HomeMy WebLinkAboutEAGLE RIVER VALLEY RANCHETTES LT 15CE gle River' Valley
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Lot 15C
#050-222-10
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•t Municipality of Anchorage =
On-Site Water and Wastewater Program 4'""'i' "'
(907) 343-7904 SAF ETY
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
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Parcel I.D. 050-222-100 Expiration Date: S LJ - /�s
1. GENERAL INFORMATION
Complete legal description EAGLE RIVER VALLEY RANCHETTES LOT 15C
Location (site address) 18709 MAN 0 WAR ROAD, EAGLE RIVER,AK 99577
Current Property owner(s) DAVID&RIANNON FREBEL Day phone
Mailing address 18709 MAN 0 WAR ROAD, EAGLE RIVER,AK 99577
Real Estate Agent Day phone
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: • TYPE OF WASTEWATER DISPOSAL:
Individual Well ❑ Individual Eg
Individual Water Storage ❑ Holding Tank ❑
Community Class_Well ❑ Community ❑
Public Water System ® Public Sewer ❑
Waiver/Variance request for: Distance:
Received by: , -494..fDate: I/'.2. .�71S
COSA to be released to the engineer,unle otherwise requested by the engineer.
COSA Fee $ -CY _ Waiver Fee $
Date of Payment 1/A6112 Date of Payment _
Receipt Number Receipt Number
COSA# °bail/U�L1 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 868-3791
Address 20441 PTARMIGAN BLVD.,EAGLE RIVER,AK 99577
Engineer's Printed Name KENNETH M. DUFFUS 1/24/2018
Engineers 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 - Or AL
occupants or can ArcTerra guarantee that no unseen
encroachments,deficiencies or discrepancies exist. / S
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49-14 9 T
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6. DSD SIGNATURE ,,�'�'�
?, KENNETH N. t FFU3//.
System #1 Approved for 3 bedrooms. , c°�F "s ,�z.,"
System #2 Approved for bedrooms. \ NI ,10" 1A"'i'
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
SITE
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=T. `z l�`1 Original Certificate Date: C jc 3^/
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.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet 10-10.12.doc
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: EAGLE RIVER VALLEY RANCHETTES LOT 15C Parcel ID: 050.222-10
A. WELL DATA — PUBLIC WATER
Well type If A, B, or C provide PWSID# Well Log (Y/N)
Date completed Sanitary seal (YIN)Y Wires properly protected (Y/N)
Total depth ft. Cased to ft. Casing height(above ground) in.
FROM WELL LOG AT INSPECTION
Date of test
Static water level ft. ft.
Well production g.p.m. g.p.m.
WATER SAMPLE RESULTS:
Coliform colonies/100 mL Nitrate mg/L
Arsenic: ug/L Date of sample: Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC I HDPE _ Date installed 91212000
Tank size 1300 gal. Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N
Date of pumping 1111412017 Pumper JRs
C. ABSORPTION FIELD DATA
Date installed 51171201.6 Soil rating (g.p.d./ft2 or ft2/bdrm)0.8 _ System type DEEP TRENCH
Length 50 ft. Width 2 ___ft. Gravel below pipe 6 .__ ft.
Total depth 10.25 ft. (Measured 5/18/16) Eff. absorption area 600 ft2 Monitoring tube Y Depression over field N
Date of adequacy test NA—NEW FIELD Results (Pass/Fail) For bedrooms
Fluid depth in absorption field before test in. Water added gal. New depth in.
Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N 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 in. High water alarm level at in.
Datum Cycles tested Meets alarm&circuit requirements?
E. SEPARATION DISTANCES - PUBLIC WATER
WELL ON LOT TO:
Septic tank/lift station on lot On adjacent lots
Absorption field on lot _ On adjacent lots
Public sewer main Public sewer manhole/cleanout
Sewer/septic service line Holding tank
Animal containment areas Manure/animal excrete storage areas
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 200'+
ABSORPTION FIELD ON LOT TO:
Property line_10'+ Building foundation 10'+ Water main 10'+
Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ _
Curtain drain 50'+(NONE KNOWN) Wells on adjacent lots 200'+
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.
OF Az,\�
Engineer's Printed Name KENNETH M.DUFFUS /(S.Q
Date 112412018 9 TI1 ,
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` 9 KENNETH '.t.
COSA canary sheet_2-6-15.doc 1�%, 718
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