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HomeMy WebLinkAboutALPINE VILLAGE BLK 2 LT 9 M ' NMWAU F1 F ANCHORAGE RAGE v� +.� 14 Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 014-132-09 1. GENERAL INFORMATION Complete legal description ALPINE VILLAGE BLOCK 2, LOT 9 Expiration Date: 9 —1 Location (site address) 7342 ZURICH STREET, ANCHORAGE, AK 99507 Current property owner(s) RONALD & SHELLY DALTON Day phone Mailing address Real estate agent 7342 ZURICH STREET. ANCHORAGE, AK 99507 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic ❑ Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Waiver Fee $ Date of Payment 7 Date of Payment Receipt Number �0 O ( Receipt Number COSA # 0 sc a f 1310 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 6/4/2021 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. 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, any estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & FWCS 1. 6. DSD SIGNATURE System #1 Approved for .� bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms meg.• 4ZLt 9 .•.:9:* ..:::��r! Ir Curtis Huffman ��f�`'sTF�• CE 18991 •������� ilIFoPROFESSIONt`�� bedrooms, with the following stipu%1QLW.((((((((((, P4-1TY pF'���i /J)))M )RyI Original Certificate Date: 67+ 1 lO 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 T T WRiA� D M . PROG� mf1ER .r /J)))M )RyI Original Certificate Date: 67+ 1 lO 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 Legal Description: ALPINE VILLAGES BLOCK 2 LOT 9 Parcel ID: 014-132-09 If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system _ A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled unknown Total depth 60'+ ft Cased to unknown ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 6/3/2021 Static water level at beginning of test 56 ft. Well production at time of test 6+ gpm Comments B. TANK DATA - NA Age of tank(s) _ years Tank type/material Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA - NA Which system tested (date installed) ❑ ALL standpipes present per record drawing Total measured depth from grade _ft (max) Measured depth to pipe invert from grade _ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® Nc ® Coliform bacteria is Negative Nitrate mg/L ® Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) WES Collected by t Date of Sample 6/3/2021 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date Results ❑ Pass For bedrooms Fluid depth prior to test in Water added gal New depth -in Elapsed time min ❑ Code -required soil cover over field Final fluid depth in ❑ System presoaked Absorption rate gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: F 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' ❑ Yes if No ft Wells on Adjacent Lots: Community Sewer Manhole/Cleanout > 100' ❑ Yes if No NA ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ❑ Yes if No NA ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' Surface Water > 100' ❑ Yes Animal Containment > 50' ® Yes if No ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No ft Surface Water > 100' ft ft ft ft ft ❑ Yes if No ft Property Line > 5' ❑ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑ Yes if No ft Private Wells > 100' ❑ Yes if No _ Water Main > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No _ Water Service Line > 10' ❑ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ❑ Yes 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 Water Service Line > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No Surface Water > 100' ❑ Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that l have determined through field inspections and review Awl of Municipal records that the above systems are in conformance ai�'•.''���� with MOA COSA guidelines in effect on this date. , . • •':� � .. .... ...........V j Curtis Huffman ;� CE 128991 ;P � .6110/21. P������ PROFESS1dN�•� M ft N C- 0 Cr 0 Ell -6 => 0 0 rQ 77 (D 0 — CL M Cr Cj a) -3 j -IN 0 o Q -,j > > ME SD CD 0 0 6o >,< > < M _0 -, 0 0 0 U (D 3 =) (n > 0 .r�, W, C Co m Cn ED :�o Lo -0 U) 00 M a s M U✓ 11 m ZCn :r X. 0 C: 0 :3 a t1i U C.(D CD < 0) 0;�-; SCD KID =1 rt a 0 (Dh OCD SN K , 0 -0 _0 0 0 -TI F. D -0 0 :3 CD -0 M CD 0 E: * :3 CO 0 CD CA CD CD M S 3— :3 CD :7 0- CD C 3 0- M Co M (�D m 0 :3 (D 0 0 CD =3 =r CD (n. (D 0 Comm C CD 0 D Q 3 : :3 ZT In 0 0 0 :3 o CL a 41 = 2--o 0-0 (D ­" K - 1 :1 E, n OO (D rl) C4 �- to CD 0 (D O rQ L4I :r E5'=r CD 0 � in— 5 (D (n :7 > < (D CD 1 O NO*07'00"W 72.50' 30' 10 UU!itv Easemer" CD n. 22.1 ' m x o CD ;s o F— > 0 Cn Co 0- NNII 0 Cn Qo 0 CD 0 (D 0 0 C: (D 0 0C) 13.4' C� 13.5' m xX. (D CD O CA CA 30' NO*07'00"W 72.50' Zurich Street r- CD 0 In 0 0. CD o CD r) In 0 _0 > 0 Cn p :�o 0 U✓ 0 :3 a t1i :7 > < (D CD 1 O NO*07'00"W 72.50' 30' 10 UU!itv Easemer" CD n. 22.1 ' m x o CD ;s o F— > 0 Cn Co 0- NNII 0 Cn Qo 0 CD 0 (D 0 0 C: (D 0 0C) 13.4' C� 13.5' m xX. (D CD O CA CA 30' NO*07'00"W 72.50' Zurich Street ' -"- INSPECTION APPOINTMENTS i DATE RECEIVED . '~tJ M E '~" ' TIME· TIME / DATE DATE ~ ~ ' DATE INSPECTOR IN P'~ ~ ' / S E(~'POJ~ / INSPECTOR/'% ....... MUNICIPALITY OF ANCHORAGE DEPT. OF HF. ALTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTL=F~I~Y~N/rENTAL p[~OTECTtON  825 L Street - Anchorage, Alaska 99501 JUL 3 0 1980 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 R EC El V E D REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES ' DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER I PHONE ~AI LING ADDRESS ' ' PROPERTY RESIDENT (If different from above) PHONE 2. BUYER- ~ PHONE MAI LING A"DDR ESS 3. LENDINg3 INSTITUTION PHONE MAI LING ADDRESS 4. REALTOR/AGENT ' ' PHONE' i5, LEGAL DESCRII~TIOI~I "STREET LOCATION ' 6. TYPE OF RESIDENCE SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF~BEDROOMS [] One [] Four [] Two [] Five ,J~ Three [] Six [] Other 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEI~I [~ INDIVI DuA'L/ON.SITE'** [] PUBLIC UTILITY ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach Icg if available.) K'~- 43 / .*YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON -SITE []PUBLIC UTILITY Connection Verified []Septic Tank or i--IHolding Tank Size: If Tank is homemade give dimensions: .[] ONE [] TWO 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: NUMBER OF BEDROOMS [] THREE [] FIVE [] FOUR [] SiX Absorption Area to nearest Lot Line [] OTHER Septic/Holding Tank Absorption Area ISewer Line Nearest Lot Line 5. COMMENTS DATE ~PPROVED FOR __~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED ~ 72-010 (Rev. 6/79) nicipality Anchorage 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M. SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION August 4, 1980 Jim Kim 100 East Fireweed Lane Anchorage, Alaska 99503 Subject: Lot 9 Block 2 Alpine Village Subdivision Approval for your individual sewer and water facilities cannot be granted until the following items have been completed: (2) (3) The water analysis report be delivered to this department from Chem Lab, 5633 B Street, for our review. The septic tank pumped with a receipt submitted to this department. The total number of gallons pumped need to be on the'receipt to verify the size of the tank. This will need to be verified by a registered engiDeer prior to submittal. An adequacy test be performed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this department for our review. If there are any further questions, please call this department at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: Ginger % Busy Bee Realty Mrs Ginger Cass~e~ Busy Bee Realty 1451 W 34th.A~e. Anchorage, Alaska 99503 Tobben Spurkland or DEPT. OF H~ALTH & 8155 Cranberry St. ENVIRONMENTAL p[~©'fECTIOIXi' Anchorage, Alaska 99502 Phone (907) 243-5302 AUG 6 1980 RECEI. ED Aug. J, 1980 Legal: Street Addrese: Re sidence: Water: Sewer: Dar · o f Te st: Test Procedure: ADEQUACY TEST Lot 9, Block 2, Alpine Village ..... 7342 ~urich, Anchorage, Alaska 99502 Double Wide Trailer On Site Well No Municipal Records. 1000 gal. tank ( from pump test ) Log Crib. Constructed 1970 July 31,~ 1980 System was inspected on July 18,1980. At that time the trailer was occupied, tank was full and very thick, not septic. Crib had 2~2 inch of water in it. On July 31 the crib was charged with 1500 gal of water. Water level rose to 24 inches. Approximately lOOOgal of sludge was removed from tank. 23 hours later the water level in the crib was checked. It was measured to be 13 inches. Apparent absorption rate 875 gal per 24 hour period.