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HomeMy WebLinkAbout20158 COSA Y (S)Legal Description: _ COSA Checklist McKinley Heights #1 Block 3 Lot 5 Parcel ID: 051-212-23 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) Date drilled 10/22/02 Total depth 180 ft Cased to 38 ft ❑✓ Sanitary seal is functioning correctly ✓❑ Wires are properly protected Casing height (above ground) 20 in. Date of flow test for COSA 8/4/23 Static water level at beginning of test 27 ft Comments... _ B. TANK DATA Measured operating fluid level in septic tank New Date of pumping New Tank 5122/23 ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 7/14/84 ❑-/ ALL standpipes present per record drawing Total measured depth from grade 9 ft (max) Measured depth to pipe invert from grade ft (min) ./❑ NIA — 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 field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies COSA Checklist June 2022 Well production at time of test 1.8 gpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ❑ Nc ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Arcterra Consulting Date C. LIFT STATION ❑✓ Required maintenance completed Age of lift station 0 years Lift station material Plastic Comments Adequacy test date Results ❑J Pass Fluid depth prior to test Water added 550 gal 8/8/23 0 in New fluid depth 0 in Elapsed time 10 min Final fluid depth 0 in Absorption rate 450+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 60 in Effective depth used 0 in Effective depth remaining 60 in 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' J❑ Yes if No Community Sewer Manhole/Cleanout > 100' ✓❑ Yes if No ft ] Yes if No Neighboring Tank > 100' © Yes if No ft Private Sewer/Septic Line > 25'�/❑ Yes if No Absorption Field on Lot > 100' Yes if No ft Holding Tank > 100'✓❑ Yes if No Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ❑./ Yes if No Yes if No ft ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ✓❑ Yes if No ft ❑✓ Yes if No ❑ 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 required) Building Foundations > 10' J❑ Yes if No ft Surface Water > 100'❑ Yes if No Tank to Property Line > 5' 7 Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' ✓❑ Yes if No ft Private Wells > 100' © Yes if No Water Main > 10' V/ Yes if No ft Community Wells > 200' ❑✓ Yes if No Water Service Line > 10' Q Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS ft ft ft 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 Arcterra Consulting Phone (907)-696-6111 Engineer's Printed Name Kenneth Duffus Date 8,/.e/`3 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 encroachments, deficiencies or discrepancies exist. COSA Checklist June 2022