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Home My WebLink AboutFRISLIE LT 5Onsite File I :> Municipality of Anchorage o °� On -Site Water & Wastewater Program (907) 343-7904 CERTIFICATE OF ON—SITE SYSTEMS APPROVAL Parcel I.D. 014-162-36 Expiration Date: 1. GENERAL INFORMATION Complete legal description FRISLIE. LOT 5 Location (site address) 7821 LADASA PLACE *ANCHORAGE AK Current Property owner(s) LEVI SMITH W/ GLACIER HOMES Day phone 748-4197 Mailing address Real Estate Agent 2. TYPE OF DWELLING: 7821 LADASA PLACE *ANCHORAGE AK Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: Day phone TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site ❑ Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer Received by: '4:1/Date: COSA to be released to the engineer, unless otherwise requested by the engineer. ` COSA Fee $ �"s� Waiver Fee $ Date of Payment �J �1 i �J _ Date of Payment Receipt Number O J`J % Receipt Number COSA # 05C. 13110 to Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seat 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. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: .In conducting this evaluation, GEG, UD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described 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 soils condition, groundwater 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 the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE t -System #1 Approved for bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. Phone 337-6179 Date 3 Ag 1 1-7 _ �F .. 49 . .................. �y Ga Hess; 9; CE 144p ^e. � 0�-"4'rofessio_ bedrooms, with the following stipulations: Original Certificate Date: �(tOF IV6r6;;, �UeP yO�pr�r- J� ON-SITE 0 v WATER ANL' �o WASTEWATER ,^ PROGRAM CAT The Wni6fipaliVorAifhorage Develop,emt Services 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 / Nitrate Advisory Septic System Advisory Well Flow Advisory (Rev. 11105) Arsenic Advisory Other If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system Legal Description: FRISLIE, LOT 5 Parcel ID: 014-162-36 A. WELL DATA Well type PRIVATE if A, B, or C provide PWSID# N/A Well Log (YIN) YES Date. completed 7/25/12 Sanitary seal (YIN)1'cS t Wires properly protected (YIN) _ Total depth 82 ft. Cased to 82 ft. Casing hei ht (above round 24+ FROM WELL LOG Date of test 7/25/12 Static water level 21 ft. Well production 20 _g— p.m-WATER SAMPLE RESULTS:. 9 9 ) H. AT INSPECTION NEW WELL ft. 9-13-m. Coliform colonies/100 ml. Nitrate 1`1 D mg./L. Collected by: GEG. Ltd. Arsenic: ND ug./L. Date of sample: 3/191 3 [2o /a B. SEPTIC/HOLDING TANK DATA PUBLIC SEWER Tank Type/Material Date installed Tank size gal. Number of Compartments Cleanouts (YIN) Foundation cleanout (YIN) Depression over tank (YIN) High water alarm Date of pumping Pumper C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ftZor Obd Length ft. Width System type ft. Gravel below pipe ft, Total depth ft. Eff. absorption ftZ Monitoring tube Depression over field Date of adequacy test Results (Pass/Fail) For bedrooms Fluid depth in absorpf Ield before test in. Water added gal. New depth in. Elapsed Ti min. Final fluid depth in. Absorption rate >= g.p.d. A ejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date D. LIFT STATION Date installed "Pump on" level at in. Size in gallons Manhole/Access (YIN). "Pump off level High water 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 Absorption field on lot- N/A On adjacent lots_ N/A On adjacent lots N/A Public sewer main 75+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Water main Wells on adjacent lots Property line Absorption fiek Water service line Surface water, SEPARATION DISTANCE FROM ABSORPTION FI Property line _ Water service line F. COMMENTS Surface water Wells on adjacent lots TO: Water main Driveway, parking/vehicle storage 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. Engineer's Printed Name JEFFREY A. GARNESS _ Date 3 I� /3 (Rev. 11/05) OF o *.: 4 . T .............. ........ CE— ••� L�R'f'o f es Sion°d 4 re) 30VId VSVCIV-1 r U w Aw N N 00 w .� � C) a � � o 49, 0 criz 0 z Is a LLJLLa 4 re) 30VId VSVCIV-1 W0ZC) F-E-Wza.a"'- w zo c!w W C) w t -z0 v�Q M0D F L 20 ar = 0 _It'�W0� CC 0 w�0�-nary p v� �Lu w < Q=z = Lu ar CL m cr a -' v t - WOO ' CLaw LU: wi r,, Cn O v -s � M w to p ..5 U) 04 z O 2r �tLu tr 0 g z a v� LJ = CL �; v Cd o Aw 00 qLL -o N ° o O Q t ° O Zi f •��" q C ° 49, Is W0ZC) F-E-Wza.a"'- w zo c!w W C) w t -z0 v�Q M0D F L 20 ar = 0 _It'�W0� CC 0 w�0�-nary p v� �Lu w < Q=z = Lu ar CL m cr a -' v t - WOO ' CLaw LU: wi r,, Cn O v -s � M w to p ..5 U) 04 z O 2r �tLu tr 0 g z a v� LJ = CL �; v Cd o Alpine Drilling & Enterprises Well Lag Permit Number: #SW12� 1 Date of Issue: 712 Date Started: 7-25-12 Date Completed: 7-25_1? parcel Identification Number: 01416236000 Legal Description; Frlslie Lot 5 Is well located at approved permit location? Property Owner Name & Address: Levi & Neid' S x Yes ❑ No Pump: Intake Depth feet -� Pump size hp Brand Name _ Well Disinfected Upon Completion? x Yes [I No Method of Disinfection: chlorine tablets Comment,: V Welt Driller: Alpine Drilling & Enterps ises PO Box 110496 Anchorage AK 99511 � mtth 5701 Whispering Spruce Drive Borehole Data: Anchorage, Alaska 99507 Soil Type, Thickness & Water StrataDepth (ft) From To Method of Drilling x air rota ry ❑ cable too] Stick-up Casing type: steel Organics & silt 0 2 Wall Thickness:.2So inches Gravelly silt 2 3 3 Diameter; 6 inches Depth: 82 feet Liner Type: silty grave, 5 5 54 Diameter: inches Depth: feet silt 54 Casing stickup above ground: _2 feet silty gravel 61 61 Static water level (from ground level); 21 feet silty nater sand & gravel79 79 82 Pumping level: 80 feet after 2 hours pumping 20 gpm Recovery ,Rate: 20 gpm Method of Testing: air Ii Well Intake Opening Type: x Open End . _. 0 Open Hole ❑ Screened Start feet Sto Stopped_ feet ❑ Perforations St Start feet Stopped feet Grout Type: ben- ntorit? Depth: Volume: I bg Pump: Intake Depth feet -� Pump size hp Brand Name _ Well Disinfected Upon Completion? x Yes [I No Method of Disinfection: chlorine tablets Comment,: V Welt Driller: Alpine Drilling & Enterps ises PO Box 110496 Anchorage AK 99511