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Home My WebLink AboutALPINE VILLAGE BLK 5 LT 13· GAAB-HD.I GR TER ANCHORAGE AREA BOROI.' 4 DI:r~FITMENT OF ENVIRONME~TAL QUALh ~ 3500 TUDOR ROAD ANCHOFIAGE, ALASKA 99§07 27g-8685 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: MAILING ADDRESS LEGAL DESCRIPTION DISTANCE FROM WELl --~-~'-'-'/ /, LIQUID CAPACITY /~" [~ ~' GALLONS. NUMBER OF / MATERIAL ('?~")i¢'J (".~': ~"~''~'' COMPARTMENTS ~.~Z---('g~/~) '- ~,/~."~'~/g.'~'=',~ LIQUID INSIDE LENGTH INSIDE WIDTH DEPT, SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS___ OUTSIDE DIAMETER OR WIDTH_ /3i t' ,,, , LENGTH ? 9 , DEPTH / '~' , LINING MATERIAL NEAREST LOT LINE__ -~'" '~ ~ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) , BUILDING FOUNDATION SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE NEAREST LOT LINE TRENCH WIDTH FOUNDATION D I,.,5.~E BETWEEN OF EACH SQ. FT. LENGT LIN E"'~ DEPTH OF FILTER MATERIAL BENEATH TILE TOTAL LENGTH OF LINES , IN. TOTAL EFFECTIVE IN. ABOVE TILE WELL: LOT LINE DISTANCES: TYPE /~L///,~~ "~, DEPTH NEAREST SEWER LINE DISTANCE FROM ., BUILDING FOUNDATION.. SEPTIC_~ / DIAGRAM OF SYSTEM WATER SAMPLE CESSPOOL NEAREST OTHER , SOURCES__ G.A.A.B. GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received 6/18/74 Time of Inspection d?~:~ REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR FHA 1. Approval requested by: Mailing Address: First Fed. Savings & Loan P. O. Box 4-2200 Phone: 2. Property Owner: same Phone: Mailing Address: 3. Legal Description: 4. Location: 5. same Lot 13, Block 5, Alpine Village Subd. 7505 Bern Street Type of facility to be inspected No. of bedrooms Well Data: A. Type C~-e~- ¢&'"~ ~,~;,,v ~:il~ngs B. Depth C. Construction ~~--/ D. Bacterial Analysis 7. Sewage Disposal System: A. Installed 1971 B. Installer C. Septic Tank: D. Seepage Pit: 1. Size /o-~oj~l~ 2. Manufacturer 1. Absorption Area 2. Material E. Disposal Field: Total length of lines Distances: A. Well to: Septic tank Nearest lot line ~'~ , Absorption area , Other contamination B. Foundation to septic tank /o ! Sewer Lines , Absorption area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - Re~...st for Approval of Individual Legal Description ~er & Water Facilities Comments Approved~~i~isapproved Date ~ 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. SIGNED Date EQ-034 (1/74) GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" St., Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES Type of Inspection: Property Owner: Mailing Address: Name of Buyer: CMRO VA FHA t~: CONV /~.~, ~O~c ~-/-2~u'~ Day Phone L7~- ~,5~./ ~TFZz.S~ ..... Mailing Address: Name of Lending Institution: Da.j/ Phone Mailing Address: Phone Name of Realtor or Agent: Mailing Address: Phone ~-7'7- ~, ~ Legal Description: Location: ~-P_~- Type of Facility to be inspected: W~t/mz/E~2-m~F 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 EQ-037 (1/74) LAN 'JSE P E R GREATER ANCHORAGE AREA BOROUGH · :- · POSt I N A CON S P I CUO.U$..;~P-E'A.'~ GRID DATE 2/pAE , 2, Mailing Xddres~~~~ Legal Descrip~ion - . 5. Street Address - 6, Description of ~ork ~E~ AI,TE~TIO~ ~D[TION OTRER 2, O~e of Ne~ Structure A, Res ident ia 1; ~ngle- Fa~t 1y~o-Famtly~ul~ t_F~y ~ccesso~y Building B. Conm~ercial: C. Industrial: D. Other: __Retail-Wholesale__Of£iee-Professional __Combination__Other Manufacturing Storage Processing I hereby affirm that the above information and that sub- mitted in application for this permit is true and correct to the best of my knowledge. I understand that this permit is issued on the basis of that informat~on and is subject to compliance with all pertinent codes a~ces of the Greater Anchorage ~ - ~' ~Signature ~f Applicant THIS PERMIT EXPI~S SIX MON~IS FROM DATE OF ISSUE ~LESS CONSTRUCTION, ~ Signature of Zoning Officer MUNICIPALITY OF ANCHORAGE Development Services Department T Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 014-132-22 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Expiration Date: 6 I — 10 — 20 ZO Complete legal description Alpine Village, Block 5, Lot 13 Location (site address) 7505 Bern Street Anchorage, AK Current property owner(s) Robert BoWlby Living Trust Day phone Mailing address Real estate agent 128 Buckingham Avenue Syracuse, NY 13210 Connie Giddings 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 907-257-0419 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 ❑i Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $_ 2-10 roul D Date of Payment -7 I � 5 I a� d Receipt Number,�� COSA # OS 2.O 1377_ 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone (907) 522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503 Engineer's Printed Name Michael E. Anderson, P.E. Date OF ;; • •• # ffi 49th 6. DSD SIGNATURE ®7I!r. , C' j" 10 System #1 Approved for bedrooms IMICHAEL E. ANDERSON t9 NO. CE -4385 System #2 Approved for bedrooms ®�®'F,•.,• Disapproved 44 ®0ao FES Conditional approval for bedrooms, with the following stipulations: -r%&l IT (l((frrrr Z_' o GYqAf k-1 CQ FR 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 blue sheet i Legal Description: Alpine Village, Block 5, Lot 13 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 1971 Total depth ft Cased to 45+* ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 19 in. Date of flow test for COSA 7/13/20 Static water level at beginning of test 45.3 ft. Comments *Based on Static Water Level at 45.3'. This Lot is on the Public Sewer Sytem. 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 This Lot is on the Public Sewer Sytem. D. ABSORPTION FIELD DATA 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 ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: Structure served by this system Well production at time of test 3.2 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Forge Engineering Date of Sample 7/14/20 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 Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES This Lot is on the Public Sewer Sytem. From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' NA Community Sewer Manhole/Cleanout > 100' Yes if No ft M Yes if No ft Neighboring Tank > 100' R� Yes if No ft Private Sewer/Septic Line > 25'✓l Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No NA ft Holding Tank > 100' 0 Yes if No ft Neighboring Absorption Fields > 100' Private Wells > 100' Animal Containment > 50' 0 Yes if No ft ✓� Yes if No ft Community Wells > 200' Fv Yes if No ft 701** Manure/Animal Excreta Storage > 100' if No Community Sewer Main > 75' ❑ Yes Jf No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) This Lot Is On the Public Sewer Sytem. Building Foundations > 10' ❑ Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5' ❑ Yes if No ft Wells on Adjacent Lots: ❑ Yes Absorption Field > 5' 0 Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10' ❑ Yes if No ft Community Wells > 200' Fv 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 distances if less than required) This Lot Is On the Public Sewer Sytem. Building Foundation > 10' El 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 ft Surface Water> 100' 0 Yes if No ft F. ENGINEER'S COMMENTS This Lot is on the Public Sewer System. **Well was in place prior to placement of AWWU Sewer. Separation distance assumed from measurements on surveyor as built and AWWU Grid Map. G. ENGINEER'S CERTIFICATION l certify that l 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. COSA Checklist yellow sheet OF q�\ ...... ' c� 8/7/20 +'•�C, ®'ROFESSr �� 6 q \ ;g7, 3& \ § 1. j0\ / 0) LU +m:\ ----------------- -—-- S \ Municipality ®f Anchorage P.O. Box 196650 ® 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program �1cnt, S Ur.parrmrnt x x x x VARIANCE/WAIVER REVIEW x x x x Waiver#: PID#: 014-132-22 COSA#:OSC201372 Permit#: Legal Description: ALPINE VILLAGE BILK 5 LT 13 Engineer: Forge engineering Your request for a waiver of the required 75 feet horizontal separation from the public sewer trunk to the private well has been approved. The approved separation distance is 70.0 feet. This waiver approval applies to the existing public sewer trunk only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted: Date: v Approved by: 4MLCk� - Name of Rev' er **** VARIAN C E/WAIVER REVIEW ****