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VALLI VUE ESTATES #2 BLK 4 LT 19
GREA,,:R ANCHORAGE AREA BOR,, Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 JGH INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCAT,ON / LEGAL OESCR,PT'ON SEPTIC TANK: FROM WELL_ _ INSIDE LENGTH MANUFACTURER INSIDE WIDTH MATERIAL LIQUID DEPTH ,.J ~__ ~___. / NUMBER OF COMPARTMENTS LIQUID CAPACITYf<~ GALLON TILE DRAIN FIELD: TOTAL LENGTH DISTANCE FROM WELL ~'//,~ FOUNDATION ~-~/~"~F~NEAREST LOT LINE ~-~) ~ OF LINES ~9FT NU~B~ o~ L~S ~ OmT~NC~ B~TWE~ UNES T~NCH W~OTH.~ ~, TOTAL E~FECT~W ABSORPTION AREA ~ SQ. FT. LENGTH OF EACH LINE ,~ DEPTH OF FILTER DEPTH: TOP OFTILE TO FINISH GRADE ~ /~ATERIAL BENEATH TILE~IN. ABOVETILE ~ IN. WELL: TYPE CONSTRUCTION BUILDING NEAREST NEAREST FOUNDATION ., LOT LINE SEWER LINE DEPTH SEPTIC SEEPAGE TANK SYSTEM CESSPOOL. OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCE FROM: DISTANCES: ~'~' /.,.? INSTALLED BY; SEWER LINE DEPTH: Form EQ-032 DIAGRAM OF SYSTEM DATE~~I~P R OV ED~ PEPRR. I"MENf OF HERLTH RN[) ENVIRONHENT~tL F'R. OTECTION 25t0 E. TUDOR RI:,., RNC:HORRGE, BK. ~'.~507 7'62];88 ) PFFLI..HN i [_ 0 f'Z: R T I 0 N LEGRL HRR',,,'ELLE,,"HRRR :[ SON LONE]"REE [:,R I ',,,'E L:t._ 84 VFtLL. I MUE SU I TE LOT _ IZE 2:]0000 S[;g_IFIRE FI£ET 'T'T'F'E OF _,]IL Hb:,_RBilEN .~,'.r._,lErl IS: TRENCH ,'R"" '~ .... I ':-' SOIL I::FFFING ,:":-0 FI'/BR)= .~..,-.:-.. f,ltUl::-',Ir,'lLll'q Nlji'lbER(:ii:' b. EE¢I~..._H.-, = 3: .-. -"·".=i REg!UIREg, SIZE OF THE ~]OIL RBSORPTION S'¢STEM IS: E::. ~::] fl-::" · ·~ H--= ::L. ~;2 [_ El ~-~ G -I'"t--] .... 3:¢~ ~S~:R%~BIL E:. E F"r i.4 = ~ 'iHE LENGTN g, iMENS~ON ~% THE LENGTH (IN PEET) OF THE 'TRENCH OR. DRRiNFiEL[:,. 1HE DEPTH OF R TRENCH OR PIT ~ THE P~STRNCE BETNEEN THE SURFRCE OF THE GI::(!UND RND THE Bo"r]oM OF THE EXCRVRTZON (IN FEE'i"). 'IHEI:'.E ~; NO SE]' WIDTH FOR TRENCHES. 'I'NE GRRVEL PEPTH ~; THE M~NZMIJM PEP'TH OF GRIRVEL E:ET[qEEN 'I'HE OUTFRLL PIPE RND I-NE BOT'T'UM OF THE E',:.:',CRVRT~ON (IN FEET). BI~uKP'iLL:(NG OF RN'¢ SYSTEM L4I"FHOUT F'tNRL. INSPECTION RND RPPROVRL B"¢ THIS DEI:'RRIMENT HILL BE SUE:JECT TO PROSECUTION. M~NIf,tUH B, IS]'RNCE BETWEEN R HELL RNB RN'T' ON-E;ZTE SEHRGE DZSPOSRL S'¢STEM ~S FEE] FOR R PR~VRTE HELL OR 2¢0 FEET FOR R PUBLIC WELL. SPECIF;(CR'I-IOHE; RNC, CONSTRLICTION DIRGRRMS PRE RVRILRBLE TO INSURE PROPER TRL. LRT ~ ON. I ..I.:F~ F t 'f'HRT · :i.: I RM FRMILIRR 1.4ITH THE RE~U~RE. HENL FOR ON-S~TE =,EWER:, RHP WELLS H=, FOI:'. FH E:'7' THE MUN ~ C Z PRE Z ~"~' OF RNCHERRGE. ~."." I i.4~LL ~NSTFiLL THE :t: fEH ~N RCCORPFIHCE H~TH THE CLE.,E:,. 2~:: i JN[':,EI::STRHD THRT THE uI-4-=,Z1E _,EWER _~.:iEfl MR're' REQUIRE ENLRR. GEMEHT ~F THE ",'" ,-'- - E:EPRO-M'~. RESI[)ENCE .[:, REMC[)ELE[) ]'0 INCLLIPE fl JRE THRN ::, J..~ ~E ...... RPt :'_ I CRNT HRRVELLE,-'"HRRR I SON . 2204 Cleveland ~ne~ora~e, ~a~k~ 9950~ Performed For Harvelle/Harrison Date Performed 6.11q,/7~ te~a] ~e$crinti0n: k0t 19 810ck 4 Subdivision Valli-Vue - Estates This Korm Renort$ Soils Loa yes Percolation Test_ yes Denth Feet Soil Characteristics 6-- 8-- 10-- 12a-- 14 ,~-. !6-- 18 20__ '£opsoil Gravelly Silty Sand with occasion gravel layers (SM) Bottom of Test Hole Was Ground Water Encountered? No J'?A I~ Yes, At what Depth? i Readinq Date Gross Time Net Time Depth to H20 Net Dron inches inches 6/15/76 0 40 0 ~ 6/16/76 24 br$ 168 128 I 6/16/76 O 40 0 6/16/76 180 min 100 60 i 6/16/76 190 mi~ 40 0 6/16/76 220 mln 47.5 7.5 I 6/16/76 250 min 53.5 6 I · Percolation Rate Prnposed Installation: Seenaae Pit Drain Field De~th of Inlet Depth To Bottom Of Pit Or Cnu~*ENTS: 125 Square Feet drainage area required per bedroom. No ground Water or bedrock encountered. Trench Test Performed By Data Certified By:~CUNSTRU~~ Date: 6/16/76 Certificate of On -Site Systems Approval Parcel I.D. 015-322-22 Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: julle 1. GENERAL INFORMATION Complete legal description Valli Vue Estates #2 Block 4 Lot 19 Location (site address) 10410 Lone Tree Dr Current property owner(s) Sergio & Courtney Padilla Day phone Mailing address Real estate agent 10410 Lone Tree Dr Jennifer Bohannon 2. TYPE OF DWELLING: ❑ Single Family (w/wo ADU) ❑ Duplex . Multiple Dwellings (Single Family and/or Duplex) Day phone (907)521-0839 Waiver request for: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: Distance: COSA # D S C�L 1 1 3 `7 0 Waiver # 3 3. NUMBER OF BEDROOMS: 4. -TYPE OF.:WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑ Private Septic ❑ Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: Distance: COSA # D S C�L 1 1 3 `7 0 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone (907) 522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503 Engineer's Printed Name Benjamin Schiller Date 7/1/21 c. -� 6. DSD SIGNATURE''r�"' System #1 Approved for bedrooms Benjarr'rva chiller System #2 Approved for bedrooms �$����sX71/2192 let,�`,®�� Disapproved ����PR®®s����-� Conditional approval for bedrooms, with the following stipulations: NVYtt L - '')))))))))WI" By: kbe"C'M Original Certificate Date: _J�_/ / /2 e,,V / The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representtitions 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 Septic System Advisory Well Flow Advisory COSA Checklist blue sheet X Nitrate Advisory Arsenic Advisory Other Legal Description: Valli Vue Estates #2 Sub B4 L19 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA is filed with Onsite (or attached) Date drill 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 Community Well B. TANK DATA Age of tank(s) 18 years Tank type/material Steel Measured operating fluid level in septic tank 50 Fm_1 Standpipes/foundation cleanout per record drawing Date of pumping AK Quality Septic 7/6/2021 D. ABSORPTION FIELD DATA Deep Trench Which system tested (date installed) 9/23/2003 FE -1 ALL standpipes present per record drawing Total measured depth from grade 9.8 ft (max) Measured depth to pipe invert from grade 3.0 ft (min) ❑ N/A — pressurized field F0_1 Monitor tubes go to bottom of effective. If not, state depth into effective Fm_1 Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 015-322-22 Structure served by this system 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) Arse . ug/L ❑ Arsenic less than MRL (ND) Collected by 1 Date of Sample FT STATION ❑ Requ maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 6/29/21 Results [Pass For 3 bedrooms Fluid depth prior to test 52 in Water added 651 gal New depth 63 in Elapsed time 1440 min Final fluid depth 54 in Absorption rate '450 gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Sep </Lift Station on Lot > 100' Q Community Sewer Manhole/Cleanout > 100' ❑ Yes if No ft ❑ Yes if No Neighboring Tank > 100' No ft Private Sewer/Septic Line > 25' ❑ Yes if No Absorption Field on Lot > 100' ❑ Yes if No Holding Tank > 100' ❑ Yes if No Neighboring Absorption Fields > 100' ft Animal Conta > 50' ❑ Yes if No ❑ Yes if No ft if No ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > Community Sewer Main > 75' ❑ Yes if No ft ❑ Yes if From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No + ft Surface Water > 100' ft ft ft ft ft ❑✓ Yes if No ft Property Line > 5' Q Yes if No ft Wells on Adjacent Lots: 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 Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' ❑✓ Yes if No Surface Water > 100' ❑ Yes if No 95** ft F. ENGINEER'S COMMENTS *MET CODE AT TIME OF INSTALLATION **WR #090042 G. ENGINEER'S CERTIFICATIONOF Al ! certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with : _ Tl MOA COSAguidelines in effect on this date,''• ' • r ' • Benjarrtochiller �� �'�� • • CE 12592 • �`� �' ��'���• 7/1/21 •'F��.v pROFESSOW��- COSA Checklist yellow sheet ����e'�'a►� ft ft ft ft • •--6_7 Municipality of Anchorage z On-Site Water and Wastewater Program (907) 343-7904 ��r„g 70 >> Certificate of On-Site Systems Approval Q ' ° .. �g22018 Expiration Date: �� 3 Parcel I.D. 015 322-22 ti << 1. GENERAL INFORMATION: a 6 8 L 9 Complete legal description VALLI VUE ESTATES#2; BLOCK 4, LOT 19 Location (site address) 10410 Lone Tree Drive *Anchorage,AK 99507 Current Property owner(s) Levi&Blair Robinson Day phone 830-7783 Mailing address Real Estate Agent 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: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class A Well ® Community ❑ Public Water System ❑ Public Sewer ❑ Distance: WaiverNariance request for: Date: i Received by: e/(W COSA to be re eased to the engineer,unless otherwise requested by the engineer. COSA Fee $ 6. -(0"' Waiver Fee $ Date of Payment ?)7J 1 t\g Date of Payment Receipt Number 03 1\ aJ G Receipt Number COSA# D5 121� . 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. Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101-Anchorage,Alaska 99507 / Engineer's Printed Name: Jeffrey A. Garness Date: `�( ?lI`8 In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system o�0 F-4 1/_ N in accordance with the guidelines and regulations established by the Municipality of Anchorage and �....• �I industry practices. The reported results describe the condition of the system/s on the date/s of the OoP?` • '•s�4 evaluation. Separation distances were measured to readily identifiable features. Hidden defects or �� • o' > •••'i---t1/1. encroachments may exist that were not identified during the evaluation. The operational life of all wells * A-��I .t *.z*V0 and septic systems depend upon a variety of variables, including but not limited to, soil conditions, c0 groundwater levels (that may fluctuate during the year), quality of construction (materials and A 0 workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and VQ are outside the control of GEG. Satisfactory test results do not guarantee future performance of the f r system/s; therefore, GEG makes no warranty '. Gorn ss, (express or implied) regarding the future performance of o09 % •GE_ 3 • �QGi the well or septic system. GEG makes no representation whether an alternative well or septic system s • can be installed on the property in the event either of the current systems fail to perform adequately in �4 .•,e '••I. .i.e. �c°o,a the future. The content of this report is for the sole benefit of the person/party that retained GEG to �i apro�essiono\ perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right 4 �0000� whatsoever. #AECC884 6. DSD SIGNATURE System #1 Approved for .--, bedrooms System #2 Approved for bedrooms Disapproved j\G\�, \--\Y'OF�t/iC,S,--- Conditional approval for bedrooms, with the folling DN.t�ti�s: �, WATER AND m WAST • s� J=WATER z PROGAj ,o Ln ''-c.71D\lti C. C 3. GaL1/4 didkji By: , ``^'� Original Certificate Date:ate. �� 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA b:ue sheet_10-10.12.doc 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: VALLI VUE ESTATES#2; BLOCK 4, LOT 19 Parcel ID: 015-322-22 A. WELL DATA Well type CLASS"A" If A, B, or C provide PWSID#210605 Well Log (Y/N) Date completed Sanitary seal (YIN), Wires properly protected (Y/N Total depth ft. Cased to ft. Casing height(abo - •round) in. FROM WELL LOG AT I -* CTION Date of test Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RES : Coliform colonies/100 ml. Nitrate mg./L. Collected by: enic: ug./L. Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 9/23/03 2 Cleanouts (Y/N) YES Tank size 1000 gal. Number of Compartments p Foundation cleanout(Y/N) YES Depression over tank(Y/N) NO High water alarm (Y/N) N/A Date of pumping 8'-). 3Ic Pumper ia Ad., G St,(ltat& C. ABSORPTION FIELD DATA I'BELOW EXISTING GRADE AT MONITORING TUBEI • Date installed 9/23/03 Soil rating . d./" •r ft2/bdrm) 0.6 System type DEEP TRENCH p• Length 58 ft. Width 2.5 ft. Gravel below pipe 6.52 ft. 756 ft2 Monitoringtube YES Depression over field NO Total depth *10+ ft. Eff. absorption area Date of adequacy test 7/18/18 Results(Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 41 in. Water added 509 gal. New depth 52 in. Elapsed Time: 240 min. Final fluid depth 45 in. Absorption rate>= 450+ g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) NONE KNOWN If yes, give date - r D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at .11 wa er alarm level at in. --- Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: (COMMUNITY WELL( Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main '.. sewer manhole/cleanout Sewer/septic service line Holding tank • - containment areas 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'+PVT&200'+ PUBLIC SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water ..95' Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+PVT&200'+ PUBLIC F. COMMENTS *MET CODE AT TIME OF INSTALLATION -5.1'FROM 1ST COMPARTMENT TANK CLEANOUT TO DECK PILE "WR090042 DECK IS BUILT OVER DRAINFIELD (SEE ATTATCHED PHOTOGRAPHS) G. ENGINEER'S CERTIFICATION 7x ......OF. ���♦ /certify that I have determined through field inspections and • 4':. • review of Municipal records that the above systems are in • conformance with MOA COSA guidelines in effect on this • • date. ♦c J: f : k Garn-ss s W i Engineer's Printed Name JEFFREY A. GARNESS �• if CE-79 Date l Z// g �'�'FQ'P,. Z I.�t, • • us'Name J ;ROFS;, �• RAECC884 (Rev. 10/12/12) S S0°27'48"W 179.33' 4 HCC r0 Z 43., m w '^ • gH1 o -s\ 0)3 a = 1 0', m • w w �� ill ,Ac* ' J Q o 0 --_ _ - --03 • _Z w 0 0 0Tz 1 NASPHALT DR��WAY CO Om C u, .1 ill �K REI 'SAL' COO 111111 ,48"E 169.11' N 80°27 AS—BUILT SURVEY 1" = 30' op04QO4 NO CORNERS SET THIS DATE .=>`=‘'z' OF A COQ I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY k . ,..•••....q QQO OF THE FOLLOWING DESCRIBED PROPERTY G��P•. `'1i ./L-p�00 LOT 19, BLOCK 4, VALLI WE NO. 2 SUB. 0* 49 al 0\\ .,a O THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE Q CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN O D NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS """�'��� EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOWN EXIST OTHER THAN NOTED. O 7 DATED AT ANCHORAGE,ALASKA THIS_31ST DAY OF OAS ' o Q HEREON ( UNLESS INDICATED) ]ULY , 2818. V a SHANE A-HOLT e r NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE — 4 ec.4.- • PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. LS-6914o O 45 o ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. NOV LAND SURVEYING 414 Oro Ae7 S10 D8\V.Q�O AIKHORAGE,AR 99547 9389 GROVER DRIVE Pro 9055. FB 107-12.137-16, SCAN 145-s513