Loading...
HomeMy WebLinkAboutGIRDWOOD ORIGINAL TOWNSITE BLK 3 LT 23duoc51 aitui\cL.0 qt.isyvizok__ Poi a3 (2661L3 A x-15- X53 -x-110 DEPT. OF ENVIRONtMENTAL CONSERVATION DIVISION OF ENVIRONMENTAL HEALTH DRINKING WATER AND WASTEWATER PROGRAM 555 CORDOVA STREET Anchorage, AK 99501 http://www.state.ak.us/dec/home/htm Robert W. Kranich, Jr., P.E. Kranich & Associates Consulting Engineers 9780 Carlson Rd. Anchorage, AK 99507 TONY KNOWLES, GOVERNOR February 20, 1998 (907) 269-7517 RE: Lot 23, Block 3, Original Girdwood Townsite; Waiver of Horizontal Separation Distance From a Proposed Class "C" Public Source Well and Wastewater Disposal System. ADEC project no. 9821 -DW -287 -047,9821 -WV -287-043. Dear Mr. Kranich: This is in response to the letter received in this office February 13, 1998, addressing this office's comments regarding a request for operation approval of a Class "C" well and a lesser horizontal separation distance between several existing neighboring wastewater disposal systems. The Department has completed a review of the submitted information which included a cover letter, additional subsurface soils information, nitrate water sample analysis, and a system as -built diagram. Based upon this review and previous information on file it appears that the previous'concerns of this Department regarding operation of the water system and the requested horizontal separation variances from neighboring wastewater disposal systems have been satisfactorily addressed. However, in accordance with State Drinking Water Regulations (18 AAC 80.030, and 80.300) before approval to operate can be granted for a class "C" water system with a lesser horizontal separation distance to neighboring on-site wastewater disposal systems the following comments will need to be addressed: Approval to operate the class "C" water system will be based on the water usage indicated in the submittal which indicated a proposed 1-1/2 bath two story residential and office structure. 2. As indicated in the previous review of this project there are a total of six individual waivers required for approval of this well as a class "C" publi water system. The total plan review fee amounts to $1525.00, attached i a copy of the previous invoice detailing this fee. Thank you f- - its Department if there are any further question! Bill Kranich 2 February 20, 1998 regarding the above please do not hesitate to call. Sincerely, Michael Lu Environmental Engineer TONY KNOWLES, GOVERNOR 7U, L= DEPT. OFENVIRONMiENTAL CONSERVATION f DIVISION OF ENVIRONMENTAL HEALTH DRINKING WATER AND WASTEWATER 555 CORDOBA STREET Anchorage, AK 99501 (907) 269-7505 October 24, 1997 Robert W. Kranich, Jr., P.E. Kranich & Associates Consulting Engineers 9780 Carlson Rd. Anchorage, AK 99507 RE: Lot 23, Block 3, Original Girdwo d Townsite; Waiver of Horizontal Separation Distance Providence to Proposed Class "C" Public Source Well. ADEC project no. 9821 -DW -287-047, 9821 -WV -287-043. Dear Mr. Kranich: This is in response to the letter received in this office October 14, 1997, concerning a request for operation approval and for a lesser horizontal separation distance between a Class "C" well and several existing on-site wastewater disposal systems. The Department has completed a review of the submitted information which included a cover letter, well log, site plan, water sample analysis, and a survey of the proposed structure on this lot. Based upon the information, submitted 'there is insufficient information in which to complete a review for the requested waiver. In order for this Department to complete its review in accordance with State Drinking Water Regulations (18 AAC 80.030) the following comments and questions will need to be addressed: Additional soils information (i.e. well logs, soils percolation test, etc.) will need to be submitted for evaluation to support the requested waivers. 2. A well flow test, design calculations, and an engineered as -built of the water system under the stamp of a Professional Engineer (P.E.) verifying that the system will meet both the peak and daily demand requirements will need to be submitted to this office. 3. In reviewing the submitted information it appears that there are a total of six individual waivers required for approval of this well as a class "C" public water system. The total plan review fee amounts to S 152553.00, attached is an invoice which details this fee in greater detail. 4. A water sample analysis for nitrate will need to be submitted to this office. The submitted analysis indicated only total coliform bacteria was sampled which was satisfactory with no bacterial count. Thank you for your cooperation with this Department if there are any further questions regarding the above please do not hesitate to call. Sincerely, 69 P -311r- Michael L Environmental Engineer attachment 0 Kranich & Associ k' Consulting Engineers 9780 CARLSON RD., ANCHORAGE, AK 99507 r (907) 346-1901 ADEC Anchorage/Western District Office 555 Cordova Street Anchorage, Alaska 99501 ATTN: Michael Lu RE- L23, B3, Original Girdwood Townsite Class "C" Well 93-21-DkJ-zcY17- cq7 qe21 -WV-Z%-? -cq3 V .7 v ONNIIENTAL HEALIF-ii, f tl ! QGT 1 4 1997 R E C ICE 11 V E- D My client, Mr. Bill Schwartz of Girdwood is building a house on subJect lot and intends to rent it out. It is arranged such that the top floor can be used for living quarters with the main floor being suitable for use as an office or other commercial space. He has asked that I make application for Class C approval for his water system. As you can see by the attached site plan, there are several possible sources of contamination in the vicinity of the well which are in violation of required separation distances per 18AAC 80.030. They are: L23, B3 - Sewer service line within 63'+- of well. 75' rejV Sewer manhole in Main St. within 138'+- 160' ne.�''t Sewer Main - DIP Construction 132'+ - Ll, B3 - Cesspool within 140'+- L3, B3 - Cesspool within 120'+- -.L5, B3 - Cesspool within 94' L7, B3 - Outhouse within 118' With the exception of the sewer main and manhole in West Street, and the sewer service line encroachment on L23, all of the encroaching facilities are destined to be abandoned as the various properties connect to the new AWWU sewer system in the area. In the meantime, it appears that the usage rate those systems receive ,is rather low since the buildings they serve are.small, minimally developed single family dwellings. The. aquifer appears to be well protected from surface contamination, as there is a 16' layer of clay (from 20, to 36' depth) shown by the well log. Intake of the well is at a depth of 45'. (See well log enclosed.) In addition to the well, the water system includes a 1 HP submersible pump, a 3/4" copper water line to the building, and a 20 gallon pressure tank. The well log indicates that the well produces 100 gpm. That should easily supply the anticipated level of activity on the lot. Considering the temporary nature of the main contamination sources in the vicinity of the well and the fact that the well presently tests negative for bacteriological contaminants (analysis enclosed), I believe that granting of the required separation distance waivers will not compromise the sanitary protection of the public which might visit this structure, or the people who may chose to live there. .Due to the complex nature of this application, I have not attempted to compute the approval fee required. We will leave that to you. Owner's name, address, etc.: Bill Schwartz Box 413 Girdwood, Alaska 99587 Phone: 783-3224 If questions arise during your review of this project, please call. Sincerely, ROBERT W. KRANICH, JR. Kranich & Associates Enclosures RWKJsk CC: Bill Schwartz '* ;F � SURVEYOR'S CERTIFICATE t her certify that I am properly registered and licensed to practice toad curve surveying In the State Of Alaska ataie east 11a=t aelr 1aa°.� and that this plot presents a survey mode by me or under my directaaa ansaaaa/a a nanaaal a lost 511111a°e°0 supervision and that all dimensions 'z, and other detoils ore correct os of 0 > ALLEN MINISN May 18, 1997. \ - Y � c',!:�,. rl?. Lc a2i7 ^i YYY p ` � THIS DRAWNG IS NOT TO BE USED FORw THE ESTABLISHING OF BOUNDARIES OR )t4� THE CONSTRUCTION OF FENCES, �Ta ��9� Lot 23, Block 3, U.S,S, 1177 Originol GirdwoQd Townsite Girdwgod, Alaska NHN West Street 'repsrse ior; _ Bill Schwartz -- -^ Boundary Line - - ---- —~ — Other Boundary Lines Buildings --------------- Drivewoys — — — — — - Easements Found or Set Rebor NOTES 1, Dote of Survey. May 18, 1997. 2. Ref, Field Book: 97-01 Pg. 10, 3. Ref, Plats: U. S. S. 1177 P.C1.8ox 190768, Anchorage, Alasko 99519 _ (907) 243- 4789 /18 97 1 Minish Miniah 1"t,20' 9601 I 96041 1 OF 1 ! 0 �4Y to `'r-r�,[T� •�• ~�/lLW t�y�I" � \ _} �" f j'"4' 4 „y�� L a D''1 +� \ Lu - . 1 C 8 �4��jw f r� a rt�•6Yl 120.05, rvy t �l 0.01 120.05co 4 CD co T 120 120 eX kkell i2 41 � o kin I% 4 / Se .- ,t � t a pe) ►� pe)0 V) © 0 0 0 • � � rG t rJ 0 G i i I '— wt Schwartz Box 413„ _, Girdwood, Alaska 99537 WELL LOG GrPc'wdcci C��r��,iaL,7cw✓5�e Date Drilled: 5-22-94 Bill Schwartz Girdwood,AK. Well #1 Static Water Level 5 feet Gallons Per Minute 100 Draw Down N/A feet Total Feet of Casing 45' Type Material Drilled: 0 feet to 10 ft.Sandy Gravel 10 ft. to 20 ft. Sandy Wet Gravel 20 ft. 36 ft. to 36 ft.Clay to 45 ft. Gravel w/H20 to to to to to HEFTY DRILLING 3540 AKUI.A DRIVE ANCHORAGE, AK 99510 (907) 345-0593 RECEIVED JUN 2 41994 Municipality of Anchorage Dept. Health & Human Services (A/cc s -r- ALL -Ey (v -6-S7 .g%>T .5-&tvvr LA re, MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM PERMIT PERMIT NUMBER:SW940078 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:SCHWARTZ WILLIAM M OWNER ADDRESS:P.O. BOX 413 GIRDWOOD, AK 99587 PARCEL ID:07515346 LEGAL DESCRIPTION: GIRDWOOD ORIGINAL TOWNSITE BLK 3 LT 23 LOT SIZE: 6000 (SQ. FT.) NUMBER OF BEDROOMS: 2 THIS PERMIT: 2 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 2 DATE ISSUED: 4/18/94 EXPIRATION DATE: 4/18/95 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: PROPERTY OWNER IS RESPONSIBLE PROPOSED WELL. THE WELL MUST ANY SANITARY SEWER MANHOLE OR FEET FROM A PUBLIC SEWER LINE. FOR PROPERLY LOCATING THE BE A MINIMUM OF 100 FEET FROM CLEANOUT AND A MINIMUM OF 75 THE PROPERTY OWNER MUST SUBMIT A THE WELL MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 SURVEYED PLOT PLAN SHOWING THE EXACT LOCATION OF AND A COPY OF THE DRILLER'S WELL LOG. RECEIVED BY: ISSUED BY: JH'hl St't I i7{ PAGE 2 OF DATE: �{—�%- (`y DATE: 4'/Jq/cj¢ (Art 11044, SW'e,A-/ �3 3 a-- 2-y MUNICIPALITY OF ANCHORAGE �c�4x� Development Services Department T Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 075-153-46 Certificate of On -Site Systems Approval Expiration Date: Legal description GIRDWOOD ORIGINAL TOWNSITE BLK 3 LT 23 Site address 166 OLD WEST ST Current property owner(s) COTHREN SHANNON M & BRYAN S 5/13/2025 X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: By: e C Original Certificate Date: 5/28/2024 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 Arsenic Advisory Other COSA Approval—June 2022 MUNICIPALITY OF ANCHORAGE Development Services Department 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. 07515346 Complete legal description Girdwood Original Townsite Block 3 Lot 23 Location (site address) 166 Old West St Current property owner(s) Cothren 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: X Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ❑ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑■ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ Z Waiver Fee $ Date of Paymentel A: COSA # 6 S c 2 V P( ? Date of Payment Waiver # COSA Application—June 2022 COSA Checklist_June 2022 COSA Checklist Legal Description: Parcel ID: If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 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. 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) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank Date of pumping Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes go to bottom of effective. If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Adequacy test date Results Pass Fluid depth prior to test in Water added gal 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: COSA Checklist_June 2022 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F.ENGINEER’S COMMENTS G.CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Phone Engineer’s Printed Name Date C&M ENGINEERING CHARLES BALZARINI, PE 5/12/24 `�;• R.3p, OF \\\kLot 21 �N .�f-�t H •• rt✓ • JE*;A.Nis �••. LS -1 9 Lot 25 Lot 24 <o' �Y s House tV d1 " It /" / 9 8g x Deck Tl FqF�• . • l • •'S�� 0 15 30 ill P'QOFESSIONAOY -. 49tlh ,'' Stair Surveying US SURVEY FEET NOTES -All dimensions shown are grid bearings and ground distances, record boundaries and easements are per Plat US Survey 1177. -49th Star has conducted a physical survey of the property and all details shown on this Asbuilt Survey are correct. Under no circumstances should any data hereon be used for construction or the establishment of property lines. -It is the owners responsibility to determine the existence of any easements, covenants, or restrictions. No title research performed. AS BUILT SURVEY LEGEND 1 49th Star Surveying LLC 1 Lot 23, Block 3, Utility Pole PO Box 738 Girdwood, AK 99587 US Survey No. 1177, (907)891-6111 Girdwood AK D Telecomm Pedestal Jeremy@49thStarSurveying.com OW Well W.O. 2419 DATE: 4/18/24 SCALE: 1"=30' 5672 is ,-- Municipality of A.ncho e � •, z, � � IT* On -Site Water and Wastewater Prog a �R 0* (907) 343-7904 i S FET Y ti Certificate of O'n=Site SystemsAppr° 9C�1� Parcel I.D. 075-153-46 Expiration Date: 1. GENERAL INFORMATION: Complete legal description GIRDWOOD ORIGINAL TOWNSITE; BLOCKS, LOT 23 Location (site address) 166 Old West Street*Girdwood 99587 Current Property owner(s) Shannon Cothren 'Day phone 382-3471 Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) FT- ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 2 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 $ Waiver Fee $ Date of Payment ,3 d� 1 OU Q6 Date of Payment Receipt Number 20536 Receipt Number COSA # 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: 3 9 Zo 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 �000�OOOo 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 ��. O"' encroachments may exist that were not identified during the evaluation. The operational life of all wells QQ�P. 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 4 T (700 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 0 rey Go ess; Q can be installed on the property in the event either of the current systems fail to perform adequately in 0049 CE— 7rr 53 c�OQQ 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 p ea o party (including subsequent property purchasers) is not authorized, nor will it confer any legal right �0 �ofess"On whatsoever. �0p���� #AECC884 6. D D IGNATURE System #1 Approved for Z- bedrooms System #2 Approved for bedrooms \`llllllll((ff/r�r��f Disapproved \G�Qp�lIT1�pF Conditional approval for bedrooms, with the following ion b; WAS tit, l Original Certificate Date: �5-��t0� 20210 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 Legal Description: COSA Checklist GIRDWOOD ORIGINAL TOWNSITE; BLOCK 3, LOT 23 Parcel ID: 075-153-46 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA ❑■ Well log is filed with Onsite (or attached) Date drilled 5122M9 l Total depth 45 ft Cased to 45 ft ❑* Sanitary seal is functioning correctly Al Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 2/25/20 Static water level at beginning of test 14.0 ft. Comments TANK DATA Age o nk(s) years Tank type/m erial Measured operate fluid level in septic tank ❑ Standpipes/foundati cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA Which system tested (date installed) RC1 ❑ ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ 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: AWVVU SEWER COSA Checklist yellow sheet Structure served by this system 1 Well production at time of test 5.9+ Spm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes X No Coliform bacteria is Negative Nitrate �2. LI'3 Ymg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ©<rsenic less than MRL (ND) Collected by GEG, LTD. Date of Sample 2/25/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date Results ❑Pass For bedrooms id depth prior to test in Wate ded gal New! in Elapsed time min Final fluid depth Absorption rate gpd Any rejuvenation treatment (past 1 onths) If yes, enter date 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' NSA Community Sewer Manhole/Cleanout > 100' ❑ Yes if No ft Q Yes if No ft Neighboring Tank > 100'✓❑ Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No NSA ft Holding Tank > 100' ❑ Yes if No * ft Neighboring Absorption Fields > 100' * Animal Containment > 50' ✓❑ Yes if No ft ✓❑ Yes if No ft ft Community s > 200' ❑ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75'✓❑ 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' ❑ Yes if No ft Surface Water > 100' ❑ Yes if No ft Property Line > 5' ❑ Yes if No ft Wells on Adjacent Lots: ❑ Yes Absorption Field > 5' ❑ Yes if No ft Private Wells > 100' ❑ Yes if No ft Water Main > 10' ❑ Yes if No ft Community s > 200' ❑ Yes if No ft Water Service Line > 10' ❑ Yes if No ft �1�If se . ank is under driveway comment below From Absorption Field on Lot to: (Please enter distart tf less than required) Building Foundation > 10' ❑ Yes if ft If absorption field is under driveway comment below Property Line > 10' es if No ft Wells on Adjacent Lots: Water Main > 10' ❑ Yes if No ft Private Wells > 100' ❑ Yes if No ft Water Se Line > 10' El if No ft Community Wells > 200' El Yes if No ft ace Water > 100' ❑ Yes if No ft F. ENGINEER'S COMMENTS *GIRDWOOD ORIGINAL TOWNSITE; BLOCK 3, LOT 3 HAS A CESSPOOL PER ROBERT KRANICH, PE (SEE MOA RECORDS FOR BLOCK 3, LOT 23) THAT IS 120' FROM WELL. AWWU SAYS THAT BLOCK 3, LOT 3 IS CONNECTED BUT NOT ACTIVELY SERVED. G. ENGINEER'S CERTIFICATION o`er OF �Q 1 certify that I have determined through field inspections and review P of Municipal records that the above systems are in conformance withMOA COSA guidelines in effect on this date. �n COSA Checklist yellow sheet ffrGarn s: tE-79 3 J444�rea • � � p �� •���.c�G d o 0 %, ��_rofesslo� o #AECC884 Parcel I.D. 075-153-46 Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Expiration Date: / / a 51 6 1. GENERAL INFORMATION Complete legal description GIRDWOOD ORIGINAL TOWNSITE; BLOCK 3, LOT 23 Location (site address) 166 OLD WEST STREET Current Property owner(s) JK AK INESTMENTS LLC Mailing address Real Estate Agent 166 OLD WEST STREET Day phone 907-782-9767 JACKIE W/ GLACIER CITY REALTY Day phone 947-0494 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 2 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well © Individual ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class Well 9 Community 9 Public Water System 9 Public Sewer WaiverNariance request for: N/A Distance: N/A Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: 8/2SAS— COSA Fee $ G9 4 — Waiver Fee $ Date of Payment Wa4!t5 (5_ Date of Payment Receipt Number t7b5-3'2261 Receipt Number COSA# 05G61I-\55 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 E. Tudor Road, Suite 101, Anchorage AK, 99507-1259 Engineer's Printed Name Jeffrey A. Garness Date 02 -/Jig. 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 dates 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 on 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. The content of this report is for the sole benefit of the person/party who retained GEG. Reliance upon the information provided in this report by any other person or party, including but not limited to subsequent property purchasers, is not authorized. In short, GEG disavows any legal duty to anyone other than the person/party who paid for this report. 6. DSD SIGNATURE �1 System #1 Approved for a bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for By: bedrooms, with the followi rey:.Gareess- / f 43C,74"firlicre \Q \IV ON-SITE WATER AND yrWASTEWATER o PROGRAM co� ng stipulations:a���j �‘rtS SER dCrti The unitality of A orage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Original Certificate Date: 6-2 6-- /r 7. ATTACHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory COSA blue sheel9-1-12.cloc Nitrate Advisory Arsenic Advisory Other D. LIFT STATION Date installed "Pump on" level at Datu E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Size in gallons Manhole/Access (Y/N in. "Pump off' level - High water alarm level at in. Cycles tested Meets alarm & circuit requirements? Septic tank/lift station on lot Absorption field on lot Public sewer main N/A N/A 75'+ Sewer /septic service line 25'+ Animal containment areas 50'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout 100'+ Holding tank 75'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line Absorption field Water main Water service line Surface water Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIE II : OT TO: Property line B . oundation Water main Water service lin- Surface water Driveway, parking/vehicle storage n drain Wells on adjacent lots F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name es )7.4) Date JEFFREY A. GARNESS (Rev. 11/05) 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: GIRDWOOD ORIGINAL TOWNSITE; BLOCK 3, LOT 23 Parcel ID: 075-153-46 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 5/22/1994 Sanitary seal (Y/N) YES Total depth 45 ft. Cased to 45 ft Well Log (Y/N) YES Wires properly protected (Y/N) Casing height (above ground) FROM WELL LOG AT INSPECTION Date of test 5/22/1994 8/7/2015 Static water level 5 ft. Well production 100 g p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate 0.413 mg /L. Arsenic: N Dug /L. Date of sample: 8/7/2015 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Date installed Tank size gal. Number of Compartments _ Cleanouts (Y/N) Foundation cleanout (Y/N) _ Depression over tank (Y/N) _ High water alarm Date of pumping Pumper C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ft2or ft2/bdr System type Length ft. Width ft. Gravel below pipe ft Total depth ft' Eff. absorption - -a_ ft2 Monitoring tube Depression over field Date of adequacy test Results (Pass/Fail) For bedrooms Fluid depth in ab,or. '.n field before test in. Water added _gal. New depth _in. Elapsed T _ min. Final fluid depth _ in. Absorption rate >= g.p.d. rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date 5 ft. PUBLIC 5.8 g.p.m. Collected by: GEG. Ltd. YES 12+ in OLD WEST STREET S 61'0853" E 120.00'1 LOT 2.1 b 02 c! if) I.; Iliw In 2" o o cv 0,9 z • 25.7' 2 6 Wail )5.5 2 sroRr. //0115E ENCLOSED i5,5' 16.3, 4.0' LOT 23 S 61'08'53" E 120.00' LOT 22 NOTES: 1) BEARINGS AND DISTANCES ARE RECORD PER REFERENCED PLAT UNLESS OTHERWISE NOTED. 2) SUFFICIENT BOUNDARY EVIDENCE WAS RECOVERED TO ESTABLISH THE SUBJECT PARCEL ON THE GROUND. NOT ALL CONTROLLING EVIDENCE 15 SHOWN HEREON. 3) STRUCTURE FALLS WITHIN CURRENT ZONING STANDARDS. GRANDFATHER ZONING STANDARDS MAY APPLY. 20' BILLY'S ALLEY ROAD 1 LOT -1 1,07' 3 L()7' 6 LOT 7 % Farpoint Land Services, LLC SURVEYING. MAPPING, LAND PLANNING, GIS 1 131 E. 7Gth Ave., Suite I 0 I Anchorage, Alaska 995 I 5 ParpointAK..com (907) 522-7770 5urveyrpfarpomtak.corn PREPAR D FOR: Jacqueline Moser Glacier City Realty Girdwood, Alaska E`GEND • Recovered Monument Water Well Power pole AS BUILT OF: Lot 23, Block 3, US Survey 1177, Girdwood, Alaska SURVEY CERTIFICATION: FARPOINT has conducted a physical survey of this p operty as shown on this drawing and that the imp oven)ents situated thereon are within the property lines and no encroachments exist other than noted. ,A3rat 15118 July 16, 2015 r0,10 .11A ME r-'20' e 1:41,041, July 9. 2015 GROMMIllt SES112 Fill, KC% 119/66 EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the f ecorded subdivision plat. NOTE: Under no circumstances should any data hereon be used for the construction or for the establishing of property