR is based on visual observations. Pump make and model Electrical Inspections performed by
Tank to
Installer PIPE MATERIAL House to tank drainfield
Drainfield CO/MT
Inspector ARCTERRA BENCH MARK (Assumed elevation) ft
Inspection 14 _ocation and description
dates: 2"d
3r~ 4~,
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
Conditional Approval: Date ,
eer's Stamp
Inspection Report_9-1-12,doc
LORE
N~ 50' 164,~ I'
WEST 1/2
LOT 15
EAST 1/2
LOT 1,5 I~ LOT 14
212 E. 5PtAve, Anchorage, AK 99503
}%~4'*'Office (907) 868-3791, Fax (907) 868-3793
Performed for:
Project:_
Depth
SOILS PERCOLATION TEST
Ethel Christensen Date Performed: 10-12-15
T12N R3W SEC 9 LOT 15 E2 TEST HOLE//
11.
13-
15-
Org/OL
SP/sm trace of silt-fines
17-
18-
19-
B.O.H.
HOLEPRE-SOAKED
PRIOR TO TEST
20-
TH 15-1
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
Was Ground water encountered? NO
Depth to water after monitoring? NO
What depth? NA
Date? 10/19/2015
Reading Date Gross Net Depth of Net
Time Time Water Drop
l 10/12/15 1:00 6"
2 1:10 10 min 12/16" 5 4/16"
3 * 1:11 6"
4 1:21 10 min 14/16" 5 2/16'
5 * 1:22 6"
6 1:32 10 rain 14/16" 5 2/16"
7 * 1:33 6"
8 1:43 10 min 15/16" 5 1/16"
9 * 1:44 6"
10 1:54 10 min 15/16" 5 1/16"
11 * 1:55 6"
12 2:05 10 min 15/16" 5 1/16"
· Water Added
Percolation Rate 2 (min/in) Perc Hole Diameter 6"
Test Run Bet~veen 5 feet and 6 feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State
and Municipal guidelines in effect on this date.
10/19/2015
To whom this may concern, During the work performed at 2748 Lore St Anchorage Alaska. The
well was extended to 12"+ above grade. The pit that the well was in was filled to even grade with the
concrete slab surrounding it. A new sanitary seal was installed with conduit encasing the electrical. A
down hole investigation was conducted to fulfill information needed for future recording purposes. We
found that the total depth of the well is 125ft. This well is cased to ~.25'+. S.W,L is 57'. No pitless is
present. Waterline extends out the top of the casing to pressure tank both are inside of structure. If
there are any questions regarding this location and the stated well, please feel free to contact us at any
time.
John Netherton