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Home My WebLink AboutPOGGAS BLK 21 LT 14 Onsite File Poggas Block 21 Lot 14 #018 - 122 - 48 OAA8 HD-] G~-.~.'rER ANCHORAGE AREA BOROIJ-~H HEALTH DEPARTMENT 327 E~GLE ST. ANCHORAGE, ALASKA 99501 279-25! 1 iNSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME_ - LOCATION ADDRESS PHONE SEPTIC TANK: DISTANCE FROM WELL LIQUID CAPACITY /'/~)~' GALLONS. / .. -, .~. ~ ~--,,-~.~'~" NUMBER OF (... U YJ~-I'~~- I~z'. COMPARTMENTS_ MATERIAL_ INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: ~'~7 NUMBER OF PITS 2 OUTSIDE DIAMETER OR WIDTH_ , LENGTH ~ r' DEPTH ~-~ , LINING MATERIAl DISTANCE FROM WELL /~'~ "J-- BUILDING FOUNDATION NEAREST LOT LINE ~"~.O '~ ~ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) -.~--/~:~ SQ. FT. TILE DRAIN FIELD: TOTAL LENGTH F~UND'A~TI~N ~"~ ~ , NEAREST LOT LINE ,OF LINES DISTANCE FROM WELt / ~."'~'~'~'" ~ ....... ~-~,,,~., , ,~.~cc /' TRENCH W DTH ~ IN TOTAL EFFECTIVE NUMBER OF LINES ...... ' - ~ u,~,~o j, DEPTH: TOP OF TILE TO FINISH GRADE. LENGTH OF EACH LINE DEPTH OF FILTER MATERIAL BENEATH TILt. IN. ABOVE TILE DISTANCE FROM WATER WELL: TYPE"~it~(_~'l) DEPTH BUILDING FOUNDATION. : SAMPLE NEAREST NEAREST SEPTIC SEEPAGE OTHER LOT LINE , SEWER LINE ,TANK , SYSTEM CESSPOOl , SOURCES DISTANCES: DIAGRAM OF SYSTEM APPROVED GAAB-HD-2 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT GREATEL ANCHORAGE AREA HEALTH DEPARTMENT 3~7 Eagle St. Anchorage, Alaska 99501 279-2511 NAME OF APPUCANT ~/~ RESIDENCE ADDRESS LEGAL DESCRIPTION .Z~:~ 7~'?¢" ,~L//r" ,,J / APPLICATION TO INSTALL: SEPTIC TANK P/ ,SEEPAGE PIT TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH M A,L'NGAOORESS LOCATION OF INSTALLATION , DRAIN FIELD. PERCOLATION TEST RESULTS PHONE NO. / ,OTHER TO BE INSTALLED BY ANTICIPATED DATE OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS "~P~' ~'~/'/ "~'"~"~ , PERMIT TO INSTALL A ~ ~ '~ ' AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED ~~ SEPTIC TANK SIZE /~ .TYPE ~~SEEPAGE AREA ~TYPE ~~ " ' 'DIAGRAM OF SYSTE~~ ~~ DISTANCES: , I, U e u L- ,S~D /~'e~ - /~ / ealth Authority I c¢~tJt'y that l am £amJ]Ja~ with the ~equ~eme~ts o£ G~eate~ A~cho~age A~ea Borough O~dJ~a~ce No. 28-68 ~d that the aboYe described system Js i~ accordance with said code. DATE /~C/'~z/g) APPLICANTS SIONATURE ,/~_,/~-g' C~. [~//~ .~c .c~/~2.4f'-'''''~ X1 8 9 70 V 17 _. ,I. •6.— Municipality of Anchorage MAR V . On-Site Water and Wastewater Program < • r. (907) 343-7904 t2 $.2:15y�' Certificate of On-Site Systems Approval !! " a 6 8 L 9 c Parcel I.D. 018-122-48 Expiration Date: 2- 1. GENERAL INFORMATION Complete legal description POggaS Block 21 Lot 14 Location (site address) 13237 Venus Way Current Property owner(s) Jeremiah & Michelle Hamilton Day phone Mailing address 13237 Venus Way Anchorage, AK 99515 Real Estate Agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer 0 WaiverNariance request for: Distance: liik,,Received by: .l . ��1' �l�:.' 0 QC J- Date: 2 �� J COSA to be released to the engineer,unless otherwise request / by the engineer. COSA Fee $ 6c2 r' Waiver Fee $ Date of Payment 3/4/42 Date of Payment Receipt Number O/5 ) Receipt Number COSA# tod3/667 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 all wells and septic systems depend on the local soil condition,ground water levels that may fluctuate during 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. All systems eventually fail and satisfactory test results do 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 the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 3/1/2018 OF A`,akk st k 7 0*: 49 / 6. DSD SIGNATURE System #1 Approved for 5 bedrooms •:S�everi .• anriolie:•' System #2 Approved for bedrooms � q• CE-8149 i Disapproved Ik1"�°ROFESS40Nl• C Conditional approval for bedrooms, with the following stipulations: �`;( OF Atuc/• �0 ON PND N1 PS EW P-reg o 0 BY 1 1/\-- Original Certificate Date: -^z- ^i g 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 X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet r c If more than 1 septic system is on the lot: COSA Checklist# 1 of 1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: Poggas Block 21 Lot 14 Parcel ID:018-122-48 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) N Date completed 1966 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 87 ft. Cased to >40 ft. Casing height(above ground) 12 in. FROM WELL LOG AT INSPECTION Date of test UNK 2/20/2018 Static water level UNK ft 31 .5. ft Well production UNK gpm 3.5 g p m WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate ND mg/L Arsenic 10.1 ug/L Date of sample: 2/20/2018 Collected by: PES B. SEPTIC/HOLDING TANK DATA Tank Type/Material Date installed Tank size gal. Number of Compartments Cleanouts(Y/N) Foundation cleanout(Y/N) Depression over tank (Y/N) High water alarm (Y/N) Date of pumping Pumper C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ft2 or ft2/bdrm) System type Length ft. Width ft. Gravel below pipe ft. Total depth ft. Eff. absorption area ft2 Monitoring tube Depression over field Date of adequacy test Results(Pass/Fail) For bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot On adjacent lots 100+ Absorption field on lot On adjacent lots 100+ Public sewer main 75+ Public sewer man-hoolee/cleanout 100+ Sewer/septic service line 25+ Holding tank L J Animal containment areas 50+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line Absorption field Water main Water service line Surface water Wells on adjacent lots ABSORPTION FIELD ON LOT TO: Property line Building foundation Water main Water Service line Surface water Driveway, parking/vehicle storage Curtain drain Wells on adjacent lots F. COMMENTS Lot is served by AWWU public sewer. G. ENGINEER'S CERTIFICATION 7- nF A\�Z OF gCq�lIk I certify that I have determined through field inspections and /rr�CijP.• `) • '�.yfjI review of Municipal records that the above systems are in g*;49 /\ •.* conformance with MOA COSA guidelines in effect on this date. / 41b. , • •• 0 Steven Pannone •i• •/ Engineer's Printed Name i•••tleven '.•'arinorie: CE-8149 . / Date 3/1/2018 Th-v:-..N..' . COSA canary sheet_2-6-15.doc Municipality of Anchorage • Z<'{��,�o::��o Development Services Department �.7-. :4l5: :=: Building Safety Division T: E On-Site Water and Wastewater Program 4700 Elmore 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 181067 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 21, Lot 14 of Poggas Subdivision. This inspection revealed an arsenic concentration of 10.1 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.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. _S 89°57'22" E 186.27 \ ,,,, xY xx xx xx xx xx CHAS LINK FENS xx I \u sN g0 • DECK \ I l� ^ 4 Q 00 . QJN ° 310.., 96.2 9 \ - Ea SjN� '�� \s.,\9el z m L , 4. M CD co RgiyFtiOIly • �`\ W Y SL \'e \ o `0 `C ' \Y ey.\ N Z ' , ` _ �o \ DRIVEWAY Ry 1---- _ -AI' gym\ ,---- °WELL \ x `- i *. a \ \ •to,J .... ... o .... ... .... .... L .,., .. ,. .... .... ..i‘ CHAIN LINK FENCE 57 S 89°46 ' 16" E 250.61 _00000000 o�� °F-A�. °soo fvQ� p� .49 TH �� 7*V 054.04 // o . OO vi SHANE A.HOLT fAS—BUILT SURVEY 1" = 30' Oh",, % LS-6914 0`O p64, -......-.• a O NO CORNERS SET THIS DATE .A't /0ssi°naI, I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY %4Oo0Op00 OF THE FOLLOWING DESCRIBED PROPERTY LOT 14, BLOCK 21, POGGAS SUB. THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY ANCHORAGE PROVEMINT DIITUITE, ALASKA, AND THAT NHE TIEIPRE IRTYOLINESTS DINOAVID THEREON ARE MINTIN CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. EXIST OTHER THAN NOTED. EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOWN DATED AT ANCHORAGE,ALASKA THIS_16 TH_ DAY OF HEREON ( UNLESS INDICATED) FEBRUARY , 2018 NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAY 8E APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. HOLT LAND SURVEYING 9309 GROVER DRIVE ANCHORAGE,OX 99507 6398. FR 66-36. 144-13.SCAN 345-5513