The URL can be used to link to this page

Home My WebLink AboutGLENN VIEW ESTATES WEST PH 1 BLK 1 LT 9Glenn View Estates West Phase 1 Block 1 Lot 9 #051-793-09 C' 'trr Municipality of Anchorage Development Services Department •isIT}r^j: Building Safety Division '•"f 'e On -Site Water and Wastewater Program. 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SW000369 PID Number. 051-793-09 Korot Leroy Alderman. M2C7 Const. Wastewater System: � 4 New Upgrade ❑ PO Box 670045. Chuoiak. AK 99567 ABSORPTION FIELD Phoria: Number of Badman,: Deed D Mound D Otter 4 D Deep Troth, ® Melo* Trench LEGAL DESCRIPTION Sod Katona: 0.8 GPD/FT tool Dean Porn aper grade: 5.88 Ft. Stoat Lot & .bdwemn: 1 9 Glenn View West Depth to ppe bottom from original grade: 1.86 Ft. Gavot depth Damm pipe: 4.02 FL TovneMp: Ronde: Sermon: Fe added above anginal prods: Gravel Length: Ver 0.59 FI. 40 Ft. Well: • New ■ Upgrad• Grovel roam: 5 R. Number of ansa: °Warns between Inas: 2 10 FL Cleaararaban (Pirate. A B. Cr Public Water Total Depen: L Geed n: FL real absorption ern:P 800 Fr .. errant: D3034 & F810 I7/aler. Data Drawl: Raw water Last FL InstallerDate South Fork Construction tmuuea: 11/2112000 Yew; GPM Pump Sat al: FI. Casing Magni Move crania: FL TANK SEPARATION DISTANCES •. Septic 0 Holding • S.T.E.P. 0 Other. • To From Septic Tank Absorption Field Litt Station Holding Tank PubticrPrtvate Sewer Line "'Maar. Anchorage Tank eep•"Y' 1250 Gel. Well 200'+, . 200'+ NA NA 25'+ Meunel: Steel Number r Compartments 2 811/1•120 w.l:r 100'+••'r 100'+ NA NA LIFT STATION LM ,.5'+ . 10'+ NA NA Sue. Gel. Manufacturer. •Famdelbn 5'+'T 10'+ NA NA 'Ramp on' MW al •PmV off aL In Hph water rano at „. QaM:r bre:, NA *501+ NA NA P'•°°L'•`•' E$ecac.l OrpaWona performed by •nR e known BENCH MARK Insulation over leachfield Location and Deeaipuon: Top of sauna tube Asawned tieralon. 100 FL ....E ,Et 4itamp 1 �� OF AC all .. ficit .e•......e..A 1 Inspections by: KND Engineering Dates: 1M 11121100 L. •a L performed - 2nd 11122120001 2•.. Development Services Department Approval;'- 5/zsiot Reviewed and approved by: 1 Date: %%fie 'tel _...... Afl vit eKennet CE 7Mt.t Jutivr 6 a ` � 41-4°.•eA•..,•• (Rev. 17/00) v,��.: �,` "\ '_a► JK ]D ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907) 696-6111/FAX (907) 696-8111 June 4, 2001 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Modification of sewer design — SW000369 Glenn View Estates West SID, Block 1, Lot 9 Gentlemen: At time of construction it became apparent that the best location for the septic system for the subject property would not be where originally planned because of the foundation location/elevation. Subsequently, on November 20, 2000 we dug one testhole (TH00-1) and performed one percolation test for the proposed system. The results of this test are attached. The test results did not effect the previous design calculations, and the system was installed accordingly. Water was not encountered during the excavation or monitoring and the soils were consistent with neighboring testhole data. All other items on the previous design remained the same. If you have any questions, please contact me at 696-6111 /FAX 696-8111. Respectfully submitted, IND Engineering Kenneth M. Duffus, P.E. Attachments: On -Site Inspection Report As -Built System Details/Site Plan Soils Log/Percolation Tests K D AS -BUILT SYSTEM DETAILS/SITE PLAN GLENN VIEW ESTATES I V) A -D=29.4' C -D=8.5' A -E=36.8' C -E=15.8' A -F=23.6' B -F=41.0' A -G=25.0' B -G=14.7' A -H=34.9' B -H=48.4' A -I=35.7' B -I=29.4' Permit SW000369 WEST S/D, BLOCK 1, LOT 9 PID1051-793-09 i01.3D) ot`4-c 00.8'2) -'1250 GAL SEPTIC TANK iQ<C�.OF.AL`�S �..._..... �9 I ORIGINAL GRADE ILTt LARK` PilfaA.Ta �942Z) SEWER ROCK A0• VASES t 1 r00.8 ORIGINAL GRADE (I 'LK. 1/40/1 "N 4+9.1A1o. SEWER ROCK R0' KENNET ' 'UF CE -7116 '?wtSSIOn N- PREPARED FOR: LEROY ALDERMAN M2C1 P.O. BOX 670045 CHUGAIK, AK. 99567 FIELD BOOKS Sa$CAL'° FLEMING STAK,G: FLEMING caw1co. oRA-t D40RCD: VBG KMO INC. PILE FLEMINC Ont 5/29/01 uo Nw1439 C98.2D,"*. C94.23X SCALE: NTS 44•44 tet 1 END ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 ACRD "1° 00055.0wC '0B 4s` 00055 (907)698-6111/FAX (907)896-8111 ID ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 1 Performed fon. Project: Depth 5- 7- I 8- j;it l��a 9 40 lir -Pi 10- ? 11- 12- 13- 14- 15- 16- 17- 18- 19- 20- SOILS PERCOLATION TEST Leroy Alderman / M2CI Const. — . OF Al000000%111 •�'•S9 f� is*:'4c'i L" es.so ...4 ••• S Kenne.hM. VG{{� 44 / 7116 4tJ PROFESSO Date Performed- 11/20/00 Lot 9, Block 1, Glenn View Estates West TEST HOLE # 00-1 Org - soft, black, moist SM - Loose, brown sandy silt SM/GM- sand & gravel layers w/silt, med. density occasional cobble to 1' Silt & density increasing B.O.H. HOLE PRESOAKED PRIOR TO TEST SEE ATTACHED SITE PLAN FOR HOLE LOCATION Was Ground water encountered? NO Depth to water after monitoring? DRY What depth? N/A Date? 11/27/00 Reading Date Gross Time Net Time Depth to Water Net Drop 1 11/20/00 11:45 - 7" - 2 12:15 30 min 313/16" 33/16" 3 * 1216 - 7" - 4 12:46 30 min 313/16" 33/16" 5 • 12:47 - 7" - 6 1:17 30 min 313/16" 33/16" 7 8 9 10 11 12 * Water Added Percolation Rate 9.41 (min/in) Pere Hole Diameter K' Test Run Between 3 feet and 4 feet I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial 1 r,.o pate tine) /91l07)e1Iam I 1 /9? /COP loan I I 9/oae lP-vm Date Issued: Sep 12, 2000 Expiration Date: Sep 12, 2001 Permit Number: SW000369 Parcel ID: 051-793-09 Legal Description: GLENN VIEW ESTATES WEST PH 1 BLK 1 LT 9 Design Engineer: 0070 KND Engineering Site Address: Owner Name: Leroy Alderman Lot Size: 40003 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 Owner Address: PO Box 670045 Chugiak . AK 99567 - This permit is for the construction of: Q Disposal Field Q Septic Tank 0 Holding Tank 0 Privy O Private Well O Water Storage All construction must be in accordance with: 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 (907) 343-4744 (24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Cizu Date: ,--(3-651) Date: 7-/2-00 )KN D ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 August 23, 2000 Municipality of Anchorage Dept. of Health & Human Services On -Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject New sewer permit — Glenn View Estates West S/D, Block 1, Lot 9 Gentlemen: The owner has requested we proceed forward to obtain a septic permit on the subject lot. On April 20, 1999 we dug one testhole for the proposed system. The result of the test is attached. The general slope of this lot is from east to west at a grade of approximately 3 - 6%. We have designed our system utilizing the testhole we excavated for the 3 -bedroom house, which is proposed for this lot. The lot will be served by public water. W e propose to install a 5' wide shallow trench. Water was not encountered during the excavation or monitoring. There are no public or private wells within 200' of our proposed system location except as noted. There is no surface water within 100' of the proposed system and there are no known curtain drains within 50'. We do not expect there to be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, iKN U Engineering Kenneth M. Duffus, P.E. attachments: On -Site Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test WELL & WASTEWATER DISPDSAL SYSTEM DETAILS/SITE PLAN GLENN VIEW ESTATES WEST S/D, BLOCK 1, LOT 9 )t 23 )t 22 PO PUKE WELLS WMIDI R00' Er PREPOSED SYSTEM. Ma PRIVATE WELLS VnlOI 200' 6 PROPOSED SYSTEM EXCEPT AS WW1 PC SEPTIC ITEM WITHIN R00' OF PROPOSED WELL EXCEPT AS ICIER AIL LOTS SERVED VTTH CDMIIOTY WATER IC) Im Im 1 .G7 I> 70 ), ✓x LG Lo '0 173 I< Imcl ROSS VOYLES :_AVENUE -n /1 DESIGN DETAILS 3 BDRM X 150 GPD = 450 GPD 450 GPD/.8 GPD PER SO. FT. (6.15 MIN/IN.)= 563 50. FT (563/5'(W) X .50(REF.) (4.0 GRAVEL) = 56.3 FT. TENCH USE 1 TRENCH - 57' (L) X 5' < X 4'(D) 0. Total depth of system Is . ron o'-r%Tnol grade. Total depth of gravel below distribution pipe Is '4.0' . NOTES! 1. USE 1000 GALLON SEPTIC TANK. INSULATE TANK IF <4' COVER. 2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM. 3. CONTRACTOR WILL ENSURE MAXIMUM 27. SLOPE INTO SEPTIC TANK. 4. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE MIN. 3' COVER IF REQUIRED. PREPARED PORI LEROY ALDERMAN M2 CI P.O. BOX 670045 CHUGIAK, ALASKA 99567 (907) 688-3403 Scale! 1'= 100' PAGE 1 OF 2 FIELD BOOKS CCPWrzO: owls" LANG DRA`At VBG nail LANG D'EaOTA KMD maall LANG DRG RE DATE 8/23/00 ORD: NW1459 AOAD 00055.DWG " No. 00055 END ENGINEERING 20441 PTARMIGAN BLVD. EAGLE EWER, AK 99577-8736 (907)898-8111/FAX (907)898-8111 WASTEWATER DISP❑SAL SYSTEM DETAILS GLENN VIEW ESTATES WEST S/D, BLOCK 1, LOT 9 x ) RESERVE FEIL c L.LJ :PR❑P❑SE.D. PR TH-99-9 MT cc CO >C❑ P FC❑ MARY FEILD USED 1000 GAL PROPOSED 3BDRM HOUSE PREPARED FOR' LEROY ALDERMAN 142 CI P.O. BOX 670045 CHUGIAK, AK. 99567 (907) 688-3403 FIELD 0001(5 Scale: 1'= 20' PAGE 2 OF 3 111k Escnc "" LANG IMAM VBG DThan LANG CHECKED: KMD AST LANG FIE: DA1L 8/73/00 04: NW1459 ACAD "LE` 00055.DWG a id' 00055 END ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)698-6111/FAX (907)896-8111 IIC D ENGINEER. .3 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 Performed fon Project: Depth 2- 3- 5- 6- 7- 8- 9- 10- 11- 12- B.O.H. 13- 14- 15- 16- 17- 18- 19- IIOLE PRESOAKED 20- PRIOR TO TESTING SOILS PERCOLATION TEST Arctic Devco/Turner Construction 7 If s / w% i EISS Date Performed: 4/20/99a Lot 9, Block 1, Glenn View Estates West Org/SM — soft, black, moist }Loose & soft on top w/ thin gravel & sand layers SM/GM — Med dense, gravel W/thin silt layers, dry TEST HOLE it 99-1/9 I SEE ATTACHED SITE PLAN FOR HOLE LOCATION Was Ground water encountered? NO What depth? N/A Depth to water after monitoring? DRY , Date? 05/15/99 Reading Date Gross Time Net Time Depth to Water Net Drop 1 4/22/99 2:14 - 8" - 2 244 30 min 32/16" 414/16" 3 • 2:45 - 8" - 4 3:15 30 min 3 1/16" 415/16" 5• 3:16 - 8" - 6 3:46 30 min 3 2/16" 414/16" 7 8 9 10 11 12 • Water Added Percolation Rate 6.15 (min/in) Pere Hole Diameter 6" Test Run Between 3.5 feet and 4.5 feet I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines In effect on this date. EPLANS C \\ • Municipality of Anchorage °, irr On-Site Water and Wastewater Program y;u'1 � (907) 343-7904 SAFETY Certificate of On-Site Systems Approval Parcel I.D. 051 793 09 Expiration Date: 10- 4-17 1. GENERAL INFORMATION Complete legal description Glenn View Estates West Phase 1 Block 1 Lot 9 Location (site address) 22808 Green Garden Current Property owner(s) Darrell and Melanie Zaugg Day phone Mailing address Real Estate Agent Kiera Dreher Day phone 2. TYPE OF DWELLING: 0 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 El Individual CI Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System 0 Public Sewer ❑ WaiverNariance request for: Distance: /1 10)q/ /Ec Received b / Date: COSA to be release. to the engineer,unless otherwise requested by the engineer. COSA Fee $ 55124 Waiver Fee $ Date of Payment 16/a`/g Date of Payment Receipt Number 6 15302 Receipt Number COSA# O3(J78—a& 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 C&M ENGINEERING Phone 907-854-5558 Address 20182 TULWAR Engineer's Printed Name CHARLES BALZARINI Date 10/0118 6. DSD °°�tAec�49TH =1– ##� SIGNATURE . System #1 Approved for 4( bedrooms System #2 Approved for bedrooms SHARLESBALZARIN1 V- CE-13854. • ,0 Disapproved �k ic..- • --v�� `ckiir4'pR4�ESSlCO-..7 Conditional approval for bedrooms, with the following s ? k ��-�4' ON-SITE c WATER AND m .. 03 WASTEWATER o ,0 PROGRAM Jam' i By: — Original Certificate Date: 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 X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet f . c If more than 1 septic system is on the lot: COSA Checklist# 1 of1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: GLENN VIEW ESTATES WEST#1 B1 L9 Parcel ID:051 793 09 A. WELL DATA Well type PUBLIC If A, B, or C provide PWSID# AWWU Well Log (Y/N) - Date completed - Sanitary seal (YIN) - Wires properly protected (YIN)- Total depth - ft. Cased to - ft. Casing height(above ground) - in. FROM WELL LOG AT INSPECTION Date of test - Static water level - ft. - ft. Well production - g.p.m. - g.p.m. WATER SAMPLE RESULTS: Coliform - colonies/100 mL Nitrate - mg/L Arsenic - ug/L Date of sample: - Collected by: - B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC / STEEL Date installed 11/21/2000 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) yes Foundation cleanout(Y/N) yes Depression over tank(Y/N) n0 High water alarm (Y/N) no Date of pumping 7/19/18 Pumper./Rs C. ABSORPTION FIELD DATA Date installed 11/22/08 Soil rating (g.p.d./ft2 or-Wit/dip) 0.8 System type shallow Length 2@40 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth 9 ft. Eff. absorption area 800 ft2 Monitoring tube yes Depression over field no Date of adequacy test 9/28/18 Results (Pass/Fail)pass For 4 bedrooms Fluid depth in absorption field before test 6/0 in. Water added +600 gal. New depth 13/16 in. Elapsed Time: <1446 min. Final fluid depth 6/0 in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) none known If yes, give date na D. LIFT STATION Date installed -- Size in gallons -- Manhole/Access (Y/N) -- "Pump on"level at-- in. "Pump off level at-- in. High water alarm level at -- in. Datum -- Cycles tested -- Meets alarm&circuit requirements?-- E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot -- On adjacent lots -- Absorption field on lot -- On adjacent lots -- Public sewer main-- Public sewer manhole/cleanout -- Sewer/septic service line -- Holding tank -- Animal containment areas -- Manure/animal excrete storage areas -- SEPTIC/HOLDING TANK ON LOT TO: Building foundation +5 Property line +5 Absorption field +5 Water main +10 Water service line +10 Surface water +100 Wells on adjacent lots +100 ABSORPTION FIELD ON LOT TO: Property line +10 Building foundation +10 Water main +10 Water Service line +10 Surface water +100 Driveway, parking/vehicle storage +5 Curtain drain +50 Wells on adjacent lots +100 F. COMMENTS Drainfield pipes extended above grade. septic tank pipes in watertight vaults in patio. G. ENGINEER'S CERTIFICATION .C`�oF- � ®�k „AarI certify that I have determined through field inspections and ° �� review of Municipal records that the above systems are in , C� ' . conformance with MOA COSA guidelines in effect on this date. *-• 4 9TH H *� Engineer's Printed Name Charles Balzarini Date 10/01/2018 CHARLES G BALZARINJ CE-13854 ° `� 4tt F,;-. - D PROFEss0 COSA canary sheet_2-6-15.doc Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-793-09 Expiration Date: 7 - c2 - / ( , 1. GENERAL INFORMATION Complete legal description GLENN VIEW ESTATES WEST PHASE 1, BLOCK 1, LOT 9 Location (site address) 22808 GREEN GARDEN DRIVE, CHUGIAK, AK 99567 Current Property owner(s) MICHAEL & USA GASKINS Day phone Mailing address 22808 GREEN GARDEN DRIVE, CHUGIAK, AK 99567 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: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well In Community ❑ Public Water System ® Public Sewer ❑ TYPE OF WASTEWATER DISPOSAL: WaiverNariance request for: Distance: r'1 Received by. ✓ r ' ;.1 i t,'"'� +ci COSA to be released to the engineer,unless,dt er�vise requested by the engineer. Date: COSA Fee $ 52-4 r Waiver Fee $ Date of Payment 7 I 1 #I!Y Date of Payment Receipt Number 01 3o 4 Receipt Number COSA # 05C-t'f 1331 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 ARCTERRA CONSULTING, INC. Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Phone 868-3791 7/10/14 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. 6. DSD SIGNATURE System #1 Approved for bedrooms. System #2 Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: `\�..S c��\ry�OFd ((( y��42%- __fN SITE ' AND z WATER BIVU /onpROGRAtvi IO o. � Jl/2, ))SER1`C-S."\ By: . Original Certificate Date: 7--2/-/1 Th.�� u p I tychorage 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 X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other rnca M1ow eM1 at 10-10-19 Nu. 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: GLENN VIEW ESTATES WEST PHASE 1, BLOCK 1, LOT 9 Parcel ID: 051.793.09 A. WELL DATA — PUBLIC Well type If A, B, or C provide PWSID # Well Log (Y/N) Date completed Sanitary seal (Y/N) Y Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic: ug/L Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC / STEEL Date installed 11/21/2000 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout�(Y/N) Y' / Depression over tank (Y/N) N High water alarm (Y/N) N j Date of pumping / -.� - /`1 Pumper �i� 5 C. ABSORPTION FIELD DATA Date installed 11/22/2000 Soil rating (g.p.d./ftor ft2/bdrm) 0.8 System type SHALLOW TRENCH Length (40 X 2) 80 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth 8.6 ft. (Measured 7/2/14) Eff. absorption area 800 ftp Monitoring tube Y Depression over field N Date of adequacy test 7/212014 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 18.5 / 17.5 in. Water added 750 gal. New depth 34 / 32 in. Elapsed Time: 1440 min. Final fluid depth 18.5 / 18 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date D. LIFT STATION Date installed Size in gallons "Pump on" level at _ in. "Pump off' level at _ in. Datum Cycles tested Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? in. E. SEPARATION DISTANCES - PUBLIC WATER WELL ON LOT TO: Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer /septic service line Holding tank Animal containment areas Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Water main 10'+ Water service line 10'+ Wells on adjacent lots 200'+ ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water Service line 10'+ Surface water 100'+ Curtain drain 50'+(NONE KNOWN) Wells on adjacent lots 200'+ F. COMMENTS System operating in the top half of the effective depth. Absorption field 5'+ Surface water 100'+ Water main 10'+ Driveway, parking/vehicle storage 10'+ G. ENGINEER'S CERTIFICATION I certify that l 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 KENNETH M. DUFFUS Date 711012014 COSA brown sheet 10-10-12.doc KENNETH M. D 7116 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING COSA# 336I a if°3a`v' Expiration Date: 7- 3- I �f Parcel I.D. 051-793-09 1. GENERAL INFORMATION P� Complete legal description Glenn View Estates West Phase I, Block 1, Lot 9 Location (site address) 22808 Green Garden Drive, Peters Creek, AK 99567 Current Property owner(s) Brean Robert & Michele Mailing address same Lending agency Mailing address Day phone 688-2280 Day phone Real Estate Agent Owner Day phone 688-2280 Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well TYPE OF WASTEWATER DISPOSAL: ❑ Individual On-site ❑ Individual Holding Tank ❑ ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. 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 NorthRim Engineering Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Phone 694-7028 Date 7/31/2012 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and sepjti ems are subject to these various and dynamic characteristics and are outside the control of theO � i n£ � -. evaluator of the well and septic system. � r.A=n=: CO C' Pt 491 5. DSD SIGNATURE II ,, l/' Approved for `'f' bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulationt. 050 e ter • ' Stevens W. Eng PE §F256 Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory -(YOF,44// �+�(�r�/ � ''Yn.G ? ON-SITE WATER AND vQ WASTEWATER �1 PROGRAM S Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: 8-R- /Z Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 wvvw. muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Glenn View Estates West PH I, Block 1, Lot 9 Parcel ID: 051-793-09 A. WELL DATA — Public Water Well type na If A, B, or C provide PWSID # Well Log (Y/N) na Date completed na Sanitary seal (Y/N) na Wires properly protected (Y/N) na Total depth na ft. Cased to na ft. Casing height (above ground) na in. FROM WELL LOG AT INSPECTION Date of test . na ha Static water level na ft. na ft. Well production na g.p.m. na g.p.m. WATER SAMPLE RESULTS: Coliform NA colonies/100mL Nitrate NA mg/L Arsenic: na mg/I Date of sample: na Collected by: NA B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 11/21/00 Tank size 1250 gal. Number of Compartments 2 Cleariouts (Y/N) Y Foundation cleanout (YIN) Y Depression over tank (Y/N) N High water alarm (Y/N) N Datebf pumping 1/Vic—Pumper Sanitary Pumpers C. ABSORPTION FIELD DATA Date installed 11/22/00 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.8 System type Shallow Trench Length 40 x 2 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth 6 ft. Eff. absorption area 800 fe Monitoring tube Y Depression over field N Date of adequacy test 7/23/12 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 3 in. Water added 600 gal. New depth 6 in. Elapsed Time: 60 -miry. Final fluid depth 3 in, Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N if yes, give date = D. LIFT STATION Date installed rra . _ Size in gallons na Manhole/Access (YIN) na "Pump on" level at na in. "Pump off level at na in. High water alarm level at na in. Datum ` na Cycles tested na Meets alarm & circuit requirements? na E..'SEPARATION. DISTANCES , SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot na On adjacent lots na Absorption field on lot na On adjacent lots na Public sewer main NA Public sewer manhole/cleanout NA Sewer /septic service line na Holding tank na Animal containment areas na Manure/animal excrete storage areas na SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Water main 10'+ Wells on adjacent lots 200'+ Property line 10'+ Absorption field 5'+ Water service line 10'+ Surface water 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain (None Known) Wells on adjacent lots A00'+ F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that 1 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 Date 7/30/2012 Steve Eng Off.. a g ePEAS 11 .* tS k. Steven w. Eng 4 c w/� D Ica ty Ji COSA Fee $490.00 Date of Payment X / 1 / 12 Receipt ttUmber ' °ItQ wI oZ (Rev. W05):. Waiver Fee $ Date of -Payment.. Receipt Number 0 co a0C� .0 'a.O OrPVyOU� �g 9OJ o 24 106 CD�yOwL LccTE.E C U> C C ....g..,...—wC•O p Op 'O' 0 0 O O C C G 9 C e O 2 E W u° 0 0 0 0 O v 0 ea€� °r g Cl/C ,▪ u,P,v 0'0 4410 o« ~O >.°o c 0 a ° u 0oa '3 o a a v`o z aaoa u u o w5 (a) 96'991 3,29,90000 S N 00) CO z (W) .aI'L91 M46,91000 N 0 N ,Ci S 4 0 .at O a a 1N3W3SV3 381 ,9 ,00'Lt 1 41,99,900 N SONIW39 dO MVO , .(W'9 8) ,6£'19£ M489,90000 N 15' T&E EASEMENT ,b'£9 6'9L 2 N w SLOPE 8 T&E w ~ 0 ' 3 N N 1 3— cn uw z z m—>g 5 a o w w 3- N OJ co a 02 2i LU 110 I NN U.1 U.1 oa I w ee r mm z z > I 0 cc 3AI2ia N34UV0 N33219 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel ID 051-793-09 1. GENERAL INFORMATION Complete legal description I Glenn View Location (site address or directions) HAA#19-1�/d Expiration Date• 7 "/ c - 0 est Block 1, Lot 9 Current Property owner(s) M2C1Day phone Mailing address PO Box 670045 CHUGIAK, AK. 99567 ' .'h. Lending agency Day phone Mailing address Real Estate Agent Mailing Address, •.7 Day phone •. Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well • Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank;;; Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates 'of Health Authority Approval (HAA) based only upon the representations given in paragraph.5,by. an ,independent professional civil engineer registered in the State.of Alaska Certificates"of,•Health Authority"Approval are, required for the transfer.of title (except between. spouses) for properties served by: single family on-site wastewater disposal and/or water supply system. DSD also -issues HAAs;"upori`. request` to; homeowners: Certificates of Health Authority Approval .are valid .for 90, days frodate' of issue for properties served by a private or Class C well and maybe reissued with new water sample results less than 30' days old. (Certificates may be reissued for a period of up,to one year with valid water samples:) Certificates are valid *.one year for properties served by Class A or B wells or a public water system.' The Municipality' of Anchorage is not responsible for errors or omissions in the professional engineer's work. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St.' P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. WELL DATA Well typ,! IPU_ BL.i Date''completed -_ Total delplth I1!1; Date,of;test Static water level If A, B, or C provide PWSID # Sanitary seal ° (YIN) ft. Cased to _ FROM WELL LOG arcel ID 051-793-09 Well Log (Y/N) Wires properly protected (YIN) is • , Casing height pbove'ground) AT INSPECTION; ft. Well g.p.m `production WATER !SAMPLE RESULTS: IL!11I! Coliform' '1 colonies/100 ml. Nitrate Collected by: _I iii il: Date of Mille: e B. SEPTICIHOLDING TANK DATA 1 ;1, L Tank Type/Material SIEE 1 I is Tank size 1250 cal. I Number of Compartments 2 Date installed 1! 0 ► I , iE i not Cleanouts` 1LFoundation cleanout Y Depression � over tank N High water alarm 1 i II ; I I. Pumper Date oflplumping C. ABSORPTION FIELD DATA II t' UstaIIed._i.iiZ2LZ.QQ d./2 or ft2ldrm) System type SHALLOW TRENCHDae ';il rating ; (9•P• � ft !I' . ✓3C1 ! ft. Gravel below: pipe 4 0 2 Length, I`'40 x—ftWidth 5' ► I' Total depth 5.88 ft. Eff. absorption area 800 ft� Monitoring tube Y Depression over field N Results (Pass/Fail) ' ' For bedrooms i in. In. Water added gal. New depth Absorption rate >= g.p.d. ' i If yes, give date mg./k. , Other bacteria _• ft. g.p.m. colonies/100m1 E Da�Ie 'of adequacy test Ijt III .i. Fluid ';deptl1 in absorption field before test III! I !I • • ming Final fluid depth Elapsed Time: , , Anylrejuvenation treatment (pest 12 mo.) (Y/N & type) I` II In.