HomeMy WebLinkAboutLITTLE BEAR BLK 1 LT 10Onsite File
Little Bear
Block 1
Lot 10
#014-061-27
0 0 0 0 0 ~ 0 0 0 0
Z
DEF'RF.:THENT HEFILTH AND EN'v' ! .r4:ONH[:'N R _ ;tL'.TEL: f I .. N
25:LF~ E. TU[:,OR E:[:,.., F~N'EHOF-:FIGE- Al<. '9:::'SEE
ED ~:INNER
B~'LAC:E
L:LE"i B± LITTLE BERF.: :,,-'£
RPF'L i CANT
I_OC:RT I ON
LEGAL
,~3::.t. E1 1.4ELL=,I_E'r C:T
LOT SIZE ,"=_':,~$E~EI 'Z:;[.;!LIAFdE FEET
MINIMUH DISTANCE BETWEEN FI WELL AND ANY ON-SITE SEI4RGE DISPOSAL S'T'SI'EM IS
· 198 FEET FOR R PRIVATE WELL OR 20E1 FEET FOR R PUBLIC NELL
NELL LOGS ARE RE6!UIRED AND HUST BE RETURNED TO TNE DEPRRTIqENT NITHIN
OF THE NELL COHPLETION.
SPECtF'ICRTIONS RNA CONSTRUCTION DIRGRRHS ARE AVAILABLE 'T'O INSURE F'ROPER
I NSTALLAT t ON.
I
:1.:
FORTH E:'.r' THE HIJNICIPRLIT'T' OF ANCHORAGE.
2: I NILL. INSTALL. THE S'-r'STEH IN RI::COR[:'RNCE WITH THE CODES.
I :,=,dEB B ~-- ' - '-~ ...............
CERT I F'.r' THAT ._,[_ i
I Rr,'l FRHILIAR WITH THE RE6!LIIREHENT2~ FOR ON-:qiTE SENERS AND NEL.LS RS
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: Garness Engineering Group Ltd (GEG) Phone: 907-337-6179
Address: 3701 East Tudor Road Suite 101- Anchorage, Alaska 99507
Engineer's Printed Name: Jeffrey A. Garness Date: t'
In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system
in accordance with the guidelines and regulations established by the Municipality of Anchorage and
industry practices. The reported results describe the condition of the system/s on the date/s of the
evaluation. Separation distances were measured to readily identifiable features. Hidden defects or
encroachments may exist that were not identified during the evaluation. The operational life of all wells
and septic systems depend upon a variety of variables, including but not limited to, soil conditions,
groundwater levels (that may fluctuate during the gear), quality of construction (materials and Q g �H
workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and • . • "'
are outside the control of GEG. Satisfactory test results do not guarantee future performance of the
system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of ;
the well or septic system. GEG makes no representation whether an alternative well or septic system Q J f. A Corn ss.
can be installed on the property in the event either of the current systems fail to perform adequately in OQ /CE-
9
the future. The content of this report is for the sole benefit of the person/party that retained GEG to o`
QQ4r x
perform the evaluation. Reliance upon the information provided in this report by any other person or P eC f�''�,�
o
party (including subsequent property purchasers) is not authorized, nor will it confer any legal right �00 proI fess*%00
whatsoever. O�OpGod
#AECC884
6. DSD SIGNATURE ``,lllltttttt((t���t�
System #1 Approved for bedrooms `�`� �� rrir
System #2 Approved for bedrooms ,-
. Disapproved � ON-SITE V60)
WATER AND
Conditional approval for bedrooms, with the following stipaioiSTEV''ATER 0
PROGKAM
r
By: Original Certificate Date.
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 Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA Checklist
Legal Description: LITTLE BEAR; BLOCK 1, LOT 10
If more than 1 septic system on lot: COSA Checklist # 1 of
A. WELL DATA
❑■ Well log is filed with Onsite (or attached)
Date drilled 1/7/77
Total depth 94 ft
Cased to UNKNOWN ft
❑■ Sanitary seal is functioning correctly
0 Wires are properly protected
Casing height (above ground) 12+ in.
Date of flow test for COSA 4/7/20
Static water level at beginning of test 14.4 ft.
Comments
B. TADATA
Age of tank(s years
Tank type/materia
Measured operating flui v
❑ Standpipes/foundation cl(
Date of pumping
I in septic tank
ab,ct.ut per record drawing
D. ABSORPTION FIELD DATA
Which system tested (date installed)
❑ ALL standpipes present per record drawing
Total measured depth from grade ft (m
Measured depth to pipe invert from grade
❑ N/A — pressurized field
ft (min)
❑ Monitor tubes go to bottom of ective. If not, state
depth into effective
❑ Code -required soil ver over field
❑ System pres ed
(Required if cant for greater than 30 days prior to
date of t
Parcel ID: 014-061-27
Structure served by this system 1
Well production at time of test 2.2+ gpm
Water storage tank volume N/A gallons
Well disinfected for coliform test? ❑ Yes Q No
Coliform bacteria is Negative
Nitrate 1-11,41 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L [�Xrsenic less than MRL (ND)
Collected by GEG, LTD.
Date of Sample 4/7/20
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments:
Adequacy test date
ults Q Pass For bedrooms
Fluid th prior to test in
Water adde gal
New depth
Elapsed time ml
Final fluid depth in
Absorption rategpd
Any rejuvenation treatment (past 12 mon h;
cons introduced gallons If yes, enter date
ents/Deficiencies:
COSA Checklist yellow sheet
cA,
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100'
❑ Yes
NSA
Community Sewer Manhole/Cleanout > 100' *50'+
Yes if No ft
es
❑ Yes
if No
ft
❑
Water Sery Line > 10'
Neighboring Tank > 100'
❑✓ Yes
if No
ft
Private Sewer/Septic Line > 25'✓❑ Yes
if No ft
Absorption Field on Lot > 100'
❑ Yes
if No
NSA ft
Holding Tank > 100' ✓❑ Yes
if No ft
Neighboring Absorption Fields
> 100'
Animal Containment > 50' ✓❑ Yes
if No ft
❑✓ Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75'
F1Yes
if No
*50+ ft✓❑
Yes
if No ft
Septic/Holding Tank on Lot to: (Please
enter distances if less than required)
Building Fo dations > 10'
❑ Yes
if No
ft
Surface Water > 100' ❑ Yes
o ft
Property Line > 5'
❑ Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5'
Yes
if No
ft
Private Wells > 10 ❑ Yes
if No ft
Water Main > 10'
❑ Ye
if No
ft
Commu Wells > 200' ❑Yes
if No ft
Water Service Line > 10'
❑ Yes
if No
ft
I ptic tank is under driveway comment below
From Absorption Field on Lot to: (Please enter dis b
Building Foundation > 10'
❑ Yes
o ft
Property Line > 10'
es
if No ft
Water'Main > 10'
❑ Yes
if Nc ft
Water Sery Line > 10'
F-1 Yes
if No ft
Sw ace Water > 100'
❑ Yes
if No ft
than required)
Iflf absorption field is under driveway comment below
Wells on Adtac nt Lots:
Private Wells > 10U' ❑ Yes if No ft
Community Wells > 200' ``] Yes if No ft
F. ENGINEER'S COMMENTS
*MET CODE AT TIME OF DRILLING (SEE ATTACHED DOCUMENTS)
G. ENGINEER'S CERTIFICATION
1 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.
COSA Checklist yellow sheet
#AECC884
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PLnTE I PLAN PROFILE
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SCALE
i III 'I ilii Engineers
I
SANITARY SEWER
and Aqsociatcs
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VICINITY MAP
' SCALE: 1% I Mlla
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VICINITY MAP
' SCALE: 1% I Mlla
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SANITARY SEWER
and Aqsociatcs
of
Baby Beor Place
..
I
IVIUNICIPALITY OF ANCHORAGE
DEPARTtVIENT OF HEALTH AND ENVIRONIVlENTAL PROTECTION
DIVISION OF ENVIRON~'IENTAL 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) Applicant Name ~]~ ~ Telephone:Home ~? O~[W Business
Applicant Address ~ 5/ ~ ~>~ ~~
(c) Applicant is (check one): Lending Institution ~; Owner/builder ~; Buyer D; Other D (explain);
(d) Lending Institution 1,~¢ ~. ~. ~ ~, Telephone
(e)
Address
Real Estate Company and Agent
Address
Telephone
(f) Mail the HAA to the following address:
TYPE OF RESIDENCE
Single-Family~ Multi-Family__[]
Number of Bedrooms
Other
WATER SUPPLY
Individual Well~ Community [] Public []
/
Note: If comrflunity 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 well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status,
Page I of 2 72-025 (11/84)
ENGINEERING FIRE~ PROVIDII'~ INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORIVIATION
As certified by my seal affixed hereto and as of the validation 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 ~ ~¢_4~ ~,,,,~..~ Telephone
Address ¢~¢ .~;~ U~'
Approved for "~f~O0 bedrooms Date
Approved ~ Disappro~e'd Conditional
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.
Page 2 of 2
WELL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST- FEBRUARY 1984
264-4720
Legal Description: ~....o-r'
L 'r'r
Well Classification '~" ~---"~ If Al B, C, D.E.C. Approved (Y/N)
Well Log Present (Y/N) '~ Date Completed Jl"~/~7 Yield
Total Depth ~ Cased to ~ ~r Depth of Grouting
Static Water Level '~, ~, Pump Set At
Casing Height Above Ground Sanitary Seal on Casing (Y/N)
Electrical Wiring in Conduit (Y/N) Y Depression Around Wellhead (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot ~1~¢/,,~ ; On Adjoining Lots
To Nearest Edge of Absorption Field on Lot ~I'¢~',¢~' ; On Adjoining Lots
To Nearest Public Sewer Line ~;~;~.. To Nearest Public Sewer
Cleanout/Manhole I '~-. TO Nearest Sewer Service Line on Lot
Water Sample Collected by '"~"' -~ ; Date !
Water Sample Test Results '~"~¢-,~
Comments
Bm SEPTIC/HOLDING TANK DATA
Date Installed
Standpipes (Y/N) Air-tight Caps (Y/N)
Depression over Tank (Y/N)
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well
To Property Line
To Water Main/Service Line
Course
Size No. of Compartments
Foundation Cleanout (Y/N)
Date Last Pumped
; for
Temporary Holding Tank Permit (Y/N)
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
o. A.SO T, ATA NOI',I
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation
Lot
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Standpipes Present (Y/N)
Date of Last Adequacy Test
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots
To Cutbank (if present)
D. LIFT STATION N (~) ~,~ ~
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verifj,ed, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed ""~'- ~ _ Date 111'1/I ¢-,,¢/~"~--~ .
Company ~ ~ MOA No. ~l ~/
Page 2 of 2 ~:~.:,. ,.~ , ¢-
203 W. 15th AVE "C" SUITE 203
ANCHORAGE, ALASKA 99501
TELEPHONE: (907) 279.3916
RESIDENTIAL WELL INSPECTION
LEGAL:
LOCATION:
LOT 10, BLOCK 1, LITTLE BEAR SUBDIVISION
6631 BABY BEAR DRIVE
OWNER:
SIGMA ALPHA
TYPE OF WELL:
WELL LOG AVAILABLE:
SINGLE FAMILY
YES
INSTALLATION REQUIREMENTS MET: YES
WELL YIELD FROM WELL LOG: 15 GALLONS PER MINUTE
PUMP YIELD: 7+ GALLONS PER MINUTE
DATE OF INSPECTION: DECEMBER 10, 1985
0
TEST PROCEDURE:
WELL WAS PUMPED AT A CONSTANT RATE OF 7
GALLONS PER MINUTE WHILE THE DRAWDOWN WAS
MONITORED WITH AN ACOUSTIC PROBE. THE WELL
WAS PUMPED TILL THE DRAWDOWN STABILIZED.
STATIC WATER LKEVEL WAS FOUND 33 FEET BELOW
TOP OF CASING. AFTER 15 MINUTES OF PUMPING
THE WATERLEVEL STBILIZD AT 54 FEET. WELL WAS
PUMPED FOR 15 MORE MINUTES WITHOUT FURTHER
DROP IN LEVEL.
TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA
DECEMBER 11, 1985. TEST WAS NEGATIVE.
TEST RESULT:
ON
THIS WELL MEETS THE REQUIREMENTS OF THE
MUNICIPALITY OF ANCHORAGE.
The Municipal requirement for well flow is
150 gallons of water per bedroom per 24
hours. This well surpasses this requirement.
The assessment of the condition of this well
applies only to the conditions as of this
date. The flow rate of the well may change
due to subsurface conditions that may not be
observed from the surface, and changes in
land use and other factors that may impact
the conditions of the aquifer feeding the
well.
Time ¥ime
Date Date Date
Inspector Inspector Inspector
Comments Conditional Approval
Date Sewer Installed Permit No. Septic Tank Size
Holding Tank Size
Soils Rating Well To Absorption Area Well Log Received
Well to Tank
APPLICANT FILLS OUT LOWER HALF ONLY
Property Owner P~I i~ ~ ~' ~ /~ Phone
Buyer ~ ~dT~
Address ~%~
Lending Institution ~/~/~ o ~ /'~¢ ~- /~/¢ ~ ~' Phone
Address 3¢ 0 /.
Realty Co. & Agent / ~/~ ~//Z~ d¢~/~/~/'- /~]///~ g:~~ Phone
Legal Description Z~ /D ~ 4 ~ / ~ Z/~'~ ~ ~~ ~ .
Type~ Residence
~'Single Family
~ Multiple Family No. of Bedrooms
~ Other
Wat~upply
~ Individual A~ACH WELL LOG. A well log is required for all wells drilled since June
~ Community ' 1975. For wells drilled prior to that date, give well depth (attach log if
~ Public Utilit~ available.}
Sewage Disposal
~lndividual Year Individual Installed: . '~ ,
Public Utility When Connected to Public Utility:. ~'~':
~ Holdin~ Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING~CAN BE INITIATED.
%\
~ ~-"MUNICIPALITV OF ANCHORAGF~
!.-,//~'-~__~?.'"~ ~:DERARTMENT',,,.,F HEA:IWTH AND ENVIRONMENTAL PROTEOTION
· ':;':~'~}~x~ .' -' 82'5 L s[reet, Ancliorage, Alaska 99501
~.(~~)), ] ~ ',.~ . 279--2511', e=t. 224, 225
-" ~ ~ -~ Date Received: March 21,
197
1st Inspection: Time 1:30 p.m.
Date 3-22-77 Tues
2nd Inspection: Time
Date
Inspector Dixson
Inspector
REQUEST FOR APPROVAL OF INDIVIDUAL.SEWER AND WATER FACILITIES
o
Lending institution Request: Alaska National Bank of the North
Mailing Address: 3301 C Street, calais II Phone: 277-5511
Property Owner:
Mailing Address;
Donald Dahl/Dahl Construction
Phone: 344-5720
Star'Route A Box 79 99507
2
Legal Description: Lot 10 Block 1 Little Bear Subdivision
Permi
Single Family Residence: (x) Number of Bedrooms:
Multiple Family Residencef ( ) Number of Bedrooms:
Permit #76311
Well Data: Type Individual Depth 94'
Construction ~/_~_~~ Bacterial Analysis
Sewage Disposal System:
Well Log Filed 5x)
On-site system ( ) Public Utility ~x~
Septic Tank Size
Absorption Area
Installed Installer
Manufacturer
Soils Rate Material
o
Dishances: Well to Septic Tank
to Sewer Lines Nearest Lot Line
Absorption Area to Nearest Lot Line
to kbsorption Area
Page'Two
Department of Health and Environmental Protection
-J Request for Approval of Individual Sewer and Water Facilities
Legal Description: Lot 10 Block 1 Little Bear Subdivision
Comments:
Affadavit Attached: ( )
Disapproved:
Letter Attached: ( )
Date:
Department Worksheet:
~/' MUNICIPALI'i'Y OF ANCHOPJ'~(~?'
MUNICIPALITY OF ANCHORAGE DEPT.
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTIO~I~IVIRONMEHTAL pRO'r[~CTION
2510 Ea~ Tudor Road, Anchorage, Alaska 99504 276-222~
~,~R ~ ~ 19/7
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES RECEI
1. Type of Inspection: CMRO VA__ FHA. CONV
Mailing Address: /~,.Y' '~ .~' ,~"7~_,~'~_ /lift-Day Phone: .~'5//-/... 5" '~ ~'~)
3.Name of Buyer: /t~ __~_~_ _~ ..~ ~ ~. -~ ~
Mailing Address: Day Phone:
Name of Lending Institution:
MailingAddress:(~,~/.~ '~ .~.~4~'/ (~'~'P'~-I~one.'?~" cb~ '~-~)/~
.. s _
7. Type of Facility to be lnspected: ~,~ /~ '~'~t,-,.-~ i I~,, No. Bdrms. ~'-
Water Supply
Type of Supply: Public Utility.
If Individual, number of dwellings presently served
If Individual, depth of well ~q!
,Individual
Sewage Disposal System
Type of System: Public Utility
If Individual, date of installation ~
f Individual (on-site)
..
72-003(3/76)