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Home My WebLink AboutLAKE RIDGE TERRACE BLK 6 LT 2Lake Ridge Terrace Block 6 Lot 2 #051-313-24 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES Address ec svnl TO SEPTIC ABSORPTION FROM TANK FIELD WELL P,0.8pox 1 t I <t ev K cls : `f Phone(s) Permit No. No. of Bedrooms WELL CC) -11 1 c 00 ! es- __5 LOT LINE LEGAL DESCRIPTION u I (i Lot Block Subtlivision f d r mac_ FOUNDATION Township, Range, Section Itl IN 0 AS-BUILT DIAGRAM (Show location of well, septic system, property lines, foundation, 'C 'D driveway, water bodies, etc.) TANKS I SEPTIC ❑ HOLDING Manufacturer Capacity in gallons _ v / -5 Al I2�C)Q ° Material No. of Compartments TYPE OF SYSTEM ❑ TRENCH BED ❑ W. DRAIN ❑ OTHER Depth to pipe bottom from Total depth from original grade original grade 15FT Z FT , Fill added above original grade Gravel depth beneath pipe ✓1 e.J I FT FT U Gravel fength Gravel width FT :2— 1 FT F nu •tee Total absorption area Distance between lines SQ FT Lp FT Number or 11 Soil rating �1 Pipe material 1 -I SQ FT Installer 4 ��. Date Installed 7 _ i nz •o s�— E _ WELLS C' C 3I I ti10 N PRIVATE ❑ OTHER (Identifv) Classification (A,B,C) Total Depth Cased to FT FT Installer Dale Installed: _ fl L Ce vv r�cD REMARKS: 2 53' r . 2w bin l; fiNl� InOCAI 71 02 IYld (JED F2al+W C//''I / Scale: M,T 5, . fGll/N �Q G ./-rp/7!/�l F� f/�� Inspections Performed by: 011gee � Date: Q z - l C) CC O /1e �,�` 59° •° c nvncaaaa",. S& p S EN�,1 GINEERING n°Nt9� •nn.essl0 ••1fO •e I a certil that this inspection was performed according to all $ •, `sober A. Shifa° Munici�7�,�trtj' No. 1457•€ p+ , Q ? Health Department Approvah . Date: MUNl�IPAL1l� uF ANCHORAGE Department of Hea1th & Human Services 825 L Street Anchorage, Alaska 99501 343 ON~SITE SEWER PERMIT VK Per�it Number: '�0O185 Upgrade [\�`�`�� Owner Name: HARVE� OLSON Day Phone: Owner Address: PO BOX 771796 786-8717 EAGLE RIVER' AK 99577 Parcel Id: 051~313`24 Lot Le�a1: Subdivision: LAKE RIQGE TERRACE Lot: 2 Block: � Section: 26 Township: 15N Range: 1W Lot Size 3�000 (sq,�t, or acres) Max 8edrooms: This Permii: 3 Total Capacity: 3 SEPTIC TANK: Minimum total septic tank capacity: 1;000 ga1lons, Each septic tank must have at least 2 compartments. Depth to top of septic tank(s) �eet requires insblation over tank(s). INGTALL PER ENGINEERS ATTACHED DESIGN" NOTIFY DHHS PRIOR TO 8E TAKEN NOT TO INSTALL NEW 7SSUi OP�SED 3 BEDROOM SlNGLE F7��[LY DWELLING ONLY AND EXPIRES ON 12/31/90" l CERTIFY THAT: . �amiliar with the requirements �or on~site sewers and we1ls as set �orth by the Municipalit� of Anchorage (MOA)and the State o� Alaska" install the system in accordance wi�h all MOA codes and regulations, and in compliance with the design criteria o� this permit. 3. I will adhere to all MOA and State o{ Alaska requirements �or the set back distances from any existing well, wastewater disposalsystem or public sewerage system on this or any adjacent or nearby lot" 4. I understand that this permit is valior a maximum oIt, s" l also understand that the capacity oT the total system is 3 bedrooms and any enlargement will require a: additional permii. Signed: _~�� __-~_^~~�_~.-._^~ - »y ,^ (Owner) HARVEY OLSON' lssued Sy: DATE: _�__'�~c��___-�~-=___~~~^�~~_.~.°~°�_�_^___ L /ter"*l►J � a Ca C-XU7—F19c71K Q W �Q 3lVJS Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVI 825 "L" Street, Anchorage, Alaska 99502-065 SOILS LOG — PERCOLATION TESD PERFORMED LEGAL DESCRIPTION:GL _ � Y±_w DEPTH FEET /.-C. sM 2 RZv 3- 4- 5- 6- 8 4 5 6 o �o 9 /.7 10 11 Y 10/7/170Itl 12 ./ 13 �T7 orJi o F �coL 14 15 16 gY t) nr a•e� Y �p • j'.} p Qy' 17 9•?iB.IS I,9ti4YQ5.Y ,li 18 Oben A ;... a Shale, a k 19 /tf Ii 641�•d. .. �'. 4pFES5i0 y� 20+n�,�m�w� COMMENTS Mle • % DATE P Towen�hip Rae, Section: SLOPE WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT // LO DEPTH? 6 i P E Depth to Water After /5 D Monitoring? ✓ Date: ` "`B,.y WEER'S SEAL) • nes ••n __CC��'' A� * IF vO VG6ipgv •. A. 1837-� Itop S� 71qo fU�A9, q` SITE PLAN M=i Dg .:. u PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT PERFORMED E17034 Engle River LOW Roap N CERTIFY THAT T S TESJ WAS PERFORMED IN River Alaska 99577 E ACCORDANCE�''ee 7H ALL STATE AND MUNICIPAL GUID SIN FECT ON THIS DATE. DATE: Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-313-24 1. GENERAL INFORMATION Complete legal description LAKE RIDGE TERRAC RIVIV COSA * QSC i a L I gjq Expiration Date: — Location (site address) 15100 TERRACE LANE, EAGLE RIVER AK 99577 Current Property owner(s) ROBERT & CASSIE POTTER Day phone Mailing address Lending agency Mailing address Real Estate Agent Mailing Address PO BOX 771796 EAGLE RIVER. AK 99577 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF -W TER S00i LY: IndiviEfual Well individual Water Storage r ❑ CommunityCiay. , Well ❑ Public Water System ❑ Day phone Day phone 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 rry 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 ARCTERRA CONSULTING, INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD., EAGLE RIVER AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date X09/2012 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions. that may not be observed from the surface;, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and th€r water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future "- Y ar .. > ._ occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. 5. DSD SIGNATURE Approved for _ 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other By: a Original Certificate Date: (Rev. 17/05) Municipality of Anchorage • '� Development Services Department Building Safety Division g On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: LAKE RIDGE TERRACE BLOCK 6, LOT 2 Parcel ID: 051-313-24 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID # _ Date completed Prior to 1990 Sanitary seal (YM) Y Total depth *1264 ft. Cased to *40+ ft. FROM WELL LOG Well Log (Y/N) N Wires property protected (Y/N) Y Casing height (above ground) 24 in. AT INSPECTION Date of test 3/21/12 Static water level ft. 112 ft. Well production g.p.m. 4.73 g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100mL Nitrate ND mg/L Arsenic: NID mgA Date of sample: 3/6/12 Collected by: ArcTerra B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 9/27/1990 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) **Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 3/16112 Pumper_ Ms C. ABSORPTION FIELD DATA Date installed 9127/1990 Soil rating (g.p.d./ft? or fClbdrm) 284 System type Bed Length 54 ft. Width 24 ft. Gravel below pipe 0_5 ft. Total depth 3.35 ft. (Measured 3/21/12) Eff. absorption area 1296 ftZ Monitoring tube Y Date of adequacy test 3/21/12 Depression over field N Results (Pass/Fail) Pass For 2 bedrooms Fluid depth in absorption field before test 0 in. Water added 450 gal. New depth 2.4 in. Elapsed Time: 40 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YM & type) N If yes, give date -- D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off" level at in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot 100'+ Absorption field on lot 1001+ Public sewer main 751+ Sewer /septic service tine 251+ Animal containment areas 50'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout 100'+ Holding tank 100'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Building foundation 5'+ Property line 51+ Absorption field 51+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 101+ Water main 101+ Water Service line 10'+ Surface water 100'+ Driveway, parking/Vehicle storage 10'+ Curtain drain 50'+ (None Known) Wells on adjacent lots 1001+ F. COMMENTS *See attached AAROW well casing verification letter. **FCO located inside foundation Conduit was added and wellhead extended with new sanitary seal by Arctic Pump & Well Supply. No STEP G. ENGINEER'S CERTIFICATION I certify that 1 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 KENNETH M. DUFFUS Date COSA Fee $490.00 / Waiver Fee $ _ Date of Payment L/ j �� 2 Date of Payment Receipt Number Receipt Number, (Rev. 11/05) SGS_ SGS Re£# 1120716001 LOQ Units Client Name ArcTerra Engineering and Surveying Printed Date/Time 03/13/2012 16:41 Project Name/# Lake Ridge Terrace B6 L2 Collected Date/Time 03/06/2012 19:00 Client Sample ID Lake Ridge Terrace B6 L2 Received Date/Time 03/07/2012 15:00 Matrix Drinking Water Technical Director Stephen C. Ede Sample Remarks: Parameter Results LOQ Units Method Container ID Allowable Prep Analysis Limits Date Date Init Metals by ICP/MS AYC Aluminum ND 20.0 ug/L EP200.8 C Hardness as CaCO3 196 5.00 mg/L SM20 2340B C 03/08/12 03/13/12 NRB Waters Department (<6) 03/08/12 03/13/12 NRB Barium 74.6 3.00 ug/L Total Nitrate/Nitrite-N ND 0.100 mg/L SM20 450ONO3-F B 03/12/12 AYC Microbiology Laboratory EP200.8 C (<5) 03/08/12 03/13/12 NRB Calcium 40300 E. Coli Negative 1 100mL SM21 9223B A 03/07/12 DLC Total Coliform Negative 1 100mL SM21 9223B A 03/07/12 DLC Private Individual Analysis Alkalinity 199 10.0 mg/L SM20 2320B D 03/09/12 AYC Aluminum ND 20.0 ug/L EP200.8 C 03/08/12 03/13/12 NRB Antimony ND 1.00 ug/L. EP200.8 C (<6) 03/08/12 03/13/12 NRB Barium 74.6 3.00 ug/L EP200.8 C (<2000) 03/08/12 03/13/12 NRB Cadmium ND 0.500 ug/L EP200.8 C (<5) 03/08/12 03/13/12 NRB Calcium 40300 500 ug/L EP200.8 C 03/08/12 03/13/12 NRB Chloride 4.49 0.100 mg/L EPA 300.0 D (<250) 03/08/12 03/08/12 SDP Chromium ND 2.00 ug/L EP200.8 C (<100) 03/08/12 03/13/12 NRB CO3 Alkalinity ND 10.0 mg/L SM20 2320B D 03/09/12 AYC Conductivity 400 1.00 tanhos/cm SM202510B D 03/09/12 AYC Copper 3.67 1.00 ug/L. EP200.8 C (<1300) 03/08/12 03/13/12 NRB Fluoride ND 0.100 mg/L EPA 300.0 D (<2) 03/08/12 03/08/12 SDP HCO3 Alkalinity 199 10.0 mg/L SM20 2320E D 03/09/12 AYC Iron 269 250 ug/L EP200.8 C (<300) 03/08/12 03/13/12 NRB Lead 0.512 0.200 ug/L EP200.8 C (<15) 03/08/12 03/13/12 NRB SGS_ SGS Re£# Client Name Project Name/# Client Sample ID Matrix Parameter 1120716001 ArcTerra Engineering and Surveying Lake Ridge Terrace B6 L2 Lake Ridge Terrace B6 L2 Drinking Water Private Individual Analysis Results LOU Magnesium 23100 Manganese 280 Nickel ND OH Alkalinity ND pH 8.00 Selenium ND Silver ND Sodium 11900 Sulfate 2.24 Total Dissolved Solids 213 Zinc 252 Arsenic ND Thallium ND Printed Date/time 03/13/2012 16:41 Collected Date/Time 03/06/2012 19:00 Received Datefrime 03/07/2012 15:00 Technical Director Stephen C. Ede Allowable Prep Analysis Units Method Container ID Limits Date Date Init 50.0 ug/L EP200.8 C 03/08/12 03/13/12 NRB * 1.00 ug/L EP200.8 C (<50) 03/08/12 03/13/12 NRB 2.00 ug/L EP200.8 C (<100) 03/08/12 03/13/12 NRB 10.0 mg/L SM202320B D 03/09/12 AYC 0.100 pH units SM20 4500-H B D (6.5-8.5) 03/09/12 AYC 5.00 ug/L EP200.8 C (<50) 03/08/12 03/13/12 NRB 1.00 ug/L EP200.8 C (400) 03/08/12 03/13/12 NRB 500 ug/L EP200.8 C (<250000) 03/08/12 03/13/12 NRB 0.100 mg/L EPA 300.0 D (<250) 03/08/12 03/08/12 SDP 10.0 mg/L SM202540C D (G500) 03/12/12 KAN 5.00 ug/L EP200.8 C (<5000) 03/08/12 03/13/12 NRB 5.00 ug/L EP200.8 C (<10) 03/08/12 03/13/12 NRB 1.00 ug/L EP200.8 C (<2) 03/08/12 03/13/12 NRB Mar 22 12 10:16a Dad 3388078 p.1 rp. rn 1L AAROW PUMP & WELL SERVICE, LLC I\2` P.O. Box 110496 }(s`" r 0P �I Anchorage, AK 99511�h Office: (907) 346-9355 • Fax (907) 333-897 l Eagle River: (907) 622-9335b� cel tt W 010 11, CE No. 9318 CUSTOMER JOB SITE 16A' 72�7 L INVOICE DATE .J WELL D/EPTb SWL CHLORINATEC FurAP DEPTH SALESPERSCH QUANYITY DESCRIPTION f PRICE AMOUNT �'1J /?rte ��"G��.S v�'G�S --0�'. �,f�"l�/�•-fJl7�,S- ___.----- -- - LABOR HOURS I RATE AMOUNT TOTAL MATERIAL TOTAL LABOR t i WORK ORDERED BY - DATE COMP.TOTAL LABOR ". RAY THIS AMOUNT Thank You SIGNATURE (1 Hereby Acknowledge the Satisfactory Completion of the Above Described Work and agree that it above work is not paid for in 90 days I agree to allow Aarow Pump & Well Service, LLC. the right to remove unpaid for equipment and charge for labor already performed & labor to remove unpaid for equipment-) TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE. SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. 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