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Home My WebLink AboutUS SURVEY 3043 LT 4 OF LT 11 T10N R2E SEC 18 On-Site Water & Wastewater Prom (907) 343-7904 tf APR ?~ 8 ~016 CERTIFICATE OF ON-SITE SYSTEHS ~:'P~'~AL Parcel I.D. 075-092-34 Expiration Date: i. GENERAL INFORMATION Complete legal description Location (site address) Current 'Property owner(s) Mailing address Real Estate Agent USS 3043; LOT 4 OF 11 121 TELEMARK WAY *OIRDWOOD, AK 99587 TIM & THERESA FINNICAN Day phone N/A 6101 MOOSE MEADOW LANE CIRCLE *ANCHORAGE, AK 99516 SAM DANIEL Day phone 227-4626 2. TYPE Of DWELLING: [] Single Family (w/wo ADU) [] Duplex [] Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 2 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well [] Individual Water Storage [] Community Class__Well [] Public Water System [] Individual On-site [] Individual Holding tank [] Community On-site [] Public Sewer [] N Waiver/Variance request for: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ Date of Payment Receipt Number COSA Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEIV]ENT OF INSPECTION i~'~'"'ENGINEER As certified by my seal affixed hereto end as of the vafidation date shown below, 1 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 GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK, 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date Engineer's Comments: In conducgr~ this avaluabe~, GEG provided an engineering evaluation of the weft ann/or septic systetn in accordance with the guidstices ned regulations established by the Municipality n/Anchorage and febealry practices. The repeded [esuhs descdbe the conditioa of the system/s on the dates ef ~he evaluation, Separation distances were measured to reedfty identifiable features. Hidden defecls o~ encroachments may exist Ihal were not idenlibed ded~ the evaluatloa. The oparstionailife of all wefts and septic systems depend o~ a variety of variables haludlng, hut not limited lo, soil conditions, gmuedwater levels (that may fluciuste dedr~ the year), quality of const~alio~ (mstedsts and workmanship), and the water usage of lhe family utilizing the system/s. These conditions ca~ vary. and are oul~e the contel of GEG, Sedsfealo~/ test ~esshs do not guarantee fulure perfermance of Ihe system/s; lberefo[e, GEG makes ne warranty (express or implied) regaNin9 the refute peele[fan,ce of the waller septic system, GE6 makes no representation whether an altemedve wall or septic syalem car~ he inslalled o~ tfte properly ln the event either of the current syslems fail, The content of this reporl ia for the sale benefit of the person/pedy who retained GEG. Reliance upon the feformedon provided al Ires report by any alhe~ perso~ or party, including but nat lshft ed to subeequent property purchaser& is ~ot authorized. Ir~ shed, GEG disavows a~y regal duly to a~yone ether than the person/pady who paid rorthls report. 6. DSD SIGNATURE ~' System #1 Approved for System #2 Approved for Disapproved. Conditional approval for bedrooms. bedrooms. bedrooms, with the following stipulations..~ .-:-.~ ON-SITE ."~ WATER AND ~ WASTEWATER -6~ Ph:UGRAIVl .~/ Original Certificate Date: ~'-~Z ~/ By' ~,. t' The Municipality or Anchorage Develop,emt Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the represenatations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipafity of Anchorage is not responsible for eh'ors or omissions in the professional engineers work. 7. ATTCHMENTS: COSA Checklist ~ Nitrate Advisory / Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev. 10/12/12) 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 Description: A. WELL DATA Well type PRIVATE Date completed ~ 1989 (ASSUMED) Sanitary seal (Y/N)__ Total depth *65.8+ ff. Cased to **40+ ff. USS 3043; LOT 4 OF 11 Parcel ID: 075-092-34 *PER GE(; INSPECTION **ASSUMED BASED UPON WELL LOG (ATTACHED) IfA, B, or C provide PWSID# N/A Well Log (Y/N) NO Wires properly protected (Y/N) YES Casing height (above ground). 12+ in. Date of test Static water level Well producti(~n FROM WELL LOG AT INSPECTION NO WELL LOG 7/10//15 ~/~'~ ft. 65.4 ft. ~ g.p.m. 6+ g.p.m. WATER SAMPLE RESULTS: Coliform ~) colonies/100 mi. Arsenic~'~ ug./L. B. sEpTicIHOLDI'NG TANK DATA Tank Type/Material Tank size.__ gal. Foundation cleanout (Y/N) __ Nitrate0'''-~ rog.IL. Date of sample: 4./6./20 Number of Compartments Depression over tank (Y/N) __ Collected by: GE(;. Ltd. PUBLIC SEWER Date installed Cieanouts (Y/N) High Wato~ Date of pumping Pumper C. ABSORPTION FIELD DATA ~ Date installed _ Soil rating (g.p.d./ff~orff~bd~]=~ System type Length ft. Width. / ff. Gravel below pipe Total depth ft. Eft. absor~ ft2 Monitoring tube Depression over field__ Date of adequacy teSt ~Results (Pass/Fail) Fluid depth in~ before test in. Elapsed~: __ min. Final fluid depth ~l~y rejuvenation treatment (past 12 mo.) (Y/N & type) Water added __ gal. in. Absorption rate >= If yes, give date For bedrooms New depth in. g.p.d. D. LIFT STATION Date installed ,,Size in g~llons ~ ..-------------'-- ''Pump on" level at m. ~igh water alarm level at ~ ._------/~Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES in. SEPARATION DISTANCES FROM 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 On adjacent lots * Public sewer manhole/cleanout 100'+ Holding tank N/A Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line Absorption field Water main. Water service line Surface water on adjacent lots ~ , Wells SEPARATION DISTANCE FROM ABSORPTI~ TO: _ P'Ai:;e;rtsYe "rv~.~e lin e ~~~a~ storage C~raJ~ Wells on adjacent lots F. COMMENTS *AWWU SHOWS LOT 5 IS STUBBED FOR SEWER SERVICE BUT NOT AN ACTIVE CUSTOMER, NO DOCUMENTED SEPTIC ON LOT 5, BUT COULD HAVE A BOOTLEGGED SYSTEM. IN SHORT WELL ON LOT 4 S GREATER THAN 100' TO ALL NEIGHBORING SEPTIC'S, EXCEPT FOR POSSIBLY LOT 5 G. ENGINEER'S CERTIFICATION I cer~ifj~ that I have determined through fieldinspections 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 JEFFREY A. GARNESS Date (Rev. 11/05) --Portion~o~ --I-,- USS 3043 -- , S 58"04~09" E 90.25' A Portion of Lot i 1 USS 30t3 A Portion oI Let 11 Uss 3043 2nd Floor 0verhong T¢lcmark:~aY ~reve~ ..... ~ Woodframe House Fixed Awning A Portion of Lot 11 USS 3043 Record Serial Nm 2014-045g04-0, Anchorage Recording District ~55~00" W 90.45' IOTE: 1) Bearings and distances are as per Record Serial No. 2014-045204-0, Anchorage Recording District, and USS 3043. 2) Based upon o~her deeds associated with. Lot l:L, there appear ~o be General. Access Easements granted for these properties. At this time we were unable ~o tocate the documents associated with these easements. Far?o nC Land Services, LLC 5UI~,VEYING. MAPPING. LAND PLANNING. Gl5 "--~ ffarpom~K.com · (907) 522-7770 ~ su~ey~farpomta~com [21 Telemark~Way, APo_rtio~f_ _Lot ! L ~ecord Se~l No. 2014-045204-0, A.R.D. US S~ No. 3043~ Gkdwoo~ ~Mar. 27. 2015 SL ) RVFY CFRTJEICA TlC) 'l~l~ARP~lldu~-d a p~ysical survey of the subject property, the improvements situa~ed EXCLUSION NOTES: I~isthe owners tesponsibili~ to determine the existence 6fan¥ easements, covenants, or restrictions which ao no[ appear o~ the Piat used for this survey. NOTE: Under no circumstances should any data hereon be used for construction ~r for the establishing of property Irnes. LEGEND -'-Q~ Power Pole [] Utility Pedestal ~ Water Well t~) Sewer Cleenout LO)' lO C