RABBIT CREEK VIEW & HEIGHTS BLK 10H LT 28A
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HomeMy WebLinkAboutRABBIT CREEK VIEW & HEIGHTS BLK 10H LT 28ARcibbit Creek View & Heights Block 1OH Lot 28A #020 - 571 - 56 Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 020-571-56 Expiration Date: J A 1. GENERAL INFORMATION: vieo Complete legal description RABBIT CREEK& HEIGHTS; BLOCK 10H, LOT 28A Location (site address) 17015 Jacqueline Circle *Anchorage Current Property owner(s) Troy Melhase & Dawn Neer — Day phone 301-8751 Mailing address Real Estate Agent 2. TYPE OF DWELLING: Z Single Family (w/wo, ADU) ❑ Duplex F71 Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual N Individual Water Storage El Holding Tank 0 Community Class Well E71 Community F] Public Water System ❑ Public Sewer El WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee 0 qDate of Payment _2( 0 _d Receipt Number oqc[qS C. COSA # 0 5 � 11 a 0 � 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: Gayness Engineerinq Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage Alaska 99507 / Engineer's Printed Name: Jeffrey A. Garness Date: _ z 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 � 1 System #1 Approved for I bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, #AECC884 `ii<<cc�cctrrrrrrrr OF Ah& SI with the following atiops�-..TE\NW AN '•`�`�. PRS _ ,�- Original Certificate Date: r / 1,20:2 T 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 COSA Checklist Legal Description: RABBIT CREEK VIEW & HEIGHTS; BLOCK 10H, LOT 28A Parcel ID: 020-571-56 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA 0 Well log is filed with Onsite (or attached) Date drilled 7'12J10 Total depth 137 ft Cased to 124 ft Fk Sanitary seal is functioning correctly ❑Q Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 4/1/21 Static water level at beginning of test 32.8 ft. Comments B. TANK DATA Age of tank(s) 11 years Tank type/material STEP/STEEL Measured operating fluid level in septic tank 49" A-1 Standpipes/foundation cleanout per record drawing Date of pumping 2/4/21 Structure served by this system Well production at time of test 4.6+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes R No R Coliform bacteria is Negative Nitrate 1.60 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑Q Arsenic less than MRL (ND) Collected by GEG, LTD Date of Sample 4/1/21 C. LIFT STATION FN Required maintenance completed Age of lift station 11 years Lift station material STEEL Comments: D. ABSORPTION FIELD DATA IDSF Which system tested (date installed) 7/9/10 Adequacy test date 4/1/21 W ALL standpipes present per record drawing Results Q✓ Pass For 4 bedrooms Total measured depth from grade 5.0 ft (max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade ft (min) Water added 753 gal ❑■ N/A — pressurized field 2 New depth in ❑ Monitor tubes go to bottom of effective. If not, state 120 depth into effective' Elapsed time min Q Gode-required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 600+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NONE date of test) Gallons introduced N/A gallons If yes, enter date N/A Comments/Deficiencies: �-' 'MT3 EXTENDS 2.4' BELOW TOP OF THE IDSF SAND. BOTTOM OF MT3 SHOULD BE SAME ELEVATION AS MT1 AND MT2 PER 2010 INSPECTION REPORT, IT IS UNKNOWN WHY THIS MONITORING TUBE IS NOT SET TO THE ELEVATIONS SHOWN ON THE RECORD DRAWINGS. COSA Checklist yellow sheet 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 *5+ Community Sewer Manhole/Cleanout > 100' Q Yes if No ft [7., Yes if No ft Neighboring Tank > 100' Q Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' R Yes if No ft Holding Tank > 100' ❑ Yes if No 75+ ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' Yes if No ft 0 Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Q Yes if No ft 0 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+ ft Surface Water > 100' Q Yes if No ft Property Line > 5' M Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Yes if No ft Private Wells > 100' Q Yes if No ft Water Main > 10' Q Yes if No ft Community Wells > 200' 0 Yes if No ft 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' Q✓ 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' Q Yes if No ft Private Wells > 100' Q Yes if No Water Service Line > 10' R Yes if No ft Community Wells > 200' Yes if No Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS *MET CODE AT TIME OF INSTALL **WR#101001 G. ENGINEER'S CERTIFICATION a N pit 1 certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with Qpm y' MOA COSA guidelines in effect on this date. fre ..- ...Qress,: PQ4 9. 7 CE— 81� OSA Checklist yellow sheet0 Professonoo #AECC884 DOpOc`' ft ft Jeff Garness From: David Harper <dlharper2@gmail.com> Sent: Friday, April 9, 2021 6:15 PM To: Jeff Garness Subject: 17015 Jacqueline Circle Jeff, the conduit located on the above well at the above location has been changed and brought up to MOA standards as of 4-9-21. Thanks Dave Harper Aarow Pump & Well Service, LLC Sent from my iPhone V 'x EJ SC7 k1wMal Wag SMd FQ,' Maintenance Ing I Maintonansc Prov.,dn�.,t: -'ature Oa,e cf mnintenaimcej�&.7 -Shone K.yl reqOwd 0 vai�eezPer 2-ppm-ved Own nasm: cupw TV TOM Want 110- Clawd -7iwt'=.: rlcasw;Ifiig -Hqh lave, 50at zettmg iricnes Point 'j of, n n,u tes �',rnp i"A' , er A nsm i); �Vu& ill RTAsm opemnon Inspow! nt yen 10 Top smog ':9 1 nl CIA" rM, emnot 13 I Maintonansc Prov.,dn�.,t: -'ature Oa,e cf mnintenaimcej�&.7 -A+ HOME SERN710ES am 750 1, 140(h Aven Lie Anict"torage, Ala-ska 99-516 ISIZWO112ita INVIIF lt;t;f 4 E ham, 2 TOTAL REMARKS Gallons Septic — Leach Area Holding Tank j -Standpipes -- Time PROSLEM AREA — CALL FOR MORE INFORMATION NEEDS TO BE DONEAGAIN IN 6 MONTHS VO. - Good Shape Sludge buildup on bottom Roat er on top Jim cap rssiN or f - Cut standpipe to 1' above ground Needs Septictn neods replacing THIS (AM 0 am MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT CE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and as of this Day of Ar,'1 of 20,,71 , by and between herein the "OWNER," and the Municipality of herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code 15.65.365. In consideration of the mutual covenants contained herein, the parties to this agree as follows: Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as located at (legal description) A P, P, tT EE k V I F— T 5 Maintenance Repairs and Alterations. is required to read, understand and initial each section) Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Ov ner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev, 05!1812018) Page I of 3 Owner acknowledges that the Municipality may request records of maintenance and or maintenance provider. repairs from the manufacturer's representative p V Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. co Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3, Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4 Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev 0511812018) Page 2 of 3 OWNER: By: h RC2 6�KA, �- (signatur) Date: L! �)v 1 t (� IL i2 -R N(-4 (print name) STATEOFA.LA&A t,,,Sj'ttNCa1 ) ss. The foregoing instrument was acknouJledged before me this 2-4 day of 20 2�by N i ca ke o�Y, 'h a n,A A �5 by f /\ 1 L NOTARY, -IP -9 IC FOR AL-A-SYs\.u0Sv x aTayj 1VIy Commission expires: 0 q�� MUNICIPALITY: By: (signature) R�e-c Ca- (�r r o � \ (print name) SUDIN PAKWAN NOTARY PUBLIC #20122352 STATE OF WASHINGTON MY COMMISSION EXPIRES 09-08-24 Date:'{ 26 .2 0 2 1 Title: (rev. 05/18/2018) Page 3 of 3