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HomeMy WebLinkAboutFREEMAN LT 10Fr cm IlL (I Development Services Department Phone: 'k7 On -Site Water & Wastewater Section Phone: 907-343-7904 Fax: 907-343-7997 Parcel I.D. 016-112-11 Certificate of On -Site Systems Approval Expiration Date: 1^ 2- " Z OZO 1. GENERAL INFORMATION Complete legal description Lot 10, Freeman Subdivision Location (site address) 11501 Hawkins Lane, Anchorage, Alaska 99516 Current property owner(s) Breckenridge Property Fund Day phone ( 907) 290-6044 Mailing address 2015 Manhattan Beach Blvd, #100; Redondo Beach, Real estate agent Teague Russell Day phone ( 907) 290-6044 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: Private Well ® Private Septic ❑ Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 0 o",49 Waiver Fee $ Date of Payment Date of Payment Receipt Number o2J�G/(®2 Receipt Number COSA #')j .0_ri 1 /,q � Waiver # CA 90278 S. 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Pinard Engineering Address PO Box 871347, Wasilla, AK 99687 Engineer's Printed Name Paul E. Pinard 6. DSD SIGNATURE System #1 Approved for a bedrooms System #2 Approved for bedrooms Disapproved Phone (907), 232-1347 Dal Conditional approval for bedrooms, with the following sLlNu,dL,U,,,. � 1\ J_ n OM ((WirirtG rri 'A i =nA/V m=- o Original Certificate Date:"� 20 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 Checklist blue sheet Legal Description: Lot 10, Freeman Subdivision Parcel ID: 016-112-11 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled Total depth 70 ft Cased to ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 3/11/20 Structure served by this system Well production at time of test 8.0 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate 6.25 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by Pinard Engineering Date of Sample 3 LLIJ 20 Static water level at beginning of test 36.2 ft_ Comments Residence had major fire damage/utilities shut off. Well pump run by generator set up by Alaska Well & Pump B. TANK DATA Age of tank(s) years Tank type/material Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA Which system tested (date installed) ❑ ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A- pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Septic system replaced by connection to public sewer system in 2009. Verified by camera. Adequacy test date Results ❑ Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min ❑ Code -required soil cover over field Final fluid depth in ❑ System presoaked Absorption rate gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) ❑ Yes if No Septic Tank/Lift Station on Lot > 100' No Septic on Community Sewer Manhole/Cleanout > 100' ❑ Yes ❑ Yes if No ft lotEXYes Wells on Adjacent Lots: if No ft Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No ft Holding Tank > 100' ❑ Yes if No ft Neighboring Absorption Fields > 100' ft Animal Containment > 50' ® Yes if No ft ® Yes if No ft Community Sewer Main > 75' ❑M Yes if No ft Manure/Animal Excreta Storage > 100' ® Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No ft Surface Water > 100' ❑ Yes if No ft Property Line > 5' ❑ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑ Yes if No ft Private Wells > 100' ❑ Yes if No ft Water Main > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No ft Water Service Line > 10' ❑ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ❑ Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No ft Wells on Adjacent Lots: Water Main > 10' ❑ Yes if No ft Private Wells > 100' ❑ Yes if No ft Water Service Line > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No ft Surface Water > 100' ❑ Yes if No ft F. ENGINEER'S COMMENTS The septic system that previously served this property has been replaced by a connection to the public sewer in 2009 See the MOA Inspection document from 3/17/09 Camera verified connection on 3/16/20, See attached invoice. G. ENGINEER'S CERTIFICATION 1 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. COSA Checklist yellow sheet MUNICIPALITY OF ANCHORAGE WASTEWATER CONNECT PERMIT WATER & WASTEWATER UTILITY 3000 ARCTIC OLVD. DATE OF APPLICATION: 01!42/2009 PHONE:(907)664-2762 SCHEDULED COMPLETION.DATE: 12/31/2009 BLOCKILOTMRACT. LT 10 SUBDIVISION: FREEMAN [91 SINGLE FAMILY n MULTI -DWELLING No. APTS ❑ COMMERCIAL TAX CODE: 01611211000 GRID: SW2633 STREET ADDRESS: 11601 HAWVJNS LN Anchorage, AK 99616 OWNER: WEEKS -THOMAS & NADINE LIVING TRUST WEEKS T A & NIT PHONE: MAIL . ADDRESS: 810 N'18TH ST LAMESA, TX 793312406 14 1 KAQ I OR !S4.. Cf-! ❑ Repair Existing Service ..[],O.n I P'Tel-OP4: Au'. ❑ Hydrant Only C] Main Tap - To Property Line Only Main Tap & On Property Connect rl Disconnect ❑ R & R - Main Tap.Only CONNECT SIZE 4 In REIMBURSABLE NUMBER, REMARKS -4 2AL'. T Row No. A222E0--)-L INSPECTION FEE $ 98.00 PERMIT FEE $ 63.00 $— 0.00 DEPOSIT $ 0.00 TOTAL .$ 161.00 ASSESSMENTS 0 Main Line Extension El To Be Levied Comments: ISSUED WWTWC PAID n *CASH 0.CHECK # Zo OTHER AA je INSPECTED BY PERMITEE (Please Print) WEEKS THOMAS & NADINE LIVING TRUST WEEK8130M NfTRUSTEES ----------------- MAIL ADDRESS ' 810 N 144 ST'LAMESA7 SIGNATURE 'A/7N8P1CUOUS PLACE AT THE JOB SITE INSPECTOR COPY DATE SCHEDULED 12/3112009 TIME 12:00 am INSPECTOR SUBDIVISION FREEMAN l_ BLOCKJLOTITRACT LT 10 I INDICATE NORTH A0 0 slot .�- LIN Nil- s I's+ SI7-E MA**` LQfA,;3:. i`YPE MAIN: q-�, QEPTH AT MAIN: �"� AT PROP. LIVE: - 'V CONNECT LOCATION: �"'� COMMENTS: t Kt w L INSEPECTED BY: DATE: 3 { 7 / I / 130.0_x_ I Lot 7 10' UTILITY EASEMENTS I I Lot 8 I \ I\ WOODEN FENCE S 89'57'00"E 200.00' GRAVEL: to I DRIVEWAY . 118.3' 30.3' l 45.4' 4.5'} U MOBILE HOME Of Z WELL LZ � I I io I LJ to , r- SEPTIC PIPE I I I d• W 3.2 o 1 12.3'I "o I Lot 9 0 4.5'x8.1' COVERED STORAGE 7.4'x9.4' LOG SHED h Z Quo / I Eco I \ Lot 10 / 29,332 S.F. I CHAIN—LINK FENCE N 89'57'00"W 200.00' Lot 2 10' T&E EASEMENT—' � \ Lot 3 � I i I I PLOT PLAN _—_ AS BUILT _X_ SCALE _1__= 40' GRID --a 2633Project No. 20=22A/ -L1--- Lang & i n 11500 Daryl Avenue, Anchorage, Alaska 99515-3049~ Associates , c • (907) 522-6476 Phone oo�pp (907) 522-4625 Fax Professional Land Surveyors kenClangsurvey.com oo� F Dpi �� 0 A / jonothan®longsurvey.com moo'` `'Qs04o I hereby certify that I have surveyed the following described property:O�P. LOT 7, FREEMAN SUBDIVISION (PLAT No. P-497) 491H - Anchorage �y�Q Recording District, Alaska, and that the im situated thereon are P 0 ....:................ rovements within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed Q premises and that there are no roadways, transmission lines or other visible Q �, KENtJ easements on said property except as indicated hereon. 01O) °op Dated this the I��'`� pa of ti�auk �o QFt'Fa ' .LS -5202.• ' yJ�� Dayofat Anchorage, Alaska It is the responsibility of the owner to determine the existence of an easements, 400ROFfSSIONA%- P AECC963 o0 covenants, or restrictions which do not appear on the recorded subdivision lat. �O C963 Nitrate Advisory Certificate of On -Site Systems Approval # OSC201126 Subdivision: Freeman, Lot: 10 A water sample revealed a nitrate concentration of 6.25 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/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. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Mailing Address P Q Box 196650' * Arichorage, ptaska 99519 6650 *www muni org From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. Mailing Address P O Box 196650 *Anchorage, Alaska 99519 6650 *www muni org GR: ,,eR ANCHORAGE AREA BOROUGH ( 1 HEALTH DEPARTMENT f '~ 327 EA~E ST. ANCHORAGE. ALASKA 99501 27¥-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM PHONE, SEPTIC TANK: DISTANCE FROM WELl LIQUID CAPACITY ,GALLONS. MAIERIAL /..~,.)! ~ NUMBER OF COMPARTMENTS j/ ~ s~,, ~.,~-s ~. /=/7~ ,~OU~D INSIDE LENGIH INSIDE WIDTH DEPTH SEEPAGE SYSTEM: NUMBER OF PITS LINING MATERIAL OUTSIDE DIAMETER OR WIDTH . LENGTH DEPIH . DISTANCE FROM WEL, BUILDING FOUNDATION NEAREST LOT LINE TOTAL EFFECTIVE ABSORPTION AREA JWALL AREA) SQ. FT. TILE DRAIN FIELD: DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TItF '70' DISTANCEF.OM WATER "-- WELL: TYPE J" DEPIH . BUILDING FOUNDATION SAMPLE. , NEAREST NEAREST SEPIIC ~, ~_ · SEEPAGE /.// OTHER LOT LINE ~ . SEWER LINE ~ . TANK SYSTEM ~ CESSPOOl . SOURCES DISTANCES: