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HomeMy WebLinkAboutTURNAGAIN BLK 4 LT 13-000 \3 ' BO ( GH GRE' A'IER ANCHORAGE AREA Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE ~ FROM WELL ' INSIDE LENGTH MANUFACTURER _ INSIDE WIDTH MATERIAL LIQUID DEPTH NUMBER OF COMPARTMENTS LIQUID CAPACITY GALLONS. -, , _E~D: DISTANCE FROM WELL NUMBER OF LINES_ / ABSORPTION AREA FOUNDATION__ NEAREST LOT LINE DISTANCE ETWEEN LINES . NGTNOF TRENCH WIDTH EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE TOTAL LENGTH ,/ DP L NES IN. TOTAL EFFECTIVE DEPTH OF FILTER MATERIAL BENEATH TILE~'~'f'_lN. ABOVE TILE ~//--~ IN. WELL: TYPE _ BUILDING FOUNDATION CESSPOOL APPROVED --. CONSTRUCTION NEAREST NEAREST LOT LINE SEWER LINE OTHER SOURCES _ DISAPPROVED DEPTH SEPTIC SEEPAGE TANK SYSTEM DISTANCE FROM: REMARKS DISTANCES: INSTALLED BY: ~ SEWER LINE DEPTH: LOT SLOPE: Forra EQ-032 DIAGRAM O F'.,~YSTE M 'tI'!E I.[:iqGTH [);[I'IlEN:~;ICdq I~; "l"Hk:: I...EIqEi"['H (II",l FEET) OF THE: TP:.'ENE:H O1:;;'. DF::FIIIqF:I[E!...[':,. qHI:ii: [:,I:EF'TH ElF' FI TREI",ICH O1:;;: F':[T I~.'~; THE DIfi;TFII",!CIE [i:[E"I"I.,.I,~Ef~:F,I THIE '.'SLII:?.F'FICE: O1:' THE: EiH:CiI. ji",I[:) F:ii",l[::, THE E:CFI'TOP1 OF: FiilE[~:E :[2:; NO '.E;E:T' I.,.I]:I)-['H FOR TF:EI",ICHE:5;. THI:E GI-;N::I'v'E'3.... DFEF:'TH ]:2; ']'FIE I"I:[N:[HL.IH C, EPTH OF diF;'.F:I'¢[EL E:E"I"I.,.IE[::3',I THE': OLJTF'f::ILL.. F:']:F:'E FIND THE E:OTTEIH OF' THE E:XCFP,,,'R'I"]:ON ,::]:N F'E[ET::'. i'1 :i: f,i ;I; P'Ii_.II"I E:,:[ :E;"i'F]I",ICE E:I:i:'I"I.,I[EEN iq I.,IEL_L. FIND t::lN"r' :jd:)CI F'EET I::'CII:;;'. I::'1 F:'F;::XVFI']"E I-'JELL O1';~'. 2EIE'I I::'EET I::'OF;: R F::'Uk'!:L1C I,JEL.t.. 'Z;F:'iZC:]:F:':[E:f:I'[');I:)N:~; F:II",~E:, C:OI'4:STI:;~'.LICTZCiN [:,'_(I::IG~'~:(::IJ"I'-'5 :[ N'-'::; ] fq_i..l::l"l" ): ON. :[ CEF~:'I']. F'~','' I'HI::fT :11.: I Fib! FFII'I:fL.]:FII:~: Iq:[-I"H THE REI;!UIREi'"IENT~!; FOR ON-".:5I"I-E '-"4;EI-,IEI'~:~:-:; F'OF;'.TH E',"r' 'I'HE: i'"IUN);C:ZF:'F:IL.]:'I-'¢ OF' F::INC:HOI;?RGEL ;2: :[ FJ):!..I... :[i",E::;TFILL -f'Ht:F: 2;'T'~:;'TEH :[[",1 FIC:E:Cff;~:Di::II"JCtE I-,.!:[TH THE :~:: ]: LIN[:)EI:;i:'i';TFIND "i"HF:IT THE: Oi".I-'-?5]:TE ~i;EPJIEF~'. 2il;'T'~;TEH 1'41::t'-r' F;:E':[;!U:[F?.IZ EI'41..J::IF,i%'ikZi'"IZHT :IF' TI'liE I:;i:IEL'";]:[::,[!~NCEi; :!:~ I:~l~.-. ~:'ELE[:' TEl ]:NE:LU[:'[E I"IOF:::E THI::II"~ 4 :, j. L.iJ',IL[:,: ................................... "' ' .-.~~-.~ ........................ I::1F:'F:'I._. ZlZ C:l:::ltq "[ F:II ~N E:Z"d ,-, .. .......... · .:,:,1...I :.[. f~ ' ~r'~ ~T~ ~ C~ORAG ~ AREA BORO"~-H /~z'~/~ ~ L~.~j HEALTH DEPARTMENT ~,...~ ~ ~TO, ,'~' ~ 327 EAGLE ~. ANCHORAGE, A~S~ 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAMF tl ~J, LOCAT,ON Z-~! /~ ~/~' ~ SEPTIC TANK: ADDREssMAILING ~.~ ~. ~. ~.~/~.(.:~_z.~ ~,./~z~.~C~__ PHONE £;. 'EGAL OESCR,PT,ON X,',/ o% Z' DISTANCE FROM WELl ,~~'~5~ LIQUID CAPACITY /~-~ MATERIAL__ GALLONS. INSIDE LENGTH NUMBER OF .~)_ COMPARTMENTS INSIDE WIDTH DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS ~ OUTSIDE DIAMETER LINING MATERIAL ~.'~/~J'~7-~' ~:~J~/~--~ NEAREST LOT LINE .~i OR WIDTH /~ LENGTH /'~ , DEPTH DISTANCE FROM WELL J~ ~ ., BUILDING FOUNDATION TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~ ~ SQ. FT, DISTANCE FROM WELL~ T N~LINE , OF LINES , NUMBER OF LINES ~~kl~-,5-"~ ~ TRENCH WIDTH IN. TOTAL EFFECTIVE DEP~T. bI~.T~I~F TILE TO EINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL, TYPE a";ll,~ DEPTH j O('JC DISTANCE FROM //R~/i';~ WATER , , BUILDING FOUNDATION SAMPLE . NEAREST LOT LINE ~ I NEAREST /~//V SEPTIC .~.~'# SEEPAGE j~l OTHER SEWER LINE. '~-' _, TANK , SYSTEM. . CESSPOOL , SOURCES__ DISTANCES: DIAGRAM OF SYSTEM I~-8 = ~-?--. it,-/' HEALTH AUTHORITY ir GREa~ER ANChORAgE AREA BO~32UgH SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT NA"E OF A'~P"OAN~o" 7"~,N~TAL'.AT,O" LOC f~ MA,,-IN~ ^DDRESS ..~oX ~-z4 PHONE TYPe AND S,ZE OF FACILITY TO BE SERVED ~ ~/~/~/ ~--~'~/~ (2 ~ ) . ~ ~ / / ' E~ l'~.) ~ NOTE: THIS PERMIT I~ NOT VALID WITHOUT SOIL FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO pROSECUTION. SEPTIC TANK SiZE TYPE SEEPAGE AREA SIZE TYPE FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT ., DRAIN FIELD . SEPTIC TANK TO SEEPAGE Pit WALL . SEPTIC TANK .* SEEPAGE Pit . TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAJN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD SEPTIC TANK, , SEEPAGE PIT 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 P[T FITTED WITH AIRTIGHT REMOVABLE CAPS. · DRAIN FIELD · SEEPAGE PIT , ALSO CONS[DER AREA WELLS. , sEePAGE PIT DRAIN FIELD [ CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE APPLICANT'S SIGNATURE Performed For John Fray flare Depth Feet 1 2-- 10- SoJ. i ¢ .............. 'c'' bro.u silty sand gray fine to coarse sand gray sandy, fine to medium gravel (GW) Location Sketch ..... Date Net Drop ¢ ''. 'FPS'. .......... area is required per bedroom with o of r~n s set at ~0 foot deuth, the bott m ~ ............ ~ ................. - Test Performed }~v: R E. Carlisle.. ~ Data Certified ~y: National Testing Servzces, Date: /ff~--:=~ , · · , .~MUNICIPALITY OF ANCHORAGE - ~/~ j DEPARTMEN,,_~OF ttEALTFI AND ENVIRONMENT~ PROTECTION Anchorage, Alaska 9950] k~2 ~ ~, 279-251]-, ext. 224 or 225 .~f~ ~l Date Received: August 15, 1977 ~1: Time _~~___ ~2: T~me ~3: X?-77 Date Date REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WA9ER FACILITIES Lending Institution Request: National Bank of Alaska Mailing Address: Post Office Box 3-3859 99509 Phone: 279-2506 2. Property Owner: Garlen Keen Phone: Mailing Address: % Jerry Ward, 276-4506 3. Legal Description: Lot 13 Block 4 Turnagain Subdivision 4: Single Family Residence: Number of Bedrooms: Multiple ~'amily Residence: ~x~ Number of Bedrooms: Four 5. Well System: Individual Well ~ Community/Public System ( ) Permit # Depth of Well Well ]Log on File Construction Bacterial Analysis Sewage Disposal System. On-site System (x~x Public U~ility ( ) Permit # Installed j~ Installer Septic Tank Size .__j~__.~..O ........... Manufacturer ~£ _ Absorption Area ~ Soils Rate _~_ ~ Material ~~-- Distances: Well to to Sewer Line to Nearest Lot Line Septic Tank Nearest Lot line to Absorption Area Absorption Area ,: Department o Health and Environmental Protection Requ ~t~ 'for Approval of Individual Sewer and Water Facilities ~LJ.p~:ion: Lot )3__~lock 4 Turnaqain Subdiyison ~fadav~t~ Art. ached. ~ Letter U Date. Disapproved: q~par~ent~ Wo~k sheet: __ ~~ MUNICIPALITY OF ANCHOR AGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3~, Anchorage, ,c,:,,.,:.~ SSSSS -- ~7~,,~1', 825 'L" street 279 2511 825R~J~Sq"aFDR APPROVAL OF iNDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA 2. Property Owne~r: ~~. ~/ Mailing Address: 3. Name of Buyer: .~ ~'J' %, ~wa,,,ng Address: 4. Name of Lending Institution: FHA CONV W Day Phone Day Phone Mailing Address: Name of Realtor or Agent: Mailing Address: Phone Phone 6. Legal Description: Location: 7. Type of Facility to be inspected: 8. Water Supply Type of Supply: Public Utility No. Bdrms. Individual If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility If Individual, date of installation Individual (on-site) EQ-037 (1/74) HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.--TO BE COMPLETED BY FHA Anchorage I l~myxflax~t Fray, John TURNAGAIN SUBDIVISION MORTGAGEE Peoples Bank and Trust Co. 188-407 t'ROPERTY ADDRESS Lot 13, Blk. 4, TURflAGAIN,SUBDIVISION 1 j 2 ~ 1 [~ Public system J'~ Cx)mmunlty system SEWAGE DISPOSAL [] FubJic system. ] Community system ] New instaJladon 4 PART II.--TO RE COMPLETED BY HEALTH DEPARTMENT : :~ ill I ~ Ii il ,Ii ;iii, i!Jl ' j ,,.,,J!!i'it!~. i!li '' ti i1[i :tL, ..: ii ' I iJ ,J .... :ill , ~ ~ il~ 'j ,I i iii~',,, ;.,, ij ........... J !~:: ,Ii [ !t ! i J! l!l: ~lii !1~ ,; I i i;i i i il ~l! j ii ! : , ,, ''1' , ? , I il 'El: '~ ..... ~ ' ' J ;'~ II I I J !tie J;!l I Iii ~[:~ 1 j,,..,: ,, il iJil '" 'l! ' ii'' II:i n Ii Iii }'i !iii ila: ! ii !1! ' I ii 1111 Iii fill Ii'l ~1~: :lli!!ili ;]ii It is the opinion or ~¢ [] State [] County [] Lc<al Department o£ HeaLth that this individual watct-suppJy system [] is [] is not satisfactory as a domestic water supply for the subject property. It is the opinion of the [] State [] County [] Local Department of Health that this individual sewage.disposal sys- tem with proper maintenance: ~ Can b~ expected to function satisfactorily, and [] Cannot be expected to funcxion satisfactorily is not likely to create an insanit~ conditio~ , , 4 ,'arch 23, 197Y /~'~-~~~ lnssistant Director [ have r~i~ the foregoing and the ~ninen( FHA Compliance Ins~ion Re~n, and ~ommend that the lndividuil water-supply system ~ considet~ ~ AccepJable ~ N~ Ac~ep~ble ~wage dis~sal ~ considered ~ Acceptable ~ Not Acceptabl~. DATE J SIGNATURE HIrALTH AUTHORITY APPROVAL GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 DATE RECEIVED: INSPECT: TIME: REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES FOR 1. APPROVAL ADDRESS: PHONE:. 2. PROPERTY OWNER: 8. LEGAL DESCRIPTION: 4. TYPE FACILITY TO BE NUMBER OF BEDROOMS: REQUESTED BY: ,]TO/,1A~ FF~ INSPECTED'. WELL DATA: A. TYPE B. DEPTH C. SIZE D. E. log CONSTRUCTION BACTERIAL ANALYSIS 6. SEWAGE DISPOSAL SYSTEM: SEPTIC TANK (IF HOMEMADE, SHOW DIAGRAM ON BACK) ~. SIZE 2. AGE /~7t 3. 'MAUU~ACTURER S/J~Z~ 4. INSTALLER ~ ~ '~ L~...~R k REQUEST FO SEWER & WATER FACILITI~ APPROVAL PAGE TWO SEEPAGE PIT SIZE /5 C. DISPOSAL FIELD 1. NUMBER OF LINES 2. TOTAL LENGTH REQUIRED MEASUREMENTS / A, WELL TO SEPTIC TANK B. WELL TO SEEPAGE PIT C. WELL TO SEWER LINE ~/ D. WELL TO PROPERTY LINE E. WELL TO OTHER POSSIBLE CONTAMINATION F. FOUNDATION TO SEPTIC TANK G. FOUNDATION TO SEEPAGE PIT H. SEEPAGE PIT TO PROPERTY LINE 8, COMMENTS: APPROVED: DISAPPROVED: DATE: ~ LY ~._~:j_'7'Z. DATE: APPROVAL VALID FOR ONE YEAR GREATER ANCHORAGE AREA FROM DATE SIGNED. BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 00C;''''. 51 eb •`2._� Municipality of Anchorage On-Site Water and Wastewater Program z. rio, (907) 343-7904 Certificate of On-Site Systems Approval Parcel I.D. 016-122-13 Expiration Date: 6"- )--d^ f 1. GENERAL INFORMATION Complete legal description Turnagain Block 4 Lot 13 Location (site address) 1202 Broaddus Street Current Property owner(s) 15th Avenue LLC Day phone Mailing address PO Box 110501 Anchorage, AK 99511 Real Estate Agent Day phone 2. TYPE OF DWELLING: ❑ Single Family (w/wo ADU) O Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well E Individual ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer 0 WaiverNariance request for: Distance: Received , : + A 9 - . � o� - Date: J -��l — COSA to be release. to the engineer,unless othe requested by the engineer. COSA Fee $ 44 !ciO Waiver Fee $ Date of Payment 3//S/tP3 Date of Payment Receipt Number CA/166 Receipt Number COSA# Ob U DO 8g 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. In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations.The reported results describe 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 soil condition,ground water 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 this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 3/12/2018 AL.xr.okk 6. DSD SIGNATURE • ..... .... V. % System#1 Approved for bedrooms •• S,evdr k.•Hormone: �{fig. CE-8149 System#2 Approved for bedrooms s•. ••� Disapproved ��� � OFESSIONA�+~ Conditional approval for bedrooms, with the following stipulations: • \WLATEY RUAFyN m WA . =. ON-SIT � 12 WASTE z= PROGRAM o Sr_Rv1G By: � _I • - Original Certificate Date: – Ce— 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 blue sheet f c If more than 1 septic system is on the lot: COSA Checklist# 1 of 1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: Turnagain Block 4 Lot 13 Parcel ID:016-122-13 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) N Date completed UNK Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth UNK ft Cased to 40+ ft. Casing height(above ground) 18 in. FROM WELL LOG AT INSPECTION Date of test UNK 2/15/2017 Static water level UNK ft 28 ft. 4+ Well production UNK g.p.m.m g.p.m. WATER SAMPLE��RESULTS: Coliforrr� colonies/1019 mL Nitrate ND mg/L A senic7` ND r3 ug/L( g D. : •• ampi : 3/6/2018 ollected by: PES • pyt 2-I S-I - ,L.r...e t t'�-✓�a�-im vk B. SEPTIC/HOLDING TANK DATA D Tank Type/Material N/A Date installed Tank size gal. Number of Compartments Cleanouts(Y/N) Foundation cleanout(Y/N) Depression over tank (Y/N) High water alarm (Y/N) Date of pumping Pumper C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ft2 or ft2/bdrm) System type Length ft. Width ft. Gravel below pipe ft. Total depth ft. Eff. absorption area ft2 Monitoring tube Depression over field Date of adequacy test Results(Pass/Fail) For bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) 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 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 100+ Animal containment areas 50+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line Absorption field Water main Water service line Surface water Wells on adjacent lots ABSORPTION FIELD ON LOT TO: Property line Building foundation Water main Water Service line Surface water Driveway, parking/vehicle storage Curtain drain Wells on adjacent lots F. COMMENTS Survey on file. G. ENGINEER'S CERTIFICATION .1.'4 OF ALiIkk I certify that 1 have determined through field inspections and Air •' ` •'- review of Municipal records that the above systems are in 0* 49 \ *Y conformance with MOA COSA guidelines in effect on this date. •••• ••? \ •••• Engineer's Printed Name Steven Pannone / .Sieveri}Z.•ISanriorie .• Date 3/12/2018 i+1lgs• CE-8149 �� COSA canary sheet_2-6-15.doc Municipality of Anchorage R • Development Services Department Building Safety Division 6=` 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 # OSC 181082 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 4, Lot 13 of Turnagain Subdivision. This inspection revealed an arsenic concentration of 105 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.