HomeMy WebLinkAboutHOPP LT 2'Hopp
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MINIMUM DISTFINCE BETWEEN FI WELL. FIND FIN"r' ON-SITE SEWAGE DISPOSAL SYSTEM IS
±CICl FEET FOR R PR IVRTE WELL; OR
::L5P'I 'FO 2'.~}0 FEET FROM FI PUBLIC WELL DEPENDING UPON THE T'¢PE OF PUBLIC WELL..
WELL LOGS F:IRE REQUIRED FIN[) MUST 8E RETURNED TO THE DEPFIRTMENT WITHIN 3:E.~ DFI"r'S
OF' ]'HE WELL COMPLETION.
OTHER REQUIREMENTS MR"r' FIPPL"r'. SPECIFICFITIONS F'/ND CONSTRUCTION DIFIGRFIMS RRE
FI'v'FIILFIBLE TO INSURE PROPER INSTFILLFITION.
I CERTIF'¢ THFI'F
Hz:,
.... N-".:, I FPS
1: I FIM FFIMILIFIR WITH THE RE']!JIREMENTS F-IF.' ¢' "' SEWERS laN[:, WELLS """" SET
.... OF' RNCHnF.'RGE
F-"CRTH B'¢ THE M!JNII_,IFHLIT"r' - .
<: I WILL INSTFILL THE ..-,~--FE£1 IN FICCOR[:'FINCE WITH THE CODES.
S I GNED: ............
FIPPL. I~NT BERNFIRE.~HOPF
PLEASE
UAT ER WELL
FO'ED
STAPLE OR TAPE
~ ~,,~,,q,P-,~*mrrv OF ANCHORAGE
DEPT. ~FiH~/~T~r~'it ~uml)er
ENVIRONMENTAL pF. OTECTION
[F C0C^T'DH Or WELL I 0'.NE~ N0.
STATE OF ALASKA
)EPARTM£NT OF NATUP~L R£SOURC[S
S~[eet Address and Area of Well Location
~ STATIC ~ATER LEVEL: ~d ft. ~a~ve ~" land surface
~ft. after / hrs. pumping /~ ,9.P.m.
II ~LL HEAD COMPLETION: /
~ln Approved Pit ss Adapter ~ 12" A~ve Grade
12 GROUTING: ~eJJ Grouted: ~Yel
~aterial: ~Neat Cern[ ~ Other:
SANITARY, ~~~ ~ l~ PUHP: (If available)
Nearest Source of ont.mJnatlon Length of grop Pipe ~[. capacity
Feet .,plrect ion Yyp' Typ': ~,sl~le ~ Other:
This ~11 was drilled under my jurisdiction and this report Is true to the best of my knowledge and beile[:
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December 29, 1978
9780628
Bernard Hopp
6850 Tondi Lane
Anchorage~ Alaska 99507
Subject: Lot 2 Hopp Subdivision
A permit issued by this department for well and/or
sewer system has expired.
Permits are issued on a calendar year basis, as stated
on the permit, by authority of Municipal ordinance.
If you have drilled the well, a well log should be
sent to this department to document the installation
date.
If there are any further questions, please contact
this office at 264-4720.
Sincerely,
Les N. Buchholz, R.S.
Senior Environmental Specialist
LNB/ljw
copy of permit
® Municipality of Anchorage z��
z 1 z
On -Site Water and Wastewater ProgramNCR
(907)1343-7904, S A E T Y
Certificate of On -Site Systems Approval
Parcel I.D.�41-091-19 Expiration Date:..
1. GENERAL INFORMATION:
Complete legal description HOPP' LOT 2
Location (site address) 6820 Tondi Lane *Anchorage
Current Property owner(s) Linda Hopp ` Day phone 351-5399
Mailing address
Real Estate Agent Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual' Well ® Individual
Individual Water Storage ❑ Holding Tank
Community Class Well ❑ Community
Public Water System ❑ Public Sewer
WaiverNariance request for: Distance:
Received by: Dater
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee Waiver fee $
Date of Payment J i"�ai� Date of Payment
Receipt Number Receipt Number
COSA # V_`� (' ;',t o j D �? 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: Garness Engineering 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: 0
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.
#AECC884
6. DSD SIGNATURE
System #1 Approved for bedrooms
System #2 Approved for bedrooms ``�`� tOF f ff,�r�i
Disapproved
Conditional approval for bedrooms, with t o I �NDSujPV s.
gy: Original Certificate Date: �C
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
E
Legal Description: HOPP; LOT 2
If more than 1 septic system on lot: COSA Checklist # 1 of 1
A. WELL DATA
Al Well log is filed with Onsite (or attached)
Date drilled 12110/78
Total depth 104 ft
Cased to 104 ft
❑ Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ground) 12+ in.
Date of flow test for COSA 3/6/20
Static water level at beginning of test 32.6 ft.
Comments
B. TANK DATA
Age of tank(s) years
Tank type/material
Measured operating fluid level in septic tank
❑ Standpipes/foundation cleanout per record drawing
Date of pumping
Parcel ID: 014-091-19
Structure served by this system 1
Well production at time of test 3.5+ gpm
Water storage tank volume N/A gallons
Wel isinfected for coliform test? F-1Yes FE] Nc
' Coliform bacteria is Negative
Nitrate mg/L Titrate less than MRL (ND)
Arsenic ug/L rsenic less than MRL (ND)
Collected by
Date of Sample 3/6/20
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed)
Adequacy test date
F-1ALL standpipes present per record drawing
Results ❑Pass For bedrooms
Total measured depth from grade ft (m
Fluid depth prior to test in
Measured depth to pipe invert from grade ft (min)
Water added gal
❑ N/A — pressurized field
New depth in
❑ Monitor tubes go to bottom o ffective. If not, state
Elapsed time min
depth into effective
❑ Code -required soil ver over field
Final fluid depth in
❑ System pres ed
Absorption rate gpd
(Required if cant for greater than 30 days prior to
Any rejuvenation treatment (past 12 months) _
date of t
G ons introduced gallons
If yes, enter date
mments/Deficiencies: AWWU SEWER
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'
NSA
Community Sewer Manhole/Cleanout > 100'
❑ Yes
if No ft
❑ Yes
if No ft
Neighboring Tank > 100' 0 Yes
if No ft
Private Sewer/Septic Line > 25' 0 Yes
if No ft
Absorption Field on Lot > 100' ❑ Yes
if No NSA ft
Holding Tank > 100' ❑✓ Yes
if No ft
Neighboring Absorption Fields > 100'
Yes
Animal Containment > 50' ✓❑ Yes
if No ft
❑✓ Yes
if No ft
❑ Yes
if No
ft
If septic tank is under driveway comment below
Manure/Animal Excreta Storage > 100'
—❑✓
Community Sewer Main > 75' ❑✓ Yes
if No ft
Yes
if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
❑ Yes
if No
ft
Surface Water > 100' s if No ft
Property Line > 5'
❑ Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5'
❑ Yes
if No
ft
Private Wel _ 100' ❑ Yes if No ft
Water Main > 10'
Yes
if No
ft
��vC unity Wells > 200' ❑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.,erstances if less than required)
Building Foundation > 10'
❑ Ye
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'
❑ Yes
if No
ft
Private Wells > 100' ❑ Yes if No ft
WA=eLine> 10'
❑ Yes
if No
ft
Community Wells > 200' ❑ Yes if No ft
r > 100'
❑ Yes
if No
ft
F. ENGINEER'S COMMENTS
AWWU SEWER
G. ENGINEER'S CERTIFICATION _� IF
I certifythat I have determined through field inspections and review Acl-)�-
4
��� 1 4
J p of Municipal records that the above systems are in conformance with *
MOA COSA guidelines in effect on this date. ��....:.....f.M. ..... .......:...
COSA Checklist yellow sheet
Qe'ff ey�A Gar. ess.
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Lot 1
S89059'30"E 139.92
f ` Chain link fence (typ)
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Neighbor's driveway
encroaches 0.7'±
24.0
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S89059'30"E 139.92
Lot 3
AW
:49th
:1�Y1
i : Elizabeth L Walatka ; ,Q s
�s� • • 80M - LS • Jc `,�
SCALE: 1"= 30' i 1*04'-
EASEMENTS OF RECORD, OTHER THAN
THOSE SHOWN ON THE RECORDED
PLAT ARE NOT SHOWN HEREON BE.
UNLESS OTHERWISE NOTED. _ FB 19-7, pg 54-55
-- 2.0 OH _.
r Asphalt
Driveway encroaches 0.4±
25
0
0
C) 614-1
ri
25
REVISED 12-05-10 Added well
J�f
AS-@ull..T NO CORNERS SET THIS DATE
1 hereby certify that I bane performed a Mortgagees inspection
of the fd(oAring described property: --LOT 2
HOPP SUBDIVISION
Anchorage Recording Pre ir:ct, Alaska, and that the
improvements situated thereon are within the property tines
and deo not overlap or encroach an the property lying
adjacent thereto, that no improvements on. the property lying
ad acent, thereto encroach on the premises in question and
that there aro no rcadvrays, transmission lines or other
visible easements on said property except as indicated
hemon.
Dated at Anckr=ge. Alaska
this Ist day a November , 2019.
FRED WALATKA & ASSOCIATES, L.L.C.
907-24S-4666 Engineers and Surveyors
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