HomeMy WebLinkAboutGRANITE VIEW BLK 6 LT 2Municipality of Anchorage
On-Site Water and Wastewater Program
(907) 343-7904
Certificate of On-Site
014-301-02 E;;ira~ioFnE~a~e~ 2016
Parcel I.D.
1. GENERAL INFORMATION
Complete legal description Granite View, Block 6, Lot 2
Location (site address) 3004 E 88th Ave.
Current Prope~y owner(s) Shelby Wagoner & Richard Spicer Day phone
Mailing address
PO Box 670545 Chugiak, AK 99567
Real Estate Agent
Day phone
TYPE OF DWELLING: [] Single Family (w/wo ADU)
[] Duplex
[] Multiple Dwellings (Single Family and/or Duplex)
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 []
Waiver/Variance request for:
Received b'
COSA to be released to the engineer, unless otherwise requested by the engineer.
Distance:
Date: <:~///~/~0 ~,
COSA Fee $
Date of Payment
Receipt Number
COSA #
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.
In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA
guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test,
and separation distances measured to readily identifiable features. The operational life of at/wells and septic systems depend on the local soil
condition, g round water levels that may flucluate dudng the year, and the water usage of the family being served by the system. These conditions
are OUtSide the control of the evaluator of this system. AIl systems eventually fail and satisfactory test results de not guarantee future
performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty
for future performance, nor can we estimate remaining life of !he system. The content of this report is for the sole benefit of the owner listed
above.
Name of Firm Pannone Engineering Services LLC
Address P.O. Box 100217, Anchorage Ak. 99510
Engineer's Printed Name Steven R Pannone
bedrooms
bedrooms
6. DSD SIGNATURE
System #1 Approved for ~
System #2 Approved for __
Disapproved
Conditional approval for
Phone (907) 272-8218
Date 2/23/2016
bedrooms, with the following stipulations:
Original Certificate Date: .~,
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (CASA) 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 X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Other
COSAbluesheet_.c '- ;.t
If more than 1 septic system is on the lot:
COSA Checklist # f of ~
Structure served by this system ~
Certificate of On-Site Systems Approval Checklist
Legal Description: Gradite View, Block 6, Lot 2
Parcel ID: 014~301-02
A. -WELL DATA
Well type Private IfA. B, or C provide PWSID #
Date completed Unknown sanitary seal (Y/N} Y
Total depth 67.5+ ft. Cased to Unknown ft.
Well Log (Y/N) N
Wires propeny protected (Y/N) Y
Casing height (above ground) 12+
FROM WELL LOG
Date of test U n known
Static water level Unknown ft.
Well production Unknown g.p.m.
AT INSPECTION
1/28/2016
34 ~.
0.75
g.p.m.
WATER SAMPLE RESULTS:
Coliform Neg colonies/100mL Nitrate ND mg/L
Arsenic 53.0 ug/L Date of sample: 1/28/2016
Collected by: Sullivan Water Wells
B. SEPTIC/HOLDING TAN,,~'~TA
Tank Type/Materi~?
Tank size j gal.
Foun~ion c~eanout (Y/N) __
,~of pumping
C. ABSORPTION FIELD, DATA
Number of Compartments __
Depression over tank (Y/N)
Pumper
Date installed
Cleanouts (Y/N)
High water alarm (Y/N)
Date installed Soil rati~2 or ft2/bdrm) System type
Length ft. J Width ff. Gravel below pipe ff.
Total depth ft? ,.,,~. absorption area ' ~ Monitoring tube Depression over field
Date of adeqUaC~t: ~ ~ " Results (Pass/Fall) __ ' ' For bedrooms
Fluid dep~bsorption field befor~ test __ in. Waier added __ gaL. New depth in.
Elapsez/d'Time: mih. Final fluid depth in, Absorption rate >= , g.p.d.
Any rejuvenation treatment(past 12 mo.) (Y/N & type) If yes, give date
LIFT STATION
Date installS._
'Pump/gn" level at __ in.
/
Da~m
Size in gallons
"Pump off" level at
Cycles tested
Manhole/Access (Y/N)
High water alarm level at
Meets alarm & cimuit requirements?
in.
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station'on lot N/A
Absorption field on lot N/A
Public sewer main 75+
Sewer/septic service line 25+
Animal containment areas 50+
On adjacent lots 100+
On adjacent lots 100+
Public sewer manhole/cleanout 100+
Holding tank 100't'
100+
Manure/animal excrete storage areas
SEPTIC/HOLDING TANK ON LOT TO:
Building~tion Property line
Wymain __
~ellS on adjacent lots
ABSORPTION./I~D ON LOT TO:
Property li~_ .
Wat./er~ervice line
~rta'm drain
Absorption field
Water service line
Surface water
Building foundation
Surface water
Wells on adjacent lots
Water main
Driveway, parking/vehicle storage.
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
re~/iew of Municipal records that the abot~e systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name Steven Pannone
Date 2/23/2016
COSA canaPj sheet_2-6-15.doc
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elrnore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
Arsenic Advisory
Certificate of On-Site Systems Approval # OSC 161054
A Certificate of On-Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block 6, Lot 2 of
Granit View Subdivision. This inspection revealed an arsenic concentration
of 53 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 I0.0 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.org/onsite) or at 343-7904.
This advisory must be attached to ail copies of the subject Certificate of On-
Site Systems Approval.
~SEMENTS OF RECORD, OTHER THAN
HOSE SHOWN ON THE RECORDED
;AT ARE ~OT SHOWN HEREON,
~7
-8-
AS-BUIlT NO CORNERS SET THIS *DATE
I hereby certify that I hav~ performed
spection cfi the following described property:
,~LoCA~ - 6 G AA?Y'%-~ YT~£~V
Anchorage Recording I~ecinct, Alaska, and that the improve-
ments situated thereon are within the property lines and do
not overlap or encroach on the property lying adjacent there-
to, that no improvements on property lying.adjacent thereto
encroach on the premises in question and that there are no
roadways, h'ansmission lines or other visible easements on
said property except as indicated hereon.
Dated a{ Anchorage, Alaska
this. /t' ~-/~ day of ~ZS' ~, 19 <5~L
FRED WALATKA & AESOCZATES
Eng/neers and Surveyors
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
Water Well Advisory
Certificate of On-Site Systems Approval (COSA) # OSC 161054
During a recent COSA on-site inspection and test of the potable water
supply well on Block 6, Lot 2 of Granite View subdivision, the well's
productivity was determined to be .75 gallons per minute. The minimum
well productivity required by this Department (AMC 15.55) for a 3-bedroom
residence is .31 gallons per minute. Although the subject well currently
exceeds this minimum requirement, all parties concerned are advised that the
production capacity of the well may fluctuate. Restriction of non-critical
water uses such as washing cars and watering lawns and gardens may be
required.
This advisory must be attached to all copies of the subject Certificate of On-
Site Systems Approval.