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HomeMy WebLinkAboutCALAIS BLK 2 LT 7Calais Block 2 Lot 7 #009-035-06 v P4G� _UGi • Municipality of Anchorage a On -Site Water and Wastewater Program (907) 343-7904 s , E r . TA CERTIFICATE OF ON-SITE SYSTEMS APPROVAL MAY 14 2015 Gretchen Stuller Parcel I.D. 009-035-06 Expiration Date: ) R - / 65_� 1. GENERAL INFORMATION Complete legal description CALAIS, BLOCK 2, LOT 7 Location (site address) 3005 EUREKA STREET, ANCHORAGE, AK 99503 Current Property owner(s) GARY ALLEN Day phone Mailing address Real Estate Agent 3005 EUREKA STREET#B, ANCHORAGE AK99503 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: Individual Well ❑ Individual Water Storage ❑ Community Class _ Well ❑ Public Water System ❑ Day phone TYPE OF WASTEWATER DISPOSAL: Individual ❑ Holding Tank ❑ Community ❑ Public Sewer Waiver/Variance.request for:� / Distance: Received by: -RJ- Date: _�— I%- / S COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ �S� Date of Payment S+ lil�rJ Receipt Number �y COSA# 050577 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. Name of Firm ARCTERRA CONSULTING, INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 5114/15 Engineers Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorptionratesmay change due to subsurface conditions that may not be observed from the surface, changes inland use, local sail characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen ` encroachments, deficiencies or discrepancies exist. / !f OF AL\ �*4TH 6. DSD SI NATURE ? IQM1iETH W DU r System #1 Approved for bedrooms. ,,,a ! System #2 Approved for bedrooms. + �n�` o �/r'40�i r'hbF'$�310Nh�' � Disapproved. Conditional approval for bedrooms, with the following stipulations: By: J Original Certificate Date: Theanis nchorage Development Services Division (DSD) issues Certificates of Onsite Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the Slate of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet-10-10-12.dw 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: CALAIS, BLOCK 2, LOT 7 Parcel ID: 009.035.06 A. WELL DATA Well type PRVT If A, B, or C provide PWSID # Date completed 1964 (CIRCA) Sanitary seal (Y/N) Y Total depth* UNKNOWN 45'+ ft. Cased to UNKNOWN ft. FROM WELL LOG Date of test Static water level Well production ft. 9— p.m- WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate NO mg/L Arsenic: 23.5 ug/L Date of sample: 012015 B. SEPTIC/HOLDING TANK DATA — PUBLIC SEWER Tank Type/Material Tank size _ gal. Number of Compartments Foundation cleanout (Y/N) Depression over tank (Y/N) Date of pumping C. ABSORPTION FIELD DATA Pumper Well Log (Y/N) N Wires properly protected (Y/N) Y Casing height (above ground) 18+ in. AT INSPECTION 51712015 ft. 9— p.m- Collected by: ARCTERRA Date installed Cleanouts(Y/N) High water alarm (Y/N) 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 ft 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 "Pump on" level at _ in. Datum E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot NA Size in gallons "Pump off" level at —in. Cycles tested Absorption field on lot NA Public sewer main 754 Sewer /septic service line 251+ Animal containment areas 504 SEPTIC/HOLDING TANK ON LOT TO: PUBLIC SEWER Building foundation Water main Property line _ Water service line Manhole/Access (Y/N) _ High water alarm levet at Meets alarm & circuit requirements? On adjacent lots NA On adjacent lots NA Public sewer manhole/cleanout 100'+ Holding tank NA Manure/animal excrete storage areas 1004 Absorption fiel Surface water Wells on adjacent lots ABSORPTION FIELD ON LOT TO: PUBLIC SEWER Property line Building foundation Water main Water Service line Curtain drain F. COMMENTS Surface water Wells on adjacent lots "ACOUSTIC WATER LEVEL WELL READINGS T045' FROM TOC Driveway, parking/vehicle storage G. ENGINEER'S CERTIFICATION 1 certify that t have determined through field inspections 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 KENNETH M. DUFFUS Date 05/14/2015 COSA canary sheet_2-6-15.doc AV %ar � ©F AL�� � 00,* 49, TH x�vn�mn iae eu� wz MM gnomo COH.II Hzm mvmmmyrz <mmimOn" O,zcmmw ag izCm�mm O p a� :EomN y Nl Z-0 mommz, O tiDTO y� ti K O T Z m T <D mU pmyA MH »Ci ...11llll z vo O m f.O c my o°pm Xypo yOa yyOmz MH LIM�yI1Y C m 2 A y� 2 mzO �c�N HH mpmz o9mOma m zNr� N O A n Z 0 < O n2C M.Z.m m2mam Z N amort F m Sy m, H g o p o v mm3m z mm ZZM8 m A OMy N , _ r N 2 m N"O m 20 Nz> oy i F3 W>M= 0==0 �n c)Sv A m mmz G; G) a m y li n D JC S 0 3 m V � m N 2 Oy'OmO �DOO My y � 2 m H m m >m3 3 A �nm o ro H m O 2 z m O G m m H mzinzz m � a a V1 aH In �Nc H N D ocx 2 < m H H Na• m m! 2 - m V A Q�ACC 2 Z O D nz• onn n m o m £ y MHT z_ z y O 2 T m O m c uli c { m X N 0 G oc Lr A N m O CC Q EUREKA STREET N 0008'34"W 71.00' Municipality of Anchorage Community Development Department = `fit {•� Development Services Division'p' 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 # 151221 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 2, Lot 7 of Calais Subdivision. This inspection revealed an arsenic concentration of 23.5 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.or onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. · MUNICIPALITY OF A~-t~;i~G~E MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH &  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIO[~VIP-ONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION SEP 2 8 1978 Telephone 264-4720 ~~~ ~ REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEW DIRECTIONS: Complete ail parts on page 1. Incomplete reques~ will not be processed. Please allow ten (10) days for processing. 1. PROPERTY~NER PHONE PROPERTY RESIDENT (If different from above) PHONE PHONE 2. BUYER ~,, MAILING ADDRESS 3. LENDING INSTITUTION PHONE MAI LING ADDRES~ ' J 4. REALTOR/AGENT PHONE MAI LIN G ADDR ESS IPTI STREET L. OCATi'Oi~ * -- 6. TYPE OF RESIDENCE ~t~SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROOMS [] One E~"'~Fou r [] Two [] Five [] Three [] Six [] Other 7. WATER SU,~,~Y [~' INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE** [~PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that d~te,,give well depth {attach log if available.) //~ ~;~ , ~¢ **If individual/on-site, give installation date If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR I NSPECTO R INSPECTOR DIRECTIONS: NUMBER OF BEDROOMS 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM [] INDIVI DUAL/ON -SITE I--] PUBLIC UTILITY Connection Verified E~Septic Tank or [] Holding Tank Size: If Tank is homemade give dimensions: [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SIX PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line Septic/Holding Tank IAbsorption Area Sewer Line [] OTHER INearest Lot Line 5. COMMENTS ~ APPROVED FOR BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) ~ DISAPPROVED ~/~/ DATE I BY (Tit'e LEGAL DESCRIPTION 72-010 (Rev. 3/78) '~'q':,.~ CE_ "A" STREET: 0 Z OLD SEWARD ~13_~ HWY