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HomeMy WebLinkAboutTURPIN BLK 1 LT 11Onsite File Turpin Block 1 Lot 11 #006-092-11 1973 Crib appears to be adequately sized for 2.5 bedrooms, but has been approved for 3 bedrooms in the past. Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201288 PID Number: 006-092-11 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name NameJ DICKENS DENNISSite ABSORPTION FIELD - EXISTING ElDeep Trench El Wide Trench E] Bed El Mound Address 6440 E 9TH AVENUE, ANCHORAGE ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Fill added above original grade Ft. Gravel length Ft. TURPIN 1 11 Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line FtZ Ft. Well 200'+ -- 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1250 Gal. Surface Water 100'+ -- Material HDPE Number of compartments 2 Lot Line 10'+ -- NA Foundation 10'+ -- LIFT STATION Manufacturer Capacity Gal. Remarks Alarm location Electrical installed by Tadkto PIPE MATERIAL House to tank 3034 dra afield 3034 Installer NORTHERN EXCAVATION Drainfield CO/MT 3034 Inspector FWCS BENCH MARK (Assumed elevation) 100 ft Inspection1s` 8/10/20 nd 8/11/20 Location and description dates: 2 3rd 4`h IBOTTOM OF SIDING ON-SITE WATER AND WASTEWATER SECTION APPROVAL A Conditional Approval: Date '•:tp,��� .. 4.. TM ....�..I`. ' r� , • j �.• Curtis Huffman Septic System A Approve �� �' • CE 128991 • `� / c��lF�• Date �� , z� . ,sn 1/202Q. •��C��..LW �k�, OPROFESSIONP Note: this approval does not include well permit requirements. \��\\Zt�� (Fev 05/02/18) 1 e g Tz,� Arlo /i TS 6 c' � 61*Ll✓ PERMIT: OSP201288 PID: 006-092-10 Traller/Shed I II I SCALE, 1' = 30 SEPTIC SECTION TURPIN BLOCK 1, LOT 11 PREPARED FOR: DENNIS DICKENS 6440 E 9TH AVENUE ANCHORAGE, AK 99504 FIRST WATER CONSULTING 13030 SUES WAY ANCHORAGE, AK 99516 907-350-9566 firstwaterAK®gmoil.com SCALE, NTS SUPPORT, SERVICES: AMP, OF At g — DATE: 8/17/2020 3 rtis Huffman e SURVEY: S4 2020 r, CE 128991 4' DRAWN: FWCS 8/17/2020e SCALE: 1 ° = 30' ��sstoK�' East 9th Avenue N89.50'00'W 60,90' 10' X O iL co a N Q M W Z Lot 11 k' 3 i7 13.6' iv o o Paved Drive g,g 14.8' 1.5 0 M Existing House d Lot 12 w 3 o Lot 10 CD 0 21.3' 26.0' 1.2' Y 0 8 N N of 3 W d 4.3' 10.3^ B o 19.6' o } FCO Z Qj Existing Garage 0 MH a_ 0 cd D CO DECOMMISSIONED EXISTING DCO S.T. & INSTALLED NEW 1250—GAL HDPE SEPTIC TANK WITH NEW FCO & DCO. MAINTAINED 19.6' 5'+ TO DECK SUPPORTS 4.2' ® CRIB MT EXISTING Traller/Shed I II I SCALE, 1' = 30 SEPTIC SECTION TURPIN BLOCK 1, LOT 11 PREPARED FOR: DENNIS DICKENS 6440 E 9TH AVENUE ANCHORAGE, AK 99504 FIRST WATER CONSULTING 13030 SUES WAY ANCHORAGE, AK 99516 907-350-9566 firstwaterAK®gmoil.com SCALE, NTS SUPPORT, SERVICES: AMP, OF At g — DATE: 8/17/2020 3 rtis Huffman e SURVEY: S4 2020 r, CE 128991 4' DRAWN: FWCS 8/17/2020e SCALE: 1 ° = 30' ��sstoK�' 8/6/2020 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 006-092-11 Phone: 907-343-7904 Fax: 907-343-7997 Property owner(s) DENNIS DICKENS Day phone 9073108828 Mailina address 6440 E 9TH AVENUE, ANCHORAGE, AK 99504 Site address 6440 E 9TH AVENUE, ANCHORAGE, AK 99504 Legal description (Sub'd., Block & Lot) TURPIN 131, L11 Legal description (Township, Range & Section) Lot Size 9,135 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) El (w/wo ADU) Septic Tank FE Upgrade FX Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (mature of property owner or authorized agent) Permit/Rush Fees: Date of Payment 168, r J( co vl D j l) Waiver Fees: ?LL 0,2 Receipt Number: 60 f `-f 0") gi Permit No. OSP201 �S? Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350 -9566 / firstwaterAK@gmail.com July 30, 2020 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: TURPIN BLOCK 1, LOT 11 PHYSICAL: 6440 E 9TH AVENUE, ANCHORAGE, AK 99504 The subject property has recently passed a 4-bedroom septic adequacy test in preparation for a COSA and the owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. We propose to install a 1250-gallon HDPE tank outside any deck supports to serve the existing 4-bedroom residence. The waterline will be located prior to construction. The lot and area are served by public water. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201288, Rebecca Carroll, 08/06/20 FIRST WATER CONSULTING TURPIN BLOCK 1, LOT 11 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201288, Rebecca Carroll, 08/06/20 GRE - R ANCHORAGE AREA BOE ' GH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME /~';'~z~ -//(./L~ LOCATION SEPTIC TANK: D,STANOE FROM WELL · INSIDE LENGTH MANUFACTURER L)'/~ LF/ }~])'/~ MATERIAL NUMBER OF / COMPARTMENTS INSIDE WIDTH LIQUID DEPTH __ LIQUID CAPACITY /'~'~-~ (~ GALLONS. SEEPAGE PIT: NUMBER OF PITS__/ DIAMETER__' OR WIDTH /~,> LENGTH /~} DEPTH LINING MATERIAL /'~('{"~ CRIB SIZE: DIAMETER ~ DEPTH `% DISTANCE FROM: WELL 2', . ~-TOTAL EFFECTIVE ~Z/~:~D BUILDING FOUNDATION ~C"~)/ NEAREST LOT LINE'~ (~' / Y~' '3ABSORPTION AREA (WALL AREA) SQ. FT, ADDITIONAL ABSORPTION ~:~)'%~' (:)'~ bl~'?/'l~? /;/U~~- ~ WELL: TYPE ' ' CONSTRUCTION BUILDING NEAREST FOUNDATION LOT LINE '" CESSPOOL OTHER SOURCES APPROVED DISAPPROVED NEAREST SEWER LINE REMARKS DEPTH DISTANCE FROM: SEPTIC SEEPAGE TANK __ SYSTEM DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: ~,\ ~'~- PIPE MATERIAL:(~.~% LOT SLOPE: REMARKS: DATE GREATER ANCHORAGE AREA E3OROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C"STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-456 $ SEWAGE DISPOSAL SYSTEM m APPLICATION AND PERMIT INSTALLAT]ON LOCATION INSTALLATION OF: SEPT[C: TANK SEEPAGE PIT RAIN FIELD ., OTHER SOIL TEST RESULTS .... NOTE: THIS PERMIT I~ NOT VALID WITHO MiNiMUM DISTANCES, REQUIREMENTS FOUN?ATION TO SEPTIC TANK ~. '* FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO ~ /~¢ ) SEPTIC TANK ~' ) , SEEPAGE PIT '~ , DRAIN FIELD /~ ~ WELL TO SEPTIC TANK /¢¢ ~ , SEEPAGE PiT ~ DRAIN F~ELD- /¢~i WATER MAiN TO SEPTIC TANK /~ ~ _, O"AIN FIEL~ /4)/ · ALSO CONSIDER AREA WELLS. · SEEPAGE PIT , DRAIN FIELD CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSS[NG GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST lEON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS, GRAVEL BACKFILL CONFORM TO BOROUGH REGULAT[ONS REGARDING INSTALLATION. I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE 229 EAST 51st. AVE. -- P.O. BOX 6087 -- ANCHORAGE, ALAS!(A 99503 Geolo~isls Land Surveyors August 27, 1973 R & M--Nos 36654 Alton Sm:[th 6z'z'O,., E~:tst 9th Avenue A~zoholcage~ AL.:.k=.~:' ~ 99504 ~a .... Hole and Soil Log Report fo:c Sanitary System~ Lot Block ]., ~ -~" ru..p.,m Subdivision .,,-. Smith: We ace submitting herewith the test boring results and our comments regarding soil conditions encountered at the subject site. This izrz~astigation was performed in accordance with your request of Angm~t 17, 1973, and those procedures outlined in a letter dated September 13~ 1971 by M'r. Ro]f Strickland of the Greater Anchorage A~.ea Borough Departmeat of Environmental Quality. A single test hole was put durum within, the Lot 1t. area for the pnrpose of d~.-'finlng general subsurface soil conditions for the proposed sanitary syr:t~mo Excavation was accomplished with a tractor-mounted backhoe' and the test hole was extended to a total depth of 12 feet below ground suwface. The final log prepared for the test hole has been :included :in bra :ii~.~g A---01 ~ water was encountered in the test hole at a uepta of llo0 fee't. a_spreciate being gives this opportunity to be of you have any questions with regard to the above~ please do not Very truly yours, R & ~.l ENGI~iEERING & GEOLOGICAL JWR; ph / :~c: CAAI~ v 8/.[7/73 SILTY SAND~f GR.&VEL 0o0 ~ 0 SANDY GRA ~ EL (6VV) W~ D. NOT J]: __%/ i.2. 0 ' T ~ ]% MUNICIPALITY OF Development Services Department Z On -Site Water & Wastewater Section Parcel I.D. 006-092-11 Certificate of On -Site Systems Approval 0 1. GENERAL INFORMATION Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: 1 (' 19 cq�-_o Location (site address) 6440 E 9TH AVENUE, ANCHORAGE, AK 99504 Current property owner(s) DENNIS J. DICKENS Day phone Mailing address Real estate agent 2. TYPE OF DWELLING: Single Family (w/wo ADU) Duplex Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Private Well Water Storage Community Well Public Water System Waiver request for:. 4 Day phone TYPE OF WASTEWATER DISPOSAL: Private Septic Holding Tank Community Public Sewer Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 9 (2— -'50- .-'50- ��lJ�� Waiver Fee $ ?1111202-0 Date of Payment 0 1 20 ZO Date of Payment Receipt Number 3 � i 1' 5 Receipt Number COSA # 05C-201910 Waiver # Distance: 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FTRST WATF,R C ONSTTT,TTNG Phone 907-350-9566 Address 13030 WETS WAY, ANCHORAGE,, AK 99516 Engineer's Printed Name CURTIS HTTFFMAN, PR Date 8/10/2020 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. 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 in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. 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, any estimate of how long a system will function satisfactory �rg�Q: • • • • • �,9 }� for current or future occupants or guarantee that no unseen encroachments, deficiencies or / r discrepancies exist can be given by First Water Consulting & Fks - / * - L .... ••;* �1 ' •� 6. DSD SIGNATURE Curtis Huffman �.•�c`��r System #1 Approved for bedrooms �� ��29% CE128991 � srF�•.,$/1oi2op���7 System #2 Approved for bedrooms l��FOPROFESSTO Disapproved Conditional approval for bedrooms, with the following` 11b r �R z^ 7S- J� -'U ENT i ByOriginal Certificate Date: 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 byan 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 Legal Description: TURPIN BLOCK 1 LOT 11 Parcel ID: 006-092-11 If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system _ A. WELL DATA — PUBLIC WATER ❑ Well log is filed with Onsite (or attached) Date drilled Total depth _ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) _in. Date of flow test for COSA Static water level at beginning of test _ft. Comments B. TANK DATA Age of tank(s) NEW 0 years Tank type/material SEPTIC / HDPE Measured operating fluid level in septic tank NEW ® Standpipes/foundation cleanout per record drawing Date of pumping NA - NEW D. ABSORPTION FIELD DATA Which system tested (date installed) 8/1973 ® ALL standpipes present per record drawing Total measured depth from grade .8 ft (max) Measured depth to pipe invert from grade 5.5 ft (min) ❑ N/A — pressurized field Well production at time of test _gpm Water storage tank volume_ gallons Well disinfected for coliform test? ❑ Yes ❑ No ® Coliform bacteria is Negative Nitrate _mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Date of Sample C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date 7/28/2020 Results N Pass For 4 bedrooms Fluid depth prior to test 8 in Water added 600 gal New depth 18 in ❑ Monitor tubes go to bottom of effective. If not, state Elapsed time 1320 min depth into effective 2.5' INTO THE 3' ED PER TOP OF CRIB ® Code -required soil cover over field Final fluid depth 4 in ❑ System presoaked Absorption rate 600 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) Gallons introduced gallons If yes, enter date NESComments/Deficiencies:. G.A.A.B. APPROVED 4 -BR SYSTEM 8127/1973. ORIGINAL TANK PUMPED AT TEST. E. SEPARATION DISTANCES Fria -;?.-Private Well on Lot to: (Please enter distances if less than required or if community well) NO WELL - PUBLIC WATER Septic Tank/Lift Sta bn, on Lot > 100' ® Yes if No Community Sewer Manhole/Cleanout > 100' ..I Yes if No ft ® Yes if No ft Neighboring Tank > 100' ® Yes irN-G-, ft Private Sewer/Septic Line > 25' ® Yes if No ft Absorption Field on Lot > 100' ®Yes if No ft `molding Tank > 100' ® Yes if No ft Neighboring Absorption Fields > 100' ® Yes if No Water Main > 10' Animal > 50' ® Yes if No ft ® Yes if No ft ® Yes if No _ Water Service Line > 10' ® Yes if No Manure/Animal Excreta Stora4e— 00' Community Sewer Main > 75' ® Yes if No ft ® Yes`-- f.No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ® Yes if No _ Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: ® Yes Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No _ Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No —ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS SEE MOA RECORD DOCS (SEPARATIONS,...) - SYSTEM APPROVED IN 1973, 2012 COSA... 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. w -� i .. TH �jj• '. Curtis Huffman �f �s�c,•.. CE 128991 .••��wmj°� ft ft ft 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com August 18, 2020 ATTN: Rebecca Carroll Municipalities of Anchorage On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: 4 -BEDROOM SYSTEM / SEPTIC TANK UPGRADE PERMIT LEGAL: TURPIN BLOCK 1, LOT 11 Per the 4 -bedroom septic tank permit submittal on July 30, 2020, it was noted that the subject property had recently passed a 4 -bedroom septic adequacy test in preparation for a COSA. The existing aged steel 1250 -gallon septic tank was replaced with a 1250 -gallon HDPE tank. No bedroom discrepancy was noted on the recently issued permit, which typically would've been noted by the MOA. Per MOA record documents (Inspection Report dated 8/27/1973) - the Greater Anchorage Area Borough approved the system as 4 bedrooms. This 4 -bedroom approval appears to be based on the soil ratings of 85 sf/br, the 200+ SF absorption area noted for the crib, the additional absorption of 150 SF of the 25' drain line (assumed 3' effective depth same as crib) and a 1250 - gallon tank. Based on this inspection report, it appears the system was built and attended to be a 4 -bedroom system and we respectfully request a 4 -bedroom COSA. The system appears to be in good condition per recent adequacy tests of 2012 and 2020. In the event the system does ultimately fail, the property will need to be connected to public sewer. Please contact us if you have any questions. Sincerely, 09w Curtis Huffman, P.E. F s I W d I ell, .°?J .:2 ...S N I NG First Water C 0 N S U L T I N G A r F hVi A 1 R 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com August 18, 2020 ATTN: Rebecca Carroll Municipalities of Anchorage On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: 4 -BEDROOM SYSTEM / SEPTIC TANK UPGRADE PERMIT LEGAL: TURPIN BLOCK 1, LOT 11 Per the 4 -bedroom septic tank permit submittal on July 30, 2020, it was noted that the subject property had recently passed a 4 -bedroom septic adequacy test in preparation for a COSA. The existing aged steel 1250 -gallon septic tank was replaced with a 1250 -gallon HDPE tank. No bedroom discrepancy was noted on the recently issued permit, which typically would've been noted by the MOA. Per MOA record documents (Inspection Report dated 8/27/1973) - the Greater Anchorage Area Borough approved the system as 4 bedrooms. This 4 -bedroom approval appears to be based on the soil ratings of 85 sf/br, the 200+ SF absorption area noted for the crib, the additional absorption of 150 SF of the 25' drain line (assumed 3' effective depth same as crib) and a 1250 - gallon tank. Based on this inspection report, it appears the system was built and attended to be a 4 -bedroom system and we respectfully request a 4 -bedroom COSA. The system appears to be in good condition per recent adequacy tests of 2012 and 2020. In the event the system does ultimately fail, the property will need to be connected to public sewer. Please contact us if you have any questions. Sincerely, 09w Curtis Huffman, P.E. 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N .V Z3 N O X -c U) U)a> N UnZa�3 o n w U) N J s U T Q � U O o � - Municipality of Anchorage On -Site Water &Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I. D. 006-092-11 Expiration Date: �„ q 1. GENERAL INFORMATION Complete legal description TURPIN; BLOCK 1, LOT 11 Location (site address) 6440 EAST 9TH AVENUE *ANCHORAGE. AK 99504 Current Property owner(s) DOUG SMITH Day phone 1-408-802-4184 Mailing address Real Estate Agent 6440 EAST 9TH AVENUE *ANCHORAGE, AK 99504 JED WEINGARTEN W/ REALTY EXECUTIVES Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: 727-5333 TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site E Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System 0 Public Sewer ❑ Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 4-ri0 Date of Payment (:;it �kc1 2 CJ Receipt Number 6AKI G, COSA# Date: 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, 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. /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 Date C ! $ A'Z Phone 337-6179 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's 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. DS,D SIGNATURE \" System #1 Approved for bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following ON-SITE WATER AND WASTEWATER PROGRAM The Municipality or Anchorage 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. ork 7. ATTCHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other By: &'i.� • Original Certificate Date: ! Get " � ✓�� j � (Rev. 11105) 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: TURPIN; BLOCK 1, LOT 11 Parcel ID: 006-092-11 A. WELL DATA Well type Date.completed Total depth ft. Date of test Static water level Well production If A, B, or C provide PWSID# Sanitary seal (Y/N)— Cased to ft. FROM WELL LOG WATER SAMPLE RESUL ft. M. PUBLIC WATER Well Log (Y/N) _ Wires properly protected Casing height (abov n AT Coliform colonies/100 ml. Nitrate mg./L. Collected by: ft. n. ug./L. Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 8/27/73 Tank size 1250 gal. Number of Compartments 1 Cleanouts (Y/N) YES Foundation cleanout (Y/N) NO Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 9/10/12 Pumper MCDONALDS PUMPING C. ABSORPTION FIELD DATA I *BELOW EXISTING GRADE TO BOTTOM OF SEEPAGE PIT Date installed 8/27/73 Soil rating (g.p.d./ftlorCbdrm 85 System type**SEEPAGE PIT/TRENCH Length 25/15 ft. Width 15 ft. Gravel below pipe 3/UNK ft, Total depth *8.16 ft. Eff. absorption area 200+ ft2 Monitoring tube YES Depression over field NO Date of adequacy test 9/6/12 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 5 in. Water added 520 gal. New depth 8 in. Elapsed Time: 145 min. Final fluid depth 5_5 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date **TESTED SEEPAGE PIT ONLY. NO MONITORING TUBE OR CLEAN—OUT IN TRENCH. D. LIFT STATION Date installed "Pump on" level at in. E. SEPARATION DISTANCES Size in gallons Manhole/Access "Pump off level High we alarm level at in. Cycles tested Meets alar & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on Public sewer main Sewer /septic service line areas PUBLIC WATER On adjacent On adjacent lots manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ 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 * Building foundation **UNK Water main 10'+ Water service line 10'+ Surface water 1001+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *LOCATION OF TRENCH IS UNKNOWN **SEPARATION FROM SEEPAGE PIT AND TRENCH TO E FOUNDATION IS UNKNOWN. 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 9./►S1(jZ (Rev.1 rros) n 0 r> Lot 12 4.3' — East 9th Avenue 0 r7 N89°50'00"W 60.90' Lot 11 10' 13.8' N 89 148' 1.5 v > Existing House J 26.0' N [\ 19.6' Ordered by: vtiy Doug Smith lz-, L O S O Legal Descriptinn: U Asbuilt Existing Lot 11, Block 1, • Garage Survey Certification: I hereby certify that a Mortgagee's Inspection was performed on the described property. Notes: It is the owner's responsibility to determine the existence of any easements, covenants, or co M M �!f plat. This 4.2' 19.6' 0 'i Trailer/Shed 10' Utility Easement S89°50'00"E: 60.90' Tract A-2 10' Lot 10 © OF ACVO�� ©5&.. . .16 m .Thomas H. DV/r ' o` LS -7625 A,,o. essianat C.� Legend: Rebar with Cap OO AL. Monument Rebar Monument Well Septic Pavement Overhang Wood Deck Concrete Fence Grid SW1339 Date: 9/12/2012 Ordered by: Doug Smith Legal Descriptinn: Asbuilt Lot 11, Block 1, • `Turpin Subdivision Survey Certification: I hereby certify that a Mortgagee's Inspection was performed on the described property. Notes: It is the owner's responsibility to determine the existence of any easements, covenants, or restriction _ which are not on the recorded subdivision plat. This asbuilt shall not be used for construction or for establishing property lines. Checked by: THD prawn by: CB Scale 1" = 20' Job 2012-59 Field Book: 114 Plat P-391 Legend: Rebar with Cap OO AL. Monument Rebar Monument Well Septic Pavement Overhang Wood Deck Concrete Fence Grid SW1339 Date: 9/12/2012 I 2 d �I o o K ;In t c m N "mm 8 E Il�1i m z,� a W Q 2 O a 5 ZQm M _v&aya� u '''1 Qsgg-m?�a� im��T`$_ aid m8su r133z°a o w �_ -GY�� .a d uuaua°voLL�=Ean°e ¢¢°°o°ao°wuxsnn¢mrv33 i. 3u)1 40, r '" 10884 s 199 �. 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