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HomeMy WebLinkAboutSAND LAKE #2 BLK 2 LT 2and Lake #2 Block 2 Lot 2 #011-133-47 SUBMITTAI ar Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page � of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: _Qey P [21 7- PID Number: of/ –I Dwelling: ;R..Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New 5� Upgrade Name: �{ rAa ABSORPTION FIELD E Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address El Other Phone Number of Bedrooms Soil Rating Total depth from or' inal grade 3 / n r r C� GPDISF p, S� Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Z-• Ft. Gravel depth beneath pipe GI Ft. Subdivision 1 '" Block Lot 1p V YI I..0 r7[ L P1�// i 7i Z' Z Fill added above original grade Gravel length Township Range Section 1, 0 Ft. 3 Ft. Gravel width "1 0 Ft. Beds: Number of Lines — Distance between lines SEPARATION DISTANCES To Septic Absorption LiR Station Holding Sewer Total absorption area Number of trenches Ft Dist. between trenches From Tank Field Tank Line 3 ffL( Ftp Ft. Well (apr ( �r-F., J TANK Septic ❑ S.T.E.P. ❑ Holding ❑ Other T Manufact,uqrr�,eer p� 1� Capacity wl �i.� Surface Water lk)4t4� ((JOt% " V%r >`PK fts C; Z) Gal. Material S J to ( l• Number of compartments .Z Lot Line �j r;F r f NA Foundation S I (d tl LIFT STATION Manufacturer Capacity Curtain Drain - Gal. Remarks Pump on level at i Pump off level at in. igh water alarm at in. Pump make a odel Electrical Inspections performed by Installer PIPE MATERIAL Housetotank Tankto 3V�it.( dminTeld 31,)vMI 4 f pY(�t/vt `% �`, Drainfleld gp K CO/MT-SV1+ cf Inspector (�It &N4 tt L -t v Aon ,Ar ` M' BENCHMARK (Assumed elevation) ( t57j ft Inspection A dates: f �/ /iE 2nd 3/ Location and description r / I r Q T 7• 1J017tlan ri lclrn5 3m am COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Conditional Approval: PP Date ~ . 4d%TH 5� • MICHAEL N. ANDERSON Approved Gam• DatedOdt�F©pROF*E�YI�`��"' CE -94 9� 's ko s Y > ®�®���� Inenwcfinn Ran Q_1_19 dnr Permit No. OSP121274 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: SAND LAKE #2 BILK 2, LOT 2 PID No.: 011-133-47 MARK A 8 \\ SEPTIC / 101 02 4 34col ` 7 CO2 2 33 34 03 17 36 �I 04 18 36 SEPTIC I 05 39 40 ) T 37 44 ` \ COICO2C01 TCO2 — CO3 ` C04 ---- \\ MT / � 1 \`III COS BOTTOM OF SIDING ELEV 103 �f \\\\\\ • NEW 1000 GALLON TANK I\ \ \ I SEPTIC ! EXISTING WAS DECOMMISSIONED PER UPI \\ \\ \ // / 7 1 / / 1 ) 4, jSEPTIC SEPTIC I 1 ASBUILT�1 I ) SCALE,: 1' 20' C01 CO2 TC01 WS CM 00.5 ...�„`7♦� ,, OF �♦I ,01 .• . ,. ♦ �•�1... • ... �I .0 CRCCM .MR . ; 49TH_ '. 11 • 100 Cum sPa wx SP ................. .. ...........•.... S L 7M L. ...,. T� MICHAEL N. ANDERSON: v •♦♦ �• '��p� SEPTIC ECTION e< .•• 1 On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP121274 Tax Code Number: 01113347000 Work Type: Septic Upgrade Permit Effective Dates: April 25, 2014 to April 25, 2015 Design Engineer: ANDERSON CONSTRUCTION & ENG'G Subdivision: SAND LAKE #2 Site Legal Address: SAND LAKE #2 BILK 2 LT 2 G:2224 Owner/Address: LLANEZA MANUEL & LUZVIMINDA PO BOX 190853 ANCHORAGE AK 995190853 Site Mailing Address: 8023 SEAVIEW ST, Anchorage This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy Lot Size in Sq Ft: 6750 Total Bedrooms: 3 N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: Date: Y ZS Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 0 (907) 343-7904 • Fax (907) 343-7997 htti)://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program "y I t S �c F f� Dear ment **** VARIANCE/WAIVER REVIEW **** Waiver#: OSP121275 COSA#: Permit#:OSP121274 PID#:011-133-47 Legal Description: Sand Lake #2 Block 2 Lot 2 Engineer: Mike N. Anderson Applicant: Manuel Llaneza 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 5.0 feet. Tank to property line is waived to 2 feet. Tank is approved to be 3 feet from the proposed field. The proposed field may be 5 feet from the existing field. This waiver approval applies to the proposed absorption field and tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ® The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. ❑ Adjacent properties are not affected by this waiver. ..............................................................................1 Waiver is Granted: X Waiver is not Granted: Date: J / Approved by: Name of Reviewe ............................................................ .................� Rec#: 156264 Amount: $200.00 Date Paid: 8128112 ti F p **** VARIANCE/WAIVER REVIEW **** Waiver#: OSP121275 COSA#: Permit#:OSP121274 PID#:011-133-47 Legal Description: Sand Lake #2 Block 2 Lot 2 Engineer: Mike N. Anderson Applicant: Manuel Llaneza 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 5.0 feet. Tank to property line is waived to 2 feet. Tank is approved to be 3 feet from the proposed field. The proposed field may be 5 feet from the existing field. This waiver approval applies to the proposed absorption field and tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ® The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. ❑ Adjacent properties are not affected by this waiver. ..............................................................................1 Waiver is Granted: X Waiver is not Granted: Date: J / Approved by: Name of Reviewe ............................................................ .................� Rec#: 156264 Amount: $200.00 Date Paid: 8128112 MUNICIPALITY F ANCHORAGE Community Development Department \ � v if Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program Mayor Tian Sullivan ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel 1. D. 0 11 — 1 33 —'f 7 Property owner(s) Mailing address _ t 41 0 2 Day phone Site address `art? 23 'xaVh Yk') '�kl Legal description (Sub'd., Black & Lot) Sun 8 t a k z., {4L 1Pj 2 L Legal description (Township, Range & Section) Lot Size (D ?� -0 Sq. Ft. Number of Bedrooms- - _ THIS APPLICATION IS FOR: THIS APPLICATION IS AN: (M all that apply) Absorption Field 14 Initial El Septic Tank Upgrade Holding Tank ❑ Renewal ❑ Privy ❑ Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: I 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. of property owner or Permit/Rush Fees: 530'7 0 _�1Waiver Fees: 00 Date of Payment: I2�lt2 C' * a5� [Date of Payment: $ I d6 t1 a C # � Receipt Number: 15(vafall Receipt Number: (�J (vollpl Permit No. Cys p ia\ �'ly Waiver No. t�5i t x12'15 G:\Building\On Site\Forms\Client Forms\Permit App_010411.doc (Rev. 1/11) Michael N. Anderson, P.E. Civil/Structural Engineering & Construction 4661 Natrona Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 April 4, 2014 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: Sand Lake 42 Blk. 2 Lot 2, Septic upgrade To Whom it may concern: This is an application for a new septic upgrade on the above referenced lot, effluent is currently spilling onto the ground therefore it needs replacing quickly. The test hole material consisted of poorly graded sandy silt, SP, for the entire 16 foot depth, with no water observed during the excavation or after the 7 day monitoring period. The pore rate is 1 minute per inch therefore the trench will consist of a deep trench 32 feet long with 6 feet effective depth. Due to small lot size the new trench and existing trench cannot be separated the required 10 feet from the property line and 12 feet from the old trench. Therefore a waiver is being requested between the two systems and the north property line. A 1000 gallon replacement tank has been shown on the site to replace the existing tank, if the existing tank is perforated by corrosion. Sand Lake #2, Blk 2, Lot 23 which is east of the site has a 1997 ADEC well waiver application on file with the MOA but not a final sign -off. Sand Lake #2 Blk 2, Lots 1 thru 6, which is south of the site has a 1981ADEC Construction and Operation Certificate for a 100' waiver on file with the MOA and appears complete. The MOA On-site Department needs concurrence by the ADEC that all of the well waivers are acceptable, thus I have added a signage block for Bill Rieth with the ADEC to concur. There is neither surface water within 100 feet nor any known curtain drains within 50 feet of the proposed system. None of this development will have any adverse effect on the adjacent lots. This area of Anchorage has a lot of Class "C" wells with waivers by the ADEC, all of the wells have been shown on the site and this upgrade will not impact any of the existing 100 foot well radius'. If you have any question please call me at 727-8864. Sincerely Michael N. Anderson, P.E. _ Concurs with my findings by the Bill Rieth with ADEC Attachments: Copies of the MOA files stated above Michael N. Anderson, P.E. Civil/Structural Engineering & Construction 4661 Natrona Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 April 18, 2014 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: Sand Lake #2 Blk. 2 Lot 2, Septic upgrade, REVIEW COMMENTS To Whom it may concern: The waiver requests are as follows: Lot line waivers of 5 feet for the leach field, separation waiver between the new and the old leach field of 5 feet and 2 feet for the tank to the property line. Reasoning is as follows: The lot is so small we can't meet all of the current separation requirements. The soils are excellent and will allow the system to work in a small area. The positive points are we will not be impacting any of the neighboring lots. We don't have any negatives that I'm aware of at this time. 4111 r< qe •a *,ns 3' briw+ e n 'lwbk i- Cr a ld - After excavating for various problems on this lot it appears the system is different than what is shown in the MOA records. The site drawing has beenshown with drainage arrows and states no slopes greater than 25 percent existing with 100 foot of the site. If you have any question please call me at 727-8864. Sincerely 44� Michael N. Anderson, P.E. tv.e p(Gr�.an 1%C79 s S' q. }meq :�.e.0 t�v p�'cu a.�4- ca4a.-�,.. S 9t 5 S { ern l Mia, DESIGN CRITERIA-MOUND OVER I (TH#1) o GRADE 3 BDRM X 150 = 450 GPD oRc SOILS = 450/1.2 = 375 GPD 05 FILTER FABRIC 375 GA/12 = 32' PIPE _3.04'0 (1) TRENCH SP SEWER ROCK 9.0' DEEP 6.0' EFFECTIVE —9'0 2.0' WIDE 12.0' 32' LONG 16 SEPTIC FIELD SECTION SPO EXISTING CLASS C lop EXISTING CLASS C WELL 100' RADIUS, WELL 150' RADIUS, WITH ADEC WAIVER TYP �4EST 80 H i� --- -- STREET — �� EXISTING HOUSE PROPERTY LINE F--1\\ EXISTING DRAJNFIELD / r i r •I EXISTING HOUSE-- E (ISTING CLASS C I i a w WELL 100' RADIUS J ,' w --` i W/ ADEC WAIVER rn I I I I • I Q 7 54� / NOTE AREA SERVED BY II\ COMMUNITY WATER. Septic Design Prepared for 11 MANUEL & LUZVIMINDA LLANEZA OF ... ��pP. .y�0 �i SAND LAKE #2, BLOCK 2, LOT 2Ar •i Anchorage, Alaska i ••••;`,,,,,,49 „ i.... Michael N. Anderson, P.E.DATE: 4/7/2014 .. ................0 •0 '•MICHAEL N ANDERSON.Pi .�: 4661 NATRONA AVE. ANCHORAGE, ALASKA 99516 DRAWN: DJR .�♦Nl' 345-3377 / FAX: 345-1391 SCALE: I'=100' �4�I1 E`= �� i N \� BEST 80TH STREET - -- — —' — — WAIVERS, 5' TO ALL PROPERTY ` LINES FOR THE FIELD AND 5' FOR NEW TO OLD FIELD JS TIC / \\ )SAN LAK 2 SOLD K 2, LO 1 /SAND LAKE #2 —�\ BLOCK 2, LOT 24 `\ EXISTING HOUSE \ `� JSEPTIC ` EXISTING 1,000 GALLON SEPTIC TANK TO BE SIONEO BY UPC/ LDECOMM ~ --- -- — PROPERTY LINE \t � 2 \—N—' 'CO --CO'Lu e SAND LAKE #2 - 1 ----MTI I BLOCK 2, LOT 23 L 0 PROPOSED DRAINFIELD w l p i EXISTING HOUSE j `�� \\\\\1H 1 w NO CUT BANKS OR N 3 SAND LAKE #21 SLOPE > 25% WITHIN L BLOCK 2, LOT 100' OF PROPOSED \�\\ i FIELD EXPLORATION APPEARS TO BE _ DIFFERENT THEN THE MAO DOC SHOW. i � a EXISTING HO{1SE SEPTIC < I SEPTIC SAND LAKE 02 ) ( BLOCK 2, LOT 22 SAND I BLOCK 2,KLOT23 nNc j too• ty44 j SAND LAKE #2 II SAND LAKE #2 / �D/US, 1 BLOCK 2, LOT 4 I I BLOCK 2, LOT 21 _ 1 SEPTIC (I SEPTIC ( tt EXISTING HOUSE ) i ' Septic Design Prepared for MANUEL & LUZVIMINDA LLANEZA OF G'°' ♦Q SAND LAKE #2, BLOCK 2, LOT 2 Anchorage, Alaska: 49TH ? .....:............ %% /.. .. ........................... .. M :MICHAEL N. ANDERSON;�A, Michael N. Anderson, RE DATE: 4/7/2014 ♦♦� No. 94 4661 NATRONA AVE. DRAWN: DJR �'. ♦ • ♦j'"• �.• ANCHORAGE, ALASKA 99516 ,..•• ♦��,1j"";'�• 345-3377 / FAX: 345-1391 SCALE: 1"=30' Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www,ci _a nchoraye a k_us (907) 343-7904 Soils Log - Percolation Test Performed For: /�IR„K4t (( L Lr,�, Date Perk Legal Description: SpK I I o i1 'c ¢1 Z (3 2/ L Z Township, Range, Section: 1 2- 3- 11 `/2 0 --jar?, e S 4, N" -Loot , 4o(n]d, �\ WAS GROUND WATER ENCOUNTERED? ,� rrp /N( S IF YES, AT WHAT DEPTH? L Depth to Water Aker Monitoring?dj��J 0 a E Date:�It 3 0 / OF z,,\fie ^-1P i • (ENGINE *:.49 49TH ..• y ................. ... rr.v................. MICHAEL N. ANDERSON ey' CE1946 �y1� rmed: 9/ l'3'0/ C Site Plan PERCOLATION RATE I. (m,rmf srnnh) PERC HOLE DIAMETER (O TEST RUN BETWEEN ? FT AND Loi <_ FT COMMENTS Nk -e e LU �- I rl.c Wl, wer PERFORMED BY: r// CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 4 e Z Z rONYKAto NVl S GOVEJ?Nol? DEPT. OF CNVIRON14ENTAL CONSERVATION 269-7519 (fax) 269-7506 ANCI[- 0RAGrE./C><JE3TFR1N l.IC SERWCE ©IFJFRCE 555 Cordova Anchorage, Alaska 99501 1.1 June 1997 Crowther Associates P.O. Box 110854 Anchorage, Alaska'99511-0854 Re:Sandlake Subdivision 42, Block 2, Lots 22,23 & 24 ADEC # 9721 -DW -111-111; 9721 -WV -111-045 Dear Mr. Crowther: Your plan submittal for an on -lot disposal system with waver on the above listed lots have been reviewed, Please proceed as you have proposed. Attached you will' find approval to construct documents for the class "C" drinking water well and the on -lot disposal systems for your wastewater needs. Inspection and sign -off of as -built plans shall be performed by a professional engineer registered in the State of Alaska. Arrangements for this work are the responsibility of the developer.. The "Certificate to Operate" for the water system will be issued when the Department has approved the applicant's as -built plans. If construction or operation have not begun within two years after issuance of the plan approval, the approval is void, and plans must be resubmitted to the Department for review and approval. Respectfully, William R. Rieth Environmental ]Engineer CONSTRUCTION AND OPERATION CERTIFICATE ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION PUBLIC WATER SYSTEM APPROVAL TO CONSTRUCT Plans for the construction of tii17 ,�7< I 5if Ii /✓C-" i)J !=%Illi K a!, (K� % 7-1-1 yrs /�'s a I public water system located i in_,r� r t I^ i-) 'N r oto p cr ;' �� ,Alaska, submitted in accordance with 18 AAC 80.100 J by 4,J i=) t i'F' O 11-%U / ! Q 2 / .5, '( have been reviewed and are 0.11 approved. ❑ conditionally approved (see attached conditions). i/i ,.s lvec--�L4LJire a1i2J�:ltc:r�f Mme" TITLE 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. Date �� 0 APPROVED CHANGE ORDERS Change (contract order no. or descriptive reference) Approved by The "APPROVAL TO OPERATE" section must be completed before any water is made available to the public. APPROVAL TO OPERATE The construction of the public water system was completed on (date). The system is hereby granted interim approval to operate for 90 days following the completion date. BY - TITLE - DATE 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. DATE rNOn p 1 � West 80th Avenue 2 100 foot well radiusOr 23 3 � IP 4 21 20 6 g 7 18 17 9 16 10 15 11 14 12 13 .w.«....u,.wwrw,.,,, i� CE .6491 0 O,P; 1g$ ONa\e� 3 A •.i «..•, .•''Z`"�`®'`' UAN00 --- West 82nd Avenue Existing Septic System Trench 0 100 200 F-1--I Proposed Septic System Trench # Existing well SCALE IN FEET P Proposed Well Crowther Associates Vicinity Map Geotechnical Engineering Services Sand Lake Subdivision #2, Black 2 Plate q Anchorage, Alaska 1 Job No. 001,027 File No. 001027P8 Date June 1997 1 � ,LP 24 P 2 .LP 23 3 � IP 4 21 20 6 g 7 18 17 9 16 10 15 11 14 12 13 MUNICIPALITY OF ANCHORAGE n 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 // v! "°(S"� C^-irxS' P �i /h-� . PHONE q �.�.3 / ;'NEW ❑ UPGRADE MAI LING ADDRESS 3-2n� LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS U Y DISTANCE TO: Well �er s.n vH✓h ( Absorption area Dwelling PERMIT F Z Wa ~ Manufacturer � t7er Meter i�I No. of compartments N Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth J0 DISTANCE T0: Well Dwelling PERMIT NO. = z Manufacturer Material Liquid capacity in gallons w= DISTANCE TO: Well Foundation Nearest l lvl PERMIT NO. wZ F Z w No. of lines Length of each Ii e Total length of lines Trench wid h 19 0 inches Distance between lines fTop p of tile to finish grade Material beneath tile �� inches Total effective absorpj�tion area rX6 o Lu 0 Length Width Depth PERMIT O. Q H Wa Type of crib Crib diameter Crib depth Total effective absorption area y DISTANCE TO: Well Building foundation Nearest lot line J J Class Depth Driller Distance to lot line PERMIT NO. w DISTANCE T0: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS f la s�4 SOI L TEST RATING s ) •- INSTALLER REMARKS 1 Ste' --d 0a j Q (liraGz Sc(ss :S%-!! e -red &Ale � APPROVED DATE LEGAL 0-30 -r/ L 72-013 (Rev. 3/78) /~� ~ ���� 1 C,I ' `�� I �� �� ������/ ����� ° * DEPHRTMENT �� HEHLTH HND ENYIRONMENTHL �OTECTION ' � 825 /L STREET, ANCHORAGE, HK. 99501 264�4720 CH P-41 I~T- El-._ L�: HLA, EE P::;- ��Frl Y. '"F PERMIT N8. ( 811147 ) HPPLICHNT HULTQUIST CONST 7]24 THNHGH CIR ]]]~1119 L8CHTION SEHVIEW LEGAL LOT 2 BLK 2 SAND LAKE SUB #2 LOT SIZE 6750 SQUARE FEET TYPE 8F SOIL ABSORPTION SYSTEM IS: TRENCH MHXIMUM NUMBER OF BEDROOMS SOIL RATING (SQ FT/BR)= 15C. I THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS� ������ �� ���C����­ �� �������� ������ � THE LENG_jTH DI'MENSION IS THE L�NGTH (IN F'EET) OF THE TRENC:H OR DRHOMFIELD. THE DEPTH OF H TRENCH OR PIT IS THE DISTHNCE BETWEEN THE SURFHCE OF THE GROUND HND THE BOTTOM {]F THE EXCAVATION (jN F�EET)� THERE IS NO SET WIDTH FOR TREf-41"HES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN TI IE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). 1Z R ClEg �V.__f I~i �r­q� PERMIT HPPLICHNT HHS THE RESPONS1BILITY TO it -WORM THIS DEPARTMENT DURING THE INSTHLLHTION INSPECTIONS OF HNY WELLS HDJHCENT TO THIS PR8PERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. �F::"E:. 71"" 1 �3 9Nll '.,=7 �P, EH. BHCKFILLINIG OF HNY SYSTEH WITHOUT FINHL INSPECTION HND APPRWHL BY THIS DEPARTMENT WILL BE SUBJEC:T TO PROSECUTIO� MINIMUM DISTHNCE BETWEEN H WELL HND ANY SEWAGE DISPOSHL SYSTEM IS 100 FEET FOR R PRlVHTE WELL OR 150 TO 2.200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIV-ATE WELL TO H PRIVHTE SEWER LINE IS 25 FEET HND TO H COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY HPPL�� SPE- IFICAT IONS HID CON5TRUcTION DIHGRHMS ARE HVAILHBLE TO INSURE PROPER INSTHLLHTION. ��1"Z11-4 1 _V �F." 1 �LE-�-. P_R IEI� EE P,! 5.31�L I CERTIFY THAT -1. I HM FHMILIHR WITH THE REOUIREMENTS FOR ON-SITE SEWERS HND WELLS AS SET FQRTH BYTHE MUNICIP�LITY OF HNCHORHGE. 2: I WILL INSTHLL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]� I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE E��LHRGEMENT IF THE RESIDENCE IS REMODELED TO IMCLUDE MORE THHN ] BEDROOMS. SIGNED:___ HPP�ICH. -QUIST CONST `ISSUED EllDATE V4.8 \ SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: 115 v)tJ /vy 7V/ Sf DATE PERFORMED: LEGAL DESCRIPTION: / 7. Noe 1- 7— b # z P SLOPE SITE PLAN 1 2i �>L 3 �M�) 4 5 6 7 �8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS WAS GROUND WATER L ENCOUNTERED? O P E IF YES, AT WHAT DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE TEST RUN BETWEEN PERFORMED BY: /— l`c—" -4' CERTIFIED BY: 72-008 (6/79) FT AND (minutes/inch) __ FT DATE: 167 -2 , - 1i—/ COSA Checklist yellow sheet COSA Checklist Legal Description: Parcel ID: If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test?Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date of Sample Comments __________________________________________________________________________________ B. TANK DATA Age of tank(s) years Tank type/material Measured operating fluid level in septic tank Standpipes/foundation cleanout per record drawing Date of pumping C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA ______________________ Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective Code-required soil cover over field System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Adequacy test date Results Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: Sand Lake #2, Block 2, Lot 2 011-133-47 57.5 Forge Engineering 10/19/20 The Lot is Served by a Class C Well and Water System. 6 SEPTIC/STEEL 48 10/26/20 - McDonald's Pumping Gravity Flow Septic System Deep Trench 5/15/14 9/14/20 3 9.5 0 3.3 504 15 1440 0 >450 No 2000 ✔ COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to:(Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’Yes if No ft Absorption Field on Lot > 100’Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’Yes if No ft Holding Tank > 100’Yes if No ft Animal Containment > 50’Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft From Septic/Holding Tank on Lot to:(Please enter distances if less than required) Building Foundations > 10’Yes if No ft Property Line > 5’Yes if No ft Absorption Field > 5’Yes if No ft Water Main > 10’Yes if No ft Water Service Line > 10’Yes if No ft Surface Water > 100’Yes if No ft Wells on Adjacent Lots: Private Wells > 100’Yes if No ft Community Wells > 200’Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to:(Please enter distances if less than required) Building Foundation > 10’Yes if No ft Property Line > 10’Yes if No ft Water Main > 10’Yes if No ft Water Service Line > 10’Yes if No ft Surface Water > 100’Yes if No ft If absorption field is under driveway comment below Wells on Adjacent Lots: Private Wells > 100’Yes if No ft Community Wells > 200’Yes if No ft F. ENGINEER’S COMMENTS 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. 10/28/20 -ClassCWell&WaterSystem 5'**✔ 2* ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ 5* ✔ ✔ *See Waiver No. OSP121275. **Septic Tank distance from foundation met MOA Code at time of construction. MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907-343-7904 On-Site Water and Wastewater Section Fax: 343- 7997 www.muni.org/onsite Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519-6650 * www.muni.org Arsenic Advisory Certificate of On-Site Systems Approval # OSC201507 Subdivision: Sand Lake #2, Block: 2, Lot: 2 A water sample revealed an arsenic concentration of 57.5 micrograms per liter (ug/L). 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. 5. LEGAL DESCRIPTI N , n DATE RECEIVED INSPECTION APPOINTMENTS TIME NUMBER OF,BEDROOMS TIME TIME _ DATE ❑ Two ❑ Five DATE DATE INSPECTOR INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE COMMUNITY ENVIRONMENTAL PROTECTION ❑ PUBLIC UTILITY MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION NOV i�� 825 L Street - Anchorage, Alaska 99501 N OV 1 INDIVIDUAL/ON-SITE** ENVIRONMENTAL SANITATION DIVISION RECEIVED ❑ PUBLICUTILITY Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER1 � PHONE MAILING ADDRESS (� A PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTION PH NE MAILING ADDRESS re 4. REALTOR/AGENT PHONE -601 MAILING ADDRESS 5. LEGAL DESCRIPTI N , n ciC STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS ❑ One ❑ Four ❑ Other R� SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY ❑ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLICUTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY .. 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED INSTALLER - ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS 21--A-PPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE 0,- -)% -9 BY C 72-010 (Rev. 6/79) PENINSULA ENGINEERING 2820 'C' Street, Suite #3 Anchorage, Alaska 99503 276-4855 November 19, 1981 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION f ov 1 9 1981 RECEIVED Dave Hultquist 7324 Tanaga Circle Anchorage, Alaska 99504 Re: Lots 1, 2, 3, 4, 5 & 6, Block 2, Sand Lake Subdivision #2 Site Inspection Dear Mr. Hultquist: Inspection was made today to investigate the septic system installation and the well construction on the above lots as requested by Robert Pratt of the Municipality of Anchorage in his letter of November 17, 1981. (1) All standpipies from the sewer system have been installed and capped in accordance with Municipal standards. (2) The two wells are at least 12" above finish grade and are sealed and installed in accordance with Municipal Standards. (3) All six septic systems appeared to be installed adequately with no visible depressions over the tank or leaching area, except as follows: (a) Lot 4 Block 2 has some subsidence above the septic tank area. (b) Lot 3 Block 2 has small amount of subsidence around the cleanout, 2 feet from building wall. These don't appear to be serious problems, however, they should be corrected. Sincerely, Wayne Henderson WH:zc—p a17 Gr. su 1 10 10 ® a °o M Q4��L°0O O°°o°°° t4v,%, a .- a Munia"Pod ty P 2 5 "1 " ST k L E r ANC110 A� c, Al.ASICA. `.19501 MM 264 <} 1 "1 1 tl i Inn -f Cif? Ui P"M iMGN(l;r November 17, 1981 Wayne Henderson Peninsula Engineering 2820 C Street, Suite 3 Anchorage, Alaska 99503 Subject: Lots 1, 2, 3, 4, 5, 6 Block 2 Sand Lake Subdivision 42 Information submitted in your leLte- of "November 12, 1981 is satisfactory regarding the water well serving the above subject property. However, we will need the following additional information: (1) After final_ grading, were the standpipes to the sewer systems in place and above ground level.? (2) Was there any depression over the sewer systems; leaching area and septic tank? (3) Does the construction of the water wells meet Municipal of Anchorage and State of Alaska regulations? The additional information submi-tL-ed to this office will. need to be stamped by an engineer on a original copy. Lf there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: Dave Ilultquist 7324 Tanaga Circle Anchorage 99504 PENINSULA ENGINEEERING November 12, 1981 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION NOV 161961 RECEIVED Dave Holquist 7324 Tanaga Circle Anchorage, Alaska 99504 Re: Lots 1, 2. 3, 4, 5 & 6, Block 2, Sand Lake Subdivision ##2 Water Sample and Analysis Dear Mr. Holquist: This tetter is to verify that I performed the water sampling and had the water tested in accordance with Municipal standards. The results of the lab analysis are satisfactory as shown on the attached lab report from Chemical & Geological Laboratories. One sample was taken directly from the well located on Lot 3, Block 2, which services lots 1, 2 3, & 4 of block 2. The second sample was Laken directly from the well on l.oL 6 which services lots 5 and 6 of Block 2 in this subdivision. TF T can be of any further service, please do not hesitate to call on me. Sincere y, i Wayne 2nderson, P.E. WH:sa Attachments: Lab Analysis 2820 "C" street, Suite ##3, Anchorage, Alaska 99503 c/h—LRS,