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HomeMy WebLinkAboutNORTON PARK LT 2BNo.ton Pa k Lot 2 · 016-151 -60 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Road 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. 016-151-60 1, GENERAL INFORMATION cos^# O3 Expiration Date: Complete legal description NORTON PARK LOT 2B Location (site address) 1 1621 ELLEN AVE. *ANCHORAGE, AK 99515 Current Property owner(s) Mailing address LYNN &: BETTY HARRIMAN Day phone 11621 ELLEN AVE. *ANCHORAGE, AK 99515 c/o AGENT Lending agency Day phone Mailing address Real Estate Agent _ PAM REYNOLDS W/PRUDENTIAL Day phone ,Mai'iing~a~dress 16635 CENTERFIELD DRIVE *EAGLE RIVER,. AK 99577 Unless Otherwise requested, COSA will be held by DSD for pickup. 2. :NUMBER-OF BEDROOMS: 242-9975 3 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 [] 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 certified by my seal affixed hereto and as of the vafidation 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. Phone 557-6179 Address 5701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. 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 afl 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. DSD SIGNATURE V'/' Approved for Disapproved. Conditional approval for bedrooms. ~': ON-SITE = , ~ATERAND = ; WASTEWATER bedrooms, with tho followin~ stipulations: % ~ .. Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory (Rev. 11/05) Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: (~ ~ ~ -// Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: WELL DATA Well type PRIVATE Date completed Total depth **69 NORTON PARK LOT 2B UNK *WELL INSPECTED BY APWS, **PER GE(;; INSPECTION IfA, B, orC provide PWSID# N/A Sanitary seal (Y/N) YES ft. Cased to *40+ ft. Parcel iD: 01 6-151-60 SEE ATTACHED RECEIPT Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) NO 12+ in. Date of test Static water level FROM WELL LOG NO WELL LOG Well production ~ g.p.m. WATER SAMPLE RESULTS: AT INSPECTION 8/22/11 52 6.26 g.p.m. Coliform 0 colonies/100 mi. Arsenic: ND ug./L. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Tank size__ gal. Foundation cleanout (Y/N) __ Date of ~ C. ABSORPTION FIELD DATA Nitrate ND mg./L. Date of sample: 8/22/11 Number of Compartments Pumper Collected by: GEG, LTD. PUBLIC SEWER Date installed High water alarm (Y/N) Date installed Soil rating (g.p.d./ft2or ft2/bdrm)~ System type Length ft. Width ft. Gravel b~ Total depth ft. Eft. absorption area ft~ Monitoring tubes...~epression over field Date of adequacy test Results (p~s/Cal0~'~ For bedrooms Fluid depth in absorption fiel~ in. Water added __ gal. New depth in. _ Elapsed T~ Final fluid depth in. Absorption rate >= g p d An ' enation treatment (past 12 mo ) (YIN & type) NONE KNOWN If yes, give date - __ ~-%..... D. LIFT STATION Date installed "Pump on' level at in. Size in gallons Manhole/Access ~ "Pump off" level_~~. High water alarm level at Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot N/^ Absorption field on lot N/^ Public sewer main 75'+ Sewer/septic service line 25'+ Animal containment areas 50'+ ,in. On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout Holding tank N/A Manure/animal excrete storage areas 100'+ 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: PUBLIC SEWER Building foundation Property line Absorption field Water main Water service line ~ ~ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPT~ TO: Property line .... __~ndation. Water main. Water service line / Surface water 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 Printed Name JEFFREY A. GARNESS COSA Fee $ Date of Payment Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number IQ~ UT/L, Lot A/'orfon ZOT ZA /V &9~ 5Z'$0"£ 3ubd/wWon ~] W~LL Anchorage Recording District~ Alask~t .5' &$° 52' ~o"w LOT SURVEY CERTIFICATION J hereby ce~tif~ that J have m~.-veyed tt~e I~ope~t~ she~n and de~orlbed hereon~ ~ t~t ~ [~em~t, eit~oted th~e~ ~e ~Jt~ the arty t~ ~d do not ~eriop or *~roooh ~ odjo~t ~o~rty and that ,%, L~1192 _~ %'..... LEGEND D ~ x ~ hub & tack r~ered 5/8" x ~" rebar set th~s survey Fence Line (Approx. Sco,e /,,~ :tO' Ref. ?770 Date © 06-Od-~~ r.~. No.//_ 035 Prepared by: t~. L. BUTTON Registered L~nd Surveyor 519 W. £/gh~h Ave. Anch~e Al~4ro 99~01 Property of: ZL/n/~ Ha/"/"//~on SGS Ref.# 1113963001 Client Name Gamess Engineering Group, Ltd Printed Date/Time 08/25/2011 16:01 Project Name/# Norton Park Lot 2B Samples Collected Date/Time 08/22/2011 13:30 Client Sample ID Norton Park Lot 2B Received Date/Time 08/22/2011 14:30 Matrix Drinking Water Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 08/23/I1 08/25/11 NRB Waters Department Total Nitrate/Nitrite-N ND 0.100 mg/L SM20 4500NO3-F B (<10) 08/24/11 AYC Microbiology Laboratory E. Coli Nep. ative 1 100mL SM20 9223B A 08/22/11 DLC Total Coliform Negative 1 100mL SM20 9223B A 08/22/11 DLC Aarow Pump & Well Service LLC (907)346-9355 Inspection Report I ran a camera 55' down the well at 11621 Ellan Ave and did not find any holes/cracks in the casing or leaking around the pitless. Beau Maxim ~0 I I.' L~ Department of Environmental QualityLJ~ 3330 "C" Street, Anchorage, Alaska 99503 ~4-4561 1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: Date Received Augustll, 1976 Time of Inspection ,~ Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Spokan~ Mortgage 3201 C Street Phone: 277-0543 Tim & Nancy Jones Phone: 278-2985 220 East IntErnational Airport Road Legal Description: Lot 2B Norton Park Subdivision Location: 5. Type of facility to be inspected 6. Well Data: Individual A. Type C. Construction Sewage Disposal System: ~/'~ A. Installed C. Septic Tank: D. Seepage Pit: Single Family No. of bedrooms B. Depth D. Bacterial Analysis B. Installer 1. Size 1. Absorption Area E. Disposal Field: Total length of lines Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank C. Absorption area to nearest lot line , Sewer Lines 2. Manufacturer 2. Material , Absorption area , Other contamination , Absorption area EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - Re~ ;t for Approval of Individual F ~r & Water Facilities Legal Description Lot 2B Norton Park Subdivision Comments Approved~_~x~ ~ ~~ Disapproved - ~ ~ - Date z~-/- ) Approval~Valid for one year from date signed k~/Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) 1. Type of Inspection: 2. Property Owner: MUNICIPALITY OF ANCHORAGE .......... ::. · DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTE~'IO~.::: :: 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 ~,',,, :: ;,,,., ',, ~- REQUESTFOR APPROVAL OF INDIVIDUALSEWERand WATER FACILITIES August ll, 1976 CMRO VA XX FHA Tim & Nancy Jones Mailing Address:. 220 East Int'l Airport Rd~3ayPhone: Name of Buyer: Richard Berry 278-2985 Mailing Address: 4. Name of Lending Institution: Mailing Address: 3201 5. Name of Realtor or Agent: Mailing Address: 3201 6. Legal Description: Location: Box 1848, Anchorage Spokane Mortgage Day Phone: 279-6039 (Attn: Shirley) "C" St., Anchorage Phone: 277-0543 Toni Brown, Jack White Company ~C" Street Phone: 2'77-1553 Lot 2B, Norton Park Subdtvi,'sion Xlatt Rd, to Ellen Stree't, le£t to second house on East/left Brown 'tone Type of Facility to be Inspected: Water Supply Type of Supply: side of street (no house n~aber) ranch style house single £ami]? home No. Bdrms. 3 Public Utility. rlndividual wel, 1 one If Individual, number of dwellings presently served__ If Individual, depth of well 160' Sewage Disposal System N/A Type of System: Public Utility If Individual, date of installation Individual (on-site) 72-003(3/76)