Loading...
HomeMy WebLinkAboutVALLI VUE ESTATES #2 BLK 3 LT 5Valli Vue Estates #2 Block 3 Lot 5 #015-322-61 Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page / of ON-SITE WASTEWATER INSPECTION REPORT �sIP1&4 z94i Permit Number: PID Number: O/ 4Z- ^ 3? 2 - (o Dwelling: KSingle Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ® Upgrade Name: l2{{�� -rii LkJ-16 tJ• ABSORPTION FIELD ❑ Deep Trench ❑Shallow Trench ❑Bed ❑Mound Address ❑ Other Phone Number of Bedrooms Soil RatingTotal from original grade GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from origi grade Ft. Gravel depth beneath pipe Ft. Subdivision �„ Block Lot t Fill added above or nal grade Ft. Gravel length Ft. Township Range Section Gravel widBeds: Ft. 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 Fiz Ft. Cv Sd /A TANK 25,Septic ❑ S.T.E.P. El Holding. ❑ Other [! Manufacturer Capacity .' h �G+, (Pi /n 8 Gal. Surface Wateri ual � (� I Material e IL -r -V,( Number of compartments Lot Line to I�. to, {. NA Foundation f ( D f LIFT STATION Manufacturer Capacity Gal. Curtain Drain GM`t Aviv ^ Remarks Pump on level at in. Pu level at in. High water alarm at in. Pum a and model Electrical Inspections performed by Installer PIPE MATERIAL House to tank V Tankto 3 drainfield 30'' ,�/,L A /� I� lkA(4d of S nei A -SI Drainfield CO/MT b Inspector n k G ki A d t o 4 H ep, BENCH MARK (Assumed elevation) ! p p it Inspection fn u V ! Z� ' dates: I Location and description ff�� S!I a" a 1)Oc9J COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL n41W k ,m b OF At 4r,F Conditional Approval: Date .:'�6': '•�• y. ow l OW 'k • 49TH ............... .......... 10 rl MICHAEL N. ANDERSON••'+. laj %, Approved i - Date \i5`_``s n iapeuim i rtepurr a- r i t.uec Permit No. OSP141298 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: VALLI VUE ESTATES BLK 3, LOT 5 PID No.: 015-322-61 MARK A B C01— � 54 20 CO2 it 22 I TCO2 18 30 CO3 30 39 C04 I 31 39 MTi 48 40 TC01 13 24 COMM. WATER / BENCH K DOOR SILL 100' Col I � OLD TANK PUMPED AND CRUSHED II CO2 A II MTi 1 ° TC01 I CO2 L C04 CO3 NEW 1000 GALLON -,STEEL TANK A BUILT 30 ' SCALE: 1"=W' Tcm coz mM cw cw ••\\\\ll�,t TCO' ♦••�E OF q �^ fi ♦ ,g. \ `�♦♦ ......................VV 000 4 TH....................,•�� IAILN SIX 0 rnxn .............................. s 0, MICHAEL N. ANDERSON: i �iN o E 469 a SEPTIC SECTION •♦♦�♦ `�1•• �'�•,•' •♦ N.T.S. to, I,l t tSS�\:••• On -Site Water and/or Wastewater System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP141298 Tax Code Number: 01532261000 Work Type: SepticTank Upgrade Permit Effective Dates: August 05, 2014 to August 05, 2015 Design Engineer: ANDERSON CONSTRUCTION & ENG'G Subdivision: VALLI VUE ESTATES #2 Site Legal Address: VALLI VUE ESTATES #2 BLK 3 LT 5 G:2538 Owner/Address: ARNOLD AARON 50% & WEST RENEE 50% 10424 MAIN TREE DRIVE ANCHORAGE AK 995076951 Site Mailing Address: 10424 MAIN TREE DR, Anchorage Lot Size in Sq Ft: 19740 Total Bedrooms: 3 This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By Bv: Date: Date: l MUNICIPALITY OF Community Development Department Development Services Division On -Site Water & Wastewater Program Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION ' • Parcel I.D. 016 ' 3u• -r. I RUSH! % t 1 Property owner(s) Gro 4, (/v r4 Day phone Mailing address Site address I dA2­1A NNP-4r%1w Legal description (Sub'd., Block & Lot) l9 l l; uei F4+, 412• (3•3 LofS Legal description (Township, Range & Section) Lot Size q. Ft. Number of Bedrooms APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) IR SepticTank ® Upgrade IX (w/wo ADU) Duplex (D) Ely Holding Tank ❑ Renewa�TAJ Multiple Dwellings El �,/ ❑ �1 -UU (SF and/or D) Private Well ❑ Water Storage F-112014 , pU H! RUSH! l� J �7 THIS APPLICATION INCLUDES A VARIANCE./ WAIVER REQUEST FOR: t Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. property owner or authorized agent) Permit Rush ees: ®Z. I S 'f' @,@,Iver Fees: _ Date of Payment: Oi tX-�`Date of Payment: Receipt Number: Receipt Number: Permit No. OS 4k Waiver No. Permit App_ :;�..:c� Michael N. Anderson, P.E. Civil/Structural Engineering & Construction 4661 Natrona Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 July 31, 2014 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: Septic Tank Replacement Legal: Valli Vue Estates #2, Blk 3, Lot 5 To Whom it may concern: This is a request for replacement of the existing tank due age and a new deck being constructed over the tank. The steel tank is very old and needs replacing. The large crib has been tested and found to be functioning well for a three bedroom system. All of the area is serviced by a community well so no wells will be impacted. None of the neighboring lots will be impacted by this upgrade. Please call me if you have any questions. Sincerely/!/4 t Michael N. Anderson, P.E. DESIGN CRITERIA: 3 BEDROOM EXISITNG HOUSE INSTALL NEW TANK OUTSIDE THE NEW DECK NO WELLS, AREA SERVICES BY COMMUNITY WATER I I SEPTIC ( VALLI VUE ESTATES #2 VALLI VUE ESTATES ,#2 SEPTIC I I BLOCK 3, LOT 6 BLOCK 3, LOT 45 I I PROPERTY LINE _ 20 DRAINAGE ENT— — — — — EXISTING LOG GRIB VALLI VUE ESTATES #2 BLOCK 3, LOT 44I I LEXISTING 3 BEDROOM SEPTIC 10' UTILITY EASEMENT I SEPTIC VALLI VUE ESTATES $2 BLOCK 3, LOT 4 I � /II II Septic Design Prepared for BRAD & RENEE WEST VALLI VUE ESTATES #2, BLOCK 3, LOT 5 Anchorage, Alaska Michael N. Anderson, P.E. DATE: 4661 NATRONA DRIVE DRAWN: ANCHORAGE, ALASKA 99516 345-3377 /FAX: 345-1391 SCALE: 7/31/2014 DJR 1"=100' 26 DpfijkNGF EASEMENT PROPOSED DECK / EXISTING TANK EXISTING HOUSE REMOVED FROM 3/ NEW 1000 GALLON I UNDER THE DECK / AND STEEL TANK RELOCATED OUTSIDE BY DECOMMISSIONED THE DECK AREA. UPC I I I I —3X I �I `--- I � I I I I I 31'X17' SEEPAGE PR. Septic Design Prepared for BRAD & RENEE WEST 8-10% 0 ALL OF THE LOTS IN THE NEIGHBORHOOD SERVICED BY COMMUNITY WATER VALLI VUE ESTATES #2, BLOCK 3, LOT 5 Anchorage, Alaska Michael N. Anderson, P.E. 4661 NATRONA DRIVE ANCHORAGE, ALASKA 99516 345-3377 / FAX: 345-1391 WATER LINE DRN`EWAY ` .. DATE: 7/31/2014 DRAWN: DJR SCALE: 111=30' PROPERTY LINE NAME ,GRF'TER ANCHORAGE AREA BO'Y'IUGH Department of Environmental Quality ���1 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ADDRESSS°r-f/9 60'N 160.17 PHONE 274 -50/¢ LOCATION ��!}� %� ��LEGAL DESCRIPTION SEPTIC TANK: DISTANCE C_ NUMBER OF FROM WELL FrYLlr7 MANUFACTURER oS�C�c__.�"��`<-� MATERIAL K1 17r /7�'COMPARTMENTS INSIDE LENGTH-'— INSIDE WIDTH LIQUID DEPTH .._ LIQUID CAPACITY %CiCJ O GALLONS. SEEPAGE PIT: NUMBER OF PITS / DIAMETER OR WIDTH`�LENGTH al, DEPTH LINING MATERIAL L 92V CRIB SIZE:. DIAMETER �•iS DEPTH I DISTANCE FROM: WELLt.Z�'g���"CJ / ( TOTAL EFFECTIVE i BUILDING FOUNDATION =1L �, NEAREST LOT LINE120 ABSORPTION AREA (WALL AREA) 76S SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE CONSTRUCTION - DEPTH G BUILDING NEAREST NEAREST SEPTIC FOUNDATION LOT LINE SEWER LINE TANK_ CESSPOOL OTHER SOURCES `� APPROVED DISAPPROVED DISTANCES: '//L�'"�''�' INSTALLED BY: C�/� PIPE MATERIAL: 01'/ /_�(,7.!v'fGhiJY�_ " LOT SLOPE: REMARKS: Form No. EQ -031 DIAGRAM OF SYSTEM DISTANCE FROM: SEEPAGE SYSTEM n ATP ('�^,�. /, /r 74 APPRn1/Fn G.A.A.B. o,v GREATER ANCHORAGE AREA BOROUGH `gam 4S DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT NAME OF APPLICANT /fU/�G' MAILING ADORES r�r �`"JAY /O ��� PHONC2-;_5l INSTALLATION LOCATION LEGAL DESCRIPTION�— INSTALLATION OF: SEPTIC TANK SEEPAGE PIT L� DRAIN FIELD OTHER TYPE AND SIZE OF FACILITY TO BE SERVED ���/lGE / ��j/�/� �"��/''G�G%�i�tl l Z �L�/�✓T FINANCED THROUGH TO BE INSTALLED BY ���C �G'7/�✓T SOIL TEST RESULTS .%1/ilNOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE TYPE MINIMUM DISTANCES. REQUIREMENTS FOUNDATION TO SEPTIC TANK j -2 r FOUNDATION TO SEEPAGE PIT DRAIN FIELD SEEPAGE AREA SIZE / SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK ^ r SEEPAGE PIT DRAIN FIELD TO NEAREST LOT LINE. / a'. WELL TO SEPTIC TANK ,/ SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. 7 WATER MAIN TO SEPTIC TANK ,SEEPAGE PIT Z C4 DRAIN FIELD SEPTIC TANK, _�C��i r, SEEPAGE PIT "f / DRAIN FIELD — 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 PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. OR LICENSED DESIGNER TYPE DIAGRAM OF SYSTEM I 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 G'���//� l�>C/ !/ ✓/ i Performed for Geo�rgee Legal Description: This form reports: Soils 1 GREATER'ANCNORAGE AREA SOROUG'll �' lepartment of Environmental Qua' ,y 3330 "C" Street Anchorage, Alaska 99503 SOILS -LOG - PEROLATION'PEST Hood Depth Feet — 1 - Overburden 2 - Sandy gravel s 3 (Inlet to seepage pit) GP 6W 4 5- 11 7 - Silty Sand (250) 8 Silty sandy gravel (150) 9 10 - S/ 0100 11 - Silty sand (250) 12 - 13 - ation ,UG ' 1974 P GDEPTE OF ECHORAO E. NTA, OU RIA O TY to Performed 8/14/74 4 Bottom of Test Hole 14' Was ground water encountered? If yes, at what depth? — Reading Date Gross TimeNet Time Depth to Water Net Drop Percolation rate minute. —•---'— Yes Drain Field Proposed installation: Seepage Pit _-------- — .)ehth of Inlet -3' Depth to bottom of pit or trench C011MENTS: 190_ square _foot" drainage_ required per_l�e_dre9m-- — ------ _ No bedrock Certified By: Construction Test Uate: 8/1.51_Z�# Performed [3 James-_D,_IKao1�--_--- fates"- ,., ,, •,� .III II / y 01 hIFI,EC. yo 4� o a > N 4&e Of iX lr : I\I o ro o 0 7q-,06 /� o I c f s98.�t K 30 f,. zs n � '• f ./V f se f TP FI,,/� -f';/ Pxis�iny /ru„hd. I OF A4,qb� B 4 Wolaika•._.'�04� 32555- ®�a� pROFfS310NA��'P`�'Q'� . Z Ul- c % - CcJ, is o , � I hereby certify that I have surveyed the following -described property:— .Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on prop- erty lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. - Dated at Anchorage, Alaska' t11 e"IZ day of c.TiJ/ rz l9--2L/- FRED 9 %L/FRED WALATKA & ASSOCIATES - Engineers and Surveyors MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Parcel ID 015 -322-61 Certificate of On -Site Systems Approval OSC241480 Expiration Date: Legal description VALLI VUE ESTATES #2 BLK 3 LT 5 Site address 10424 MAIN TREE DR Current property owner(s) LD & E TRUST X The On-site system(s) is/are approved for 3 bedrooms By: Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 12/4/2024 r . '/ t Th s/tertificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject systep (s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Devt lopment Service Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional enqineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other MUNICIPALITY OF ANCHORAGE Development Services DepartmentPhone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-322-61 Complete legal description VALLI VUE ESTATES #2 BLK 3 LT 5 Location (site address) 10424 MAIN TREE DR ANCH AK Current property owner(s) LD&E TRUST 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: ❑ Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑■ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ❑■ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ■❑ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 10 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $J Date of Payment COSA# V C-2 Waiver Fee $ Date of Payment Waiver # COSA Application_ June 2022 COSA Checklist Legal Description: VALLI VUE #2 BLK 3, LOT 5 Parcel 1D: 015-322-61 If more than T well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL ❑ Well log is filed wit a (or attached) Date drilled Total de 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 Measured operating fluid level in septic tank 48" Date of pumping 9/11/24 ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 10/1/1974 Q ALL standpipes present per record drawing Total measured depth from grade 11 ft (max) Measured depth to pipe invert from grade 3 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. 0 Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: COSA Checklist—June 2022 Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes © No ❑ Coliform bacteria is Negative t mg' ❑ Nitrate less than MRL (ND) Arsenic 1L ❑ Arsenic less than MRL (ND) Collected by Date C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 9111124 Results 0 Pass Fluid depth prior to test 24 in Water added 450+ gal New fluid depth 36 in Elapsed time 1440 min Final fluid depth 24 in Absorption rate 460+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) , 96 in Effective depth used 24 in Effective depth remaining 72 in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' ❑ Yes if No _ ft ❑ Yes if No _ ft Neighboring Tank > 100' ❑ Yes if No _ ft Private Sewer/Septic Line > 25' ❑ Yes if No _ ft Absorption Field on Lot > 100' ❑ Yes if No _ ft Holding Tank > 100' ❑ Yes if No _ ft Neighboring Absorption Fields > 100' Animal Containment > 50' [—]Yes if No _ ft ❑ Yes if No _ ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑ Yes if No _ ft ❑ Yes if No _ ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No _ ft Surface Water > 100' ❑r. Yes if No _ ft Tank to Property Line > 5' ❑r. Yes if No _ ft Wells on Adjacent Lots Field to Property Line > 10' ❑E Yes if No _ ft Private Wells > 100' Yes if No _ ft Water Main > 10' Water Service Line > 10' F. ENGINEER'S COMMENTS ❑r. Yes if No _ ft Z Yes if No _ ft Community Wells > 200' [�] Yes if No _ ft If tank or field is under driveway comment below G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm _ f4t h-2 4.,4 CN .60 W) Phone 727-8864 Engineer's Printed Name 17ewc_� Date 2 4s 1 a U i.l, n s, '49TH ' c�. . .... A MICHAEL N A%Dt FSCN �o CE -9 q COSA Checklist June 2022 • Municipality of Anchorage sPa On -Site Water and Wastewater Program (907) 343-7904 5'n F TY CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 015-322-61 Expiration Date: 1. GENERAL INFORMATION Complete legal description VALLI VUE ESTATES #2 S/D BLOCK3, LOT 5 Location (site address) 10424 MAIN TREE, ANCHORAGE, AK 99516 Current Property owner(s) RENEE WEST Day phone Mailing address 10424 MAIN TREE, ANCHORAGE, AK 99516 Real Estate Agent Day ph ^ry 2. TYPE OF DWELLING: a ��� ® Single Family (w/wo ADU) AFP ❑ Duplex � I ® 2015 �/ DD ❑ Multiple Dwellings (Single Family and/or Duplex) �` _ ,D/'� 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class A Well ® Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: / AA% Date: ) r COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ $ W. (46 Date of Payment q 1111116 Receipt Number CKAr / 76/ COSA #_ 05C16/5b/ Waiver Fee $ Date of Payment Receipt Number MITI B 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. Name of Firm MIKE N ANDERSON P.E. Phone 727-8864 Address 4661 NATRONA AVE. Engineer's Printed Name MIKE N ANDERSON, PE Date 09/9/15 �o®aa�09 ,•/IF •..... ar..e. 6. DSD SIGNATURE �.. MICHAEL Afdokf iS N . tt _/ System #1 Approved for _ bedrooms. d1}'l� . g�9 System #2 Approved for bedrooms. ��$,A�Ai'►y� Disapproved. Conditional approval for bedrooms, with the following stipulations: By; +'lwz� W, kJ� Original Certificate Date: Theunicipa!ttyof A orage 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. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic.System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10.10-12.doo If more than 1 septic system is on the lot: COSA Checklist # of _ Structure served by th_is system _ Certificate of On -Site Systems Approval Checklist Legal Description: VALLI VUE ESTATES #2 SID BLOCK 3, LOT 5 Parcel ID: 015-322-61 A. WELL DATA Well type A. If A, B, or C provide PWSID # 210605 Well Log (Y/N) Date completed Sanitary seal (Y/N) Total depth _ft. Cased to _ft. FROM.W ELL LOG Date of test Static water level ft. Well production g.p.m. WATER SAMPLE RESULTS: Wires properly protected (YIN) _ Casing height (above ground) Coliform colonies/100 mL Nitrate mg/L Arsenic: ug/L Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC l STEEL Tank size 1000 gal. Number of Compartments 2 AT INSPECTION ft. 9 -P.M. Collected by: V Date installed 8912014 Cleanouts (YIN) Y Foundation cleanout (YIN) Y Depression over tank (YIN). N High water alarm (Y/N) N Date of'pdmping NEW Pump"br NEW C. AQ,S;ORPTION FIELD DATA— Date installed 101111974 i.Soil rating (g.p.d./ft2 orft2/bdrm) 85 Length 31 ft., '' Width 17 ft. System type CRIB Gravel below pipe 8.0 ft. T.otal,depth.,11 .ft. Eff. absorption area Mft2 Monitoring tube Y Depression over field N Date of adequacy test' -8.1_ 44 Results (Pass/Fail) PASS For 3 bedrooms Fluid doth in absorppien field before test 47 in. Water added 500+ gal. New depth 66 in. Elapsed Time: 240 min. Final fluid depth 53 in. Absorption rate >= 500+ g,p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) UNKNOWN if yes, give date D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons Manhole/Access (YIN) in. "Pump off' level at Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot NA Absorption field on lot NA Public sewer main NA Sewer /septic service line NA Animal containment areas NA SEPTIC/HOLDING TANK ON LOT TO: in.High water alarm level at _ in. Meets alarm & circuit requirements? On adjacent lots NA On adjacent lots NA Public sewer manhole/cleanout Holding tank NA Manure/animal excrete storage areas NA Building foundation 51+ Property line 51+ Absorption field 54 Water main 100'+ Water service line 101+ Surface water 1004 Wells on adjacent lots 1001+ ABSORPTION FIELD ON LOT TO: Property line 101+ Building foundation 10'+ Water main 104 Water Service line 10'+ Surface water 1001+ Driveway, parking/vehicle storage 10'+ Curtain drain 50'+(ttoneKnown) Wells on adjacent lots 1001+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that / 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 MIKE N. ANDERSON, PE Date 0 91912 01 5 COSA canary sheet 2.6-15.doc ......... MICHAEL N. ANDERSON : "L- Cf - C - 7469 Lot 43 II R Lot 44 w C1, O Lot 45 Lot 6 N87°00.1TE 140.51 I 20' Drainage Easement — _ _ _ _ _ _ chain link fence Lot 5 " I 11+� 0 28.06 IIII oC r� O+ I rn deck 3 CD 3 S2.0 Obt 28.0 7 I 'e I I woo I ret. wall I /Wire fence N87`0015" E 140.51 Lot 4 A, Sir �I 00. 49�tjh% 00 ��� f....r C. '.Fred Walatka:ff/ �� ^�� • 3255 - S SCALE: 1 "= 30' � % xvgk"`� 8-la-lS' EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. FB 14-11, pg 52-53 I 30 z 0 N 01 O A w 0 30 r1 6611 RECERTIFIED 7-03-15 V, AS -BUILT NO CORNERS SET THIS DATE I hereby certify that I have performed a Mortgagee's inspection of the following described property: LOT 5. BLOCK 3, VALLI VUE ESTATES UNIT No 2 Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 30th day of December ,2014. FRED WALATKA & ASSOCIATES BE (907-248-1666) Engineers and Surveyors