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Home My WebLink AboutWENTWORTH BLK 1 LT 8 MUNICIPALITY OF ANCHORAGE Efwfmpqnfou!Tfswjdft!Efqbsunfou Qipof;!!):18*454.8:15 Po.Tjuf!Xbufs!'!Xbtufxbufs!Tfdujpo !!!!!Gby;!!):18*454.8::8 Dfsujgjdbuf!pg!Po.Tjuf!Tztufnt!Bqqspwbm PTD372362 Kvof35-3138 Parcel ID 119!.134.5:Expiration Date: Legal description XFOUXPSUI!CML!2!MU!9 Site address 4331!F!51UI!BWF Current property owner(s) !CBTTFUU!SPCFSU!D Y4 The On-site system(s) is/are approved for bedrooms Conditional approval forbedrooms, with the following stipulations: Comments or conditions: Op!dpnnfout Curtis Townsend 802503137 By:Original Certificate Date: This Certificate of On-Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development 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 engineer's submittal. ATTACHMENTS: !!!!!!Y COSA ChecklistWell Flow Advisory Absorption Field AdvisoryNitrate Advisory Tank Age Advisory Arsenic Advisory Other MUNICIPALITY OF ANCHORAGE Development Services DepartmentXIV Phone: 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. 008-023-49 Complete legal description Wentworth Subdivision Block 1 Lot 8 Location (site address) 3220 E 40th Ave., Anchorage AK Current property owner(s) Robert Bassett 2. ON -SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 907-215-8324 3. TYPE OF WATER SUPPLY: FNI Private Well serving # 1 dwelling units ❑ Other Non-public well as regulated by MOA ❑ Water Storage ❑ Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: ❑ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank 0 Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age - See advisory if steel or fiberglass 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 $ 3 40. ° ° Waiver Fee $ Date of Payment 4T�_ /2- U� � Date of Payment COSA # US C Z- iv it'Z- / Waiver # COSAAppiicWti Apr2425.doc COSA Checklist Legal Description- Wentworth Subdivision Block 1 Lot 8 Parcel ID: 008-023-49 If more than I well and/or septic system on lot provide separate checklist. Structure served by this system El Well log is filed with Onsite (or attached) Date drilled 1963 Total depth 55 Cased to 55 ft Well production at time of test 4.0 Qpm Water storage tank volume 40 gallons Well disinfected for coliform test? E] Yes No Sanitary seal is functioning correctly (f Coliform bacteria is Negative Wires are properly protected Nitrate - mg/L Nitrate less than MRL (ND) Casing height (above ground) 12 in. Arsenic 2.8 ug/L Arsenic less than MRL (ND) Date of flow test for COSA June 24, 2026 Collected by Gary Solin Static water level at beginning of test 16.2 ft. Date June 24, 2026 Comments Well drilled 1963, casing height 12" allowed for old wells. No well log I 0 Renuired maintenance completed if AWWTS Comments: AWWU public sewer Which system tested (date installed) P)o n e- El ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (Mjn) n N/A - pressurized field. El Per record drawings, field is insulated. -ifiDnYMTbMSot000uom-oTetTective. If not, state depth into effective El 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 LIFT STATION Age of lift station - years Lift station material Comments: h an � Adequacy test date Results [:] Pass Fluid depth prior to test in 'ITater added aal New fluid depth in Elapsed time - min Final fluid depth in Absorption rate _ gpd FIELD STATUS - POST RECOVERY Effective depth (per record drawings) _ in Effective depth used in Effective depth remaining _ in Comments/Deficiencies: Waiver exists dated 7/10/1985 from AK DEC for well to sewer line of 63'. This waiver in MOA Septic Tank/Lift Station m Lot > 1W @ Yes if Sewer Man > 100' — No ft 21 Yes if No ft Neighboring T ank > 100' [E]Yes if No ft Sewer ServicetSeptic Line 2:25'21 Yes if No—ft Disposal Field on Lot > 100' 2] Yes if No ft Holding Tank > 100' [E] Yes if No ft Neighboring Disposal Fields > 100' Animal Containment ?� 50' [E] Yes if No ft 2] Yes if No_ ft Sewer Line/Main > 100' []Yes if No 63 ft Manure/Animal Excre� Storage 2� 100' E] Yes if No —ft From SqWdHolding Tank and Disposal Field(s) on Lot to: (Please enter distatices if less than required) Tank to Property Une > 5' ye -A Field to Property Line > 10' 0yes M Water Main/Service Line> 10' 0 Yes ifNo P _11 F. ENGINEER'S COMMENTS Gary P-E. The reported results descrt-%,!� syst,,,��n ;vv&�Fjt, 11 . . . . . . . G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal afted hereto and as of ths validation date shown below, I verify that my Investigation, based on procedures outlined in the Cerfificate of On -Site Systerns Approv,�W Guklelines, irtdicates that the on -site water supply andlor wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and reguiatons in effect at the Urne of installation, unless noted otherwise. Name of Firm Gary Sofin P.E. Phone 907-338-1308 Engineer's Printed Name. Gary Solin Date July 10, 2026 • r 9`59'45"E 60'�...-4XDEN POST &L PANEL FENCE & C2AIL FENCE 10' UTILITY - EASEMENTS Lot 20 � WELL C}t (,,a GRAVEL --WOODEN FENCE, a # • I 1 LOG_ rr •.--`j LUG HOME rl zs.3' ISEWER PIPES 6.0' x &0' DECK Ora P) 6.3' x ? 0.3' --\ SHED Lot 21 Lot 22 DATE OF REVISED t 26 NOTES: GROUND LEVEL IMPROVEMENTS SHOWN ARE APPROXIMATE. DATE OF SURVEY: 07 MAY 2026 PLOT PLAN AS BUILT _�L S-. Lanr • Associates, Professional Land Surveyors surve�y@langstjr-vey.com OF A I hereby certify that I have surveyed the following described property: LOT # BLOCK;ate :li •(Plot # Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property :. and do # encroach no improvements on the property lying adjacent thereto encroach on the surveyed promisesand #thereare no roadways, transmissionor other visible easements on said property except as indicated hereon. Dated Day of at Anchorage, Alaska' It is the responsibility of owner to determine #: # a : • as # #:#a„,#. ib:# ### plot.^. State of Alaska AE C'C 963 MTJNICIPALiTY OF ANCHOR-&GE DIVISION OF ENVIRONMENTAL HE~TH DEPA/{TMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date 18 July, 1985 (a) Legal Description (include lot, block, subdivision~ section, township, range) Lot 8, Block 1, Wentworth Subdivision, Sec 28, T12N, R3W, S.M. Location (address or directions) 3220 East 40th, Anchorage, AK 99508 (b) Applicants Name Lyl~ M~nrh~nt (c) (d) Telephone - Home3R7_0215Businesspv6-12%q Applicants Addres~.~ 'An~Jox~_a~.e~ 9950q Appliqant is (check one) Lending Institution ~; Owner/buildor~ ; Buyer ~--~ ; Other ~ (explain); ' Lending Institution ' TelophCne~ ~ .~ {-/~/~ Address .~; (e) Real Estate Co. & Agent Address (f) Telephone Mail the HAA to the following address: Lyle Marchant call when ready 2. Type of Residence Single-Family~ for pick-up 337-~2~ or 276-1333 Multi-Family~ Other (describe) Number of Bedrooms _ Three 3. Water Supply- Individual Well~. Community~--~ Public~ ~ Note: If community well system, must have ~zritten confirmation from the State Department of Environmental Conservation attesting to the legality and status° 4. Sewage Disposal Onsite ~ Public ~-~ Community ~ Holding Tank ~ Note: If community well system~ must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] Engineering Firm Providing Inspections, Tests~ File Search~ Data and Information As certified by my seal affixed hereto and as of the validation date sho%m below, I '~ verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection° Name of Firm CRW ENCTMERRTMC CROUP Telephone 562-325? Address 3900 .Arctic Blvd. ~?os~_a~nborag~: AM qqsOq Date 18 July, 1.985 DHEP Approval # ~"~" ~,pproved , f bed rooms Approved _~ ' Disapproved Term~ of Conditional Approval itional CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENSfIRON~NTAL PROTECTION (DHEP) ISSUES HF~kLTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGPakPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF AI~SKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DREP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPAJ~ITY OF ANCHORAG? IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK° (DNEP SEAL) RR4/eJ/D18 [Page 2 of 2] MUNICIPALIT'/ OF ANCHORAGE D[Pf. OF HEALTH & ENVIRONMENTAL PROTECTION RECEIVED WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: Lot R , R1 n~.lz I ; N~n t-~n~¼ Subdivision - Sec 28, T13N, R3W Well Classification Private Well Log Present (Y/N) No Total Depth 55 ~ Cased to 55 ~ Static Water Level 1 4 ' Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: If~A, B, C, D.E.C. Approved (Y/N) Date Completed 1 9 6 3 Yield To Septic/Holding Tank on Lot N / A Depth of Grouting Unknown ~9 Pump Set At . ~ Yes Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) No ; On Adjoining Lots N / A To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line 6 3 ' Cleanout/Manhole 1 1 8 ' Water Sample Collected by B. Looney WateF S~im ple~Test Results Satisfactory Comments N / P, ; On Adjoining Lots N/A TO Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date 6/26/85 72' See attached waiver from DEC for separation distance between a public sanitary sewer line and this private SEPTIC/HOLDING TANK DATA Date Installed Standpipes (Y/N) Depression over Tank (Y/N) well. No driller's Size No. of Compartments Air-tight Caps (Y/N) Foundation Cleanout (Y/N) Date Last Pumped Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line To Water Main/Service Line Course ; for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments P~ge 1 of 2 72-026(11/84) C, ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major,Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) LIFT STATION N/A Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments I certify that I h.(g/Cc~57¢ok~d, veri]~ied, or conformed to all Signed //~~"/ Date 18 July, Company Receipt No. Date of Payment Amount: $ ** Check Permitted Bedroom Rating Against HAA Request ** MOA and HAA guidelines in effect on the date of this inspection. Page 2 of 2 72-026 (11/84) 1985 : .... MOA NO. ST-85-253 DEPT. OF ENVIRONMENTAL CONSERVATION BILL SHEFFIELD, GOVERNOR ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 274-2533 CRWEngineering Group 3900 Arctic Boulevard Anchorage, Alaska 99503 July 10, 1985 Horizontal Separation Waiver Between Well and Community Sewer, Lot 8, Block 1, Wentworth Subdivision, Anchorage, Alaska 8521-WA-009 Dear Sir: The Department has reviewed the subjectwaiver request and hereby waives the horizontal separation between the well and ccam~mity sewer to 63 feet on the subject property for a 3 bedroom single family residence only. Sincerely, Steve Eng, P.E. District Engineer SE/dd GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received Time of Inspection Date of Inspection 1. Approval requested by: Alaska Mutual Savings Bank 4. 5. 6. o December 20, 1976 Mailing Address: Post Office Box 1120 Phone: 274-3561 Property Owner: Mailing Address: Nathiel Goodhue 3220 East 40th Avenue Phone: 274-4679 Legal Description: Lot 8 Block 1 Wentworth Subdivision Location: 3220 East 40th Avenue ~ Type of facility to be inspected Single Family Well Data: A. Type C. Construction Sewage Disposal System: A. Installed C. Septic Tank: 1. D. Seepage Pit: 1. E. Disposal Field: Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank C. Absorption area No. of bedrooms 3 Individual B. Depth D. Bacterial Analysis Public Utility~.~ B. Installer Size 2. Manufacturer Absorption Area 2. Material Total length of lines , Absorption area , Other contamination , Absorption area to nearest lot line ., Sewer Lines , EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - Req_~st for Approval,~of Individual ~er & Water Facilities Legal Description Lot 8 Block 1 Wentworth Subdivision Comments Approved ~--~- Disapproved Approval iValidfor one year from date signed Date Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) GREATER ANCHORAGE AREA BOROUGH DePartment of Environmental Quality 3330 "C" St., Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES i. Type of Inspection: CMRO VA 2. Property Owner: Nathiel Goodhue Mailing Address: _3ee~O.E. bOth 3. Name of Buyer: .Susan O. Besse FHA CONV X Day Phone e?4-q679 .. Mailing Address: 2o5~ Campbell Place Day Phone 4. Name of Lending Institution: Alaska Mutual Savings Bard~ Mailing Address: P.o. Box 1120 Phone 5. Name of Realtor or Agent: NONE Mailing Address: Phone Legal Description: Lot 8, Blk. 1 W~ntworth Shhd. Location: 3220 E. 40th Avn. Anchorage, Alaska to be inspected: Single Family No. Bdrms. 3 Type of Facility Water Supply Type of Supply: If Individual, If Individual, Public Utility number of dwellings depth of well X date of installation Sewage Disposal System Type of System: Public Utility If Individual, Individual presently served x Individual (on-site) EQ-037 (1/74)