HomeMy WebLinkAboutSUNNY SLOPES LT 61 t, ,' APPaLl? ~NT FILLS OUT uppER I;IA,' "~ ONLY
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Phone
~ Single Family .
~ulBple Family NO. of Bedroo~
Other
Water Supply
~omm~nity ~ ATTACH WELL LOG A w~l log is required for all welts drilled s~nce June 1975.
~ Public Utility For wells drilled ~r~or to t~at date, give well depth (attach log if available).
Sewer Disposa~
~ndividual' Year Individual Installed:
~ Public Utigty When Connected to Pubgc Utility:
~ He,ding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time Time Time Time
Date Date Date Date q
Inspector Inspector Inspector inspector
E,.,d.o,e.: c ¢-
~ APPROVED BEDROOMS *CONDITrONS OF APPROVAL
,
( ) CONDITIONAL APPROVAL' ~ ~ ~
DATE
BY:
Sogs Rating Date ~wer Jnstaged Well To Absorption Area Well Log Received
Well to Tank Septic T~k Size
023 (3/~)
EXCAVATION
ROBERT A. SHAFER
WORK
September 5, 1983
CIVIL ENGINEER
694-2979
Area Commonwealth Realty
ATTENTION: Maureen Clayton
P.O. Box 249
Eagle River, Alaska 99577
Dear Mrs. Clayton,
Reference: Lot 61: Sunny Slope Subd~%ision
A sewer system adequacy test was performed on the system located on
the referenced property, as you requested. The septic tank
was pumped and verified to have a capacity of 1000 gallons. The
seepage pit which had arigihally been installed on this property
was apparently abandoned in 1980 and the system was upgraded with
the addition of a trench, according to the owner, approximately
4-5 feet in length. An adequacy test of the trench was performed
by allowing a continuous flow of water over a period of 48 hours.
The average flow in the 48 hour period exceeded 489 gallons in each
24 hours.
It can be concluded from this test that the Waste Water disposal
system serving the three bedroom residence located on this'-property
is currently functioning adequately. However the system cannot
be guaranteed against subsequent failure.
If we may be of further service, please do not hesitate to contact
us.
Si~c'~l~ ~/
cc: Municipality of Anchorage
Department of Health and Environmental Protection
SRB 196X EAGLE RIVER,ALASKA
HEALTH AUTHORITY APPROVAL
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM
PART I.--TO BE COMPLETED BY FHA
lnohorage~ Alaska FL~e% Na%ional ~ar~lc of A~ehorage
AnChorage, Alaska 111-001844-203
Quilled' and Norma L. Burne ~/L Monte Rd. Eagle River, Alaska
Burmly Slopoa BLOCK NO. LOT No61
'! 2 a ["~ Yes [~]No ~"] Yes I-~No
[] Public system [] Community system [] Individual .o. o~ ~o.~s. O^..AO~ D,s~os^t
[] Public system [] Community system [] Individual 2 [] Yes [] No
PART II.--TO BE COMPLETED BY HEALTH DEPARTMENT
REPORT OF INSPECTIONmlNDIVIDUAL SEWAGE-DISPOSAL SYSTEM
PRIMARY TREATMENT consists of J~ Septic tank. [] Cesspool.
Septic Tank:
Distance from well, ~ feet. Material, ~4'q'~---t~ ~:~ <.~--~9 ~ ~_ Number of comp~ments..
To~l liquid capaci~, 7~ gallons. Capaci~ inlet companment, .gMlons.
Inside leng~, feet. Inside width,~ feet. Liquid depth,_ feet.
Cesspool:
December 26, 1963
First National Bank
FHA Department
Anchorage, Alaska
Gentlemen~
A properly designedindividualsewage system can
be expected to function satisfactorily on the
following described property:
Lot 61, Sunr~ Slopes Subdivision,
Eagle River, Alaska
Yeurs ver~ truly,
JP~:hm
Enco
John R, Kuhn
District Sanitarian
Municipality of Anchorage
On -Site Water and Wastewater Program
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 050-152-18
1. GENERAL INFORMATION
Expiration Date: 1 2 3 20 z-(
Complete legal description Sunny Slopes Lot 61
110(of
Location (site address) V��Monte Road. Eagle River. AK
Current Property owner(s) Timothy & Mary Hoppingarner Day phone
1'(o fo l
Mailing address '1�9�6'I Monte Road. Eagle River. AK
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
TYPE OF WASTEWATER DISPOSAL:
4. TYPE OF WATER SUPPLY:
Individual
Individual Well
❑
Holding Tank
❑
Individual Water Storage
❑
Community
❑
Community Class Well
❑
Public Sewer
❑
Public Water System
WaiverNariance request for: Distance:
Received by:
COSA to be released to the engineer, unless otherwise requested by the engineer.
Date:
COSA Fee $ ' S 8- Waiver Fee $ _
Date of Payment I Z 5Tz 0 _Z2_ Date of Payment
Receipt Number 0 g 1 1 G G Receipt Number
COSA # M C,2 � 1 0 V) 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 696-6111
Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577
Engineer's Printed Name KENNETH M. DUFFUS Date z
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 AAV
encroachments, deficiencies or discrepancies exist. �l` =�Ls
�1 �J T'H'
6. DSD SIGNATURE
System #1 Approved for 3 bedrooms. + ? EEtzxETH �M6 wof
System #2 Approved for bedrooms. es u .7
FFS�IOtr� �
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
�iq GetIV1-09-v' L (_,1_C d IAPf. �,, t� 1 e
m.2) WASTr-vttnTl=0 �^
J
�^ PROGRAM ,
Original Certificate Dat�1�t1C1V"
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
Septic System Advisory
Well Flow Advisory
COSA blue sheet 10-10-12.doc
X Nitrate Advisory
Arsenic Advisory
Other
Legal Description: Sunny Slopes Lot 61 Parcel ID: 050-152-18
If more than 1 septic system on lot: COSA Checklist # of
ELL DATA
❑ Well to f' ed with Onsite (or attached)
Date drilled
Total depth ft
Cased to ft
❑ Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ground) in.
Date of flow test for COSA
Static water level at beginning of test ft.
Comments
B. TANK DATA
Age of tank(s) 19 years
Tank type/material Septic/Steel
Measured operating.fluid level in septic tank 44"
11 Standpipes/foundation cleanout per record drawing
Date of pumping 4/28/21
D. ABSORPTION FIELD DATA
Which system tested (date installed) 8/31/03
ALL standpipes present per record drawing
Total measured depth from grade 11.75 ft (max)
Measured depth to pipe invert from grade 3.75 ft (min)
❑ N/A — pressurized field
Monitor tubes go to bottom of effective. If not, state
depth into effective
Structure served by this system
Well production at time of test 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)
Al'Seal_ ug/L ❑ Arsenic less than MRL (ND)
Collected
Date of Sample
FT STATION
❑
Req-u'tredmaintenance completed
Age of lift stationyears
Lift station material
Comments:
Adequacy test date
1/23/22
Results Q Pass
For 4 bedrooms
Fluid depth prior to test
21 in
Water added 600
gal
New depth 48 in
Elapsed time 1200
min
• Code -required soil cover over field Final fluid depth 21 in
• System presoaked Absorption rate 600+ gpd
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months)
date of test)
Gallons introduced 2000 gallons If yes, enter date
Comments/Deficiencies:
COSA Checklist yellow sheet
E. SEPARATION DISTANCES
Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift on Lot > 100' Community Sewer Manhole/Cleanout > 100'
Yes if No ft []Yes if No ft
Neighboring Tank > 100' ❑ Yes i �ft-.�. Private Sewer/Septic Line > 25' ❑ Yes if No ft
Absorption Field on Lot > 100' ❑ Yes if No ft ling Tank > 100' ❑ Yes if No ft
Neighboring Absorption Fields > 100' Animal Contai > 50' ❑ Yes if No ft
❑ Yes if No ft
Manure/Animal Excreta Storage
Community Sewer Main > 75' ❑ Yes if No ft ❑ Yes It
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10' ❑ Yes if No 5'* ft Surface Water > 100' Yes if No ft
Property Line > 5'
Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5'
® 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'
® 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'
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'
Yes
if No
ft
F. ENGINEER'S COMMENTS
*Per 8/31/03 Inspection Report.
G. ENGINEER'S CERTIFICATION
I certify that 1 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
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