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HomeMy WebLinkAboutSAND LAKE #2 BLK 1 LT 7and Lake #2 Block 1 Lot 7 #011-132-42 a Municipality of Anchorage ' Development Services Department Yyt Building Safety Division OnSfte Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page /of iv w.el.anchorage.ak.us (907)3437904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SWO50446 PID Number: 011-132-42 R.nr. Kevin Elfrink Wastewater System: ❑ New Q Upgrade Aaabb 8109 Wilcox St, Anchorage, AK 99502 ABSORPTION FIELD pro Rumoa a BwlokmR 4 torp Twn,l]ar.pw TbnM 09.a ❑MaM ❑OOrr LEGAL DESCRIPTION Sol RSMV 1.0 TDw Drm fmm afprrl p.M: Dpn,[:e 12.5 R. Bock Lot 8, iaw,. 1 7 Sand Lake #2 Dpmbppepeanfemor9rrl9wr. Drava rrel Dar= P" 4,5 A. 8.0 R To.wV Rap'. e.cmm Fp Rm.a Remronprw pnO.'. OrrM Lrnpe, 0.3 fl, 44 effective q, Well ❑New [3 Upgrade abwlwam. 2,5 rum »ri Dwk e I nano, R ciaza m (GwwrAB, c} Tam Dolan Grab. Tmlao ,lxmii .. Pp llaarl Mips fl. R 704 Fe D 30341E 810 Dbw DowDrrw. abaCwal,t~ Irby[ A+ Home Services Dmlmara 12/20/05 R rra PrnD s.l a. c..ro"`a.oa.."l�ra. v� 0!5 Dl DN TANK aw fl. R SEPARATION DISTANCES [aSeptic ❑Holding ❑S.T.E.P. E3 other. To Septic Absorption LIR Holding lubloRreste , ,n„a. pcRy. From Tank Field Station Tank sewer une Anchorage Tank & Welding, Inc. 1500 aa. w.R 106' 108' N/A N/A 102' Y.rrrl. Steel NunWr a co,npanw,b. 2 s,.r.a.w.w 100'+ 100'+ N/A N/A LIFT STATION to Law 14' 3' N/A N/A � NA Gal � a GDurbepn 14' 25' N/A N/A 'Gump on'rva a. 'GUInP err rva" M{ylvww error et r cbbr Dior WA N/A N/A WA Pump Mar a Maw EMCRea rapKib,r Iwblmw q'. Rana r. 3' lot line waivers to north &south. BENCH MARK 135' waiver to Class C well on lot 4. Laruw,ar Orn�pcon. Back door threshhold Waiver for 108' to drainfield & 105' to tank from Lot 9 rw 100.00 FE well. Old tank and drainfield abandoned In place. Trench encountered 8 It of contaminated soil. Total length of new trench Engineer's Stamp OF �� q 52 ft, with 44 ft effective. Inspections performed by: Cindy W. Ellis, P.E. Dates: 1" 12/19/05 49LH 2nd 12/20/05 =1.7rz_ Development Servl es Departmen3Approval':, Reviewed and approved by: 60, i a rte: Cl d Y W. Ellis ,•' CE -10577 (Rw. 12=)% .•, / W W W S 89054'31'W 135.72' Lot 4 / 135' well radius—,/ / s col MT7 ASPHALT DRIVEWAY EXISTING '\ �1500ga1 Steel 48R HOUSE >` Septic Tank N 89°54'31 "E 135.72' ' B FCO 18.6 17.8 STI 23.4 FCO w 32.8 DEC DCO 35.0 I C01 52.3 O � A 37.6 N 89°54'31 "E 135.72' STI \Lot 9 108' well radius Lot 9 ' 105' well radius,, Based upon a survey by Shane A. Holt LS -6914; December 22, 2005. ADEC Waivers: Lot 9 Well to Drainfield: 108' Lot 9 Well to Septic Tank: 105' Lot 4 Well to Drainfield: 135' AS -BUILT Sand Lake #2 Block 1 Lot 7 c�oo����o0p Record Drawing of Septic Upgrade op k� ............... s40 Kevin Elfrink Watkins Engineering, Inc ��? �-0 Parcel ID- 011-132-42 g g' p,�? 49 TTH •7 Permit No. SW050446 0 VEY Cindy W. Ellis, P.E. P.O. Box 110443 0�;'cl-"iosn is.;' January 1, 06 Anchorage, Alaska Scale 1 inc20 20 ft Phone: (907) 349-18511Fa0: (907) 349-1934 00 •4 ., oeo 4 hto A B FCO 18.6 17.8 STI 23.4 26.0 ST2 32.8 32.0 DCO 35.0 34.2 C01 52.3 26.0 CO2 28.0 37.6 MT1 50.025.0 MT2 35.5 40.9 STI \Lot 9 108' well radius Lot 9 ' 105' well radius,, Based upon a survey by Shane A. Holt LS -6914; December 22, 2005. ADEC Waivers: Lot 9 Well to Drainfield: 108' Lot 9 Well to Septic Tank: 105' Lot 4 Well to Drainfield: 135' AS -BUILT Sand Lake #2 Block 1 Lot 7 c�oo����o0p Record Drawing of Septic Upgrade op k� ............... s40 Kevin Elfrink Watkins Engineering, Inc ��? �-0 Parcel ID- 011-132-42 g g' p,�? 49 TTH •7 Permit No. SW050446 0 VEY Cindy W. Ellis, P.E. P.O. Box 110443 0�;'cl-"iosn is.;' January 1, 06 Anchorage, Alaska Scale 1 inc20 20 ft Phone: (907) 349-18511Fa0: (907) 349-1934 00 •4 ., oeo 4 hto FINAL GRADE _ DG ioial (engin. 9,i euecuve TRENCH TRENC N.T.S. RELATIVE DEPTHOF TEST HOLE = 80.02' AS—BUILT �_�T TTT �+ No NATER A V 1L Sand Lake #2 Bik 1 Lot 7 Record Drawing Septic Upgraded 000000pppp �p0 of ,.OF•Atq S'.f Kevin Elfrink Parcel ID: 011-132-42 Watkins Engineering, Inc o�,�P. 00 of.O"49TTH Permit Number. SW050446 0•.•. .. '.).G..',%"j�� p p.r.. .1..Gti?.�..p Q o •, CINDy W. E = 0 p0� : •.• c@@@ 10577 0e, Cindy W. Ellis, P.E. P.O. Box 110443 January 18, 8, 2006 Alaska 99511-0443���p0000000�v� AnchoraPhone: No (907) 349-1851, Fa (907) 349-1934 Municipality of Anchorage CO. IWX MAIM •,1ncLnmgc, .\Liam!k6i1!Llilill • Tclephunc 1!X17):M1-NU)I • ISas (!X)7) S43.N_,(M) 471X) lintgaw Sirco • A,wbumgc,AIn.Ln!M.N)7 a���r.numLory; Mayor Mark Begicll Iluildln" Safely Divlslon 4/11/2007 Cindy Ellis Watkins Engineering Subject: Waiver Request for Sand Lake #2 Block 1 Lot 7 Waiver Request #WR070015 Parcel ID #011-13242 HAM or Permit # 050446 Dear Engineer, Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 3.0 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Jeffrey W. Poet Engineering Technician On -Site Water R. Wastewater Program Community, Security, Prosperity Municipality of Anchorage Development Services Department • +.+ Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchoragc.ak.us (907)341-7904 WR#: 070015 PID#:011-132-42 Date Received: 11114/05 :.. a _ r.• t [,�$tr -MllF] Waiver Review Worksheet HAM Permit#: 050446 Waiver Requested: 3 feet separation distance absorption field to property line. Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: ...........................................•.....8866.......................... Waiver is Granted: _I Waiver is not Granted: List Conditions or Reasons for above: Date: Y—// - d 7 By. ..................66......8.86688688868.6..►'6..6............ .... .886.6eensee66. Reck 11/14/05 Amount: 5175.00 Date Paid: 11114105 MUNICIPALITY OF ANCHORAGE Development Services Department Onsite Water 6 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Dec 06, 2005 Expiration Date: Dec 06, 2006 Permit Number: SWO50446 Parcel ID: 011-132-42 Legal Description: SAND LAKE #2 BLK 1 LT 7 Design Engineer: 0844 Watkins Engineering, Inc Site Address: 008109 WILCOX ST Owner Name: KEVIN ELFRINK Lot Size: 6750 SQ. FT. Owner Address: 8109 WILCOX STREET Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE. AK 99503-4 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. All 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. IZ'LD/o�- C'14PI CA' -4450 •,t Foz 0E514�w/cNvi�,E RWp 7© p:'t�Vsed NMi' fIJ RAJ "j To 0.-D ORA J�/(�.E�p �R�"'1 FA••c A✓n It oe/, Ti+ti vc r/ .b.S�yN u1a-� GIiA^•iE 70 ILICrD aao A?A+V,.ANO wl�� '3E q"% �-02sr5�J o✓t A T-Ccnlr'jvR. 7-ro✓ T".. inE�TAoGAJ'rc H8Sorr97jw✓. PEYI(,AI CNAA.yE W11-1, A/07 r✓r+,HFZ FN[+7i.Ach GcAYt "C Received By. Date: Issued By. Date: Municipality of Anchorage • -- Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 011-13242 Permit Number SW Property owner(s) Kevin Elfrink Day phone Mailing address (1) Site: 8109 Wilcox Street, Anchorage, AK 99502 Mailing address (2) Globe Rea) Estate, 3300 C Street, Suite 115, Anchorage, AK Zip Code 99503 Legal description (Lot, Block & Sub'd.) Sand Lake #2, Block 1, Lot 7 Legal description (Section, Township & Range) Lot Size 6750 Acre(o THIS APPLICATION IS FOR: Number of Bedrooms Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade El THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Date of Payment: Receipt Number. 4* w Receipt Number. 7 L6�G�6 (Rev. 14/00) Watkins Engineering, Inc. P.0 Box 110443, Anchorage, AK 99511 (907)349-1851 cwellis@gci.net November 11, 2005 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RE: Sand Lake #2 Block 1 Lot 7 Proposed Septic System Upgrade To Whom It May Concern: Attached please find the application and supporting documentation to upgrade the septic system for the referenced 4 bedroom house. The original septic system was installed in 1986, and the drainfield is now surcharged. Since the original septic system was designed for 2 bedrooms, it is proposed to abandon it in place. This drainfield is suitable as a reserve site, if an advanced wastewater treatment system is installed in the future. The septic tank will also be abandoned in place. The proposed design is based upon a test hole dug on October 28, 2005. The hole was dug to 19.5 ft with no water encountered. After a 7 day monitoring period, no water was detected. The proposed drainfield will be installed in a silty sand layer between 5.5 ft and 13.5 ft. A percolation test between 6.5 ft and 7 ft resulted in a rate of 3.5 minutes per inch. An application rate of 1.0 gpd/ft2 is used in the design. The soil log is attached. Proposed Soil Absorption System: 4 Bedrooms x 150 GPD/BR = 600 GPD System Type: Deep trench Application rate: 1.0 gpd/ ft= 600 GPD / 1.0 gpdKf = 600 ft required Maximum Depth: 13.5.0 ft Effective Depth: 8.0 ft Proposed Length: 38 ft Absorption Area: 608 if Sewer Upgrade Permit Application for Sand Lake #2 Blk 1 Lot 7 Watkins Engineering, Inc.; November 11, 2005; page 2 This lot is served by a Class C well, located on Lot 9 of Sand Lake #2 Block 1. A waiver has been requested from the Alaska Department of Environmental Conservation to reduce the separation distance between the proposed septic system and the well to 100 ft. Another waiver to a Class C well located on Lot 4 of Sand Lake #2 Block 1 has been requested for a separation distance of 135 ft. No other wells will be encroached upon. A three ft lot line waiver is requested to the north and south property lines. There are no surface waters or private wells within 100 ft of the proposed septic system. There are no slope concerns. I am not aware of any adverse effect that this upgrade would have on any adjacent properties' water and wastewater treatment needs. Thank you for consideration of this permit application. If you have any questions or need further information, please call me at 349-1851. Yours truly, City Ellis, P.E. President -------VLSI 1/ 24 2 / 23 /w11 2T I' 2j / 4 421 / 5 \ 22 6 7 18 CIM C 4 Wrl 8 • Pw 7-1 17 a I wal 10 15 11 1 12 /13 / --W 82nd - 1 2�\ 2 6 23 3 Sand Lake A2 Blk 1 Lot 7 Proposed Septic Upgrade -Site Plan Kevin Elfrink Parcel D 011-13242 IN _n. Proposed Septic Existing Septic i System I System/ I 124/1 2T I' /3 3$ I \ 22 CIM C 4 Wrl I �j 21 L201==0 / 9 P. Wan Vv ;— WNI wNl 9 I I I b P -;- we 1U / 15 / 1 % / 14 wpl 12 Ib 13 - 80th Ave. 12 IOA I 9A Me I ti� / 24 I o �2 23 Iw 3 22 Watkins Engineering, Inc. Cindy W. Ellis, P.E. P.O. Box 110443 November 11, 2005 Anchorage, AK 99511-0443 Scale 1' - 100' Phone: (907) 349-1851 Fax: (907) 349-1934 I 6A L ---- Op lQ ' ? 49 TH CI DY W. ELLIS CE - 10577 . ...... Sand Lake #2 Blk 1 Lot 7 Private Well Lot 5 Kevin Elfrink w c000000p00 OF qL�4� o�' .40 Proposed Septic Upgrade Design I a Parcel ID: 011-132412 Test Hale Tre^°� sedl -0 y I b 10x2=5 FILL ROLL / Sand Lake #2 Blk 1 Lot 5 1.a / Cindy W. Ellis, P.E. P.O. Box 110443 Anchorage, AK 99511-0443G� p.;.......... p C� c. 'w.'e«�s' � "'p -1057 2.01UNDEVELOPEd ;,' • ML 3.5 (Surveyor to mark well radii �➢p4..........' .. . pert \ prior to construction. \0 p /\J0(�0 384pe R� sewer / I V j \ 0y0` 2 Cjrj G/ m Proposed 1250 gal Propos drainfield.• G O— steel septic tank 38 R I eNective 19.5 I / � / I CO 8 W / Existing 1000 gallon / MTs / septic tank - to be T n W/ Lot 7 �I c abandoned in pl I I , 0 I\ C II �0 — — — — — Existing FC House I�11 M 1002 TT H III I e � I 3 ft lot line waive requested to north ad south X50 O U DESIGN DETAILS Lot 8 J 4 SR, 600 GPD O I 1.0 gpd/ft2 Requires 600 ft2 O \ Deep Trench 8 ft 100 R to effective waiver \\ 38 ft long Class C well on Max 13.5 ft deep Lot 9 requested. 1 \ 100" I € " \\ W I � I I Class C Well Lot 9 f Sand Lake #2 Blk 1 Lot 7 Kevin Elfrink Watkins Engineering, Inc c000000p00 OF qL�4� o�' .40 Proposed Septic Upgrade Design Parcel ID: 011-132412 49 TH $ty' ..... a Cindy W. Ellis, P.E. P.O. Box 110443 Anchorage, AK 99511-0443G� p.;.......... p C� c. 'w.'e«�s' � "'p -1057 November 11, 2005 ;,' • Scale 1' - 20' Phone: (907) 349-1851 Fax (907) 349-1934 �➢p4..........' .. Municipality of Anchorage Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 3437904 Soils Log - Percolation Test Performed For. Kevin Elfrink Date Performed: Oct 28, 2005 Legal Description: Sand Lake #2 Blk 1 Lot 7 Township, Range, Section: Depth Fn �2 0ors 4Aics WIL Q� 100kv- 3.5 SIM WAS GROUND WATER 9- ENCOUNTERED? No 8 10- IF YES, AT WHAT DEPTH? — L Depth to Water AMr o 11 -Monitoring? E 12- Date: _/0-05 13- /9.5 Site Plan Reading Date Gross Time Net Time Depth to Water Net Drop 1 10/31/05 11:35-11:56 21 6-0 6- 2 12:05-1226 21 6-0 6" 3 12:27-12:48 21 6-0 6" PERCOLATION RATE 3.5 (n*Kd -ycn) PERC HOLE DIAMETER s `c TESTRUNBETWEEN 6.5 FT AND 7 FT COMMENTS 2hour pre k PERFORMED BY: Rocky Trainor/Cindy Ellis I ` CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELI ES IN EFFECT ON THIS DATE. DATE: //,//-65 12:05/05- NON 10:53 FAX 907 289 7649 ADEC ANCHORAGE U002 DEPT. OF ENVIRONMENTAL CONSERVATION DIVISION OF WATER WASTEWATER DISCHARGE PROGRAM Watkins Engineering, Inc. P.O. Box 110443 Anchorage, Alaska 99511-0443 FrankMurkowskl, Governor December 5, 2005 Re: Sand Lake Number 2, Block 1, Lot 7 -Separation Distance Waiver Approval ADEC Plan Tracking Number 1210 & 5328 Dcar Ms. Cindy Ellis: 555 CORDOVA ANCHORAGE, AK 99501 Phone: (907)269-7519 Fax: (907) 269-7509 hnp:/1www.statc.ak.us/dec/ On December 5, 2005 our office received a request to modify the waiver distances between a proposed replacement onsite wastewater system serving a 4 bedroom single family home located on Lot 7, and the two Class C public drinking water wells. The proposed on-site wastewater system consists of a two compartment 1,250 gallon septic tank and a deep trench type soil absorption system (38 feet long by 8 foot ineffective depth). Construction of the on-site wastewater system must be approved by the Municipality of Anchorage, Development Services Department, On-site Wastewater & Wastewater. The waiver requests from the existing Class C wells to the proposed wastewater disposal system, have been reviewed and based upon the engineers recommendation, soil conditions, well test results, well logs, and the additional site conditions arc approved as follows: 1. The new septic tank can be placed at a distance no closer than 105 fed and the soil absorption system 108 fed to the existing Class "C" well which is located on Lot 9. 2. The new septic tank and soil absorption system can be placed at a distance no closer than 135 feet to the existing well which is located on Lot 4. This approval does not imply the granting of additional authorizations nor obligate any state, federal or local regulatory body to grant required authorizations. Any person who disagrees with this decision may request an adjudicatory hearing in accordance with 18 AAC 15.195- 18 AAC 15.340 or an informal review by the Division Director in accordance with 18 AAC 15.185. Informal review requests must be delivered to the Division Director, 555 Cordova Street, Anchorage, Alaska 99501, within 15 days of your receiving the. decision. Adjudicatory hearings requests must be delivered to the Commissioner of the Department of Environmental Conservation, 410 Willoughby Avenue, Suite 303, Juneau, Alaska 99801, within 30 days of the decision. If a hearing is not requested within 30 days, the right to appeal is waived 12/05/05 'MON 10:53 FAI 907 269 7649 ADEC ANCHORAGE Thank you for your cooperation. If you have any questions please do not hesitate to contact me at 269-7519. Respectfully, w William R Rieth, P.E. Environmcntal Engineer cc: David Johnson, WW, 0003 r MUNICIPALITY OF ANCHORAGE r DE'. ;TMENT OF HEALTH AND HUMAN SERI .S Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES I"etvr= SCo 7 . Address TO SEPTIC ABSORPTION FROM TANK FIELD WELL 2 Z%t,J (Th 7 G N, 9V -SIO / WELL Phone(s) Permit No. No. of Bedrooms LEGAL DESCRIPTION LOT LINE �Lo I ✓'1 i �� Lot Bloc Su division V Avo L y4 -j_ FOUNDATION r Township, Range, Section I7� AS -BUILT DIAGRAM (Show location of well, septic system. property lines, foundation, driveway. water bodies, etc.) TANKS SEPTIC ❑ HOLDING Manufacturer Capacity in gallons b,, I� V ova Material No. of Compartments TYPE OF SYSTEM []TRENCH BED ❑ W. DRAIN ❑ OTHER Depth to pipe bottom from Total depth from original grade h'� original grade 'ij S FT 0 FT �sr r M Fill atltletl above original grade Gravel depth beneath pipe OSS FT o .S FT r Gravel length Gravel width �. 45 '220,C) FT k S' C) FT k Total absorption area I Distance between lines -ASO SO FT IJ �1 FT 10W Nue of lines Soil rating Pipe material V r{ Installer Date Installed 3l WELLS ❑ PRIVATE X -OTHER (ldentifv) Classification (A,B,C) ` Total Depth, Cased to �l�b SS e�' �/b FT �� FT Installler Date Installed REMARKS r✓ �t e V I © 5 Scale: N�,�J.t� *f f Inspections Performed by: EkC,%S SEAL N Date: !o- 30-86 , ao ISO SR B certify that this inspection was performed according to all Municipal K P Jrp Pkr. 14.47-E I ,r •„sP �"'..{.yam Health Department Approval: 72-mn IniRsf APPLICANT: GENE SCOTT ADDRESS: 227 W 11TH #7 ANCHORAGE, AK 99501 CONTACT PHONE: 274�4259 LEGAL DESCRIP: SUBDIVISION: SAND LAKE #2 SECTION: 1O TOWNSHIP: LOT SIZE: 675O (SQ"FT, OR ACRES> C> *S5 / ow` L(]T: 7 BL[}C/'��: I certi�y ... �� , � ` DEPARTMENT HEALTH AND ENVIRONMENTAL ROTECTION . 825 L STREET� ANCHORAGE, AK 995O1 by the Municipality o� Anchora-s (MOA)~~nd 264~4720 2. I will C". I I accorda-ce with -ll MOA codes and regul^tions ~ F" II.E.- q�~� PERMIT NO: 860392 ENGINEERED DESIGm adhere to all MOA and DATE ISSUED: 10/17/86 requirements for the set back distances �rom any existing well� APPLICANT: GENE SCOTT ADDRESS: 227 W 11TH #7 ANCHORAGE, AK 99501 CONTACT PHONE: 274�4259 LEGAL DESCRIP: SUBDIVISION: SAND LAKE #2 SECTION: 1O TOWNSHIP: LOT SIZE: 675O (SQ"FT, OR ACRES> C> *S5 / ow` L(]T: 7 BL[}C/'��: I certi�y that: �amiliar with the requ�rements �or on�s it e sewers and well s as set �orth by the Municipality o� Anchora-s (MOA)~~nd the State of Alaska 2. I will install the system in accorda-ce with -ll MOA codes and regul^tions ~ and in compliance with the design criteria o[ , this permit , 3" I will adhere to all MOA and State o� Alaska requirements for the set back distances �rom any existing well� wastewater 1:.i system or sewerage system on this or any adjacentor nearby public lot" IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS^B�ILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) T,E ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN^ SIGNED � DATE: . AppLICANT: GENE OTT~~ ISSUED BY ~�Lr�' DATE: ........ .... .... __^__ �"�'�m��r ~�~�. T^p �� �� m� � `� 6L -S, `^ U �. . t°C_S�e- pec y°a_°1� SEER'S SEAL) e Municipality of Anchorage✓ td�o�� DEPARTMENT OF HEALTH & HUMAN SERVICE 825 "L" Street, Anchorage, Alaska 99502-0650 ¢ "° A' ��'• �8' SOILS LOG - PERCOLATION TEST N) 14"S �M�+�ap�OFE;SS1trNp`� pe PERFORMED FOR: G % TT DATE — Z--'19 ,/� �%J9 iQ -Z.�-S LEGAL DESCRIPTION 7 B ?f-40Wnship, Range, Section: ' Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 \ . SOILS LOG — PERCOLATION TEST PERFORMED FOR: (, UA ) H %y LEGAL DESCRIPTION:_ Loy &a ( NT 2 4_zz 5 6 7 8 Y 9 10 11 A&)O — CLAY 12 13 14 13 v TtoAA Oa K�c= 15 16 17 18 19 20 COMMENTS I -,T -f2. DATE PERFORM Township, Range, Section: WAS GROUND WATER Q ENCOUNTERED? S IF YES, AT WHAT L DEPTH? 0 P E Depth to Water After Monitoring? Date:10'S'8(P SITE PLAN Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT PERFORMED BY: i 1� � AK 99577 1 ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINE; 1 72-008 (Rev. 4/85) -/ CERTIFY THAT THIS TEST WAS PERFORMED IN ON THIS DATE. DATE: Z-0 N ti r cSo r o kA v t l , 2 r cSo r o kA 1`1Iw ON n Z Q) Ylk A 0 77, — 0 C CA n � O ft 0 CONSTRUCTION AhMID OPERATION CERTIFICATE ALASI:A DEPARTMENT OF ENVIRRONMENTAL CONSERVATION . PUBLIC YVIATER SYSTEM APPROVAL TO CONSTRUCT f Plans for the construction of _--a-a-._.x_' public water system located in__j , Alaska, submitted in accordance with 18 AAC 80.100 shave been reviewed and are 01 approved. U conditionally approved (see attached conditions). If construction has not started within two years of the approval date, this certificate is void and new plans and specifications must be submitted for review and approval before construction. A€'�si®V[3f§A1C ORDERS Change (contract order no. Approved by or descriptive referer!ce) Date CO/I64t'/ i'ag2Gi The "APPROVAL the public. r7 f B:e F✓�i/3- rj 1�� a OPE�tA`I E section must ire vamp etbefore ariy a FerisLeJ/e6��loia an /f made avarla fe to ER VAt, TQ t1PERATI t The construction of thenjL".TM public water system was completed on____ (date). The system is hereby granted interim approval to operate for 00 days following the completion (late. OATC As -,built plans submitted during the interim approval period, or an inspection by the Department has confirmed the system was constructed according to the approved plans. The system is hereby granted final approval to operate. �! ,�...�,,.�..,.�-.�..�._v�. Y,...-.,........,..�w..-,..a�a,. �`ri"it"-. w.,..a,-.-..._...�,,..v....._._,_..m.�.,..._..,...s....,.....____.�_. UAT[_..,..,.<.......��. --� EJx Win'. m O �t p , O O t ti IJ t9 O O 200 - 110.00 Com 92 '0 v ) .__ L..----I��AO °17'49 W 023.3 O p - ��. 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Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # \_�,. - 1-1 �1 HAA # _- IA PV-) k ,i)l-l1- 1. GENERAL INFORMATION Complete legal description Lot 7; Btock 1; Sand Lake Subdi.vi6ion W2; Location (site address or directions) 8109 O)itcox S.tneet Property owner Beveay J. Scott Day phone Mailing address 8109 Wilcox S.tn.eet Anchorage, Al?. Lending agency Day phone Mailing address Agent Peggy F,%ench MARSTON REAL ESTATE Day phone 248-2804 Address 2804 wezt No&thenn L.Lgh.t6 Blvd., Anchoaage., Ataska 99503 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 2 3. TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 5. a By: STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that tmy investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Rr5 bNGRVERIPl6 Phone 17034 Eagle River Loop Road No. 204 Address—_Eagle River Alasko 995_ Engineer's signature DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Additional Comments 1UTIC Date I — / 3 "7 :49� ••,; '. a nvv R 3. 'iA�ER� Y.�. a }w bedrooms, with the following stipulations: Date/ Z� The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Laf T.44-- li Ua� 44Kp Parcel I.D. _ A. WELL DATA Well type CIASA If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed Driller i Total depth _ Cased to Casing height 1 2 Sanitary seal (Y/N) (4 Wires properly protected (Y/N) I-OGA fe d oti IL&c( FROM WELL LOG AT INSPECTION M�UNICIPAL17Y OF ANCHORAGE Date of test ` 3o-JJVIRONMENTALSERVICES DIVISION Static water level Well flow g,p.m. Z Pump level U K rrE f 1 V E p� V SEPARATION DISTANCES FROM WELL TO: I Septic/holding tank on lot On adjacent lots Absorption field on lot (is ; On adjacent lots Public sewer main A)/iA Public sewer manhole/cleanout '.).J Sewer service lineS Petroleum tank A)p1Je /�iy0W A) 3F LJA%J&_r IJ0 ed oN p�rn�i-i WATER SAMPLE RESULTS: tt Coliform d �L Nitrate/Vi !, Other bacteriang Date of sample: - �1 ( Collected by: S4 5 ct6(� `x K /Z 11/� l�sP ��i'n2'r/Z►S B. SEPTIC/HOLDING TANK DATA1 5 LAr3�� �, A5 1-oT 7 v 2 / oA, Date installed f Tank size 1 DOO AAI Compartments 2 �i Cleanouts (Y/N) Foundation cleanout (Y/N) Depression (Y/N)_ High water alarm (Y/N) �.7�th Alarm tested (Y/N) n1/ 14 nv A Date of pumping �7 - l O -Ci ( Pumper A iAloma �Selrtl(cc- S SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot On adjacent lots j !S;O t Foundation 6 t To property line Z O Absorption field If Water main/service line Z- 4 r I Surface water/drainage t OD + 72-026 (Rev. 7/91) Front - CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) "Nmp on" level at High water alarm level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STAI�ON TO: Well on lot On adjace D. ABSORPTION FIELD DATA Manufacturer Manhole/Access (Y/N) "'Pump off" level at Cycles tested Surface water Date installed i5 j- i76r/p ed t Soil rating f_ 2-19 o System type G Length- 30 Width ! 5 Gravel thickness _ 7Total depth.' Total absorption area �� Cleanouts present (Y/N) G Depression over field (Y/N) pp A Date of adequacy test Results (pass/fail) S S for Peroxide treatment (past 12 months) (Y/N) It yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: bedrooms Well on lot On adjacent lots / / Property line— ( n S To building foundation / D /'F To existing or abandoned system on lot 7 On adjacent lots— Cutbank Water main/service line- Surface ine Surface water �LA Driveway,a parking/vehicle storage area SD Curtain drain ti� ANO -5 ; fn(SP 2��fLq- r-ivz 7 s F-Or��Ty 1s � �t� AT LoT"7 E. ENGINEER'S CERTIFICATION 9L,l 2 //,-Y "0A F,�/ I certify that l have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature S & S ENGINEERING Euglct River, Alaska 99577 Engineer's Name ^. �, • , • , , - • , e # • e e Date — 9�/3.-��_ �s e••a•'a• • e•� [[[ ty^a RO .R J. FIAFER, P.E. � Gj •• p 15 e° <G � FESSti�N��� HAA Fee $ Date of Payment � /%- 91 Receipt Number ?_1Y7 -S I3 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number �- WALTER J. H/CKEL, GOVERNOR LJ J. DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 PHONE: (907) 563-6775 September 12, VrC E I V E D Mr. Rodney Jones. SEP 16 1991 S & S Engineering Municipality of Anchorage 17034 Eagle River Loop, Suite 204 Dept. Health & Human Services Eagle River, Alaska 99577 Subject: Class C Public Water System providing water to Lots 7, 81 9 and 10, Block 1, Sand Lake #2; Review Dear Mr. Jones: This is in response to your submittal, received in this office on September 10, 1991 in which you requested a letter of approval for the above -referenced public water system. My review of the records on file in this office reveals that the above -referenced Class C Public Water System is in compliance with the provisions of 18 AAC 80, State of Alaska Drinking Water Regulations. At this time, the Department is assigning Public Water System Identification (PWSID) Numbers to all Public Water Systems in the State. As a result, the PWSID Number assigned to this system is 217314. The current State Drinking Water Regulations do not require any routine water sampling for Class C Public Water Systems; however, if the regulations change, the Department will notify your clients. In order for the Department to contact your client on the changes to the State Drinking Water Regulations, please have them complete the highlighted areas on the enclosed "Inventory Update Form" and return it to me. Thank you for your cooperation with this Department. If you have any questions, please do not hesitate to contact me. Enclosures: As Stated KKK/cf Sincerely, 4� Keven K. Kleweno Environmental Engineer r-_ ��:.. e.; pan `'. n r _,