HomeMy WebLinkAboutGLENN VIEW ESTATES LT 4Glen View
Estates
Lot 4
#051-521-41
F—s—_
Municipality of Anchorage Page _I of
DEPARTMENT OF HEALTH AND HUMAN SE=RVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 o Anchorage, Alaska 99519-6650 0 Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: :�
1�1 ,��l �Q� 7 PID Number: _65I��U
Name: AF /nE <
Wastewater System: New ❑Upgrade
Address
ABSORPTION FIELD
Z607u
Phone:
No. of Bedroo ts:
❑ Deep TrenchShallow Trench ❑ 8ecf ❑Mound ❑Other
LEGAL DESCRIPTION
Soil Hating
Total Depth from original grade I
�P
GPO/Sq. FL
Lot: Block_ ubdivisi n'
— e
Depth to pipe bottom from original grade:
2,3 FL
Gravel depth beneath pipe
�. 67 Ft.
Township:
Hange:
Section:
Fill added above original gra c
Gravel length:
D• 7l - Z • (o Ft.
5 Ft.
WELL New
O Upgrade
Gravel width
S
Number of lines.
Distance between lines
FL
Ft.
Classificatio (Private,t.B.C):
Total Depth:
Cased To:
Total absorption area::
Pipe material: D 30
YI vcu e,-930
Ft.
2? Ft.
500 SQ. Ft.
Driller: /
w111 ✓ay.. d e✓
Date Dr lled:
OM
Static Water Level:
1583 Ft.
Installer: 1
60W Sar-
Dale installed.
Yield:
Pump Set at:
Casing Height Above Ground:
TANK
GPM
l.cittiL✓l
Fl.
FL
SEPARATION DISTANCES
Xseptic D Holding D S.T.E.P.
To
From
Septic
Tank
Absorption
Field
Lilt
Station
Holding
Tank
Public/Private
Sewer Lines
Manufacturer: 0
✓C'.e✓, _......".
Material: -
Capacity in gallons:
` O
Well-
Number of Compartments:
/00 +-
/c)c�l I
—
—
Surface
Water
/�Q f•f
100,+
—
—
—
LIFT STATION
Loti
I
_
Size in gallons: Manul Curer:
Line
/0 f
10 --
—
—"
r
Foundation
"Pump on" level a
"Pump off' level a.
High water rm at:
Curtain
I
i
Pump Make & ode[
Electrical Inspect ns performed by:
Drain 4-
100 +
100 •t
Remarks: -Y- NOhe ffL/0wpj
_
BENCH MARK
Location and Description '' I
.SOYICI.
Assumed Elevation:
FI.
ENGINEER'S SEAL
�� ppoF A4
1�I���s�
�R�i°.,'
® ``4.�
Inspections performed by:
Dates: 1st
2ndio
®
�t,% K t
® tra Kenneth M. D
Department of Health and Human Services ap rot/fg
04 e° CE 7116 .�"N "o
Reviewed and approved by:Date:
�
72-019 (Rev. 9/91) MOA 25
A-C=25.�
B -C=11.0'
A -D=32.0'
B -D=17.3'
A -E=47.0'
B -E=43.9'
A -F=53.3'
B -F=25.2'
AS -BUILT
SYSTEM
DETAILS/SITE PLAN
Permit
SW970125
LOT
4, GLENN
VIEW ESTATES S/D
PID#051-521-41
99507
LOT 3
SYS'TEM rn-t/IT
R SERV AREA
0 T.H. 77-1
E T H 1
4 BDRM
-1-2[:p TIC TANK
SFD FC[l
WELL
eo
LOT 4
M
0
ry
rr
lL
2 5 "OG GAL
SEPTIC
TANK
0117 AZ4�SIA
KENNE"Ill M. Wl
CE- 71
'16 #4
0_2t'14 6 -AW101
Ilk
FINISHED GRADE
FILTER FABRIC\,
SEWER ROCK
54'
PREPARED FOR1
AARON SCOTT
A.F. SCOTT, INC.
2607 PUFFIN PT. CIR.
ANCHORAGE, ALASKA
99507
FIRD BOOKS
COMPOIED:
BOUNDARY:
DRAWN:
KMD
MAKING: LANG
CHECKED:
KMD
ASBUILP LANG
DAIE:
-5_/26/
MG. FILE:
GRID:
NW1 J6
AGAD F"E; 97041.I)WC
JOB No.:
97041
VACANT
LET 5
SCALE, 1' = 50'
SCALE, NTS 79;37 Y7 BN
&L.A\!JJJ ENGINEERING
20441. PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(907)096-6111/FAX {907)696-8111 j
® OVEE,fistll!
P '; •.
Municipality of Anchorage ;'4��
DEPARTMENT OF HEALTH & HUMAN SERVICES ••• ••••• •••• •••••'••
T 825 "L" Street, Anchorage, Alaska 99502 0650 . ,.",...,",..,. .,.�•,.
SOILS LOG — PERCOLATION TEST T'; Kenneth M. sCE
// // D
PTO 0
PERFORMED FOR: AG ,5co Tr 144, DATE PERFORMED:'%\®•O'4 z �Z �l_�O
LEGAL DESCRIPTION:
Township, Range, Sec IIon_
DEPTH SL�OPE� I IIf ITSIT ITE PLAN
1 (FEET)
2
3
a ;\
IR
'
fie !�G Lo
6
7
8
10
11
12
13
14
15
16
17
18
19
20
COMMENTS
WAS GROUND WATER
ENCOUNTERED? D
S
IF YES, AT WHAT /�J L
--(tiff O
DEPTH? p
E
Depth to Water Aller
Monitoring? Dale:
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
2 -Ze
Z; 5
—
Z
Z.
min
3�
3
z_ z
-
-•
Z:z3
zm
mz
3
,r
PERCOLATION RATE�/'� (mmulesnnch) PERC HOLE DIAMETER
TEST RUN BETWEEN—_,_,f` __ FT AND �_ FT
PERFORMED BY. IKAID e /% ee%r I � 1lf?ar 6eJ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNI ]PAL GUIDELINES IN EFFECT ON THIS DATE. DATE.
72-008 (Rev. 4/85)
iferfiffirb �rilltn� +�u� RECEIVED
DOC Co. on
SULLIVAN WATER WELLS JAN 16199B
P.O-BOX 670272,CHUGIAK,ALASKA 99567•TELEPHONE 688-2759 MutticipalityofAnchoragie
OWNER OF LAND &9(',J SA ti!
ADDRESS J Sl(9 J / uli+1 / HiQ 14..1CJf
LEGAL DESCRIPTIONGLa+J^J 01HY) EST
DATE. • Started Ended
PERMIT NUMBER
KIND OF FORMATION
Dept. Health & Human SurviceQ
DEPTH OF WELL D' a ) t 7'c,
_
STATIC LEVEL OF WATER Fr. • �!i
DRAW DOWN FT. _
GALS. PER HR c i] —Cl
KIND OF CASING
From—Ft, to y Ft,.-,.-C-dyIA S -l" jp From
Ft, to --Ft.
From Ft. to _Ft,c) o$C &Z4PJ Front
FLto__Ft.
From Ft. to_.Lt__Ft. _�"}0 6441174Front
Ft. to Ft.
I /< ip a L.
Ftom4-!Ft. toFt. S/ i. ty� From
Ft. toFt.
rom Ft, to�_Ft.�� �� Bc�,i Froro�—Ft. to Ft.
From—,15---
Ftom Ft.to/1-T_Ft. 94*1 ,�` bQ�� From
Ft.tn—Ft.
From to to %ba' Ft. SAT 'Y T4 J10— ` 4y— From
Ft. to Ft.
From���brr a` Ft. to_Ft. _-/ �� From
Ft. to F4.
From_�_L�%_Ft. to
Ft, to Ft.
From-AFt. to Ft. 136M-0GrL. From—Ft.
to—Ft.
From
Ft, to
Ft,
From
Ft. t0
Ft.
From
Ft. to
Ft.
From
Ft, to
Ft.
From
Ft, to
_Ft.
From
Ft. to
Ft.
From—Ft.
to
Ft.
MISCL. INFORMATION;
cmeojc ASARA-t-`!;9
From
Ft. to --Ft.
From
Ft, to
Fr.
From
Ft. to—J_—Ft.
From
Ft. to
Ft.
—
From
Ft, to
Ft.
From
Ft, to
Ft.
From
Ft. to --Ft
DRILLER'S NAME --aAAL�
Told bbbbbbbbbbbb6SLZ 889 5-113m 2131FJm NoeNi-ins Wd ti:To 3t11 L6 -o£ -d38
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW970125 DATE ISSUED: 6/10/97
DESIGN ENGINEER:KND ENGINEERING EXPIRATION DATE: 6/10/98
OWNER NAME:AARON SCOTT AF SCOTT, INC.
OWNER ADDRESS:2607 PUFFIN POINT CIR.
ANCHORAGE, AK. 99507
LEGAL DESCRIPTION:��
/-T15N--PRl-W SEG-1-6--5W--C-OR-NW4 NEW PID# 05152141
/LOT 4, GLENN VIEW ESTATES..
LOT SIZE: 40000 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM
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 ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED
ISSUED BY:
BY: DATE:
/' 'VYI�W L.. I v �/��u(/1?�✓L DATE:
I1 ISc2rv�
c
(�-'_�-0`
ND ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
111/FAX (907)696-8111
May 26, 1997
Municipality of Anchorage
Dept. of Health & Human Services
On -Site Services Section
P. O. Box 196650
Anchorage, Alaska 99519-6650
MUNICIPALITY OF ANCHORAGE
ENVIRONMENTAL SERVICES DIVISION
Subject: New sewer/well permit - Glenn View S/D, Lot 4
Gentlemen:
MAY 2 8 1997
RECEIVED
There is one previous testhole which was dug during the preliminary plat process,
this hole is suitably located for the four bedroom house which is proposed for this
lot. A copy of the results of this test and water monitoring is attached. The original
was submitted to DCPD/DHHS in conjunction with the plat
We propose to install a deep 2' wide trench. The original testhole indicated there
was no water found and that the hole was dry. We designed the system to utilize
both the upper and lower soil layers, and designed the system compliant with the
percolation rate of the slower of the two as the GW layer would percolate at a faster
rate. Additional fill will be placed over the system to provide a minimum of 3' of
cover when complete.
There are no public or private wells within 200' of our proposed system location
except as noted. There is neither surface water within 100' nor any curtain drain
within 50'. We do not expect that there will be any adverse effect on adjacent lots by
the development of this system.
If you have any questions, please contact me at 696-6111/FAX 696-8111.
Respectfully submitted,
1X14D Engineering
Kenneth M. Duffus, E.
attachments: On -Site Well and Sewer Application
Wastewater Absorption System Details/Site Plan
Soils Log/Percolation Test
WASTEWATER SYSTEM DETAILS/SITE PLAN
LET 4, GLENN VIEW ESTATES S/D
PROPOSED SYSTEM EXCEPT AS NOTED.
NO SEPTIC SYSTEMS WITHIN 200' OF
PROPOSED WELL EXCEPT AS NOTED.
"o-®740® N
AV
FAL4�
- I{ENNli'1'lI M. S _ /
CG -7116 A'
'! \ I'�'OFESSICN�'L
DESIGN DETAILS
4 BDRM X 150 GPD = 600 GPD
600 GPD/1.2 GPD PER SQ. FT. = 500 SQ. FT
500/(6.5'X2') (6.5' GRAVEL) = 42 FT. TRENCH
Total depth of system is 10.0' from original grade.
Total depth of gravel is 6.5' .
NOTES:
1. USE 1250 GALLON SEPTIC TANK. INSULATE TANK IF <4' COVER.
2. INSULATE TRENCH WITH 2" HD BURIAL FOAM IF <3' COVER.
3. CONTRACTOR WILL ENSURE MAXIMUM 21 SLOPE INTO SEPTIC TANK.
4. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE
MIN. 3' COVER IF REQUIRED.
PREPARED E❑R:
AARON SCOTT
A.F. SCOTT, INC.
2607 PUFFIN PT. CIR.
ANCHORAGE, ALASKA 99507
KND ENGINEERING
20441 PTARMIGAN BLVD
EAGLE RIVER, AK, 99577
(907)696-6111/Fax (907)696-8111
ATE- 5720797 DRAWING N
SCALE I' = 100' 97041 -Si
i, Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: Tu/L�l�/Z CO/VST G./VLr • DATE PERFORMEDrpI4t42 "
(AT � (q SuBDlv�SION OF Sw CaaNElZ Nhl/� ----
LEGAL DESCRIPTION: 6aNlq 11/,6w E57/Q7ES Township, Range, Section: rjSN Q/Gv GEN. lD ':zM
2
3 (!
4 ,.
17
18
19
20
COMMENTS
SLOPE
T/pso/�
GW yvr7H SRND
SOME PvziE 84-1
SAND &A16 t4
GM
5/t,T/ SAND`I C,/1AiEl,
6I AU.
MEDIUM DC�NS';�
zy WAS GROUND WATER
vDENCOUNTERED? N 0
501yoM of Hn4
S
IF YES, AT WHAT L
0
DEPTH? P
E
Depth to Water Alter
Monitoring?d-i _alit
SITE PLAN
Reading
Date
Gross
Time
Net
Time
rNaAM!8i`m�L) .
er➢, �,, '7e ?n
•�
l
ey
aP ✓i
eF': :'�
2
/d
W!(i''
11/llo
�A
H
/
. ZIP
y a /r
PERFORMED FOR: Tu/L�l�/Z CO/VST G./VLr • DATE PERFORMEDrpI4t42 "
(AT � (q SuBDlv�SION OF Sw CaaNElZ Nhl/� ----
LEGAL DESCRIPTION: 6aNlq 11/,6w E57/Q7ES Township, Range, Section: rjSN Q/Gv GEN. lD ':zM
2
3 (!
4 ,.
17
18
19
20
COMMENTS
SLOPE
T/pso/�
GW yvr7H SRND
SOME PvziE 84-1
SAND &A16 t4
GM
5/t,T/ SAND`I C,/1AiEl,
6I AU.
MEDIUM DC�NS';�
zy WAS GROUND WATER
vDENCOUNTERED? N 0
501yoM of Hn4
S
IF YES, AT WHAT L
0
DEPTH? P
E
Depth to Water Alter
Monitoring?d-i _alit
SITE PLAN
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
l
9
"04
2
/d
W!(i''
11/llo
H
/
Ilse
y a /r
/r
PERCOLATION RATE I immutesnnch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND --Z—Q FT
PERFORMED BY: E Q �S I �`'��<= CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. OArE.
Municipality of Anchorage
-�1 Development Services Department .I30,t
Building Safety Division
On -Site Water 8 Wastewater Program
4700 Bragaw Street
P.O. Box 196650 Y! 5 5 u a nc e ---
Anchorage, AK 99519-6650 I \
www.muni.orglonsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 0s/— _6 2 COSA# 00 0 a !i g
1. GENERAL INFORMATION Expiration Date:, — f9 — O 1
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
GLENN VIEW ESTATES, LOT 4
23303 GLENN HILL CIRCLE • CHUGIAK. AK 99567
EARL do SHARON MILLER Day phone 210-289-1046
PO BOX 671411 ► CHUGIAK. AK 99567
Day phone
LES BAILLEY w/PRUDENTIAL VISTA Day phone 689-6451
16635 CENTERFIELD DRIVE • EAGLE RIVER, AK 99577
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual Well
N
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
0
Individual Holding lank
❑
Community On-site
❑
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 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 riles 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 Finn GARNESS ENGINEERING GROUP
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 B 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 lost
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.
Phone
337-6179
Date 'Z C
Conditional approval for bedrooms, with the fllowing stipulations:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
V Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By:
(R.. I IMS)
`�<<lll(Y OF/�rrr
ON-SITE G�
WATERAND
WASTEWATER
PROGRAM'
Original Certificate Date: �7,— 2 Q - O 9
Municipality of Anchorage
• Development Services Department
Building Safety Division
Onsite Water & Wastewater Program
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: GLENN VIEW ESTATES, LOT 4 Parcel ID: DS I I — L//
A. WELL DATA
Well type PRIVATE If A. B, or C provide PWSID# N/A
Date completed 8/1997 Sanitary seat (YIN) YES
Total depth 238 ft.
Date of test
Static water level
Well production
Cased to 238 ft.
FROM WELL LOG
8/1997
WATER SAMPLE RESULTS:
138 ft.
5 g.p.m.
Well Log (Y/N) YES
Wires properly protected (Y/N) YES
Casing height (above ground) 18 in.
AT INSPECTION
7/22/2008
131 {t,
5.18 g.p.m.
Coliform1 1� colonies/100 mL Nitrate:?. 59 mg./L.Other bacteria U colonies/100 ml.
Arsenic: �• r1ug./L Date of sample: 2/11/2009 Collected by: GEG Ltd.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL Date installed 9/1997
Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N.) N/A
Date of pumping 7/22/08 Pumper MCDONALD'S PUMPING
•BELOW EXISTING GRADE: LESS THAN 3 OF
C. ABSORPTION FIELD DATA I R996 INSPECTION REPORT
Date installed 9/1997 Soil rating (g.p.d./ft'o t /bd 1_2 System type 5—WIDE
Length 54 ft. Width 5 ft. Gravel below pipe 3.67 ft.
Total depth *6.41 ft. Eff. absorption area 500 ft' Monitoring tube YES Depression over field NO
Date of adequacy test 7/22/2008 Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test DRY in. Water, added 700 gal. New depth 4 in.
Elapsed Time: 120 min. Final fluid depth DRY in. Absorption rate >= 600+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date —
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N
`Pump on" level at in. "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 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main N/A Public sewer manhole/cleanout N/A
Sewer /septic service line 25'+ Holding tank N/A
Animal containment areas 500+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation t o'+ Water main N/A
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
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 Printed Name JEFFREY A. GARNESS
Date Z-Ilyl'ai
COSA Fee
Date of Payment
Receipt Number
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
ANALYTICA
GROUP
Gamess Engineering Group, Ltd.
Atm: Jody GEG, Ltd.
3701 E Tudor Road, Suite 101
Anchorage, AK 99507
907-337-6179
Fax: 907-338-3246
Client Sample ID:
Glennview Est. Lot 4
Sampling Location:
Glennview Est. Lot 4
Client Project:
Private Well Testing
Sample Matrix:
Aqueous
COC #:
SG
PWS#:
Residual Chlorine:
Comments:
Lab#: A0902073 -01A
SP-Analytica, Inc. -Anchorage
4307 Arctic Blvd.
Anchorage, AK 99503
Phone: 907-258-2155
Fax: 907-258-6634
Report Date:
2/182009
Receipt Date:
2/112009
Sample Date:
2/112009
Sample Time:
8:20:OOAM
Collected By:
SG
Flap Definitions:
MRL = Method Reporting Limit
MCL = Maximum Contaminant Limit
B = Present also in Method Blank
F1= Exceeds Regulatory Limit
M = Matrix Interference
J = Estimated Value
D = Lost to Dilution
'• = RL higher than MCL; target not detected
TNC = Too Numerous to Count - result rejected
CF = Confluent Growth - result rejected
TCNG = Turbid Culture No Growth - rejected
Analysis Method Prep Prep Analysis
Parameter Result Units Flags hIRL MCL Method Date Dale Analyst
92228 (Aqueous) - TCbyMembFilt: Enumerat Test was conducted by: Analytica - Anchorage
Bacteria, Other <MRL CFU/IOOmL 1.0 2/112009 2/112009 DL
Total Coliform <MRL CFU/IOOmL 1.0
Lab#: A0902073 -01B
2/112009 2/1120(19 DL
Analysis Method Prep Prep Analysis
Parameter Result Units Flags AIRL MCL Method Date Date Analyst
45(10-NO3E (Aqueous) - Nitrate+Nitzite prcs Test was conducted by: Ana/yrica - Anchorage
Nitrate -Nitrite as Nitrogen 2.59 mg/L 1.3 10 2/17/2009 2/17/2009 JQ
Lab#: A0902073 -OIC
Analysis Method Prep Prep Analysis
Parameter Result Units Flags MRL MCL Method Date Date Analyst
200.8/200.8 (Aqueous) - Family Well Water I Test was conducted by: Analytica - Thornton
Arsenic 1.17 ug/L 0.15 10 200.8 2/162009 2/162009 GY
Page 3 of 3
Municipality of Anchorage
�• Development Services Department
Building Safety Division ..
On-SHe Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 6650
www.muni.org/onsfte
(907) 343.7904 j►r/'�""
CERTIFICATE OF ON-SITE SYSTEMS APP OVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 1251-3N,41 COSA# QFW IZ
1. GENERAL INFORMATION Expiration Date: ,- 10 -a C) 8
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
GLENN VIEW ESTATES, LOT 4
23303 GLENN HILL CIRCLE " CHUGIAK. AK 99567
EARL & SHARON MILLER Day phone 210-289-1046
PO BOX 671411 • CHUGIAK. AK 99567
Day phone
LES BAILLEY w/PRUDENTIAL VISTA Day phone
16635 CENTERFIELD DRNE • EAGLE RNER, AK 99577
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual Well
0
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
689-6451
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank
❑
Community On-site
❑
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 certified by my seal affixed hereto and as of the validation date shown below, 1 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 (les 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
Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date -7 2 5-10 "
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 Q 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 identsable 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 me
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
otherperson or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for 1/ bedrooms.
Disapproved.
Conditional approval for bedrooms, with the filowing stipulations:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Reort
Other
�nIGR �
PROGRAM
Original Certificate Date: :z, ;2, I - Q 8
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program ' �' "
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: GLENN VIEW ESTATES, LOT 4 ParcelID: 05' I/— 2/'1//
A. WELL DATA
Well type PRIVATE If A. B, or C provide PWSID# N/A
Date completed 8/1997 Sanitary seal (YIN) YES
Total depth 238 ft. Cased to 238 ft.
FROM WELL LOG
Date of test 8/1997
Static water level 138 ft.
Well Log (Y/N) YES
Wires properly protected (YIN) YES
Casing height (above ground) 18 in.
AT INSPECTION
7/22/2008
131 ft.
Well production 5 g.p.m. 5.18 g.p.m.
WATER SAMPLE RESULTS:
Coliform 4-1—colonies/100 ml. Nitrate 2' 95mgJL. Other bacteria 4—colonies/100 ml.
Arsenic: (' O ('ug./L. Date of sample: 7/17/2008 Collected by: GEG Ltd.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material
SEPTIC/STEEL
Date Installed
9/1997
Tank size 1250 gal.
Number of Compartments 2
Cleanouts (Y/N)
YES
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A
Date of pumping 7/22/08 Pumper MCDONALD'S PUMPING
-BELOW ExISTING GRADE: LESS THAN .3 OF
C. ABSORPTION FIELD DATA INSPECTION REPORT
Date Installed 9/1997 Soil rating (g.p.d./ft'o t /bd 1_2 System type 5–WIDE
Length 54 ft. Width 5 ft. Gravel below pipe 3.67 ft.
Total depth •6.41 ft. Eff. absorption area 500 ft' Monitoring tube YES Depression over field NO
Date of adequacy test 7/22/2008 Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth In absorption field before test DRY in. Water added 700 gal. New depth 4 in.
Elapsed Time: 120 min. Final fluid depth DRY in. Absorption rate >= 600+ g.p,d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date –
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N
"Pump on" level at in. '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 100'+ On adjacent lots 100'+
Absorption field on lot 100'+
Public sewer main N/A
Sewer /septic service line 25'+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
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
5'+
Property line 51+
Absorption field
5'+
Water main
N/A
Water service line 10'+
Surface water
1006+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main N/A
P
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Welts on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that 1 have determined through field inspections and e !
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this ....
date. Q J f r rness:
Engineer's Printed Name JEFFREY A. CARNESS �Q �J 79 F�
Date -7 X5-/4513 �Op�?rofeaatoo�oo
COSA Fee e 1T74
Date of Payment q-�a-5/0Y
Receipt Number L/lb&?I
(Rev. 11/05) 1
Waiver Fee $
Date of Payment
Receipt Number
ANALYTICA
GROUP
Gamess Engineering Group, Ltd.
Attn: Jody GEG, Ltd.
3701 E Tudor Road, Suite 101
Anchorage, AK 99507
907-337-6179
Fax: 907-338-3246
Client Sampie ID:
Sampling Location: Lot #4
Client Project: Private Well Testing
Sample Matrix: Aqueous
CDC #: 65460
PWS#:
Residual Chlorine:
Comments:(J "Je Lt
� r, ," L
SP-Analytica, Inc. -Anchorage
4307 Arctic Blvd.
Anchorage, AK 99503
Phone: 907-258-2155
Fax: 907-258-6634
Report Date:
7/24/2008
Receipt Date:
7/17/2008
Sample Date:
7/17/2008
Sample Time:
7:00:OOAM
Collected By:
Flae Definitions,
MRL = Method Reporting Limit
MCL = Maximum Contaminant Limit
B = Present also in Method Blank
It = Exceeds Regulatory Limit
M = Matrix Interference
J = Estimated Value
D = Lost to Dilution
• • = RL higher than MCL; target not detected
TNC = Too Numerous to Count - result rejected
CF = Confluent Growth - result rejected
TCNG = Turbid Culture No Growth - rejected
Analysis Method Prep Prep Analysis
Parameter Result Units Flags MRL 11ICL Method Date Date Analyst
Arsenic
Well Water I Test was conthrcted by: Analytica - Thornton
1.06 ug/L 0.15 10 200.8 722/2008 722/2008 GY
Reported by: Patryce D. McKinney,
Laboratory Project Manager
Page 2 of 2
ANALYTICA
GROUP
Gamess Engineering Group, Ltd.
Attn: Jody GEG, Ltd.
3701 E Tudor Road, Suite 101
Anchorage, AK 99507
907-337-6179
Fax: 907-338-3246
Client Sample ID:
Sampling Location:
Lot #4 —/ _
Client Project:
Private Well Testing
Sample Matrix:
Aqueous
COC #:
65460
PWS#:
Residual Chlorine:
Comments:
Lab#:
Comment: Glenn View Estates
SP-Analytica, Inc. -Anchorage
4307 Arctic Blvd.
Anchorage, AK 99503
Phone: 907-258-2155
Fax: 907-258-6634
Report Date: 7/24/2008
Receipt Date: 7/17/2008
Sample Date: 7/17/2008
Sample Time: 7:00:OOAM
Collected By:
Flag Definitions:
MRL = Method Reporting Limit
MCL = Maximum Contaminant Limit
B = Present also in Method Blank
ti = Exceeds Regulatory Limit
M = Matrix Interference
J = Estimated Value
D = Lost to Dilution
•• = RL higher than MCL; target not detected
TNC = Too Numerous to Count - result rejected
CF = Confluent Growth - result rejected
TCNG = Turbid Culture No Growth - rejected
Analysis Method Prep Prep Analysis
Parameter Result Units Flags MRL MCL Method Date Date Analyst
4500-NO3E (Aqueous) - Nitrate+Nitrite pres Test was conducted by: Analytica - Anchorage
Nitrate -Nitrite as Nitrogen 2.95 mg/L 0.50 10 7/17/2008 7/17/2008 JQ
Lab#: A0807172-OIB
Sample Comment: Glenn View Fstates
Analysis Method Prep Prep Analysis
Parameter Result Units Flags AIRL MCL Method Date Date Analvst
92228
MF
Bacteria, Other <MRL CFU/100mL 1.0
Total Coliform <MRL CFU/IOOmL 1.0
Lab#: A0807172 -OIC
Sample Comment: Glenn View Fstates
Reported by: Patryce D. McKinney,
Laboratory Project Manager
Page 1 of 2
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