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Home My WebLink AboutHILLCREST BLK 8 LT 2D 71 GREM ER ANCHORAGE AREA BORuvGH Department of Environmental Quality �.- 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAMEE�'�LL� �'�t� MAILING ADDRESS PHONE LOCATION LEGAL DESCRIPTION L Z- 3k Y SSC TANK: DISTANCE NUMBER OF FROM WELL MANUFACTURER MATERIAL COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY`QMP�`Od GALLONS. SEEPAGE PIT: NUMBER OF PITS LINING MATERIAL BUILDING FOUNDATION DIAMETER OR. WIDTH—,LENGTH_, DEPTH _ CRIB SIZE: DIAMETER DEPTH DISTANCE FROM: WELL TOTAL EFFECTIVE NEAREST LOT LINE ABSORPTION AREA (WALL AREA) SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE CONSTRUCTION DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION LOT LINE SEWER LINE—,TANK—,SYSTEM CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY:to r �T 6"� PIPE MATERIAL: (td 01 �p LOT SLOPE: REMARKS: DATE Zc-If3Z 2 J_ APPROVED G.A.A.B. GREATER ANCHORAGE .AREA BOROUGH n ,q4°pG DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. tu' 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 e. . SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT K t ""`� MAILING ADDRESS PHONE INSTALLATION LOCATION LEGAL DESCRIPT INSTALLATION OF:I ' SEPTtC"TANK TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH SOIL TEST RESULTS COMPLETION DATE ANTICIPATED SEEPAGE PIT , DRAIN FIELD , OTHER , TO BE INSTALLED BY NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST 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. D C.) C' v C 'it'ANK SIZE TYPE MINIMUM DISSTT NOES, REQUIREMENTS FOUNDATION T05EPTtC=TANK FOUNDATION TO SEEPAGE PIT , DRAIN FIELD SEEPAGE AREA SIZE SETIC TANK TO SEEPAGE PIT WALL f SEP -T44 -TANK 4�, SEEPAGE PIT , DRAIN FIELD TO NO.fA)EST LOT LINE. fi WELL TO, -SEP -'FIC TANK � �� ,SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT 114 RAMI FIELD 4 > S%PTIC TANK, I , 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 REGULATIO S REGARDING INSTALLATION. 1 OR LICENSED DESIGNER TYPE DIAGRAM OF SYSTEM i r I I f ii1 1€� -�- —_ TI- -if -III I ji I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBEDSYSTEM IS IIVfACCORDANCE WITH SAID CODE. DATE r APPLICANT'S SIGNATURE t FORM NO. EQ -01 6 'n. •�t June 24, 1976 POUCH 6-650 ANCHORAGE, ALASKA 99502 (907) 278-4531 GEORGE M. SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Environmental Sanitation Division (2510 East Tudor Road) To whom it may concern: Subject: Holding tank on Lot 2, Block 8, Hillcrest subdivision. An approved holding tank has been installed on Lot 2, Block 8, Hillcrest subdivision, that is adequate to serve a 3 bedroom dwelling. A copy of signed agreement between the ocupant and a pumping company, reflecting this holding tank will be pumped out as requred, must be furnished this office. roeBlair i9,7 19 TYINI .11-AUI,Y yr ANCHORAGES DEPT. GF HEALTH ENVIRONiv1ENTAL PRO i E' .TION pp r M -W DRILLING, Inc. /�, L' f�.`'�, P. O. Box 4-1224 1310C International Airport Road �, • (907) 274-4611 ANCHORAGE, ALASKA 99509 RECEIVED DRILLING LOG Well Owner Use of Well - Location (address of: Township, Range, Section, if known; or distance main road Size of casing Depth of Hole feet Cased to feet Static water level ft. (above•)- (below) land surface. Finish of well (check one) open end Screen ( ) ; Perforated Describe screen or perforation Well pumping test at gallons per ,(hour) (minute) for ,: hours with 3 ft. of drawdown from static level. Date of completion WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness TO 7 TO `, 75 To -1,-A7 . Tip; i?7;1y !',;.- fli f-nd Goiltractor Q4 A —a -'at" 2 —STATE MUNICIPALITY OF ANCHORAGE Development Services Department '. Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On-Site Systems Approval Parcel I.D. 016-271-41 Expiration Date: tr 2 gr! q 1. GENERAL INFORMATION Complete legal description HILLCREST BLK 8 LT 2 • Location (site address) 1116 CONTRARY CT, ANCH AK Current property owner(s) JEAN TOSCANO Day phone Mailing address P.O. BOX 113062 Real estate agent Day phone C 2. TYPE OF DWELLING:Single Family (w/wo ADU) •Duplex22019 Multiple Dwellings (Single Family and/or Duplex)3. NUMBER OF BEDROOMS: 38L9 � 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic • ❑ Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System LJ Public Sewer Waiver request for: Distance: Received by: Date: 3 ilri COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ .. Z) Waiver Fee $ Date of Payment 02.13119 Date of Payment Receipt Number /�� n613`/? J, Receipt Number CJ COSA# c�(��'7/Uv I 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. I acknowledge that On-Site staff may visit the site to verify the information submitted. Name of Firm MIKE N ANDERSON, P.E. Phone 727-8864 Address 4661 NATRONA AVE ANCH AK Engineer's Printed Name MIKE N ANDERSON, P.E. Date 2-27-19 6. DSD SIGNATURE %', •°497H \� o°o J/��/ System#1 Approved for 3 bedrooms fi°o°° 0 .i s...Petry System #2 Approved for bedrooms MICHAEL N. ANDoneN Disapproved �� , • C/ 9/469 ?x,40 09 Conditional approval for bedrooms, with the following stipulttj• ffssiO'0%.� • `� a4` , N-SITEvvATE WAST EwAT D rni PROGRAM Q SERVI* Original Certificate Date: 3- The -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 X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other . • COSA Checklist blue sheet COSA Checklist Legal Description: HILLCREST BLK 8 LT 2 Parcel ID: 016-271-41 If more than 1 septic system on lot: COSA Checklist# of Structure served by this system A. WELL DATA ❑■ Well log is filed with Onsite (or attached) Well production at time of test 6+ gpm Date drilled �-'�"f"76 Water storage tank volume 0 gallons Total depth 111 ft Well disinfected for coliform test? 1Yes I�No Cased to /1 / ft ref Coliform bacteria is Negative E Sanitary seal is functioning correctly Nitrate mg/L [Nitrate less than MRL (ND) 0 Wires are properly protected 14. Arsenic 170 ug/L ❑Arsenic� less than MRL (ND) 1.5+Casing height(above ground) 24 in. Collected by Z- � _ ( � Date of flow test for COSA 2/13119 Date of Sample Wl►Y/ A Static water level at beginning of test 2-Z ft. Comments COMM. SEWER 0 h 'Ted- oR I ,1 B. TANK DATA C. LIFT STATION Age of tank(s) years ❑ Required maintenance completed Tank type/material Age of lift station years Measured operating fluid level in septic tank Lift station material ❑ Standpipes/foundation cleanout per record drawing Comments: Date of pumping D. ABSORPTION FIELD DATA Which system tested (date installed) Adequacy test date ❑ALL standpipes present per record drawing Results 0 Pass For bedrooms Total measured depth from grade ft(max) Fluid depth prior to test in Measured depth to pipe invert from grade ft(min) Water added gal ❑ N/A—pressurized field New depth in ❑ Monitor tubes go to bottom of effective. If not, state Elapsed time min depth into effective ❑ Code-required soil cover over field Final fluid depth in ❑ System presoaked Absorption rate gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: COSA Checklist yellow sheet 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' Community Sewer Manhole/Cleanout> 100' —0 Yes if No ft 0✓ Yes if No ft Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line>25' M Yes if No ft Absorption Field on Lot> 100' ✓0 Yes if No ft Holding Tank> 100' 0✓ Yes if No ft Neighboring Absorption Fields> 100' Animal Containment> 50' E Yes if No ft ❑✓ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main> 75' Q✓ Yes if No ft ✓❑Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations> 10' 1 Yes if No ft Surface Water> 100' ❑✓ Yes if No ft Property Line > 5' EI 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' p 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' ✓0 Yes if No ft Private Wells> 100' QQ Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft Community Wells>200' E✓ Yes if No ft Surface Water> 100' ✓❑ Yes if No ft F. ENGINEER'S COMMENTS "i,\V:••. .,•,rte G. ENGINEER'S CERTIFICATION # --;.• ••:- y`?� i •:'449TH .d' • ... ,� I certify that I have determined through field inspections and review /•• • • •. of Municipal records that the above systems are in conformance with I F MOA COSA guidelines in effect on this date. /•• . " • :Z: +; .' NDERSC,V 411 f CE�gK,9 %, . ,�::s COSA Checklist yellow sheet MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT • ' c : 907-343-7904 On-Site Water and Wastewater Section ' Fax: 343-7997 www.muni.org/onsite • Arsenic Advisors' Certificate of On-Site Systems Approval # OSC191057 Subdivision: Hillcrest ,Block, 8 Lot 2 A water sample revealed an arsenic concentration of 170 &21.4 micrograms per liter (ug/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Information on arsenic is available from the On-Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. Mailing Address: P.0. Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org (--- 1 i , . E • '-0 • 25 ® N00°08'00"W 140.15 . ° Mcn 1 I` ' coo P 0 o / 1 1 �zI-H30.5 c.,4 IIS- \\ i 0 I /U CD 40.4 r. O c - ONE STORY 1 I � I O MODULAR HOME Cri Ai 6) NO PERMANENT FOUNDATION _/ �p 12.8 19.4 _ 17.4__ —\ w 7.5 w o0 0 O 0 I I o F.4 —9_ o ra O n w 40.4 1 N00°08'00"W 140.15 NOTE; 1 I Some minor features may be omitted due to deep snow and ice at the time of this survey. I Date Scale Legal Description 2/15/2019 1' = 20 .4...'46.\ Grid Lot 2 Block 8 44W OF• A\\ SW 2432 As-Built HILLCREST GRAPHIC SCALE: 1 Inch = 20 Feet Air,,t,,,` ,) `q� , Drawn by Field Book SUBDIVISION II II /`�• • ,I, y BFB ASB2019 PLAT # 71-118 10 0 10 20 40 r* .'4 • :�_, i\ *�/ I hereby certify that the property described hereon has been surveyed • BOBBYF. BURNETT by me, or at my direction, and that the improvements situated thereon F. BURNFTT are within the property lines and do not overlap or encroach on the 14 BOBBY / LS-5484 / 2941 Carriage Drive property lying adjacent thereto unless otherwise shown. That no /S ,( F 4 Anchorage, Alaska 99507 improvements on the property lying adjacent thereto encroach on the , g�,,, � • • o (907) 350-5541 premises in question and that there are no roadways, transmission ` '' ssroN�ti 4.) lines or other easements on said property except as shown. w```_f