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Home My WebLink AboutT12N R3W SEC 15 LT 69T12N R3W ec. 15 Lot 69 #015-053-05 uAAB -MIDI GR!'^TER ANCHORAGE ARIBA 14OKOU'�H HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM ne All !Jr_ SEPTIC TANK: NUMBER O DISTANCE FROM WELL �/ C G'. _MAT ER IAL_C� "Wji -- COMPARTMENTS_ / c �� .J -1,114 G= % LIQUID LIQUID CAPACITY_ Z- GALLONS. INSIDE LENGTH 41 -INSIDE WIDTH "- _DEPTH_ - SEEPAGE SYSTEM: SEEPAGE PH: — % NUMBER OF PITS ---L OUTSIDE DIAMETER_-- OR WIDTH I -�. LENGTHS_, DEPTH.—, �O LINING MATERIAL GGA -`'S - . DISTANCE FROM WELL-Z�U L" ,BUILDING FOUNDATIO FIT N re RFSi IM IINF c G) r __ _. TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA(_ ��` -� SQ. FT. TILE DRAIN FIELD TOTAL LENGTH DISTANCE FROM WELL , / _i\o UNDATION__ , NEAREST LOT LINE -- OF LINES_ NUMBER OF ES DISTANCE BTW FEN LINES— TRENCH WIDTH - — IN. TOTAL EFFECTIVE ABS PTION AREA- _ SQ. FT. LENGTH OF EACH L -.-1 DEPTH: TOP OF TILE TO FINISH GRADE_ _DEPTH OF FILTER MATERIAL BENEATH TILE OVE TILE DISTANCE FROM WATER WELL' TYPE✓L-L•�rt' DEPTH_. -,BUILDING FOUNDAITON.—"-SAMPLE NEAREST NEAREST SEPTIC SEEPAGE OTHER LOT LINE _, SEWER LINE ,TANK SYSTEM_ CESSPOOL_ SOURCES "--� DIAGRAM OF SYSTEM DISTANCES: =//1z ' .rte jq. 'Fj n `ll cYrt�r�,v DATE -�" �/� /� �� APPROVED._,f!!�'"�--—��—— GAA13-1111-=2 = ' GREATER \NC OR AGE AREA T 'IROUGH Case No/z�� nALTII DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 -- 279-2;i11 —� '� �N SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPLICANT. ILING ADDRESS RESIDENCE ADDRESS / —_ LOC TION OF INSTALLATIO —LEGAL DESCRIPTION. 1�_,-_7. --L� APPLICATION 'TOINSTALL: SEPTIC TANK TO SERVE THE FOLLOWI FINANCED THROUGH PERCOLATION TEST RESULTS THIS IS TO SERVE 1'1�(Z SEPTIC TANK SIZE " TYPE F., C4t.�74 E PIT_ ✓ , GRAIN FIELD TO BE INSTALLED BY ANTICIPATED DATE OF COMPLETION SEEPAGE AREA DIAGRAM OF SYSTEM PHONE NO._ OTHER HEALTH AUTHORITY OR LICENSED DESIGNER I certify that: I am familiar with the requirements of Greater Anchorage, Area Dor igji Orgipanc � 28 8 and that the above described system is in accordance with said code. 3 %2 YtL DATE L _ APPLICANTS SIGNA RF.._ ------ REATL'R ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT 327 EAGLE STREET ANCHORAGE, ALASKA 99501 Performed for Legal DescripYi.on��ot Bl ck� Si: This Form Repor.�ts a: Soils Log��Ww Depth i'eet Soil Characteristics �w �, rr Cr Df Y•p<�c- `�hr sedZry>eni Q011+C,Ci5 Gre BrrciiY The Sw �IOS PPI'G FIC C�i Cj 4 J _ SL CASE =1 Date Performed�� ,`�a n T Location Sketch Was Ground Water Encountered?_ r1 AP If: Yes, At What Dopth ..� .m Reading Date Gross Time Net Time Depth To B2Os Net Drop erco a ion a e i'PT" pr-----.-m-�b•n ..� .m Proposed Installattio i�"Seepage Pit Drain field Depth Of Inlet De th To Bottom Of Pit Or COMMENTS: ( rench�Y js1 ii __ - w2,",�..L�L,.f�(,L.._.-7.a Test Performed By; Data Certified By C1 /,,1, 7 livcZz !l I CtiCA,4r July 7.7, 1972 Alaska Regal Lstate 117 !dost northern Lights Anchuruge, Alaska 99SCJ Subject: Lot: 6D, Section 15, i12M. Rail C.1i. Spahnholz Property Dear Sir: The inspection of July 24, 1972 revealed that the daylight gravity feed drain had bean installed with the subject property well, and the well now serves the Spohnbul z property only. it physical disconnection of the water line survinq 'Lie neighbor was made. A water sample previously taken from the well proved to be satisfactory. The well and sewage sysLuw serving; the subject property is now approved. If yqu have ally questions regarding the above, please Collt,,t this office. Sincerely, Lynn Coad Sanitarian II nib GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3500 'Tudor Road, Anchorage, Alaska 99507 27986886% / Date Reeoived G /_ Lo ( Time of Inspection �0 Date of Inspection HgUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR /A I.. Aoproval Requested By:__ (,U Address: as, mu6 2. Prooert:v Owner: (x(T 3. Legal Description:�a�B-L Nthera('S 1� Phone: Phone: J751� 4. Location: ! % 0/ •i "oma 3 'OS) 5. Type of Facility to be Inspected: Number of Badrooms: ._._,��_ 6. Well Data: , A, Tvpe L(/ B. Depth,._ D. Bacterial Anal sis C. Construction^l�� + /h/ Y• 7. Sewage Disposal System: (�<<�d/'✓s'v�'��5;��1:—//�C A. Installed / B. InstaIJ.er. C. Septic Tank: l., Size_2. Manufacturer .� ��L'j �J ) /(_V ; 0 D. Seepage Pit: l.. Size%��12. Materials E. Disposal Field: Total. Length of Lines-_______ B. Distances: A, Wall To: Septic Tank ai Absorption AreaSewer Lines Nearest Lot Line;...�� T; Other Contamination�� B. Foundation to Septic Tank / C Absorption Area C. Absorption Area to Nearest Lot Line 0-(/y,7• — W Q gni AA, Request for Approval of Inuividual Sewer S Water Fa""e Page Two / ) 9. Comments: c' ] % I�u-' .� ._: _1. �LSa�c X0,1 ✓'''%�l AN Apnroved �. Disapproved /"/ � l%r:,: i ate Q Approval Valid for One Year From Date Signed Greater Anchorage Area Borouqh, 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 subiect sewer and water facilities located at: 7�1 June 30, 197? Alt€5ice; Roal t:state 117 most Ctorthorn Lights Etvei. C.W.Anchorage, Alaska 99503 Subj PW Lot 651 Section 15, TIM RUI Spohaholz Property Door sir. An inspection Of the au►rAct protOKY rev€rn' 0d that the ednt'i aas iocated in a rail:. The wall is also serving a neighbor. The noir?hbor's, sewcr system i$ they closest systole to the Wolf. Froo the well to tho noi;hbor's SuPtic tank M distance; is 3 feet; from the w0l to their seePn,te pit it Is 101 Ott. The sewer system serving the s€ bject property is approved by this 0 partwent and was functioning satisfactorily on the date; of the inspoction„ June 27, 1972. Before approval for thy: wotor systvt€ cogld be „iven a daylioht gravity feed drain would reed to be installed with the well pit. The W611 could be sapproved for a single family dweallinq only. if you have any quQstions rc:t}ardinfr the wove, please: do not hesitate to contact this office. si nc,arely. Lynn Coed Environmontal Specialist, h i0 ecl C. 4. spohnholx VA Mationai Unk of Alask€i • • BG'` •t Municipality of Anchorage On-Site Water and Wastewater Program y, , (907) 343-7904 SA ETY CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 015-053-05 Expiration Date: 7- 7—( 1. GENERAL INFORMATION Complete legal description T12N R3W SEC 15 LOT 69 Location (site address) 9630 JUPITER DRIVE,ANCHORGE,AK 99507 Current Property owner(s) JACOB &BONNIE GURNEY Day phone Mailing address 9630 JUPITER DRIVE,ANCHORGE,AK 99507 Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 2 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual Individual Well ® Holding Tank ❑ Individual Water Storage ❑ Community ❑ Community Class C Well ® Public Sewer ❑ Public Water System ❑ WaiverNariance request for: Distance: Received by: Date: /iS/e �� engineer. COSA to be released • theme_ eer,unless otherwise requested by the ngrn COSA Fee $ 524, Waiver Fee $ Date of Payment 21131a Date of Payment Receipt Number 650/1-) Receipt Number COSA# 1 v1 /a 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 8/7/2018 THIS COSA DOCUMENT CANNOT BE USED TO TRANSFER TITLE UNLESS ALL VENDORS(ENGINEERING,SURVEYING,CONTRACTORS,ETC...ASSOCIATED WITH THIS COSA ARE PAID IN FULL AT OR BEFORE CLOSING. Engineer's 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 absorption rates may change due to subsurface conditions that may not be observed from the surface,changes inland use, local soil 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. APRs. OF4 � Ar ( )S{ 6. DSD SIGNATURE * A 9TH ;\ System#1 Approved for 2_ bedrooms. �- i � t�l\1;ETH 1. � / System#2 Approved for bedrooms. Disapproved. \ preopEss10 0'`' \ `"gb:411.- Conditional approval for bedrooms, with the following stipulations: STEW By: ( �� l /� - 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 blue sheet_10.1 a12.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: T12N R3W SEC 15 LOT 69 Parcel ID: 015.053-05 A. WELL DATA Well type PRVT-CLASS C If A, B, or C provide PWSID#_ Well Log (Y/N) N Date completed Sanitary seal (Y/N) Wires properly protected (Y/N) Y Total depth _ ft. Cased to ft. Casing height (above ground) 24+ in. FROM WELL LOG AT INSPECTION Date of test 7/28/2018 Static water level ft. 199 ft. Well production g.p.m. 5.17 g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate Di f/! mg/L Arsenic: N0 ug/L Date of sample: 7/27/2018 Collected by: ARCTERRA B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic I Concrete Date installed 8/13/1970 Tank size 750 gal. Number of Compartments 1 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y(inside foundation) Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 7/27/2018 Pumper ONE STOP C. ABSORPTION FIELD DATA Date installed 8/1311970. Soil rating (g.p.d./ft2 i or ft2/bdrm) 158 System type Seepage Pit Length 21 ft. Width 13 ft. Gravel below pipe 9 ft. Total depth 13.5 ft. Eff. absorption area 612 ft2 Monitoring tube Y Depression over field N Date of adequacy test 7/28/2018 Results (Pass/Fail) PASS For 2 bedrooms Fluid depth in absorption field before test 23 in. Water added 350 gal. New depth 33 in. Elapsed Time: 1380 min. Final fluid depth 23 in. Absorption rate >= 300+g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) N If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm &circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ _ On adjacent lots 100'+ _ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 100'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+_ 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'+ 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 50'+(NONE KNOWN) Wells on adjacent lots 100'+ F. COMMENTS Private/Class C well serves Lot 69&68. G. ENGINEER'S CERTIFICATION I certify that I 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. -41.-+ : °r ALS 1 Engineer's Printed Name KENNETH M.DUFFUS � r� Date 8/712018 * 4 • TH „lima * �'�_ COSA canary sheet_2-6-15.doc / t KENNET vS 71 1;\ / hbFI;ssto141- ' ,� Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 pP 4.gg U 6 SA E T Y CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-053-05 COSA # ®SC I a C Pa7- Expiration Date: 1. GENERAL INFORMATION Complete legal description T12N R3W SEC15 LOT 69 Location (site address) - 9630 TUPITER AVENUE ANCHORAGE AK 99516 Current Property owner(s)JACOB GURNEY Day phone Mailing address 9630 JUPITER AVENUE ANCHORAGE AK 99516 Lending agency Day phone Mailing address _ Real Estate Agent Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 2 Day phone 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER -D Individual Well 1:1 Individual Water Storage ❑ Community Class C Well Public Water System Individual On-site Individual Holding Tank Community On-site F] Public Sewer The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. 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 06/15/2012 Engineer's 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 absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil 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 futureAt occupants or can ArcTerra guarantee that no unseen Ar encroachments, deficiencies or discrepancies exist. t� a d 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Ili))) -I tit III )SN Maintenance Agreements Supplemental Engineer's Report Other_ By: / Original Certificate Date: (0 ' -Z (Rev. 11/05) Municipality of Anchorage Development Services Department ° Building Safety Division < On -Site Water & Wastewater Program s ^ F 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: T12NR3W SEC15, LOT 69 Parcel ID: 015-053-05 A. WELL DATA Well type C If A, B, or C provide PWSID #_ Well Log (Y/N) Date completed Sanitary seal (Y/N) Wires properly protected (Y/N) Total depth _ft. Cased to _ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft, ft Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100mL Nitrate ND mg/L Arsenic: ND (11/30/11) mg/l Date of sample: 6/8/12 Collected by: ArcTerra B. SEPTIC/HOLDING TANK DATA Tank Type/Material Concrete Date installed 8/13/1 970 Tank size 750 gal. Number of Compartments 1 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (YIN) N High water alarm (Y/N) N Date of pumping 2012 Pumper A+ C. ABSORPTION FIELD DATA Date installed 8 3 970 Soil rating (g.p.d./fe or ft2/bdrm)158 fe/bdrm System type Seepage Pit Length 21 ft. Width 13 ft. Gravel below pipe 9 ft. Total depth 13.5 ft. Eff. absorption area 612 ft2 Monitoring tube Y Depression over field N Date of adequacy test 6/11/2012 Results (Pass/Fail) Pass For 2 bedrooms Fluid depth in absorption field before test 29 in. Water added 380 gal. New depth 33 In. Elapsed Time: 1245 min. Final fluid depth 29 in. Absorption rate >= 300+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at _in. "Pump off' level at _in. High water alarm level at in. Datum E. SEPARATION DISTANCES Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 150'+ Absorption field on lot 1501+ On adjacent lots 1501+ On adjacent lots 1501+ Public sewer main 2001+ Public sewer manhole/cleanout 2001+ Sewer /septic service line 2001+ Holding tank Y001+ Animal containment areas 1501+ Manure/animal excrete storage areas 150'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 51+ Absorption field 51+ Water main 101+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 2001+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 1(Y+ Water main 10'+ Water Service line 301+ Surface water 1001+ Driveway, parking/vehicle storage 10'+ Curtain drain. 50'+ (None Known). Wells on adjacent lots 100'+ F. COMMENTS Class C well serves both Lot 69 and Lot 68 to north G. ENGINEER'S CERTIFICATION I certify that I 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 06/15/2012 COSA Fee $490.00 Waiver Fee $ _ Date of Payment Date of Payment Receipt Number_ 62 S /) Receipt Number (Rev. 11/05) WO =S C- N D z g m z ro 6 Q 9v gc�— C a s ® z Nim N �e�nv i t° Go �z30,= o g DmAv�Zmg.H{�� m 2 Z �A A = y i m O z m m x ® m ®NA�o0m00�g]�-'m Z- y Z 000glry o QQO M m O O ZipOo�n = v rri 'n ril n Cis �ZR�t�*�--1go m � D §4 -04 o o R�'1 0 9 0 o0 50' BLM ROAD RESERVATION o o JUPITER STREET STOWE i,2 26.0' I 9 0 o0 50' BLM ROAD RESERVATION o o JUPITER STREET �Q i I 0 mz 71.0• 26.0' • I I z I I �r N O Z> X IPD p.r 22.0' o r u w n I I rrl 37.7' 3.0' • S i I L il 6 N Zz N o JC n I v _ Z(n T 7.7' 20.0'S Z Z ®m Z Q 0 ;u N i o 0)w Oo ry 17P� z OD 44 m -i DFri N x 0 o r, W x i Q OO iXX' 11 z M v 0. C-.0) 01 W a Cfl Z �7 > m Dv cn A R1 2 u 9 0 o0 50' BLM ROAD RESERVATION o o JUPITER STREET