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Home My WebLink AboutSPENARD ACRES BLK B LTS 1 E 10' & 2 N2E2Spenard Acres Block B Lot 1 #010-115-36 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF 'ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING COSA # 01 0 /16 Expiration Date: pj — / 9 -09 Parcel I.D. 010-115-36-00 1. GENERAL INFORMATION Complete legal description E. 10 ' of Lot 1 8 N. 1/2 of E. 1 /2 Spenard Acres Subdivision Location (site address) 1112 chuaach wav Lot 2, Blk uBu Current Property owner(s) Mary Lee Simpson Day phone _ Mailing address Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 1112 Chugach Way 99503-5610 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System 2 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 8Y 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 nHI Consulting Engineers Address 800 E. Dimond Blvd. Suite 3-550 Engineer's Printed Name Dee High 5. DSD1./.-Approved SIGNATURE V Approved for 2. bedrooms. Disapproved. Conditional approval for Phone 344-1385 Date 5/11/09 - ?L% ,,' . 6666 � •.7zre ' it DEE H• H if f•,,. CE - 5607 bedrooms, with the following stipulations: J\� ;i:C�iYOF.foo `� : • ON-SITE •• m. trE ▪ WATERANu ▪ WASTEWATER _= o'• PKOuRAM : Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: i ./ Original Certificate Date: 6-4 / Y - D (Rev 11105) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & 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 atic,p. Lis 4 $ /0' J -z 4v2EZ Legal Description: t Parcel ID:010-11 5-1/1-000 Spenar• Acres Subdivision 3G A. WELL DATA Well type Private if A, B. or C provide PWSID f/ Well Log (Y/N) no * Date completed-44tt7Ler Sanitary seal (YM) Yes Wires properly protected (Y/N) Yes Total depth 1 1 7 ft; Cased to 1 1 7 ft. Casing height (above ground) 1 2 in. FROM WELL LOG AT INSPECTION Date of test ' roar„ctt (e1 Au&14.4 4/24/09 Static water level .- - • Q►4.DFnrw. 4.> t Qat. 2 0.85. ft. Well production g.p.m. 7.0 g.p.m. WATER SAMPLE RESULTS: Coliform . 0 colonies/100 mL Nitrate 0 -mg/L Arsenic: 35_3 ug/I B. SEPTIC/HOLDING TANK DATA Tank • - .1. "to rs uL Irl, e " Date installed Tank size gal. - - Number o • • .. - is ' - Cleanouts (YIN) Foundation cleanout (YM) Depression over tank (YIN) _ High w Date of pumping Pumper C. ABSORPTION FIELD DATA Date of sample: 4/ 2 4/ 0 9 Other bacteria 0 colonies/100 mL Collected by: DHI Consulting Engineers Date '• alled Soilltating (g.p.d./ft2orft2/bdrm)_ Length Width ' 'ft. ' Gravel below pipe ft. Total depth ft. Eff. abso • • area _ft2 Monitoring tube Depression over field "Date of adequacy test Resu - s/Fail) For _ bedrooms Fluid depth in absorption field before test in. Water a• • gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption ra - - g.p.d. Any rejuvenation treatment (past 12 mo.) (YM & type) If yes, give date System type * well drilled in 1956, prior to 1975 well log requirement. 0. LIFT STATION Date installed Size in gallons • 'Pump on level at in. 'Pum Cycles tested Manhole/Access 1n. High water alarm level at E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot No septic Absorption field on lot None Public sewer main Greater than 75' Sewer/septicserviceline Greater than 25' Animal containment areas None Meets alarm & circuit requirements? in. On adjacent lots No septic On adjacent Tots None Public sewer manhole/cleanout Greater than 100' Holding tank None Manure/animal excrete storage areas None SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line Water main jacent lots ice line • Surface water SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Building foundation .• Water Service line a er in drain Wells on adjacent lots F. COMMENTS: . Driveway, parkingtvehicle storage G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and review o! Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. . Engine is P ' ted Name '5 a Ng 4 a. Date COSA Fee $ 4-9:0 ° Date of Payment .-/a/o Receipt Number (Rev. 11/05) 120139 Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Arsenic Advisory Certificate of On -Site Systems Approval # 90116 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block B, Lot 1 E10' & 2 N2E2 of Spenard Acres Subdivision. This inspection revealed an arsenic concentration of 35.3 micrograms per liter (ug/L) for the property's well water sample. 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. LOT1 \) EAST V bJ 43e. 50' LOT 9A 9' 1 LOT 2 C 'Co'ria7 y O Lc' E , Block e r J cenCW-Ci Acns ....52.16W. Ar_norage Recording Precinct, Aloskc _ 1.i •i SURVEY CERTIFICATION -.:y:Andy that thaw sweied the prceertl • .. .. .. .. '.and fiat the •nprovernents situated thereof. at • . •c•. aid dorm are, kir a enaoom an adjccer p• . • - :tn rs on odoten1 property overlap or enr. • ..• ;:,.n and awl Were ore notoot /ays. Wilily crat r. . • . r1s On Will property ncept as indicated he•el:r. DATE .. Foos', coot: d mGaTen: re ...+er M U Iur. prpe•Cn:4,r rEtJr rOUN,rl' " 2 a2 tub fi 1:3-4 re,-.gnred • ::V8%2. recur sr: oils e,xee. ealetti OF i►e A< "'0 P '4 1192.8 ) ..r..% r LEGEND3/4%44 /729 Date //../0 -75 FB. No. 942 Prepared by: R. L. BUTTON Reprtrered Leo! Sr. e.o• 19071719•cera 59 £ignm Are Ar.v.eJJe, Atrsru ycs(• Property of i'Jnb / We/.sh Sas RAM Client Name Project Name/II Client Sample 1D Matrix 1091591001 D111 Consulting Engineers 1112 Chugach Way 1112 Chugach Way Drinking Water Printed Date/Time Collected Date/Time Received Date/Time Technical Director 05/04/2009 16:57 04/24/2009 12:06 04/24/2009 13:10 Stephen C. Ede Sample Remarks: Parameter Results PQL Units Method Allowable Prep Analysis Container ID Limits Date Date Init Metals by TCP/MS Arsenic Waters Department 35.3 Total Nitrate/Nitrite-N ND Microbiology Laboratory Colony Count Total Coliform Fecal Coliform 0 0 0 • 5.00 ug/L EP200.8 C (<10) 04/27/09 05/01/09 NRI 0.100 mg/L SM204500NO3-F B (<10) co1/100mL SM209222B co1/100mL SM209222B col/10OmL SM209222B A A A (<200) (<1) (<1) 04/28/09 JDZ 04/24/09 DLC 04/24/09 DLC 04/24/09 DLC Time Time e Date Date Inspector c 3 Date - �', Inspector Ins tor Comments` / / LLP LA.,, E_, 0.9",-/�j /�/ 1 /�-/�I-�= j_ (1`.moi.- tY.�^ 9 4GiGam`._. III 6I Conditional Approval ._T-.. - - _.__ 1 -/// - Il 1 1 \ t 3 — J ' 1 Date Sewer Installed Permit No. Septic Tank Size Holding Tank Size Solis Rating Well To Absorption Area Well to Tank Well Log Received APPLICANT FILLS OUT LOWER HALF ONLY Property Owner k%Y r/9 Mailing Address ///y cXi4j4.4,, Phone 275" -mac /C Buyer r?Gvi e y e-74 Address Lending Institution Y7 /ci Address Phone Realty Co. & Agent 6,/' o t� fr 07--- .-�. !vl u.erS- Addressr� //7 53 Phone 7G-/777 Legal Description L fy G 4' 4 / ,g - e ,,1;0'�--r-Te.-v61,'Cr re"s Street Location / // <- e 1-1,4,1 oL e L-_ Type,�cqy{f Residence .6 Single Family ❑ Multiple Family No. of Bedrooms ❑ Other - Wateupply daii Individual 0 Community 0 Public Utility ATTACH 1975. For available.) Year Individual When Connected WELL LOG. A well log is required for all wells wells drilled prior to that date, give well Installed: drilled since June depth (attach log if Sewage Disposal Individual 111. Public Utility 0 Holding Tank to Public Utility' . NOTE: THE INSPECTION FEE MUST.ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.