HomeMy WebLinkAboutBROOKSIDE LT 4 S50' •
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Municipality of Anchorage 8 s ,o
•t � On-Site Water and Wastewater Program < 1.111411-' 77
(907) 343-7904 rt'�:
Certificate of On-Site Systems Approval MAY 26448
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Parcel I.D. 010-085-22 Expiration Date: 11— co
Parcel
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1. GENERAL INFORMATION
Complete legal description Brookside Lot 4 S50'
Location (site address) 3303 Iowa Street
Current Property owner(s) Karin Trovato & William Bacon Day phone
Mailing address 10159 E. Tierra Buena Lane Scottsdale, AZ 85255
Real Estate Agent Day phone
2. TYPE OF DWELLING:
El Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 2
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 El
WaiverNariance request for: Distance:
Received : • ,���:� _1i��" 1 ��� Date: (91611(a
COSA to be released to the engineer,unless o*rwise requ-e by the engineer.
COSA Fee $ SOL Waiver Fee $
Date of Payment 572811 ' Date of Payment
Receipt Number 4381 97 Receipt Number
COSA# OYJ ? 1437 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.
In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA
guidelines and regulations.The reported results describe the performance of the system under the conditions encountered at the time of the test,
and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil
condition,ground water levels that may fluctuate during the year,and the water usage of the family being served by the system.These conditions
are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future
performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty
for future performance, nor can we estimate remaining life of the system.The content of this report is for the sole benefit of the owner listed
above.
Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218
Address P.O. Box 100217, Anchorage Ak. 99510
Engineer's Printed Name Steven R Pannone Date 5/23/2018
OF At.
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6. DSD SIGNATURE ..•• •• •��� *�I
System #1 Approved for -2—bedrooms •S� •. ••
•nno•ne •9CE-814System #2 Approved for bedrooms •���9� •�Disapproved %,131).009.014`
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Conditional approval for bedrooms, with the following stipulations:
OFr;;v,-.
ON-SITE
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•
WATER AND
o WASTFWATER oz
PROGRAM },65-
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By: G _ 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 of 1
Structure served by this system 1
Certificate of On-Site Systems Approval Checklist
Legal Description: Brookside Lot 4 S50' Parcel ID:010-085-22
A. WELL DATA
Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y
Date completed 11/29/1984 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y
Total depth 163 ft. Cased to 163 ft. Casing height(above ground) 24+ in.
FROM WELL LOG AT INSPECTION
Date of test 11/29/1984 5/17/2018
Static water level 80 ft. 44.2 ft.
Well production 5 g.p.m. 6.6 g.p.m.
WATER SAMPLE RESULTS:
Coliform NEC' colonies/100 mL Nitrate N mg/L
Arsenic 11 .6 ug/L Date of sample: 5/17/2018 Collected by: PES
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material _ Date installed
Tank size gal. Nu•.:-r of Compartments Cleanouts (Y/N)
Foundation cleanout(Y/► Depression over tank(Y/N) High water alarm (Y/N)
Date of pum..-• Pumper
C. ABSORPTION FIELD DATA
Date installed Soil rating (g.p.d./ft2 or ft2/bdrm) _ - type
Length ft. Width ft. Gravel below pipe ft.
Total depth ft. Eff. absorption area ft2 ,onitoring tube Depression over field
Date of adequacy test '-sults(Pass/Fail) For bedrooms
Fluid depth in absorption field befo - est in. Water added gal. New depth in.
Elapsed Time: . Final fluid depth in. Absorption rate >= g.p.d.
Any rejuvenation eatment(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. "Pu •_ • ' 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 100+ On adjacent lots 100+
Absorption field on lot 100+ On adjacent lots 100+
Public sewer main 75+ Public sewer manhole/cleanout 100+
Sewer/septic service line 25+ Holding tank 100+
Animal containment areas 50+ Manure/animal excrete storage areas 100+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation P••perty line Absorption field
Water main Water service line Surface water
Wells on adjacent lots
ABSORPTION FIELD ON •T TO:
Property line Building foundation Water r ain
Water Service line Surface water Dri -way, parking/vehicle storage
Curtain drain Wells on adjacent lots
F. COMMENTS
G. ENGINEER'S CERTIFICATION 'ArkP QF ,Q(,��1kk
I certify that I have determined through field inspections and /,•leeb.-• ���•'x:17 A
review of Municipal records that the above systems are in O*;•Q9 TH /\ •.*y
conformance with MOA COSA guidelines in effect on this date. / P1 NI•
EnginSteven Pannone , .. _-,..4. 01
fili
eer's Printed Nameannone•
Date 5/23/2018 t♦� g�;. CE-8149 • ice
COSA canary sheet_2-6-15.doc
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT t 907-343-7904
On-Site Water and Wastewater Section ` �` j! Fax: 343-7997
www.muni.org/onsite
Arsenic Advisory
Certificate of On-Site Systems Approval # OSC181238
Subdivision: Brrokside , Lot: 4 S 50'
A water sample revealed an arsenic concentration of 11.6 micrograms per liter
(ug/L). 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.
Mailing Address:P.0.Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org
Y.
W. 32nd Avenue _ Found 17" 3472V
LEGEND Aluminum Ca
ICorner 1/16th
Monument
(R) Record per Plat No.85-312
(R1) Record per Plat No_P-100
(P) Proportioned
l (C) Computed
(M) Measured
Note: The boundary for this parcel was Q
9 1 based on information found on Plat o t '
Z) No.85-312,a subdivision of adjacent c cco
Lot 9,Brookside Subdivision.
ik
SS• AIA) ( :) N1/2 LOT 4
4'ss
N89°54'27"W 149.11
J I �EaVrs N89°59'00'W 150.00((R1))
I I ;.� "tt �`'' 8 d e 1 ^30
IS `'''' ` '`?••phalt� S Wood fence(typ) Greenhouse CC a- >oat
v ��CL.n A
w Nca
O ZO1 r 24.0 r� N �'Qmta
e2 . u 4, 414
n S112 LOT 4 to 0 (0 to
obi I0 - illi 1 Story Frame 102 Well 0 _> O0
Q o • deck o i
B. ? r o House 'r _
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0 26. 24.0 NJ 10.2 o o o0
Q}1 shed o co
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ZZ q d 9 6` 6 > 'L Z O Z Z
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N89°59'00'W 150.00(R1) /on
t1 N89°55'16'W 149.33(C)
2 a zo LOT 5 I
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N N Z N N
Basis of Bearings N89°00100"W 170.30 (R) 170.29 (M) f
` _I W. 34th Avenue + Pipe
Found PK Nail L
4-"PA w vi v AS-BUILT NO CORNERS SET THIS DATE
¶2 8 co-0y')VLAti.j(Ai �® -�®®®11% I hereby certify that I have performed a Mortgagee's inspection
k co N N�' C ikRD, OF A II of the following described property: S112 LOT 4.
�- � . • - • . C,q 1 BROOKSIDE SUBDIVISION
co' 49th - '' o Anchorage Recording Precinct,Alaska,and that the
®�' • •* oo improvements situated thereon are within the property lines
)•'�;�r ,� ' ��17%1 and do not overlap or encroach on the property lying
411..!„,:- adjacent thereto,that no improvements on the property tying
® i+ lizobeth L Wolatko. P adjacent thereto encroach on the premises in question and
A that there are no roadways,transmission fines or other
• i �sr�,•. 8036 - LS ••,.,,p visible easements on said property except as indicated
hereon.
SCALE: In= 30' �t��0�o- • • • • •J,o + Dated at Anchorage,Alaska
8 SSIONAa � °•
this 15th g dayof
EASEMENTS OF RECORD,OTHER THAN %V®®0`a MAY 2018.
THOSE SHOWN ON THE RECORDED 5'2-1-t 6 FRED WALATKA&ASSOCIATES,L.L.C.
PLAT ARE NOT SHOWN HEREON Engineers and Surveyors
UNLESS OTHERWISE NOTED. FB 18-5, pg 4 BE 907-248-1666
M -W DRILLING, Inc.
P.O Box 10-378• 10300 Old Seward Highway
(907)349-8535 84-328
ANCHORAGE, ALASKA 99511
DRILLING LOG
Well Owner ��' j,A�AtVD Use of Well 1213-mL
Location (address of: Township, Range, Section, if known; or distance main road
South k Lot 4 Brookside Subd. - Anchorage
Size of casing 6" Depth of Hole 165 feet Cased to 165 feet
Static water level 80 + ft. /'a$BP'e) (below) land surface. Finish of well (check one) open end ( X );
Screen ( ); Perforated ( ).
Describe screen or perforation None
Well pumping test at 5 gallons per AWZi.9 (minute) for 1 hours with___ 100% ft.
of drawdown from static level.
Date of completion I'ovenuer 29, 1984
WELL LOG
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness •
0 TO 2 Casing stickup
2 TO 16 Brown sand
16 TO 30 Brown clay _
30 TO 35 Grey silt & gravel -
35 TO 40 Brawn clay____-- — -- _
40 TO 120 - Grey silty sand
120 TO 135 Grey silty sand - damp —
135 TO 142 Grey silty sand &_gr vel - wer
142 To-_162 GYey_aamelly_hardpar, - damp
162 To 165 __crey_waterbearingnd & avn
---To — --- _ -
614.(-;7/ ;-
NWWA Certified Contractor
— _ --- Ueruileute No's. 8i: & 913-
- TO
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PERMIT AND CERTIFICATE OF APPROPRIATION LAS 413i
THIS CERTIFICATE OF APPROPRIATION IS ISSUED BY AUTHORITY OF
AS 46. 15. 120 AND 1 i AAC 93. 130 ON _._.._.._. c.bru �_off ..__._..__._..____.._, 1917_.
APPROVED:
TITLE: __ C.-.�._.. iaiL�O_.eT . -_CL rrl.3__.._.__.-._----.
DIV:[SID OF LAND AND WATER MANAGEMENT
STATE OF ALASKA
) SS
___�_ JUDICIAL DISTRICT)
THIS IS TO CERTIFY THAT ON ._.__.._.._.._ �-?-� 6a- �3 19°7
.._
BEFORE ME APPEARED _ h41 0} c6�-e :aLi_._._._._ , KNOWN BY
ME TO BE THE DIRECTOR OR AUFiORIZED REPRESENTATIVE OF THE DIVISION OF
LAND AND WATER MANAGEMENT, DEPARTMENT OF NATURAL RESOURCES, AND
ACKNOWLEDGED TO ME THAT THIS CERTIFICATE OF APPROPRIATION WAS VOLUN-
TARILY EXECUTED ON BEHALF OF THE STATE OF ALASKA.
Lj3 1
NOTARY PUBLIC IN AND FOR THE STATE OF ALASKA
MY COMMISSION EXPIRES
PURSUANT TO AS 46. 15. 160 AND APPLICABLE REGULATIONS THE CERTIFICATE
HOLDER SHALL NOTIFY THE ALASKA DIVISION OF LAND AND WATER MANAGEMENT
UPON CHANGE OF ADDRESS OR TRANSFER OF ANY REAL. PROPERTY RELATED
THERETO.
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