HomeMy WebLinkAboutLANGNES LT 5Langnes
Lot 5
#016-151-54
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a Certified
Well
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#� LocatiorL .. rLangnes Subdivision
gree a� I ' Date Complebed 11,:,2./y�:
Depth of well 1-7
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Size of CaSing Six . no..h..
Distance _Water : 79�� 1�% ) }'�jr+ 5
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I certify, the above true and correctRECE �
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1 1335 I IGRA PH.' 279-2343
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ANCHORAGE,. ALASKA 99501 cc '' D (zG.Sn_I / +
We advise you to attach this certificate to your deed.
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Municipality of Anchorage
On -Site Water &Wastewater Program
(907)343-7904
1� SSLLUf1C C—'.
e- t
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 016-151-54 Expiration Date: Lo —2
1. GENERAL INFORMATION
Complete legal description LANGNES S/D LOT 5
Location (site address)
301
LANGNES COURT, ANCHORAGE
AK, 99515
Current Property owner(s)
DON
WAGNER
Day phone 344-5939
Mailing address
301
LANGNES COURT, ANCHORAGE,
AK, 99515
Real Estate Agent
JUDY
ROSENBERG W/ PRUDENTIAL
Day phone 229-1097
2. TYPE OF DWELLING:
N Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
3
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
LJ
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
Received by.' ' (
Date:
COSA to be released to the engineer, unless otherwise reques'
d by the engineer.
COSA Fee $_
Date of Paymen
Receipt Number
COSA #
Waiver Fee $
Date of Payment
Receipt Number
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 GARNESS ENGINEERING GROUP, Ltd.
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK, 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineers Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & 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 wells 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 owner listed 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.
6. DSD SIGNATURE
System #1 Approved for ? bedrooms.
System #2 Approved for
Disapproved.
Conditional approval for
bedrooms.
Phone
337-6179
Date O j 2 U
bedrooms, with the following stipulations:
k��Y tOF (fir
j ON-SITE
MATER AND
Original Certificate Date: �? _,Z) 3 - / 3
The Mlirflcipaliry or Anch&6ge Develop,emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the represenatations 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. ATTCHMENTS:
COSA Checklist
Septic System Advisory
Well Flow Advisory
(Rev. 11105)
Nitrate Advisory
Arsenic Advisory
Other
If more than 1 septic system is on the lot:
COSA Checklist # _of
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description: LANGNES S/D; LOT 5 Parcel ID: 016-151-54
A. WELL DATA *ASSUMED BASED UPON SURROUNDING WELL LOGS. SEE ATTACHED.
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (YIN) YES
Date completed 11/24/1972 Sanitary seal (YIN) YES Wires properly protected (Y/N) YES
Total depth 117 ft. Cased to *40+ ft. Casing height (above ground) 12+ in.
FROM WELL LOG
Date of test 11/24/1972
Static water level 79 ft.
Well production 20 g.p.m. —
WATER SAMPLE RESULTS:
Coliform colonies/100 ml. Nitrate NO mg./L.
Arsenic: /U b ug./L. Date of sample: 7/25/2013
B. SEPTICIHOLDING TANK DATA IPUBLIC SEWER
Tank Type/Material
Tank size gal. Number of Compartments
Foundation cleanout (Y/N) _ Depression over tank (Y/N) _ High water alarm
AT INSPECTION
5/30/2013
83
4.12+
ft.
Collected by: GEG, Ltd.
Date installed
Cleanouts(Y/N)
Date of pumping
C. ABSORPTION FIELD DATA
Date installed
Length it.
Total depth ft. Eff.
Date of adequacy test
Pumper.
Soil rating (g.p.d./ft2or
Width i
System type
Gravel below pipe ft.
ft Monitoring tube_ Depression over field
Results (Pass/Fail) For bedrooms
Fluid depth in absor ' n field before test _ in. Water added _gal. New depth _in.
Elapsed T' _ min. Final fluid depth _ in. Absorption rate >= g.p.d_
y rejuvenation treatment (past 12 mo.) (Y/N & type)
If yes, give date
D. LIFT STATION
Date installed Size in gallons ManholelAccess
"Pump on" level at in. "Pump off' level
E. SEPARATION DISTANCES
level
Cycles tested Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot N/A On adjacent lots 100'+
Absorption field on lot N/A On adjacent lots 100'+
Public sewer main 75'+
Sewer /septic service line 25'+
Public sewer manhole/cleanout 100'+
Holding tank N/A
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: PUBLIC SEWER
Building foundation
Water main
Wells on adjacent lots
Property
Absorption
Water service line Surface water.
SEPARATION DISTANCE FROM ABSORPTION
Property line .
Water service
m
Cudvrain
F. COMMENTS
G. ENGINEER'S CERTIFICATION
1
Water
Surface water Driveway, parking/vehicle storage
Wells on adjacent lots
I certify that l 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 JEFFREY A. GARNESS
Date ?i) 12-)13
(Rev. 11105)
Municipality of Anchorage
ye I, a „ a yri3#at'�
On -Site Water &Wastewater Program
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 016-151-54 Expiration Date:
1. GENERAL INFORMATION
Complete legal description LANGNES S/D; LOT 5
Location (site address) 301 LANGNES COURT, ANCHORAGE, AK, 99515
Current Property owner(s) DON WAGNER
Mailing address
Real Estate Agent
Day phone 344-5939
301 LANGNES COURT ANCHORAGE, AK, 99515
JUDY ROSENBER W/ PRUDENTIAL Day phone
2. TYPE OF DWELLING:
N Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY:
229-1097
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
LJ
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ $�RL�,w Waiver Fee $
Date of Payment �/�a�/3 Date of Payment
Receipt Number 22� Receipt Number
COSA # �� w1a q Waiver #
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, 1 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. t 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
Address
GARNESS ENGINEERING GROUP, Ltd.
3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK, 99507
Phone
Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date
Engineer's Comments:
In conducting this evaluation, GEG, VD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines 8 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 identire ble to a tures. The operational life of off wells 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. Sab'sfactory 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 DSO. The content of this report is for
the sole benefit of the owner listed 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.
6. DSD SIG ATURE
System #1 Approved for 3
System #2 Approved for
Disapproved.
Conditional approval for
bedrooms.
bedrooms.
337-6179
&l5 U
bedrooms, with the following stipulations:
�J
ON-SITE V
WATER AND
m WASTEWATER C)
PROGRA,vt
Original Certificate Date: 6- 1 / - Y3 -
The Muheipalify,6&A$ [�Wge Develop,emt Services Division (DSD) issues Cenificates of On -Site Systems Approval (COSA) based only
upon the represenatations 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. ATTCHMENTS:
COSA Checklist
Septic System Advisory
Well Flow Advisory
(Rev. 11105)
Nitrate Advisory
Arsenic Advisory
Other
If more than 1 septic system is on the lot:
COSA Checklist # of
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description: LANGNES S/D; LOT 5 Parcel ID: 016-151-54
A. WELL DATA *ASSUMED BASED UPON SURROUNDING WELL LOGS. SEE ATTACHED.
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES
Date completed 11 /24/1972 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth 117 ft. Cased to *40+ ft. Casing height (above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test 11/24/1972 5/30/2013
Static water level 79 ft. 83 ft.
Well production 20 g.p.m. 4.12+ g.
WATER SAMPLE RESULTS:
Coliform O colonies/100 ml.
Arsenic: mug./L.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material _
Tank size gal.
Foundation cleanout (Y/N)
Date of pumping
C. ABSORPTION FIELD DATA
Date installed
Length ft.
Total depth ft. Eff.
Date of adequacy test
Nitrate NO mg./L.
Date of sample: 5/22/2013
PUBLIC SEWER
Number of Compartments
_ Depression over tank (Y/N) _
Pumper
Collected by: GEG, Ltd.
Date installed
Cleanouts(Y/N)
High water alarm
Soil rating (g.p.d./ft2or ft2/bdr System type
Width ft. Gravel below pipe ft.
bsorptio ea—ft 2 Monitoring tube Depression over field
Results (Pass/Fail) For bedrooms
Fluid depth in absor n field before test _ in.
Elapsed Ti _ min. Final fluid depth
y rejuvenation treatment (past 12 mo.) (Y/N & type)
Water added _gal. New depth _in.
in. Absorption rate >= g.p.d.
If yes, give date
D. LIFT STATION
Date installed
"Pump on" level at in.
Size in gallons Manhole/Access (Y/N)
"Pump off"level at wa er 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 N/A On adjacent lots 100'+
Absorption field on lot N/A On adjacent lots 100'+
Public sewer main 75'+ Public sewer manhole/cleanout 100'+
Sewer /septic service line 25'+ Holding tank N/A
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: PUBLIC SEWER
Building foundation
Water main
Wells on adjacent lots
Property line - Absorption
Water service line Surface w
SEPARATION DISTANCE FROM ABSORPTION FIE LOT TO:
Property line B 'oundation Water main
Water service line Surface water Driveway, parking/vehicle storage
Cuftg-ln�drain Wells on adjacent lots
F. COMMENTS
G. ENGINEER'S CERTIFICATION o<G _ .......
I certify that t 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. O ',J A. rness:'
Engineer's Printed Name JEFFREY A. GARNESS DO .. E -79i53
Date
(Rev. 11!05)
fro
Eav,237.98'
I
I to to _ /, • �..
h IN ai r
- i I Igo• --'fit•• 0
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� 39, 230 SF f 1 p
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LA NG NES SUED. IPq
Z LI ship � $
93. f' IP' no fad \
at !d'Ufil. Erm>'
7 Fad.3/s" Wesf 23789' __
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/l���S►,e� 1 hereby certify that an accuraie survey of the
O/ ti pp .4 ; a following described property:
I�y�P,..••••••• , �r. L07 5, LANGNES S!/BGt
*•• a * rPy/-2�9J
• 49th '
.. -i. N %Wem4er 9, 1997
�^ F. IfE WAWIKM
w \,rr •
No, 3143-S
W O%i" ESi P& Y'
4
0017
f
f2,Re64r
AS -BUILT
ed Mereoo ate 11114117 the propert7r lines and do nal
IYNN.
DATE
GRM
nvnach on the Property tying a�jacent thereto
'ovencafs on the property lylrp adjacent therela
CR
FILE NO.
!0-/0-97
F
2730
JOB
the premises In 4u$*1IW and that there ars no
- 9701
N
ronsmieeion lines at other visible easements on
97/4
/p, 40
9799
r a=pl as Indicated hereon.
-
KARABEL N/KOFF
Alaska, this 10th day of 61OJr4/J or .1997
SURVEY/NG 337-3434
GREATEN ANCHCRAGE AREA BOROUGH
D,inartrient of E:nvfronment;33 (?a?lity
3500 Pidor ?i>al. An,chm•a7�,, Alaska 99507 279-9696
Dai,e Rpceivr-d /— a?/- %3
Time of Insnection
Date of Insnr;ction
FOP AuOROVAL QF
INDIVIDUAL ''EiN['u & ''AATER FACILITIES
1. Aoproval Requested 9y:
Address: U� �7 ^� g�i-'hone
2. Pronerty. Owner :���j/yy(f(�- Phone
3. Legal, Description:
4, Location:
5. Tyne of Facility i:o
Number of Bedrooms:
6. Well Data:
C. Cors+..ruction D. flacterial Analysis
7, Sewage Disoosal System:
A. Installed I /I / � ?, Installer
C. Septic Tank: 1. ' ize�O�))z2. Manufacturer_ `------��
D om : ?.. Sire Y;I( 2. Material.
E. Disposal Field: To) al. Tarr. th of Lines
B. Distances:
r!1 /
A. Well To: Sentic Tank Absorrtion Area f Sewer Lines
Other Contamination
?3. Foundation to Sonti.c T?nk Ah>orotion Avsa
C. Absorotion Area to r.[eares' Lat;
Request for Anprovai of lr,dividual Sewer & Water Facilities
Facie Two
9. Comments:.
ed -1,461,& DisapprovedDate — 0/- 7
Approval Valid for One Year. From Date Signed
Greater Anchorage Ares Borough, Department of Envirnnrrental lity
DZAG?APG Or SYSTEM.
0
a# /
!W.J.
!17
JfiFp,46w�'
T certify that the information containe-1 in this request for approval to be a true
and accurate representation of the sewer and water facilities located at:
Si'lned Date
January 31, 1973
Greater Anchorage Area Borough
Department of Bn.vironmental nuality
3333 C Street
Anchorage, Alaska 99503
Gentlemen:
Z hereby voluntarily agree to hook up to public sewer_
on Lot 5, Langnes Subdivision, at such time as it
becomes available.
very truly yours,
Sigurd M. Langnes
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3500 Tudor Road, Anchorage, Alaska 99507 279-8696
Date Received __/
Time of Tnsnection
Date of Inspection/=.,:? �, -2 -,3 /oma,,,
REQUEST FOR APPROVAL OF
INT
TVIDUAL SEWER & '11IATER FACILITIES
FOR
1. Approval Requested 8y: /� -A—,•
Address : 5" 39 Phone: y-
2. Property Owner: `�_ Phone:_
3, Legal Description:
4, location:
V t
5. Type of Facility to be Tnsperted:
0�
Number of Bedrooms:
6. Well. Data:
A. Tvpe
C. Constructi on_4_ Z"44�,
7, Sewage Disoosal System:
A.
C.
D.
i
B. Deptb_ --.%�-
D. 9acterial Analysis
Tristalled,—L ! I 9. Installer
Septic Tank. 1.. Size Ja d 2. Manufacturer.
Seepage Pit: 1.. Size W1 2. Material
Disposal Field: Total ?ength of Lines—«- __
8. Distances:
A. Well To: Septic Tank m , Absorption Area Sewer Lines
Nearest Lot Lino Other Contamination
9. Foundation to Sentic Tank Absorntion Ar-a----
C.
rea_—C. Absorption Area to Nearest Lot Line` ___q
,quest for Approval of ,idividual Sewer & Water Faciliti�.
.lana Twn
Aorroved^^� Disarproved-,0--
Date
Approval Valid for One Year From Date. Signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SVSTFM
I certify that the information contained in this request for approval to be a true
and accurate representation of the subject sewer and water facilities located at:
Signed ate
d
January 30i 1973
lir. Si qurd Langn€ss
,ox 4--75
AncOurage, Alaska 99509
Sub,jc:ct: Pruf3ortry Lot a, Lanrnes Subcivi51oji
hear air:
1'trds department requires all on -situ sewage systcl!'s
to tie irrsP€:ctcci zana approved. Your sewaoc JisPusal
syste„ was nut i;r517ected for approv€l and therofore,
we can not jive approval to the b an4; for your c.unven
-
Liondl -lour+.
Approval may be given if funds are cscruwc+r to covc_'r
charje�; •Fur shun€ing proof of cxiztinc1 s('vWr WitE'1.1-
i'tris will involve di cines cxisting systcI:i fur, our
inspection. The system, elust be. upproveJt by this <.:aPart-
:ic:nt by duly 1, 197:1, or logui action Will f IMI.
If yuu lrav€= any questions, call ?74-4561, ext-enstionl37.
Si racer€.ly,
Robert C. Pratt
Lnvironmental Control Officer