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HomeMy WebLinkAboutMCCABE WEST LT 6Mccabe West Lot 6 #018-231-32 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 NAME�PHONE ���- NEW UPGRADE MAILING ADD tSS,, LEGALLDESCRIPTION \ LOCATION�l �� � a ry � c % NO. OF BEDROOMS U DISTANCE TO: Well / / �� AbcsorrptitioC,n aaarrep Dwelling n ( a P yi F_ Q WF Manufacture e�� Material C� ✓/ No. of c partments rn Liq. �� capacity �J7 246ons �®CL.. IF HOMEMADE: Inside length Width Liquid depth J0z DISTANCE TO: Well Dwelling PERMIT NO, Z Q 2—F Manufacturer Material Liquid capacity in gallons D w= DISTANCE TO: Well r 4kip Min Foundation. / Nearest lot line (' PERMI CSS LL Z F- Z w0 No. of lines C211 1 Le th of each line Total, gth ofJines Tren i th inches Distance between lines ¢ cc p Top of rile to finish grade -41 Material beneath rile f' 7 inches Total effe tie (byrption area LU Length Mdth Depth PERMIT NO. QI— wa Type of crib Crib diameter Crib depth Total effective absorption area LU DISTANCE TO: Well Building foundation Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. W DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MA(Lv/ S " SOIL TES//TAT R..11•J'/A�I3T'' III NN G t®® INST LLER AI r UjT0 r00, REIMARKS 1 APPROVED DATE / LEGAL 72-013 (Rev. 3/78) 1 \j m R L -0n' Hl JEF 9—:--- 1'� F-1 R— F— DEPARTMENT OF HEALTH AND ENV I RONMEr-,lTAL PROTECTIM-11 8 ;25 L STREET, Flt-,ICHORAQE:, FiK. 99501 C? 264-4712`0 L.— L... F=k t -,l C.), 0 P -J -'ES': I F-E.* JEE L4 E-- F::"E.-- Fru Pet 1 PERMI T r-40. '..`:1.i C9, " oe�.Exe, APPLIC-ANT f3F*NE .-TA61IGO P. 0. BOX 10-122-3 ]-ill 4 5 5140 1-OCATION IMC­-CABE CIRCLE WEST LEGAL LE -3 rqe CARE S/D LOT' SIZE 5.1,000 -S�:.O(Jt€E FEET 'TYPE' Ur SkJIL A... ..r. ST STE.P1 TRENL>- MAXIMUM NUMBER OF BEDRO(.'ft'.5, RATING (SQ 'THE RE.QUIREI`j SIZE Of" 'THE SOIL Fle-SORP'T S, Y ST E'rl I S '.. r1l 0-1 �s L) 'THE LErl, TH DIIIENSIMI 'IS THE LENGTH -'161 FEEET) ()F THE TRENCH OR DF: f i I N FI E. I IX I THE DEPTH OF A OR PIT IS THE 4CE BETWEEN "'I IE --; R.FAC , L) TM 1 s Ll E OF THE GROUND AND THE BOTTOM OF 'THE EXCAVATION (.'IN F-EET). 'THERE IS NO SET WIDTH FOR 'TRENCHES. THE GRA'-fi-H.. DEPTH IS THE MIhllMUM DEPTH OF GRAVEL BETWEE:N THE ot.rrFALL PIPE AND THE BOT-rom OF' THE EXCF-M.-M&I ,::IN FEET). PERMIT APPLICANT HAS THE RESPONSIBILITY 'TO INF!:.'Rrl 7*1 IIS DEPARTMENT DURING 'THE INSTFILLATION INSPEC'TIONS' OF Ffl'TTI WELL.S FIDJACENT TO PROPERTY FIND l+-IFE. NUt -lE)Er,.' OF RESIDENCES THAT THE WELL WILL. SERVE. 4 BAf.`KF ILLI NG OF M-4SYSTEM WITHOUT FINFIL INSPECTION AND APPROVAt BY 'THIS DEPARTMENT l,-lILL_ BE St.. BJEf."T 'TO PROSECUTION. 1'-11f4IMUM DITS�TANCE BE"1114EEN A INE -L.1- AND ANY fJN--'--,I'T . E SEWAGE DISPOSAL SY.'---,TErl IS 100 FEET FOR A PF?IVATE 1,4ELL. OR 1.50 TO 200 FEET FRIOM A PUBLIC JAIELA DEPENDING UPON 'THE' 'TYFIF OF` PUBLIC WELL. MIP-41MLIM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWEF, LINE IS. 25 F"Ef.".7 AND TO A COMMUNITY SEWER LINE IS 7`51 FEET, WIEL.L.. LOGS ARE RM.."MI'RED AND ML)ST BE RETURNED TO THE DEPARTMENT wrn-IIN '2-1,0 DAYI.-,i; OF THE COr-lPLr."*-.rjOV-4. OTHER, REQUIREMENTS MAli-I APPLY. SPECIFICATIONS AND CONSTRUCTION DIFiGRAM.1--i-ii: ARE AVAILAM-E 'TO lr-,lSURE FROPER IhISTAI LATION. F="EH. RZ! �'-1 I 'T' EEOr----.4Fz-a I F E.".7"ST. E:N JEE (::� FY Ir -1 H-31 E-- -j- .. 1. I CEF."(IFY IDIFI T 1: 1 AN FAMILIAR 1,111TH THE REGI )IREMENTS FOR SE14ERS Aklf*.) I-JELA ... S AS SET' FORTi-i E.,Y 'THE NUNICIPAII ITY ("IF ANCHORAG'E. 2: LWILL INSTALL 'THE SYSTEM It,! ACCORDANCE WITH THE CODES. I Ut-,IDERSTAII.K.', THAT 'THE ON --SITE SEWER SYSTEM rlf"il-rl REQUIF.E ENLARGENENT IF THE -�e(fh - Is RESIDENCE IS REMODELED 'TO INCI LIDE. MORE THAN 4 BEDROONm4 sur, Too-kt 11 �T 01441zle APPL. I C E Tr -J.C:F, e ISSUED Bl.j. %14. 0 r tf{�tw+ ,. •;"'° ` ' ;SQ11.S. LOG MONICIPALITY OF ANCHORAGE C DEPARTMENT OF HEALTH AND ENVIRONMENTAL P.RATECTION v Cl'.,PERCOLATION TEST 1� 825 L. Street, Anchorage, Alaska 99501 2641720 SOILS LOG - PERCOLATION TEST' L' o , PERFORMED FOR: DATE PERFORMED; L C �C° V LEGAL DESCRIPTION: �+ ' DEPTH/ (FEET) o4 C/4 ARCS SLOPE � z 3- S C�EA01)C��vIFL. y 5- 6- 5-/ f }s 7 S Ar )v 8 6) R-4 Ii✓�G C 0�[ TM'' 777 5A AJD 19 " .sr.ck WAS GROUND WATER `V© l ENCOUNTERED? O 12 P' E, IF YES, AT WHAT " 13 DEPTH? H 14 Reading. Date _ Gross Time Net Time pepth to Water Net Drop t 15 16 epeeeeseyea ea� s o e. ae 17- 18 � ae a m e as arae � o• aoeae®oae000.. ea aa9 ab 19 �� �i'�ay '< NO. 1732. E ®aS June 22, 1968�me.�•°'4 �; e®•m•90 20 Raee®0a w®�� " " PERCOLATION RATE (minutes/inch) TES RUN BETTWEEN// FT AND FT �� �.J � TO COMMENTS / �'/ f PERFORMED BY: CERTIFIED BY:, T 72.008 (6/79) F. WELL LOG ppii n Date Drilleds II Static Water Level feet Draw Down feet Type Material Drilledc Gallons Per Minute Total Feet of Casing F® 0 feet to 0 rO S-50 to -74 75 to to to to Hefty Drilling S.R.A. Box 1553 H Anchorage,Alaska 99507 4d 4 /?e d, 4,6 / e ,CSA�E 9/f 5cR k Z,-)- Lt>E5 / Time APPLI(�NT FILLS OUT UPPER HA;"--"%, ONLY 1 Property Owner J ! - jl - 7Phone Mail ng AddressZip Code7 Date Buyer Date Date Address Zip Code Lending Institution .l ''' Phone Inspector Zip Code Address�tcG Realty Co. & Agent , Phone Address Zip Code Legal Description � Street Location i Type of Residence Field Notes: _,- >x Single Family ❑ Multiple Family No. of Bedrooms ❑ Other Water Supply W. Individual ENVIRUib. f.:°. i)..:.TION ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ❑ Community For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility 4 1983 Sewer Disposal Individual Year Individual Installed: ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time T�6LC'b L -Q Date Date Date Date Inspector Inspector Inspector Inspector MUNICIPALITY OF ANCHORAGE Field Notes: _,- >x DFPT CI' ENVIRUib. f.:°. i)..:.TION x Lii`.' 4 1983 RECEIVED ( APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE BY: Soils Rating Sewer Installed Well To Absorption Area ,.�«g� Well Log Received Septic Tank Sizer�, w' / TDaa;te f . g Well to Tank 3 ,..., ,r ;..3 72-023(3182( r. L CHEMICAL & GE, LOGICAL LABORATORIES IL ALASKA, INC. NOEPtNOE `90 TELEPHONE (907).279.4014 ANCHORAGE INDUSTRIAL CENTER®- '- 274-3364 5633 B Street y° a O A v _ MATOe1�° Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER " TO BE COMPLETED BY LABORATORY Xl Analysis shows this Water SAMPLE to be: WATER SYSTEM: I.D. NO. Satisfactory Unsatisfactory Water System Name Phone No ❑ Sample too long in transit; sample should not be over 48 hours old at examination Mailing Address + i 5 'to indicate reliable results. Please send 0,new sample. ChyState ,Zip Code ff C S Date Received . AMPLE DATE: S ,') Mo. Day Year s Received SAMPLE TYPE; Arlelytical Method: " � Route .- q Tube .:"❑O'Check Sample (for routine sample ,Fermentation With lab ref. no. -t . ❑ '#sated Water {Membrane Filter ❑ Special Purpose ❑ UMU64Veto SAMPLE Time "dollec#>3a Lab; Ref. No; Result* Analyst NO LOCATION Collected - F3y fr LZ z a 3 ED 4 '4 G I 1 �. '- colonies/,100ml or No,pf P9sitive pbrIions RECORD' 0e -1220(b) 6ACTkit10LOGICAL)kkfistA"LVsiS " Rev. 1978 a Date Collected Source READ INSTRUCTIONS ` a.m. - - Date: Received ` Time Received p.m. Lab. No. Presumptive 10ml 10ml 20mi 10m1 10ml 1.0ml 0.1m1 24 Hours BEFORE 4e Hours t Confirmatory 24 Hours l '48 Hours - EMB Broth 24 hours: Broth 49 hours: COLLECTING SAMPLE Multiple Tube Report: `10ml Tubes Positive/TOUI 10MI Portion$` - Membrane Filter: Direct Count Collform/100m) verification: LTB BGB Final Membrane Filter Results Coliform/100ml d.'.� lr''. Reported BY Data Time • A.M. !� Municipality of Anchorr--N On-Site Water &Wastewater Progra(907) 343-7904 USNII G 2012 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 018-231-32 Expiration Date: 1. GENERAL INFORMATION Complete legal description MCCABE WEST LOT 6 Location (site address) Current Property owner(s) Mailing address Real Estate Agent 2. TYPE OF DWELLING: 13301 PEAKVIEW CIRCLE *ANCHORAGE, AK 99516 DAVID & BARBARA QUAID Day phone 345-0112 13301 PEAKVIEW CIRCLE *ANCHORAGE, AK 99516 E Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: Day phone TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site N Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ '� `- Received by: �,k r � q �� n- Date: COSA to be released to the engineer, unlessb erwise requested by the engineer. COSA Fee $ CA9 b Waiver Fee $ Date of Payment 11 I 1 3] i ori — Date of Payment Receipt Number b?JS5 �.yr t Receipt Number COSA # 0 '�) C.-` ;�� S 9-(2) Waiver # 5. STATEMENT OF INSPECTION SY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date ` 17— Engineers ZEngineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, 0��4 conscientious engineering analysis of the system in accordance with ADEC and MOA OF q DSD Guidelines & Regulations. The reported results described the performance of the p �C . • ""' q system under the conditions encountered at the time of the test, and separation Q s DO distances measured to readily identifiable features. The operational life of all wells and ��� g Fi*�Q septic systems depend on the local soils condition, groundwater levels that may �. . fluctuate during the year, and the water usage of the family being served by the system. ...... PA These conditions are outside the control of the evaluator of the system. Satisfactory test ... . , , .� results do not guarantee future performance of the system, nor do they guarantee that Q •.Je r ness;' G there are no hidden defects or encroachments. GEG, LTD. can therefore not provide �Q 9, 111 7g 3 00� any warrantyor future estimate of how long the system will continue to meet the s f ^ • i+' c c°O operational requirements of the ADEC or MOA DSD. The content of this report is for 4 0\ Eo the sole benefit of the owner listed above. Any reliance upon or use of this report by any X00 a ro f T% o� other person or party is not authorized, nor will it confer any legal right whatsoever. s�f//<<_ 6. DSD SIGNATURE J� ON-SITE System #1 Approved for � bedrooms. � � WATER AND System #2 Approved for bedrooms. = t WASTEWATER Disapproved. PROGRAM 0 Conditional approval for bedrooms. with the following stipulations/lila,;, � & The Municipality or Anchorage Develop,emt 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. ATTCHMENTS: / COSA Checklist Nitrate Advisory l/ Septic System Advisory Arsenic Advisory Well FI Advisory Other By:Original Certificate Date: (Rev. 11/05) 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: MCCABE WEST LOT 6 A. WELL DATA Well type PRIVATE If A. B, or C provide PWSID# N/A Date completed 11/18/81 Sanitary seal (Y/N) YES Total depth 80 ft. Cased to 80 ft. FROM WELL LOG Date of test 11/18/81 Static water level 51 Well production 12 WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Arsenic: ND ug./L. B. SEPTIC/HOLDING TANK DATA Nitrate 13.0 mg./L. Parcel I D: 018-231-32 Well Log (Y/N) YES Wires properly protected (Y/N) YES Date of sample: 10/11/12 Casing height (above ground) 12+ in. AT INSPECTION 10/16/,12 1.89+ g.p,m, Collected by: GEG. Ltd. Tank Type/Material SEPTIC/STEEL Date installed 11/2/81 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 10/15/12 Pumper NORTHLAND PUMPING SERVICE C. ABSORPTION FIELD DATA Date installed 11/2/81 Soil rating (g.p.d./Wor /bdrm 100 System type TRENCH Length 32 ft. Width 3 ft. Gravel below pipe 7 ft. Total depth *8.70 ft. Eff. absorption area460 ft2 Monitoring tube **YES Depression over field NO Date of adequacy test 10/16/12 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test **12.5 in. Water added 760 gal. New depth ***37. in. Elapsed Time: 120 min. Final fluid depth ****27.5 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give�dpte **MONITORING TUBE ONLY EXTENDS 34.5 INCHES INTO EFFECTIVE. (r-rmu`Q V`"V`" �" BEIO"t ***3 INCHES ABOVE INVERT OF LATERAL. '(-tE L��) ****7 INCHES BELOW INVERT OF LATERAL. D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off" level i . High water alar level Cycles tested Meets alar & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tanknift station on lot 100,+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Sewer /septic service line 25'+ Public sewer manhole/cleanout N/A Holding tank Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation -4 5'+ Property line 5'+ Absorption field 5' Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS * (.'2"'"ria-eYM 6 -rt -ro oviP A"or1 G. ENGINEER'S CERTIFICATION I certify that t 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. Engineer's Printed Name JEFFREY A. GARNESS Date i) / t1 1) 7- P;Wv. 1IM5) 17- (Rev.'1IM5) Municipality of Anchorage gE ' Community Development Department p* =g Development Services Division $A ETY On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # OSC121520 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Lot 6 of McCabe West subdivision. This inspection revealed a nitrate concentration of 13 milligrams per liter (mg/L) was reported for the property's well water sample. 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. , ... ....:: .� .. . . . ..>.�: . . ... .. \+05 � - \� <��- - \� :� , ARROW PUMP & WEU SERVICE, LLC P.O. Box 110496 Anchorage, AK 99511 Office: (907) 346-9355 • Fax (907) 345-0202 Eagle River: (907) 622-9335 CUSTOMER r �3 � c�,r e4e e_- -1 % MUM No. 9601 JOB SITE L �-7 1-:2 J INVOICE !yTE OICE DA (�P WELL DEPTH AW�� a. SWLv J 51 CHLORINATED PUMP DEPTH r SALESPERSON /QUXNTITY - DESCRIPTIO PRICE AMOUNT C: CG.� -7� ' _ p_" i / 741,65 6 �5 0 LABOR HOURS,7 RATE AMOUNT TOTAL MATERIAL TOTAL LABOR WORK ORDERED BY DATE COMP. TOTAL LABOR PAY THIS AMOUNT - `• Thank You 4C. SIGNATURE (I Hereby Acknowledge the Satisfactory Completion of the Above Described Work and agree that if above work is not paid for in 90 days I agree to allow Aarow Pump & Well Service, L.L.C. the right to remove unpaid for equipment and charge for labor already performed & labor to remove unpaid for equipment.) TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE. SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. 1 , 1 ' 301 E. International Airport Rd. Anchorage, Alaska 99518 (907) 563-3770 Ph (907) 563-5502 Fax WORK ORDER NUMBER `.� 2.2 i DATE STARTED CUSTOMER NAME A-26--12. 9A&; s D AK 6JJrd�1. MODEL kscs DATE COMPLETE ADDRESS ' w-26 ,I., 1330% ��tli�ifc+v crk.1A. SERIAL NUMBER ci .Z METER READING CONTACT PHONE P.O. NUMBER TECH DATE TRAVEL START STOP PROBLEM D CASH ❑ SIA ❑ FBM REPEAT ❑ YES ❑ NO ❑ CHARGE ❑ WARRANTY ❑ RENTAL COMPLETE ❑ YES ❑ NO OTY PART OR SUPPLY EACH SERVICE PERFORMED ; f >' Ac 1.L t! W P � ct epi '�GZ f [ �' a ! s ✓A� P 1"WJwday.- J.. AL ✓ :.✓ L.d � � TJ d' izd l' 4 �. Vag r, A-LSA1 Ora, ''k i V dS.SG L✓ s"a-t1d.s TOTAL PARTS & SUPPLIES ❑ ESTIMATE ONLY $ TOTAL EST. LOANER INFORMATION CHARGE SUMMARY ESTIMATE ACTUAL MODEL SERIAL 3,1 LABOR ( IfHOURS�a $ /I_ S�` PARTS AND SUPPLIES OTHER ESTIMATE CHARGE TOTAL ACTUAL CHARGE DATE DELI EDC &TOMER SIGNATURE o v cA DATE REMOVE SOLD BY WARRANTY IS FOR ACTUAL WORK PERFORMED WITHIN 30 DAYS AFTER DATE COMPLETE OR DATE SIGNED, WHICHEVER IS LATER. i &/,2fvd/.-)- Q C ., 00 T p B ;rKq 7,70 ®, ❑ CASH $ CUSTOMER SIGNATURE ATE APW-W5 (?JOB)