The URL can be used to link to this page

Home My WebLink AboutGOLDEN VIEW HEIGHTS LT 7AGolden View H ights Lot 7A #020-042-32 Municipality of Anchorage Peg, 1 of.~_3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P,O, Box 196650 Anchorage, Alaska 99519-6650 Telephone: 543-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number:, SW990365 PID Number:. __ 020-042-32 Nam':STUART MILLAR Wastewater System: · New [] Upgrade 7301 MICHELIN STREET ANCHORAGE. AK 99518 [WEST/EAST] ABSORPTION FIELD Phone:(907) 522--2251 5 · Deep Trench ri Shatlow Trench I=1 Bed t'lMound I'lOUler LEGAL DESCRIPTION 1.2 m/s, ~ lO' MAX. au e~o~k: s,b~,~.~o,: ~.~ ~. ,~,. ~ ~ "~ ~"~ ~ ~ --'~'~' ~6~.'99/7.36 7A - GOLDENVIEW HEIGHTS 2.64-3.01 ro.nehip: -- -- -- 1 - 3 ,. 52' (2 O 26') WELL: · New I~ Upgrade 2.5 ~ 2 14 ASTM D-3034/ F-810 PRIVATE 207 r~ 70 r~ (364/383) 747 s~... OWNER INSTALL 10/6-7/1999 ALPINE DRILLING 10/7/99 41 ~ - I-' I--'--: TANK 10 ~, 207 r~ 2 SEPARATION DISTANCES · s, pua 0.o~., n $.T.F--P' From Tank Reid Station Tank GREER 150o wen 100'+ 100'+ - - 25'+ STEEL 2 s,,oco lOO'+ loo'+ - - - LIFT STATION Water Lot 5'+ 10'+ -- -- -- s~z' la ~n'~'"'-I BENCH MARK TOP OF GARAGE SLAB I~_=-~ c "~ 104.89 Inspections performed by: AWWC, INC. Dates: 2ndlSt 10/7-21/9910/6/99 I ....................... ~.~ ~j '~ ............ .... Department of Health and Human Services approval ~o, .. ........... .. R6viewed and approved by:.,~/~,.__ /~/' ~_ Dote: "~,~,o,...,o~_~.~ BUILT DRAWING PE~.~ .u.a~.: AS 020-042-32 5W990365 ~ co~] ~ ,co, aa ~ ~c . / 5 /,-- -- ~1 33.6 40.1 - f D8~ 47.9 ~4.5 - ~ C01 - 40.1 ~ 63.7 . ~1 - 51.4 52.8 [ co~~ =~.~ .~.~ / +~ co~ - s~.. ~.~ GONSOLTAHT$, lNG. '"' .,,~ .o.: .~o,~7~: ~' '~: ~ ............ :...., STUART MILER 522-2251 2 OF ~ [ ~ ess: GOLDENVIEW HEIGHTS SUBDIVISION; LOT 7A ~S-BUILT OF SEPTIC SYSTEM UPGRADE AS BUII.T 020-042-52 5W990365 = WEST TRENCH ~ TRENCH ~SI~ WATER & WASTE~TER ,. CONSULTANTS. INC.- N.T.S. ~ , ~ I ~ . .... STUART MILER (907) 522-2251 GOLDENVIEW HEIOHTS SUBDIVISION; LOT 7A AS-BUILT PROFILE OF SEPTIC SYSTEM UPGRADE cc g �QQ 'S ;� �` ooy � CG Av +� r m o W T Z -P, D 00 o n o �� .••„� G sG�•.• foo cn X _ O o o m co OD a- z-Ae Vt e m<, C >_4 n . w ET -)CD O I ® P mN C W> z — m o �or (n :O 12 =M c > D o c (/l n o5 O r-.. z 7.8� m < M X = D CO Z O D O F A m' 5a < N 0 a 40 0 N PQ Fm O O Amo 0) Uj � D� C3m (D� �.. �� -m c ^ 0 0 -C o > (A C,w o J m txl N II C/") W m p r D z FTI n Oo o �v(n O cn tli y m m N • `n N J �- X � _ Z _ , o -700 cp MM N rnrU oN oo CO N Cf7 c, o � 0 nz D O o n a C/) Doc 0 o0 r® n ® WII N N n ,., 0 m s rnrn ' 1 _ 3 o,<N n m m m �!y m o o s D m m = 0 o - .� n N D y o' o. T o C) o 0 m N Z o O no N ® O 0 ® _ ll o0 o r m o D o 0 o T m m z p 6 r i Q c ,,. D n u� m .r O D ^-"D F-0: O Q c) D 0 m 5'0 o a m o o o m Ln Nn, oc o o cnoc m aogin n � 0 no o n 0 m o zo 8-owpom � z 0 m m o m r� m(n D n *o O m D�w oo M� 2 r' m m Y I D 1� z �A1 0 D I o 1 D m z D 3 O omD N ' r® p D o o c o Mz;, x LI t (n 00 (O (n c 0 U, n 0 c r FTI D N m K rl N z WIND SONG DRIVE O O 99•tr02 M„60,20.00N F— O D 07, 99'tb02 3„60,20.00S 25' • e• Ui �QQ 'S ;� �` ooy � 1D o C) :, N w m I \lJ m o W 00 o n o �� .••„� G sG�•.• foo F— O D 07, 99'tb02 3„60,20.00S 25' • e• Ui N • �e Z OD a- z-Ae U1 e m<, _ . w _ � U ® N 0 28.1 m 0)10.1 rn 12 =M o5 O (nom 7.8� M O C) 5a N 0 a 40 0 PQ 0) 25' Rick ~ strom Mayor Municipality of Anchorage Department of Health and Human Services 825 "L" Street P~O. Box 196650 Anchorage, Alaska 99519-6650 htt p://www.ci.a nchorage.a k.us Permit Number: #SW 990365 Date of Issue: 9-30-99 Parcel Identification Number: 020-042-32 Date Started: 10;7-I~9 Date Completed~.' 10-7-99 Is well located at approved permit location?_~ Yes [--] No Legal Descripti0i~'- ~ Goldenview H,qhtslT 7 A Property ownerName & Address: Stuart Mil/ar 7301 Michelin St Anchorage, Ak 99518 Borehole Data: Depth (ft) Soil Type, Thickness & Water Strata From To stick-up 0 2 silty cobbly grave/ 2 gravelly silt 13 4 silty sandy gravel h2o 41 61 silty gravel h20 61 65 bedrock 65 207 RECEIVED JAil 05 000 Municipality el A~lGrtOrego Dept. Health & 14uman Services Method of Drilling [] air rotary [] cable tool Casing type: steel Wall Thickness: .250 inches Diameter: _6 inches Depth: 70 feet Liner Type: Diameter:__ inches Depth: Casing stieknp above ground: _2 feet feet Static water level (from ground level): 41 feet Pumping level: 207 feet after _2 hours pumping 10 gpm Recovery Rate: 10 gpm Method of Testing: airlift Well Intake Opening Type: [] Open End [] Open Hole [] Screened Start__ feet Stopped feet [] Perforations Start 4'/feet Stopped 4~5 feet Grout Type: bentonite # 8 Volume: 1 bag Depth: Start_0 feet Stopped feet Pump: Intake Depth feet Pump size hp Brand Name Well Disinfected Upon Completion? [] Yes [] No Method of Disinfection: Clorine Tablets Comments: also perforated 61 - 65' Well Driller: Alpine Drilling & Enterprises P.O. Box 110496 Anchorage AK 9951 l MUNICIPALITY OF ANCHORAGE Deparlment of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box ~96650, Anchorage, AK 99519-6650 (9O7) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Date Issued: Sep 30, 1999 Expiration Date: Sep 29, 2000 Permit Number: SW990365 Legal Description: GOLDEN VIEW HEIGHTS LT 7A Design Engineer: 0041 AK Water & Wastewater Consulta Owner Name: Stuart Millar Owner Address: 7301 Michelin Street Anchorage, AK 99518- Parcel ID: 020-042-32 Site Address: Lot Size: 36967 SQ. FT. Total Bedrooms: 5 Permit Bedrooms: 5 This permit is for the construction of: [] Disposal Field [] SepticTank [] Holding Tank [] Privy [] Private Well [] 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: Cf~?'.~"L ~.~'/'~'~,/J~ ~ Date: Da,e: Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2B ~ Anchorage ~ Alaska 99504 (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers September 21, 1999 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Well and Septic Design for Lot 7A, Goldenview Heights Subdivision To whom it may concern: The proposed 3 bedroom house will be served by a private well and septic system. Several test holes were excavated on the property. The proposed septic system will be designed around the 30 foot radii of test hole #3 and #4. Comments regarding the proposed design are summarized as follows: 1. SOILS: Attached are logs which shows the soil profile, and the percolation test results. In test hole//3, the soils below the organic layers are a SW/GW material to a depth of 10.5 feet and then transitions to a SP/GP material to a depth of 16 feet (bottom of TH#3). In test hole #4, the soils below the organic layers are a SP-SM material to a depth of 11.5 feet and then transitions to a SP material to a depth of 16.5 feet (bottom of TH#4). No groundwater was encountered during the excavation of the test holes. 2. TRENCH DESIGN: a. Percolation Rate: <1 & 3.64 minutes/inch b. Allowable Application Rate: 1.2 gallons/day/fi2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 375 122 f. Total Depth: 10 feet (max.) g. Effective Depth: 7 feet h. Width: 2.5 feet i. Reduction Factor: N/A i. Minimum Length: 30 feet long j Effective absorption area = 420 fi2 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: As can be seen on the attached topography site plan, the lot slopeSat a 15 to 20 percent running from approximately southeast to northwest; in short, there are no slope concerns. The trench is to be installed parallel to slope contours. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179, or 244-9612. Thank you for your assistancei/~] Sincerel~ ,~f[ PrUsk r~rlt NOTE: Attached is a site plan drawing, a design drawing, a topography site plan, four soils logs and a 4 page construction specification letter which are all part of the design package for this septic system. , AR_~,--,~ ~---- '~"" GOLDENVIEW HEIGHTS, LOT 6K GOLDENV]EW HEI%HTS,"LOT 4C~ C~SEPTIC / ~ i ~ -- I A-* PROPOSED SEPTIC SYSTEM ~ ! /\(SEE DESIGN, PAGE 2 OF 2) WEST CIRCLE .... V I / / / \ r-ALTERNATE SiTE ' I mJ i ~,~,, \ / ~- \ GOLDEN W c~' I +,-~, ~ o, ..... I,]- / i ~1 , ', . I - XNN ~ J It// ~PROPOSED / GO~E~ H[IG~S~ LOT ~l !.~ WELL / I I I I I I I ~IDD~ POR~ON OF ~E S ~/~, S ~/~, J N ~/~, NW ~/~, SEO. ~, T~N, R~W ~AS~ WA~R ~ WAS~WA~R CONS~T~S, ~C.~ F~ GOLDENVIEW HEIGHTS SUBDIVISION; LOT 7A, ~E OF WORK: SITE P~N FOR PROPOSED WELL LOCATION AND SEPTIC SYSTEM ~.,,~ =REP~EO FOR: PHONE NUMBER: ,~._~ '.. ......... ..' >~.~ I SC~: PAGE: J.L.M. 1 = 100' 1 OF 2 / ALTERNATE SFFE. 12' X FILTER. LI,:T STATION I I / / PROPOSED DRAINFIELDS. EXCAVATE- ~* TRENCHES EACH THAT ARE 10 ~ / FEET DEEP MAX. BY 25 FEET LONG ~- BY 25 FEET WIDE. ADD 7 FEET OF ~ I CLEAN, WASHED SEWER DRAINROCK? ~ I I INSTALL INSTALL TRENCHES PARALLEL TO ~ TH 3 I I DOUBLE ALL SLOPE CONTOURS ~ CLEANOUTS / , , ,..~ L_SEPTiC / N'~PLnl~R II ~F~ I. ~ ~ ~ 15oo GALLON ~ / NN [~MT coL,~M~I ~ / ~'-~ SEPTIC TANK \ I PROPOSEO- I \ ~, WELL ~ t / ,~/V., \ NOTE: THE CONTRACTOR SHALL HAVE THE WEST // ~ PROPERTY LINE AND THE IWO NEIGHBORING PROPERTIES' WELL RADII TO THE WEST FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO / ANY CONSTRUCTION. LEGAL DESCRIPTION: i GOLBENVlEW HEIGHTS SUBDIVISION; LOT 7A SITE PLAN~~ ............ STUART IdlLLAR }ATE:9/28/99// RAWN BY: ISCA~: PAGE: A~.O. Pro. _.~oe, o\ I GOLDEN WOOD LANE MIDDLE PORTION OF THE S N 1/2, NW 1/4, SEC. 2, 6901 PHONE )ENVIEW SUBDI WORK: PLAN FOR PROPOSED PREPARED FOR: STUART MILLAR GOLDENVIE'W LOT 6K SITE WEST CIR' PROPOSED PAGE 2 Of 3 BEDROOM HOUSE Ld LDENVIEW HI PHONE (907) 337-6179 * FAX (907) 338-3246 ISOlL LOG - PERCOLATION TEST I , LEGAL DESCRIPTION: OOLDENVIEW HEIGHTS SUBDIVISION, LOT 7A .... PE.FO.MED FOR; ~ru.~...~. ,~.'~ DATE PERFORMED: 3/12/99 ~"t ~Et '95,3. ITEST HOLE ~EPT[-I ~ - LOAM ~. ,..: :..~ .... ~ 4~IBII~II ~ GC ~ OL I 5~ILIIIRII ~,, ~;~ ~///~ CH ' 6JIFIIINII SUGH~Y BONDED ~ SC ' 7 I1~11Ull e~e ROCK.S DEPTH TO ~ I IIBII 8~ILIII FIll DRY ' 3/12/99 -[- II~IINII ~., ~/18/99 'SITE PLAN' 12 SW/GW is~B'O'H' ~ ~¢~ - I 20~ TEST RUN BETWEEN 5~ ~rT. A~;~/ ~.0 FT. co,~..TS: /'////// //{/ //~ I t r' DEPTH TO DATE 2ROUNDWATER DRY 3/12/99 DRY 3/18/99 ALASKA WATER & WASTEWATER CONSULTANTS, INC. PHONE (907) 337-6179 * EM (907) 33B-3245 [SOIL LOG - PERCO~TION TEST[ DATE PERFORMED: 3/12/99 ITEST UOL ~E~8 ~ f*"~) ~ ORGANICS ~; ~ ~P~C 4 ~M GC OL [ ~ Z ~ SW HH ~ / SLIO~LY BONDED ~ SP CH 5 ] W/SOME~ ~ G~VEL POCK~ SH OH ~ ~ ] 6 ~ AND LENSES. SC { Z 7 DEPTH TO DATE [ ~ / r¢~.~:,~oo.,,.~, GROUNDWATER [ / ~?~,>~:e DRY 3/12/99 / ~ o %0,*-~:, 3/18/99 o0' v,su * ~i~=,} <1 MIN/INCH CLOCK NET TIME WATER LEVEL NET DROP 11 ~$~ DATE READING %%,~%,: TIME (MINUTES) READING (INCHES) 12 %~ ~,;.,~,~; 5/18/99 1 4:52 -- 6" %~ ~,;.,~.,,~ 2 4:42 10 4 3/8" 1 5/8" 13 ~,~;~ 3 4:42 -- 6" __ ~ 4 4:52 qO 4 1/2" 1 1/2"-- 14~ ~ 5 5:~2 ~ 6' ~ -- · ~t~'.e 6 5:12 ~ 4 1/2" 1 1/2" 15 %¢~" Sp ~ _ 7 5:13 ~ 6" '"t~'"' ~ 5:23 ~ 10 ¢ 1/2" 1 1/2" ~S]B.O.H. 9 5:23 ~ 17~/ 10 5:33 10 4 1/2" 1 1/2" 11 5:33 ~ ~ 6" _ 18 12 5:43 10 4 1/2" 1 1/2" 19 PERCOLATION RATE 6.7 (HIN./INCH)~ PERC. HOLE DIA. 6 (INCHES) 20 PERFOMED BY A~S~ WATER · WA~ATER , ( ~ 'tJL ~} , CERTI~ THAT THIS WAS P?FORM~D I~ ACCORDANCE WITH ALL STA~/~N > ~N~ GUIDELINES IN EFFECT ON THIS DATE. DATE. DEPTH TO DATE GROUNDWATER DRY 3/12/99 DRY 3/18/99 ALASKA WATER & WASTEWATER CONSULTANTS, INC. PHONE (907) 337-6179 * FAX (907) 338-3246~;~' ~'~,'~ ~,, ' .,. [SOIL LECAL DESCRIPTION: GOLOENV1EW HEIGHTS; LOT 7A DATE PERFORMED: 8/30/99 I I '~h;.'",,_ "'.~¥ ..." o~' BEPTli ~ (feet) =:::: TEST HOLE #3 ~; ' k~,', r o f ess'~o >~=. 1 --: ~ ~ ~: ORGANICS ~ ~:?"::5 SW/OW I o I ~ z / 7 ;5~; DEPTH TO DATE ,~ ~ / z ' ;~::~":: GROUNDWATER ,~ ~ ~), DRY 8/50/99 _ :,~,;: ................. 11 -- ~ ;~; DATE READING CLOCK NET TI~E WATER LEVEL NET DROP ~;:E~: TIME (MINUTES) READING (INCHES) 12-- ~ .;4.~, 8/51/99 P=RC. XOL: ................ ',:CUR~R',~R TO ~',N3 15-- [m.4 ~, B.O.H. 17--: _B~O~~ 18-- 19--' PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) 20---~ TEST RUN BETWEEN 5.5 FT, AND 6,0 FT, PERFORMED BY A~S~ WATER · WASI~ATER. I, JEFFR~ A. OARNESS, OERTI~ THAT THIS WAS PERFO~ME~ IN ACCORDANCE WITH ALL SlAIE AND MUNICIPAL GUIDELINES IN EFFECI ON DEPTH TO DATE GROUNDWATER DRY 8/30/99 DRY 9/7/99 ALASKA WATER & WASTEWATER CONSULTANTS, INC.~ ~"'75~-~~//hF / ~7~mil 6901 DEBARR ROAD, SUITE 29 * ANCHORAGE, AK. 99504 PERFORMED FOR: STUART MIL[AR .. DATE PERFORMED: 8/50/99 [0~>..?" . ¢ E-7955 ....'" (foeu _~:=' TEST HOLE #4 ~gt~',t .......... 1 -- 0RG^NICS 0 C I ~ GH CL GC OL I / 5-'"~'' ~ SP CH I ~ 7-- ,'.'~ DEPTH TO 0 ~'oo DATE I~ ~ / z ,'~*~ GROUNDWATER~ ~ ,',* DRY 8/50/99 . ~ "%~ DRY 9/7/99 9 ~ ~%~ ~ I ""~ CLOCK NET TIME WATER LEVEL NET DROP 11 -- '~"' DATE READING ,',~ TIME (MINUTES) READING (INCHES) ~'*~%' 8/51/99 PERC. HOLE W~ PRESO~ED 4+ HOURS PRIOR TO ~INO ~% ~o· ~ 1 12:49 6" 15~,.~.%. 2 12:59 10 2 7/8" ~ 5 1/8" ~'.~ 3 1:01 6" '"~*'." SP 4 1:11 10 3 3/16" 2 13/1~ 15--~.~%~ 6 1:23 10 3 1/4" 2 3/4" ~% ~%' 7 1:24 6" ~8 1:34 10 3 1/~" 2 3/4" 17-- 9 1:35 6" 10 1:45 10 3 1/4" 2 3/4" 18 ~ 11 1:46 ~ 12 1:56 10 3 1/4" 2 3/4" 19- PERCOLATION RATE 3.64 (HIN./INCH) PERC. HOLE DIA. 6 (INCHES) 20~ TEST RUN BETWEEN 6.5 FT. AND 7.0 FT. COHHENTS: PERFORMED BY A~S~ WATER & WAST~ATER. I, JEFFR~ A. OARNESS, CERTI~ THAT THIS WAS PERF~M~ IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON DATE: DEPTH TO DATE GROUNDWATER DRY 8/30/99 DRY 9/7/99 MUNICIPALITY OF ANCHORAGE Development Services Department p P �' Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 020-042-32 1. GENERAL INFORMATION Expiration Date: 1p ^ 1 J-2-7— Complete ZZ Complete legal description GOLDEN VIEW HEIGHTS LT 7A Location (site address) 15801 WIND SONG DR, ANCH, AK Current property owner(s) Mailing address Real estate agent STUART & KATHLEEN MILLAR SAME 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $__675_0 Waiver Fee $ _ Date of Payment 3 I O O Q 2 Date of Payment Receipt Number 0 1 OD(00 Receipt Number COSA # O, )r 22 109 1 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm MIKE N ANDERSON, P.E. Phone 727-8864 Address 4661 NATRONA AVE ANCH AK Engineer's Printed Name MIKE N ANDERSON, P.E. Date 3-3-22 CF AAA2ti, 6� g � ER AN ``. YiYF'`�.`Y�l a WAS � •'a• � 6. DSD SIGNATURE 49TN ; System #1 Approved for 3 bedrooms System #2 Approved for bedrooms ,t '. MlChAE r<.r;: Jy„ C Disapproved `i".,•.�7=' 7 Ft .•� Conditional approval for bedrooms, with the following stipulai�� CF AAA2ti, 6� Original Certificate Date: 3^ Z D 2 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 S_t--Te � Selo+; , je r j -4t l COSA Checklist blue sheet A—d(% r ,,t C) r_1 A +"V g � ER AN a WAS &vl Original Certificate Date: 3^ Z D 2 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 S_t--Te � Selo+; , je r j -4t l COSA Checklist blue sheet A—d(% r ,,t C) r_1 A +"V Legal Description: GOLDEN VIEW HEIGHTS LT 7A If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled '0'7(99 Total depth 207 ft Cased to 70 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 12" in. Date of flow test for COSA 2123122 Static water level at beginning of test 191 ft. Comments B. TANK DATA Age of tank(s) 22 years Tank type/material S�'"II"e' Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping 3/1/22 D. ABSORPTION FIELD DATA Which system tested (date installed) 701&7/99 ❑ ALL standpipes present per record drawing Total measured depth from grade 12/13 ft (max) Measured depth to pipe invert from grade 5/5.5 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 0 gallons Comments/Deficiencies: ' west trench tested only COSA Checklist yellow sheet Parcel ID: 020-042-32 Structure served by this system Well production at time of test 6+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes FOR No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by MNA Date of Sample 2/23122 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 2123122 Results MPass For 6 bedrooms Fluid depth prior to test *12 in Water added 750 gal New depth 24 in Elapsed time 1440 min Final fluid depth 12 in Absorption rate 750 gpd Any rejuvenation treatment (past 12 months) 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' 0 Yes Community Sewer Manhole/Cleanout > 100' ft 0✓ Yes if No ft Q Yes if No ft Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' Q✓ Yes if No ft Absorption Field on Lot > 100' Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' Surface Water > 100' 0 Animal Containment i 50' 0✓ Yes if No ft ft ✓(] Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 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' Q✓ Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5' Q Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Q Yes if No ft Private Wells > 100'✓0 Yes if No ft - Water Main > 10' .' Yes if No ft Community Wells > 200'✓Q 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' p✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓❑ Yes if No ft . Private Wells > 100'[]✓ Yes if No ft Water Service Line > 10' P/1 Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION 1 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. COSA Checklist yellow sheet �.► a�' ' 49TH J ' Pic EL N. ANL`_.R:-CN -C, CE -9 , �$�rP4a tJ�.1 •t.�4 •l { A5 0 i � t W) ... DEVELOPMENT SERVICES DEPARTMENT On -Site Water and Wastewater Section www.muni.org/onsite on Septic Tank Advisory Certificate of On -Site Systems Approval #OSC 221081 Subdivision: Golden View Heights Lot 7A Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this COSA / property is 22 years old. A leaking septic tank may be"a source of contamination to the aquifer. Typical replacement costs range from $10,000 to $15,000 This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of a 16 -year-old septic tank. Mailing Address P O Box 196650 *Anchorage, Alaska 99519 6650 * www mum org , Municipality of Anch.o.rage · Development Services Department, . Building Safety DIvlsion, . -. ' On-Site Water & Wastew~te'r P~og~m' ~ ' 4700 South Bragaw SL . . .. '.' -. ..... P.0~.Box196650Anchorage0'AK99519-6650" - -, ' ........... ., · www.cLanchorage.ak.us ' · (907) 343-7904 ~' .. C'ERT'IFICATE OF 'HEALTH.., UTHORITY. APPROVAL FOR A SINGLE',FAHILY DWELLING- GENERAL INFORMATION Complete legal description OOLDENVIEW .HEIGHTS S/D; .LOT 7A. 15801 WINDSONG 'DRIVE; ANcHoRAGE, AK. 99518 : STU'ART' MILl_AR Day phone (907) 522'-2251 .7301 MICHELIN STREET;ANCH. AK,'gg518 .... Dayphone Day phone Location (site address or dire~ons) Current property owner(s) M~iling~ address' Lending agencY.- Mailing address Real Estate Agent M'ailihg address Unless othenMse requested, HAA will be held by DSD forplckup. 2,' NUMBER OF BEDROOMS: 5 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 Municlpality 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 a single family on-site wastawater disposal and/or water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a pdvate or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a pedod 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. STATEMENT OF INSPECTION BY ENGINEER, ; · ' -, :- ' ~.. ~y my .... ~" " ' " ' "'~ ' " '" ' ~ " ' "'" r~y* " "'',~ ",, ~" .,~ c~ sea/alfred hs~t,o erd..es of the. v~(ida~ ~te,~h, .~. . be/OW, I v~,~t . .' ~. ' .'. In vesfigation, based on procedures outlined in.the Health Aufllorfly A~/al Guideli~es' for ~hls 'al~iCa'~on, ~ .~ sf:ows that the on-site water supp~' an~l/or'waSt~tei' disposal system, is(are) ~af&, fur~l ;~nd adequate r the tiumbar Of b~lrooms end ~ Of structure Indicated h&i. efn..I furthe~ Verify that b~s~d on th~ ,',.. ~ Informatlon obtained from the Munlcll~altly ~)f Anch~ge flleg and frOm my lr~estlgati~n'~md lnS~on, the on-slte water S. uppl~ and/or wastewi~ter'di$ '.po~,al,~ystem Is(~Fe) In cornptiarice ~ all, ap~able M~nlclp~l, and State cooes, o,rdtnances, and regulattons ln effect at the tlme of lnstallatton -::= .:':. ' : ~: .~ 0 WA~r L~Ai~S ~ ' ' "" '" ' .Name fFlrm ' ALASKA WATER.& E'WATER,coNsu ,' iN .., . Phone,: 537-6179.:~" Address 6901 DEBARR ROAD. SUlTE,2B *..'ANCHORAGE- AK,99504 .~ '.. .... ..~ / ' Engineer's Comments: . " "~-. ~=~..,~.,~',=~%.'~.,~''' ' ' ·" .. In c°nducting thl~ evaluatk~n, AWWC, Inc. alt~npted to Pt~de'a ll~'ough,' ' '.i' ..', ?~. 'DSDGuldelines&Regulatiens. Thereportedresultsdescdbedthope#ermanceblthe . ~;' i system under the conditlons encountered et the tfme o~ the ."nd....'' dis~nces measured to readi~ Identifiable features. The operalienal life of all wells a~d '~!! ............. septic systems depend en the local soils ~onditien; ~roundwat~ levels that may'... fluctuate during the ~ and the water usag~ of ~t~ family bel..ng ~ by the system..? es~..' .' ." ....... - These c°nditi~s are outslde the ~ntrel °f the'evaluator of the system. $a~facfoo/ teat , ' · there are no hidden defects or encreachments.'AWWC, Inc. can themfere not provide. any warranly or lutore ~stimate of how long th& 'system vdll continue to meet the operational r~qulrements of the ADEC or MOA DSD. The content of thls repert ls fo~ ' , the sole beneflt of the ownor listed above. Any rellance upon or use of thls report by any : ' '" ,,the,'pe=e, or,,,m,,~,,ot eu~o,'~, no,',~l,.,:,o,',fer e~,,i,~, ~,,t~,e,-. ~.,.~.,.t [~ ,, 0 ~ .~.,-rr , - ~ Approved forJ~ bedrooms .~.,~- .... ..... - ... - . ~:.:.,ur~-$1TE -.. - ~ ,... WATER AND u~sapproveo ~ . ~ _ Conditional approval for . bedrooms, with the fllowlng stipulations~_, <3. °o PROGRAM ~'... ..",4-',~, ,. e~Zo~:"-.- ~ · . . Attachments: HAA Checklist Septic System Advlsory Well Flow Advisory Manltenance Agreements Supplemental Engineer's Reort Other Original Certificate Date:. ,,~"° ~/' &) ! Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 8oul~ Bmgaw St. P,O, Box tg6850 Anchorage, AK 99519-6650 w~w,ct~hemge.ek.us (907) 342-7~04 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: GOLOENVIEW HEIGHTS S/O: LOT 7A Parcel ID: 020-042-32 A, WELL DATA Well type PRIVATE: Date completed ~ 0/7/99 Total depth 207 fL Data of test IfA, B, or C provide PWSID~ 8anita~ seal (Y/N) YES Casedto 70 ft. FROM WELL LOG 10/7/99 41 ft, 10 g.p.m. Static water level Well production WATER SAMPLE RESULTS: Coliform ~{~ colonies/100 mi, Data of sample: 5/25/01 B. SEPTIC/HOLDING TANK DATA Well Log (Y~) YES wires properly protected (Y/N) YES Casing height (above ground) 12 + AT INSPECTION ft. ..J g.p,m, in, Nllmta aq ,I 7 mgJL. Collected by: Other bacteria ~ colonies/100 mi, AWWC. INC. Tank Type/Material Tank size 1500 gal, Foundation deanout (Y/N) YE.S, Data of pumping NEW C. ABSORPTION FIELD DATA SEPTIC/STEEL Number of Compartments 2 Depression over tank (Y/N) NO Pumper Data installed 10/6/9g- 10/7/99 . Cleanouts (Y/N) YES High watar alarm (Y/N) N/A fto Data Installedj0/e/99-~°/7/90~OII rating t~or ~redrm) 1.2 Len~h 26/26 fL Width 2.5 ft. [wEST/EAST] System type DUAL TRENCH Grovel below pipe 7/7.4 Totaldepth 12/13 ft, Eff, absorption area 747 ft~ Monltorlngtube 'rES Depres$ion over field NO Date of adequacy test NEW Results (Pass/Fail) ~ '~--b~----~'~ in, Water ac[ded,-----"'{~l,,, Now depU~ in, Fluid depl~ in absorption field before test . ~ Elapsed Time: ~ , in, Absorption rata >= g,p,d. ~,~3~nt (past 12 mo.) (Y/N & type) If yes, give data D. UFT STATION Date installed Size in gallons Manhole/Ac~~-/ at in. "Pum~ter alarm level at in. 'Pump on' level Datum ~ ..____ Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES Absorption field on lot. Public sewer main Sewer/septic sewtce line SEPARATION DISTANCES FROM WELL ON LOT TO: Septic ten.lit stefion on lot 100% 100'+ N/^ 25'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5% Pmpen*y line 5'+ Water main N/A Water eewice line 10'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'4- Water service line 10'+ Curtain drain NONE; KNOWN F. COMMENTS Building foundation 10'+ Surface water 100' + Wells on adjacent lots 100'+ On adjacent lots 100' + On adjacent lots 100'+ Public sewer manhole/deenout Holding tank N/A Absorption field 5'+ Surface water 100' + Water main N/A Driveway, parking/vehicle storage 2'+ G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspect'one end review of Municipal mcerds that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed NaF~e Date .~/go4 JEFFRE;Y A. GARNESS HAAFee$, '~OcD. oo Date of Payment ,~/-~/<:~/ Receipt Number ,.~'/~-'~, (Ray. Waiver Fee $ Date of Payment Receipt Number