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Home My WebLink AboutNORTON PARK #1 BLK 2 LT 3 56e 8—j 70 • Municipality of Anchorag On-Site Water and Wastewater Program NOVay i 9 (v0U 3 " 20174 VIM (907) 343-7904 12- Certificate hCertificate of On-Site Systems Appro o 5 3 L 9 5� Parcel I.D. 016-211-42 Expiration Date: 3 ` Uf ' 1. GENERAL INFORMATION: Complete legal description NORTON PARK#1; BLOCK 2, LOT 3 Location (site address) 230 West 121st Ave. *Anchorage 99515 Current Property owner(s) Timothy&Geri Keenan Day phone 702-513-1180 Mailing address 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: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class _Well ❑ Community ❑ Public Water System ❑ Public Sewer WaiverNariance request • : Distance: Received br 11W / Date: 1a4 ��— COSA to be rete. to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5249 Waiver Fee $ Date of Payment 11134 J« Date of Payment Receipt Number O5Za? 2214 Receipt Number COSA# O6en-15 6 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: it I30/i oa000 ADO In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system o OF •t in accordance with the guidelines and regulations established by the Municipality of Anchorage andSQO industry practices. The reported results describe the condition of the system/s on the date/s of the 0,(C •' Qn evaluation. Separation distances were measured to readily identifiable features. Hidden defects or �i T ! •SVD encroachments may exist that were not identified during the evaluation. The operational life of all wells i' a ; 9 3 and septic systems depend upon a variety of variables, including but not limited to, soil conditions, r;* .. "' Q groundwater levels (that may fluctuate during the year), quality of construction (materials and '� VA workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and .i. are outside the control of GEG. Satisfactory test results do not guarantee future performance of the / .ff' •y •. .rness system/s, therefore, GEG makes no warranty(express or implied) regarding the future performance of P� • CE_-05 , the well or septic system. GEG makes no representation whether an alternative well or septic system Q 9s �ce4� can be installed on the property in the event either of the current systems fail to perform adequately in V4fP,e **•11/.3P •17 c.,(` A\\- the future. The content of this report is for the sole benefit of the person/party that retained GEG to '71\ ofess�o�000 perform the evaluation. Reliance upon the information provided in this report by any other person or 1�4'Op' party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE System #1 Approved for ` bedrooms System #2 Approved for bedrooms ,�\G�pPLITY OFI"ii, Disapproved ` y . Conditional approval for bedrooms, with the followl stei .1 E .',; W4 ql/p ren': EIN r- PR "direR ••'•SERVICSSC)\ • By: tom. Vlek 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 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: NORTON PARK#1; BLOCK 2,LOT 3 Parcel ID: 016-211-42 A. WELL DATA *PER GEG INSPECTION Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) NO Date completed 1972(?) Sanitary seal (Y/N) Wires properly protected (Y/N) Y Total depth *58.9+ ft. Cased to UNK ft. Casing height(above ground) 18+ in. FROM WELL LOG AT INSPECTION Date of test 11/10/17 • Static water level ft. 19.5 ft. N• Well production g.p.m. 4.5+ g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 ml. Nitrate 1.48 mg./L. Collected by: GEG, Ltd. Arsenic: <5.0 ug./L. Date of sample: 11/10/17 B. SEPTIC/HOLDING TANK DATA AWVVU Tank Type/Material Date installed Tank size gal. Number of Compartments Cleanouts (Y/N) Foundation cleanout(Y/N) Depression over tank(Y/N) High water alarm Date of pumping Pumper C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ft2or ft2/bdr • System type Length ft. Width ft. Gravel below pipe ft. Total depth ft. Eff. absorptio - ea ft2 Monitoring tube Depression over field Date of adequacy test Results (Pass/Fail) . For bedrooms Fluid depth in absor• '•n 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 100'+ Absorption field on lot N/A On adjacent lots 100'+ Public sewer main *50+ Public sewer manhole/cleanout •50'+ Sewer/septic service line **UNK 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 • 4 I LOT TO: Property line B ' _. • foundation Water main Water service lin- Surface water Driveway, parking/vehicle storage .In drain Wells on adjacent lots F. COMMENTS *SEWER MAIN INSTALLED IN AUGUST 1982. REQUIRED SEPERATION AT THAT TIME WAS 50 FEET **IN 1982 THERE WAS NO REQUIED SEPERATION DISTANCE -NORTON PARK#1; BLOCK 2, LOT 4 AND NORTON PARK#1:BLOCK 2,LOT 2 ARE BOTH CURRENTLY SERVE CITY SEWER (PER CHRISTI WITH AWWU) OF � At •• G. ENGINEER'S CERTIFICATION `P�.•••' .•. j • Air *tI certify that I have determined through field inspections and •• • review of Municipal records that the above systems are in I/ • conformance with MOA COSA guidelines in effect on this • `• • date. ♦t^'• J f' -y • . ness s,IN Engineer's Printed Na e JEFFREY A.GARNESS •,�--/•• CE 7• a113o . •�� Date / 3a ' 1" •.�� 47 �PROFESS\U"'4. LICENSE 111 „`..** #AECC884 (Rev.10/12/12) 8466U W. 121st Avenue 0 0 co EAST 108.00 co ; w ,Asphalt 4 > ',-0`;.: ,:>�'•�:�:- Well t1'a-.;`r.yc,.^..�.: 7.5 OH ll, i :=.ham f- • `idti Lleck 1 Entry 23.4- - r 50.0 > CD 1 0 2 Story Frame 0o CD w 1 N House c" x o 0 33.9_____I 50.0 N N o.s off deck x W W 0 0 x Lot 4 o Wood fence r- Lot 2 o , LOT 3 0 0 0 (/) t o Chain link fence(typ) w 7.4—•— 28.0 0 0 N N Garage x --s.9-- 28.0 .1 n n i 10' Utility Ease'yment "i — — — — — -- / Wre fence EAST 108.00 Lot 10 / Lot 11 Bonnie Jean Subd. �C,• • • • •A• �� I, AS-BUILT NO CORNERS SET THIS DATE �P'• ' •'S'f ,i I hereby certify that I have performed a Mortgagee's inspection Ago •• 49th 7\ •'77 / of the following described property: LOT 3, BLOCK 2, *• •.* � NORTON PARK ADDITION, UNIT 1 ; • p if ••• •••• Anchorage Recording District,Alaska,and that the / c^ .Fred Wal atka .Pot improvements situated thereon are within the property lines •• • . and do not overlap or encroach on the property lying l4 • 3255 - S .• ,,z- .. adjacent thereto,that no improvements on the property lying ' Fo • • • • . • •moo ` adjacent thereto encroach on the premises in question and I. 4;0, - �"- that there are no roadways,transmission lines or other I X"N. visible easements on said property except as indicated hereon. SCALE: 1"= 40' Dated at Anchorage,Alaska EASEMENTS OF RECORD,OTHER THAN this 13th day of November ,2017. THOSE SHOWN ON THE RECORDED FRED WALATKA&ASSOCIATES,L.L.C. PLAT ARE NOT SHOWN HEREON Engineers and Surveyors _. nr