HomeMy WebLinkAboutCALAIS BLK 5 LT 7Onsite File
Calais
Block 5
Lot 7
#009-035-02
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Certificate of On-Site Systems App a 6 G ,, g`'
Parcel I.D. 009-035-02 Expiration Date: " a® ^ 10
1. GENERAL INFORMATION
Complete legal description Calais Sub Block 5 Lot 7
Location (site address) 3105 Eureka St
Current Property owner(s) Susita Solo 401 K Trust Day phone
Mailing address 121 W 4th Ave #99, Anchorage, AK 99501
Real Estate Agent Chris Swires Day phone 830-0073
2. TYPE OF DWELLING:
❑ Single Family (w/wo ADU)
El Duplex
D Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 7
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well 0 Individual ❑
Individual Water Storage ❑ Holding Tank ❑
Community Class Well El Community ❑
Public Water System ❑ Public Sewer 0
WaiverNariance request for; Distance:
Received by: (ilii/14/lie/I`- l/ Date: /()/ - 3//7
COSA to be released to the engineer,unless otherwise requested by the engineer.
COSA Fee $ ?`41.£ 0Waiver Fee $
Date of Payment /0 1 zo1 rr Date of Payment
Receipt Number 6194qD Receipt Number
COSA# 00 El-q-1(-461 Co 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 Forge Engineering Phone 522-7773
Address PO Box 240773, Anchorage, AK 99524
Engineer's Printed Name Benjamin Schiller, PE Date 10-19-2017
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SIGNATUREy " �;
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System #1 Approved for 7bedrooms �s Bll ir;; i ; .moo +
System #2 Approved for bedrooms * ,y,� • 114 °
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Disapproved
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Conditional approval for bedrooms, with the following stipulations:
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PRoGRAM
By: _ ( tom--- ( Original Certificate Date: i O•-2O `I 7
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 t
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: Calais Sub, Block 5 Lot 7 Parcel ID: 009-035-02
A. WELL DATA
Well type Private If A, B, or C provide PWSID# Well Log (YIN) N
Date completed Unknown Sanitary seal (YIN) Y Wires properly protected (YIN) Y
Total depth Unkn ft. Cased to ft. Casing height(above ground) 12 in.
FROM WELL LOG AT INSPECTION
Date of test Unknown 10/18/17
Static water level ft. 25.0 ft.
Well production g.p.m. 2'6 g.p.m.
WATER SAMPLE RESULTS:
Coliform ND colonies/100 mL Nitrate ND mg/L
Arsenic 25.8 ug/L Date of sample: 10/12/17 Collected by: Forge Eng
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Public Sewer Date installed
Tank size gal. Number of Compartments Cleanouts (Y/N)
Foundation cleanout(Y/N) Depression over tank (Y/N) High water alarm (Y/N)
Date of pumping Pumper
C. ABSORPTION FIELD DATA
Date installed N/A Soil rating (g.p.d./ft2 or ft2/bdrm) System type
Length ft. Width ft. Gravel below pipe ft.
Total depth ft. Eff. absorption area ft2 Monitoring tube Depression over field
Date of adequacy test Results (Pass/Fail) For bedrooms
Fluid depth in absorption field before test in. Water added gal. New depth in.
Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d.
Any rejuvenation treatment(past 12 mo.) (Y/N &type) If yes, give date_.
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 >100'
Absorption field on lot On adjacent lots 00'
Public sewer main '75 Public sewer manhole/cleanout >100'
Sewer/septic service line >25' Holding tank >75'
Animal containment areas >50 Manure/animal excrete storage areas 100'
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation Property line Absorption field
Water main Water service line Surface water
Wells on adjacent lots
ABSORPTION FIELD ON LOT TO.
Property line Building foundation Water main
Water Service line Surface water Driveway, parking/vehicle storage
Curtain drain Wells on adjacent lots
F. COMMENTS
Static level did not drop during test, indicating water flow is limited
by interior plumbing instead of by well capacity
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G. ENGINEER'S CERTIFICATION ,vec;.••••• <<?S�!•
! certify that I have determined through field inspections and , �� :r •407�1
review of Municipal records that the above systems are in +' `i :•
conformance with MOA COSA guidelines in effect on this date. we
Engineer's Printed Name Benjamin Schiller � j^ ;;.; µ /HIS
10/19/2017 %� • a' � '
Date s40 6.4.1,11,1 �7,.h*cc 4....z.
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COSA brown sheet 10-10-12.doc
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Municipality of Anchorage
t • Development Services Department
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Building Safety Division ,
On-Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
Arsenic Advisory
Certificate of On-Site Systems Approval # OSC 171496
A Certificate of On-Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block 5, Lot 7 of
Calais Subdivision. This inspection revealed an arsenic concentration of 25.8
micrograms per liter (ug/L) for the property's well water sample. The
Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 ug/L for public drinking water systems.
While private wells are not subject to this regulation, EPA standards are
based on existing health information and can therefore be used to gauge the
relative quality of water from private wells. information on arsenic is
available from the On-Site Water and Wastewater Program website
(www.muni.org/onsite) or at 343-7904.
This advisory must be attached to all copies of the subject Certificate of On-
Site Systems Approval.
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PLOT PLAN AS BUILT X SCALE 1" = 20' GRID SW 1630 Project No. 17-406/A1
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A 11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & s o c i a f e s � ( n C . (907) 522-6476 Phone 44pppg4
(907) 522-4625 Fax oa
Professional Land Surveyors kenOlangsurvey.com a O.. A . ��
jonathanOlangsurvey.com xi
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I herebycertifythat I have surveyed the followingdescribed roe ��� , V�
Y property:rtY� �� � 40TH I� ••�
LOT 7. BLOCK 5. CALAIS SUBDIVISION (PLAT P-522) PA
Anchorage Recording District. Alaska, and that the improvements situated thereon are
within the property lines and do not encroach onto the property adjacent thereto, that
no Improvements on the property lying adjacent thereto encroach on the surveyed
%IA' KENN LAPIe� : 4�remises and that there are no roadwo s, transmission lines or other visible
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easements on said property except as indicated hereon. ¢ 101�.'ir11.-7 O
Dated this the i'�Ce, Day of bct aY)��- ` , at Anchorage, Alaska Q Q� A.'�S-5... �Q�;�p�
till
FESSIONAL'4
It is the responsibility of the owner to determine the existence of any easements, �4�Op��a
covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963