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Home My WebLink AboutSUNSET HILLS WEST BLK 3 LT 2Suns t Hills West Block Lot 2 #018-204-20 Municipality of Anchorage p.O. Box 196650 · 4700 Elmore Road ~,nchoraqe. Alaska 99519-6650 · (907) 343-7904 · Fax (907) 343-799/ apartment J~ttp.'l/www.munl.orqlOnsifo D -- Development Services Department ,On-S te Water and Wastewater Proqram **** VARIANCE/WAIVER REVIEW **** WP, fi: _090025 HA#: ~)90125 Permitfl: PID#: .018-204-20 Legal Description .Sunset Hills West; Block 3: Lot ? Engineer. .GEG Applicant: Your request for'a waiver of the required 75 feet horizontal separation from the public sewer trunk to the private well has been approved. The approved separation distance is 50.0 feet. This waiver approval applies to the existing public sewer trunk to private well separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: ~{ Waiver Is not Grant~d: Date: ~/'26/2009 Approved b · ,-,-,,.,...,,.,,.,,,,,,,,,,,,,,,,, [ /~ I~a~fR~vi"ew'e'r Rec#: 120601 Amount: ~;1.050.00 Date Paid:..5/22/09 **** VARIANCE/WAIVER REVIEW **** Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, Alaska 99507 www. muni.org/onsite (907) 343-7904 ON-SITE SEWERJWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 018-204-20 Property owner(s) Betty Smith Mailing address 14314 Hancock Lane Site address 14314 Hancock Lane Legal description (Sub'd., Block & Lot) .Sunset Hills West BIk 3, Lot 2 Legal description (Township, Range & Section) _ Lot Size 16504 Sq. Ft. Day phone. Zip Code .99515 .Zp Code 99515 Number of Bedrooms 3 THIS APPLICATION IS FOR (~] all that apply): Absorption Field Septic Tank Holding Tank Privy Private Well [] Water Storage [] THIS APPLICATION IS AN: Initial Upgrade Renewal I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Sig nat~r~e o~f p~'perty owner or authorized agent) bJ . . /977 Permit/Rush Fees: . Date of Payment: . Receipt Number: . (Rev. 11t05} Waiver Fees: Date of Payment:. Receipt Number: . Municipality of Anchor. age I! ~/~'~ Anchora e W_at_er& Wast ~e rater Utilit~ ~ itlatt Claman May 19, 2009 Development Services Department On-Site Water and Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Re: SUNSET HILLS WEST LT 2 BLK 3(Grid SW3033) Request for Waiver of Separation distance between the Well on Property and Public Sanitary Sewer Main. The existing three (3) bedroom house is served by a private well and public sanitary sewer. The well was installed in April of 1983 and the public sanitary sewer was constructed in July of 1995. Per the COSA inspection report the separation distance between the well and the public sanitary sewer line is less than the required 75 feet. The attached record drawing from the sanitary sewer main line construction places the well at about 50 feet from the public sanitary sewer line; therefore we are requesting a separation distance waiver of 50 feet. Justification for the waiver is summarized as follows: · The encroachment has existed for approximately 14 years and recent water samples indicated nitrate levels at 2.28 mg/I and total chloroform bacteria were not detected. · Attached is the original well log from M-W Drilling for the subject property. The well is 111 feet deep and cased to 110.51 feet. · This sanitary sewer line has no records of breaks or leakage within the last 14 years. It has had routine maintenance performed just last summer on cleaning. · The expected life of the Ductile Iron pipe is adequate given the fact that the Ductile Iron pipe is only 14 years old. Based upon the aforementioned facts, it appears that there is minimal risk associated with granting the requested 50 feet waiver between the well and the public sanitary sewer main. If you have any question, please contact us at 564-2739. Thank you for your assistance. Sincerely, Kurt Vause P.E. Director, Engineering Division MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPI:-CTION REPORT NAME MAILING ADDRESS ! -- LEGAL DESCRIPTION LOCATION Well Absorption area DISTANCE TO: I O~)" ] ~ ' Manufacturer DISTANCE TO: Manufacturer IF HOMEMADE: Well Dwelling D,STANCETO: Iwe'' Lengtb o each line kengtb Width Type of crib Crib diamet DISTANCE TO: Well ~ 7 Depth II Z, ; OTHER REMARKS [PRONE ¢J ~EW ~__',~..{~ · ~'~¢¢7-~ * ~..~.~ [] UPGRADE Material Foundation~..~ Nearest Iot¢iie*. Total lengtUt li~es Tren idtli Material beneath tile ~ t/ inches epth NO, OF BEDROOMS No, of compartments Liquid deptb PERMIT NO, Liquid capacity in gallons PERMIT NO. Distance betwe~lines Total ef feet iPe aBs~-¢o r pFar ea depth Total effective absorptiol] area Building foundation Driller Sewer lin~ ~1. Nearest lot line Distance to lot line PERMIT NO, Septic tank ~bs~n~area (s) __ Icg,~ I:i ? APPROVED 72-013 (Rev. 3/78) DATE LEGAL ~,,~'*- I¢- l?~'¢- I'"'l LI I".I I C: I F' E:'EPRRTMENT OF 825 L ON--SITE PERMIT NO: 840486 DRTE ISSUED: 06/20,/84 BPPLICRNT BDDRESS: CONTRCT PHONE: HEBL. TH BND ENVIRONMENTRL PROTECTION STREET, RNCHORFtGE.. RK 9950± 264-4?20 MB"PNFIRD SMITH P.O. BO,''z, BNCHORRGE, RK 99510 ~45-09~3 LEGFIL DESCRIP: LOT SIZE: MR),:: BEDROOMS: SLIBDIVlSION: SIJNSET HILLS WEST[ LOT: SECTION: 22 TOWNSHIP: :1.2N R~NEiE: iG500 <SQ. FT. OR BORES) 5: BLOCK: LISTED BELO[q RRE THE OPTIONS RVRILRBLE TO YOU IN DESIGNING YOUR SEPTIC SYSTEM. CHOOSE THE OPTION THRT BEST FITS YOUR SITE. DEPTH TO PIPE BOT]'OFI (FT.) 4. 0 :' 4. 0 4, GRRVE:L DEPTH (FT, ) 6. el 0. 5 ~. TOTRL DEPTH .FF. ) 'i. 0. Cd 4. 5 ?. GRRVEL WIDTH (FT._ .';, ~. 5 2Z. 0 5. GRRVEL LENGTH (FT.) 60. 0 44. 0 ?~. 'GRRVEL VOLUM~ (CU, VDS, ) 2~6, ~ ~Z. 4 5?, TRNK SIZE (GRLS) :L, 000. 0 ~ :L., 000. 0 ** ~L, 000. SOIL RRTING (SQ, FT. /'DR) 2~7 220 227 *.~. GRRVEL LENGTH } 75 Fl', REQUIRES MULTIPLE RUNS (NOT EXCEEDING 75 FT. ERCH) .m TRNK MUST HRVE FIT LERS'I- THO COMPRRTMENTS CERTIFV THRT: i. IRM FRMILIRR HITH THE 2. REQUIRENENTS FOR ON-SITE SEWERS RND ~ELLS RS SET FORTH BY THE MUNICIPRLITV OF FINCHOR8GE (I'40R) FIND THE STATE OF RLRSK8. I HILL INSTRLL THE S'¢S'fEM IN FICCORDRNCE WITH FILL MOB CODE':; RND REGULRTION2;., 8ND IN COMPLIRNCE HITH THE DESIGN CRITERIR OF THIS PERMIT. I HILL RDHERE TO RLL MOB RND STRTE OF RLRSKR REQUIREMENTS FOR THE SET BBCK [.',ISTRNCES FROM BN'.r' EXISTING HELL., WBSTISNRTER DISPOSRL SgSTEM OR PUBLIC SEWERRGE S'¢STEM ON THIS OR RNV RDJRCENT OR NERRB~' LOT. I UNDERSTRND THRT THIS PERMIT I5 VRLID FOR R MRXIMUM OF Z BEDROOMS RNI) RNV ENLRRGEMENT WILL REQUIRE RN RDDITIONRL PERMIT. iISSUED BY IF R LIFT S'I'RTION IS INSTRLI_ED IN RN RRER COVERED B'¢ MOR BUILDING CODES., THEN (zL) RN ELECTRICRL PERMIT RND INSPECTION MLIST BE OBTRINED; (2) RS-BUILTS HILL NOT BE RPPRO',/ED HITHOUT RN ELECTRICRL INSPECTION REPOR'r.~ RND (2) THE ELECTRICRL 1,40RK MUST BE DONE Bb' R LICENSED FLECTRICIRN. SIGNED F'ERHIT NEL HFbL I_.HN I L 0 C FI T I 0 N LEGFIL _,FILTH CO CONST. INC L.,~E,~, _,UN_,EI HILL.., F'L E,U,.., 'Lg~'~: Hi" IL.t-'-"IIJI~.IdL~E'-" '~':'¢F~it ¢~ LO1" :,I,.E 999999 .... LIPItE. E.. FEET T"r'F'E OF ':;F~II HE=L[ F FI LN _,'/_,TEH I.:,: [F..ErlL. H I,'IFf,,.,',IHLIH NUI'dBER OF BEE)RO01"IS = 4 SOl[_ RRTING (SQ FT?BR)= 237 THE LENGTH B'If"IENSZON IS THE LENGTH (IN FEET) OF THE TRENCH OR I::,RRZNFIEI_[.'.". TIqE DEPTH OF R TRENCH OR PIT IS THE DP. STRNCE E:ETHFEN THE SURFFlCE OF THE GROUND FIND THE BOTTOFI OF TFIE E;'",CRVRTZON ':.'IN FEET). THERE IS NC) SET !-'.ItE:'TFI FOR TRENCHES. THE C'iRFIVEL OEF'TH ]:~ THE r,IINIHLIH DE:PTH OF GRFIVEL BIETI.IE:EN THE OUTFRLL PIPE RND '['FIE BOTTOP1 OF THE E,XCR',,,'RTION ,.'.IN FEET). F'IERHIT RF'F'LIL-:RNT I-tH_, THE RE_,F3N..,IL, IL.[T~r TO II',IFORH TH.[:, [EFRF. TI IENI' E:,I..IF.:ING TFIE ~'": ...... '-" ...... "' - "; flqI=, P~ 3FERT'r RND TFIE II-.I=,THLLFIIIuN IN.:,FI:.L..F.'(ui'..I~ OF RN'¢ 1.41--LL:: RD._TRI2ENT TO ' "' " ' "'" ~I{_II1E[_L. OF RE..,Ir.'.ENL. E_, THR'r THE NELl_ Hi[I_L :,ER E. ....... 1'" tl...-~ ~:.~ ,:: ;:' ::, :E [ ,~ _, F E_ L- ! ]-: ~---J I"-,! :-'-; F! F~: IE F.: .[--Z ¢;." ILl I !~'.' EPL. kFILLIi'Ii3 OF FIN"r' _,'L, rEII NITHOUT FINFIL Zt',I_FEL. TIuI'.I FINE:, FIF'F'RO'v'RL. E,'r 'Till.., E:'EF'RF::Tf"tE~N.T' !.4ILL E,E _,UE,..'rE:CT TO FI~u::,E~..I.T] _N I',ltNIi',lLJi',l DISTRNCE BET!IEEN FI NELL Ri".,ID RN"r' ON-SITE SEWFIGE B, ISF'OSFIL S"r'STEM ::LE~(~ FEET FOR Ft PRIVRTE HELL OR 15E~ TO 288 PEET FROP1 R PLIE:LIC HELL [:'EPEN[:'tNG UPON THE T"r'F'E OF PUBLIC HELL. r,'IIIqIHUH DISTFINCE FROH R PRIVFlTE HELL. TO Fl F'F;:IVFI"I"E SE!.,.IER LINE IS 25 FEE'.'T FIN[) TO Fl COI',IHUNIT'¢ SE!.qER LINE IS 75 FEET. HELL LOOS FIRE REQUIRE[:, FIN[:, i',ILIST BE RETURNED TO THE DEPRRTHENT 1.4II'HIN 2.:EI [)Fl'.r'E; OF' THE HELL COIdPLETION. OTHEF,' REQLIIREHENTS HR"r' FIF'F'L'T'. SF'ECIFICRTIONS RNLt., CONSTRUCTION DIFIGR. RHS RRE FIVRILFIBL. E TO INSURE [:'ROPER INSTRI_LFITION. I CEF:'.TIF"r' THFlT '.1.: I Fli"l FRI"IILIRR HtTH THE REQUIRENENTS FOR ON-SITE SE,NERS RND .NELL:E; RS ':'gET FORTH E:"r' THE FIUNICIPI=ILIT"r' OF RNCHORRGE. 2: I !.'.IILL INSTFtLI_ .T'HE S"r'2;TEH IN FICCOR. E:,FINCE !.,.!ITH THE COE:,EL:,. .3:: I UNDERSTFIND THFIT THE ON-SITE SENER S'~'STEI'"I I"1R'¢ REC,.!UIF:'.E EN[_FIRGEr'IENT IF TFIE I:,.E:II..EN...E IE; REHOE:,ELEE) TO INCLIJE:,E i'"IOI;~'.E THRN ,4 BEE:,F.:OCff"tL:,. /ur_..__ :r. ::..s,_,: ...... ....... ............... ...... '.0 : /0 v4. e, MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchora[le, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST ~;~ SOILS LOG PERCOLATION TEST ,EREORMEDEOR: AYNAI : DATE PERFORMED: LEGAL DESCRIPTION: 5- 6- 7- 8- 9- SLOPE i..o F' ;2. SITE PLAN 13 14 15 16 17 18 19 2O W^SOROUNOWATER ENCOUNTERED? IF YES, AT WHAT DEPTH? ~* Gross Net Depth to Net Reading Date Time Time Water Drop · ~ ~)~0 3 -~q .~_~ i i',~ 0 I,oq PERCOLATION RATE ~'~ (minutes/inch) .f' TEST RUN BETWEEN t'~, 5 FT AND ,-~-~ FT COMMENTS 72-008 (6/79) Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw 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 Parcel I.D. 018-204-20 ¸. GENERAL INFORMATION Complete legal description Location (site address) COSA# 0%2, Expiration Date: 3 - / ~-/.~..._. SUNSET HILLS WEST BLOCK 3, L'OT 2 16314 HANCOCK LANE, ANCHORAGE, AK 99515 .Current Property owner(s) CHRISTOPHER C SEAMAN Day phone Mailing address 14314 HANCOCK LANE, ANCHORAGE, AK 99515 Lending agbnCY,.:: L..:') ..... .... '- ¢' Day phone Mailing address, ', Real Estate Agent Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. NUMBER OF BEDROOMS: 3. TY'PEi'~OF~'WA~TER SUPPLY: Individual Well:, "",:~: [] ,~ ,, n¢i~idUal .Water St~Orage [] , Oommurdty: O,'ass __ Well [] P ublid~wa'te~:iSyStem [] 3 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 pdvate or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a pedod 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. 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 vedty 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 ail applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING, INC. Phone 868-3792 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 12/09/2011 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment only to the conditions as.of the and ~ chart water usage of the 1 The operafiOnal life of all well and septic subject to these vadous 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 ' ' ':~~ i~'i' .: system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen .. ~.~?~-~/....-..~.! ~:.._~.. encroachments, deficiencies or discrepancies exist. . DSD SIGNATURE ~isapproYed ......... . ....:....' .... .. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X . WAST WATER . Arsenic Adviso~ Maintenance Agreements Sopplemental Engineers Repo~ Other (Rev. 11/05) Original Certificate Oate:f.~- -///'7/-// Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: SUNSET [~-L~.S WEST BLOCK 3, ~.OT 2 A. ,WELL DATA Parcel ID: 018'204-20 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 24 in. AT INSPECTION 12/1/2Oll 15 g.p.m. 6.7 g.p.m. · Well type PRIVATE. IfA, B, or C provide PWSID # __ Date completed 4/2o/198~ Sanitary seal (Y/N) Y__ Total depth 111 ff. Cased to 110 ft. FROM WELL LOG Date of test 4/20/1983 Static water level Well production WATER SAMPLE RESULTS: Coliform NEG colonies/100mL Nitrate 2.33 Arsenic: ND mg/I Date of sample: 12/1/2011 B. SEPTIC/HOLDING TANK DATA ~ mg/L Collected by: ArcTerra Tank Type/Material Septic/Steel Date installed 8/14/1984 Tank size 1000 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 12/1/11 Pumper McDonalds C. ABSORPTION FIELD DATA Date installed 8/14/1984 Soil rating (g.p.d./ft2 or ft2/bdrm) 237 System type TRENCH Length 61 ft. Width --3 ft. Gravel below pipe 7___ff. Total depth 8.45 ft. (Measured 1211111) Eft. absorption area 8~4 ft2, Monitoring tube Y Depression over field NT Date of adequacy test 12/1/1_1 Results (Pass/Fail) Pass For 3 Fluid depth in absorption field before test 0 in. Water added 610 gal. New depth Elapsed Time: 15 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N__lf yes, give date -- bedrooms 5.4 in. D. LIFT STATION Date installed "Pump on" level at __ Datum .in. E. SEPARATION DISTANCES Size in gallons "Pump offf level at Cycles tested in. ManhOle/Access (Y/N) High water alarm level at in. Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 10o,+ Absorption field on lot ;tOO'+ Public sewer main *$$'+/- Sewer/sePtic service line 25!+ Animal containment areas On adjacent lots ;tOO'+ On adjacent lots ;tOO'+ Public sewer manhole/cleanout 100'+ Holding tank Manure/animal excrete storage areas 10o'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line ;to'+ Surface water ;tOO'+ Wells on adjacent lots ;tOO'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation Water Service line 10'+ Surface water Curtain drain 50'+ (None [(nown) COMMENTS Water main ;to'+ Driveway, parkingNehicle storage __ Wells On adjacent lots 100'+ lo'+ Based On field observations on 1 2/1/1 1 and previous COSA--MTs may not extend the fUll effe~tive dePth per MOA record inspection report. *WR#ODOOZ5 G. ENGINEER'S CERTIFICATION I certify that I 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 I(~NNETH l~,[. DLrFFLT$ Date 12/912011 COSA Fee $490.00 Date of Payment Io~ Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number ................ S_GS_ SGS Ref.# 1115794001 Client Name ArcTerra Engineering and Surveying Printed Date/Time 12/08/2011 14:57 Project Name/# Sunset Hills West B3, L2 Collected Date/Time 12/01/2011 13:00 Client Sample ID Sunset Hills West B3, L2 Received Date/Time 12/01/2011 16:30 Matrix Drinkin~ Water Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 12/02/11 12/05/11 SCL Waters De~ar tment Total Nitrate/Nitrite-N 2.33 0.100 mg/L SM20 4500NO3-F B (<10) 12/07/11 AYC Microbiolo~ Laboratory E. Coli Total Coliform Negative 1 100mL SM20 9223B A 12/01/11 DLC Negative 1 100mL SM20 9223B A 12/01/11 DLC MunicipsRty of Anchorage Development Services Depsrtment Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw Sb'eet P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsitb (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. _; ..=. 1. GENERAL INFORMATION COSA# O q'. 12 p. onOate: Complete legal description SUNSET HILLS WEST, LOT 2, BLOCK 3 Location (site address) 14514 HANCOCK LANE * ANCHORAGE, AK 99515 Current Property owner(s) Mailing address MAYNARD & BLIIY SMITH Day phone 14314 HANCOCK LANE * ANCHORAGE~ AK 99515 339-8106 · Lending agency Mailing address Day phone Real Estate Agent Mailing address BARBARA RAMSEY w/DYNAUlC PROPERTIES Day phone 3111 C STREET #100 * ANCHORAGE~ AK 99503 261-7552 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site · Individual Holding tank [] [] Community On-site [] [] Public Sewer [] The Municipality of Anchorage Development Servlces 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 Ataska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for propertie% served by a single-family on-site wastewater disposal and/o,r 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 pdvate or Class C well and may be reissued with new water samples. (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. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of ~he validation date shown be/ow, 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, funcfiona/ 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 fi/es and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with ali applicable Municipal and State codes, ordinances, and regulations in effect at the time of insta#ation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUI'I'E 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Phone 337-6179 Engineers Comments: In conducting this evaluation, GEG, LtD. affempted to provide a thorough, conscientious engineering analysis of the system in accordanca with ADEC and MOA DSD Guidelines & Regulations. The reported resu/ts described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily Identi§ab/e features. The operational life of ali we/Is and septic systems depend on the local soils condition, groundwater levels that may £uctuate 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 t[~e 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. DSD SIGNATURE ~ Approved for -~ Disapproved. Conditional approval for bedrooms. '~ ' D '~: bedrooms, with the fllowing st~ns:WATER AN . . ...... Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Ni~3/~e Advisory//~., //-- Arsenic Advisory Maintenance Agreements Supplementa. I Engineer's Repor[ Other Original Certificate Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www. munLorg/onsite (907) 343-7904 ' CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: A. WELL DATA SUNSET HILLS WESTr LOT 21 BLOCK 3 Well type PRIVATE . Date completed 4/20/1983 Sanitary seal (Y/N) YES IfA, B, or C provide PWSID# N/A Total depth 111 ft. Cased to 110 ft. FROM WELL LOG Date of test 4/20/1983 Static water level 66 ft. Well production 15 g.p.m. WATER SAMPLE RESULTS: Coliform ~ (~ coloniesll00 mi. We'll Log (Y/N) Wires proPerly protected (Y/N) Casing h ~eight (above ground) AT INSPECTION 5/i/2009 63 ft. 3.26 g,p,m. Nitrate ~, ~ mg./L. Other 'bacteria YES YES 24 in. · . coloniesllO0 mi, Arsenic: i (~) ug./L. Date of sample: 4/30/2009 Collected by: GEG Ltd. SEPTIC/HOLDiNG 3:ANK DATA Tank Type/Material SEPTIC/STEEL Date installed 8/14/1984 Tank size 1000 gal. Number of Compartments 2 Clean0uts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 5/12/2009 Pumper. MCDONALD'S PUMPING ABSORPTION FIELD DATA Date insta!led 8/14,/1984 Soil rating (g.p.d./ft~oO 237 S,yslem type TRENCH Length 61 ft, Width 3 ft. ~r~vel below pipe 7 ft. · Totaldepth*9.25-9.Sft. Eff. absorption area 854 ft~ Monitoring tube ~*YES Depression over field. NO Date of adequacy test 5/1/2009 Results (Pass/Fail), PASS ' For 3 bedrooms Fluid depth in absorption field before test DRY in. Water added 490 gal. . New depth 4 in. Elapsed Time: 540 min. Final fluid depth DRY in· Absorpt on rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YiN & type) NONE KNOWN , If yes, give date - **MT1 AND MT2 ONLY EXTEND 62 AND 59 INCHES BELOW THE INVERT D. LIFT STATION Date installed ~ize in gallons ~ ~ .Pump on. level a~h watertI~rm !.evel at in. ~ ~ C I~ets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot, 100'+ Public sewer main *,,,55' Sewer/septic service line 25'+ Animal containment areas 50'+ 100'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout 100% Holding tank N/A Manure/animal excrete storage areas 100% sEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation. 5'+ Property line 5'+ Absorption field Water main N,/A Water service line 10'+ Surface water We/Is on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Water service line 10'+ Curtain drain NONE KNOWN F. COMMENTS 5'+ 100'+ Building foundation. 10'+ Water main N/A Surface water 100% Driveway. parking/vehicle stdrage lO'+ Wells on adjacent lots 100'+ *THE WELL WAS DRILLED IN 1983 PRIOR TO THE SEWER MAIN BEING INSTALLED IN 1995. NO WAIVER WAS FOUND TO BE DONE PER AWWU. THE APPROXIMATE DISTANCE FROM THE WELL TO SEWER MAIN IS 55 FEET G. ENGINEER'S CERTIFICATION I certify that I 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 cOSA Fee $ z-~ 0 ''~ ~ Date of Payment ~//'~/('') OJ Receipt Number /~.OL~ I~ (Rev ~1~5) Receipt Number SGS Ret.# 1091678001 Client Name Gamess Engineering Group, Ltd. PHnled Date/Time 05/18/2009 8:25 Project Name/# Sunset Hills West L2,B3 Collected Dalefrime 04/30/2009 ] ] :00 Cllent Sample ID Sunset Hills West L2,B3 Received Date/Time 04/30/2009 11:35 Matrix Drinking Water Technical Director Stephen C. Ede Sample Remarks: Allo~ahle P~ep Analysis Metals by ZCP/MS I lardness as CaCO3 232 5.00 mg/L SM20 2340B C 0~/06/09 05114/09 NRB Waters Deparement Total NitratedNitrilc.N 2.28 0.100 mg/L SM204$00NO3-F A 05/08/09 JDZ Private Individual Anal~sLs Aluminum ND 20.0 ug/L EP200.8 C 05/06/09 05/14/09 NRB Antimony ND 1.00 ug/L EP200.8 C (<6) 05/06/09 05/14/09 NRB Arsenic ND 5.00 ug/L EP200,8 C (<10) 05/06/09 05/14/09 NRB Barium 24.2 3.00 ug/L EP200.8 C (<2000) 05/06/09 05/14/09 NRB Cadmium ND 0.500 ug/L EP200.8 C (<5) 05/06/09 05/14/09 NRB Calcium 69900 500 ug/L EP200.8 C 05/06/09 05/14/09 NRB Chromium ND 2.00 ug/L EP200.8 C (<100) 05/06/09 05/14/09 NRB Copper 125 1.00 ug/L EP200.8 C (<1300) 05/06/09 05/14/09 NRB Iron 4990 * 250 ug/L EP200.8 C (<300) 05/06/09 05/14/09 NRB Lead 3.23 0.200 ug/L EP200.8 C (<15) 05/06/09 05/14/09 NRB Magnesium 13900 50.0 ug/L EP200.8 C 05/06/09 05/14/09 NRB Manganese 33.7 1.00 ug/L EP200.8 C (<30) 05106/09 05114/09 NRB Chloride 21.5 0.100 mg/L EPA300.0 D (<250) 05/06/09 05/06/09 JDZ Fluoride ND 0.100 mg/L EPA 300.0 D (<2) 05/06/09 05/06/09 JDZ Selenium ND 5.00 ug/L EP200.8 C (<50) 05/06/09 05/14/09 NRB ,Sodium 6840 500 ug/L EP200.8 C (<250000) 05/06/09 05/14/09 NRB Sih'er ND 1.00 ug/L EP200.8 C (<100) 05/06/09 05/14/09 NRB Thallium ND 1.00 ug/L EP200.8 C (<2) 05/06/09 05/14/09 NRB Sul£ale 25.3 0.100 mg/L EPA300.O D (<250) 05/06/09 05/06/09 JDZ Zinc 8.22 5.00 ug/L EP200.8 C (<5000) 05/06/09 05/14/09 NRB SGS Ref.# 1091678001 Client Name Gamess Engineering Group, Ltd. Prlnled Dale/Time 0.5/18/'2009 8:2.5 Project Name/# Sunset I lills West L2,B3 Collected Datetrime 04/30/2009 I1:00 Cllent Sample ID Sunset Ilills West L2,B3 Receis ed Date/Time 04/30/2009 11:35 Matrix Drinking Water Technical Director Stephen C. Ede AIIo'~able Prep Analysis Parameter Results PQL Units Mclhod Container ID Limits Date Date Init Private Individual Analysis Total Dissolved Solids 271 10.0 mg/L SM20 2540C D (<500) 05/01109 ACF Nickel ND 2.00 ug/L EP200.g C (<100) 05/06/09 05/14/09 NRB IICO3 Alkalinily 175 10.0 mg/L SM20 2320B D 05/05/09 WAW Conductivily 489 1.00 umhostcm SM202510B D 04130/09 RJT pll 6.50 0.100 pll unlts SM20 4500.11 B D (6.5-$.5) 04/30/09 Alkalinity 175 10.0 rag/L SM20 2320B D 05/05/09 WAW Colony Counl . 0 col/100mL SM20 9222B A 04/30/09 DLC ToulColitorm 0 col/100mL SM209222B A (<1) 04/30/09 DLC Fecal Coliform 0 ¢offl0OmL SM20 9222B A 04/30/09 DLC