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HomeMy WebLinkAboutGLACIAL LT 4 Onsite File Glacial Lot 4 #075 - 091 - 14 • Municipality of Anchorage o ` On-Site Water&Wastewater Program (907)343-7904 s 9 10 71 ' 4i nr r • CERTIFICATE OF ON-SITE SYSTEMS APP-Ci A�,�i 201 ti A , Parcel I.D. 075-091-14 Expiration Date: Y:j' 1. GENERAL INFORMATION Complete legal description GLACIAL;LOT 4 Location (site address) 157 RAVENWOOD CIRCLE*GIRDWOOD,AK Current Property owner(s) GABRIELLE HOESSLE Day phone 229-6927 Mailing address 157 RAVENDOOD CIRCLE•GIRDWOOD,AK Real Estate Agent Day phone 2. TYPE OF DWELLING: II 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 I Individual On-site ❑ Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer WaiverNariance request for N/A Distance: - • Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. - COSA Fee$ Waiver Fee$ Date of Payment 10-1-18 Date of Payment Receipt Number 065-6 G Receipt Number COSA# o5C t81622- 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. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 *ANCHORAGE,AK, 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date iO 1 f ii ' Engineer's Comments: In conducting this evaluation,GEG provided an engineering evaluation of the well and/or septic system in accordance with the .40001%11% i, guidelines and regulations established by the Municipality of Anchorage and industry practices.The reported results describe the .•,, � OF f'♦ condition of the system/s on the dates of the evaluation.Separation distances were measured to readily identifiable features. ••• \)N... ••••.'•• . •••..(1 ♦ Hidden defects or encroachments may exist that were not identified during the evaluation.the operational life of all wells and septic a CO 0 1 �♦ systems depend on a variety of variables including but not limited to,soil conditions,groundwater levels(tha'may fluctuate during the year),quality cf construction(materials and workmanship),and the water usage of the family utilizing the system's.These 4•/ • * .0 conditions can vary,and are outside the control of GEG.Satisfactoy test results do not guarantee future performance of the al system/s;therefore,GEG makes no warranty(express or implied)regarding the future performance of the well or septic system. 0 GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail.The content of this report is for the sole benefit of the person/party who retained GEO..Reliance upon the j r z �� : r- . G ess 41. information provided in this report by any other person or party,including but not limited to subsequent property purchasers,is not ♦ GjZso authorized.In short,GEG disavows any regal duty to anyone other than the person/party who paid for this report. 1. 5) C E-7(95 �. I par 6. DSD SIGNATURE �LICENSE , � /°ROFESS%' '�P��� S* #AECC864 I1 System#1 Approved for bedrooms. ,'* System#2 Approved for bedrooms. Disapproved. �QQ.-�� Oi-, 1VC` Conditional approval for bedrooms, with the following stipulns: �O J ON-SITE 57. WATER AND rn' WASTEWATER c c-..<,\ PROGRAM ���'�SER�1�cF�0 = _.f' Original Certificate Date: The Municipality or Anchorage Develop,emt Seivices Division(DSD)issues Certificates of On-Site Systems Approval(COSA)based only upon the represenatations 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. ATTCHMENTS: COSA Checklist : • _Zit_ Nitrate Advisory Septic System Advisory _ Arsenic Advisory Well Flow Advisory Other , . S . , - • (Rev.10/12/12) • r 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: GLACIAL, LOT 4 Parcel ID: 075-091-14 A. WELL DATA SEE ATTACHED DOCUMENTATION FROM AAROW PUMP AND WELL REGARDING THE DECOMMISSIONING OF THE ABANDONED WELL Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 8/7/2009 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 60 ft. Cased to 60 ft. Casing height (above ground) 18+ in. FROM WELL LOG AT INSPECTION Date of test 8/7/2009 9/16/2018 Static water level 31 ft. 31.5 ft. Well production 50 g.p.m. 10.4+ g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 ml. Nitrate 0.414 mg./L. Collected by: GEG, Ltd. Arsenic: <5 ug./L. Date of sample: 9/16/2018 B. SEPTIC/HOLDING TANK DATA AWWU SEWER 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/bdrm System type Length ft. Width ft. Gravel below pipe ft. Total depth ft. Eff. absorption . -a ft2 Monitoring tube Depression over field Date of adequacy test Results (Pass/Fail) For bedrooms Fluid depth in absorp field before test in. Water added gal. New depth in. Elapsed Ti ••. min. Final fluid depth _ in. Absorption rate >= g.p.d. • •. 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 *75+ Public sewer manhole/cleanout *100'+ Sewer/septic service line •25'+ Holding tank 100'+ 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 FIELD 0•• •T TO: Property line Build'., •undation Water main Water service line Surface water Driveway, parking/vehicle storage Cu ..• • ain Wells on adjacent lots F. COMMENTS *ASSUMED BASED UPON AWWU RECORD DRAWINGS AND CONNECT CARD; COULD NOT PHYSICALLY VERIFY •.'\� OF i G. ENGINEER'S CERTIFICATION :'<' ...•• ji.•' ..•♦ • I certify that I have determined through field inspections and • *; '' 9;• �� .' *1. �• review of Municipal records that the above systems are in •' •••• • • conformance with MOA COSA guidelines in effect on this •••• . ••; • 1date. ••1-. ' f'-y A. arness;'I JEFFREY A. GARNESS : CE-71954(•• :: Engineer's Printed Name �. A' , 1 �'�, Date /0/17I .4 OFESS\ �,•• LICENSE I#%„`k* #AECCBB4 (Rev. 10/12/12) 11 LOT 5 3.7 LOT 66E CABIN t , O 0 v CO DP* 43. ix 0.5' N �^ 8.96',6, C �' O 616L) 3-.496k G L) 3 / " CULVERT 3 7 SHED ti 1p•r\,\'r (TYPICAL) 12.3' • m N OLD WELL N/ •5.6;4 • Cw / .4?) ,Z) $52°3fir' T5:(�Q' . • .; • ,.: • ':.•• . 24.2. •• h. • • • .• �; EXISTING / . . . .RAVENWOOD CIRCLE � N ':' (GLACIER DRIVE) ... . • .© HOUSE - • N ••` :. •• 11 ' t'` NEW WELL �l' 24.2' si LOT 4 s--:a �` -/ 6 O V a86, TRACT H LOT 3 a00000pp� OF A \N fA •• ' ()00 p g:._KR. 49TH i\ . QSTEVEN CALLAG•AN: • o 0„,,,.. L 12034 .,Q 0000a� � ��a °fessiono\ L°o ��DO0000�a— NOTE: THIS DRAWING SHALL NOT BE MODIFIED FOR USE AS A PLOT PLAN WITHOUT THE EXPRESSED WRITTEN CONSENT OF LCG LANTECH. ORDERED BY: GABRIELLE HOESSELE PARCEL#: 075-091-14-000 SURVEY CERTIFICATION:LCG LANTECH,INC HAS CONDUCTED A PHYSICAL SURVEY OF THE PROPERTY AS SHOWN ON THIS DRAWING AND CERTIFIES THAT THE IMPROVEMENTS LEGAL DESCRIPTION: ADDRESS: 157 RAVENWOOD CIRCLE SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO ENCROACHMENTS EXIST OTHER THAN NOTED. AS-BUILT EXCLUSIONARY NOTE:IT IS THE OWNERS'RESPONSIBILITY TO DETERMINE THE EXISTENCE OF LOT 4 ANY EASEMENTS,COVENANTS,RESTRICTIONS OR RIGHT-OF-WAY TAKINGS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY GLACIAL SUBDIVISION DATA HEREON BE USED FOR CONSTRUCTION,FOR ESTABLISHING PROPERTY LINES,OR FOR PLOT-PLAN PURPOSES. LEGEND: 250 H Street CLEAN OUT ocD ' Anchorage,Alaska 99501 Overhang i Asphalt:::::•. g WATER WELL QV >� 1 k.,. - , ., Wood Deck/ Gravel FENCE X---- .�_ __ . ,. Survey Department DRAWN DATE: 09/20/2018 WORK ORDER: 18126 Phone 562-5291 ' 1 -r1 Inc Mainline DRAWN BY: ADS PLAT: 66-28 aistizectuite• P"o.,ePiic.,guA.0Ae 9, Phone 243-8985 CHECKED BY: SC GRID: SE4813 AECC 668 SCALE: 1"=20' FB/PG:811/29 REF:94L504 • Alpine Drilling & Enterprises 33144. Well Log Permit Number: #SW090137 Date of Issue: 8-4-09 Parcel Identification Number: 075-091-14 Date Started: 8-7-09 Date Completed:8-7-09 Is well located at approved permit location?x Yes ❑ No Legal Description: Glacial Lot 4 Property Owner Name&Address: Kirk&GabrielleHoessle PO Box 917 Girdwood, Alaska 995.87 Borehole Data: Depth(ft) Method of Drilling x air rotary ❑cable tool Soil Type,Thickness&Water Strata From To Casing type:steel Stick-up 0 3 Wall Thickness:.25 inches Gravel fill 3 4 Diameter:6 inches Depth:of feet Liner Type: Silty gravel 4 27 Diameter: inches Depth: feet silty gravel 27 49 Casing stickup above ground: 3 feet water sand&gravel 49 Static water level(from ground level)11 Leet Pumping level: 60 feet after 2 hours pumping 50 gpm Recovery Rate: fpm Method of Testing: air lift Well Intake Opening Type: x Open End ❑Open Hole ❑ Screened Start feet Stopped feet ❑Perforations Start feet Stopped feet WATER 9VALITY TESTING Grout Type: bentonite Volume: 1_g Coliform r\L e CoI/100mL Depth: Start 0 feet Stopped?feet Nitrates ► mg/L Pump: Intake Depth feet Arsenic � ug/L Pum size h Brand Name P P Well Disinfected Upon Completion?x Yes❑No Method of Disinfection: chlorine tablets Comments: Well Driller: Alpine Drilling&Enterprises DE?.OF NKTURAL RESOURCES PO Box 110496 DIV OF MINING.BAWD&WREN Anchorage AK 99511 NOV 302010 DIRECTORS omc ANCHORAGE 06/12/2018 00:57 907-345-0202 ALPINE DRILLING PAGE 01,''01 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT /* Jr 907-343-7904 On-Site Water and Wastewater Section ,� 1r Fax: 343-7997 www.muni.org/onsite Well Decommissioning Log Legal Address: Subdivision Glacial Ls 7 „ ,;.,peeBlock Lot 4 T R Section Lot On-site Water&Wastewater Section certified contractor performing the well decommissioning: Name: David Harper Signature:`���• /` r - Company: Aarow Pump&Well Svs, LLC Well decommissioning date 9'28-18 Method of decommissioning:AMC 15.55.060L1 a. ❑ b. ❑ C. 0 Location:Use the space below to provide a drawing of the property showing the following items: • North arrow • l)ecommiaaioned well location • Location of other water wells on the properly • Two separate swing-tie distances for each well shown on the drawing Note•The swing-tie distances shall be measured from either permanent structures or the property corners. 0 J71 • G\development Services1Building Safety\On Site Water and Wastewater\Forms\Client FormslWell Dacommisioning form.doc "ON PROPERTY" Service Line Locatior. By Sketch a Show Location of Control Manhole STREET ALLEY `D 1S' n 0 i � 1 lJ Comments / N.. , . / ., ,/ • . . . , . N -, , • -. /' , / sN, 7... /NNC., NNN, !,9•-c91 "7.1.5- 0-L6) / ....Co-7 <93, H.J.07-41. .:...... ,/ (., --„... • / / • N .... . , , . . , ... , , .. , N. . r i. .J:, ,,,,..*, i , . _ .. P 'r: . ,•, -_-___ __ . . . . . . . . • i• ; , 1 ; :.:3.:211.1 . '‘ r, I!, ,1: :,' 1...1.,IPVI i . ......____ .•...,, . ,I .)1 4 )O : titli)",) ;.: .ii; 1'.. •:....t).' .i.'1.;%1;1`..) TAX CODE No. 075-091- h- GRID No. MUNICIPALITY OF ANCHORAGE — SEWER UTILITY PROPERTY: Name : f Address .d AcctNo Plat No Subd. - . ei,�c.c _ Z� Lot BIock_. Residential 0 Commerial 0 Industrial ❑ No. of units CONNECT: // Main Tap 0 On Property A] Permit No. 3 4�S Size + Type Drawing No. Size Main —Type Depth at Connect Insulation 0 Cleanouts Type Connect Agent Inspector r __Date -,23 3 3 Comments Connect Locations-Q1 U>aig 7Cr yZ 3 g tS C.-- ASSESSMENTS:ASSESSMENTS: L.I.D. No. Private Dev. No. Subd. Agreement 0 No. Sewer Agreement 0 No. P.T.E. 0 Roll No. DYE TEST: Positive ❑ Negative 0 N.S.A. ❑ Date Page No.- _M.H. No. Billing Cycle - a Tested By Comments • "ON PROPERTY" Service Line Location By Sketch a Show Location of Control Manhole c STREET ALLEY • • • i1 • • • Comments • • TAX CODE No. 07,E -OQI - l'--f GRID No. MUNICIPALITY OF ANCHORAGE — SEWER UTILITY PROPERTY: \OL-0 Lofi )- Name _ Address Acct.No Plat No. Subd. LAc,'a/ Lot C---x-11 Block Tip' Residential 0 Commerial U Industrial 0 No. of units CONNECT: Main Tap 0 On Property 0 Permit No. Size y Type Drawing No. Size Main ,Type Depth at Connect Insulation 0 Cleanouts� Type Connect Agent /yA/C _Inspector G, k/-r/ ,c,C Date_I/2-11– 74 Comments Connect Location 1` < <) 4/j l 32 N 0/ /1-2.).i. X-5 '' ' 14/1 /1/' IASSESSMENTS: L.I.D. No. Private Dev. No. Subd.Agreement 0 No.—_ Sewer Agreement 0 No. P.T.E. 0 Roll No. DYE TEST: Positive 0 Negative 0 N.S.A. ❑ Date • Page No. M.H. No. Billing Cycle Tested By Comments