HomeMy WebLinkAboutSCHROEDER EAST BLK 6 LT 5 KELSO MANOR PUDSchroeder
East
Block 6
Lot 5
#050-071-26
144
AUL ��� WATERW--EA
Domestic s commercial - Geothermal
Phone 907-688-2755
www.suilivanwaterwells.com
i
Permit Number: #SW 101089 Date of Issue 6/2912010 Parcel Identification Number: 05007126000
Date Started: 6/30/2010 Date Completed: 7/1/2010 is well located at approved permit location? nYes nNo
Property Description SHROEDER EAST Lot 5 Block 6 Section: Town: Range:
Property Owner Name & Address: C & T CONSTRUCTION
11404 JESSIE MAE CIRCLE EAGLE RIDER, AK 99577
Borehole Data:
Depth
Method of Drilling1 air rotary cable tool
Soil Type, Thickness & Water Strata
From
To
Casing type:
Casing Stickup
0
2
Wall thickness 0.25 inches
Fill
2
4
Diameter 6 inches Total: 44 feet
Liner type:
Peat
4
8
Diameter 4.5 inches Depth: 160 feet
Shale
8
87
Casing stick-up above ground: 2 feet
Static Water Level (from top of casing) 8 feet
Gray Bedrock Soft 87 111
Gray Shale
111
129
Pumping Level: feet after
Gray Bedrock
129
177
1 hours pumping gpm
Recovery hate 2 gpm
Purple Bedrock
177
183
Method of Testing: Air
Brown Bedrock
183
200
Well Intake Opening Type
Open End �] Open Hole
L J Screened Start feet Stopped feet
Perforations Start feet Stopped feet
Grout Type: Bentonite dry granular Volume: 350 Pounds
Depth 44 Start 0 feet Stopped 44 feet
Pump Intake Depth: feet
Pump size: HP brand name
Well disinfected upon Completion? X Yes 770
Method of disinfection CHLORINE 50 PPM
Comments: YIELD IS FROM PUMP TEST AFTER HYDRO -
FRAC. WELL CONFORMS TO ALL DEC/MOA
STANDARDS.
Water Sample Results:
Arsenic:
ug/1
Well Driller:
Cole Sullivan
Nitrates
mg/l
Sullivan Water Wells
Total Coliform Bacteria
colonies/100mL
P.O. Box 670272
Chugiak, AK 99567
Other bacteria:
col/100mL
(907) 688-2759
Attention: The property owner shall provide this log to DSD (onsite) and DN'R within 30 days of completion.
a�nrtwiata�a�'
ARCTIC PUMP & WELL INC.
Jim SUIIiV=
PO Bax 770197
Eagle River, AK 99577
(907) E88-2510
(907) 258-2510
(907)745-2510
apw@gci.net
� Pump Installation Log
Well Drilling Permit Number: SW osp101089
Parcel Identification Number: 05007126000
Legal Description: Schroeder East B6 L5
Lot: 5
Block: 6
Pump Installaion Date:
Pump Intake Depth Below Top of Well Casing
Pump Manufacturer's Name
Pump Model:
Pump Size:
Pitless Adapter Burial Depth:
Pitless Adapter Manufacturer's Name
Pitless Adapter Installer:
Well Disinfected Upon Completion?
Method of Disinfection:
Comments:
'um pinstallerNam e:
krctic Pump & Well, Inc.
itednesdm-, December 01, 2010
Date Of Issue: 6/29/2010
Property Owner Name Address:
C&T Construction
11404 Jessie Mae Circle
Eagle River AK 99577
8/18/2010
191 Feet
Franklin
10JS07S4-2W230
13 Feet
S-50
Arctic Pump & Well, Inc.
Yes
Chlorine
On -Site Water System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number: OSP101089
Tax Code Number: 05007126000
Work Type: Well Initial
Permit Effective Dates: June 29, 2010 to June 29, 2011
Design Engineer: GARNESS ENGINEERING GROUP LTD
Subdivision: SCHROEDER EAST
Site Legal Address: SCHROEDER EAST BLK 6 LT 5 G:0353
Owner/Address: C & T CONSTRUCTION INC
11404 JESSIE MAE CIR EAGLE RIVER AK 995777964
Site Mailing Address:
This permit is for the construction of:
Lot Size in Sq Ft:
Total Bedrooms:
20927
3
N Disposal Field N Septic Tank N Holding Tank N Privy Y Private Well N Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater
Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80).
3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received B
Issued By:
Date:
Date: !� t
>srni0t0�""(
Municipality of Anchorage
Development Services Department
Building Safety Division
,On -Site Water & Wastewater Program
4700 Bragaw St.
P.O. Box 196650
"Anchorage, AK 99519-6650
awww. ci . a n c h o ra g e. a k. u s
R (907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel 1. D.
Property owner(s) JOHN THOMSON W„/ C&T CONSTRUCTION Day phone 240-2020
Mailing address 11404 JESSIE MAE CIRCLE, EAGLE RIVER, AK
Site address
Zip Code 99577
Legal description (Sub'd, Block & Lot) SCHROEDER EAST S/D• BLOCK 6 LOT 5
Legal description (Township, Section & Range)
Lot Size
Sq. Ft.
THIS APPLICATION IS FOR ( ®all that apply):
Absorption Field
❑
Septic Tank
❑
Holding Tank
❑
Privy
❑
Private Well
Water Storage
❑
Number of Bedrooms
THIS APPLICATION IS AN:
Initial
Upgrade
❑
Renewal
❑
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal codes.
GARNESS ENGINEERING GROUP, Ltd.
Permit/Rush Fees: _'4 a 0 0
Date of Payment: (0 0
Receipt Number: L- 3 3
(Rev. 11/05)
Waiver Fees: ) ZQ
Date of Payment:
Receipt Number:
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS,,
June 21, 2010
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Elmore Street
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907) 343-7904
Ref: Proposed Wells for Schroeder East S/D; Lots 5, 6, 7, & 8, Block 6,
To whom it may concern:
We request a well permit be issued for each referenced property. An application and the
MOA permit fee have been submitted for each property. As can be seen on the
attached site plan/design drawing, we are proposing that a .community wastewater
system be installed to serve these properties. A design package was submitted to
ADEC and on June 16, 2010, we received an "Approval to Construct" for the
wastewater system. We have attached a copy of the Approval to Construct.
Construction of the wastewater system started on June 17, 2010 and is progressing.
The contractor would like to drill all four wells sequentially so the well driller can remain
on-site until all the wells are completed. As can be seen on the attached site
plan/design drawing, there are no encroachments concerns.
We are unaware of any adverse impacts this
or septic systems. If you have any questions
you for your a!Aistance.
cere
arnes$, P.E., M.S.
installation would have on adjacent wells
, please contact us at 337-6179. Thank
3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com
DEFT. OF EN`-JIROIV'MENTAL CONSERVATION
DMSION OF NATER
WASTEWATER DISCHARGE PROGRAM
June 16, 2010
Jeffery A. Garness, P.E.
Gayness Engineering Group
3701 E. Tudor Road, Suite 101
Anchorage, Alaska 99507-1259
Sean Parnell, GOVERATOR
555 CORDOVA
ANCHORAGE, AK 99501
Phone: (907) 269-7519
Fay: (907) 269-3487
http: //,w,wv.state.ak.us/dee/
Re: Schroeder East Subdivision, Block 6, lots 5-8- Eagle River -Conditional
Approval to Construct a Community Wastewater Treatment and Disposal
System-ADEC Plan Tracking Number 8125
Dear Mr. Garness:
On June 14, 2010 the Department received an engineering plan submittal for
an onlot advanced wastewater treatment system with, a new Quanics
treatment system and a new soil absorption system that will serve four(4)-
three (3) -bedroom homes (total of 12 bedrooms served) at the above location.
In addition an existing single family source well must be properly
decommissioned to allow this system to be constructed at the site.
The new 5,500 gallon STEP tank will pump into four in parallel 650 Aerocell
units. The soil analysis on site determined 10 minutes per inch and 2.5
minutes per inch for field percolation ratings an onsite soil absorption system
using an application rate of 2 gallons per day per ft2. Thus for the 1,800
gallons per day/2 gallons per day per ft2 application rate a field of 900 ft2 is
required and has been sited for use on Lot 7 of this subdivision.
The Department has reviewed the engineering plans submitted for the
community onsite wastewater disposal and treatment system and per the
Wastewater Regulations 18 AAC 72.235 Conditional Approval to Construct the
proposed system is hereby issued. A "Certificate to Construct" for the
community wastewater system is enclosed. Please use the referenced plan
number in correspondence regarding this system.
This approval is contingent upon compliance with the following
conditions:
1) The soils information has results which are differing in value, to assure
the design is met, please provide an engineer to inspect the site at the
tulle the soil absorption system is installed.
2) Provide contact information for the following individuals who will
mariaging the community wastewater system:
Owner Director -John E. Thompson- provide contact number
Engineer- Jeffery A. Garness- (907) 337-6179
Complaint Contact -(907) 337-6179
Pumper Service -provide contact number
Electrical and Additional Service Providers -provide contact number
This information must be kept current at the local ADEC Office should
providers or individuals change contact (907) 269-7519 Bill Rieth.
3) Tests for Nitrate as nitrogen will need to be provided along with the
record drawings. Even though a nitrogen reducing system is being
installed, the nitrate level of 12.6 mg/1 found at lot 9, Block 6, Schroeder
East Subdivision is a concern and additional protection of Public Health
may need to be provided based upon sampling information.
4) If the applicant fails to construct, alter, install, or modify the system
within two (2) years after the date that the department issues an
approval to construct, the approval is void, and plans must be
resubmitted, [along with associated fees], for department review and
approval.
5) Deviations from approved plans which affect capacity, flow, operation,
major design of units, point of discharge, materials of major system
components (such as pipe, lagoon liners, etc.), or separation distances,
must be approved by DEC in writing prior to their implementation.
6) This approval is contingent upon compliance with the conditions of
Wastewater Disposal Regulations, 18 AAC 72.235, Construction
Certification. The noted section of the regulations requires that a
11 Certification of Construction" be completed and submitted to the
Department within ninety (90) days of completion of construction. As -
built plans or record drawings should indicate any changes or deviations
from the approved plans to facilitate final review. A "Certification of
Construction" form is enclosed for your use.
7) This approval is contingent upon your receipt of any other state, federal
or local authorizations which are required for your project. You are
requi-red to obtain all other necessary authorizations before proceed;. -.g
with your project.
8) You are advised that if this rle'velQrl�Ylient vAll �re1qui-r- plonir�g fill M
1' � v �ru�..tax� ua xdi
vretlands or working in a stream, river, or lake, permits from the H.S.
Army Corps of Engineers and the Alaska Department of Natural
Resources may be required. A Coastal Projects Questionnaire will help
you identify other permits and approvals that may be required for your
project.
This approval does not imply the granting of additional authorizations nor
obligate any state, federal or local regulatory body to grant required
authorizations.
Any person who disagrees with this decision may request an adjudicatory
hearing in accordance with 18 AAC 15.195- 18 AAC 15.340 or an informal
review by the Division Director in accordance with 18 AAC 15.185. Informal
review requests must be delivered to the Division Director, 555 Cordova
Street, Anchorage, Alaska 99501, within 15 days of receiving the decision.
Guidance information on the informal review process may be found at
htt-p://www.dec.state.ak.us/commish/ReviewGuidance.htm. Adjudicatory
hearings requests must be delivered to the Commissioner of the Department
of Environmental Conservation, 410 Willoughby Avenue, Suite 303, P.O. Box
111800, Juneau, Alaska 99801, within 30 days of the decision. If a hearing is
not requested within 30 days, the right to appeal is waived.
Thank you for your cooperation. If you have any questions please do not
hesitate to contact nye at 269-7519.
Respectfully,
William R. Rieth, P.E.
Environmental Engineer
Enclosure: As stated
cc: William Smyth, WW, w/o enc.
,`J'AL CCNSc�'v'�, i ivN
CONST RUC" NAND -
t t0 OPE-RATION CER I i=10ATE
for
DOMESTIC WASTEWATER DIsPOSAL SYSTEMS
SO4rZeEPER CA5'r Sv4t7iV�sroNy E3tl k Lv'E'S S-$
C0MM('N''11`/ (rtJ'.45't'E cJ.4`PE2 `i'i�E4�j'�''IEI,''i' DisF'�SA4
A. APPROVAL TO CONSTRUCT ADE:c PLgK) 'TfrACW-w6 I.�UM�EI� Si2�
Flans for the construction or modification of NEW QvAf4ICS
660AF-►-OCELL "JiM . S SoaGA�N 5PP-P5,7 9ov r.3K �F i^L �� �JSitJ�;
�omestic wastewater disposal system
located in , Alaska, submitted in accordance with 18 AAC 72,225
by Fir �A►�IJE55 of GA/�SS Eit1G• have an reviewed and are
❑ approved.
conditionally approved (see attached conditions), 1,�
sY �"`e L-rjU. illG,. 2-0)0
r (TLE DaTE
If canatructio,
fit h s io,6 ot8ri36 `NILt1ln mvo years of ths approval date, this c�
sp=_c fications must be submittad ,.prove! for;aview and a� rtifica;e is void and new plans and
• o_fare comtructton.
1. APPROVED CHANGE ORDERS
Change (contact ordarno. ordeacrFcva rsfar3nca
s ,
APPROVAL TO OPERATE
;.• "his and 3i-tn=,4
i3 3j5C9 !S t'13 3 3>ai° = S3. Y .i 3
:..
:V
r,
y" " '1� ,���J J'..v�• w�� �i vin •� t~i `+ .._ �,^�_
-'i�. !•,�
rf;3
i.rn
^� ao:1 i 3
3'"' .. i
SCHROEDER EAST COMMUNITY
PROJECT MOR.
J.L.M.
:
WASTEWATER SYSTEM
DESIGNED BY
J.I-M.
JOHN THOMSON 907=240-2020
DRAWN BY
J.LM.
CHECKED BY
J.A-G.
GARNIESS ENGINEERING GROUP, Ltd.
SCHROEDER EAST SUBDIVISION; LOTS 5 TO B. BLOCK 5
II
CONSULTANTS & GENERAL
DAM- 3/31/2010
CONTRACTORS
Q.
14
0 U)
SCHROEDER EAST COMMUNITY
PROJECT MOR.
J.L.M.
:
WASTEWATER SYSTEM
DESIGNED BY
J.I-M.
JOHN THOMSON 907=240-2020
DRAWN BY
J.LM.
CHECKED BY
J.A-G.
GARNIESS ENGINEERING GROUP, Ltd.
SCHROEDER EAST SUBDIVISION; LOTS 5 TO B. BLOCK 5
II
CONSULTANTS & GENERAL
DAM- 3/31/2010
CONTRACTORS
a Municipality of Anchorage
On -Site Water & Wastewater Program
(907) 343-7904 ¢
C
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 050-071-26 Expiration Date: .moi 1
1. GENERAL INFORMATION
Complete legal description SCHROEDER EAST S/D• BLOCK 6, LOT 5
Location (site address) 12534 SPRINGBROOK DRIVE *EAGLE RIVER, AK 99577
Current Property owner(s)
C&T CONSTRUCTION
(JOHN THOMSON)
Day phone 240-2020
Individual Water Storage
❑
Mailing address
11404 JESSIE MAE
CIRCLE *EAGLE
RIVER, AK 99577
Real Estate Agent
2. TYPE OF DWELLING:
Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
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:
COSA to be release
COSA Fee
Date of Payment
unless otherwise requested by the engineer.
Receipt Number
COSA # 1� 3 3 /�
Date: t L Vic' /
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
6. 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. 1 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
Address
GARNESS ENGINEERING GROUP, Ltd.
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
DSO 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
7
System #1 Approved for .i bedrooms.
System #2 Approved for
Disapproved.
Conditional approval for
bedrooms.
Phone 337-6179
Date f i /Z9/t'2
bedrooms, with the following stipulations:
Original Certificate Date:
ON-SITE
WATER AND
WASTEWATER
PROGRAM
The Muu-niclpigtity46Ahchorage 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 C�
Septic System Advisory
Well Flow Advisory
,Pa iunm
Nitrate Advisory %
Arsenic Advisory
Other
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: SCHROEDER EAST S/D; BLOCK 6, LOT 5 Parcel ID: 050-071-26
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES
Date completed 7/1/10 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth 200 ft. Cased to 44 ft. Casing height (above ground) 24+ in.
Date of test
Static water level
FROM WELL LOG
7/1/10
Well production
WATER SAMPLE RESULTS:
Coliform Q colonies/100 ml.
Arsenic: /U i'J u ./L.
(,/4,y 13
B. SEPTIC/HOLDING TANK DATA
ft.
AT INSPECTION
7/3/13
8 ft.
3.2 —
9 -p.m -
Nitrate A]mg./L. Collected by: GEG. Ltd.
Date of sample: 10/22/13
COMMUNITY SEWER SYSTEM
Tank Type/Material
Tank size gal. Number of Compartments _
Foundation cleanout (YIN) _ Depression over tank (Y/N)
Date of pumping
C. ABSORPTION FIELD DATA
Date installed
Pumper
Soil rating (g.p.d./ft2or ft2/bdrm)_
Length ft. Width ft.
Total depth ft. Eff. absorption area ft2 Monitoring
Date of adequacy test Results
Fluid depth in absorption field before _ in.
Elapsed Time: Final fluid depth
A venation treatment (past 12 mo.) (YIN & type)
Date installed
Cleanouts (YIN)
High water alarm (Y/N)
System type
Gravel below
_epres io ft.
Depression over field
iss/Fail) For bedrooms
Water added _gal. New depth _in.
1. Absorption rate >= g.p.d.
If yes, give date
D. LIFT STATION
Date installed Size in gallons �Hlghwata==alarm
M
"Pump on" level at in. "Pump off" evel vel
Cycles testedMeets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankllift station on lot NSA On adjacent lots 100'+
Absorption field on lot NSA On adjacent lots
Public sewer main
Public sewer manhole/cleanout 100'+
Sewer /septic service line 25'+ Holding tank N/A
Animal containment areas 50'+ Manurelanimal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation
Water main
Wells on adjacent lots
Property line Absorption
Water service line Surface
SEPARATION DISTANCE FROM ABSORPTION
Property line
Water service line
Cu in
F. COMMENTS
G. ENGINEER'S CERTIFICATION
TO:
Water
Surface water Driveway, paridngtvehide storage
Wells on adjacent lots
I certify that I have determined through field inspections and a .;' 4 n r*
review of Municipal records that the above systems are in A " ' • ............
conformance with MOA COSH guidelines in effect on this
date. Q y rness
Engineer's Printed Name JEFFREY A. GARNESS Q 9, CE4�795 m�
Odd a, 1.13�,OG
Date /O/ZV, 112 Pd Drofessio�°���
(Rev. 77/05)
Municipality of Anchorage i €,
On -Site Water & Wastewater Program "^
(907) 343-7904 p s a E r
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I. D. 050-071-26p
Ex iration Date: s3 "
1. GENERAL INFORMATION
Complete legal description SCHROEDER EAST S/D; BLOCK 6, LOT 5
Location (site address) 12534 SPRINGBROOK DRIVE *EAGLE RIVER AK 99577
Current Property owner(s) C&T CONSTRUCTION (JOHN THOMSON) Day phone 240-2020
Mailing address
Real Estate Agent
2. TYPE OF DWELLING:
11404 JESSIE MAE CIRCLE *EAGLE RIVER, AK 99577
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
3
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
❑
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
0
Public Water System
❑
Public Sewer
❑
Received by: 1 �3 Date:
COSA to be released to the engineer, unless otheiwise requested by the engineer.
COSA Fee $
Date of Payment -i I f[�
Receipt Number 04-10 �J' 01 y1
COSA # (xC 1;31:3 I'T
Waiver Fee $
Date of Payment
Receipt Number
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.
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, LtD, 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
System #1 Approved for bedrooms.
0
System #2 Approved for bedrooms.
Disapproved.
Phone 337-6179
Date `7 loi 4
Conditional approval for bedrooms, with the following stipulations:
ojy tOF tft�ff�ir�i
ON-SITE N�
WATER AND
WASTEWAT ER
Original Certificate Date: :�Z' / (P ./ 3
Th6-Munidipal" o[gach"orage Develop, emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the rep senatations 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.
ATTCHMENTS:
COSA Checklist
Septic System Advisory
Well Flow Advisory
(Rev. 11105)
Nitrate Advisory ,
Arsenic Advisory —�-
-.6
Other
If more than I septic system is on the lot:
COSA Checklist # of
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description: SCHROEDER EAST S/D; BLOCK 6 LOT 5 Parcel ID: 050-071-26
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (YIN) YES
Date completed 7/1/10 Sanitary seal (Y/N) YES Wireserl
ro
p p y protected (YIN) YES
Total depth 200 ft. Cased to 44 ft. Casing height (above ground) 24+ in.
FROM WELL LOG
Date of test 7/1/10
Static water level 8
Well production
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 ml.
Arsenic: NQ ug./L.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material
Tank size gal. Number of Compartments
Foundation cleanout(Y/N) _ Depression over tank (Y/N)
AT INSPECTION
7/3/13
g.p.m. 3.2 g.p.m.
Nitrate Wmg./L. Collected by: GEO. Ltd.
Date of sample: 6/28/13
COMMUNITY SEWER SYSTEM
Date of pumping
C. ABSORPTION FIELD DATA
Date installed Soil rating (g.p.d./ft2or ft'/bdrm)_
Length ft. Width ft.
Total depth ft. Eff. absorption area_ ft2 Monitoring
Date of adequacy test
Fluid depth in absorption field
Date installed
Cleanouts (Y/N)
High water alarm (YIN)
System type
Gravel below ft.
_Depression over field
es uRs ail) For bedrooms
in. Water added _gal. New depth _in.
Elapsed Time: Final fluid depth _ in.
A uvenation treatment (past 12 mo.) (Y/N & type) _
Absorption rate >= g.p.d_
If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (YIN)
"Pump on" level at in. "Pump ofr,ke—va1at--------:rrHlgh water alar level at
Cycles tested Meets alar & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankiliR station on lot N/A On adjacent lots 100'+
Absorption field on lot- N/A
Public sewer main 75'+
Sewer /septic service line 25
On adjacent lots 100'+
Public sewer manhole/cleanout 100'+
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
Property line Absorption
Water main Water service line Surface water
Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELDJpN T TO:
Property line Build' ndation Water main
Water service line Surface water Driveway, parking/vehicle storage
Cu in Wells on adjacent lots
F. 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 COSH guidelines in effect on this
date.
Engineers P Name JEFFREY A. GARNESS
Date 7 jo11a
(Rev. >>ros)
OF q
As"Ifflam
Municipality of Anchorage
• '~� Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Braaaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. _ __ _ COSA# 01-)� O ��
1. GENERAL INFORMATION Expiration Date:
Complete legal description SCHROEDER EAST S/D; BLOCK 6, LOT 5
I �L Y3 y
Location (site address) SPRINGBROOK DRIVE * EAGLE RIVER, AK
Current Property owner(s) C & T CONSTRUCTION, INC. Day phone 240-2020
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
11404 JESSIE MAE CIRCLE * EAGLE RIVER AK 99577
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
Day phone
Day phone
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
❑
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
0
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As Cer't'ified by rrlj/ Seal of IiEG' ilerEiv any as ofthe /aiativn datc sivvir bell0w, I ver t„af 'y
.,.y
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
JEFFREY A. GARNESS P.E. /1
Engineer's Printed Name Date
Engineer's Comments:
In conducting this evaluation, GEG, LtD. 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.
5. DSD SIGNATURE
Approved for bedrooms.
Disapproved.
Conditional approval for
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
I'M aLe r%UV IJV,y
49 H
....... ... .. . ......... ....
e A. rness;
E 7 53 v
40��pro f ession o0
���\ill leilt l,.
. ON-SITE
�=X : WATER AND
bedrooms, with the following stipulations : MSTEWATR
'. PROGRAM
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
d=t'
By; KE � Original Certificate Date:
e
(Rev. 11/05)
Municipality of Anchorage
4� BV
Development Services Department ............ ..
Building Safety Division T
On -Site Water & Wastewater Program 3.A Y
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: SCHROEDER EAST S/D; BLOCK 6, LOT 5 Parcel ID: C>50 - 0 7 1 'c?,- 6
Well type PRIVATE If A, B, or C provide PWSID# N A Well Log (Y/N) YES
Date completed 7/1/2010 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth 200 ft. Cased to 44 ft. Casing height (above ground) 24+ in.
FROM WELL LOG
Date of test 7/1/2010
Static water level 8 ft.
Well production 2 a.D.m.
WATER SAMPLE RESULTS:
Coliform colonies/100 ml.
Arsenic: g./L.
B. SEPTIC/HOLDING TANK DATA
Tank size gal.
Foundation cleanout (Y/N)
C. ABSORPTION FIELD DATA
lea
Length
Total depth ft. Eff.
AT INSPECTION
ft.
g.p.m.
Nitra g./L. Other bacte _ onies/100 ml.
Date of sample: 1/27/2011 Collected by: GEG Ltd.
COMMUNITY SEWER SYSTEM
Date installed _
over tank (Y/N)
Pumper
(Y/N)
alarm (Y/N)
COMMUNITY SEWER SYSTEM
Soil rating (g.p.d./Wor ft2/bdrm) System type
Width ft. Gravelpipe ft.
ft
Depression over field
Date of adequacy test Res /Fail) For bedrooms
Fluid depth in absorption field be st in. Water addecl`� al. New depth in.
Elapsed Time: in. Final fluid depth in. Absorption rate >- g.p.d.
rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date
D. LIFT STATION
Size in gallons Manhole/Access
"Pump on" level at in. "Pump off' lev_ a High water alarm level at in.
Cycles tested Meets alarm & ci
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
Sewer /septic service line
25'+
Animal containment areas 50'+
Holding tank N/A
100'+
Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: COMMUNITY SEWER SYSTEM
Water main
Property line Absorption
Surface water.
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: COMMUNITY SEWER SYSTEM
Prope Building foundation Water main
Water service line Surface w Driveway, parking/vehicle storage
Wells on adjacent lots
F. 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.
Engineer's Pri teA Name JEFFREY A. GARNESS
Date Z
rim
COSA Fee $ �� Abp -V Waiver Fee $
Date of Payment of I / I Date of Payment
Receipt Number ®� 7�� Receipt Number
(Rev. 11/05)
SGS ReC#
1110300001
Client Name
Garness Engineering Group, Ltd
Project Name/#
Schroeder East Lot 5, Blk 6
Client Sample ID
Schroeder East Lot 5, Blk 6
Matrix
Drinking Water
PWSID
0
Printed Date/Time
02/03/2011 8:40
Collected Datef rime
01/27/2011 10:15
Received Date/Time
01/28/2011 8:35
Technical Director
Stephen C. Ede
Sample Remarks:
Allowable
Prep Analysis
Parameter
Results
LOQ Units
Method Container ID
Limits
Date Date
h -it
Metals by ICP/MS
Arsenic
ND
5.00 ug/L
EP200.8
C
(<10)
01/28/11 02/01/11
NRB
Waters Department
Total Nitrate/Nitrite-N
ND
0.100 mg/L
SM20 450ONO3-F
B
(<10)
02/02/11
AYC
Microbiology Laboratory
E. Coli
Negative
1 100ml-
SM20 9223B
A
01/27/11
SDP
Total Coliform
Negative
I 100mL
SM20 9223B
A
01/27/11
SDP
�
4SB0LT'
SEN&8D &
ASSOCIATES LAND SURVEYING 6
i HEREBY CERTIFY THAT I HAVE SURVEYED THE
SCALE
'
FOLLOWING DESCRIBED PROPERTY:
OF A
25-
DATE.
AND THAT NO F'�C`~~`='°"E"'S EXIST E^Ccr AS
'NOIC"TED. 17 IS THE RESPONS;SILITY OF THE
—6
4
OWNER TO DE TERMINE HE EXISTENCE OF A�Y
EASEMENTS, COVENANTS, OR RESTRICTIONS
GRIM:
Ly
WHICH DO NOT APPEAR ON THE RECORDED SUBDI-
Duan. Mp,,k S.-a,d
VISION PLAT. UNDER NO CIRCUMSTANCES SFMLD
,,rRUCTI ON
ANY DATA HEREON BE USED FOR CONsk
FB:
# oI- LS 69 1 �3
JI
OF FENCE LINES, OR FOR ESTABLISHING BOUND-
RAWN:
s*:K
ARY LINES.
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