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HomeMy WebLinkAboutSPENDLOVE VIEW HEIGHTS BLK 3 LT 10pendlove Vi Hight W Block 3 Lot :1.0 #021-021 - 18 (J e Municipality of Anchorage ..'~- .. , Development Services Department :~ ~: Bui~i~ Safe~ DMsion ~ ~ On-Site Water and W~t~ter Program, 4700 S. Bragaw SL P.O. Box lS6650 ~Oomge,~ 9951~650 Page I of ~ ~.ci.an~cm~e.a~us (907) ~3-7S~ ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PermitNumbec ~OJO~ PIDNumbe~' ~1--~1-- ]~ "~":~r~~+~[~ FIO~ WastewaterSystem: ~New ~Opgrade /1- /~7~ ff~[~trape.~ ~q~/ ] ABSORPTION FIELD LEGAL DESCRIPTION I, 0 ~Po~ ~. [otl~ S~'~ , ., · ,. ,.. SEPARATION DISTANCES ~'Septic O Holding O S.T.E.P. O Othec ~ Septic Absomtion Li" Holding publish .7; ~e~ ~ ~ I~OV j~+ % / LIFT STATION qT' 72' V BENCH MARK . E~¢~e~r'~ Stamp - 'o~'¢""~'''~"~a'E~ ~" I~-~'01 ~.~.~ '~ 9, ~ Inspectionspefformeduy: ....... ,._,____,~ . u~tes. ~__~Z.,~ -.__~ '""" .... ' 2.~ I O-lo-o~ ~i--./~,. ~ ~ ~ ~ EOBEET ~ EOWAN ~ ~ Development So.ices DepaAment Approval ~t~ CE-8801 ~ PERI~flT NO. SWO 10379 PAGE 2 OF 3 DEPARTHENT OF I-IE~TH ~NL) ~ur~AN SERVICES ENVIRONMENTAL SERVICES DIVISION · P.D. Box 19GG50 e_Anchor'c~ge, Arc, st<r, 995tg-GGSO · Tetephone= 343-4744 ON-SITE WASTEWATER IJISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LECAL LOT 10~ BLOCK 3, SPENDLOVE VIEW HEIGHTS P.I.D. NO. 021--021--18 j CULVERT ~ , 100' WELL RADIUS I /I , / x x% NEW TR[NCHESJ ~C04 SCA~: I' = 40' ~0 , PERMIT NO. SWO 10379 PACE 3 OF 3 Municip. o[it oF .A. ng h.o. F a g~e' DEPARTHENT OF HE~_THAND HUIViAN SERVICES ENVIRONHENTAL SERVICES DIVISION P.D. Box 196650 e Anchorage, Alaska 99519-6650·Te[eohone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEH AND/OR WELL INSPECTION REPORT LEGAL LOT 10~ BLOCK 3, SPENDLOVE VIEW HEIGHTS P.I.D. NO. 021--021--18 ST1 ST2 /92.5' FINAL GRADE· SULATION ~NEW 1000 85'9'/I GALLON I J SEPT,C TANK I CO1 CO3 C02nMTljCO1 = 88.7' C04 MT2 t iF~o~ = ~,~' I] [I-~~ = ~'~' = 83.0' ~_, .~..--FI NAL GRAD E-,.,.~_, __JJ.. 2-INSULATION 01= 84 6 ~ · , ~.u~ = 80.8' 02 = 84.8 C04 = 80.9' MT1 = 84.1' '~'"'-MT~ = 79.7' A B FCO 22.0' 10.0' ST1 29.5' 16.5' ST2 35.0' 15,0' ;DBL1 39,5' 15.0' DBL2 41.5' 16.0' FS 45,0' 19.0' C01 33.0' 29.5' C02 66.0' 55.5' C03 56.5' 4.6.5' C04 81.5' 53.0' MT1 34,0' 31.0' MT2 58.5' 48.5' NO WATER FOUND 73.2' B.O.H. FROM : ALPINE DRILLING FAX NO. i 90? 345 0202 Sep. 23 2002 12:43PM P1 Municipality of Anchorage Department of Health and Human Services~ 825 'L' Street P,O. Box 196650 Anchorage, Alaska 99519-6650 ~ Mystrom httpT/www.ci.a nchorage.ak, us Mayor Pc, uiit Number: #$W ,010379 Date of Issue: 9-18-02 Parcel Identification Number: 021.021-18 Date Started: 5-19-02 Date Completed: 5.'I9-02 Is well located at approved permit 1 ~oc~__'on? [] Yes [] No Legal Description: Property Owner Name & Address: Spendlove View H.qts .BIk 3 Lt 10 Gte~hen & Eric Flora PO Box 11-1878 Anchorage, Alaska 99511 Depth fit) From To 0 2 2 8 8 15 15 126 Method of Dnqling [] air rotary [~ cable tool Borebol¢ Data: Soil Type, TMc~,~ & Water Strata stick-up gravelly silt Bedrock-weathered Bedrock Casing type: ~;oal Wall Thickness: ,2,5q inches Diameter: _6 inches Depth: 20 feet Liner Type: Diameter: inches Depth: Casing sticlmp above ground: 2 feet feet Static water level (fi~om ground level): .~ 8.feet Pumping level:_~_5..feet after 2 hours pumping _3 gpm Rt~ovenr aarp: _3 ~m Method of Testing: airl~ Well Intake Opening Type: [] Open End [] Open Hole n ser~ed Start f~et Supped [] p~oalions Start ~ Su~pped feet Grout Type: Bentonite Rranules Volume: ~ Depth: Start 0 feet Stopped:feet Pnmp: Intake Depth feet p~mp size hp Brand Name __ Well Disinfe~__n!_ Upon Completion? [] Yes [] No Method of Disinfection: chlodne tablets Alpine Drgling & Enterprises PO Box 110496 Anchorage Alaska 99511 Comments: Well Driller:. Attention: The well driller ~h,al! provide a well log W the property owner ~rh;. 30 days of completion and thc property August 5, 2002 Municipality of Anchorage George I~. Wuerch, Mayor Building S,'ffety Dix-ision P.O. Box 196650 · 4700 S..Bragaw Strcct. Anchoragc, Alaska 90519-66,50 · (907) 3-~8'-8301 http://www.ci.anchoragc.ak.us Gretchen & Eric Flora PO Box 11-1878 Anchorage AK 99511 Subject: On-Site Water and/or Wastewater Permit. Permit Number: SW010379 ~'L~giil De-~i~i4Pii0h: Si~ndlove vieTM Heights Block 3 Lot 10 Dear Gretchen & Eric Flora: An On-Site WaterAVastewater Permit, number SW010379, issued by this office for a single-family system, will expire on September 18, 2002. This permit was valid for 365 calendar days. If this was a well permit and the well has been drilled, a well log must be sent to this office for documentation of the installation and to close the permit. If this permit was for a wastewater disposal system, an original as-built inspection report must be sent to this office for review, approval and documentation. This as-built inspection report must be signed by the licensed Professional Engineer who inspected the installation ofthe system. As-built inspection reports are required to be submitted within 30 days of the completion of the system. If no system was installed under this permit, and you are still planning to install a well or wastewater disposal system, a new permit must be obtained from this office. A new permit for a second year may be issued for a fee of $100.00 if the renewal application is received on or before the expiration date of the original permit. When applying for a new permit, the fees are: $400.00 for a wastewater permit and $150.00 for a well permit. If you have any questions, please call this office at 343-7904. ss, P.E. On-Site Water and Wastewater Program Enc: Copy ofpemdt MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 Soufh Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Date Issued: Sep 18, 2001 Expiration Date: Sep 18, 2002 Permit Number: SW010379 :Legal Description: SPENDLOVE VIEW HEIGHTS BLK 3 LT 10 Design Engineer: 0003 S & S Engineering Owner Name: GRETCHEN & ERIC FLORA Owner Address: PO Box 11-1878 Anchorage. AK 99511- Parcel ID: 021-021-18 Site Address: Lot Size: 81959 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [~ Disposal Field ~ Septic Tank ~ Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design, 2. Ail 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Issued By: ~ Date: Development Services Department Building Safely Division On-Site Water and Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. Permit Number SW 010~? Propertyowner(s) ~'r~.,+~.~.~'/+ ~('ic.. Flo)/'ot Dayphone Mailing address (1) PO ~o~ II- Mailing address (2) ~n~o~ ~ ~ Zip Code . Legal description (Section, Township & Range) Lot Size I~ ~ Number of Bedrooms ~ THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool [] Well Only [] ~ Water Storage [] [] Jacuzzi [] [] Water Softening Un'it [] I certify Ihat Ihe above information Is correct. I further cedify that this application is being made for a Single Family Dw~lllng and Is In accordance with applicable Municipal Codes, ~2 /~/~.~~ S & S I~NGIN£ERING 17034 Eagle River Loop Road ~io, 204 ' ~:~..la River. Alaska 99577 (Signature of property owner or authorized agent) I Permit Fees: ~ H ~). c O Date of Payment: . ....'~/~.O/o I Receipt Number: .0 0 "/,J"' ~.J" ,~ (Rev. 12/00) Waiver Fees: Date ot' Payment: Receipt Number: I July 19, 2001 ROBERT C. COWAN, P.E. CML ENGINEERS (907) 694-2979 FAX (907) 694-1211 SEW[R &WATER MNN E~TENSION~ SEWER & WATER INSPECTION EN~NEERING $?U~ES N~DREPORTS WEU. INSPECTIO~J & FLOW TEST S~TEST TEST STRUCTUI1AL & ME~CN. INSPECTIO~'S ON,SITE W~TEWATEFI I~$PO~AL SYSTEM ~)ESIGN MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 10, Block 3, Spendlove View Heights S/D It is requested that you issue a permit to install a septic system and well to serve the proposed three bedroom dwelling on the referenced properS'. Two test holes were excavated and percolation tests performed. The approximate locations of the test holes are located on the attached site plan. At the time of excavation 9/6/91 no water was found. After ground water monitoring, the tubes were found to be dry. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. If you require additional information, please contact us. Sincerely, ~e~C/. Cowan, P.E. RCC/bjj Enclosure 17034 NORTH EAGLE RIVER LOOP * SUffE 204 · EAGLE RIVER, ALASKA 99577 "~ LOT 10, BLOCK 3, SPENDLOVE VIEW HEIGHTS ~f~,.O..F....A~ ~ a t I I ,~ ~ ~ AREA PRIOR TO ANY E~C~qATION ADD 2 O' M.O.A. APPRQVED SANg~ ~ ~ , I LOT 9 a ~ LOT 10, BLOCK 3, SPENDLOVE VIEW HEIGHTS R.C.C. ~Tt: 7--24--01 2 OF 2 ' ff~/~--" ~"~2~'" "- ' vria~ DESIGN CRITERIA: SOILS = 1.0 GPD/$Q.FT. 450/3.0 = 450 SO.FT. REO'D. Ul:tlltl'l~U bllllDlil&. / ~ ~p. ~ OBTAIN UTIU~ LOCATES ' D~ P ~ PRIOR TO ANY EXCAVATION 2.0 / z ADD 2.0' M.O.A. APPROVED SAND ~ ~ ~//. ~ ' ~ 0.5' EFFECTIVE ~ INSTALL FCO~ ~ ~&. ~ ~ 5.0' wlOe ~ ,.~,... ,~ ~ ~-.~ ~ - ZX/ / / coOo ~ ~ / ~. I [ [//TRENCHESF' //%% / I~ ~ ,// /~ /~. ~INSTALL FLOW SPLITTER (FS) / ~ <l ¢6' HIGH -/ ~4~/ // ~ ~THIS AREA IS TO BE , / '/. I /CUTBANK % ~,//.'~/ /_"// --FILLED TO A SLOPE OF , i I /A/ONC EOAn ~/' // / ///-- LESS THAN 25~ '/ ~ ~ r / ~ /- / WITHIN 35 OF LEACHFIELD Performed For: Municipality of Anchorage Development Services Department Building Safety Division On. Site Water and Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.ci,anchoraqe.ak,us (9O7) 343-7904 Soils Log - Percolation Test LegalOescflption: ~..~7' I0 J~b~ 3 5- 6- 7- Date. Perfo,'m,,~: P / 3 } o I township, Range, Section: Slope Site Plan 9- 10- WAS GROUND WATER ENCOUNTERED? ~1 0 S IF YES, AT WHAT DEPTH? "'""- L o Depth to Water After /j)/ p Monitoring? ~d E Date: 13- 14~ 15~ 16- 17- 18- 19- 20- COMMENTS Reading Date Gross Time Net Time Depth to Water Net Drop " /0 /O ,~,,,) 1.3 Y~." ~. '/~." ~,~,,~. ~ to'~,,,"' ~0 13Y¥" ;l'/,~~ /~ ~, ~,,~ r o Io%" ~, 0 I ~. ?/¢'' ~_ y~ ' PERCOLATION RATE ~ (minutesAnchI PERC HOLE DIAMETER TES~"UN~WEEN ~. rr ~o -~ '/~. ~ $ & S ENGINEERING. ~dP~ PERFORMED BY: 'J 7034 ~a~e J~JYer Lo~ JJ~l:J No. 2t,~ CERTIFY THAT THIS TES/T W~S PERFORMED IN ACF.,~,I~I~'I/'FRrJ~]~9~A~[ AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~/"~/l~ I __~;-"5-15 Te~:hhlchl So~vlce~ 1,'/530 Echo Street 2[fichorage, .Alasl:a 9951g Munlclpallly of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 'L" Street, Anchorage, Alaska 99502-0650 SOILS LOG-- PERCOLATION TEST PERFORMED FOR: FAT KFu~E LEGAL DESCRIPTION: II0 fi3 ~PEAIbLo¢~ pT GP CLEAN tfTS.Townshlp, Range, Section: <~EC 3o. TI21q.. ~14/ 2 3 4 6 7 8 g ~0 11 13 14 15 16 17 .SA Nb"t GRAVEL. COMMENTS GM ~;A htb'~ RAVEL WATER ~NCOUNTERED? BEDROCK' , i~tt. ROBERT C. COWAN CE-8801 SLOPE SITE PLAN S L IF YES, AT WHAT O DEPTH? '-'"" P E Depth Io Water After PERCOLATION RATE TEST RUN BETWEEt~4 -- Im~nutes/inch) PERC HOLE DIAMETER FT AND __ FT ~'ERFORMEDey: .F'I-/~TTOp TECH ~vC~ I ~~ CE"TIFYTHATTHIST[STWASPE.FOnM~DiN ACCORDANCE WITH ALL .STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~ (R~. ~j PERFOnMED FOR: /:'/IT · ~' .~4530 Echo S~reet ~fichorage, ~la~;a 9351~ Munlclpality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street. Anchorage. Alaska 99502-0650 SOILS LOG-- PERCOLATION TEST LEGAL DE$CR PTION ,LIO_ g~ SP£~bLOV.F VIEW tfT$.T°wnship. Range, Section: SEC 30. TI2iq., SI.OPE SITE PLAN pT' 6P CLEAN ~'/a, Nb~ ~RAVEL 3 POCk:ETS c~F GM 5 Gt'4 .~ANbY SILTY GRAVEL 6 10 11 12 I?- COMMENTS fUND WATER ENCOUNTERED? S L IF YES. ATWHAT O DEPTH? "'-" p E ne~,h Lo Water X,Ler c Monitoring? bRV Dale: II:S3:30 21 ~ ~ART jl:S&:2o 23 ~ 11:5~:2o Iq PERCOLATION RATE ~ lmmute~inc~ PERC HOLE DIAMETER TEST nUN BETWEEN ~ FT AND . ~'~ FT erd:U:ORUEDm': . F/./~TTOP TECH SvC~ ' ~-'---'~ ~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON TH~S DATE. DATE: 72-008 (Rev. 4/85) ESP AWS • • t o • Municipality of Anchorage On-Site Water and Wastewater Program a • (907) 343-7904 Certificate of On-Site Systems Approval Parcel I.D. 021-021-18 Expiration Date: 1. GENERAL INFORMATION: Complete legal description SPENDLOVE VIEW HEIGHTS; BLOCK 3, LOT 10 Location (site address) 13275 Spendlove Drive*ANCHORAGE, AK 99516 Current Property owner(s) Alonna Brorson Day phone 229-9344 Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) C Duplex 7 Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank C Community Class Well ❑ Community C Public Water System ❑ Public Sewer WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ SO'���O �'- Waiver Fee $ Date of Payment 6--)a?//9 Date of Payment Receipt Number 005-3(o67 Receipt Number COSA# an .Q 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 (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101-Anchorage,Alaska 99507 / Engineer's Printed Name: Jeffrey A. Garness Date: /2///q �4��p •1 4 In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system o in accordance with the guidelines and regulations established by the Municipality of Anchorage and g��,O `�An industry practices. The reported results describe the condition of the system/s on the date/s of the p P.•' •:v,�l'� evaluation. Separation distances were measured to readily identifiable features. Hidden defects or 1 _. I i. • O encroachments may exist that were not identified during the evaluation. The operational life of all wells �j * , 4 r • Q and septic systems depend upon a variety of variables, including but not limited to, soil conditions. G•''•'•' • • +•" A groundwater levels (that may fluctuate during the year), quality of construction (materials and Q workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and r� p are outside the control of GEG. Satisfactory test results do not guarantee future performance of the ...Jr f�f. A. Corn--s: system/s; therefore, GEG makes no warranty(express or implied) regarding the future performance of QQ (F_ ��� the well or septic system. GEG makes no representation whether an alternative well or septic system o ni1. • . cep can be installed on the property in the event either of the current systems fail to perform adequately in `9, •,- � Zi• I�c,,t , the future. The content of this report is for the sole benefit of the person/party that retained GEG to WY‘.,/"roressl000av perform the evaluation. Reliance upon the information provided in this report by any other person or �O.D�o'':' party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE / System #1 Approved for 3 bedrooms \\\`,�itlT(((r���((� System #2 Approved for bedrooms G�p OF�!ii Disapproved ON y0 Conditional approval for bedrooms, with the follows tlj H G-^ ; Pf?Qc:F ; 11)»),)lttil)l i By: IA_ Original Certificate Date: 3 d 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 blue sheet '0.10-12.doc COSA Checklist Legal Description: SPENDLOVE VIEW HEIGHTS; BLOCK 3, LOT 10 Parcel ID: 021-021-18 If more than 1 septic system on lot: COSA Checklist# 1 of 1 Structure served by this system 1 A. WELL DATA []Well log is filed with Onsite (or attached) Well production at time of test 0.9+ gpm Date drilled 5119/02 Water storage tank volume N/A gallons Total depth 126 ft Well disinfected for coliform test? ❑ Yes 0 No Cased to 20 ft 0 Coliform bacteria is Negative ❑■ Sanitary seal is functioning correctly Nitrate 2.08 mg/L ❑ Nitrate less than MRL(ND) 0 Wires are properly protected Arsenic ug/L 0 Arsenic less than MRL(ND) Casing height(above ground) 18+ in. Collected by GEG, LTD. Date of flow test for COSA 5/13/19 Date of Sample 4/18/19 Static water level at beginning of test 18.8 ft. Comments B. TANK DATA C. LIFT STATION Age of tank(s) 18 years ❑ Required maintenance completed Tank type/material W"4"i" Age of lift station years 0 Standpipes/foundation cleanout per record drawing Lift station material Date of pumping (:7 // 5) Comments: NO LIFT STATION D. ABSORPTION FIELD DATA `AT MONITORING TUBES Which system tested (date installed) 70f 0`C1 Adequacy test date 5/17119 ❑■ ALL standpipes present per record drawing Results Pass For 3 bedrooms Total measured depth from grade *3.8+ft(max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade ...2.3+ft(min) Water added 500 gal ❑ N/A—pressurized field New depth 2 in IN Monitor tubes go to bottom of drainfield. If not, state Elapsed time 125 min depth into effective ❑ Code-required soil cover over field Final fluid depth 0 in Absorption rate 450+ gpd ❑ System presoaked NONE (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) date of test) Gallons introduced N/A gallons If yes, enter date Comments/Deficiencies:TESTED NORTH TRENCH ONLY-SCUTH TRENCH WAS CRY UPONARRIVAL ANO STAYED DRY TIWOUGHTOU TEST.SEE ATTACHED EMAIL REGARCING FREEZING COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot> 100' Community Sewer Manhole/Cleanout> 100' 0 Yes if No ft 0 Yes if No ft Neighboring Tank> 100' 0 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' Animal Containment> 50' ['Yes if No ft ['Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ['Yes if No ft ['Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations> 10' ID Yes if No '5'+ ft Surface Water> 100' ['Yes if No ft Property Line > 5' ['Yes if No ft Driveway/Parking> 0' ['Yes if No, comment Absorption Field > 5' ['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 From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 0 Yes if No ft Driveway/Parking > 0' ['Yes if No, comment Property Line > 10' ['Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 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' ✓Q Yes if No ft F. ENGINEER'S COMMENTS *MET CODE AT TIME OF INSTALL _Q.o�000< OF ,'•: �s°o G. ENGINEER'S CERTIFICATION ,::"?.'V . •• ; � � 1 certify that!have determined through field inspections and review ' :44 ''•�Q of Municipal records that the above systems are in conformance with ;*'(2..-. A •rH I/ .•.y*avo MOA COSA guidelines in effect on this date. DGo , •.J•ff1 ilii Gar -ss. A _ E 7•. • AGO D�f�oi .'j zl .14q���� pro f essiof oao COSA Checklist yellow sheet #AECC884���OOQo<� MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT i • , ri• 907-343-7904 On-Site Water and Wastewater Section \ / Fax: 343-7997 www.muni.org/onsite Well Water Advisory Certificate of On-Site Systems Approval # osc191182 Subdivision: Spendlove View Heights, Block: 3, Lot: 10 This well's productivity was determined to be .9 gallons per minute. The minimum well productivity required under (AMC 15.55) for a 3-bedroom residence is .31 gallons per minute or 150 gallons per day per bedroom. Although the subject well currently exceeds this minimum requirement, the production capacity can fluctuate. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. Mailing Address: P.O.Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org Municipality of Anchorage Development Services Department Building Safety 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 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. ©al-021- GENERAL INFORMATION Complete legal description ~i:~¢,~c~\o~ Location (site address) [3'2-~-5 £p~,,~ Current Property owner(s) ~-c~.~c¼~, F'[o ~,~, COSA # Expiration Date: Day phone ~q'-1-3H35~ Mailing address Lending agency Day phone M~iling address Real Est~ate Agent' Mailing'Address. ¥ UnlOsS othet~iise r~q,uested, COSA will be held by DSD ~or pickup. NUMBER OF BEDROOMS: ~ Day phone TYPE OF WATER SUPPLY: Individual Well 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 a~n independent p~ofessional 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 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. 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, Address '~o~ ~,, Engineer's Printed Name DSD SIGNATURE Approved for .~ Disapproved. Conditional approval for Phone bedrooms. bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory X Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: (Rev. 11/05) 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: A. WELL DATA Well type. PHvaYe.. Date completed ~J/l~//z~)al Total depth tT-b ft. Date of test Static water level Well production If A, B, or C provide PWSID # Sanitary seal (Y/N). ¥, Casedto. '?.D ft.~ FROM WELL LOG 5/141 7_ool 1'3 ft. _3 g.p.m. Parcel iD: 0~-I?Zl- I~ Well Log (Y/N) wires properly protected (Y/N) Casing height (above ground) AT INSPECTION Sq.' ft. 0,5 g.p.m. ¥ Iq in. WATER SAMPLE RESULTS: Coliform N6(r .colonieS/100mL Nitrate I,'SI mg/L Arsenic: ../V D ug/L date of sample: ~/'Z~l/tl B. SEPTIC/HOLDING TANK DATA Tank Type/Material Arco)nor ~.~6 Tank size I00~~" gal. . . Number of Compartments Foundation cleanout(Y/N) ~ Date, of pumping t~,'~ C. ABSORPTION FIELD DATA Date ,~'stalled' Io110 [ ~-om. Sdil rating ~or ~/bdrm)... Length ")- ~ z/(~ ff.- Width. Total depth ~,$ ff. Eft. absorption area ~ Date of adequacy test ...(~ 17.-'11 tt Fluid depth in absorption field before test ~ Elapsed Time: Iq~lD min. Final fluid depth ~ Any rejuvenation treatment (past 12 mo.) (Y/N & type) Depression over tank (Y/N) . Pumper Collected by: L~ Date installed I O/'//Zt.~l Cleanouts (Y/N) High water alarm (Y/N) .A/ 1,0 System type s~,llo~ ft. Gravel below pipe O,~ ' ft. /'/~) ft2 Monitoring tube "/ Depression over field Results (Pass/Fail) Press For ~ bedrooms · in. Water' added °ol~0 gal. NeW depth _~ in. . . in. Absorption rate >= ~,~O .g.p.d. ~ If yes, give date D. LIFT STATION Date installed ,,--Size in gallons ~/l~lanhole/Access (Y/N) /" "Pump on" level at ,,~n./ ~ J "Pump off" level at . High water alarm level at in. Datum~J Cycles tested /// Meets alarm&circuit~'e~ts? SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Ioo' + Public sewer main Sewer/septic service line Animal. containment areas 5o ~ 4 On adjacent 10ts I On adjacent lots Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation S' i +. Property line ~ !+ Water main A/'/~, Water service line to I Wells on adjacent lots I00 4 Absorption field Surface water Property line lO Water Service line Curtain drain SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: ~ foundation [ O 4- Water main Surface water t001 + (~, O Wells on adjacent lots 100'+ (/V,O~ F, COMMENTS -~ _,.. ,. %~., G. ENGINEER S CERTIFICATION ~-,, ~... ~' . review of MunicJpal records that the above systems are in -, . -,-- . Date 'f'th~ll ' ' I~'?-D~' "~(~k~'¥-~t. 'P~. COSA Fee $ Date of Payment.. Receipt Number (Rev. 4110) Waiver Fee $ Date of.' Payment Receipt Number M'unicipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Water Well Advisory Certificate of On-Site Systems Approval (COSA) # 111254 During a recent COSA on-site inspection and test of the potable water supply well on Block 3, Lot 10 of Spendlove View Heights subdivision, the well's productivity was determined to be 0.5 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3-bedroom residence is 0.3 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. WELL :...:_07- I / EAST' /OZ~ Lot /0 , B,ock .5 Anchorage Recording Distriott Alaska $Em77C LOT SURVEY CERTIFICATION I hereby certify thot Ihove surveyed the property shown and described hereon, and that the improvements situated thereon ore within the prop- erty lines and do not overlap or encroach on adjacent property and that no improvements on adjacent property overlap or encroach on the premises in question and that there are no roadways, utility lines, o~ other visible easements on said property except ae Indicated hereon. d~/, .909 s.F I 1 Eosernente of r~oord other thon those shown the plat of r~oord are not shown hereon unlesl otherwise noted. LEGEND ' I~ Brass or Aluminum capped monument re( 0 Iron pipe and/or rebar recovered. [3 2 x 2. hub & tack recovered · 5/8" x :50" rebar set this survey 'EY&~/~ OF V£A~TICAL ~TLI,,~ = ':./827 A/.~..% /,972 A~JL/S~ Scale Ref. Date © oT-oz-o/ Prepared by: (907727,9- e200 Property of:&/c t~. L. BUTTON t?eg~tered L. ond Surveyor 51,9 I,E. E/ghth ~ve. Anchorage Alaska