HomeMy WebLinkAboutMOUNTAIN VIEW BLK 11 LT 4 S3 W2
Mountain View
Block 11
Lot 4 S3 W2
#004-036-36
MUNICIPALITY OF ANCHORAGE
Development Services Department r' Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Parcel I.D. 004-036-36
Certificate of On -Site Systems Approval
Expiration Date: YLS -Z" 1.3
Legal description MOUNTAIN VIEW BLK 11 LT 4 S3 W2
Site address 425 MUMFORD ST
Current property owner(s) KELLY CLARK
X The On-site system(s) is/are approved for 2 bedrooms
Conditional approval for
Comments or advisories:
bedrooms, with the following stipulations:
By: Original Certificate Date: S
3/ 23
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
MUNMPAUT 1( OF ANCHORAGE U5
C..,; {
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. 004-036-36
Complete legal description Mountain View Block 11, Lot 4 53 w2
Location (site address) 425 Mumford St. Anchorage, AK
Current property owner(s) Kelly Clark Day phone
2. ON-SITE SYSTEMS SIZED FOR 2 BEDROOMS
3. TYPE OF WATER SUPPLY: ® 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 $ q q26' Waiver Fee $
Date of Payment
COSA # O S G 2"F 1173
Date of Payment
Waiver #
COSA Application—June 2022
Legal Description: .
COSA Checklist
Mountain View Block 11 Lot 4
Parcel ID: 004-036-36
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 11950' Total depth 45.8+ ft
Cased to Unk ft
✓❑ Sanitary seal is functioning correctly
❑✓ Wires are properly protected
Casing height (above ground) 18 in.
Date of flow test for COSA 5/17/23
Static water level at beginning of test 42 ft.
Comments *Per previous COSA
DATA
Measured operating fluE tic tank
Date of pumping
❑ Required maintenance completed, if AWWTS
Comments:
. BSORPTION FIELD DATA
Which s em tested (date installed)
❑ ALL standpl present per record drawing
Total measured depth grade ft (max)
Measured depth to pipe inve L m grade ft (min)
❑ N/A - pressurized field.
❑ Per record drawings, field is insulat
❑ 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
Comments/Deficiencies
COSA Checklist June 2022
Well production at time of test 3.3 qpm
Water storage tank volume NA gallons
Well disinfected for coliform test? ❑ Yes 0 No
✓❑ Coliform bacteria is Negative
Nitrate 1.52 mg/L ElNitrate less than MRL (ND)
Arsenic ug/L ✓❑ Arsenic less than MRL (ND)
Collected by Arcterra Consulting -
Date 5/15/23
C. LIFT STATION
❑ Required maintenance completed
A e of lift station years
Lift station ma
Comments:
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
LD STATUS - POST RECOVERY
Effecti depth (per record drawings)
Effective dep sed in
Effective depth rema in
In
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'
Building Founda _ 10'
❑ Yes
Community Sewer Manhole/Cleanout > 100'
❑ Yes
if No
NA ft
❑✓ Yes
if No ft
Neighboring Tank > 100' 0 Yes
if No
ft
Private Sewer/Septic Line > 25'✓❑ Yes
if No ft
Absorption Field on Lot > 100' ❑ Yes
if No
NA ft
Holding Tank > 100'✓❑ Yes
if No ft
Neighboring Absorption Fields > 100'
❑ Yes if No ft
Water Service Line > 10'
Animal Containment > 50' Q Yes
if No ft
✓❑ Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' F-1 Yes
if No
65** ft
Q Yes
if No ft
❑ N/A — Served by Community Well (not on lot) or Public Water
SepticlHolding Tank and Absorption Fields) on Lot to: (Please enter distances if less than required)
Building Founda _ 10'
❑ Yes
if No ft
Surface Water > 100'
❑ Yes if No ft
Tank to Property Line > 5'
if No ft
Wells on Adjacent Lots:
Field to Property Line > 10'
❑ Yes
if No
Private Wells > 100'
❑Yes if No ft
Water Main > 10'
❑ Yes
if No ft
Co I Wells > 200'
❑ Yes if No ft
Water Service Line > 10'
❑ Yes
if No ft
If tank or field is under '
comment below
F. ENGINEER'S COMMENTS
** PerAWWU record drawings, previously approved.
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 Arcterra Consulting Phone (907)-696-6111
Engineer's Printed Name Kenneth Duffus Date `f 3t 4 S
Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. . -0,
TheOF
The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The + L
flow and absorption rates may change due to subsurface conditions that may not be observed from the �t
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. �` KENNETH M
♦ CE t t
y' ■
COSA Checklist June 2022
•
• E au
•EtcA Municipality of Anchorage
On-Site Water and Wastewater Program 4 WM
(907) 343-7904
Certificate of On-Site Systems Approval
Parcel I.D. 004-036-36 Expiration Date: 2-- -- f CJ
1. GENERAL INFORMATION:
Complete legal description MOUNTAIN VIEW; BLOCK 11, LOT 4
Location (site address) 425 Mumford Street*Anchorage 99508
Current Property owner(s) Vanessa Lincoln Day phone 227-4228
Mailing address
Real Estate Agent Day phone
2. TYPE OF DWELLING:
El Single Family (w/wo ADU)
® Duplex
El Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 2
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ® Individual El
Individual Water Storage ❑ Holding Tank ❑
Community Class_Well Cl Community ❑
Public Water System ❑ Public Sewer
WaiverNariance request for: Distance:
Air
Received by: — r - Date: It ' 1
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 5-94, Waiver Fee $
Date of Payment it 17 0- Date of Payment
Receipt Number 1 ((7 Receipt Number
COSA# 8'3C 12/5 2-2- 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: "1 ! -41 q-
,,,:::. ; ,. .‘‘,..,q-
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4Qdoo4D
In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system /.Q
in accordance with the guidelines and regulations established by the Municipality of Anchorage and .0�' .••`��Qt\
industry practices. The reported results describe the condition of the system/s on the date/s of the O 1
evaluation. Separation distances were measured to readily identifiable features. Hidden defects or " 1j• 'i % ��//�
encroachments may exist that were not identified during the evaluation. The operational life of all wells �j rr :' 4 q�J ' .•.37 V0
and septic systems depend upon a variety of variables, including but not limited to, soil conditions, i 11/J i
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 Q •,Jf r y Aness: ie
system/s; therefore, GEG makes no warranty(express or implied) regarding the future performance of Q 'v G'
Q ;; • CE-7953- p
the well or septic system. GEG makes no representation whether an alternative well or septic system 1J I • �c$'Q
can be installed on the property in the event either of the current systems fail to perform adequately in �4 i4..�.r ��°o
the future. The content of this report is for the sole benefit of the person/party that retained GEG to 40eaprofess+O"°oQ
perform the evaluation. Reliance upon the information provided in this report by any other person or OD400�poa
party (including subsequent property purchasers) is not authorized, nor will it confer any legal right
whatsoever.
#AECC884
6. DSD SIGNATURE
YSystem #1 Approved for 2- bedrooms s„0.,:;‘,.,4,
System #2 Approved for bedrooms _ Qp���� GEC'S'Q'
Disapproved =`Z ON-SITE �G'.
;. W
Conditional approval for bedrooms, with the fo�dwing {{ uEt I R z
fo WASTE o=
-12 PROGRAM
t�` • -
p---
>?7 NT SE '
():y: k 4.,.. EOriginal Certificate Date: /1 — l"- ii
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
COSA blue sheet 10.10.12.doc
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: MOUNTAIN VIEW; BLOCK 11, LOT 4 Parcel ID: 004-036-36
A. WELL DATA 'PER GEG INSPECTION
Well type PRIVATE If A, B, or C provide PWSID# NSA Well Log (YIN) NO
Date completed 1950 (?) Sanitary seal (YIN) YES Wires properly protected (YIN) YES
Total depth '45.8+ ft. Cased to UNKNOWNft. Casing height (above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test 10/4/17
Static water level v. ft. 45.5 ft.
N
Well production g.p.m. 3.2+ g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 ml. Nitrate 1 36 mg./L. Collected by: GEG, Ltd.
Arsenic: <5 0 ug./L. Date of sample: 9/28/17
B. SEPTIC/HOLDING TANK DATA AWWU
Tank Type/Material Date installed
Tank size gal. Number of Compartments Cleanouts (Y/N)
Foundation cleanout (YIN) Depression over tank (Y/N) High water alarm •
Date of pumping Pumper
C. ABSORPTION FIELD DATA
Date installed Soil rating (g.p.d./ft'or ft2/bdr i System type
Length ft. Width ft. Gravel below pipe ft.
Total depth ft. Eff. absorptio - ea ftMonitoring tube Depression over field
Date of adequacy test Results (Pass/Fail) For bedrooms
Fluid depth in absor• en field before test in. Water added gal. New depth in
Elapsed T • e: min. Final fluid depth in. Absorption rate >= g.p.d.
• y 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 wa er alarm level at in.
• _ - Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot N/A On adjacent lots 1004
Absorption field on lot N/A On adjacent lots 100'+
Public sewer main 50+ Public sewer manhole/cleanout 50'+
Sewer/septic service line 25'+ Holding tank 75'+
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: AWWU
Building foundation Property line Absorption field
Water main Water service line Surface water
Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIE ' a 1 LOT TO:
Property line B ' • oundation Water main
Water service lin- Surface water Driveway, parking/vehicle storage
5'+
- -in drain Wells on adjacent lots
F. COMMENTS
PER SULLIVANS WATER WELLS,THE PRESSURE TANK NEEDS TO BE REPLACED
af. _ 4+1
G. ENGINEER'S CERTIFICATION �.`P,•.•• ' ,. ♦j♦
_ -.:vq
I certify that l have determined through field inspections and • '9 10
review of Municipal records that the above systems are in i
conformance with MOA COSA guidelines in effect on this , •
date. ♦♦c%:
ScalFrontier Surveys, LLC Project No: 17-268 Date:October 31st,2017
1" = 76 Ordered By:Amy Bacon Plat:P-5A Grid:N/A
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Legend:
0 Electric Meter/Outside Power -0'-Over Hanging Power
n Gas Meter , Deck V/ Water Well 0 25 50
12,5
Fence c-Q_) Telephone Pole ��'� Feel
General Notes:
1.This document is created for the purpose of a single property transaction and is subject to Federal Copyright Law.
2.Excepting for gross negligence,the liability for this survey shall not exceed the cost of preparing this survey.
3.All measurements/setbacks are to the visual/apparent building footprint.
4.Dimensions to property lines are plus/minus 0.1ft.
,N\\\ I t I I t I This survey complies with A5PL5 Mortgage Location Standards.The survey represents visible improvements and
ti+`�{� O F q z q f+ conditions at the time of the survey.This document does not constitute a boundary survey and is subject to any
s 111 inaccuracies that a subsequent boundary survey may reveal.It is the responsibility of the Owner to determine
'` -. rr the existence of any easements,covenants,or restrictions which do not appear on the record plat.Under no
CI • '.9 /j circumstances should this document be used for construction or for establishing a boundary or fence line.
* • 49TH •.* i
• As-Built Survey of:
.--7.,..-a-- ---7 % Lot 4 S3 W2 Block 11, Mountainview Subdivision
p FREDERICK NER I,Frederic Wagner,herebycertifythat this Mortgage Ins Inspection Surveywasperformed byme,or
No.us:s94s 6P
10' 4...... under my direct supervision on September 22nd,2017.
re• . 10/31/2017
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