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HomeMy WebLinkAboutSPRUCE ACRES LT 13 DATE RECEIVED. TIME TIME _.1~/ / ] TIME INSPECTOR INSPECTOR INSPECTOR ~UNICIPALI~ OF ANCHO~GE MUNICIPALITY OF ANCHORAGE ~ ENVIRONMENTAL SANITATION DIVISION MAY ~ 9 1981 Telephone 264-4720 REOUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEW~I~I~ DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be proce~ed. Please allow ten (10) days for processing. P~ERTY R~SlDENT (If different from above) ~ PHONE MAILING ADDRESS MAI L~N~ ADDR~S ' ~I'P~F.~-'L-~CATI ON NUMBER OF~BEDROOMS [] One [~ Four [] Other [] SINGLE FAMILY [] Two [] Five E~ MULTIPLE FAMILY [] Three [] Six WATE~UPPLY 7. ' INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. ~ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(Rev. 6/79) ~ I ~,__,~ THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE E~ SINGLE FAMILY [] MULTIPLE FAMILY 2, WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM [~] INDIVIDUAL/ON -SITE []PUBLIC UTILITY Connection Verified []Septic Tank or []Holding Tank Size: If Tank is homemade give dimensions: NUMBEROFBEDROOMS [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SIX PERMIT NUMBER DEPTH OF WELl. DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER ~ RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL Septic/Holding Tank 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line Absorption Area Sewer Line [] OTHER Nearest Lot Line 5. COMMENTS [J~'/APPROV ED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE 72-OLO (Rev. 6/79) , . CHEMIC/iL & G~OLOGICAL LABORATORIES OF ALASKA, INC. /~'~~lk /IX TELEPHONE 274-3364 (9071-279-4014 ANCHORAGE E633 B St INDUSTRIAL re et CENTER .......... ~ Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: Mailing Address City SAMPLE DATE: Mo. Day SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with lab ref. no. [] Special Purpose I.D. NO. ~C? ~, · \~ ..... ; ~-~., Phone No. State Zio C~de Year [] Treated Water [] Untreated Water SAMPLE NO. 1 2 3 4 5 LOCATION I I I Time Collected Collected By TO E~E COMPLETED BY LABORATORY Analysis snows tins Water SAMPLE to be: D' Satisfactory [] Unsatisfactory [] San' ole too long m transit; sample should not De over 48 hours old az examination to ndmate reliable results. Please send r~_ew sam Die. Date Received Time Received ";;' ::;' Analytical Method: - Fermentation Tube I~ Membrane Filter Lab Ref. No. Result* Analyst Ir'??,;,'? '',,,::,,q ~ I I~ I I~ I II-i-I I II-I-I READ INSTRUCTIONS BEFORE COLLECTING SAMPLE 06-1220 Rev. 1978 BACTERIOLOGICAL WATER ANALYSIS RECORD 24 Hours R~portlKt By ~ :~" •': Municipality of Anchorage On -Site Water and Wastewater Program " (907)343-7904 Certificate of On -Site Systems Approval Parcel I.D. 014-231-20 1. GENERAL INFORMATION Complete legal description SPRUCE ACRES; LOT 13 Location (site address) 8301 SPRUCE STREET Current Property owner(s) CAROL SPENCE Mailing address Real Estate Agent 8301 SPRUCE STREET TOM ALEXANDER Expiration Date: 15 l Day phone 243-0377 Day phone 257-0411 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class _ Well ❑ Community ❑ Public Water System ❑ Public Sewer lid WaiverNariance request for: N/A Distance: - Received by: 117 Date: V/,/i5 COSA to be released to the engineer, unless othermse requested by the engineer. COSA Fee $ 696 Date of Payment t-1 1 a 1 t 5 Receipt Number 0AAI&VC� COSA#VcS05-11-3y 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. Phone (907) 337-6179 Address 3701 E. Tudor Rd., Suite 101 Anchorage AK 99507-3246 ` Engineer's Printed Name Jeffrey A. Garness Date k ik In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reporkcd results describe the condition of the systems on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend on a variety of variables including, but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail. The content of this report is for the sole benefit ofthe person/party who retained GEG. Reliance upon the information provided in this report by any otherperson or party, including but not limited to subsequent property purchasers, is not authorized. In short, GEG disavows any legal duty to anyone other than the person/party who paid for this report OF 6. DSD SIGNATURE J� ON-SITE System #1 Approved for S bedrooms _ WATER AND m System #2 Approved for bedrooms ) WASTEWATER o^ PROGRAM Disapproved Conditional approval for bedrooms, with the followlhg`��ft, " ,W�O ` By: Original Certificate Date: f{17 /✓r The Municipality of Anchorage D elopment 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 Nitrate Advisory Septic System Advisory Arsenic Advisory X Well Flow Advisory Other COSA blue sheet 9-1-12.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: SPRUCE ACRES; LOT 13 Parcel ID: 014-231-20 A. WELL DATA *ASSUMED PER SURROUNDING WELL LOGSI Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) NO Date completed PRE 1983 Sanitary seal (Y/N). YES Total depth 40'+ ft. Cased to *40'+ ft. FROM WELL LOG Date of test UNK Static water level LINK ft. Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 3/26/2015 37 ft. Well production LINK g.p.m. 7.5+ 9.p -m. WATER SAMPLE RESULTS: Coliform��,".�d colonies/100 ml. Nitrate L10 mg./L. Collected by: GEG. Ltd. Arsenic�v.1—ug./L. Date of sample: 3/26/2015 B. SEPTIC/HOLDING TANK DATA AWWU Tank Type/Material Date installed Tank size gal. Number of Compartments _ Cleanouts (Y/N) Foundation cleanout (Y/N) Date of pumping C. ABSORPTION FIELD DATA Depression over tank (Y/N) _ ' High water alarm Dw< Date installed Soil rating (g.p.d./ft2orftlbdrv----� System type Length ft. Width ft. Gravel below pipe ft. Total depth ft. Eff. absorption a—ft' Monitoring tube_ Depression over field Date of adequacy test Results (Pass/Fail) For bedrooms Fluid depth inbsor field before test — in. Water added _gal. New depth _in. i Elapsed Ti —min. Final fluid depth — in. Absorption rate >= g,p.d, rejuvena�on treatment (past 12 mo.) (YJ & type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Acoess (YIN. "Pump on" level at in. "Pump ofP leve High water alar level at in. Datu Cycles tested Meets alar & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot N/A On adjacent lots- N/A Absorption field on lot N/A On adjacent lots N/A Public sewer main *50'+ Public sewer manhole/cleanout *50'+ Sewer/septic service line 25'+ Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: AWyW_U Building foundation Property line Absorption field Water main Water service line Surface water Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIEL T TO: Property line Buil ' ndation Water main Water service line Surface water Driveway, parking/vehicle storage Cu ' m Wells on adjacent lots F. COMMENTS *PER MOA RECORDS, WELL EXISTED ON 5/19/1981. AWWU SEWER INSTALLED IN 1971. MET CODE AT TIME OF INSTALLATION **SEE ATTACHED 1995 LETTER AND DRAWING BY TOBEN SPURKLAND, P.E. 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. Engineer"s Printed Name JEFFREY A. GARNESS Date (Rev. 11/05) Municipality of Anchorage Community Development Department Development Services Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Arsenic Advisory Certificate of On -Site Systems Approval # OSC151130 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Lot 13 of Spruce Acres Subdivision. This inspection revealed an arsenic concentration of 20.7 micrograms per liter (ug/L) for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.or /og nsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. T.SPLRKLAND P.E. 203 NEST 15TH. AVENUE SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (9117)-276-6013 Kevin K. Klewero P.E. District Engineer State of Alaska Dept. of Environmental Conservation Anchorage District Office 555 Cordova Street Anchorage, Alaska 99501 Subject: Bank Certification Lot 13, Spruce Acres SID Gentlemen; 5421- DA1- 35y, n*f December20.1995 CCE,VE DEC 2 4 ;995 . I am applying for a bank certification for the well serving the duplex Iocated atITASpruce Street, Lot 13, Spruce Acres. This well was issued a Certificate to Operate on May 24, 1.986. The Identification No. For the well was 8721 -FA -012. The file at ADEC was missing the documentation that was used in certifying the well in 1986. I have included a site plan showing the location of the well and also the location of two sanitary sewer lines that serves this area. An 8 inch A. C. Sewer line was constructed in 1971. This line was located more than 120 feet from the well. The required separation distances in 1971 was 50 feet both for sewer lines and manholes. A 12 inch D.I. sewer line was constructed in 1979. This line has a 60 feet, more or less, separation to the well. This sewer line was encased in concrete and approved. A flow test of the well performed on Dec. 12, 1995 showed that the well was deliverh,g 6 gpm with a draw yfG f gr, Thr rah, racpirc uac ne_gat=iie. Yours Ft �' Tobben S arkland P.E. 1 it PIPE CONT?A'UOUS ?HP,OLGH MANHOLE 1 I�i I , I PIPE ENCASED IN CONCRETE I ' I well I I ! I ! I I I i un W r I I I I I �T vr 23 P5 5D 75 .IDD j25 ?50 wEEt�✓ FT, .•��ti, OF..: Petr 4-9 t. �s ...:..... .. :- 70' A.C. SANITARY S£PER LINE 5,,,,,,,,,,,,,ts,..`..................... TDEBEN PURKLAND • FAST 94Th A IF �j� °: P10, CE -2225 e' —_ TOBBEN SPURKLAND P. E. LOT 13 SPRUCE ACRES SID 203 W 1 5TH. AVENUE 8301 SPRUCE STREET ARCH. AK. 99501 PATE BAILEY PLOT PLAN DATE: DEC. 20, 1995 SHEET: ?/I GR!D: 2235 ..39. 33 ?ASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON tECORDED PLAT ARE NOT SHOWN HEREON,' Me information hereon is for the use of lend: ineti r.�ri n,+c rhnvino rhPi, relationshill of ex.— N -" OF AC 49T" r., .....,:... 1 A'A W°m.M-O& So ju7� LS.691 p9=SUILT'No dome°ta set this date herehy certay that I have performed a htortagee's in- apeetion of thefollowing, ng, described property: Soruce Acres Subd• Lot 13 k Anchorage RecordingPrecinct, Alaska, and that the improve - menta situated thereon are within the: property lines and do iQ' nne .,,.Prlan-or enezoach on the orooerty lying adjacent there- Ni • "®. ° 'P• ✓, A ° u •e Q•� C �' n •. •A a • o• LVEST /.?3.65 • ?ASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON tECORDED PLAT ARE NOT SHOWN HEREON,' Me information hereon is for the use of lend: ineti r.�ri n,+c rhnvino rhPi, relationshill of ex.— N -" OF AC 49T" r., .....,:... 1 A'A W°m.M-O& So ju7� LS.691 p9=SUILT'No dome°ta set this date herehy certay that I have performed a htortagee's in- apeetion of thefollowing, ng, described property: Soruce Acres Subd• Lot 13 k Anchorage RecordingPrecinct, Alaska, and that the improve - menta situated thereon are within the: property lines and do iQ' nne .,,.Prlan-or enezoach on the orooerty lying adjacent there-