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HomeMy WebLinkAboutT12N R3W SEC 27 LT 12Depadmentof~nvironmentalQucdffy "': ~'" ANCHORAGE AREA BORQU~H 350%'ru~',$r Roc~d -- Pouch 8-050 . , ~,LTH~-PER. ARTM~N~ r ' N.° 994 INSPECTION REpO'RT ON-SITE SEWAGE DISPOSAL sYSTEM SEPTIC TANK: MAILING ~ ADDRESS .~5'-b///~ ~/.~ PHONE.~/~'-~/' LEGAL DESCRIPTION 7~-'~-~-,/~/' ~'~4)~'~1 ~r~//'~, DISTANCE FROM WELL LIQUID CAPACITY. /~_4~-~') GALLONS. _ ,~/ ~NUMBER OF MATERiAL~,~-~,~?---- ~,-)/ ~r~ COMPARTMENTS / INSIDE LENGTH ~ INSIDE WIDTH / DEPTH~ SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS // OUTSIDE DIAMETER / OR WIDTH /'~-~..*~ LINING MATERIAl ,-'~////~/~(~ -- ~ "~/~,~,-~7~'~ . DISTANCE FROM WELl NEAREST LOT LINE ~'~) "'-~ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA] · LENGTH /~'<~ , DEPTH · BUILDING FOUNDATION ~'~ ~' SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL ~ATION NUMBER OF LINES /DISTANCE BETWEEN LINES AI~SORPTION AA~E~~ SQ. FT. LENGTH OF EACH LiNE H TOTAL LENGTH NEAREST L INE. , OF LINES IN. TOTAL EFFECTIVE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL: LOT LINE TYPE /~'/~/~c~ DEPTH /~/~ ' r/-~. r'7/~ NEAREST /: ~ SEPTIC · SEWER LINE TANK DISTANCE FROM / /_~_ WATER BUILDING FOUNDATION. /~) T SAMPLE ~/ /'~ / SEEPAGE ),¢ .. "; /--~)' , SYSTEM //~/ , CESSPOOl /~//~//~'/~/~ , SOURCE~''-/X~-~ DISTANCES: DATE DIAGRAM OF SYSTEM APPROVED GREA, ER ANCHORAGE Area BONuUgH /~ ANCHORAGE. ALASKA 99502 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT NAME OF APPLICANT INSTALLATION LOCATION . ,~ '~f~i"AD/]~ _l~.{~-~ - ~ ~/~7~?.~fq'g~,~.~ ~ 7 ~/~y ~ ~'[~'~ ~ a:[:~' / ~/~ . NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OP ANY SYSTEM WITHOUT FINAL INSPECTION BY THE MINIMUM DISTANCES, REQUIREMENT~ SEPTIC TANK , SEEPAGE PIT TO NeA}~EST LOT L]NE. DRAIN FIELD WATER MAIN TO SEPTIC TANK . DRAIN FIELD , DRAIN FIELD · SEEPAGE PIT ALSO CONSIDER AREA WELLS. · SEEPAGE PiT SEPTIC TANK·"~'5""~'~=-/ ., SEEPAGE PIT ,//~lv/~'} (' DRAIN FIELD TO RIVER, LAKE, STREAM. ~AST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB C~SS~LN!~_~.A~P.~OF EXCAVATION 5 FEET iNTO UNDISTU~B~IL. ~ INCH DIAMETER CAST IROn--PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. SEEPAGE AREA SIZE GRAVEL BACKFILL CONFORM TO BOR UGH F~EGULATIONS REGARDINg INSTALLATION. AND THAT THE ABOVE GRiSLiER ANCHORAGE AREA BOROUGH~.-~ DEPAR ~NT OF ENVIRONMENTAL QUAL! 3500 TUDOR ROAD ANCHORAGE, ALASKA 99502 CASE # Performed For ~--~/~/~x4F/ ~s~ Legal Description: Lot Block This Form Reports Soils-L-~g ~ Date Performed 1/-~_,7 Subdi vi sion ~o,k. (of- ~-~ %~-~r. Percolation Test Depth Feet Soil Water Encountered? /~/~ ~ If Yes, At What Depth? Reading Date Gross Time Net Time Depth to H20 Net Drop Minute Proposed Instai'lation: Seepage Pit Drain Field Depth Of Inlet Depth To Bottom Of Pit Or Trench~ Test Performed ~y, ~--~F'-~ ~ / 'Data Certified By~ / N Parcel I.D. 018-092-09 Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION: Expiration Date: Complete legal description T12N R3W SECTION 27; LOT 12 Location (site address) 13661 Mulligan Road *Anchorage 99516 -17 z( Current Property owner(s) John Reese Day phone 907-227-8688 Mailing address Real Estate Agent 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: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5Jr0 Date of Payment AF0 2 1 Receipt Number 00159 G COSA# QS G2,1 1057 - 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: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: r ( ' 7 i In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for —3 bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, OF J-, TH [./(/CE -79 3 o f e s sio 00\ 'Fo #AECC884 ON-SITE with the follo)8stiATE � W� 'HS;gNp m AST%WATER J .O S�\�,,� ��Jl)))r)))) 10' Original Certificate Date: 2--17— 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Legal Description: T12N R3W SECTION 27; LOT 12 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 **80.8+ ft Cased to UNKNOWN ft Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 1/27/21 Static water level at beginning of test 78.8 ft. Comments *PER OWNER **PER GEG WELL TEST B. TANK DATA Age of tank(s) 13 years Tank type/material ''-°"EE` Measured operating fluid level in septic tank 49" W Standpipes/foundation cleanout per record drawing Date of pumping 5/20/20 D. ABSORPTION FIELD DATA TRENCH Parcel ID: 018-092-09 Structure served by this system Well production at time of test 5+ gpm Water storage tank volume N/A gallons Z ell d.sinfected for coliform test? E] Yes Q No Coliform bacteria is Negative Nitrate ' `� mg/L ❑ Nitrate less than MRL (ND) Arsenic dIlyw_ ug/L MA senic less than MRL (ND) Collected by GEG, LTD. Date of Sample 1/27/21 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: N/A Which system tested (date installed) 9/12/07 Adequacy test date 1/27/21 Q ALL standpipes present per record drawing Results QPass For 3 bedrooms Total measured depth from grade 11.08 ft (max) Fluid depth prior to test 30 in Measured depth to pipe invert from grade 5.4 ft (min) Water added 608 gal ® N/A — pressurized field 45 New depth in © Monitor tubes go to bottom of effective. If not, state 120 depth into effective Elapsed time min Al Code -required soil cover over field Final fluid depth 36 in ❑ System presoaked Absorption rate 450+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) Gallons introduced N/A gallons If yes, enter date N/A Comments/Deficiencies: PIPE FOR RESERVE CRIB NOT FOUND - CONDITION UNKNOWN COSA Checklist yellow sheet NONE 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 Community Sewer Manhole/Cleanout > 100' ❑v Yes if No ft Q Yes if No ft Neighboring Tank > 100' 1✓ Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' F✓ Yes if No ft Holding Tank > 100' F✓ Yes if No ft Neighboring Absorption Fields > 100' Yes if No ft Water Main > 10' Animal Containment > 50' ✓� Yes if No ft F✓ Yes if No ft Yes if No ft Water Service Line > 10' F/71 Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway comment below Community Sewer Main > 75' F✓ Yes if No ft [Z] Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ✓� Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5'✓0 Yes Yes if No ft Wells on Adjacent Lots: F71 Absorption Field > 5' 7 Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10' ✓� Yes if No ft Community Wells > 200'✓❑ Yes if No ft Water Service Line > 10' F/71 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' 1(✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' Q Yes if No ft Wells on Adjacent Lots: Water Main > 10' F71 Yes if No ft Private Wells a 100' M Yes if No ft Water Service Line > 10' F,/� Yes if No ft Community Wells > 200'[]✓ Yes if No ft Surface Water > 100' FV -1 Yes if No ft F. ENGINEER'S COMMENTS *MET CODE AT TIME OF INSTALL G. ENGINEER'S CERTIFICATION / 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. 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