HomeMy WebLinkAboutALPINE VILLAGE BLK 5 LT 11
COSA Checklist
Legal Description: Alpine Village; Block 5, Lot 11 Parcel ID: 014-132-17
If more than 1 septic system on lot::COSA Checklist # _of _ Structure served by this system_
A. WELL DATA Nowell on Lot 11
❑ Well log is filed with Onsite (or
Date drilled _
Total depth
Cased to .f
ta�F(ed) Well production at time of test WA gpm
Water storage tank volume gallons
Well disinfected for coliform test? ❑ Yes N No
0 Coliform bacteria is Negative
❑ Sanitary s Is functioning correctly
ElWir re properly protected
Nitrate mg/L 0 Nitrate less than MRL (ND)
Arsenic ug/L H Arsenic less than MRL (ND)
Wing height (above ground) in. Collected by GEG, LTD
Date of flow test for COSA N/A Date of Sample lorzarzo
Static water level at beginning,of test N/A ft.
Comments Former Class "C' Well on Lot 10 is now considered private -Well serves two homes (Lots 10 & 11)
B. TANK DATA Public Sewer
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 Public Sewer
Which system tested (date installed) _
❑ ALL standpipes present per record drawing
Total measured depth from grade ft x)
Measured depth to pipe invert from gr ft (min)
❑ N/A — pressurized field
❑ Monitor tubes go to bolt of effective. If not, state
depth into effective
❑ Code -require il cover over field
❑ System esoaked
vacant for greater than 30 days prior to
C. LIFT STATION
well was not inspected
❑ Required maintenance completed
Age lift station years
Lift station
tion material
Comments:
Adequacy test date _
Results ❑Pass For bedrooms
Fluid depth prior to test _ in
Water added _ gal
New depth _ in
Elapsed time _ min
Final fluid depth _ in
Absorption rate _ gpd
Any rejuvenation treatment (past 12 months)
� Gallons introduced _gallons It yes, enter date
Comments/Deficiencies:
COSA Checklist yellow sheet
SGS Ref.#
1205901001
Units
Method Container ID
Client Name
Gamess Engineering Group, Ltd (GEG)
Printed Date/Time
10/30/2020 15:06
Project Name/#
Alpine Village; B5, Ll I
Collected Date/Time
10/23/2020 14:45
Client Sample fl)
Alpine Village; B5, Ll l
Received Date/time
10/23/2020 16:04
Matrix
Drinking Water
Technical Director
Stephen C. Ede
Sample Remarks
P.e:nneter
Results LOQ
Units
Method Container ID
Allowable
Limits
Prep Analysis
Date Date Init
Metals by ICP/Ms
Ai"senie
ND 5.00
ug/L
EP200.8 B
(Q0)
10/26/20 10/30/20 DMM
Waters Department
Total Nitrate/Nitrite-N
ND 0.200
mg/L
SM214500NO3-F C
(<10)
10/28/20EWW
Microbiology Laboratory
E. Coli Negative 1 lOOmL SM219223B A 10/23/20 A.1,
Total Coliform Negative I IOOmL SM21 92238. A 10/23/20 A.L
Page 2 of 5
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It is the responsibility of the owner to determine '•'
the existence of any easements, covenants, or re- 09, �." K°•� O°+•K'N
strictions which do not appear on the recorded sub- fj `"',�'•156"
division plat. Under no circumstances should any 10%%, ........
data hereon be used for construction or for estab- TE���tas�aw,.s�i �s�����
lashing boundary or fence lines. The surveyor takes SHOWN OTi THE AFCOND'UTPUT, A•^••RE� O
re�onsibi,l ltv for the initial transaction only. SHOWN HEREON.
LOT BLOCK LEaEND
AL��NL� V�LGNU r'�%�' aMAU C"NORONfOT A..
1' rPLAT NO. -1 • �r eiieeeea,nro ✓�.('b'
ANCHORAGE RECORDING DISTRICT 13 Nw.rAcx {� IhKytx
EvA er mumu
nn.,nvnmA t ALASKA 99501
3s'f4Y dZ BY: SCALE:
33
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
~~ ~J.~/ Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Date Received
Approval requested by:
Mailing Address:
,/
7. Sewage Disposal System:-~7~-~-~-~--
A. Installed B. Installer
/,,2-~0 "/ ('Z~--~_,) Phone:
w~'~"~x..~..,~'~ P ho ne:
2. Property Owner:
Mailing Address: ZJ-~.j7 /~%~ ~
3. Legal DescriPtion: // ~_
4. Location: [ ~ ~?~ ~.
5. Type of facility to be inspected ~of bedrooms
6. Well Data: ~~~ ~)
A. Type ~~- h
C. Septic Tank: 1. Size
2. Manufacturer
D. Seepage Pit: 1. Absorption Area
2.~ Material
E. Disposal Field: Total length of lines
e
Distances:
A. Well to:
Septic tank
, Absorption area
, Sewer Lines .... ,
Nearest lot line
, Other contamination
B. Foundation to septic tank
C. Absorption area to nearest lot line
., Absorption area
EQ-034 (1/74) Page 1 of two pages
GREATER ANCHORAGE of Environmental AREA BOROUGH
Department Quality
3330 "C" St, Anchorage, Alaska 99503 - 274-4561
'
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
t. Type of Inspection:
2. Property Owner:
Mailing Address:
3. Name of Buyer:
4~
CMRO VA )< ~HA CONY
7 '4,7 Daj/ Phone
Mailing Address: Das Phone
Name~of Lending Institution: ~.
Mailing Address: o~&~- ~Y_9. ~q~- ~ . Phone
Name of Realtor or Agent: ...~ ~J~
Mailing AddresS: ~~S ~ Phone ~-77--~d%J--
Legal Description: /z .o-
Location: ~;~,.?r_.f ~/~('./~ ~'~J" d~., ,.~'~ ~ ,,JO.J__~ c:~x.~
Type of Facility to be inspected: "~Y--~ No. Bdrms, ~
Water Supply
Type of Supply:
Public Utility
Individual.
If Individual, number of dwellings presently served
If Individual, depth of well
Sewage Disposal System
Type of'System: Public Utility
Individual (on-site)
If Individual, date of installation
~ge 2of two pages - Request for Approval of Individual S~.~r & Water Facilities
Comments
Disapproved ~' ~~ Date ~P/~/~iz~
Approved
Approval Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
I certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
~ Date
EQ-034 (1/74)
August 19, 1974
Ste~n Realty
5304 Cope Street.
Anchorage, Alaska
99503
SUBJECT:
Sewer and w~ter Cactllttes on Lot 11, Block 5, Alptne Vtllage
Subdv.
Dear M~s. Stern:
Your request for approval of the sewer and water facilities on Lot ll, Block 5,
Alpine Village Subdivision has been processed by this Department.
The water system serving this lot cannot be approved for the following reasons:
l) The subject lot is using thew ell on Lot 10, Block 5 making this
Wall a Semi-public system which must meet semi-public distance
requirements of 80' to the tank and 120' to the seepage pit.
2) The sawer system on the subject lot {ll), of which there ts no
record, is located only 67' from this well.
3) Public sewer is not expected to be put into this area for at
least two (2) y~ars.
4) lhe drilling of an individual well on this lot and disconnecting
from the present water supply is not possible bedause another
well cannot meet the necessary dtstence requirements. The main
reason for thts is that the sever system on Lot lO is located in
the front of the lot and can only be 68' at the most from a
well to be located tn the front far carnet of Lot 11. The require-
ment ts 100'.
Unttl such ttme as publtc water or publlc sever ts available to thts area, thts
Department cannot approve the sever and water facilities,
The stgned affidavit from the owner of Lot 11, Mr. Robert Ferguson, was
cetved 8/12/74 and accepted by thts Department. Hr. Ferguson certified that
the extsttng sever system conststs of a seepage ptt (no stze glven) wtth a
depth of 8' and asepttc tank of approximately 1000 gallons,and certified
that the system was operating satisfactorily.
August lg, 1974
Stern Realty
Page 2
The water analys~s o1. the well betng used ts also satisfactory. Because
ot' these factors, thts Department ~11 allow the ex~sttng smmr and water
1.aclltttes to re, atn as they are unt~l such time as publlc sewer Js avail-
able to thts area.
If you have any questions, please do not hes~tato to eoneact th~s oCf~ce
at 274-4561.
St ncerely,
Oenlse C. Bashaw,
Environmental Control Offtcer ]!
DCB/ko
Enclosure: Water Sample Analysis Report
/
