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Home My WebLink AboutOPAL LT 1Opal Lot 01 #008-051-16 \ Municipality of Anchorage -� Development Services Department .: Building Safety Division On -Site Water and 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 FOR A SINGLE FAMILY DWELLING Parcel I.D. nm-nSI- Ke COSA# D 001 Expiration Date: — ei,G�- 0 7 1. GENERAL INFORMATION Complete legal description Lot 10oal Location (site address) 3210 Lark Street, Anchorage. AK Current Property owner(s) Ruth Mathes and Marione Ford Day phone 360-5535 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address P.O. Box 92294, Anchorage, AK 99509 Day phone Rona FlodoMomes Unitd Day phone 748.4500 Unless otherwise requested, COSA will be held by DSD for pickup. 2.' NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well El Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ 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 We (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 sample results. (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. 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 Pannone Engineerinq Services, LLC Phone 272-8218 Address P.O. Box 102954, Anchorage, AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date G /1 ,7/0 5z Engineers Comments: In conducting an adequacy lest, l attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. •••��aaaaa The operational life of all wells and septic systems depend on the local soil condition, ground water *4* 644 levels that may fluctuate during the year, and the water usage of the family being served by the system. : �p •j These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory lest results do not guarantee future performance of the system, nor do they guarantee that there arc no hidden defects or encroachments. PES can therefore not provide any warranty for future performance nor give any estimate of how long the system will continue to meet the operational requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed i Steven a. Ponnone above. Any reliance upon or use of this report by any other person or party is not authorized nor will it 0 No. CE 6149 confer any legal right whatsoever. #j"eA;`�?�d 5. DSD SIGNATURE ��aCaOaaass�a� ••• _L Approved for _ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: 7�04--� Original Certificate Date: 4; — LZ b -D m" tract Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 198850 Anchorage, AK 99519-6850 www.muni.orglonstte (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST A. WELL DATA Well type P � i ma 11 A, B, or C provide PWSID # Date completed 811611M Sanitary seat (YIN) I Total depth 117 ft. Cased to —HCLt—ft. Date of best Static water levet Well production FROM WELL WATER SAMPLE RESULTS: Coliform : ooloniesl100 mL Arsenic: tib mgn B. SEPTICIHOLDII Tank rater Tank size Foundation dear Date of pumping ft. g.p.m. Wed Log (YIN) N Wires properly protected (YIN) — Casing height (above ground) 4.�-_in. AT INSPECTION (0 j (a I g.p.m. Nitrate &-b- mglL Other bacteria_ coloies1100 mL Tl Date of sample: o Collected by: , " vw- TANK DAA Date iriat811ed gal. Number of Compartments _ Cleanouts C. ABSORPTION FIELD DATA Date installed Length R. Total depth _ ft. Eft. Date of adequacy test Fluid depth in abso eld Elapsed Time: min. Depression over tank (YM) _ High w_4W'alarm (Y/N) Pumper Soil rating .&e o rn) _ Width a area onibt Results (P before test _ in. Water Final fluid depth _ in. Any rejuvenation treatment (past 12 mo.) (YIN & type) System type R Gravel below pipe ft. ng tube _ Depression over field For _ bedrooms hd gal. New depth_ in. Abad rate >= g.p.d. I , give date D. LIFT Date installed 'Pump on" level at Datum E. SEPARATION DISTANCES J v S' "Pump I M _ in. Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/Ilft station on lot _Al� Absorption field on lot NLA Public sewer main '75"- Sewer 6 r Sewer /septic service line 26# - Animal containment areas /OOt TION DISTANCES FROM SEPTIGH Building foundation Props Water main Web" Wells on adjacent lots SEPARATION DIST Property line Water nice line Pfrtain drain _ F. COMMENTS Manhole/Aocess (Y/N) _ HIM water alarm level at Masts alarm &-&c4 requirements? On adjacent lots /00 t On adjacent lots /00 } Public sewer manhole/cleanout Holding tank /0,0,0- Manure/animal 0,0tManure/animal excrete storage areas TANK FROM ABSORPTION FIELD ON LOT TO: Building foundation _ Surface water Wells on adjacent lots G. ENGINEER'S CERTIFICATION I cer* that I have determined through fab 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 Steven R. Pannone, P.E. Date (9(1410,7-- COSA Fee $ v Date of Payment Receipt Number (Rev. I IMS) 211 Absorption flea Surface water Water main Driveway. paWagNeNcle Waiver Fee $ _ Date of Payment Receipt Number, 0 R. Ponn( -E 6149 ti/0 X., N in. SCS RtLM 1072596001 Client Name Pannone Eng. Srv. Project Name/# Lot I Opal Client Sample ID Lot l Opal Matrix Drinking Water P%NISID 0 Sample Remarks: All Dates/Times; are Alaska Standard Time Printed Datdrime 06/14/5007 16:03 Collected Date/rime 06/06/2007 21:00 Received DatefTime 06/072007 11:10 Technical Director Stephen C. Ede Allowable Prep Analysis Parameter Resole POL Units, Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.9 C (<10) 06108/07 06/12/07 TK Waters Department Total Nitratc/Nitrite-N ND Microbiology Laboratory Total Coliform 0 0.100 mg/L SM20 450ONO3-F D (<IO) col/IOOmL SM209222B A (<I) 06/11/07 TRM O6/07/07 DLC m M tD O r W 0 0 it 0 0 M O O t=j) Z O Z D J Y U_ LARK STR EL _ 0 IW O LOT 2 0 6 00 I asementsignedl2.15.780� CD d� N89054'00"E 86.67 I Z sement signed 12.15-78 Note: Easement Information Is per survey try Fleming Surveying Servkes, dated 11-1497 EASEMENTS OF RECORD. OTHER THAN THOSE SHOWN ON THE RECORDED Fleming FLAT ARE NOT SHOWN HEREON. BE I'A 8315W Portion BLM LOT 25 Lot 3 SCALE: 1'= 30' V AL sib, tt that I NN pw*~ a�MoryTapee'a evpecoon Archomp Recorded Fna,ct. All" and tot IM arprovemutts situated hereon am weh to Vope" in" and do not otodap IN onmoo w to IN we ty "V adpant twelo, tut w /nprovemute pn"prop" wj adpurd twetu encroach w to pnn tsa in Wesdon and tri ttsm"tto roodwrA. tuumasrort anal a otnar "Ia0» "" w" on sad property aaupt n adrJted Illaan. Dated at Areo-210. Alaska Mr /tlth day of XJ07 FRED WALATKA t ASSOCIATES Enpnewe and Suneyore (907d411+ee6) �� me �,f q. 1!O• M��1_ � AS•BULT NO COPMRS SET THS DATE tt that I NN pw*~ a�MoryTapee'a evpecoon Archomp Recorded Fna,ct. All" and tot IM arprovemutts situated hereon am weh to Vope" in" and do not otodap IN onmoo w to IN we ty "V adpant twelo, tut w /nprovemute pn"prop" wj adpurd twetu encroach w to pnn tsa in Wesdon and tri ttsm"tto roodwrA. tuumasrort anal a otnar "Ia0» "" w" on sad property aaupt n adrJted Illaan. Dated at Areo-210. Alaska Mr /tlth day of XJ07 FRED WALATKA t ASSOCIATES Enpnewe and Suneyore (907d411+ee6) 03--d O-! I-1 E R . "`-`- GR=E`R 1ANCHORAGE—ARRA bUKUUUH � x� 7V149 apartment of Environmental Qual t 3330 "C" atreet, Anchorage Alaska 99503 274-45561 Date Received 0-15-74 Time of Inspection 3:00 P.M. Date of Inspection 3-16•-74 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & NATER FACILITIES FOR VA 1. Approval requested by: Charles B. Wells Mailing Address• SRA Box 711-J _ Phoneo864°-3157 (work)" _ 2. Property Owner. _Charles B. Wells _ Phone: 8643157 (work) Mailing Address: SRA Box 711! - ®� i 3. Legal Description, Lot 1. Block 1, Opal Subdivision o _ 4. Location: 2310 Lark Street (2 blocks nest of Tudor Office) 5. Type of facility to be inspected Single FarnilyNo. of bedrooms 4 6. Well Data: A. Type -I ndividual B. DepthC. 117`_ — Construction D. Bacterial Analysis Satisfactory 7. Sewage Disposal System: Public Utility - approved D-27-74 A. Jnstalled .��1972 B. Installer C. Septic Tank: 1. Size _ 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank � Absorption area , Sewer Lines Nearest lot linea _, Other contamination�� B. Foundation to septic tank __, Absorption area C. Absorption area to nearest lot EQ-034 (1/74) - - Pagel of twopages" j:.:. 1 ; ti-'� t,t }-- (