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HomeMy WebLinkAboutRAVEN MOUNTAIN ESTATES #1 BLK 5Raven Mountain Estates Block 5 #0'76-031-18 Municipality of Anchorage page :.IL DEPARTMENT OF HEALTH AND 14UMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 ® Anchorage, Alaska 99519-6650 · Telephone: 343-4'744 On-Site Wastewaler Disposal Syslem and/or Well Inspection Report Permit Number: ~ ~O ?~ PID Number: ~O ~ ~_ ~O~~ WastewalerSystem: ~New ~Upgrade ~ ,o, 60~ ~t~ . ~o,¢~ K~ ABSORPTION FIELD ~5 b--2-~t~/ ' 'U Deep Trench U Shallow Trench ~Bed UMound UOlher LEGAL DESCRIPTION WELL: ] New U Upgrade e,a,e, widlh: ~ S Ft. 3 j . (¢ Ft. Yield: J 0 GPM O ~ F. / ~ ~ F. ' / TANK SEPARATION DISTANCES STATION FoLlndaJJo, ~ / ~ / ) ~ ) x~ "Pumpon"levelat: "Pumpol,"levef~ Highwaleralmmel: Remarks: ~ oF ~¢~ e T, ~ BENCH MARK J'i~J)~ , J AssumedElevatio,l: , $ & S ENGINEERING fnspections performed Dy', ...... ~ ..... R=~e~s: 1st ~-I~- ~ ~ ~, . ~agle River, Alaska g9~77 2nd fl'-V~ -~ ~...,'~ Department of Heallh arid Human Services approvm PERMIT NO. SW980279 PAGE 2 OF 5 N~nicip, aLi~;..__y_..of' .A. nah qp ~ 9.e' BE?ARTMENT OF ½EAL.¥H AN~ hUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.B. Box' 196650 eA~choro, ge, A/o. sko. 99519-6650~,Tetephone: 343 4744 OH-S~TE WASTEWA%ER DISPOSAL S¥SYE~t AN[D~/OR WELL INS?ECYgON REPORT LEGAL BLOCK 5, RAVEN MOUNTAIN ESTATES #1 P.LD. NO. 076--051-1~ NEW ABSORPTION BED NEW 1500 GAL DBL2 SEPTIC TANK ~DBL1 ,.~.~...._._~_~_.~, ~~cCoO3~.MT__ __ ~ST2, STiff/''~''-- F C O C04~--~-' ~] .~01 A _ / / % %% x ,¢751.. ...... ~?~,,. / .... ~ ' ~ ~~4'7'~ % I PERMIT NO SW980279 PAGE 3 OF 3 ivlunicip, o, ti$ o¢' Anchoro, qe BEPARYNENT OF' BEA[TBANB BU~AN SERVICES ENVlRONNENTAL SERVICES BIVISJ©[~ P,B, Box 196650 ~hnchoPage, A~aska 99519-6650~Tetephone~ 343-4744 ON-SiTE WASTEWATER B~SPOSAL SYSTEB AND/OR WELL ~NSPECTDON REPORT LEGAL BLOCK_5,_RAVEN_MOUNTAIN_ESTATES_J,.~I P.I.I), NO. 076-031 - 18 , ~FINAL GRADE 101.4~ / .~ST1 ST2 ff~ ~/z~~-INSULATION 1500 GAl. 9 SEPTIC 94 9' TANK ' ff100.3' C02 MT C03/ C04 A B FCO 16.5' 54.5' ST1 36.0' 61.0 ST2 44.0' 66.5 DBL1 49.0' 68.0' DEL2 50.0' 68.5 C01 52.0' 58.0' C02 115.0 120.5 CO3 113.0' 118.0' C04 113.0' 116.0' MT 113.5' 121.0' SCALE=N,T,S. GRADE · NO WATER FOUND 87.4' B.O.H. ¢" '~'k '" '" ' ," ~ ~, · ,~1,,,~,,"~'"'~2 ........ ~, ~ .. CE-8801 RECEIVED APR 29 1999 WATER WELl. RECORD STATE OF ALAg~;A DEPARTMENT OF NATURAL RESOURES Division of Geologicol ~ Geophyslcol Surveys Municipality ol Ancl~orage Oept, Health & Human Services LOCATION OF WELL (Pleese complafe either lo, lb or lc.) Ic~.JDISTANCE AND OIRECTION FROM ROAD INTERSECTIONS WELL LOS A.D.L. NO. Top Boflom 4. WELL DEPTH: (flnol) J 5. DATE OF COMPLETION ~ Irrigotlon ~ Rlch~rgl ~ Commerlcol ~ Tesf Well ~ Oilier; ~ 8~ CAS[N6= ~ Threaded ~ded 9. FINISH OF WELL: Type; ~) ,~9~. ~/p ~ Olar~eler: I0, STATIC WATER LEVEL=· ~7~ ft. / ~ [~Above or [~ B~iOW land surface Dote Equlpment used: ° [3P ~c MUNICIP/kLITY OF ANCHORAGE DEPARTMEH~f OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF 1 ON=SITE WELL AND WASTEWATER DISPOSAL SYSTEM PER/~IT PERMIT NUMBER:SW980279 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:POWERS DAVID E & DIANE L OWNER ADDRESS:P.O.BOX 410 GIRDWOOD ALASKA 99587 DATE ISSUED: 8/03/98 EXPIRATION DATE: 8/03/99 PARCEL ID:07603118 LEGAL DESCRIPTION: RAVEN MOUNTAIN ESTATES #1 BLK LOT SIZE: 41512 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC T/LNK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WIT] 1. THE ATTACHED APPROVED DESIGN. 2. 1ALL REQUIREMENTS SPECIFIED IN ANCHORAGE 15.55 /kND 15.65 /LND THE STATE OF AJ~AS~3% REGULATIONS (18AAC72) AND DRINKING WATE5 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 PRIOR TO EACH INSPECTION. PROVIDE NOTIF CALLING 343-4744 ( 24 HOURS ) (NOT 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREti WEATHER MUST BE EITHER: A. OPENED /~XTD CLOSED ON THE SAbIE DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING THE FOLLOWING SPECIAL PROVISIONS. RECEIVED BY: ISSUED BY: SPECIAL PROVISIONS: 2 FOOT SAND LAYER MUST BE MOA APPROVED. HEALTH AUTHORITY APPROVALS ENGINEERING STUDIES AND REPORTS WELL INSPECTION &FLOWTEST ROAD DESIGN SOJLTEST STRUCTURAL& MECHANICAL iNSPECTiONS ONSITE WA,STEWATER DISPOSAL SYSTEM OESIGN ROBERT C. COWAN, RE. ROBER'I'A. SHAFER, RE. July 15, 1998 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Block 5, Raven Mountain Estates #1 Subdivision Request you issue a permit to install a septic system and well to serve the four bedroom house on the referenced property. A test hole was excavated and percolation test performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation 7/J x/98 water was not encountered in the test hole. AfLer seven days the ground water monitohng tube~ wos found to be dry. We do not anticipate any adverse effects on neighboring wells, septic systems reserve areas or drainage patterns by the installation of the proposed septic system. ']?he construction of this system will not prevent any future development on any of the adjacent properties. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/mg Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 o EAGLE RIVER, ALASKA 99577 F 1": SC^Er50' DESIGN / /~'/ / / Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: ~ L O 6 ~, .~' '~"/~l'/'t't'~'Y"~'~ ..... ="""9 DATE IL . ........ "~ ' ~ ~V~ '~ ~), Township, Range, Section: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O COMMENTS SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT SL DEPTH? ~ pO E Deplh Io Water After D~v ~7/~1/~V MoflilarJflg? D31e; Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLA'rION RATE /~ ;( (m~nute$/~nch) PERC HOLE DIAMETER __ TEST RUN BETWEEN FT AND ~ FT $ & S ENGINEERING PERFORMED BY ~'-~,~.e ~-..k ~ ........ I~m=~-;..---- CERTIFY THAT THIS TEST WAS PERFORMED IN ACGORDAN CE W~C~II,~LJ~I~IJ~T~I~I~N~I~PAL. GUIDELIN ES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) HEALTH AUTHORITY APPROVAL8 SEWER & WATER iNSPECTION ENGINEERING STUDIES AND REPORTS WELL LNS PECTION & FLOW TEST ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAt & MECHANICAL INSPECTIONS ~ ROBERT C. COWAN, RE. ~I~I~IEERIH~ ON-SITE WASTEWATER DISPOSAL SYSTEM ROBERTA. SHAFER, RE. ~'~tt CONSTRUCTION PRACTICES CIVIL ENGINEERS a.d (907) 694-2979 '>// MATERIAL SPECIFICATIONS FAX (907) 694-1211 REFERENCE: Block 5, Raven Mountain Estates #1 July 24, 1998 GENERAL: 1. The scope of this project includes the installation of a 1250 gallon septic tank and an absorption bed to se~we the proposed four bedroom residence located on the referenced property. 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensnring a satisfactory vegetation growth over the mounded area. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufactm'er. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 17034 NORTH EAGLE RIVER LOOP. SUITE 204 · EAGLE RIVER, ALASKA 99577 Page Two Block 5, Raven Mountain Estates #1 Jul 24, 1998 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. LEACHFIELD BED INSTALLATION: Excavate the proposed Bed/u'ea to the depth shown on the design. The bottom of the excavation shall be within 2 inches of level. If the bottom of the excavation becomes smeared, it must be raked or scratched (ruffed-up) before gravel or sand placement. Ifa sand layer is required, place sand over entire excavation to the required depth shown on the design. The top of the sand layer must be within 2 inches of level. Sewer rock shall be placed uniformly thi'oughout the entire bed. Perforated distribution pipe must be installed level with perforations down. Gravel depth below the perforated pipe shall be a minimum of six (6) inches. Gravel depth above the perforated pipe shall be a minimum of two (2) inches. The total gq'avel depth throughout the entire bed shall be a minimum of twelve (12) inches. The perforated distribution pipes must be no more than six feet apart. The distance between the outermost perforated distribution pipes and the sidewall of the absorption bed must be no more than three feet. Silt barrier material nmst be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor and cleanout tubes shall be of four (4) inch diameter, installed at the locations shown on the design, and extend a miuimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel depth shall be perforated six (6) inches below the bottom of the horizontal distribution lines. The monitoring tube should not extend below the bottom of the gn'avel surface. Page Three Block 5, Raven Mountain Estates #1 Jul 24, 1998 Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finished grade over the bed must be mounded to prevent the formation of a depression after settliug. MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt battier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. When sand is being used as a filter material, its gradation specifications must confm~n to cut, ent M.O.A. or D.E.C. requirements. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: Page Four Block 5, Raven Mountain Estates #1 Jul 24, 1998 The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, presstu'ized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOIUINSTALLER MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 076-031-18 Certificate of On -Site Systems Approval Expiration Date: 2 2, Legal description RAVEN MOUNTAIN ESTATES #1 BLK 5 Site address 191 GOLD CLAIM DR Girdwood AK Current property owner(s) WESTBY X The On -site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Septic field passed adequacy test, but is at end of useful life. 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 Services 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 work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory X Arsenic Advisory Other COSA Approval_June 2022 Development Services Departments -7 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. 076-031-18 Complete legal description Raven Mountain Estates #1 Block 5 Location (site address) 191 Gold Claim Drive, Girdwood, AK 99587 Current property owner(s) Darren & Deana Westby Day phone (608) 206-7742 2. ON -SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: Al 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: IN Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: Ifl Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 25 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS 0 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 $ ` Waiver Fee $ Date of Payment t /Z ✓ 2 3 Date of Payment COSA # d S C 2 3J Waiver # COSA Application —June 2022 Raven Mountain Estates #1 Block 5 076-031-18 5.8 8/14/98 92 N/A 92 1.32 18+ 10/31/23 Forge Engineering 68 10/24/23 50" 11/2/23* McDonald's Pumping 9/17/98 6.0 5.5 N/A N/A N/A 10/31/23 5.0 > 600 Benjamin Schiller, P.E.11/1/23 (907) 522-7773 Septic Tank Advisory Certificate of On -Site Systems Approval # OSC231431 Subdivision: RAVEN MOUNTAIN ESTATES #1 Block:5, Lot: The septic tank for this property is 25 years old. The average life of an asphalt coated steel septic tank is 20 years. Typical replacement costs are $10,000 or more, not including engineering, surveying or MOA permitting fees. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 30 year old steel tank MAY look like. xsr Mailing Address P O Box 96650 *Anchorage, Alask95154550 * vuww muni org sL T ! ® Municipality of Anchorage ° On -Site Water and Wastewater Program (907) 343-7904 5 f E T Y Certificate of On -Site Systems Approval Parcel I.D. 076-031-18 1. GENERAL INFORMATION: Expiration Date: l0-7 r 2 Complete legal description RAVEN MOUNTAIN ESTATES ##1; BLOCK 5 Location (site address) 191 GOLD CLAIM DRIVE GIRDWOOD, AK 99587 Current Property owner(s) DIANE POWERS Mailing address Real Estate Agent 2. TYPE OF DWELLING: X❑ Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 230-2439 Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well © Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 550 Waiver Fee $ Date of Payment %�42! Date of Payment Receipt Number 059l7 G Receipt Number COSA # ESL 21 I? 6 q 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: b 3v % 1 in conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to 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 whatsoever. 6. DSD SIGNATURE System #1 Approved for _�/_ bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, J tti e�r�r ess: f CE 79[5 fer •�5•fi '�'{' G�CO e s s1o�°q #AECC884 with the following atiorQN-SITE WATER AND m ,J1))))))))WW �,/� C ✓ Original Certificate Date: ' Z 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 72!f— Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Other SAeeJ 4mAk Ale Myil i 0 � COSA blue sheet 10.10.12.doc Leclal Description: COSA Checklist. ;Er i RAVEN MOUNTAIN ESTATESfBLOCK 5 "1' parcel ID: 076-031-18 If more than i septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA I Well log is filed with Onsite (or attached) Date drilled 8118/98 Total depth 92 ft Cased to 92 ft W Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 6/13/21 Static vvater level at beginning of test 72.8 ft. Comments v. TANK DATA Age of tank(s) 23 years Tank type/material SE-C-EE Measured operating fluid level in septic tank 51 Standpipes/foundation cleanout_per record drawing Date of pumping O _ D. ABSORPTION FIELD DATA Well production at time of test 7.3+ gprn Water storage tank voiurne N/A gallons Well disinfected for coliform test? ❑ Yes C I\Ic X Coliform bacteria is Negative Nitrate 1,, ma/L ❑ Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by GEG, LTD. Date of Sample 6/13/21 C. LIFT STATION ❑ Required maintenance completed Aae of lift station years Lift station material Comments: N/A Which system tested (date installed) 1998 Adequacy test date 6/13/21 J ALL standpipes present per record drawing Results Pass For 4 bedrooms Total measured depth from grade 725 ft (max) Fluid depth prior to test 2 in Measured depth to pipe invert from grade 3.33 ft (Inin) Water added 664 gal ❑ N/A - pressurized field New depth *2 . in M-1 Monitor tubes go to bottom of effective. If not, state Elapsed time *0 min depth into effective 10"-11' © Code -required soil cover over field Final fluid depth *2 in LJ System presoaked Absorption rate 600+ gpd (Required if vacant for greater than 30 days prior to NONE Any rejuvenation treatment (past 12 months) date of test) N/A If yes, enter date N/A Gallons introduced gallons Comments/Deficiencies: 'LIQUID LEVEL DID NOT CHANGE DURING ADEQUACY TEST COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > '100' * Community Sewer Manhole/Cleanout > 100' 0 Yes if No ft ❑✓ Yes if No ft Neighboring Tank > 100' 0 Yes if No fit Private Sewer/Septic Line > 25' M Yes if No ft Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' El Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' ✓1 Yes if No ft 0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0 Yes if No ft ✓❑ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0✓ Yes if No ft Surface Water > 100' �]✓ Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10' F71 Yes if No ft Community Wells > 200' 0 Yes if No ft Water Service Line > 10' 0 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' 0 Yes if No ft Wells on Adjacent Lots: Water Main > '102 [I Yes if No ft Private Wells > 100` Yes if No ft Water Service Line > 10' 0 Yes if No ft Community Wells > 200' R1 Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS *APPEARS TO BE 100' EXACTLY PER 1998 INSPECTION REPORT DRAINFIELD HAS DRIVEN STEEL MT INSTALLED BY OWNER 4/16/19. PIPE LABLED C04 ON INSPECTION REPORT IS NOT SHOWN ON AS -BUILT SURVEY; HOWEVER, IT IS PRESENT. o�oO�t G. ENGINEER'S CERTIFICATION �LJJQf �`�tl 1 certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with Cf). 0 A'i ( Q� MOA COSA guidelines in effect on this date. % • • . • .. • Q J�fr } A. Garn ss:' lCE 32-4 �� l O COSA Checklist yellow sheet �r'rofessW�`�o #AECC884 ��0010Ca C(3 www.muni.org/onsite Septic Tank Advisory Certificate of On -Site Systems Approval #OSC211369 Subdivision: Raven Mountain Estates #1 Blk 5 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 23 years old. Typical replacement costs range from $8,000 to $11,000 This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 20-year-old steel tank MAY look like. � � ' � Mailing Adc�}ress P O�Box�196650: * {anchorage, Alaska 99519 6650 * www rnurn org EpCRA/S • Municipality of Anchorage On-Site Water and Wastewater Program (907)343-7904 SA [TT Certificate of On-Site Systems Approval Parcel I.D. 076-031-18 Expiration Date: d - 1 tl 1. GENERAL INFORMATION: • Complete legal description RAVEN MOUNTAIN ESTATES#1;BLOCK 5 Location(site address) 191 GOLD CLAIM DRIVE GIRDWOOD,AK 99587 Current Property owner(s) DIANE POWERS Day phone 230-2439 Mailing address 191 GOLD CLAIM DRIVE GIRDWOOD,AK 99587 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 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL Individual Well ® Individual El Individual Water Storage 0 Holding Tank - ❑ Community Class Well ......... 0 Community • ❑ Public Water System 0 . Public Sewer 0 WaiverNariance request for. Distance: Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 6-6-0 Waiver Fee $ Date of Payment 61/71/9 Date of Payment Receipt Number ,q O(�,f J'°-1Ej Receipt Number COSA# i5c/9//5.3 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: In conducting this evaluation.GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and `,'<C'•.•••'•'•• •' t��� industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or � ,� encroachments may exist that were not identified during the evaluation. The operational life of all wells ; /.:Q -� and septic systems depend upon a variety of variables, including but not limited to, soil conditions, /50. groundwater levels (that may fluctuate during the year), quality of construction (materials and VA workmanship).and the water usage of the family utilizing the system/s. These conditions can vary,and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the A ••..ef-rey A. Corness. G system/s; therefore. GEG makes no warranty(express or implied)regarding the future performance of iil '• cc_795- 4 a the well or septic system. GEG makes no representation whether an alternative well or septic system " l� can be installed on the property in the event either of the current systems fail to perform adequately in ��,�� ✓••.1•1.1 c7k--../ the future. The content of this report is for the sole benefit of the person/party that retained GEG to �ar°P- r e S s;onc. perform the evaluation. Reliance upon the information provided in this report by any other person or gyp`»��o� party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE System#1 Approved for bedrooms System#2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: By: I t--(� Original Certificate Date: C 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 A . L l COSA blue sheet_10.10-12.doe COSA Checklist Legal Description: RAVEN MOUNTAIN ESTATES, BLOCK 5 Parcel ID: 076-031-18 If more than 1 septic system on lot: COSA Checklist# 1 of 1 Structure served by this system 1 A. WELL DATA 0 Well log is filed with Onsite(or attached) Well production at time of test 6.9+ gpm Date drilled 8/18/98 Water storage tank volume N/A gallons Total depth 92 ft Well disinfected for coliform test? ❑Yes Q No Cased to 92 ft Q Coliform bacteria is Negative 0 Sanitary seal is functioning correctly Nitrate i •Sq mg/L 0 Nitrate less than MRL (ND) ❑■ Wires are properly protected Arsenic Nn ug/L Arsenic less than MRL(ND) Casing height(above ground) 18+ in. Collected by GEG, LTD. Date of flow test for COSA 4/16/19 Date of Sample 4/16/19 Static water level at beginning of test 70.4 ft. Comments B. TANK DATA C. LIFT STATION Age of tank(s) 21 years ❑ Required maintenance completed Tank type/material "`"4"' Age of lift station - years ❑■ Standpipes/foundation cleanout p record drawing Lift station material - A Date of pumping / k(-yJu-„( c-- -o/(1 Comments: NO LIFT STATION LIQUID LEVEL IN TANK IS 50 INCHES D. ABSORPTION FIELD DATA Which system tested (date installed) 1998 Adequacy test date 4/16/19 ---Ai ALL standpipes present per record drawing.0 Results ❑✓ Pass For 4 bedrooms Total measured depth from grade 7.5+ ft(max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade 3.3+ ft(min) Water added 752 gal 0 N/A—pressurized field New depth 4 in 0 Monitor tubes go to bottom of drainfield. If not, state depth into effective Elapsed time 15 min ❑� Code-required soil cover over field Final fluid depth 0 in 0 System presoaked Absorption rate 600+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) —"— date °"date of test) n/a Gallons introduced N/A gallons If yes, enter date Comments/Deficiencies: -' e✓' - JO-GC-20-A09.4 COSA Checklist yellow sheet qi E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot> 100' Community Sewer Manhole/Cleanout> 100' E✓ Yes if No ft Q✓ Yes if No ft Neighboring Tank> 100' El Yes if No ft Private Sewer/Septic Line >25' ❑✓ Yes if No ft Absorption Field on Lot> 100' QYes if No ft Holding Tank> 100' 12Yes if No ft Neighboring Absorption Fields> 100' Animal Containment>50' ✓0 Yes if No ft E Yes if No ft Manure/Animal Excreta Storage> 100' Community Sewer Main > 75' Q Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations> 10' El Yes if No *5•i• ft Surface Water> 100' ✓Q Yes if No ft Property Line>5' ['Yes if No ft Driveway/Parking>0' Q✓ Yes if No, comment Absorption Field >5' E✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10' Q Yes if No ft Private Wells> 100' QYes if No ft Water Service Line> 10' Q Yes if No ft Community Wells>200' Q✓ Yes if No ft From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation> 10' Ell Yes if No ft Driveway/Parking>0' 0 Yes if No,comment Property Line> 10' Q✓ Yes if No ft Wells on Adjacent Lots: Water Main> 10' E✓ Yes if No ft Private Wells> 100' ✓0 Yes if No ft Water Service Line> 10' ❑✓ Yes if No ft Community Wells>200' Q✓ Yes if No ft Surface Water> 100' ✓Q Yes if No ft F. ENGINEER'S COMMENTS *MET CODE AT TIME OF INSTALL. DRAINFIELD HAS DRIVEN STEEL MT INSTALLED BY OWNER 4/16/19. 0.o600pp.,..0 G. ENGINEER'S CERTIFICATION �\c OF '..,,Q,, ` .. s o0 I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with ,1 9 .*.�*00 MOA COSA guidelines in effect on this date. g i o .•.J r`y/A. Corness; 0 'O 9 . .UeE-�95 ..• . OpO wea t... .. ��o p•ofession a' COSH Checklist yellow sheet #AECC884 4��0000 •� MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 1-----.;.'" F • 907-343-7904 On-Site Water and Wastewater Section Fax: 343-7997 www.muni.org/onsite Septic Tank Advisory Certificate of On-Site Systems Approval #0SC191153 Subdivision: Raven Mountain Estates B5 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 21 years old. Typical replacement costs range from $6,000 to $9,000. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. This is an example of what the metal of a 20 year old steel tank MAY look like. M YY IV k.. 1:-It; • �i ** �I r2 Y. 0 a 22 .b ". . _'S • a" - .- n ^+�‘^ . _ems., Mailing Address: P.0. Box 196650 *Anchorage,Alaska 99519-6650 *www.muni.org Chugach National Forest S 89'34'37" W 288.10' U-1 30 Anch r Ease., 3-Story 73.9' House Lot 5, IB'j (o) c I L-, c) Block 3 0 W QA� 5) Dv Gen. Shed 88.0' r 17 Lot 4 00 Block C, 00 o C: 27.5' 01or�1778P 12.0' cn COWMd 3-Story House 4.0' !7!: [a c 0 11.5' — 49thN j Star Lot 3, 0 1.0' in 0 411 Ir 11.1 lw�l Suirve ing Block 3 1 y (D a,.,31 1 0 25 50 House Detail: I" = 30' US SURVEY NOTES FEET -All dimensions shown are grid hearings and ground distances, Record boundaries are per Plat No. 66-161. -49th Star has conducted a physical survey of the property and an details shown on this Asbuilt Survey are correct. Under no circumstances should any data hereon be used for construction or for establishment of property lines. -It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. AS BUILT SURVEY LEGEND 49th Star Surveying LLC Block 5, 0 Found Property Comer 321 Fireoved Drive Raven Mountain Estates, 0 Septic Sys. Pipe/Clem Out Anchorage, AK 99508 (907)891-6111 Unit 1, a Solar Panel Jeremy@49thStarSurveying.com Girdwood, AK OO well W.O. 19004 1 DATE: 04/10/19 Is