HomeMy WebLinkAboutMACHENFELD ACRES LT 1AMachenf leeld
Acres
Lot 1 A
#011-142-49
Municipality of Anchorage
Development Services Department ;'4
Building Safety Division ,.
• C
On -Site Water 8 Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage. AK 99519-6650
www.muni.org/onsile
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. - r►ua- 4 9 COSA#096,2 y 1
1. GENERAL INFORMATION Expiration Date: 1 0 3 0.— 0
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
MACHENFIELD ACRES: LOT 1A
4640 W. 80TH AVE • ANCHORAGE. AK * 99502
TEDDI PORTER Day phone 245-2403
4640 W. BOTH AVE • ANCHORAGE. AK • 99502
Day phone
JANELLE PFLEIGER W/ REMAX Day phone
110 W. 38TH AVE, #100 • ANCHORAGE, AK -• 99503
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 5
242-0076
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
0
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
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 an Independent professional 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 samples. (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 riles 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.
Address 3701 E. TUDOR ROAD, SUITE 101 ' ANCHORAGE, AK 99507
Engineer's Printed Name ,JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, GEG, LID. attempted to provide a thorough,
conscientious engineering analysis of the system In accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
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.
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
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report Is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
S. DSD SIGNATURE
V Approved for bedrooms.
Phone 337-6179
Date % h t7 D.I
:y
e f ey ....or ss� ••
e CE -7953 e�
40i1n°
Disapproved.
Conditional approval for bedrooms, with the filowing stipulations:
Attachments: t
COSA Checklist ✓ Arsenic Advisory
Septic System Advisory Maintenance Agreements
OFrrq/S%r'',
ON-SITE •.��=
WATER AND
;WASTEWATER
PROGRAM '
Well Flow Advisory Supplemental Engineer's Report
Nitrate Advisory Other c�
By- Original Certificate Date:?" 3 O 1
�.. nrost
Municipality of Anchorage
Development Services Department
\ Building Safety Division
On -Site Water 8 Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: MACHENFIELD ACRES; LOT to Parcel ID: D
A. WELL DATA 'PER GEC INSPECTION. ••ASSUMED, BASED ON SURROUNDING WELL LOGS. SEE ATTACHED
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (YIN) NO
Date completed UNKNOWN Sanitary seal (YIN) YES
Total depth '49+ ft. Cased to •'40+ ft,
FROM WELL LOG
Date of test
Static water level
�NPJp\\Ag\� ft.
Well production g.p.m.
WATER SAMPLE RESULTS:
Coliform C)_ colonies/100 ml.
Arsenic: ug./L.
Wires properly protected (YIN) YES
Casing height (above ground) 12+ in.
AT INSPECTION
7/15/2009
47 g,
3.3 g.p.m.
Nitrate N Q mg./L. Other bacteria SZcolonies/100 ml.
Date of sample: 7/115/2009 Collected by: GEG Ltd.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material
Tank size gal. Number of Compartments _
Foundation cleanout (YIN)_ Depression over tank (Y/N)
Date of pumping
C. ABSORPTION FIELD DATA
Date Installed
Length ft
Total depth ft. Eff.
Date of adequacy tes
Soil rating (g.p.c!Mor
PUBLIC SEWER
Date installed
Cleanouts(Y/N)
High water ala )
System type
tth / ft. Gravel below pipe ft.
i
area_ ft' Monitoring tube_ Depression over field
Results (Pass/Fail) For bedrooms
Fluid dept absorption field before test _ in. Water added _gal. New depth _in.
EI sed Time: _min. Final fluid depth _ in. Absorption rate >_ g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type)
If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N
"Pump on" level at in. "Pump off" level High water alarm level at in.
Cycles tested Meets alar & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAift station on lot N/A
Absorption field on lot N/A
Public sewer main 75'+
Sewer /septic service line 25'+
Animal containment areas 50'+
On adjacent lots N/A
On adjacent lots N/A
Public sewer manhole/cleanout 100'+
Holding tank N/A
Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation Property line Absorption
PUBLIC SEWER
Water main
Water service line Surface water
Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FI OT TO:
Property line
B ' oundation Water main
Water service lin
Surface water Driveway, parking/vehicle storage
mdrain
Wells on adjacent lots
F. COMMENTS
G. ENGINEER'S CERTIFICATION o< %-,I
I certify that I have determined through field Inspections and p ,T ! '+ L
review of Municipal records that the above systems are in
conformance with MCA COSA guidelines in effect on this 0 ,, ............ • • • • •
date. f r y G rness:
Engineer's Printed Name JEFFREY A. GARNESS Q , . C 7 3
7.1
Date -7as
COSA Fee s /,?v
Date of Payment 1A 51/f) q
Receipt Number0Q 3565
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
Municipality of Anchorage
• Development Services Department
Building Safety Division '[ r
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
Arsenic Advisory
Certificate of On -Site Systems Approval # 090241
A Certificate of On -Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block , Lot
IA of Machenfield Acres Subdivision. This inspection revealed an arsenic
concentration of 32 micrograms per liter (ug/L) for the property's well water
sample. The Environmental Protection Agency (EPA) has established a
maximum contaminant level (MCL) of 10.0 ug/L for public drinking water
systems. While private wells are not subject to this regulation, EPA
standards are based on existing health information and can therefore be used
to gauge the relative quality of water from private wells. information on
arsenic is available from the On -Site Water and Wastewater Program
website (www.muni.org/onsite) or at 343-7904.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
TEMP, TURNAROU ND
M" MOTE N0. 4IPLAT [DOO-e YI
_____________ � ____________
}JI r
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F— �
I II I I
I I I I I 30' amER [Ae ENEM
I.11�
II o Ir I
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I_IIgII
NI 411 < I I NOTES:
cel g,l
REFER TO NOTES I- 9 REGARDING
0]b,l 11 I EASEMENTS . WETLANDS. AND OTHER
^ II I I , INFO. AFFECTING THIS PROPERTY.
31 m I I i, I L PLAT 2000.521
a I II I I 2 SEWER PIPES ARE SHOWN ON THS LOT
❑, , I I, I ON PLAT 2000.52 IN THE TELE. & ELEC.
oli II II I EASEMENT: NOT LOCATED OR CONFIRMED
°❑I II I, I BY THIS SURVEY.
I II p I
TRACT 33 - iA
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PSE. �F• A gSO�O
Off•
49TH a°oo
AS-BUILTSURVEY
JAN
OoA SHANE A. HOLT: ;QQ SCALE:1'e 50'
JA\Z i °
J I QO ' L5-6914 iQ
HAT jeOO DESCRIBED
BY RTIFYTTY. IHAVE PERFORMED
MORTGAGEE'S INSPECTION OF THE FOLLOWING
I Q44p��QOao�
LOT 1 A MACIIENFELD ACRES SUB
I
ANCHORAGE RECORDING DISTRICT. ALASKA AND THAT
THE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE
THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN
PROPERTY LINE S AND NO VISIBLE ENCROACHMENTS EXIST
EXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS AND 15 NOT TO BE USED FOR POSITIONING ADP 1101
OTHER THAN NOTED.
STRUCTURES OR FENCELNES
DATED AT ANCHORAGE. ALASKA THIS
EASEMENTS OF RECORD. OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HEREON,
_BTN_
DAY OF JULY 2009
HOLT LAND SURVEYING 11069. FB 106 73
NOTE MY FENCELINES SHOWN ARE LOCATED APPROXIMATELY AND ME NOT TO BE USED TO DETERMINE PROPERTY LINES
TEL 345.5510
OR LOCATE STRUCTURES
Scsr
SGS Ref#
1093464001
Client Name
Garness Engineering Group, Ltd
Project Name/O
Machen Field Lot I
Client Sample ID
Machen Field Lot I
Matrix
Drinking Water
Printed Datd inic
Collected Datorl'ime
Received Datefl'imc
Technical Director
07272009 12:06
07/1512009 18:00
07/162009 8:10
Stephen C. Ede
Sample Remarks:
Allowable
Prep Analysis
Parameter
Results
PQL
Units
Method Container
ID Limit%
Date Dam
Imt
Metals by ICP/MS
lardness as CaCO3
ND
5.00
mgJL
SM20 2340B
C
0723'09 07/_7/09
NRB
Waters Deoartmant
Total NitratdNitrite-N
ND
0.100
mgtL.
SM204500NO3-F
B
(<10)
07/16/09
LCE
Private Individual Analysis
Aluminum
ND
20.0
ugR.
EP200.8
C
0723109 0727/09
NRB
Antimony
ND
1.00
ug/L
EP200.8
C
(<6)
07,23109 O727/09
NRB
Arsenic
32.0
• 5.00
ug/L
EP200.8
C
(<10)
0723109 0727/09
NRB
Barium
ND
3.(8)
ug/I,
EP200.8
C
(<2000)
0723/09 07,27/09
NRB
Cadmium
ND
0.500
ug/L
EP200.8
C
(<5)
0723109 07.27/09
NRB
Calcium
ND
500
on
EP200.8
C
0723/09 0727/09
NRB
Chromium
ND
2.00
u&fL
EP200.8
C
(<I00)
0723/09 0727/09
NRB
Copper
ND
L(N)
ug/L
EP200.8
C
(<1300)
0723109 0727109
NRB
Iron
ND
250
ug/L
EP200.8
C
(<300)
0723/09 07,27/09
NRB
Lead
ND
0.200
ug'L
EP200.8
C
(<15)
0723/09 0727/09
NRB
Magnesium
ND
50.0
ug -L
EP200.8
C
0723!09 0727/09
NRB
Manganese
ND
1.00
ugR.
EI1200.8
C
(<50)
0723/09 0727/09
NRB
Chloride
2.82
0.100
m&l.
EPA 300.0
D
(<250)
07/17109 07/17109
LCE
rluoride
0.154
0.100
mg/L
EPA 300.0
D
(<2)
07/17/09 07117/09
LCE
Selenium
ND
5.00
ug/L
EP -100.8
C
(<50)
0723/09 0727/09
NRB
Sodium
854(8)
S00
ug/L
EP200.8
C
(Q50(0M)
07,23/09 0727/09
NRB
Silver
ND
1.00
ugn.
EP200.8
C
(<1(0)
0723109 0727/09
NRB
Thallium
ND
1.00
ugfL
EP200.8
C
(<2)
0723/09 0727/09
NRB
Sulfate
1.25
0.100
mg'L
EPA 300.0
D
(<250)
07/17/09 07/17109
LCE
Zinc
ND
5.00
ugl.
EP200.8
C
(<5(H)0)
0723/09 0727/09
NRB
WIq
SCS Ret#
1093464001
Nickel
ND
I ICO3 Alkalinity_
Client Name
Garness Engineering Group, Ltd
Printed Date/Time ime
07272009
12:06
Project Name/#
Machen Field Lot I
Collected Date/(imc
07/152009
18:00
Client Sample II)
Machen Field Lot I
Receised Datcfl'ime
07/162009
8:10
Matrix
Drinking N'atcr
Technical Director
Stephen C. Ede
D
0721/09
MPL
10.0
mgA.
SM202320B
D
Allowable Rep
Analysts
Parameter
Results PQL
Units Method Container ID
Limits Date
Date Imt
Private Individual Analvsis
Total Dissolved Solids
200
Nickel
ND
I ICO3 Alkalinity_
178
CO3 Alkalinity
ND
Of I Alkalinity
ND
Conductivity
363
pll
8.30
Alkalinity
178
Colony Count
0
Total Coliform
0
Fecal Coliform
0
10.0
mg/L
S%120 2540C
D
(<500)
07/16/09
OLT
2.00
ug/L
EP200.8
C
(<100)
0723/09 0727/09
NRB
10.0
mg/I.
SM202320B
D
0721/09
h1PL
10.0
mgrl.
S\12023208
D
0721/09
MPL
10.0
mgA.
SM202320B
D
0721/09
KIPL
1.00
umhos/cm
SM20251013
D
07/16/09
OLT
0.100
plI units
SM204500.11 8
D
(6.5-8.5)
07/16/09
OLT
10.0
mgA.
SM20232013
D
0721/09
h1PL
col/100ml.
SM2092228
A
07/16/09
DLC
col!100ml.
S\120 922213
A
(<I)
07/16!09
DLC
co11100ml.
SM20922211
A
07/16'09
DLC
WATER WELL DRILLERS LOG DO NOT FILL IN
�,� i a-4—�o f 1ti
Drilling Co. r -.S � ��re; � 4 USGS-Not y
Driller -e, Area Z ) ? 700020
We II Owner Wt* I/i o k,I VLcw'r'v11 Use of Well 0VIIer
Location (address of: Township, Range, E Section (if known); distance from road:
I ..-1' 1 RLa.k'l. _Su.vnd; � I, Kt,
Size of Casingn�Depth of Bole/ t9 feet. Cased to feet.
Static water level_ land surface. Finish of well
(check one) Open end (p4: Screen ( ): Perforated
Describe screen or perforations:
Wellpummping test at: 117L per (hr) n or
a 1feet of drawdown from static level.
Remarks
Date completed G / 1i WELL LOG
Depth in feet from Give details of formations penetrated, size of material, ground surface color, and hardness.
to Stuv, J n t
to
to
to
to
to
to.
to
to
to
to
1J
M -W DRILLING, Inc. �yS7
P.O. Box 110378 a to= Old Seward Highway 87-186 i
(907) 34MS35 i
ANCHORAGE. ALASKA 99511
DRILUNG LOO
Well Owner Lou Mass . UseofWell Domestic
Location . (address :of: Township, Range, Section, if ]mown; or distance main road
Lot3 Block 1 Sundi Lake Subdivision
Size of casing—J"pth of Hole— 99' feet Cased to 991 feet
y,¢ . .
Static water level 659 ft. below) land surface. Finish of well (check one) open end QXX );
Screen ( ); Perforated (,s' ?
Describe screen or pet
Well pumping test at 10
of drawdown from sta
Date of
'(minute) for 1 hours with 100% ft.
sil
7,!
0
TO__L_
WELt too
Depth in feet from . ;' r'
,:
around surface GWfr
bf.formations penetrated, size of material, color and hardness
0
TO__L_
2
TO
3
3
TO
52
52
TO
97
97
TO
99
TO
TO
TO.
-TO
TO
TO
TO
TO
TO
i
t
L
F�
NWWA Certified Contractor
p,.ssfirntn No's. 814 dt 973
2 —STATE
i
Frcm ALPINE DRILL 907 34: 020=
I
Apr.18.1994 11:33 PM PO1
STATE OF ALASKA j
DEPARTMENT OF NATURAL RESOURCES
DIVISION OF WATER /
WATER WELL RECORD rr,
=;f1011000N
EUBDMSION
LOT
aLOCX
SECTION QTR6SECTION
TOVAIP
RANDS
.618111DIAN'"
(
/.Z S
M.�
W
w
:iS ATWN/SKETCH:
WELL tJo Ade,r%
99Svz
"O,ff
ppk
Lc
S MEASURED FROM:Ocasing top []ground surface
WELL DEPTH: DATE OF COMP - ' fOt�,
Depth of hole: /Jq ft
Depth of Basir t
:01OPOLE DATA: Depth
i� I Type and Color From To
/
1 /
DEPTH T9 STATIC WATER LEVEL:
1t below 0 top of casing ❑ ground Stdooll "
Date/•
//
METHOD OF DRILLING: ,® air rotary O cable tool
�....t�
.:.'' /
f1
,0 other
! 1 f
%�
j
USE OF WELL:4 domestic O irrigation O MoAlfibr;
�.+..•.cCi-, 1... ��! ! !
/ 1
O
0 public supply 0 other
1 . s
CASING STICK-UP., ft. Diam:T.
Casing type: ^A•. h in; to
• j /1/1
_
WELL INTAKE OPENING TYPE: ;0 open and 0`soi6enod'-
it, .4 N��� °ice"
`
45V,
11112-1
O perforated 0 open hole
Depths of openings: to ft
SCREEN TYPE: Diem: 'In. "
Slot/Mesh Size: Length: ft
GRAVEL PACK TYPE:
Volume used: Depth to top:
�pR 2
GROUT TYPE: Volume:
. C
ora9e
Depth: from 1t to it
Muni, a
&
DEVELOPMENT METHOD:
Dept.Health
Duration; /
PUMPING LEVEL AND YIELD:
•,
A a. " It after ___/_ hrs pumping � Qprry.
PUMP INTAKE DEPTH: ft Horsepower..,
WELL DISINFECTED UPON COMPLETION? 0 YES !• 0 NO,41;
,C'*p'' ACTOR INFORMATION:
Tveg-i e0 Business [Jame
r-
5ignuture ol AuthariZedoFp sontativc ate
REMARKS:
PLEASE MAIL WHITE COPY OF LO T0:
DNRIDIVISION OF WATER ,
PO BOX 772116