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Home My WebLink AboutVALLI VUE ESTATES #2 BLK 3 LT 25Va lli Vu states lock Lot 2 015-341 -43 ctr ~ GRE?' R ANCHORAGE AREA BORf"'i GH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ?i v'~i !? LOCATION MAILING ADDRESS LEGAL DESCRIPTION PHONE SEPTIC TANK: DISTANCE FROM WELL '~.00 ~ t INSIDE LENGTH MANUFACTURER ~'~ INSIDE WIDTH MATERIAL NUMBER OF COMPARTMENTS LIQUID DEPTH ~- LIQUID CAPA(~ITY/~2-'~-7) GALLONS. T'L · ': DISTANCE FROM WELL '~__oo ('~-FOUNDATION ~'~O ! NUMBER OF LINES 1 DISTANCE BETWEEN LINES ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GR.,~DE ¢! WELL: TYPE (_' ~L..~U¢~ ~ CONSTRUCTION __ BUILDING NEAREST FOUNDATION LOT LINE __ CESSPOOL OTHER SOU RCES APPROVED DISAPPROVED NEAREST LOT LINE TOTAL LENGTH OF LINES ~"~,~/'~- ! TRENCH WIDTH,~'(C IN. TOTAL EFFECTIVE MATERIAL BENEATH TILE NEAREST SEPTIC SEWER LINE TANK__ REMARKS IN. ABOVE TILE /'7/~ IN. DEPTH . SEEPAGE SMSTEM DISTANCE FROM: DISTANCES; 0 ~. __ INSTALLED BY: REMARKS: ~,.O ~. "( DIAGRAM OF SYSTEM f [---_~ GREATER ANCHORAGE AREA BOROUGH LIABILITY REEEASE-- ( I, the undersigned, cert. i'l~y .that I am the ) owner, ( ) occupant, ( ) manager of the property, describedas (street a d d r e ~ s~ o c-~-tlo-n-)- Greater Anchorage Area Borough,~ and also described as Lot , Block , Subdivision of Anc~orage, I hereby agree to save the Greater Anchorage Area Borough, its agents and employees, harmless from any legal ac~(on or other claim arising from any injury to persons or property ~s a result of the Grea~er Anchorage Area,Borough remowng junked v~icles from the a~ove described prope,rty, provided however, that the undersigned will no~ save the Greater Anchorage Area Borough harmless for any injuries caused by negligent acts of commission or ommission by Greater Anchorage Area Borough agents or employees. Date: Witness: Greater Anchorage Are~'Borough Agent Name: Owner~ Occupant, o~fqanager lype of Yehicle (s): PLEASE RETAIN ONE COPY OF THIS FORM FOR YOUR OWN FILES AND RETURN THE COPY TO THIS OFFICE WITH REMITTANCE. THANK YOU. EQ-042(8-74) GRE~ ~R ANCHORAGE: AREA BoF~ DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-456! PERMIT NO, SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT INSTALLATION Of: SEPTIC TANK SEEPAGE PIT DRA]N FIEL~ ~/ OTHER COMPLET]ON 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. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF FOUNDATION TO SEEPAGE PIT ,DRAIN FIELD SEPTIC TANK TO SEEPAGE PiT WALL / ~ /" SEPTIC TANK ,SEEPAGE PIT DRAIN FIELD TO NEAREST LOT LINE, WELL TO sePTIC TANK SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. /D/ '----- WATERMAIN TO SEPTIC TA SEEPAGE PiT GRAVEL BACKFILL DESCRIB~ED SYSTEM IS IN ACCO?~CE WITH SAID CODE. // ,GREATER ANCHORAGE AP, LA [,'OR{)UGiC~-'~ uepartment of Environmental qual.~y 3330 "C" Street Anchorage, Alaska 99503 SOII,S 1,0(i PEt{OLATION TEST Performed for ~ge~ ~,~.~..~-,g¢s Legal Oescrip~i-o-nT-PJi~-~-- ~[j~-/<~ This form reaorts: Soils log_ Dep th Feet 1 2 - 3- 4 5- 6- 7- 8- 9 - tO- ll 12 - 13- ~W~a s gr Da te Pe rfo rmed_ .f[~_~_[7,1- Percolation :est :ountered? if yes. at what depth?' Reading Date Gross Time Net Time th to Water} Net Drop Percolation rate minute. -Proposed installation: Seepage Pit Drai, Field ....................... Depth of Inlet ............... . Dept~'~6~--pit or trench COHblENTS: ~(_ ~<¢6 ............................................................. ED 040 (6/74) Test Hole 5 Lot 25, Block 3 Depth in Feet From To 0.0' 1.0' Elevation: 1 .0' 15.0' 15.0' 16.5' Bottom of Test Hole: Frost Line: Free Water Level: Existing Ground Soil~Description W.O. #17378 F-4, ~andy gravelly silt, ML, tan, damp NFS, sandy gravel, GP-GM, gray, damp, Group D NFS, gravelly sand, SW-SP, gray, damp, trace of silt, Group E 16.5' None Observed None Observed Type of Sample Depth M:~. Samplq Group I 5.0'-6.5' DAMP G D 2 10.0'-11.5' DAMP G D 3 15.0'-16.5' DAMP G E Remarks: 1. Type of Sample, G = Grab . 2. Group refers to similar material, this study only GREATER ANCHORAGE AREA BOROUG~ Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by: 6~r~ [~'- -_ ~ --. Mailing Address: Phone: 2. Property Owner: Phone: Mailing Address: 3. Legal Description: 4. Location: 5. 6. Type of facility to be inspected~-~ .~'~)~(~ NO. of bedrooms Well Data:~ ~, A. Type C. Construction D. Bacterial Analysis Sewage Disposal A. Installed C. Septic Tank: System: ~/~ ~ B; Installer . /~'~'~) 2. Manufacturer ~_~ 1. SiZe D. Seepage Pit: 1. AbsorPtion Area E. Disposal Field: Total length of lines 2. Material 8. Distances: A. Well to: Septic tank , Absorption area , sewer Lines __ Nearest lot line , Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages ~a-3e 2 of two pages - Re< st for Approval 6f Individual ~ ~r & Water Facilities Legal Description Comments Approved~ ~'~.1 Disapproved Date ~/~/.~-~ ApprR~?alid for one year from '~at'e signed Greater Anchorage~Area Borough, Department of Environmental Quality. DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true a'nd accurate representation of the subject sewer and water facilities and the~e f~ilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) - ;':' Municipality of Anchorage .' DeveloPment services Department' Building Safety Division On-Site Water & Wastewater Program /.. ,~1/' 4700 Bragaw Street /f ~ .~ 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. 01534143 1. GENERAL INFORMATION COSA# Expiration Date: Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address VALLI VUE ESTATES #2; BLOCK 3, LOT 25 10001 LONE TREE DRIVE *ANCHORAGE, AK 99507 JEREMY & JULIE COUNTER Day phone 230-8032 10001 LONE TREE DRIVE *ANCHORAGE, AK 99507 Day phone JAMIE HARVEY W/ PRUDENTIAL Day phone 227-!059 3801 CENTERPOINT DRIVE #200 *ANCHORAGE, AK 99503 Unless otherwise requested, COSA Will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well [] ' Individual On-site · Individual Water Storage [] ! Individual Holding tank [] Community Class A Well ·. Community On-site [] Public Water System [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water 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. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my sea/affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of Qn,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 GARNESS ENGINEERING GROUP, Ltd. Address 5701 Eo TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 .Engineer's Printed Name JEFFREY A. GARNESS, P.E, Phone 537-6179 Date 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. DSD SIGNATURE t~""~ Approved for Disapproved. bedrooms. Conditional approval for WATER AND ~ ~ WASTEWATER : ~ bedrooms, with the fllowing stipulations~. ~. PROG~M ?&..~ Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory (Rev. 11/05) Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report' Other Original Certificate Date: Municipality of Anchorage Development ServiceS Department Building Safety Division On-Site Water & Wastewater Program CERTIFICATE OF 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orgtonsite (907) 343-7904 0N-SITE SYSTEMS APPROVAL Legal Description: VALLI VUE #2; BLOCK 3, LOT 25 A. WELL DATA CHECKLIST Parcel ID: 015341.43 Well type COMMUNI'IY "A" If A, B, or C provide PWSID# 210605 Well Log (Y/N) Date completed Sanitary seal (Y/N) Wires properly protected (Y/N)?.--'""" Total depth f. Cased to ft. casing'hei~~~ .in. FROM WELL LoG AT !N~;~TION Date of test . ~~~ Static water level ~.ff. ~,.-"~~ ~ ft. Well production _ g.p.m. ~ g.p.m. ~Vo~TfoEr~ SAMPLE R~,~..1~.~onies/1 OO mi. Nitrate mg./L. Other bacteria colonies/100 mi. /ug./L. Date of sample: by: Collected B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/FIBERGLASS Tank size 1250 gal. Number of Compartments Foundation cleanout (Y/N) YES Date of pumping 8/10/09 C. ABSORPTION FIELD DATA Date installed 9/12/75 Length 23.5 ft. Date installed 1 Cleanouts (Y/N) Depression over tank (Y/N) NO High water alarm (Y/N) Pumper NORTHLAND PUMPING SERVICES 9/12/75 YES N/A I'BELOW EXISTING, GRADE] Soil rating (g.p.d./ft2o~ 85 Width 3 ft. System type,. DEEP TRENCH Gravel below pipe 8 Total depth .12 ft. Date of adequacy test 7/6/2010 Results (Pass/Fail) PASS Fluid depth in absorption f~ld before test DRY in. Water added '60~..gal. Elapsed Time: 0 min. Final fluid depth DRY in. AbsOrption rate >= Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN Eft. absorption area 376 ft2 Monitoring tube YES Depression over field NO If yes, give date For 4 bedrooms New depth DRY in. 6OO+ g..p.d. D. LIFT STATION Dateinstalied Size in g~llons ~__. · "Pump on" level at in. "Pump off level ' . High water alarm level at Datum ~ Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES COMMUNITY WELL SEPARATION DISTANCES FROM WELL ON LOT TO: in. Septic tank/lift statiOn on lot Absorption field on lot Public sewer main Sewer/septic service line On adjacent lots On adjacent lots ------- ~anout -----'---'"'-'"'~ Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Water main 10'+ Water service line 10'+ Absorption field 5'+ Surface water 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+. Water service line 10'+ Building foundation 10'+ Water main· 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify thatlrhave determined.through field inspections and review of Municipal records that the above systems are in conformancewith MOA' COSA guidelines in effect on this date. Engineer's Printed. Name JEFFREY A. GARNESS Date COSA Fee $ {'~'~ O'''~'' Date of Payment '~/~ j I O Receipt Number ~ ~.~~___~,L~~ (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.. o t ~;"- 3¥1 - tf ~ GENERAL INFORMATION Complete legal description Location (site address or directions) . Current 15roperty ownei-(s). /1-~0/-,,._ Mailing address Lending agency Mailing address Real Estate Agent Mailing Address HAA# 0 3 Expiration Date: 7-w,¢ Day phone lO oo I Day phone Unle'ss otherwis~ requested, HAA will be held by DSD for pickup. 2.~:' NUMBE ~R OF BEDROOMS: . 3. TYPE OF WATER SUPPLY: IncJMdual Well Individual Water Storage Community Class. ,~ Well Public Water System Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding tank [] Community On-site [--I Public Sewer r-] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER e 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 Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(aro) 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 F'/,~ Address I '/.4'~'~, Engineer's Printed Name DSD SIGNATURE [-"/' Approved for ~ Disapproved. Conditional approval for bedrooms. Phone '3'q_<-- ~5'~- Additional Comments · ,,>;..~,x ,.. · .. -~',,3 :~ ~:' I E ~ ON-ST . ~. = :. WASTEWATER: .-'x,.? Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: (Rev. 01/02) Mumopality of Anchorage Development serVices Del artment Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. ~ P.O. Box 196650 Anchorage, AK 99519'6650 www.ci, anchorage.ak, us i (907) 343-7904 i Legal Description: A. WELL DATA Well type. Date completed Total depth Date of test HEALTH AUTHORITY APPROVAL CHECKLIST L~'f ~-~, Gloc~ 3_, ~,ll,'~'~? ~.r~. ~ Par~llD: *A'. ' If~ B, or C Provide P~ID ~ ..~ to ~ ~ Well Log ~/N) Sani~ seal ~/N) ~res properly protected (Y/N) Cased to ~ FROM WELL LOG Static water level fL Well production g.p.m. WATER SAMPLE RESULTS: : Coliform ~ colonies/100 mi. Nitrate mg.fl. Arsenic: mg.fl. Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Uateria 5'¢ph;c / F0 b¢~'~/q'/~.r.r, , Tanksize 18.~-o gal. Number of Cempartments I Foundation cleanout (Y/N) T' Depression over tank (Y/N) /v Date of pumping ~'"/ I~ /O3 Pumper ~'xo, o~ r' Casing height (above grc und) AT INSPEClION g.p.m. other bacteria. Collected by: colonies/100 mi. Date installed, ?/iz./' Cleanot~ts (Y/N) High water alarm (Y/Ni A./. ~-, System type Gravel below pipe Y" Depression over field in. ft. C. ABSORPTION FIELD DATA Date installed ?/t2,[75'- Soil rating (g.p:d.lt~ or~lbdrm) Length. '2. 2.~ f. Width ,: ~ ff. Total depth i?_ ft. Eft. absorption area37g '.ft~; Monitoring t~be Date of adequa~ test I~ / Z.7/0~ Results (Pass/Fail) ~ Fluid de,th in absorption field before test ~.~ in. '~ Water adde~?8$~qaL. E!a~sed Time: !ZO min. Final fluid depth ~-~ in. Absorption rote >= Any rejuvenation ~eatment (past 12 mo.) (Y/N:& type) 'A/~,~ l.c~., For "/ bedrooms New depth-.~-- in. 0"0~ g.~.d. If yes, gwe date Ee LIFT STATION /k/. ,4. Date installed 'Pump On" level at in. Datum SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: /~-).,4'. Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer/septic service line Size in gallons 'Pump off" level at in. Cycles tested Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? in. On adjacent lots, On adjacent lots Public sewer manhole~cleanout Holding tank Property line CO' Wa'tot Service line '~ t ~" Curtain drain ~o,,,¢ $ ~,,,~ COMMENTS SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation IO' Property line 5'0' Absorption field t Q ' Watermain "',> to' Water service line ~ tc,' Surface water ~ too' Wells on adjacentlots "~ too' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation '~-" Water main ~. ¢o ' Surface water ~' ~oc,'° Driveway. parking/vehiclestorage ~'O' Wells on adjacent 10ts ~' too° G. ENGINEER'S CERTIFICATION I c~rtify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Date ~2c~,/-~¢~- ~'~, HAA Fee $ Date Of Payment Receipt Number (Rev. 12/01) Waiver Fee $ Date of Payment Receipt Number 30.0 EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HEREON. D THE INFORMATION HEREON I$ FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFUCTS BETWEEN EXISTING STRUCTURES AND PLA3'rED LOT LINES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES ORFENCEUNES, ' "ASBUILT" No corners set I hereby certify that I have sur~eye~ the following ¢le$cribed property, Lot Z ~' Block I V~E ,m~rovements sit~a~eo mereon are w;tmn the pt0pe~ lines ano do ~ot ove,ap or enuoa~ on me ptope~ lying aolacenl t~erelc. Inal no improvements on prope~y yng adjacent thereto encroa~ on t~e premtses in questiort and t~st ~ere Ire no roadways, t~ansm~ss~on hnes or 0t~er ~alble easements on aald prope~ except al Indl~l~ hereon. AnchorageoAJaska Book pg ,~//.E