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Home My WebLink AboutROCKHILL BLK 4 LT 9Rockhill lock 4 Lot 9 015-063 -30 MUNICIPALITY OF ANCHORAGE ~ ~ , DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION e ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT MAi'LiNdADDR-ESs' · LEGAL DESCRIPTION LOCATIO~ welI Absor~i~n area Dwelling PERMIT NO. ~<~ ~ Manufacturer ~~ Mate~ ~ No. of~compartments ~ ~ DISTANCE TO: Well Dwe~i¥~~ PERMIT NO. O Z ~ Manufacturer Material Liquid capacity in gallons ~ DISTANCE TO: ~Z~ No. oflines I Length of 22~e1. Total length o~ lines~_ Trenchwidth~ inches ~ Q~ ~ Top of tile to finish grade ~ I Material~ ~')be~eath tile ~ inches Total effective~_absorpti~n~ ~-~area ~ Length Width ' Depth ~ PERMIT NO, ~ ~ Type of crib Crib diameter C~b dept Total effective absorption area m ~ DISTANCE TO: Well ~ ~oundation Nearest lot line ~ ~Slass Depth~ Driller Distance to lot line PERMIT NO, ~ ~ DISTANCE TO: Buildin~ion I Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS INSTAELE~ , ~ REMARKS ~ . , ~A~PROVED DATE LEGAL ~ T~LL LOG ~, Date Drilled: Static Water Level .~.~,~. 7~ feet Gallons Per Minute~4- Draw Down NtA feet Total Feet of ?TA Type Material Drilled: 0 feet 75 S,R.A, Box 1953 H A nchorage,Alaska 99507 MUNIcIPALiTy OF ANcH ~wA'IENTAL PROTECTION RECEIVED SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST [~ PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O SLOPE I I{~ll I IIIII WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? SITE PLAN PERCOLATION RATE /~ (minutes/inch) -' TEST RUN BETWEEN Z, ~' , FT/I~ND ;~1~ FT ~ ~ ~ ~ ~ /~ ~ /J, . :/7 Gross Net Depth to Net Reading Date Time Time Water Drop Parcel I.D. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING o~5- - o~/2 - 3'0 1, GENERAL INFORMATION Complete legal description Location (site address) Current Property owner(s) Mailing address COSA # Expiration Date: Lending agency 3/7/// G~lly &£~<.ra~ 30 ~-~.~ Dayphone Day phone Mailing address Real Estate Agent Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. NUMBER OF BEDROOMS: ~ TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class ~ Public Water System Well TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [] [] 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 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..~'~' ~ ~-/-~¢ ~,,.{ ~.x.,~ NameofFirm ~(~p ~c~~[ ~r~ Phone Address )'1~3~ ~c4~ ~~ ~~j ~ ~ Engineer's Printed Name ~~o~ ~. )~~ Date DSD SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulatic Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other (Rev. 11/05) Original Certificate Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program ~ 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST IfA, B, or C provide PWSID #~ Legal Description: ~,1~ ~ A. WELL DATA Well type ~/' Date completed 7,//7/~6'" Sanitary seal (Y/N) ~ Total depth 3 Z'-/ ft. Cased to ?-"/¥ ft. FROM WELL LOG ft. g.p.m. Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform {:~ colonies/100 mL Nitrate 7. ~7 mg/L Arsenic: ~. ~" ug/L date of sample: 7/tS' / B. SEPTIC/HOLDING TANK DATA Tank Type/Material. _~_~ Ac. // ~' ~ z I Tank size I ?--~0 gal. Number of.Compartments Foundation cleanout (Y/N) ~ Date of pumping II !!&'/ ABSORPTION FIELD DATA Depression over tank (Y/N) ~ Pumper /~r -f-- Parcel ,4'. Well Log (Y/N) "r' Wires properly protected (Y/N) casing height (above ground) AT INSPECTION 7, ~'~' "/' g.p.m. Other bacteria 'colonies/100 mL Collected by: Date installed 7 / l ~ / ! 9 g,,_~"-- Cleanouts (WN) High water alarm (Y/N) AJ. ~ Date installed 7/lo /~ Soil rating (g.p.d./~ or ft%drm) I~'&- r~or~,~stem type Length ~ ~ ff. Width ~. ~- ff. Total depth I 0 ff. Eft. absorption ama 7~ff~ Monitoring tube Date of adequacy test II /~/~ Results(Pass/Fail) Fluid depth in absorption field before test ~ in. Water added ~Ygal. Elapsed Time: ~ min. Final fluid depth ~n. Absorption rote >= Any rejuvenation treatment (past 12 mo.) (WN & ~pe) ~ ~ ~ ~ ~ o ~ ~ If yes, give date Gravel below pipe &'-, 5- ft. Depression over field K/ For z,/. bedrooms New depth,f'2-'l~in. 0'~ g.p.d. D. LIFT STATION /~J' ?1--. Date installed "Pump on" level at ~ in. Datum SEPARATION DISTANCES Size in gallons "Pump off" level at Cycles tested in. ManhOle/AcceSs (Y/N) · High water alarm level at Meets alarm & circuit requirements? in. SEPARATION DISTANCES FROM WELL ON LOT TO: SePtic tank/lift station on lot ~) ~q ' ~ Absorption field on lot Public sewer main Sewer/septic service line Animal containment areas On adjacent lots On adjacent lots ~> ! c-"-O- / Public sewer manhole/cleanoUt Holding tank Manure/animal excrete storage areas. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation I ~ ~ Property line ~' O" Absorption field Water main /V. /I-, water service line ;:> lO ' Surface water 'Wells on adjacent lots "~ /. O'o ~ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Propertyline ~ ~'-~' Building foundation ~ ~ ~ ' Water main Water Service line ;::> ~ ' Surface water ~ ~ ~'o ' Driveway. parking/vehicle storage ~ '~ ~ Curtain drain ~/~,~ £E~,'~ Wells on adjacent lots ~, [~'~ ~ F. COMMENTS 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 -T-Jl¢~,('~,,'-E' /=.. ~--t~,.~ ~-~ Date COSA Fee $ ~/~ c~7 ~ Date of Payment Receipt Number /'~ q~ ~ ~) ~, (Rev. 11/05) Waiver Fees Date of Payment Receipt Number Municipality of Anchorage P.O. Box 196650 · 4700 Elmore Road Anchorage, Alaska 99519-6650 · (907) 343-7904 · Fax (907) 343-7997 ,,h,,,~tP:llwww.muni.or.qlOnsite Development Services Department On-Site Water and Wastewater Pro,qram )epartment **** VARIANCE/WAIVER REVIEW **** WaiverS: OSP101284 COSA#: OSC101322 PID#: 015-063-30 Legal Description: Rockhill Block 4 Lot 9 Engineer: Flattop Technical Services Permit: Applicant: Billy and Susan Andrews Your request for a waiver of the required 100 feet horizontal separation from the septic tank to the private well has been approved. The approved separation distance is 99.0 feet. This waiver approval applies to the existing septic tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted: Date: //~-/~7//~c~ Approved by: ! Name of RevieWer Rer_,~: No fee Amount: Date Paid: **** VARIANCE/WAIVER REVIEW **** MAIN TREE DRIVE 0~'$6 N ,,0~ ,~0 O0 N 0z O0 >E <co Oz ~LU Oz 'lC' TELE. & ELEC. ~, , ES,L~Zo£ S FLATTOP TECHNICAL SERVICES CIVIL & ENVIRONMENTAL ENGINEERING * ENERGY CONSERVATION & ANALYSIS TED MOORE, P.E. 14530 ECHO CANYON ROAD PH.IFAX: (907)345-1355 ANCHORAGE, AK 99516 E-Mail: tgmoorei~gci.net November 23, 2010 M.O.A. DSD On-Site Services P.O.Box 19-6650 Anchorage, AK 99519-6650 Dear Sirs: By means of this letter I am requesting issuance of a waiver allowing the private well on Lot 9, Block 4, Rockhill S/D located at 9850 Main Tree Drive to be approved in its present location 99 feet from the septic tank on the same lot. A site plan and site detail illustrating the relevant configuration, as well as a COSA application are enclosed. Per my telephone conversation with Ross Noffsinger on 11/17/2010, I understand that will the Municipality has agreed waive its waiver fee for approving this minor deviation from standards. According to Municipal records the existing 1250-gallon Greer steel septic tank was installed on 7/10/1985, at which time the well had not yet been drilled. According to the driller's log the well was drilled on 7/17/1985 and has a total depth of 324 feet. The casing is reported to be perforated between 75 feet and 80 feet. Water samples which I collected on 11/15/2010 showed 0 coliform bacteria per 100 ml, 7.17 mg/1 of nitrate nitrogen and less than 5 micrograms per liter of arsenic. The enclosed as-built property survey prepared by Shane Holt on 11/15/2010 revealed that the separation distance between the center of the well cap and the center of the standpipe for the first compartment of the septic tank is 102.0 feet. By carefully plotting the dimensions of a typical septic tank along with the configuration from the as-built survey, it appears that the closest comer of the septic tank is 99.7 feet from the center of the well casing, assuming the standpipe is straight and in the center of a typically configured septic tank manhole. This configuration is illustrated on the enclosed site plan and site detail. The requested waiver to 99 feet is to allow for the radius of the well casing, if applicable, and to compensate for the fact that the septic tank cleanout leans slightly away from the well. Thus, as you can see, the requested waiver is for a very minor deviation from code requirements. It is probable that the driller could not measure the straight line distance between the septic tank standpipe and the well because of the intervening house foundation; even if he did it is probable that he believed the 102.0 foot separation from the septic tank standpipe was sufficient to achieve the required 100-foot separation from the closest portion of the tank. The fact that the surface elevation at the septic tank is lower than the surface elevation at the wellhead, combined with the presence of the intervening house foundation guarantees that, were the tank to overflow, there is no possibility of effluent flowing towards the well. When the tank needs to be replaced in the not-too-distant furore, it will be a simple matter to locate the replacement tank so as to achieve the minimum required separation distance. It should be recognized that the measured nitrate level of 7.17 mg/1 approaches the maximum allowable concentration of 10.0 mg/1, however this level is consistent with similar elevated nitrate levels observed in other wells on adjacent properties. For examples; on Lot 10, Block 4 a nitrate level of 5.48 mg/l was measured on 6/8/2010, on Lot 7, Block 4 a nitrate level of6.11 was measured on 6/18/2004, and on Lot 6, Block 4 a nitrate level of 7.80 was measured on 12/8/2006. The source of the elevated nitrate levels observed in this and other Hillside areas has yet to be determined; however there is no indication that construction of the well or the proximity of the tank is responsible. Thank you for your favorable consideration of this waiver request, and for your fairness to the homeowner in waiving the typical Municipal waiver fee. Please give me a call if you have any questions. Billy Andrews Dave Windsor Sincerely, Ted Moore, P.E. o SEPTIC ".. SYSTEM '.... / ,, '' ..... R = 1"00' ..'" HOUSE ..... DRIVE --..~'.,~ .., SEPTIC '"' LU TANK ..-" _ SOIL ABS. TRENCH LOT 9 ....... LOT 10 SEPTIC AREA "F- ~ ~_oI~,1,~,,~,~ ~. LOT 9, BLOCK 4, ROCKHILL S/D J &'~ e~ ~A WELL AND SEPTIC SYSTEM ~ ,~ ~]-- %¢, ~ SITE PLAN j FLATTOP TEC~ICAL SER~CES 1 INCH = 50 FEET ~,~ · . ~ 14530 ECHO CANYON ROAD D~WN BY TFM ~. ~ CE- 3589 .~ :,~ NOVEMBER, 2010 ~~__~.~ NOTE: THIS IS NOT A SURVEYED P~T. ~~_ . . ALL LOCATIONS SHOWN ARE APPROXIMATE. LOT 9 WELL R = 100' HOUSE TANK - SOIL ABS. TRENCH ~ eo~oe ooe eoo eo eeeee ooeee ~ ~ . mEODOREF. MOORE DRIVE LOT 9, BLOCK 4, ROCKHILL SID WELL AND SEPTIC SYSTEM SITE DETAIL -"~L~TTo--pTEcHN;CA-L SER;icES ' 1 INCH: ;0 ~EET- 14530 ECHO CANYON ROAD / DRAWN BY TFM _ AN_CH_ 01~_ GE~,_.~LAS~KA_995 l~ .... NOVEM_BER~?O_I 0 NOTE: THIS IS NOT A SURVEYED PLAT. ALL LOCATIONS SHOWN ARE APPROXIMATE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date ,~ GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) ' ,, (b) ApPli~;i~i'Ni~;~.~.-~_//'~5~f ~/.)/~',~:~t~' Telephone:Home.~4~,"/'~,~ Business ~-W~I :" Appli~an~ Address .,~(~, · (c): &~plicant is (check.on'e): Lending Institution D; Owner/buitder~; Buyer ~; Other ~ (explain); (d),. Lend~rtg Inst~tubo~ .' ff'~ ,;? ' Address "'"* :' ,~'~f* , .......... .: ~,.~'--'~ . (e) Real.Estate..c°m~.. :.~ and Agent Address Telephone Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family'S. Multi-Family [] Number of Bedrooms ~ Other WATER SUPPLY Individual Well~' Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite.~ Public [] Community [] Holding Tank [] Note: If community weil system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 [11/84) Page I of 2 ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the va idat on date ~shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm '/~'~ Telephone Address /.~7~'~ ~'./ .~-~'~ ~'~./.~ /'~'., Date Approved ' ~ ,, Disappr0ve~. Condition~-~" Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: ~°~'~ 7'7z Well Classification Well Log Present~N) Total Depth 3;7-'~'/~ Cased to Static Water Level ?-.~/~ Casing Height Above Ground Electrical Wiring in Condui (Yt~) Separation Oistances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results MUNICIPALITy OF ANCHORAGE DEPT. OF HEALTH & ~I~IVIRONMENTAL PROTECTION >~'/I/~ If A, B, C, D.E.C. Approved (Y/N) Date Completed 7"/?~'5'/ Yield ~Td t Depth of Grouting Pump Set At '~)j'~ Sanitary Seal on Casin N) Depression Around Wellhead (Y~"~ ! /~L~ ; On Adjoining Lots /42~,- ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot Comments B. SEPTIC/HOLDING TANK DATA Date installed Standpipes&N) Air-tight Caps~)N) Depression over Tank (Y~N.¢I Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: Size ,/~'~ g"~'g NO. of Compartments Foundation Cleanou~,,N) Date Last Pumped ~///~ ;for djh Temporary Holding Tank Permit (Y/N) To Water-Supply Well To Property Line To Water Main/Service Line Course / To Building Foundation //~"~" To Disposal Field ~' To Stream, Pond, Lake, or Major Drainage Comments Page I of 2 ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed · Width of Field ~",.~' Square Feet of Absorption Area Depression over Field (Y~ Results of Last Adequacy Test Separation Distance from Absorption Field: Type of System Design '-~/ Length of Field ~'~'~' / Depth of Field ,~ ~' Gravel Bed Thickness ~'.~ / Standpipes Present(~) Date of Last Adequacy Test To Water-Supply Well /~,~' To Property Line To Building Foundation -"~'" ! To Existing or Abandoned System on Lot ; On Adjoining Lots /~ 7*' To Water Main/Service Line ,'u~/,,'~¢' To Cutbank (if present) TO Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments LIFT STATION Dat~ Dimensions Size in ?at.l.c:ns . ~ Manhole/Access(Y/N) "Pump On" Level at ~'"'--~_ "Pump Off" Levet at High Water Alarm Level at ~"..,...,~ent (Y/N) Tested for Pumpin~J~>yc, L~during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I hav(~che~ked, v(~rified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~ Company /~5 MOA No. ~ ~' Receipt No. 5V Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) ALASKA ENVIRONlU~NTAL CONTROL SERVIC, , INC. 12OO West 33rd Avenue. Suite B ANCHORAGE. ALASKA 99503 (907) 561-5040 CALCULATED BY CHECKED BY SCALE OF DATE__ DATE