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Home My WebLink AboutTUXEDNI PARK BLK 1 LT 11Tuxedni Park Block 1 Lot 1 1 #041-022-13 ~'" MUNICIPALITY OF ANCHORAGE ('~'~ DEPARTN~ENT OF HEALTH & ENVIRONMENTAL PR0~ECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264~720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ' NAME~ ~ : .,PHONE I ~EW LEGAL DESCRIPTION LOCATIOn' BEDR~MS ~ Z Manufacturer l Eiq. ~apacity in gallons Inside length Width Liquid depth ~ O ~ O IF HOME,DE: ~ ~ ~ ~ ~ DISTANCE TO: Well .~ Dwelling PERMI~ ~ ~ ~ Manufacturer Material Liquid capaci~in gallons ~ ~ell : Foundation Nearest lot line PERMIT N ~ ~ ~ No. of lines Length of each~n~ t Total lengt f e l. ~ ~ ~ ~ ~ Trench width~w., inches Distance b nes ~ ~ Top of tile to finish grade Material beneath tile Total effecti ' O ~' ~ ~ inches v~rpSo, area Length Width Depth PERMIT NO. ~--q ~ Type of~ r ~. Crib depth ... Total effective absorption are~ ~.. ~ ~TANCE TO: Well ~ .... Building foundation Nearest lot lin ~ ~ Cla~ Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tan~ [~ ~ Absorption area~ OTHER PIPE MATERIALS ~ ~ ~ SOl L TEST~A~I N~ INSTALLER _ 72-013 (Re~. 3/78l I"1 L! 1'-4 I ;] I ~ L ir T '-r' "D !--- F~ I'-.I C:. I--! f'"']~;.' l~ ~..]i E DEPFlF.:TMENT OH~-HEFtLTH FIND ENVIRONMENTFIL F'r,oOTECTION ,-,~,.- STREET, 264-4720 ~:,~'-.I--S I TE SEI.,.IEF-: F"EF-:£,I I T F'EF.:MIT NO. ( 790291 ) TOM BESH COPPEF.: DF.: Lid B'I. TU;-::EDNI FHRg. S,-"[:, FlF'PL I CRNT LOCRT I ON LEGRL _~:0±'1 N. 3:1ST R',/E LOT SIZE 682:64 SQURF.:E FEET T~r'F'E OF SOIL RBSORE:TION SVSTEM IS' TRENCH MR,.,IrlUM NLIME:ER OF E:EDF.:OOMS = _~: 'SO I L F.:FlT I NG ( S.¢..! FT,/BR) = 125 THE REQUIRED SIZE OF THE SOIL FIBSOF.:PTION S'¢STEM IS- [:,EF'TH= 12 LE~-4L3TFI= '~:: ::: L~ F-: R '...' E L C, EF'TI4= 5 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OF.: DRFIINFIELD. THE DEPTH OF Fl TRENCH OR PIT IS THE DISTFlNCE BETI4EEN THE SLIRFFICE OF THE GROUND FtND THE BOTTOM OF THE EXCFlVFlTION (IN FEET). THERE IS NO SET NIDTH'FOR TRENCHES. THE GRFlVEL DEPTH IS THE r'IINIMUM DEPTH OF GRR',.,'EL 8ETNEEN THE OUTFFlLL PIPE FIN[:,,:THE BOTTOM OF THE EXCFI',/FITION (IN FEET). -.. E ~_---., Ij I !-4.: E [:' S E F' T I L--: T R I%! I-:: S I Z E = 1 ~-]~ ~-_--'~ ~:'~ ~-'~ R L C El l'-.! S F'ERMIT RF'F'LICRNT HRS THE RESPONSIBILITY TO INFORM THIS [)EF'FIF.:TMENT DLIF..:ING THE INSTRLLRTION INSPECTIONS OF RN'T' NELLSRD,TRCENT TO THIS PROF'ERT'T' RND THE NLIMBER OF RESIDENCES THRT THE 14ELL NILL '-']ERVE. -- -- -- T I-.J ~-~ ," 2 ."-. I I"-.i :~ F' E ~-: T T U--I !'-.I :5 R F-: E F-: E _¢--! IJ I F-: E C, E:RCKFILLING OF FiNer' S'T'STEr,1 HITHOUT FINRL INSF'ECTION RND RPF'ROVFIL E:'¢ THIS DEF'FlRTMENT N ILL BE SUBJECT TO F'ROSEC:LITION. I'tlNIMUfl DISTFtNCE BETHEEN Fl ldELL FIND RN'¢ ON-SITE SEI4RGE DISPOSFIL S"r'STEM IS ±E~O FEET FOR Ft PRIVFlTE NELL; OR 15¢r~ TO 20E'~ FEET FROM R PUBLIC NELL DEF'ENDING LIPON THE T"r'PE OF PUBLIC NELL. OTHER REQUIREMENTS f'IFIV RPF'L"r'. SPECIFICRTIONS RND CONSTRUCTION DIRGRFlMS RRE RVRILRBLE TO INSURE PROPER INSTFlLLRTION. PERt-11 T 'E:=-,-IF' I RE:5 E-,EC:-Er,IBEF; ---=:1.. 1L:~.. 7~-~-- '-- I CERTIF'T' THRT ' 1: I Rf'l FRMILIFIR WITH THE REQUIREMENTS FOR ON-SITE SENERS RND NELLS RS SET FORTFI B'¢ THE MUNICIPFtLIT'¥' OF RNCHORRGE. 2: I HILL INSTFlLL THE S~r'STEr'I IN RCCORDRNCE HITH THE CODES. 2:: I UNDERSTFlND THRT THE ON-SITE SEHER S'¢STEM f'lR~r' REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED 70 INCLUDE MORE THFtN _'2: BEDROOMS. S I GNED · I SSLIED PERFORMED FOR: ' SOILS LOG · 212 E. INTENTIONAL AII?ORT ROAD' · ANCI'I~,~GE, ALASKA{99502 'P,~.O..~.'P ONE~: ~~ LEGAL DESCRIPTION: 1 2 3 4 5 6 ~7 9 10 11 13 14 15 16 17 18 19 2O COMMENTS' PERFORMED BY: I-I PERCOLATION TEST· .' ' ' SLOPE 51TN PLAN .' ~'.' 1 .... T'--T-" { .............. I .... t .... ~'~ ............ ~__ "' -..4 ...... ~ .... ~- I ~--~' .... ~-'~-" .... ' ' '' ! I : i , ~ , / I~ ,. ~., ~- ~ ...... i ---:, .... ] .... ~--'~-~'~-~" ~ ~ ' , ~~ i'~/I I I ~ ........ ~~___~ .... l_l /. t_.] ..l ..t._.~__.~..~ .......... I ...... I ~'~? WAS GROUND WATER ~.,~ ~..1~./ ENCOUNTERED? IF YES. AT WHAT E DEPTH~ Gross Net Depth to. . Net Reading Date Time Time . Water ' ; Drop :OLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT. CERTIFIED BY:~dATE:. ,~"./-~'~. . ..,-- ~. 72.0O8 (71761 PERMZT NCI. I-'l I_I I"-! I I_-: I ~ I__ I T "r' '] F Ft l'-,I C: I-! '5: Fi ,] E DEPBRTMENT OF HERLTH FIND ENVIRONr'ENTRL P,--..-,TECTION 825 'L' STREET, RI".ICHORRGE¢ FI;.{. 9950i 264-4?20 L.-IELL F'ERr-1 I T ?90102 ) RPPLICRNT LOCRTION LEGRL TOM BESFI COPF'ER DR L Ii B 1 T~XIDNI F'RRt.'.' NEST ~iST LOT SIZE 2?7 g7t9 6900 SQLIRRE FEET MINIMUM DISTFINCE BETNEEN FI NELL RND RNY ON-SITE SENRGE DISPOSRL SYSTEM IS 100 FEET FOR R PRIVRTE NELL; OR 150 TO 200 FEET FROM R PUBLIC NELL DEPENDING UPON THE TYPE OF PUBLIC NELL. NELL LOGS FIRE REQUIRED RND MUST BE RETURNED TO THE DEPRRTMENT NITHIN ~0 DRYS OF THE NELL COMPLETION. OTHER REQUIREr,IENTSiMRY RPPLY. SPECIFICRTIONS RND CONSTRUCTION DIFIGRRMS FIRE FIVRILRBLE TO INSURE PROPER INSTRLLRTION. PERM I T E::-(F' I F.'E$ D, EC:-Er, IBEF.' '~--:1.. 1'__-~- ?::~- I CERTIFY THRT 1: I RM FRMILIRR NITH THE REQUIREMENTS FOR ON-SITE SENERS RND NELLS RS SET FORTH BY THE MUNICIPRLITY OF RNCHORRGE. 2: I MILL INSTRLL THE SYSTEM IN RCCORDRNCE NITH THE CODES. SIGNED: ~_. ~ RF'PLICRNT~Ohl 8ESH ~,,Je_~l Lo? Zeve./ 3 7 ,c'-,/- aT- I..~ CPLftNS • • oc e� •; ,� Municipality of Anchorage t = On-Site Water and Wastewater Program (907) 343-7904 SA [T. Certificate of On-Site Systems Approval Parcel I.D. 041-022-13 ,1 Date: (- 04, ^ I 1. GENERAL INFORMATION: ► Complete legal description Tuxedni Park:Block 1,Lot 11 Location (site address) 9721 Copper Drive*Anchorage,AK 99507 Current Property owner(s) Steve&Stephanie Walker Day phone 830-2128 Mailing address 9721 Copper Drive*Anchorage,AK 99507 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 El 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 (p/1 q /(9 Date of Payment Receipt Number o a 7-6 Receipt Number COSA# 0 5 C 16? / 4-/(.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. 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: (v 1/ t S 11°7 In conducting this evaluation,GEG provided an engineering evaluation of the well and/or septic system <. 0 �,%lir in accordance with the guidelines and regulations established by the Municipality of Anchorage and 4�c>..• 4(o)� industry practices. The reported results describe the condition of the system/s on the date/s of the '`i•-•,• `1),, evaluation. Separation distances were measured to readily identifiable features. Hidden defects or (�� N.,7 !+ encroachments may exist that were not identified during the evaluation. The operational life of all wells /J * r) and septic systems depend upon a variety of variables, including but not limited to. soil conditions, "" .. •" .. '•.. ""'.""' v' 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 VP-� V are outside the control of GEG. Satisfactory test results do not guarantee future performance of the ey �ff'' �S5,• �/ system/s: therefore, GEG makes no warranty(express or implied)regarding the future performance of vi1 r CF yq ,,, the well or septic system. GEG makes no representation whether an alternative well or septic system lir / 0J can be installed on the property in the event either of the current systems fail to perform adequately in 4..b. . 11-,,, ,,,, the future. The content of this report is for the sole benefit of the person/party that retained GEG to ,Lp�''or�ss• n v perform the evaluation. Reliance upon the information provided in this report by any other person or ��`.."0* c� party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE 3 ``lllltll(((f((" �(/ System#1 Approved for bedrooms �`�_`\'(Y OF,Q , System#2 Approved for bedrooms `�G�QW Q.Q�� Disapproved WA ERON-SI TE AND ` r" Conditional approval for bedrooms, with the followg5tip Iir WATER 1 PROGRAM ate` i^.'TJ7-iC�t v\C `,1� 1�)'))))SER1 \'1 1 0 By: \ V.......\::::,S Original Certificate Date: 7.S i 9 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 7 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other CASA blue sheetl0-10-12.doc COSA Checklist Legal Description: Tuxedni Park; Block 1, Lot 11 Parcel ID: 041-022-13 If more than 1 septic system on lot: COSA Checklist# of Structure served by this system A. WELL DATA 0 Well log is filed with Onsite (or attached) Well production at time of test 7+ qpm Date drilled 5/23179 Water storage tank volume n/a gallons Total depth 78 ft Well disinfected for coliform test? ❑Yes 0 No Cased to unk ft ❑t Coliform bacteria is Negative [=]Sanitary seal is functioning correctly Nitrate 4.2 mg/L ❑ Nitrate less than MRL (ND) Wires are properly protected Arsenic ug/L ❑■ Arsenic less than MRL(ND) Casing height(above ground) 12+ in. Collected by GEG, LTD. Date of flow test for COSA 6/10/19 Date of Sample 5/29/19 Static water level at beginning of test 32.1 ft. Comments B. TANK DATA C. LIFT STATION Age of tank(s) 13 years 0 Required maintenance completed Tank type/material """"' Age of lift station years Measured operating fluid level in septic tank 51" Lift station material 0 Standpipes/foundation cleanout per record drawing Comment Date of pumping 5/6/19 D. ABSORPTION FIELD DATA Which system tested(date installed) 1979 Adequacy test date 6/10/19 ALL standpipes present per record drawing Results ❑✓ Pass For 3 bedrooms Total measured depth from grade 12.3 ft(max) Fluid depth prior to test 3 in Measured depth to pipe invert from grade *6.1 ft(min) Water added 671 gal ❑ N/A—pressurized field New depth 48 in Monitor tubes go to bottom of effective. If not, state Elapsed time 1310 min depth into effective 0 Code-required soil cover over field Final fluid depth 12.5 in • Absorption rate 450+ gpd 0 System presoaked (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) no date of test) Gallons introduced n/a gallons If yes, enter date - Comments/Deficiencies:•at sump-data shown is for the 1979 trench.The 2006 trench was found to be surcharged on 5/30/19.Owner had A.Home services diven flow to 1979 trench on 5/30/19.The 2006 trench was not evaluated. 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 0 Yes if No ft Neighboring Tank> 100' 0 Yes if No ft Private Sewer/Septic Line>25'ii Yes if No ft Absorption Field on Lot> 100' 0 Yes if No ft Holding Tank> 100' 0 Yes if No ft Neighboring Absorption Fields > 100' Animal Containment> 50' CI Yes if No ft 0 Yes if No ft Manure/Animal Excreta Storage> 100' Community Sewer Main> 75' 0 Yes if No ft [CI Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations> 10' E3Yes if No *5+'.i., ft Surface Water> 100' Q✓ Yes if No ft Property Line > 5' El Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Q Yes if No ft Private Wells > 100' ✓❑ Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells>200' p✓ 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' 0 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 > 10' 0 Yes if No ft Private Wells > 100' 0 Yes if No ft Water Service Line> 10' 0 Yes if No ft Community Wells>200' 0 Yes if No ft Surface Water> 100' 0 Yes if No ft F. ENGINEER'S COMMENTS *Met code at time of installation oo�oo�~O G. ENGINEER'S CERTIFICATION oo OF AI C N 1 certify that 1 have determined through field inspections and review ‘0,1‘0,17‹,, . •• `j1_.••5��00 of Municipal records that the above systems are in conformance with 0* ,, 9 TH /\ Tv 00 MOA COSA guidelines in effect on this date. 0QO s • • —7* .- 11111111P c�Q�O �4�PP ••'f•�3. 1cc'% COSA Checklist yellow sheet %4°'1r0 f e s si°11.,_... .' � #AECC884 �DOp��Q ' I LI-,~TI~ RECEIVED ~,~'~, ~ .: . iNsPECTiON APPr~I~'rM;-~TS:,. ,., ,,,. ~.,,, TIME TIME TIME q - ,,--,, ,4<,,4,, ,*. DATE ~ DATE DATE ,. I1-~-"1~ t.rs ' , I NS PF-.M~TO R : INSPECTOR INSPECTOR /)_ ./I DEPARTMENT OF HEALTH & ENVl RONMENTAL!PROTECTION ........ ~.~ ION 825 L Street - Anchorage, Alaska 99501 j !, NOV 1 1979 ENVIRONMENTAL SANITATION DIVISION :: ....... Telephone264-4720 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER ~FACiLITIES DIRECTIONS; Complete all parts on page 1. incomplete requests will not be processed. Please allow ten (10) days for processing. MAI LIN6 ADDRESS PROPERTY RESIDENT Jif different from above) I PHONE ~ · J 2. BUYER ; PHONE MAILING ADDRESS j 3. LENDING INSTITUTION J u v ~ PHONE 4. REALTOR/AGENT ! PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION ~ I HEET LOCATION 6. TYPE OF RESI~NCE NUMBER OF~BEDROOMS ~ SINGLE FAMILY ~ One ~ ~ Four D Other ~ Two ~ Five ~ MULTIPLE FAMILY ~ Three ~ Six INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY 8. SEWAGE DISPOSAL S¥~iEM [] INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY ATTACH WELL LOG. A Well log is required for all wells drilled since June 1975. For wells ~lrilled prior to that date, give well depth (attach log if available.) ~,~. / ~.f~ /~ ~ ~ YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. ....... THIS. SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE r-I SINGLE FAMILY [] MUL'~IPLE FAMILY [] ONE [] TWO 2. WATER SUPPLY [] INDIVIDUAL [] cOMMUNITY [] PUBLIC UTI LITY Connection Verified NUMBER oF BEDROOMS [] THREE [] FOUR [] FIVE [] SiX [] OTHER >ERMIT NUMBER DEPTH OF WELL, DATE DRILLED LOG RECEIVED 3. SEWAGE DIsPoSAL SYSTEM []INDIVIDUAL/ON -SITE [] PUBLic UTI LITY Connection Verified []Septic Taj~ .k..or [] Holding Tank Size: f~)c'Jr'J If Tank is homemade give dimensions: )ERMIT NUMBER DATE INSTALLED , i ........ INSTALLER SOILS RATING TYPE OF TANK · MANUFACTURER TOTAL ABSORPTION AREA . - , MATERIAL 4. DISTANCESwELL TO: Septic/Holding Tank IAbsorption Area 1Sewer 'ine INearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS DATE ~ APPROVED FOR.~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED 72-010 (Rev. 6/79) Municipality Anchor e POUCH 6-650 ANCHORAGE, ALASKA 99502 {907) 279-2511 GEORGE `CL SULLIVAN, ,CfA ¥OR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (825 "L" Street} November 5, 1979 Thomas K. Besh 3011 West 31st Avenue Anchorage.. Alaska 99503 Subject: Lot 11 Block 1 Tuxedni Subdivision Approval for your individual sewer and water facilities can not be granted until the follbwing items have been completed: (1) A well log submitted to this department. (2) The water analysis report be delivered to this office from Chem Lab, 5633 B Street, for our review. If there are any further questions, please contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: First National Bank of Anchorage Mortgage Loan Department Post Office Box 3128 99508