HomeMy WebLinkAboutROBIN HILL #1 BLK 1 LT 1ARobin Hill #1
Block 1
Lot 1 A
#017-442-03
Municipality of Anchorage •.
• �; Development Services Department
Building Safety Division
On-Site Water 8 Wastewater Program
4700 Bragaw Street
P.O. Box 196650 l)�,,•(j+j%IrlV�v
Anchorage. AK 99519-6650
www.muni.org/onsite D Q_j
(907) 343-7904 PZ0 `,`1_
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING0/` , r /
Parcel I.D. 017-44-203 COSA# C- I0 I OWC/
1. GENERAL INFORMATION Expiration Date: 040.49
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
ROBIN HILL N1, BLOCK 1. LOT 1A
6240 EAST HUFFMAN ROAD 'ANCHORAGE. AK
JAMES MCLAIN Day phone C/O AGENT
36055 MURRAY LANE 'SOLDOTNA, AK 99669
Day phone
PETER GRIBBON W/ PRUDENTIAL Day phone 301-8037
3801 CENTERPOINT DR. #200 'ANCHORAGE, AK 99503
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 2
3. TYPE OF WATER SUPPLY:
Individual Well
0
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
0
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 wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. 1 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. Phone
Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, GEG, LID. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines d Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily Identifiable features. The operational life of all wefts and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator 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 how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report Is for
the sole benefit of the ownerlisted above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for Z bedrooms.
337-6179
Date /to
Disapproved.
Conditional approval for bedrooms, with the filowing stipulations;;
v VIV-JI I C
WATER AND
..........
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By:
IRay. 11N5)
Original Certificate Date: O /(%
\ Municipality of Anchorage
Development Services Department `
Building Safety Division'
On -Site Water & Wastewater Program
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: ROBIN HILL #1, BLOCK 1, LOT 1A Parcel ID: 017-44-203
11 A. WELL DATA *PERFORMED BY ARROW
PUMP do WELL SERVICES
Well type PRIVATE If A. B, or C provide PWSID# N A Well Log (Y/N) N
Date completed PRE -7/1973 Sanitary seal (Y/N) YES Wires property protected (YIN) YES
Total depth ' 179+ ft. Cased to *145 ft.
FROM WELL LOG
Date of lest NO WELL LOG
Static water level ft.
Well production g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 ml. Nitrate 0.499 mg./L.
Casing height (above ground) 12+ in.
AT INSPECTION
3/31/10
»117 ft.
•0.46 g.p.m.
Other bacteria 0 colonies/100 ml.
Arsenic: <5_ug./L. Date of sample: 3/30/10 Collected by: GEG Ltd.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL Date installed 7/23/1973
Tank size 1000 gal Number of Compartments Cleanouts (Y/N) YES
Foundation cleanout (YIN) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A
Date of pumping 3/31/10 Pumper ISAACS PUMPING
C. ABSORPTION FIELD DATA BELOW EXISTING GRADE
Date installed 7/23/1973 Soil rating (g.p.d.do /bd 225 System type CRIB
Length 28 & 29 ft. Width 11 k 14 ft. Gravel below pipe 8 ft.
Total depth * 11.08 ft. Eff. absorption area 656 ft' Monitoring tube YES Depression over field NO
Date of adequacy test "3/25/10 Results (Pass/Fail) PASS For 2 bedrooms
Fluid depth in absorption field before test DRY In. • Water added 1000gal. New depth 6 in.
Elapsed Time: 271 min. Final fluid depth DRY in. Absorption rate >= 300+ g.p,d,
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date —
*•1000 GALLON PRESOAK ON 3/24/2010.
1000 GALLON PRE—SOAK ROSE WATER LEVEL TO A TOTAL DEPTH OF 40
.
RECEIVING SOILS FOR ADEQUACY TEST WERE PRE—SOAKED.
D. LIFT STATION
Date installed Size in gallons Manhole/Access (YIN)
"Pump on" level at in. 'Pump oft" level High water alarm level at - in.
Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 'S0'+ On adjacent tots 100'+
Absorption field on lot 100'+
Public sewer main N/A
Sewer /septic service line 25'+
Animal containment areas 50'+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Holding lank N/A
Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
*CODE WAS 50 FEET FOR WELLS DRILLED PRIOR TO JULY 1973.
'oQOF .
I certify that I have determined through field inspections andp� .4 / *07
review of Municipal records that the above systems are in �p
conformance with MOA COSA guidelines in effect on this 0............
date. QQ ff y A. Go ness.. DDO
Engineer's Printed Name JEFFREY A. GARNESS dOo CE -79 e fes'
Date SI[, Ila �4ed P�ofessVo��
COSA Fee S Waiver Fee $
Date of Payment Date of Payment
Receipt Number Receipt Number
(Rev. 11/05)
Municipality of Anchorage
• Services Department
Development
P :.:
Building Safety Division `
On -Site water and wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchoragc.ak.us
(907)343-7904
Nater Well Advisory
Certificate of On -Site Systems Approval (COSA) # OSC101004
During a recent COSA on-site inspection and test of the potable water
supply well on Block 1, Lot IA of Robin Hill #1 subdivision, the well's
productivity was determined to be .46 gallons per minute. The minimum
well productivity required by this Department (AMC 15.55) for a 2 -bedroom
residence is .21 gallons per minute. Although the subject well currently
exceeds this minimum requirement, all parties concerned are advised that the
production capacity of the well may fluctuate. Restriction of non-critical
water uses such as washing cars and watering lawns and gardens may be
required.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
SCS Ref.#
1101309001
Client Name
Gamcss E•nginccring Group, Ltd
Project Name/p
Robin hill #1 DI L1A
Client Sample ID
Robin llill#1131LIA
hlatri:
Drinking Watcr
Sample Remarks:
Printed Dateffime
Collected Datefrime
Received Datc/Time
Technical Director
04,'06,2010 14:54
03/302010 11:30
03/30!2010 13:50
Stephen C. Ede
Alloovblc Prep Ana;) -vis
ParamenK Results I.OQ Univ Method Container ID Limits Date Date Init
Metals by ICP/M3
Arsenic 5.000 5.00 ug/L EP200.8 C (<10) 03/31!10 04!02110 KDC
Waters Department
Total Nitratc/Nitritc-N 0.499 0.100
Microbiology Laboratory
Colony Count 0
rotal Coliform 0
Fecal Coliform 0
mg/L SM20450ONO3-F D (<I0)
coV100mL SN'209222G
col/IOOmL SM209222B
cnl'IOOml, SM209222D
04/02/10 AYC
03!30!10 ULC
03.90110 DLC
03,90/10 DLC
APR -1-2010 12:23A FROM:
AAROW PUMP & WER SERVICE, LLC
P.O. Box 110496
Anchorage, AK 99511
Office: (907) 346-9355 - Fax (907) 333-8976
Eagle River: (907) 622.9335
CUSTOMER
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Thank You
SIGNATURE
(I Hereby Acknowledge the Satisfactory Completion of the Above Described Work and agree that If above work Is not paid for In 90 days 1 agree to allow Aarow
Pump a Well Service, L.L.C. the right to remove unpaid for equipment and charge for labor already performed b labor to remove unpaid for equipment)
TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE.
SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS.
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<�GR"-"' ",ER ANCHORAGE AREA BOA 'O' GH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME MAILING MAILING ADDRESSHONE ��E�7y�Zz
LOCATION'M�� LEGAL DESCRIPTION
SEPTIC TANK:
DISTANCE ,��QQ l NUMBER OF
FROM WELL_MANUFACTURER MATERIAL i� COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY�GALLONS.
SEEPAGE PIT:
NUMBER OF PITS DIAMETER OR WIDTH A/ LENGTH, DEPTH M /
LINING MATERIAL /G CRIB SIZE: DIAMETEROf ,J�lDEPTHIL DISTANCE FROM: WELL
'7 f TOTAL EFFECTIVE /
BUILDING FOUNDATION—, NEAREST LOT LINE . ABSORPTION AREA (WALL AREA) J O SQ. FT.
ADDITIONAL ABSORPTION �—
WELL: /
TYPE f/N�� /%�1/ CONSTRUCTION G///� (D C�i�S�IU DEPTH 1dV / DISTANCE FROM:
BUILDING FOUNDATION LOT NEAREST NEAREST C INE, SEWERINE A) TANKSEEPAGE! SYSTEM
CESSPOOL — OTHER SOURCES
well
APPROVED DISAPPROVED REMARKS AZlf/,U Lyf/.1/-"
Jif/Gf/1 j1p
,
DISTANCES: Ate' = .F DIAGRAM OF SYSTEM
/
,dFo,��isiiv 4/
INSTALLED BY:�_i/
1
l
PIPE MATERIAL:
LOT SLOPE: Ulilf/�GI/�ST y�/`yU
REMARKS:
DATE l/� 3 APPROVED
G.A.A.B.
e -
„o,,,F GREATER ANCHORAGE AREA BOROUGH
4
o ` �I !o IlLllt DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO.
3330 "C" STREET ANCHORAGE, ALASKA 99503
U{; TELEPHONE 274-4561
o9�/MiZEO IEK,. Vee
SEWAGE DISPOSAL SYSTEM ® APPLICATION AND PERMIT
NAME OF APPLICANTy ��/��i L/ -- MAILING ADDRESS ('�' / `� "'"�.BHONE �—
INSTALLATION LOCATION �' �' ` Y'�/'�N� �` �`� A�t�
LEGAL DESCRIPTION
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
SEEPAGE/PIT V/ , DRAIN FIELD OTHER
TO BE INSTALLED BY
SOIL TEST RESULTS /�-"y���-'/- NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR -NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
peau x,(/; sll'r,,_e
SEPTIC TANK SIZE _,^ � TYPE `� / -M �1'-I- SEEPAGE AREA SIZE ��� TYPE
MINIMUM DISTANCES, REQUIREMENTS
11'
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE`' L`" 7j APPLICANT'S SIGNATURE
SEPTIC TANK , SEEPAGE PIT
�^-O DRAIN FIELD
TO NEAREST LOT LINE.
n
WELL TO SEPTIC TANK
SEEPAGE PIT
DRAIN FIELD
ALSO CONSIDER AREA WELLS.
V
WATER MAIN TO SEPTIC TANK ,cam
SEEPAGE PIT
DRAIN FIELD ^'
SEPTIC TANK, E-�----D SEEPAGE PIT
DRAIN FIELD
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS. ,
GRAVEL. BACKFILL,
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
G.A.A.B.
OR
LICENSED DESIGNER
I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA B
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE`' L`" 7j APPLICANT'S SIGNATURE
DIAGRAM OF SYSTEM
ORDINANCE NO. 28-68 AND THAT THE ABOVE
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