HomeMy WebLinkAboutMCMAHON BLK 2 LT 10McMahon
Block 2
Lot 10
#017-041-11
GREif ',R ANCHORAGE AREA BO[,
Department of Environmental Quality
3500 Tudor Road
Anchorage, Alaska 99507
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME J//tP, gS /-.)C~/~ MAILING ADDRESS ,'~g~ /-~], ~.~21) PHONE27&] -/~2Z~O
LOCATION ~/(4/;fl)1f'~~ ~, ~"~/¢-~/)~.. ~'. LEGAL DESCRIPTION Z~'f:$ /0 ?// ,,~L/~ ~ /~'Z~g~-/~/~/~-~¢
SEPTIC TANK:
DISTANCE
FROM WE Lk/q/~'(,/-~'/-~'
INSIDE LENGTH
MANUFACTURER ~.-f[¢~/ (?~2,,q~'£C?~ MATERIAL
NUMBER OF
COMPARTMENTS /
INSIDE WIDTH
LIQUID DEPTH LIQUID CAPACITY /~ GALLONS.
SEEPAGE PIT:
NUMBER OF PITS / DIAMETER _ OR WIDTH LENGTH/O'~ , DEPTH <~ /
LINING MATERIAL ,-~il'¢)l~/'/>/g~7~-~/~3'RIB SIZE: DIAMETER .DEPTH ~ /
__ DISTANCE FROM: WELL
BUILDING FOUNDATION '~(~ ! NEAREST LOT LINE ~g~ ~ TOTAL EFFECTIVE
, ABSORPTION AREA (WALL AREA)
SQ. FT.
ADDITIONAL ABSORPTION
WELL:
TYPE /[OL)/~ ]~JLLb-I) CONSTRUCTION
BUILDING / NEAREST //.
FOUNDATION /~ ~ LOT LINE //--)
CESSPOOL ,/I]~?t~. OTHER SOURCES
APPROVED / DISAPPROVED
NEAREST
SEWER LINE
REMARKS
DEPTH ~-~J4
SEPTIC
TAN K~/~/~X
DISTANCE FROM:
SEEPAGE
SYSTEM /'~(-)
DISTANCES:
INSTALLED BY: ,-.:~l~_O"ltle~ ~0~g.7~,
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
DIAGRAM OF SYSTEM
Form PW-026
DATE ,/~/2,/~ ~-2 1~/7,2~ APPROVED
G.A.A.B.
GREA,ER ANCHORAGE AREA BORuUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD POUCH 6-650
ANCHORAGE, ALASKA 99502
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
F'NANCED THROUGH
eom PLETION DATE ANTIC] PATED --~~7~--
/--
NaME OF APPLICANT ,¢J"~,~¢~ L~-~ .' MAILINg ADDRESS
~ SEEPAGE Pit ~'"" , DRAIN FIELD , OTHER
NOTE~ THIS RMIT I~ NOT VALID WITHOUT 5OIL TEST
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROBECUTION.
SEPTIC TANK SIZE /~O~¢~'~` TYPE SEEPAGE AREA SIZE
TYPE
MINIMUM DISTANCES, REQUIREMENTS DIAGRAM OF SYSTEM
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT , DRAIN FIELD
SEPTIC TANK TO SEEPAGE Pit WALL
SEPTIC TANK
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
DRAIN FIELD
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
, Seepage PIT ,~/~ / DRAIN FIELD .
ALSO CONSIDER AREA WELLS.
SEEPAGE PiT
SEPtiC TANK,'~ ~ j 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.
HEALTH AUTHORITY
I CERTIFY THAT [ AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
GREATER ANCHORAGE AREA BOROU~-~
DE~"~MENT OF ENVIRONMENTAL QU,
3500 TUDOR ROAD
ANCHORAGE, ALASKA 99502
Performed For James Cook
Legal Description: LotlO Block g
This Form Reports Soils Log, "X
Depth
Feet
Soil Characteristics
Gray Silty Sand
Gray Sand (SW).
w/poorly graded Sand Seams (SP)
FY
CASE #.
Date Performed 8/14/72
.. Subdivision Mahon
Percolation Test
Was Ground Water Encountered?
If Yes, At What Depth?
Date Gross Time
Net Time
Reading
No
!r -
Depth to H20
Percolation Minute
Proposed Installation: Seepage Pit
Depth Of Inlet
COMMENTS:
Net Drop
X Drain Field
Depth To Bottom Of Pit Or Trench ,
~28 sq. A. ofdraJ~_fe area~s required per bedroom below 4'depth -
Test Performed ~By Carlisle '"
O'alfa Certified By:National Testin~
Date:
~ APPLICANT FILLS OUT UPPER HAL~'ONLY
-"%~ ;3 Phone
Buyer
Address Zip Code
Realty Co. & Agent
Address Zip Code
Type of Residence
{~,,,-Sft~le Family
[] Multiple Family No. of Bedrooms
[] Other
W~er
L.J-.d'ndividual ATI-ACH WELL LOG, A well log is required for all wells drilled since June 1975.
[] Comm.nity For :?,d? thatdate.,,vewe,,de,th,attach'og"ava"ab'e'.
[] Public Utility
Sewer D,epoea,
[~'~ividual Year Individual Installed:
[] Public Utility When Connected to Public Utility:
[] Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQtJEST BEFORE PROCESSING CAN BE INITIATED.
Time Time Time Time ( I~
Date Date Date Date
Inspector Inspector Inspector Inspector
Field Notes: ~%.. .,,¢,//~ MUNICIPALITY OF ANC,O~GE
]~O ~~ DEPT. OF HE/',LTIJ &
-- -~l/¢~¢~ ~. ENViRONM:NTAL PROTECTION
RECEIVED
( )DISAPPROVED
( )CONDIT[ONAL APPROVAL'
Soils Rating Date ~wer Installed Well To Absorption Area / ~ ~ Well Log Received
~ ~ ? ,~ WelltoTank Septic T~k Size / ~ O o
72-023 (3182)
CHEMICAL & GE'~',OG~CAL LABORATORIES (~-~ALASKA, INC. ~
TELEPHONE (907) 562-2343 ANCHORAGE INDUSTRIALCENTER
"~ Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
WATER SYSTEM:
Water System Name
I,D. NO.
Phone No.
Mailing Address
City '
SAMPLE DATE:
Mo. Day Year
SAMPLE TYPE:
,~,~outine
hack Sample (for routine sample
with lab ref. no. )
[] Special Purpose
[] Treated Water
[] Untreated Water
SAMPLE Time Collected
NO. LOCATION Collected By
I
TO BE COMPLETED BY LABORATORY
Analysis shows this 'Water SAMPLE to be:
[~ Satisfactory
[] Unsatisfactory
'-} Sample too long in transit; sample should
not be over 48 hours old at examination
to indicate reliable results: Please send
new sample.
Date Received
Time Received '
Analytical Method:
[] Fermentation Tube
?~Membrane Filter
Lab Ref. No. Result*
I
I I-FI
J I-FI
. _ ,- . *.N~o of colon,es/~J0_0, m.!. or H~:,ot Positive port,ons
Analyst
/
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
06-1220 (b)
Rev. 1978
BACTERIOLOGICAL WATER ANALYSIS RECORD
Date Collected, Source
a.m.
Presumptive 1Omi 1Omi 1Omi 30mi 1Omi Z.Oml O./ml
24 Hours
48 Hours
Confirmatory
24 Hours
48 Hours
EMB Broth 24 hours:
Multiple Tube Report=
Membrane Filter: Direct Count
Verification: LTB
Final Membrane Filter Results .- ~ ~r~
ReDorted By ~ 9~'~t/~///~
/
Broth 48 hours:
]Omi Tubas posltlve/-rotal 1Omi po~tloni
Collform/100ml
BGB
~Collfon~/100ml
ALASKA
eliOIROIlmeTAL COIqTROL
~n§ineerin§ 6 ~nuironmental $1u~ics
InC.
1/3/84
JIM COOK
ANCHORAGE AK 99501
SELLER - JIM COOK BUYER - REFINANCING
SUBDIVISION - MCMAHON BLOCK - 2 LOT - 10
ADEQUACY TEST FOR SEWER SYSTEM
THE TYPE OF ABSORPTION SYSTEM IS A PIT WITH AN AREA OF 513 SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 675 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
3 BEDROOM HOME.
THE SEPTIC TANK WAS PUMPED ON 1/4/84 .
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR
THIS 3 BEDROOM HOUSE.
1200 LUest 33tq Auenu¢, Suite ~ · Anchort~§e, Aloska 99503 · [907) 276-1361
Parcell.D, 017-041-11
Municipality of Anchorage
On -Site Water and Wastewater Program =.
(907)343-7904 -
Certificate of On -Site Systems Approval
1. GENERAL INFORMATION
Expiration Date: / I Y L14f
Complete legal description McMAHON BLOCK 2 LOT 10
Location (site address) 4000 McMAHON DR., ANCHORAGE, AK 99516
Current Property owner(s) JIM COOK
Mailing address
Real Estate Agent
Day phone 250-5966
Day phone
2. TYPE OF DWELLING: Sul;
❑ Single Family (w/wo ADU)�° is
F-1Duplex
t❑ Multiple Dwellings (Single Family and/or Duplex) AUG 2 r
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ❑x Individual ❑x
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
Waiver/Variance request for: NONE r, Distance:
Received by: Date:�21�/
COSA to be released to the engineer, unless othenmise requested by the engineer.
COSA Fee $2/0 P Waiver Fee $
Date of Payment V 24 liq (_a"�Date of Payment
Receipt Number Receipt Number
COSA # o I q �i_j 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 SPURKLAND
Address 203 W. 15TH AVE.,STE.202A, ANCHORAGE, AK 99501
Engineer's Printed Name LARS SPURKLAND
6. DSD SIGNATURE
System #1 Approved for J bedrooms
System #2 Approved for bedrooms
Disapproved
Conditional approval for bedrooms,
Phone 279-3916
�4�
Date8/20/wXz;�
:4 ,
SPURKLAND
f u 15
ES
with the following stipulations:
By: / Original Certificate Date: 0 "'?, G' / Ll
The nic li f chorage 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 X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet E , c
If more than 1 septic system is on the lot:
COSA Checklist # 1 of 1
Structure served by this system 1
Certificate of On -Site Systems Approval Checklist
Legal Description: MCMAHON BLK 2 LT 10
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID #-
Date completed 1972 Sanitary seal (YIN) Y
Total depth 214 ft. Cased to >40 ft
FROM WELL LOG
Date of test
Static water level
riff
Well production g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 mL Nitrate 4.78 mg/L
Arsenic ND ug/L Date of sample: 8/13/14
B. SEPTICIHOLDING TANK DATA
Parcel ID: 017-041-11
Well Log (YIN) N
Wires properly protected (YIN) Y
Casing height (above ground) 30 in.
AT INSPECTION
8/13/14
177 ft.
6.0
9 -P.M.
Collected by: ANSON MOXNESS
Tank Type/Material CONCRETE Date installed 8/1972
Tank size 1000 gal. Number of Compartments 1 Cleanouts (YIN) Y
Foundation cleanout (YIN) Y Depression over tank (YIN) N High water alarm (YIN) N
Date of pumping 8/13/14 Pumper NORTHLAND PUMPING
C. ABSORPTION FIELD DATA
Date installed 8/1972 Soil rating (g.p.d./ftz or ftz/bdrm) LINK System type CRIB
Length 13 ft. Width 13/18 ft. Gravel below pipe 9 ft.
Total depth 15 ft. Eff. absorption area 513 fe Monitoring tube Y Depression over field N
Date of adequacy test 8/13/14 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test 61 in. Water added 450 gal. New depth 98 in.
Elapsed Time: 130 min. Final fluid depth 92 in. Absorption rate >= 450 g p d
Any rejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date
D. LIFT STATION
Date installed
"Pump on" level at
Datum
Size in gallons _
Manhole/Access(Y/N) _
in. "Pump off"level at in. High water alarm level at _
E. SEPARATION DISTANCES
WELL ON LOT TO:
Cycles tested _
Septic tank/lift station on lot 100'+
Absorption field on lot 100'+
Public sewer main NA
Sewer /septic service line 25'+
Meets alarm 8 circuit requirements? _
On adjacent lots 1004
On adjacent lots 1001+
Public sewer manhole/cleanout NA
Holding tank NA
Animal containment areas 50+ Manure/animal excrete storage areas 100'+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5+ Property line 5+ Absorption field 51+
Water main NA Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
ABSORPTION FIELD ON LOT TO:
Property line 10+ Building foundation 10+ Water main NA
Water Service line 10'+
Curtain drain 50'+ (N.O.)
F. COMMENTS
G. ENGINEER'S CERTIFICATION
Surface water 100'+(N.O.)
Wells on adjacent lots 100'+
l certify that / 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 LARS SPURKLAND
Date 8/13114
COSA brown sheet 10-10-12.doc
Driveway, parking vehicle storage 10'
0F.A..1
1
'00
. :49T � rl
10 :..
. . . .. .. .....�
SE PURKLAND..
�r3•,150
in.
O
U
$°°e6fp e.ce
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t-. .-=li'cfatkc S�
.=,h , •,`>a �*!O. 3255-5 e j��
4M1s~�'DFG°'s.ee, re.�°°JCGJ�
i`�Y aJFrss�GNF,1.�*�
ASFMENTS OF RECORD, OTHER THAN
THOSE SHOWN ON THE RECORDED
FLAT ARE NOT SHOWN HEREON.
AS -BUILT NO CORNERS SET THIS GATE
3o'
I hereby certify that I have performed a Mortagee s in-
„r,�,
snection o£ the following described.property;--
_Anchorage Recording Precinct, Alaska, and that the improve-
ments situated thereon are within the property lines and do
not overlap or encroach on the property lying adjacent there-
to, that no improvements on property lying adjacent thereto
encroach on the premises in ouestion and that there are no
roadways, transmission lines :;r other visible easements on
said property except as indicated hereon.
Dated at Anchorage, Alaska U3
�3`d /A/avej;;bev
this day oL —. 19---
FRED 'W"ALATK_A 8 ASSOCIATES
Engineers and Surveyors