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Home My WebLink AboutEKLUTNA WEST LT 10GREA""~'"~ANCHORAGE AREA BORr~U'~ Department of Environmental Quality 3330 C Street ^nchorage, ^laska 90505 INSPECTION LOC^T,ON REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ADDRESS ~,/~t~ ~t~ ~'~ LEGAL DESCRIPTION ~(2"~ /0 SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH MANU FACTU REP ~TL~:Z C~ Sh~/ MATERIAL INSIDE WIDTH LIQUID DEPTH __ N MBER OF COMPARTMENTS .lIQUID CAPACITY J~O GALLONS. SEEPAGE PIT: NUMBER OF PITS / . DIAMETER LINING MATERIAL Z~' ~' CRIB SIZE: BUILDING FOUNDATION__ or WIDTH ! ~ LENGTH//~'/~. DEPTH DIAMETER <~/DEPTH ~ ~ DISTANCE FROM: WELL TOTAL EFFECTIVE NEAREST LOt LINE__ ABSORPTION AREA (WALL AREA). SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE BUILDING FOUNDATION __ CESSPOOL APPROVED CONSTRUCTION NEAREST LOT LINE OTHER SOURCES DISAPPROVED NEAREST SEWER LINE _ REMARKS DEPTH DISTANCE FROM: SEPTIC SEEPAGE TANK __ , SYSTEM DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: PIPE MATERIAL: LOT SLOPE: I"- 2.0 REMARKS: Form No. EQ-031 DATE f~//~f-[~.~APPROVED~ ~ ~ o TG 6 U, Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 s a Certificate of On -Site Systems Approval n 2 Parcel I.D. 051-062-47 Expiration Date: 1. GENERAL INFORMATION: Complete legal description EKLUTNA WEST LOT 10 Location (site address) 21434 Tina Street *Chugiak 99567 Current Property owner(s) Kevin Galbraith Day phone 727-3425 Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: ❑X Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class A Well © Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ .5 5 6) Date of Payment Receipt Number. 32 5G COSA# 0SCAI15311.1 Waiver Fee $ Date of Payment Receipt Number Waiver # 4qe 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: �3 I� -4-I-L[ 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 systemis: 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 System #1 Approved for __V bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, O r�`� O ! 7. % i .377 ,J Ffey A.Gei ness: 9• GE -795 Pro '•.U��...i��G SiOn& OJ #AECC884 Q`Q Ty, �/_1 with the followings ula\t* PN ER O NMI P RO By: Original Certificate Date: 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 Checklist Legal Description: EKLUTNA WEST; LOT 10 Parcel ID: 051-OG2-47 If more than I septic systern on lot: COSA Checklist # -of Structure served by this system A. WELL DATA [] Well log is filed with Onsite (or attached) Well production sdtime oftest _____gpm Date drilled Water storage tank vu|umo_gallons Total depth ft Well disinfected for coliform teat? Fl Yee FE No Cased toft . Fl Coliform bacteria is Negative El Sanitary seal is functioning correctly Nitna1emQ/L Nitrate less than MRL (ND) F]Wires are properly protected Arsenicug/L Arsenic less than MRL (ND) Casing height (above ground) in. Collected by Date offlow test for COSA Date ofSample Static water level at beginning of test _ft. Comments COMMUNITY WELL PWS|D#211431 B.TANK DATA Age oftank(s) 15 years Tanktype/mataria| SEPTI—TEE._ " Measured operating fluid level inseptic tank 51____ AStandpipes/foundation cleanout per recorddrawing Date cfpumping D.ABSORPTION FIELD DATA DEEP TRENCH Which system tested (date installed) 9/13/06 ALL standpipes present per record drawing 12 Total measured depth homgrade _,�.251t(max) G K8eaoureddepth topipe invert �omgrade_v.4 ft(min) FlNA\—preasurizedfie|d Monitor tubes gotobottom ofeffective. |fnot, state depth into effective____ ��Code-required soil cover over field ElSystem presoaked (Required ifvacant for greater than 3Odays prior to date of test) Gallons introduced N/A "a||uno Comments/Deficiencies: COSA Checklist yellow sheet C. LIFT STATION F�Required maintenance completed Age oflift station ____years Lift station material N/A 8/21/21Adequaoybaetda�� Results EJ Pass For 4 bedrooms Fluid depth prior totest 0 in Water added 710gal New depth 8in Elapsed time 0 min Final fluid depth U in Absorption rate 600+ gpd Any rejuvenation treatment (past 12months) wowe N/A If yes, enter date ____ From Private Well on Lot to: (Please enter distances if less than required or if community well) SepdcTank0-ift Station onLot >100' El Yes if No Community Sewer Manhole/Cleanout >1OU' MYea ifNoft Property Line >5' MYes ifNoft Neighboring Tank >1OO' 1771 Yes ifNoft Wells onAdjacent Lots: Private Sewer/Septic Line >25'[_]Yes ifNoft Absorption Field onLot >100' MYea ifNoft Private Wells >1OO' Holding Tonk>1OO' RYna ifNoft Neighboring Absorption Fields > 100' ifNoft ifNoft Animal Containment >5O' Yea ifNoft Yes ifNnft iyNoft ifNoft |fseptic tank iounder driveway comment below F.ENGINEER'S COMMENTS Manure/Animal Excreta Storage > 100' Community Sewer Main >75' [lYes ifNoft *MET C(l[lE AT TIME r] Yes ifNoft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations >1O' El Yes if No 51+ ft Surface VVuter>1O0' Yes ifNoft Property Line >5' P/1 Yes ifNoft ifNoft Wells onAdjacent Lots: Wells onAdjacent Lots: Absorption Field >6' Yes ifNoft ifNoft Private Wells >1OO' Yea ifNoft Water Main >1O' Yen ifNoft ifNoft Community Wells >2OO' Yea ifNoft Water Service Line >1U' Yes iyNoft ifNoft |fseptic tank iounder driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation >1O' Yeo ifNoft |fabsorption field iaunder driveway comment below Property Line >1O' Yeo ifNoft Wells onAdjacent Lots: Water Main >1O' 0You ifNoft Private Wells >1OU' Yeo ifNoft Water Service Line >1O' P'lYen ifNoft Community Wells >20O' nYes ifNoft Surface Water >1OO' r_V1Yeo ifNoft F.ENGINEER'S COMMENTS *MET C(l[lE AT TIME OF INSTALL / certify that / have detenninedthrough field inspections and review ofMunicipal records that the above xyoK*moare it) oo//f»/naoomwith COSA Checklist yellow sheet —79 #AECC884 on X1 8 9 70 77 •t Municipality of Anchorage MAY 6 1 20 �_ On-Site Water and Wastewater Program �,�� 2 (907) 343-7904 ,tf•E T Y of On-Site Systems Approval °L 6 9 L � Certificatey pp Parcel I.D. 051-062-47 Expiration Date: 05-- II 1. GENERAL INFORMATION: Complete legal description EKLUTNA WEST: LOT 10 Location (site address) 21434 Tina Street*Chugiak 99567 Current Property owner(s) Clinton Stapleton Day phone 306-6161 Mailing address Real Estate Agent Kaite Likkel Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 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: Date: l/ 5/17-/) �� `�- COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ ' Z(P — Waiver Fee $ Date of Payment 6(I le /i -7 Date of Payment Receipt Number d4;-CA' Receipt Number COSA# ( 5C- \-1 1\Z 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/Lc/ . oQ000p�ti In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system oQ OF AV in accordance with the guidelines and regulations established by the Municipality of Anchorage and K\'c•• ./SN industry practices. The reported results describe the condition of the system/s on the date/s of the p Q ' pA • evaluation. Separation distances were measured to readily identifiable features. Hidden defects or �� •-� V encroachments may exist that were not identified during the evaluation. The operational life of all wells �* 49 H ��' ,�*00 and septic systems depend upon a variety of variables, including but not limited to, soil conditions, �'1ag 0 groundwater levels (that may fluctuate during the year), quality of construction (materials andVA ✓ 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 0 •J ff . ness;• system/s; therefore, GEG makes no warranty(express or implied) regarding the future performance of dnhco • E_ 9 �Q5 the well or septic system. GEG makes no representation whether an alternative well or septic system UQ 9 — �p can be installed on the property in the event either of the current systems fail to perform adequately in 4p e, is•• cc°'o the future. The content of this report is for the sole benefit of the person/party that retained GEG to nd �o 4'.fessto perform the evaluation. Reliance upon the information provided in this report by any other person or Q party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE System #1 Approved for LI bedrooms System #2 Approved for bedrooms Disapproved \G\?! •Conditional approval for bedrooms, with the following tiIpulatig -vA rn 14 4 'NC m a RnCR 44 By: w,,, Original Certificate Date. J `� 7-1 7 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 blue sheet 10.10.12.dOC 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: EKLUTNA WEST LOT 10 Parcel ID: 051-062-47 A. WELL DATA Well type COMMUNITY If A, B, or C provide PWSID# 211431 Well Log (Y/N) Date completed Sanitary seal (Y/N) Wires properly protected (Y/N Total depth ft. Cased to ft. Casing height(ab. - •round) in. FROM WELL LOG AT I CTION Date of test Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RES Coliform colonies/100 ml. Nitrate mg./L. Collected by: enic. ug./L Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 9/12-13/06 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (IY/N) YES. Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping Si I S i T LPumper C. ABSORPTION FIELD DATA -BELOW EXISTING GRADE Date installed 9/12-13/06 Soil rating Cp.d/ 2or ftz/bdrm) 1.2 System type DEEP TRENCH Length 50 ft. Width 2.5 ft. Gravel below pipe 5.05 ft. Total depth '11.5+ ft. Eff. absorption area 500 ft' Monitoring tube YES Depression over field NO Date of adequacy test 5/11/17 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 849 gal. New depth 4 in. Elapsed Time 120 min. Final fluid depth 0 in Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date - D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) "Pump on" level at in. "Pump off' level at a er alarm level at in. • - _ •• Cycles tested Meets alarm &circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: COMMUNITY WELL Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main -•• sewer manhole/cleanout Sewer/septic service line Holding tank - . containment areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main _ 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS sem.,61,swas la i i 4 "_ f . G. ENGINEER'S CERTIFICATION `4,7 ... �••' �` �� Ø 1 certify that I have determined through field inspections and • Th /�� , • review of Municipal records that the above systems are in 1 •• conformance with MOA COSA guidelines in effect on this / • /i ; date. • ♦ Je•r. ( . • ss•;,w= Engineer's Printed Nam JEFFREY A. GARNESS ��GJJ.,,.. . C 795 • Date s/6--- I •'.. 6'�40FESS\o0+4 LICENSE ,III II%%wawa* NAECC884 (Rev 10112/12) r I .i\/ 82951 C / j:1l cry Lot 11 4,69073,moo, 301A, / 169 6 .74 Ia? N reii LOT10 ry v /Septic ven • . te14 / �r S"e 2. Sin r.A came / # -..,- 1 Se 1�0 s Kos 1. �� 0 _? 3y • . / ' Brevet Dthre i+er.SI # / N. (t / s o ry • 7s N. 1???,, `• / �a y?o/ �� C d / Lot 9 / _%%NAS%I / _�Q�`• OF /•••is, 1s RECERTIFIED 3-03-170/ ��• AS-BUILT HO COSET THIS DATE 48th► \ inspection I h that 1 haus MbrVsgee Po• •:,.h••• ••• ••• / of the*renins deaaihed OT 16. �a on EKI UTNA WEST SUBQMSION SCALE: 1"= 40' % ..Fred Walatka •.-.. .-: - •. - •. ' ' ' , ,� its situated thereon are within the property linea `��-1,.• 3255 – a ••• and do not overlap or encroach on the property lying 44 •• . . • • • • •' O y — adjacent thereto.that no improvements on the property lying ' � �1I' adjacent thereto encroach on the premises in question end + 1 SSh L`�4111. that(hare we no roadways,transmission lines or other 14 1‘‘..16%% vdaible easements on said properly except as Indicated hereon_ Dated at Anchorage.Alaska EASEMENTS OF RECORD,OTHER THAN this 2nd day of Fethrtuary .2006 THOSE SHOWN ON THE RECORDED FRED WALATHA&ASSOCIATES PLAT ARE NOT SHOWN HEREON. Fb 06-1.pg 37 Engineer'and Surveyors u BE (907-248-1666)