HomeMy WebLinkAboutTURTLE HILLS LT 1Onsite File
Formerly US Survey 3043 Lot 15 52
MUNICIPALITY OF /ANCHORAGE
o
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Parcel I.D. 075-092-15
Certificate of On -Site Systems Approval
Expiration Date:
Legal description US SURVEY 3043 LT 15 S2 T1 ON R2E SEC 18
Site address 1011 Alyeska Highway Girdwood
Current property owner(s) Hendrickson
X The On-site system(s) is/are approved for 2 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
Original Certificate Date: 11/18/2022
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
M UHMPAP OF ANCHORAGE
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. 075-092-15
Complete legal description US SURVEY 3043 LOT 15 S2
Location (site address) 1011 AlyeSka Highway *Girdwood
Current property owner(s) Christina Hendrickson Day phone 575-4184
2. ON-SITE SYSTEMS SIZED FOR 2 BEDROOMS
3. TYPE OF WATER SUPPLY: X 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 $ 02?30 Waiver Fee $
Date of Payment /1z'? Date of Payment
COSA # 05 e 'a 2_/ 536 Waiver #
4 03 75-6(f7 COSA Applka� June 2022
COSA Checklist
Legal Description: US SURVEY 3043 LOT 15 S2
Parcel ID: 075-092-15
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) Well production at time of test 5.7+ gpm
Date drilled PRE 6/3186 Total depth *78 ft Water storage tank volume N/A gallons
Cased to UNK ft Well disinfected for coliform test? ❑ Yes ® No
N Sanitary seal is functioning correctly Coliform bacteria is Negative
X Wires are properly protected Nitrate g/L ❑ Nitrate less than MRL (ND)
Casing height (above ground) 18+ in. Arsenic ug/L [aA'rsenic less than MRL (ND)
Date of flow test for COSA 10/28/22 Collected by GEG, LTD
Static water level at beginning of test 44.4 ft. Date 10/28/22
Comments *PER AWPS PUMP TEST REPORT IN MOA RECORD
B. TANK DATA
Measured operating fluid level in septic tank
Date of pumping
❑ Required maintenance completed, if AWWTS
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed)
❑ ALL standpipes present per record drawing
Total measured depth from grade ft (max)
Measured depth to pipe invert from grade ft (min)
❑ N/A — pressurized field.
❑ Per record drawings, field is insulated. /
❑ Monitor tubes go to bottom of effective.
If not, state depth into effective
❑ Presoaked required if
(Required if house vacant or fi not used for more
than 30 days prior to date o st)
Gallons introduced gallons date
Any rejuvenation tre ent (past 12 months)
If yes, enter, to
COSA Cheddist June 2022
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments: ZZ
Adequacy tes ate
Result Pass
Fluid pth prior to test in
ater added gal
New fluid depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
FIELD STATUS — POST RECOVERY
Effective depth (per record drawings)
Effective depth used in
Effective depth remaining in
in
91,
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' Community Sewer Manhole/Cleanout > 100'
MYes if No NSA ft Q■ Yes if No ft
Neighboring Tank > 100' no Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No ft
Absorption Field on Lot > 100' ❑ Yes if No NSA ft Holding Tank > 100' M Yes if No ft
Neighboring Absorption Fields > 100' Animal Containment > 50' Q Yes if No
Di Yes if No ft
* Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' RlYes if No ft ri Yes if No
LJ N/A — Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than Aui
Building Foundations > 10' ❑ Yes if No ft Surface Water x,189 ❑ Yes if No
Tank to Property Line > 5'
Field to Property Line > 10'
Water Main > 10'
Line > 10'
Yes if No ft
❑Yes '-{�M'�' ft
Yes if No ft
❑ Yes if No ft
WMFs on Adjacent Lots:
Private Wells > 100' ❑ Yes if No _
Community Wells > 200' ❑ Yes if No _
If tank or field is under driveway comment below
F. ENGINEER'S COMMENTS
*PER 1987 AWWU RECORD DRAWING sti ty-t5I
ft
ft
ft
ft
ft
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 Gamess Engineering Group, LTD. (GEG) Phone 907-337-6179
Engineer's Printed Name Jeffrey A. Gayness Date
In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in
accordance with the guidelines and regulations established by the Municipality of Anchorage and industry
practices. The reported results describe the condition of the system/s on the date/s of the evaluation.
Separation distances were measured to readily identifiable features. Hidden defects or encroachments may
exist that were not identified during the evaluation. The operational life of all wells and septic systems depend
upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate
during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing
the systems. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not
guarantee future performance of the systems; therefore, GEG makes no warranty (express or implied) regarding
the future performance of the well or septic system. GEG makes no representation whether an altemative well
or septic system can be installed on the property in the event either of the current systems fail to perform
adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG
to perform the evaluation. Reliance upon the information provided in this report by any other person or party
(including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever.
COSA Checklist June 2022
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On -Site Water and Wastewater Program d
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 075-092-15 Expiration Date: eo- 9 J Q 0 1
1. GENERAL INFORMATION
Complete legal description US Survey 3043 Lot 15 South 2
Location (site address) 1011 Alyeska Highway
Current Property owner(s) Gary Johnson Day phone
Mailing address 1011 Alyeska Highway
Real Estate Agent Y rc-t,r, Day phone d ado ' x.75 �o
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
2
TYPE OF WASTEWATER DISPOSAL:
4. TYPE OF WATER SUPPLY:
_ _
Individual
❑
Individual Well
®
Holding Tank
❑
Individual Water Storage
❑
Community
❑
Community Class _Well
❑
Public Sewer
Public Water System
❑
WaiverNariance request for:
Distance:
Received by:
Date:
COSA to be released to the engineer, unless otherwise requested by the
engineer.
COSA Fee $ 6-Y6 Waiver Fee $
Date of Payment 79/27/14 Date of Payment
Receipt Number Receipt Number
COSA# 05CiT4%CIO? 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 ARCTERRA CONSULTING, INC. Phone 696-6111
Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577
Engineer's Printed Name KENNETH M. DUFFUS Date
Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition
of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface
conditions that may not be observed from the 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 Or \
encroachments, deficiencies or discrepancies exist. ��14.49 TH
6. DSD SIGNATURE
V% System #1 Approved for ? bedrooms. `���H
7 16
System #2 Approved for bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
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By: _fi&AA)Lal%I 7'm Cmc lu.)d Original Certificate Date: c c2a % 9
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. r�
7. ATTACHMENTS: • Cf 11
COSA Checklist X Nitrate Advisory i 14, "'.
Septic System Advisory Arsenic Adviso'Py%11T1;S ' _'V,`:
Well Flow Advisory Other ,:! ,1it_ -�
,.3- ; .
COSA blue sheet 10-10-12.doc
Legal Description:
COSA Checklist
US Survey 3043 Lot 15 South 2
If more than 1 septic system on lot: COSA Checklist # of
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled NA
Total depth 78* ft
Cased to NA ft
® Sanitary seal is functioning correctly
® Wires are properly protected
*
Casing height (above ground) 34 in.
Date of flow test for COSA 8/16/19
Parcel ID: 075-092-15
Structure served by this system 1
Well production at time of test 6.8* gpm
Water storage tank volume gallons
Well disinfected for coliform test? ❑ Yes ® No
S Coliform bacteria is Negative
Nitrate — _ mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by Anchorage Well and Pump.
Date of Sample , � ?/./% ?
Static water level at beginning of test 43* ft.
Comments *All information provide�C—y Anchorage Well and Pump Service
B. TANK DATA -PuBL.t C�, si✓v l 6;�2
Age of tank(s) years
Tank type/material
Measured operating fluid level in septic tank
❑ Standpipes/foundation cleanout per record drawing
Date of pumping
D. ABSORPTION FIELD DATA RL'61G 5&1NE Z
Which system tested (date installed)
❑ ALL standpipes present per record drawing
Total measured depth from grade ft (max)
Measured depth to pipe invert from grade ft (min)
❑ N/A — pressurized field
❑ Monitor tubes go to bottom of effective. If not, state
depth into effective
❑ Code -required soil cover over field
❑ System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced gallons
Comments/Deficiencies:
COSA Checklist yellow sheet
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments:
Adequacy test date
Results ❑ Pass For bedrooms
Fluid depth prior to test in
Water added gal
New depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
Any rejuvenation treatment (past 12 months)
If yes, enter date
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100'
NA
if No
Community Sewer Manhole/Cleanout > 100'
❑ Yes
if No
ft
[0 Yes
if No ft
Neighboring Tank > 100' ® Yes
if No
ft
Private Sewer/Septic Line > 25'21 Yes
if No ft
Private Wells > 100' ❑ Yes if No ft
NAft
❑ Yes
if No
ft
Absorption Field on Lot > 100' ❑ Yes
if No
❑ Yes
Holding Tank > 100' ® Yes
if No ft
Neighboring Absorption Fields > 100'
Animal Containment > 50' ® Yes
if No ft
® Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ® Yes
if No
ft'
0 Yes
if No ft
From-b-ept' /Holding Tank on Lot to: (Please
enter distances if less than required)
Building Foundations > Yes
if No
ft
Surface Water > 100' ❑ Yes
if No ft
Property Line > 5' E] Yes
If
Wells on Adjacent Lots:
Absorption Field > 5' ❑Yes
if No
ft
vate Wells > 100' El Yes
if No ft
Water Main > 10' ❑ Yes
if No
ft
Community WeIs _ 00' ❑ Yes
if No ft
Water Service Line > 10' El Yes
if No
ft
If septic tank is under driveway comm
low
From—A-bsoyption Field on Lot to: (Please enter distances if less than required)
Building Foundation >
❑ Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
❑ Yes
ft
Wells on Adjacent Lots:
Water Main > 10'
❑ Yes
if No
ft
Private Wells > 100' ❑ Yes if No ft
Water Service Line > 10'
❑ Yes
if No
ft
Commune ells > 200' ❑ Yes if No ft
Surface Water > 100'
❑ Yes
if No
ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and review
of Municipal records that the above systems are in conformance with
MOA COSA guidelines in effect on this date.
COSA Checklist yellow sheet
W.ATERVVELL - TEST PUMP REPORT
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