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HomeMy WebLinkAboutMOUNTAIN VALE LT 7 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PRo~ Well j_ ~ Absorption ar~..~ f Dwelling r PERMI,T.,NQ. __ __ Manufacturer / ~ Mat~fl~ . ~ No. of~ompartments Liq c t ' ons Inside length Width Liquidde th '~ t,~/IF HOMEMADE I .... ' ..... Well~ . .~ . Foundation , I N~rest lot ne PERM T NO.~ No. of lines .... Length of ea~ lins-, Total length ~f I~ I Trench width r) / Distance~w~en lines Top of the to finisn grads .. Material beneath tile ~g ~ Total effe~ve absorption area Length Width Dspth PERMIT NO.--~ · ,~. o, Cr~diamete, ~ Crib d~, / ,Total effective absorption area I~ ~/~ Depth Driller Distance to lot line PERMIT NO. / DISTANCE TO Buildi,g foundatioB Sewer line Septic tank I Absorptioa area(s) / OTHER INSTALLER ~'/ . REMARKS MUNICIPALITY OF PEPT. OF ENVIRONMENTAL A~PR?V ED ~ · · 72-013 ,~/ev. 3/78) ~,,I ~L F:'EF::H]iT NCI. FI [:' F:'L ]: c;i::l[',~l"r' L. 0 C:F:IT i [) t:;.:(]I]iEF.: I'"1 :[ L. I O1"1 I...I:3T 7 HI' UI'.,ITF1:1: I'.,[ ',,,'FILE S',,.-'T:, B'"0':; .LI:I. L. I:::II'.~CHOF.':FrlGE FIK '.:,:)ff]:L'Li .:..-.I-.. -4:,:-.,' L.OT S]:;7. E :~"LS:J.'2' 'L(;[.:!L.IFIF::iE: T'.FF:'E 17F ~i;IZI]:l.... FIEU~;IZ)F.:I::'T]:I]II'.,I . ,.:l[:ll :IS:;: TF:E'I'.,tCH . .:, ~ .z,T[:I I '/:~i;: THE: Fi:E[.:!IJ :1: F.':Ii:T:' ::.i; ]: ,..'.':I!F. OF' 'THE SO :[ L.. FIE ':;F' I:;i:F'T.Z 131'*,I '"' '" ..... " (-r ,, 'q / 0 ' P ' , ........ ..... .U'.:. !.'T~: IF..'.' ""if" I]..-.11 ...... :::fi... ::iL IL. EC IY-.9 ~:-:Fi "T' I!-fi ..... ;;;i!: ;;?. La F,,::. If41 .,,,, tE::.. I~ ..... 'I"HE LEI',II:]iTH B,]: HENS I O1'.,! I E; THE L..ENE~i'I"H ,:: I t',l F'EET ::, OF '/"HE'Z TI'T.':E:i'.,IC:H OF~: [:,F.':FI I I'.,IF I EL.D. THE [:,EPTH i]ll::' I::1 TF.:E.']'.,IC:H CIF.: F:']:T IS 'I"HE: DIE;'I'F:II'.,IC:E BETHI-2:[!i:I'.,I THE SI...IF~.:F'FICE OF THE: I]iF;.:OLIt'.,ID FII'.,I[:, 'THI~:!: E',OTTOH CIF THE: E:qCFI',,,'F:ITIOI'.,t ,:: :[1'.,t FIEE'I"::,. THEF::E .]::5 I'.,IO '..T:,E:T I.,.IZD'I"FI FOF?. TF[:EI'.,IC:HES':. THE GF:'.I:::I',,,'EL [:,E'F"¥'H .:1:.:5 THE H ]: I'.,I:t:t"'ILtH [':,EF:'TH OF: GF'.I::I',,,'EL BE!:THEEN THE OLITFFiL.L. F:':[ F'E: t:::Ii'.,tD THE BOTTOH [)F THE E~::.,;C:Ft'v'FI'I"I O1'.,t ,:: ): i'.,t F:I~:IET ). F'EFH'I]:T FtF:'F'L:[I::::FINT HFIS "I'FIE: F.I:~SF:.I',I.5iE, 11.....[T~ "FO :I:I"~FO[~:H THt:'5 t],EF'I::If~:']"I'"IEI"~'T I)L.IFi:.TI',IG THE :t: NS"FFIM~.F:IT :[ ON ]: NSPE:CT :[ ONS OF: FIi'.,I'./ 141EI._L'::]; FII:)J'FICENT T '] TH 1:5 F:' RO ::'EFU"!T' FIND THE NI I'"IE EF.: OF F.:E:i.:.; Z [:,[~::NC:!.T.S THFIT THE HE:LL H I M..., SEF:',,,'E. E FIC I'::'F:: .TI.L '[ I'.tl.?j (:)F' F:IF,I'T' S'T'STEH !.,.! :1: THIZII.jT F' ]: I'.,IFIL I t'.,ISI::'ECT ]: O1",t 1:"11'.,t[::, FtI::']::'F~::I:]',,,'FII.... B'T' Tlq ]: S [::,EF'FIF::THE:i'.,I'I" H :t: I...L.. E',E: '}~;L.IE .TECT TO F:'F~::(3S[i!:I]IJT .]: CII'.,I. I'I:[I",tlt"ILIH F.:,:t:'.~;TFII',ICE[ B[E'I'HEEI',I FI I.,.IEL. L I::11",![:, F:II',I'T' ON-SITE SEHI::I[iiE [)t'E;F'OSI:II.. S'T'STEH IS :j. Fjl.~.:l F'[~':ET FOF~'. FI F:'t;:./:',,,'FI'I"E HELL. [1'~ ::L[~il.":~ T[I ~?.1~1~1 [..'7~..:~:"[' F'F::OH i:::1 F'I...IEIL. ZC I.,.IEI....L I:::,EF:'[£t'qt:::,.T.i'.,IG i...IF:'Oi'.,I THE 'F"r'F'E: OF' F:'IJE~I..:[C H['::L.L.. H :[ I",1 :i: HI...IH [> .l: STFII",IC:[:'.': F'F~::Cff't FI PF:.': Z "/laTE NELL 'TO I:::1 F'F:::[ ',,,'FITE :SEI.q[.:..'F~: L :[ I",IE :1_' :5 ;:2'.i~i I::EE'I" FII",I[:, TO F:I COHt'IUi'-,IIT'-F '.SEHEt;'. L. II",IE Z%:; ';::'~ili FIEIET. HELL I_OG:'.:.'; FIFRE Fi:E[.:!U:[F.:E:[:, FII",I[)I"'IL.I'.:5'T EriE: F:i.F:TI..II:Rt",IED TO THE [:,EF:'I::II;;:THIZI",I'I" t.'.I.'[TH:[Iq :!i:C~ [:' Fl "r".:~; OF::' THE HE:I...L COI"IPL_ET ]:O1",1. OTHEF;.: IT::[~:(i:!I...I ]: Fi:[i~:I'"I[EI",IT:~'Z,, 1"1FI'¥' FIPPL."/. ::SPEC :[ F ~[ C:FIT .'[ OI",I::'T, I::Ii'.,ID COI'-,I'.:T.,TF:'.UF:T ]: O1",t [:' 1' F:IGI;i:FIHS I::l'v'FI :[ L. FtE:L.E TO Z i",I:.:.i;UF.:E PF:;OF:'I!.:.':F: :1: I",I:ii;TI:::ILL..I:::IT ]: O1",1. ROGER f'I[L TONII'O LOT '5 [ ~ .... '~ I"¢F'E OF 'Sg[t. ~$ORPT~.ON '..4'r'C,l'El, t fR~:NCH THE LZ'PaTH bfI,I~ZN'_::,ION ['i; THC tJ%N,:,FH (IN FEET:' OF FHC ?R~NC:H OR TH; O~:PFH OF R TRENCH OR P~f IS 'rile O[STRNC;~ E, EFI,I~EN I'HE 5URFFIC~ QF I'HC:~[ [5 I10 SET H[DI'H FOR /REHCHCS. I'H~ C]RRV~L O~°Tlt [5 THE I,I[N[I.IIJH OE~TH OF J3RRVEI_ 8E-F~EN THE OUTFRLL PERt'I [ ]' laPPL l,'.:Rl'lf HRS THE RE'SPON'5 [8 IL [ I'V TO [HFORI'I TH 15 Os:PRR I'I,I[Nf C, UR[t.tl] I I'HE ~ _ . - . ~ ,, ~ i-i~ ,-., ~,- · ~ ~ ~ DEPFtR'FI,I~Nr FI[LI_ BE SI_IBJECT TO pRO¢~CIJTIEiN. 'U-~'~ F'~e'i.T FOR ~ ~'~' ..... TO R COPII'PJN[TY 5EI,IER L~FIC [G f~ OF FHE HELL COHPL~T[ON, : .... ,qL.L.U,RD,~:IL.~ PI[ FH -tHC COOE'~. ; '. ~'="= _ _ Cr_,r~.ll /'IRY REg!LI[RE Et. II.,RRI3EHENT IF TH~: : [ UttO,.,x;,TRND THflT 'FttE ON'-';['FF SEI'IER ':'"= c~, MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST ~. SOILS LOG [] PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION; DATEPERFORMED: 1 2 3 4 5 6 7 8 SLOPE SITE PLAN I0 11 12 13 14 15 16 17 18 19- 20- WAS GROUND WATER S ENCOUNTERED? ~'~J~ L 0 E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop No, 'ERCOLATION RATE (minutes/inch) TEST RUN BETWEEN m FT AND COMMENTS ~o<1 ¢'z~-'[~J V,'S,-.~{[~-[ ~ /OC)~'/[~ "~TO,~ ~r' % Iq' -- FT PERFORMED BY: ~ d c ~ 1 CERTIFIED BY: 72-008 (6/79) i April 18 ~ 1978 ~77165 To~ Thompson Post Offic~ Box 4~932 Anchorage, Alaska 99509 Subject: Per>~!t Exj?irahion A peri, it issued by this depart~c~nt for well and/or on-site se%~er installation on Lo~. 7 }-~Qun~ain Val~ Subdivision ]'[~s expired since th~ issue [!~t~l c~cee, ds one(l) year, In the ev~nt you s~.ill pl~.n to J. nstall th~ ,~s~)lt and/or on-site sewer syste~, a nets, per~uit is required. The ori~3inal soil test may be uso6~, to obtain a current per~uit. th(~ ~.,~11 has been drilled, a well !o~.~ sho]lld b~, sent this ~lepart_~i¢~nt to ~.locui'~l~nt the installation date~. %f you have any q%leshions regarding the above. ~lat'ue, r, please contact this office b'~edtately at 264-4720° Sino~r(~ly, Senior Environ~ental f~pecialist F' f~:F;d'"l ]: T FI F' P L ]: C: R N T H:iZN]iI'"II..If"I I;:, ]: :-.:r;Tfff.,ll:;:lE E;IE'FI.,.IE[i:I",I Fi 1.4iEI..L Ftl",~[:, FII'.,I¥ Of "I'E :H;IEI.,.ff::IGE I) ;ti '.=;l=u.3'.:}~F:tl .. ::L]:/.t[.]i ~:'ti:[i~:'l" FO[;.'! F:I PI:;?. ]z VFrTE I.,.!IEI....I.. IEill;~! :;?.l;~l~;::.l FLEET FOR FI :'I..IE:I..]:C !.,.IIEL. L I.dlCI..l... L.OEit..T:; FIRE i:;.'.~-}Zi;!l..l'JlF:'.E='t) FIl'.,t[) i-,ll...I:iE, T I~E F?.E'f'I. JRNEI) TCi "HFJ tl::,EPRF?.TI,II.~:iNT t.,.t ]( TH ]i N :ii:El CIF: -t'HIE I.,,IIEI..,,I... I[i;I:.II',IF'I...[:,':~T :il I.')N. :ii;F:li!ilZ:it:F'iI:CI::tTi[EiN'.E; FII'.,I[::, CCII'.,I'.!~;TI:;?.I..IC"I"]iOI'.,I Iii:, ]i I::IGF?.RH~i; FII::?.F;.i .l::ll~i~l...t~ TI:il ]ii',l:~i;LIF;:'.l:i.i I='Iq'.OF:'EI:,~'. L( N :~:i; T Fi L I.,.t:::l T iii O N. :E; E I.,,I E: F..::i~; I=1 i1.,I [) THE :i:; :[ G i'.,I E I) · - I: P I. CFII'.,tT 'f'Eff,'l • Municipality of Anchorage On-Site Water and Wastewater Program <`}®��� (907) 343-7904 SAT Y Certificate of On-Site Systems Approval Parcel I.D. 020-581-12 Expiration Date: / 2 - ((- 7 1. GENERAL INFORMATION Complete legal description Lot 7, Mountain Vale Subdivision Location (site address) 8601 Paine Road, Anchorage, Alaska 99516 Current Property owner(s) Mike Taylor Day phone (907) 538-3701 Mailing address 940 Botanical Heights Circle, Anchorage, AK 99515 Real Estate Agent James Cash/RE Brokers AK Day phone (907) 360-7448 2. TYPE OF DWELLING: II Single Family (w/wo ADU) Cosi _ 5 1/041— ❑ Duplex ❑ 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 ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: 9.11741-7 COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 1110-0 V Waiver Fee $ Date of Payment q( 5/2O/') Date of Payment Receipt Number 21 L002 f Receipt Number COSA# (35C-1 ' 1403- 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 Pinard Engineering Phone (907) 232-1347 Address PO Box 871347, Wasilla, Alaska 99687 Engineer's Printed Name Paul E. Pinard Date 9/4/17 { SOFA( ftP4,17%.' NQS, rr � ae s �,* Y, Ofh �) ! , 'h � 4,4 6. DSD SIGNATURE •• /ca X .--K System#1 Approved for bedrooms ',..Si ,a• Pi a� rn; PaurE. Pinard w System#2 Approved for bedrooms P;,40 o CE -4793 e.°� 1 Disapproved *Tata+ iez) * `�• 4 " a ESS10 yI/1r Conditional approval for bedrooms, with the following stipulations: Alp -���.\-, OFgNc S . ON-SITE ,; WATER AND rit --- WASTEWATER o =, PROGRAM gs_ OtirSER\J\-.., 1 -'--- -- .-- -------- )U��/ BY � 7 Original Certificate Date: --.1-• 17 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 r - c If more than I septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On Site Systems Approval Checklist Legal Description: Lot 7, Mountain Vale Subdivision Parcel ID:020-581-12 A. WELL DATA Well type Pvt If A, B, or C provide PWSID#_ Well Log (YIN) N Date completed Unkn Sanitary seal (YIN) Y Wires properly protected (Y/N) Y Total depth 71 ft. Cased to 71 ft. Casing height (above ground)18 in. FROM WELL LOG AT INSPECTION Date of test 4/4/1 '7* Static water level ft. 62 ft. Well production g.p.m. 1 •8 g.p.m. WATER SAMPLE RESULTS: *Work done by Arcterra Coliform 0 colonies/100 mL Nitrate ND mg/L Arsenic ND** ug/L Date of sample: 8/23/1 7 Collected by: Pinard Engineering ##4/3/17 by Arcterra • B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel. Date installed 10/19/83 Tank size 1 250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (YIN) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 8/18/19 Pumper A+ C. ABSORPTION FIELD DATA Date installed 10/19/83 Soil rating VcIut. ftiNixft2/bdrm) 100 System type Deep Trench Length 25 ft. Width 3 ft. Gravel below pipe 8 ft. Total depth 7. 5 ft. Elf. absorption area400 ft2 Monitoring tube Y Depression over field N Date of adequacy test 5/2/17 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 3 in. Water added 450 gal. New depth 0 in. Elapsed Time: 375 min. Final fluid depth 3 in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION NA Date installed Size in gallons Manhole/Access (YIN) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100 + On adjacent lots 100' + Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75 + Public sewer manhole/cleanout 1001 + Sewer/septic service line 25 + Holding tank 100'+ Animal containment areas 501+ Manure/animal excrete storage areas 1001 + SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5 '+ Property line 5 '+ Absorption field 5 '+ Water main 101 + Water service line 10'+ Surface water 1001+ - Wells on adjacent lots 100 '+ ABSORPTION FIELD ON LOT TO: Property line 101 + Building foundation 101 + Water main 10'+ Water Service line 101 + Surface water 100' + Driveway, parking/vehicle storage 10' + Curtain drain 50' + Wells on adjacent lots1001 + F. COMMENTS As previously noted from Adequacy Test on 5/2/17, the septic system is nearing the end of its useful life. This renewal of the COSA is requested based on new water samples for bacteria & nitrate on 8/23/17. G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in al�,�E OF A� conformance with MOA COSA guidelines in effect on this date. t}.r r`''7-"•�.•S',r�_`` ,1 5e .___-. •.9 Engineers Printed Name Paul E. Pinard Wyk • th • Date 9/4/17 **, : Paul E. Pinard th I `•• CE -4793 •.•cP� ktt mr01`PROFESS 0.7/ COSA yellow sheet 2-6-15.doc I4t(.'1 • Municipality of Anchorage On-Site Water and Wastewater Program (907)343-7904 SA ETV CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 020-581 -12 Expiration Date: F--IC-1 7 1. GENERAL INFORMATION Compigte,legalklescription Lot 7, Mountain Vale Subdivision Location (site address) 8601 Paine Road, Anchorage, Alaska 9951 6 Current Property owner(s) Mike Taylor Day phone (907) 538-3701 Mailing address 940 Botanical Heights Circle, Anchorage, AK 99515 Real Estate Agent James Cash/RE Brokers AK Day phone (907) 360-7448 2. TYPE OF DWELLING: ® Single Family(w/wo ADU) ❑ Duplex 0 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 0 Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Received by: v Date: /i ;/l COSA to be released to t engineer,unless otherwise requested by the engineer. COSA Fee $ `� 0 41—C2-. .itsntlWaiver Fee $ Date of Payment 5/(2./17 A6 � 'Date of Payment Receipt Number Zi t r6 Receipt Number COSA# 05C n I t 18 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 Pinard Engineering Phone (907) 232-1347 Address PO Box 871347, Wasilla, Alaska 99687 Engineer's Printed Name Paul E. Pinard Date �1 `, A•41/41:- •• • VIA CO: e* 1 . ;,49TH 6. DSD SIGNATURE ©e000j00000000 Demo Y. System #1 Approved for . bedrooms. eo�°, pope i 1y�lora R. 4= System #2 Approved for bedrooms. CE 4793 =�T .4., Disapproved. r 1,c)! "° oeeo� ✓•< • Conditional 0.S approvalfor bedrooms, with the following stipulations:PO( lti 4 0, I l o fi-e&A4 yvt"4„ lY'r� P 4bf- ON-SITE WATER AND cn . VVAS i EWATEN PRnGRAM .2 By: Original Certificate Date: .c;"! �(7 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 9-1-12.doc If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of Oce-Sate Systems Approv 18 ChcckHst Legal Description: Lot 7, Mountain Vale Subdivision Parcel ID: 020-581 -12 A. WELL DATA Well type Pvt If A, B, or C provide PWSID# Well Log (YIN) N Date completed Unkn Sanitary seal (YIN) Y Wires properly protected (Y/N) Y Total depth 71 ft. Cased to 71 ft. Casing height (above ground) 18 in. FROM WELL LOG AT INSPECTION Date of test 11/H /2,0 /7 Static water level ft. o ft. Well production g.p.m. l S/ g.p.m. ' QFP WATER SAMPLE RESULTS: work �C> CJS 0-1ne by Coliform Neg colonies/100 mL Nitrate 0. 398 mg/L h E-tijin `ef',), pd n tr< Ccs. Arsenic ND ug/L Date of sample: 4/3/17 Collected by: ARCTERRA B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 10/19/83 Tank size 1 250 gal. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (YIN) Y Depression over tank (YIN) N High water alarm (YIN) N Date of pumping 8/18/16 Pumper A+ C. ABSORPTION FIELD DATA Date installed 10/19/83 Soil rating (g px d#'icor ft2/bdrm) 100 System type Deep Trench Length 25 ft. Width 3 ft. Gravel below pipe 8 ft. Total depth 7. 5 ft. Eff. absorption area 400 ft2 Monitoring tube Y Depression over field N Date of adequacy test 5/2/17 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 3 in. Water added 450 gal. New depth 0 in. Elapsed Time: 375 min. Final fluid depth 3 in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment(past 12 mo.) (YIN & type) N If yes, give date D. LIFT STATION NA Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100 + On adjacent lots 100' + Absorption field on lot 100' + On adjacent lots 100'+ Public sewer main 75' + Public sewer manhole/cleanout 100'+ Sewer/septic service line 25' + Holding tank 100' + Animal containment areas 50' + Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5' + Absorption field 5' + Water main 10'+ Water service line 10 + Surface water 1 00' + Wells on adjacent lots 100' + ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10' + Water main 10' + Water Service line 1 0'+ Surface water 1 00' + Driveway, parking/vehicle storage 10'+ Curtain drain 50' + Wells on adjacent lots 100'+ F. COMMENTS See COSA issued 4/19/17. New owner requested upgrade to 3 bdrms. Original system sized for 4 bdrms. See Field test data shts (3) for comments on this system & testing. System nearing end of its useful life. G. ENGINEER'S CERTIFICATION ..61%'i.Nac k. OF I certify that l have determined through field inspections and otri,.. •r'':;r g-` 4 review of Municipal records that the above systems are in riY'• ;"t7 ofte Oir conformance with MOA COSA guidelines in effect on this date. y: l • Engineer's Printed Name Paul E. Pinard �•• •` A Ofjp•Date 5/10/17 fo,; Paul E. Pinard :476. rteC CE-4793 :PrP •• •'p�.�'� ••.•• 1t PROFESS' �~' . COSA yellow sheet_2-6-15.doc • PINARD ENGINEERING P.O. Box 871347 / gt lk VVasilla,AK 99687 '' 11p1 (907) 357-ENGR (3647) ADEQUACY TEST-PAGE 1 LOCATION: Lot 7,Mountain Vale Subdivision JOB NUMBER: 17-055 APPLICANT: Mike Taylor DATE OF TEST: 5/2/17 940 Botanical Heights Circle Anchorage,Alaska 99515 FIELD STAFF: PJ Pinard SEPTIC TANK TYPE/SIZE: SteeU1250 Gallons,per MOA Records NUMBER OF BEDROOMS: 3 ABSORPTION SYSTEM: Deep Trench,per MOA Records SCUM: 0.2' SLUDGE: 0.2' DAILY FLOW: NEEDS TO BE PUMPED: Yes No XX 3 BEDROOMS x 150 GAL/BR= 450 Gallons CURRENTLY IN USE: Yes No XX TEST DATA Time Flow Volume Cumulative Septic Tank Septic Soil Absorption System Comments Rate Volume Tank pM (GPM) (GALs) (GALS) Liquid Level A Level Monitor A SAS Monitor A SAS Tube 1* Level Tube 2* Level 1:30 2.0 - - 4.2' - 2.8' - Start Flow- Meter 249980 1:45 2.0 30 30 4.2' 0.0' 2.9' 0.1' 250010 2:00 2.0 30 - 60 4.2' 0.0' 2.9' 0.0' 250040 2:15 2.0 30 90 4.2' 0.0' 2.9' 0.0' 250070 2:30 30 f- 120 4.2' 0.0' 2.9' 0.0' Out of Water 250100 3:00 3.3 - 120 4.2' 0.0' 2.8' -0.1' Re-Start Flow 250100 3:15 2.0 50 170 4.2' 0.0' 2.9' 0.1' 250150 3:20 - 10 180 4.2' 0.0' 2.9' 0.0' Out of Water 250160 RECOVERY *ALL MEASUREMENTS IN FT. Date Time SAS MT1 SAS MT2 TEST: PASSED FAILED COMMENTS: Testing of this septic system progressed in intervals where the test flow was added until such time that the well ran out of water and then allowed to recover for 30 minutes,at which time the flow to the septic system was resumed. Total time for the test was 5 hours and 45 minutes.See page 3 for additional comments. Reviewed by: Paul Pinar 1 Gt" Date: 5/8117 --\ PINARD ENGINEERING P.O. Box 871347 , 1 o Wasilla,AK 99687 (907)357-ENGR (3647) I !It / ADEQUACY TEST—PAGE 2 LOCATION: Lot 7,Mountain Vale Subdivision JOB NUMBER: 17-055 APPLICANT: Mike Taylor DATE OF TEST: 512117 940 Botanical Heights Circle Anchorage,Alaska 99515 FIELD STAFF: P.1 Pinard SEPTIC TANK TYPE/SIZE: Steel/1250 Gallons,per MOA Records NUMBER OF BEDROOMS: 3 ABSORPTION SYSTEM: Deep Trench, per MOA Records SCUM: 0.2' SLUDGE: 0.2' DAILY FLOW: NEEDS TO BE PUMPED: Yes No XX 3 BEDROOMS x 150 GAUBR= 450 Gallons CURRENTLY IN USE: Yes No XX TEST DATA Time Flow Volume Cumulative Septic Tank Septic Soil Absorption System Comments Rate Volume Tank PM (GPM) (GALs) (GALS) Liquid Level a Level Monitor a SAS Monitor A SAS Tube 1' Level Tube 2* Level 3:50 3.3 - 180 4.2' - 2.8' -0.1' Re-Start Flow— 250160 4:05 - 50 230 4.2' 0.0' 2.9' 0.1' Out of Water 250210 4:35 3.3 - 230 4.2' 0.0' 2.8' -0.1' Re-Start Flow- 250210 4:50 50 280 4.2' 0.0' 2.9' 0.1' Out of Water 250260 5:20 3.3 - 280 4.2' 0.0' 2.8' -0.1' Re-Start Flow 250260 5:35 - 50 330 4.2' 0.0' 2.9' 0.1' Out of Water 250310 RECOVERY `ALL MEASUREMENTS IN FT. Date Time SAS MT1 SAS MT2 TEST: PASSED FAILED COMMENTS: See pages 1 and 3 for comments. Reviewed by: Paul Pinard T' Date:5/8/17 PINARD ENGINEERING P.O. Box 871347 a, Wasilla,AK 99687 11E1 (907)357-ENGR(3647) ADEQUACY TEST—PAGE 3 LOCATION: Lot 7,Mountain Vale Subdivision JOB NUMBER: 17-055 APPLICANT: Mike Taylor DATE OF TEST: 5/2/17 940 Botanical Heights Circle Anchorage,Alaska 99515 FIELD STAFF: PJ Pinard SEPTIC TANK TYPE/SIZE: SteeU1250 Gallons,per MOA Records NUMBER OF BEDROOMS: 3 ABSORPTION SYSTEM: Deep Trench,per MOA Records SCUM: 0.2' SLUDGE: 0.2' DAILY FLOW: NEEDS TO BE PUMPED Yes No XX 3 BEDROOMS x 150 GAUBR= 450 Gallons CURRENTLY IN USE: Yes No XX TEST DATA Time Flow Volume Cumulative Septic Tank Septic Soil Absorption System Comments Rate Volume Tank pM (GPM) (GALs) (GALs) Liquid Level A Level Monitor A SAS Monitor A SAS • Tuber' Level Tube 2` Level 6:05 3.3 - 330 4.2' - 2.8' -0.1' Re-Start Flow— 250310 6:20 - 50 380 4.2' 0.0' 2.9' 0,1' Out of Water 250360 6:55 3.5 - 380 4.2' 0.0' 2.8' -0.1' Re-Start Flow- 250360 7:15 - 70 450 4.2' 0.0' 2.95' 0.15' Out of Water 250430 Stop Test RECOVERY *ALL MEASUREMENTS IN FT. Date Time ST MT SAS MT 5/2 7:45 4.27-0.0' 2.8'1-0.15' PM 5/3 7:00 4.2'/-0.0' PM TEST: PASSED XXX FAILED COMMENTS: The test on this system showed that it was able to absorb the design daily flow for a 3 bedroom, single family residence(450 gallons)within 24 hours. It is noted however,that the drainfield is close to being fully saturated, nearing the end of its useful life. Reviewed by: Paul Pinard ►i° Date:5/8/17 • , GE Municipality of Anchorage V .r y t On-Site Water and Wastewater Program 4 `•H IV (907) 343-7904 SA ETV CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 020-581-12 Expiration Date: ! — f"L''17 1. GENERAL INFORMATION Complete legal description MOUNTAIN VALE LOT 7 Location (site address) 8601 PAINE ROAD, ANCHORAGE,AK 99516 Current Property owner(s) SABRINA C. HERRICK Day phone Mailing address 8601 PAINE ROAD,ANCHORAGE,AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 2 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual ZI Individual Well. E Holding Tank ❑ Individual Water Storage El Community ❑ Community Class Well ❑ Public Sewer ❑ Public Water System ❑ WaiverNariance request for: Distance: Received by: r' Date: - Z rr /7 COSA to be released to the =.• _ otherwise requested by the engineer. COSA Fee $ (2.(0IWaiver Fee $ Date of Payment // o /19' Date of Payment Receipt Number 092'5110 Receipt Number COSA# q"l i g 7 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 ARCTERRA CONSULTING,INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD., EAGLE RIVER,AK 99577 Engineer's Printed Name KENNETH M.DUFFUS Date 4/12/2017 THIS COSA DOCUMENT CANNOT BE USED TO TRANSFER TITLE UNLESS ALL VENDORS(ENGINEERING,SURVEYING,CONTRACTORS,ETC...ASSOCIATED WITH THIS COSA ARE PAID IN FULL AT OR BEFORE CLOSING. Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use. local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore,ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen encroachments,deficiencies or discrepancies exist. 4--c) OF Az 4 Aor 4 .2 1111 ' . — 6. DSD SIGNATURE /- -���11111 �,.- System #1 Approved for 2_ bedrooms. t.s`�/ KENNETH System #2 Approved for bedrooms. # 71 `� ra ` -le Disapproved. \ `' •Esslos Conditional approval for bedrooms, with the followi g stipulations: c k Z earrS 614 L(c e 3 `f ic✓y Vkzav cowl.kklued 1700 ►� QFz`1CY OF, c : ON-SITE WATER AND m cc n WASTEWATER z PROGRAM co By 4" LI (7 Original Certificate Date: 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 sheet10-10-12.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: MOUNTAIN VALE LOT7 Parcel ID: 020.581.12 A. WELL DATA -See attached letter from 907 Water Well Services. Well type PRVT If A, B, or C provide PWSID # Well Log (YIN) N Date completed Unknown Sanitary seal (YIN) Y Wires properly protected (Y/N) Y Total depth 71 ft. Cased to 71 ft. Casing height (above ground) 18 in. FROM WELL LOG AT INSPECTION Date of test •• 4/4!2017 Static water level ft. 62 ft. Well production g.p.m. 1.8 g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 0.398 mg/L Arsenic: ND ug/L Date of sample: 413(2017 Collected by: ARCTERRA B. SEPTIC/HOLDING TANK DATA Tank Type/Material _SEPTIC!STEEL Date installed 10/19/1983 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N _ Date of pumping 8/18/2016 Pumper A+ C. ABSORPTION FIELD DATA Date installed 10119/1983 Soil rating (g.p.d./ft2 or ft2/bdrrj 100 System type DEEP TRENCH Length-8 25r ft. Width-S- ' ft Gravel below pipe 3:5-- 0 ft. Total depth 7.6 ft. (3.75' INV.) Eff. absorption area 400 ft2 Monitoring tube Y Depression over field N Date of adequacy test 4/4/2017 Results (Pass/Fail) PASS For 2 bedrooms Fluid depth in absorption field before test 2 in. (BELOW INVERT) Water added 300 gal. New depth 0 in. (BI) Elapsed Time: 1350 min. Final fluid depth 2 in. (BELOW INVERT) Absorption rate >= 300 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 100'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain 50'+(NONE KNOWN) Wells on adjacent lots 100'+ F. COMMENTS System is operating at full capacity and is 99% saturated & at the end of its life. Buyer and seller are aware that the system is marginally operating and although meeting minimal 2-bedroom COSA specs it will most likely need to be upgraded in the near future. Due to the shallow well, it is recommended or suggested to add 300-gallon of water storage for peak or heavy usage. An existing well was decommissioned-please see attached 907 Water Well Services documents. 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. !�� OFA Engineer's Printed Name KENNETH M.DUFFUS /��' �- , t k." * Date 04/12/2017 * 4 9 T i{ 'yAAki COSA canary sheet_2-6-15.doc 1 / KE'_VIrF.7. � -..Ess Otv I Tract D, Cinerama Terrace Subd. 8455E I N89°42'00"E 173.74 30 _ 10' UTILITY EASEMENT _ W CC 0 F- o WI rn T- CO cV O O ti Ct i- Lot ? `� I Lot 6 0 l— z ct 0 z 0-1 Septic vent SCALE: 1"= 50' -- -- _ Note: There exists easements affecting Lots Gravel driveway 6 and 7, Mountain Vale Subdivision recorded - in Book 65 at page 421 &422 for 46.0 `' 5 construction and maintenance of roadway. _.:- r JA.: O Story Frame • a Said easement dimensions are not specific (NO House o •� and cannot be plotted hereon. °Well- o 8.0 ° -., c\i 70.. .- 54.0 (V 06 \ \ 1 \. 30 — — — N89°42'00"E 173.74 M co co co PAINE ROAD _ _ — REVISED 4-20-17,Added septic ventsi kr, '`!� OF x ' AS BUILT NO CORNERS SET THI DATE Ali �� • • • •• •• ' I hereby certify that I have performed a Mortgagee's inspection ,�,`Q'•• • .s,� f, of the following described property: LOT 7, - C.j. 49th * •'9 I MOUNTAIN VALE SUBDIVISION •- L! � Anchorage Recording Precinct,Alaska,and that the !!� t � / Ar '.Fred Walatka. ,o improvements situated thereon are within the property lines a and do not overlap or encroach on the property lying ' �, 4,, 00adjacent thereto,that no improvements on the property lying 4r •• 3255 – S •• JQ- ,., adjacent thereto encroach on the premises in question and `,P, • . 0, that there are no roadways,transmission lines or other OOFESSIONAL•\P`' visible verbon o air easements on said property except as indicated \\N.N� Dated at Anchorage,Alaska this 17th day of APRIL ,2017. EASEMENTS OF RECORD, OTHER THAN FRED WALATKA&ASSOCIATES THOSE SHOWN ON THE RECORDED FB 17-4, pg 6 Engineers and Surveyors PLAT ARE NOT SHOWN HEREON. BE (907-248-1666) , 07 W -t"-17-1-7... \A[pr RESIDENTIAL & COMMERCIAL WATER AND WELL SERVICES 24HR EMERGENCY SERVICES AVAILABLE FREE ESTIMATES John Netherton P.O Box 210249 Anchorage,AK 99521 907-230-7868' In regards to 8601 Paine Rd. Anchorage AK. During decommission of the old well on property the well being used was inspected for the following Total Depth of well found to be 71 ' Static Water Level found to be 62' John Netherton Municipality of Anchorage Community Development Department On-Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907)343-7904 Well Decommissioning Log Legal Address: 0,/,,.)/9 ./ _--, Subdivision !/i ,,.)/9.J/7 I4I Block Lot T R Section Lot On-site Water&Wastewater Program certified contractor performing the well decommissioning: Nam 5-7.4 � .- Signature: 4-""-‘71.r. Company: "--/(-3? 4..../e;71. ../e t L�./c✓ri P‘,"sL am} Well decommissioning date /7'i 7 Method of decommissioning: AMC 1 5 55.060L1 a. ❑ b. D c.yr Location:Use the space below to provide a drawing of the property showing the following items; • North arrow • Decommissioned well, • Other water wells on the property, • Two separate swing-tie distances for each well shown on the drawing, Note:The swing-tie distances shall be measured from either permanent structures or the property corners. e �t t,_.,z N \Z/ G:ACommunit Develo menttDevelo ment Services u fetyA W.. 1, eco.. y p p ilding Safetyl0n Site Water and Wastewater\FormslClient FormslWell Decommisioning form.doc