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Home My WebLink AboutTALL BIRCH BLK 1 LT 1ATall Bi ch Block Lot lA #011 - 084- 46 Pump Installation Los W~ll Drilling ?~rmit Nun:bar: SVff Da~e of Issue: parcel Identific,~don Number:, Property Owner Nme & Address: Pump Intake Depth BelowTop of Well Casing: /~P feet pump Siz~ ///3- hp Pit,ss :~dgptsr Installer: ~/e[t DisinfacZed ~pon (3om~Led.o~'7~fes ~/iethod ,~f Disinfection: INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM N.° 96zl NAME t~'-'/__-)/~/// LOCATION SEPTIC TANK: MAILING ADDRESS ~/-~'..~2 /~'~.,.~'~.~.:~%...~" PHONE DISTANCE PROM WELL/'~'~/,~:)~', //fid~ / LIQUID CAPACITY ,/'d~)~/fl GALLONS. NUMBER OF / MATERIAl,~-Fj-~/~-/J/'~('~- COMPARTMENTS INSIDE LENGTH INSIDE WIDTH ~ DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS /' OUTSIDE DIAMETER / OR WIDTH ~-~'~., LENGTH -~ , DEPTH NEAREST LOT LINF c::~Z]~) /-7~ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~'~ ~/~' / SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL . FOUNDATION_ , NEAREST LOT LINE NUMBER OF LINES ~LINES~ TRENCH WIDTH DEPTH: TOP OF TILE lO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILF TOTAL LENGTH , OF LINES IN. TOTA~L EFFECT~ IN. ABOVE TILE WELL:. LOT LINE TYPE ,~"~'/~-~-~ DEPTH ~.,~, / DISTANCE FROM WATER , BUILDING FOUNDATION /~ / SAMPLE ~( . NEAREST /~ /~ NEAREST SEPTIC ~/~- SEEPAGE~/~~ . SEWER LINE~ /~ OTHER ~/~ , TANK /~ / , SYSTEM /~ ~ , CESSPOOL ~, SOURCE~ DISTANCES: DIAGRAM OF SYSTEM ,XKz: ~,d~c :,~7 GRE~-A~ER ANCHORAGE AREA BO~UGH PERMIT NO.. ~¥ j{VI~ 3500 TUDOR ROAD POUCH 6-650 ANCHORAGE, ALASKA 99502 PHO.E3qV Ylo INSTALLATION OF: SEPTIC TANK ~ TYPE AND SIZE OF FACILITY TO BE SERVED ,!SEEPAGE Pit. ~ , DRAI~ FIELD -, OTHER NOT~= THIS PERMIT IS NOT VALID WITHOUT SOIL ~T WELL TO SEPTIC TANK .~"~'*O e SEPTIC TANK. ~--e . SEEPAGE P~T /r2~ ¢ TO R~VE,. LAK~. sme^~. . SEEPAGE PIt [ O0 ! ALSO CONS}DER ARea WELLS. . SEEPAGE PIT /~ ~' DRAIN FIELD CAST~IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP EXCAVATION 5 PEET INTO UNDISTURBED SOIL. 4 INCH D~METER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE piT FITTED WITH AIRTIGHT REMOVABLE CAPS. CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. SEEPAGE AREA SIZE TYPE DIAGRAM OF SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS Of GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO, 28-68 AND THAT THE ABOVE APPLICANT'S SIGNATURE ~ON', ~L DE, AI~q...~ENT OF r~v ~ ~r_~'~',, U 3500 TUDOR ROAD ANCHORAGE, ALASKA 99502 CASE Performed For John Lapeire Date Performed 9/27/71 Legal Description: Lot lA Block I Subdivision Tall B±rch This Form Reports Soils~g~x_ ~est Depth Feet Soil Characteri i ~ St C~ Gray and tan Clayey silt (CD) Gray silty sand (SM) with sand seams (SW) containing sandy silt pockets and lenses W~s Ground Water Encountered? nn _ If Yes, At What Depth? Reading Date Gross Time Net Time Percolation Rate Proposed Insta]'T~-T-on: Depth Of Inlet COMMENTS: Depth to H20 Minute' Seepage Pit × .Depth To Net Dror Drain Field Bottom Of Pit ~ Trench 235 square feet of drainage area i~ required ~r bedroom ~_izh th~ r~p o ¢ ~h~ crib at ~' depth. Test Performed By.. R. E. ~rlisle '-- ~;'~ified By:National Testing Svs. Da~e: 13, o67 s,¢, I hereby certify that I have surveyed the following described property, Lot lA stock I Addition T'ALL l~c~A GuF~.'D~ ~.~4cH~ . recording Precinct, Alaska, and. that improvemenls situated thereon are within the proper~y ]lnel* and :do not overlap et encroach on the properly lying adjacent thereto, that no Improvement~ on proper~ lying ad[acen~ theref9, A~chorege, t~ Aoc~ ,19'7t Rush Municipality of Anchorage Development Services Department Building Safety Division CERTIFICATE OF 0N-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION COSA# Expiration Date: [O -. 7 - ~) G Complete legal de. scription Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address TALL BIRCH SUBDIVISION; LOT lA, BLOCK 1 4440 RASPBERRY ROAD * ANCHORAGE, AK 99502 LAPEIRE FAMILY TRUST Day phone C/O MARY COX w/ REMAX PROPERTIES Day phone C/~ AGFNT MARY COX w./ RFMAX Dayphone 257-0165 110 W. 38th. SUITE 100 ; ANCHORAGE. AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBEROF BEDROOMS: 5 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site B Individual Holding tank Community On-site [~ 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 samples. (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 wastawater 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 invest/gat/on and inspection, the on-site water supply and/or wastewaler 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 CARNESS ENGINEERING CROUP. Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99~07 Engineer's Printed Name JEFFREY A. CARNESS. P.E. Phone 337-6t79 Engineer's Comments: In conducting this evaluation, GEG, LtD, a~lempted to provide a therough, · conscJentious enginendng analysis of the system in acc~dance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the Eme of the test, end separation distances measured to readily Ident#Table features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may flucfuate du~ing the year, and the water usage of the family being served by the system. These conditions are ~utside the control of the evaluater of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of bow long the system will continue to meet the operational requirements of tho ADEC or MOA DSD. The content of this report is for the sole benefit of tho owner listed above. Any reliance upon or use of this report by any . other perso.n or party is not autherfzed, nor willit confer any legal right whatsoever. 5. DSD SIGNATURE ~ Approved for .~ bedrooms. Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenanc~ Agreements Supplemental Engineer's Reort Other Original Certificate Date:, Municipality of Anchorage Development Sentlces Department On-Site Water & Wastewater Program 4700 Bmgaw Street P.O. Box 196850 Anchorage, AK gg519-6650 www.munLo~g/onsite (gO7) 343..7go4 CERTIFICATE OF ON-$1TF SYSTEPIS APPROVAL CHECKLIST Legal Oescdpaan: TALL BIRCH SUBDMSlONi LOT 1A~ BLOCK I A. WELL DATA Well type PmVA~ Date ~ompletep ~1971, Total depth 252 lt. If A, B, or C provide PVI/SID~ N/A Sonitmy seal (y/N) ~s ~te 4O+ lt. FROM WELL LOG Date of test ,/ Stetio water level / lt. Well predu~Uon ,.~/ g,p.m. WATER ~M~IPLE RE,SULT~: Well Log (Y~N) Wire8 pmpedy protected (Y/N) Casing height (above ground) AT INSPECTION / 3.4.+ g.p.m. NO A~enio: ~' ~UgJL. Date of ~ample: e/20/2005 Collected by: OEO, Ltd. D. SEPTIO/NOLDINOTANKOATA PUBLIC SEWER Tank Type/Material Date Instel~.....~ Tank .ize gal. Number of CompS/N) Found~~) ~k (Y/N) H~h water alan~ (Y/N) ..... Date Pumper C..aBSORPTION FIELD DATA PUBLIC SEWER Date installed Soil rating (g.p.dJft~x It~3dm~) System Leng~ f. Width It. Gravel below Total depth It. Eft. abso~ptlonarea It' M~g~~=~-'~_ ovm?ld ..... Fluid depth in before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. At)$orpUon rate >= g.p.d. Any mjuvenatkm I~atmant (past 12 mo.) (Y/N & type) If yes, give date LIFT STATION D, ate installed Sm ~ gallons ~ Pump on" level at in. "Pump off' le . High water alarm level at in. ~ Cycles tested, Meets alarm & circuit requirements?. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO:. Septic tank/IR station on lot H//A Absorption field on lot N/A Public sewer main 50+ Sewer/septic service line 25'+ Animal containment ames 50'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cteanoul Holding tank N/A Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: PUBLIC Building foundation Property line Absorption field Water main ~~~~qql~~~~~ Wells SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: PUBLIC SEWER SEWER Property line Building foundation Water main F. COMMENTS G. ENGINEER"~ CERTIFICATION I certify that I have datennined through field inspect/one and review of Municipal recoils that the above systems are/n conformance with MOA COS~ guldellnea in effect on this date. Engineer's Printed Name JEFFREY A. 0ARNE:~S Date ~ COSA Fee S .~-~'g ~ Data of Payment Receipt Number (~. 11~) Waiver Fee $ Data of Payment Receipt Number 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 xvxvw.rauni.org/onsite (907) 343-7904 Arsenic Advisory, Certificate of On-Site Systems Approval # 060290 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 1, Lot IA of Tall Birch Subdivision. This inspection revealed an arsenic concentration of 14.6 micrograms per liter (ug/L) for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Information on arsenic is available from the On-Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. SGS Environmental Services Inc 200 W. Potter Drive Anchorage, AK 99518 Tel: (907) 562-2343 Fax: (907) 561-5301 SGS Ref. #: 1063263 All dates~mes ere Alaska Standard Time Client Name: Gan'tess Engineering Group Printed Date/Time: 07/06/06 11:15 Project Name: Tall Birch, L1 lA, B1 Collected Date/Time: 06/20/06 11:05 Client Sample ID: Tall Birch, L1 lA, BI' Received Date/Time: (36/20/06 12:40 Matrix: Drinking Water Technical Director: Stephen,~de PVVSID Sample Remarks: Allowable Prep Analysis Parameter Results PQL Units Method Limits Date Date Init Bacteda 0.00 9222B .06/20/06 06/20/06 t~f Nitrate ND 0.10 mg/~g EPA 300.0 10.00 06/20106 06/20/06 air 'Arsenic 14.60 5.00 ug/L 200.8 10.00 06/22/06 06/26/06 mh Aarow Pump & Well Service, LLC P.o. Box 110496 Anchorage, AK 99511 office: (907) 348-9355 · Fax (907) 333-8976 Palmer:. (907) 745-9077 · Eagle River:. (907) 622-9335 CUSTOMER JOB SITE ~'-/~t ~'[4o1"~/'~'. Y~t~, fT~~ ~ QUA~ DESCRI~ION PRICE AMOU~ 1 I ~BOR HOURS ~TE AMOU~ TOTAL MATERIAL TOTAL ~BOR NORK ORDERED BY~ DATE COMP. TOTAL I ~BOR Thank You SIGNATURE (I Hereby Acknowledge the Satisfactory Completion of the Above Described Work.) TERMS: ACCOUNT~ PAYABLE AT lOTH OF MONTH FOLLOWING PURCHASF- SERVICE CHARGE AT RATE OF 1.$% PER MONTH WILl. BE CHARGED ON OVERDUE ACCOUNTS. ~un ~8 ~OOG ~:29R~ ~H~ ~R~Y COX ~R~ 90? ~?? ~558 ~.~ 2328-t SCALE: 1"= 30' F.A~ OF RECORD, OTHER THAN THOSE SHOWN C~ ~-IE RECORDED PI.AT ARE NOT ,~HOWN HEREON. S89'56'50"E 179.00 30 I I ow~ o I o II LOT lA I BE '1 0 3 ~.88 N0o03'0'%/ 73.00 8,88 SOUTH 45,00 54,50 50.00 54,50 6200__ SO~ TH 45.50 __66.0,0_ 62,00 66,00 73.00 NOOO3,0"v/ FW NORTH 50.00 66,00 I 66,00 198,74 f \ \ SOU 73.00 66,74 TNH I I 0 3 '0 69,60 203,87