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Home My WebLink AboutSAND LAKE #2 BLK 3 LT 10and Lake 2 Block 3 Lot 10 #011 � 134�39 r Z E7, 7 F i TT -0 Municipality of Anchorage V On -Site Water and Wastewater Program - (907) 343-7904 OCT J059M of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP131217 PID Number: 011-134-39 Dwelling: M Single Family (SF) El Duplex (D) Multiple (SF and/or D) Project: El New N Upgrade Name: ROBIN CONNOLLY ABSORPTION FIELD E] Deep Trench E] Shallow Trench [:]Bed E] Mound Address 8133 SEACLIFF ST ANCHORAGE AK 99502 El Other Phone Number of Bedrooms Soil Rating depth from original grade 13 ITotal GPD/SF Ft LEGAL DESCRIPTION Depth to pipe invert from original grade Ft.lGravel depth beneath pipe Ft Subdivision Block Lot SAND LAKE #2 3 10 Fill added above original grade Ft. JGravel length Ft. — Township Range Section Gravel width Ft. I Beds: Number of Lines Distance between lines Ft. — SEPARATION DISTANCES TO Septic Absorption Lift Station Holding Sewer Total absorption area of trenches Dist. between trenches From Tank Field Tank Line FelNumber Ft. well >100' >215' TANK E Septic El S.T.E.P. 0 Holding El Other Manufacturer GREER Capacity 11000 Gal. Surface Water >100' Material Num r of compartments Lot Line >5' STEEL 2 I NA Foundation > - LIFT STATION Manufacturer Capacity Curtain Drain >50' I Gal. Remarks EXISTING SEPTIC TANK ABANDONED Pump on level at in.1 Pump off level at in.1 High water alarm at in. PER UPC REQUIREMENTS 120'FROM CLASS C WELL ON LOT 8 -Fump make and model Electrical Inspections performed by PIPEMATERIAL HousetDtank3034 Tankto drainfield 3034 Installer ISAAC'S CONST. Drainfield C01MT inspector LARS SPURKLAND BENCH MARK (Assumed elevation) 100 ft Inspection 1� 9/13/13 Location and description dates: 2 30 4th CONCRETE SHED POST FOOTING COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date C,2., . . .. ...... SPURKLAN ADDro Mao, Date inspecuon KepartJ-i-iz.doc -9 s # A LOT 10 S 16 Septicn Area ABANDONED ixISTING ISEPTIC IANK PER MOA REMM W', R4"' STAKED '5 'ELL BY REMSTERED LAND SURVE;j Septicn- Area BOUBLE 4 FEET COVER CLEAN COhNECTED IV 10M CALLON SEPTIC TAW EXIST PRAINFIELB FaWBATIDN CLEANOUT mm MARK SHED POST foonmo ASSUMED ELEVATION 100 FaT 14 SPURKLAND ENGINEERING 203 V 15 TH. AVENUE ANCH. AK. 99501 (907) 279-3916 SAN LAM 12 BLK 3 LT 10 R17BIN C5NNULL Y 8133 SEACLIFF STREET, ANCHURA6E AK 99502 110 SYSTEM ASBUILT SEPT 25, 9013 1/1 6RID, 2224 Sntic!). Ar a PERMIT # ESP 131217 PlB # 11-134-39 SAAWLAKE#2B3LlO-ASR.VV6 INST, NEW 100 0 GALLON STEEL SEPTIC I UoN SIEL 'L S"PTIC a7 CONNECT TO DRAIN FIELDt 12 13 SWING TIES A 8 S. I. C. 0. C 68' 58' 25 0 25 50 75 Im 125 150 S. T. C. 0. D 75' 65' SCALE., 1' = 50 FT. M. C. 0. E 76' 67' NOTE. THIS IS NOT A SURVEYED PLAT WELL & SEPTIC LOCATIONS TAKEN FROM ON-SITE WATER AND WASTE WATER DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE APPROXIMATE. BOUBLE 4 FEET COVER CLEAN COhNECTED IV 10M CALLON SEPTIC TAW EXIST PRAINFIELB FaWBATIDN CLEANOUT mm MARK SHED POST foonmo ASSUMED ELEVATION 100 FaT SPURKLAND ENGINEERING 203 V 15 TH. AVENUE ANCH. AK. 99501 (907) 279-3916 SAN LAM 12 BLK 3 LT 10 R17BIN C5NNULL Y 8133 SEACLIFF STREET, ANCHURA6E AK 99502 SEPTIC BATE, SHEET., SYSTEM ASBUILT SEPT 25, 9013 1/1 6RID, 2224 PERMIT # ESP 131217 PlB # 11-134-39 SAAWLAKE#2B3LlO-ASR.VV6 On -Site Wastewater Disposal System Permit Permit Number: OSPI31217 Tax Code Number: 01113439000 Work Type: Septic Permit Effective Dates: August 01, 2013 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 to August 01, 2014 Design Engineer: SPURKLAND ENGINEERING Subdivision: SAND LAKE #2 Site Legal Address: SAND LAKE #2 BLK 3 LT 10 G:2224 Owner/Address: CONNOLLY ROBIN R 8133 SEACLIFF STREET ANCHORAGE AK 995024136 Site Mailing Address: 8133 SEACLIFF ST, Anchorage This permit is for the construction of: N Disposal Field Y Septic Tank N . Holding Tank Lot Size in Sq Ft: 6750 Total Bedrooms: 3 N Privy N PrivateWell N WaterStorage 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: F 919 MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 011-134-39 Property owner(s) ROBIN CONNOLLY Mailing address — Site address 8133 SEACLIFF ST., ANCHORAGE, AK 99502 Day phone 243-6399 Legal description (Sub'd., Block & Lot) SAND LAKE #2 BLOCK 3 LOT 10 Legal description (Township, Range & Section) Lot Size -Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (0 all OW apply) Absorption Field E] Initial El Single Family (SF) El (w/wo ADU) Septic Tank El Upgrade El Duplex (D) F-1 Holding Tank 0 Renewal El Multiple Dwellings Privy F-1 (SF and/or D) Private Well R Water Storage F1 THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: NONE Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Mu.nicipal Codes. owner or allthorizea agent) Permit/Rush Fees: 4,206 - Date of Payment: Receipt Number: Permit No. Pe"ItApp_9-1-12.doc Waiver Fees: Date of Payment: Receipt Number: Waiver No. JAL,Ak SpuMand Engdoneenong Environmental Consulting and Design July 17,2013 Municipality of Anchorage Development Services Department Building Services Division On-site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 Subject: SEPTIC TANK PERMIT APPLICATION Sand Lake #2 Block 3 Lotf to C.A. Ladies and Gentlemen: We are submitting an application to upgrade the septic tank for this lot. The existing septic tank serving the above referenced property is 30 years old and the owner would like to replace it. The submittal consists of one (1) drawing showing the present improvements on the lot and the proposed improvements of the lot, of which only the septic tank is subject to this permit application. An existing waive to the Class "C" well on Lot 8 reduces the required separation distance between the tank and well to 120 feet. Per a conversation with ADEC drinking water this waiver would also apply to the new tank. The installation of this septic tank will not prevent wells and septic systems from being installed on the adjacent lots. There arc no developed or natural surface / sub surface drainage courses within 100 feet of the proposed septic tank location. ne proposed septic tank will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. If you have any questions or are in need of additional information please contact me at 279-3916. Sincerely'� ars Spurkland, P.E. 203 West 15th Avenue Suite 202, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEng*gci.net D 16 Septic Area Septic!). 9LOCK 3 Area A&MOON EXISTING SEPTIC TANK PER kVA COX REWREMENIS LOT 10 WELL RADI TO BE STAKED 15 3 BDRM IBY REGISTERED SURVEYOR SFR Septicn. Area ASO I Area 14 \4 G Septic!) d 75 \-11 INST, LL NEW 1000 GALLON =STEEL Sf:PTIC COAWECr TO DRAIN RELD 12 13 25 0 25 50 75 loo 125 159 SC4LE., 1' = 50 FT. NOTE. THIS IS NOT A SURVEYED PLAT WELL & SEPTIC LOCATIONS TAKEN FROM ON-SITE WATER AND WASTE WATER DEPARTMENT DOCOMENIATION. ALL LOCATIONS SHOWN ARE APPROXIMATE. 4 FEET COVER BDUBLE CLEAN17UFS C9WCTEB 111 1000 GALLIN SEPTIC TAW EXIST BRAINFIELD FlIATATEN CLEANDUr SPURKLAND ENGINEERING SAND L4KE 12 BU 3 LT 10 SEPTIC SYSTEM ,003 V 15TH, AVENUE ANCH AK 99501 R17BIN CDNN17LL Y BATE, _Uf Y 8, 2013 (907) 279-3916 8133 SEACLIFF STREET, AAChVRAGE AK 995A? SHEET, 1/1 GRID, 2224 PERMIT # OSP 131XXXX PlB # 11-134-39 SANDLAKE#20LIADV6 Page I of 3 Crewdson, James A. From: Crewdson. James A. Sent: Monday, July 29. 2013 11:14 AM To: 'Lars Spurkland' Cc: 'thomas.brannan@alaska.gov' Subject: RE: Sand Lake #2 B3 Li 0 Lars, Although it isn't explicitly stated that the well waiver is approved for the new septic tank, it appears ADEC has no objection to the proposal. They also don't appear to be making an approval contingent on submittal of sealed documents, which further reinforces the thought that a statement of non -objection is all you're going to receive. On-site will now consider the waiver applicable to the new septic tank and flag the associated permit review comment as satisfied. A copy of this email will be put in the subject property's file. Thanks Jay James "Jay" Crewdson, P.E. Civil Engineer Municipality of Anchorage - Development Services Division On -Site Water and Wastewater Program Location: 4700 Elmore Road Mail: P.O. Box 196650, Anchorage, AK 99519 v. 907.343.7908 f. 907.249.7601 From: Lars Spurkland [mailto:Lspurkland@gci.net] Sent: Monday, July 29, 2013 9:24 AM To: Crewdson, James A. Subject: Sand Lake #2 B3 LIO Jay, Is the email below sufficient documentation? La rs ---------- Forwarded message ---------- From: Brannan, Thomas W (DEC) <thomas.brannangalaska.ao Date: Fri, Jul 19, 2013 at 12:00 PM Subject: RE: Waiver Request Info To: Anson Moxness <anson.moxnessgigmail.com,> Anson, So we both have a record of what we discussed on the phone: The septic absorption field for Sand Lake S/D Block 3 Lot 10 is healthy, however the septic tank is reaching the end of its useful life and needs to be replaced. When this system was constructed it was 7/29/2013 Page 2 of 3 granted a Separation Distance Waiver to a well on Sand Lake S/D Block 3 Lot 8 by the ADEC in a letter dated June 25, 1985. This Separation Distance Waiver issued by Mr. Steve Eng, P.E., District Engineer, reduced the separation distance requirement to 120'from well to septic tank and 137'from the well to the absorption field. Seeing that the absorption field is not being relocated, the septic tank is being replaced in a location consistent with the requirements of the original Separation Distance Waiver, the system will meet all other current separation distance requirements, and that the new septic tank will offer additional protection overthe existing aging tank, I find no objection to holding the original waiver valid. Please forward the drawing that you previously submitted that is signed by an engineer licensed to practice in Alaska and I will copy that drawing into our records. If you have any further questions please feel free to contact me. Thanks, T.W. (Thomas) Brannan, E.I.T. Environmental Engineering Assistant I Alaska Department of Environmental Conservation EN I Drinking Water Piograrn OFFICE 907.269.3076 1 FAX 907.269.7650 555 CORDOVA STREET I ANCHORAGE, AK 99501 htlp://�.dec.state.ak.�/eh/dw/ind�.httn From: Anson Moxness [malito:anson.moxness(cbqmall.com] Sent: Tuesday, July 16, 2013 3:29 PM To: Brannan, Thomas W (DEC) Subject: Re: Waiver Request Info TWI Here is a pdf of the drawing for the tank replacement on Sand Lake #2 Block 3 Lot 10. 1 can get you an officially signed one by a PE if you'd like. We would be be installing a 1000 gallon steel tank from Greer Tanks in Anchorage. The new tanks from Greer are much higher quality than the ones that were installed 20+ years ago. They are coated with a coal tar pitch material which resists corrosion and are made of a higher quality material. All septic tanks have a limited lifespan and the tank on this lot has reached that point. Greer has a very good reputation and produces a very consistant product that will most likely last longer than the existing tank did. Information on their septic tanks can be found at: http://www.greertank.com/septietanks.html, or you can call them at (907)243-2455. 1 have found them very helpful in the past with any questions. Let me know if you have any questions or if there is anything else yoiYd like to see On Mon, Jul 8, 2013 at 10:28 AM, Brannan, Thomas W (DEC) <thomas.brannan@alaska.gov> wrote: Anson, The following link contains the Engineering Plan Checklists for the entire DEC Drinking Water. The Waiver —Source, checklist that you are interested in is #7.0, you will also need to complete a Plan 7/29/2013 Page 3 of 3 Review Application #0.0. Please feel free to contact me if you have any further questions. Thanks, T.W. (Thomas) Brannan, E.I.T. Environmental Engineering Assistant I Alaska Department of Environmental Conservation EH I Drinking Water Program OFFICE 907.269.3076 1 FAX 907.269.7650 555 CORDOVA STREET I ANCHORAGE, AK 99501 httl)://�.dec.state.ak.us/ch/dw/indcx.htrn Anson Moxness anson.moxness&gmail.co (907) 242-5995 Anson Moxness anson.moxness&amail.com (907) 242-5995 7/29/2013 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING oe*. DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME '6426 C'eosev &_-A16MJcZjC PHONE I IVNEW EJUPGRADE MAILINGADDRESS r 7 1Z,5 LEGAL DESCRIPTION LOT 0 SL-0cie 7) SANDLAKE LOCATION 5f -A mk�' NO. OF BEDROOMS DISTANCE TO: Well 1 100 AbsorpticL�uArea Dwelling PERMIT NO. le — 11JO-1 Id 84N 9'9 1.- 2 (L < Manufacturer G: �Eoc Material No. of c artments oz LUI.- m _5'TL7L_L_ Liq. capacity in gallons IF HOMEMADE: Width Liquid depth 6 _J02 DISTANCE TO: - Well I At gn Dwelling PERMIT NO. Oz `� m F_ Manufacturer t � I Material Liquid capacity in gallons !9 L) 0 DISTANCE TO: 1 Well 16)b I —_ Foundation 41171 iAJ Nearest lot 11., )10.A& PMCN LU LL z Z LU No. of lines t Length ofact Yne Total leng!tWhylines Trench Distance tween lines 'A cc wi0tht) A inches 99 1v 7 cc j.- 0 Top of tile to finish gr de a m t rial beneatm tile 1/2z - 2- I dQ 41 -J-C�P inches Total dffective absorption area W Length Width Depth I PERMIT NO. 0 < LU Type of crib C� Ifflin t Crib depth To—tal effective absorption area W V) DISTANCE TO: Well Building foundation Nearest lot line _j Class Depth Driller Distance to lot line PERMIT NO. _j LU —line 3: DISTANCE TO Buldi4#a_ton Sewer S—eptictank Absorption area(s) OTHER PIPE MATERIALS At UX-AA10151 Cftr, PRZE bUl L I t; i I HATJ NG INSTALLER J3 C_ L---XC4 VAA -17A/ f REMARKS /&V4"zb &obno /'//2 a .FM_9tr_ �S7A*IW19r 4T- /�-xj/N 9 0 01� 0 I .0'r VW 4 2 _LA&-xa� vdl 2 13 Ive t, -i -L (770� OF Vt, &ii'�j AW-_�� ut .44 V r - _Lj I z 'AFPROVED DATE LEGAL 11 1 - PERMIT NO� DATE ISSUED: HPPLICHNT� HDDRESS� CONTHCT PHONE LEGHL DESCRIP LOT SIZE: MHX BEDROOMS� 840i88 04/16/84 MHRK D. BRINTON P O BOX 4~285] ANCHORAGE, HK 99609. 248��021 SUBDIVISION: SAND LAKE #2 SECTION: 10 TOWNSHIP: 12N 6751' OR ACRES) ] LOT: 10 BLOCK: ] RANGE: 414 LISTED BELOW HRE THE OPTIONS AVAILABLE TO YOU IN DESIGNING YOUR SEPTIC SYSTEM� CHOOSE�THE OPTION THHT BEST FITS YOUR SITE. ' . 7��C, 11-i DEPTH TO PIPE BOTTOM (FT. ) 10.5 � OBTAINED.; (2) AS--BVILTS WILL NOT BE ~ , -T0- DEPTH ) 140 ��Ch F<- F-1 C,3- E-= GRAVEL WIDTH (FT , DEPHRTHENT OF HEALTH AND ENVIRONMENTAL PROTECTION GRHVEL VOLUME (CUYDS) ' 20.0 825 L STREET, ANCHORAGE, HK 99501 SOIL RHTING (SQ.FT/BR) 125 264�4720 ** TANK MUST HAVE HT LEAST TWO COMPARTMENTS /^ Cfi F�A, T, L_,*_,, EE 11.4 - 11-11 EE 0 . 1_ �r-1 I -T' SEWER,::: AND WELLS AS SET PERMIT NO� DATE ISSUED: HPPLICHNT� HDDRESS� CONTHCT PHONE LEGHL DESCRIP LOT SIZE: MHX BEDROOMS� 840i88 04/16/84 MHRK D. BRINTON P O BOX 4~285] ANCHORAGE, HK 99609. 248��021 SUBDIVISION: SAND LAKE #2 SECTION: 10 TOWNSHIP: 12N 6751' OR ACRES) ] LOT: 10 BLOCK: ] RANGE: 414 LISTED BELOW HRE THE OPTIONS AVAILABLE TO YOU IN DESIGNING YOUR SEPTIC SYSTEM� CHOOSE�THE OPTION THHT BEST FITS YOUR SITE. ' . 7��C, 11-i DEPTH TO PIPE BOTTOM (FT. ) 10.5 THEN(1) AN ELECTRICAL PERMIT HND INSPECTION I-R)ST BE OBTAINED.; (2) AS--BVILTS WILL NOT BE GRAVEL DEPTH(FT. ) ]5 TOT (FT. /I 17Z -T0- DEPTH ) 140 - GRAVEL WIDTH (FT ELECTRICIHN. GRHVEL LENGTH (FT. ) 54.0 SIGNED GRHVEL VOLUME (CUYDS) ' 20.0 DATE THNK SIZE (GHiS) | 000 0 ^ _' � SOIL RHTING (SQ.FT/BR) 125 ** TANK MUST HAVE HT LEAST TWO COMPARTMENTS /^ I CERTIFY THAT: DATE: L I HM FHMILIHR WITH THE REQUIREMENTS FOR ON-SITE SEWER,::: AND WELLS AS SET FORTH BY THE MUNICIPHLITY OF HNCHORHGE (MOH) HND THE STATE OF ALASKA. ` 2 I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH ALL MOH CODES AND REGULATIONS/ AND IN COMPLIANCE WITH THE DESIGN CRITERIH OF THIS PERMIT. ] I WILL HDHERE TO ALL MOH AND -`---;TATE OF HLHSKH REQUIREMENTS FOR THE SET BACK DISTHNCES FROM ANY EXISTING WELL/ WHSTEWHTER DISPOSAL SYSTEM OR PUBLIC SEWERAGE SYSTEU ON THIS OR Al -4Y HDJHCENT OR NEHRBY LOT. 4 I UNDERSTAND THHT THIS PERMIT IS VHLID FOR H`MHXIMUM OF 7 BEDROOMS AND HNY WILL REQUIRE AN HDD7TIONHL PERMIT. IF H LIFT STATION IS INSTHLLED IN HN HREH COVERED BY MOH BUILDING CODES.- ODES/THEN THEN(1) AN ELECTRICAL PERMIT HND INSPECTION I-R)ST BE OBTAINED.; (2) AS--BVILTS WILL NOT BE APPROVED WITHOUT HN B.ECTRICHL INSPECTION REPORT/ AND (3) THE ELECTRICHL WORK MUST BE DONE BY H LICENSED ELECTRICIHN. SIGNED ^ . ��mL�� DATE � APP[ICAN.T: MARK D. MT�ToN ISSUED BY DATE: SOILS LOG MUNICIPALITY OF ANCHORA&NICIPALITY OF ANCHORAGE CP�T - . ' - ' ' DEPARTMENT OF HEALTH AND ENVI RON MENT4Nfj09T, E&I.6N " " - '0 PERCOLATION ,--] , , 1-. - . 11� - -1-TiON TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST 2 5 1982 PERFORMED FOR: D vo AAR PEE: 1Z e LEGAL DESCRIPTION: --5ANJjLAV-j5Z' -51i-p L3�v' '�� 1- 0 T' 0 OPE SITE PLAN T(A-pj,- fl, 0 L i 1 1 1 1 1 1 1 2 3-, 4 5 6 7 8 9 10 11 12 13- 14- 15- 16- 17- 18- 19d :S P /�kL SANOY SILT plt� 4e- S; - � -(e' /e 'I I rA , & CAII-) 5e ; /S z S I L -7-Y SAND)e GP-AVF L WAS GROUND WATER S ENCOUNTERED? L 0'-, P IF YES, AT WHAT E DEPTH? ;S f)/C f, Reading Date Gross Time Net Time Depth to Water Net Drop 20 C' /-,,A PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND — FT COMMENTS. V I S' V A L ?,Ar 1 J4 C 0 r- I s 0 P3 A R—J?-A IS r— 7- w G I� IJ AN IZ) '9 Ajvn ff A& Q L�5: r W 9 A AJ 0 V7 PERFORMED BY: COJVA4'0- 1!:)P—vAX�Z CERTIFIEDBY: DATE/O—/3 ZZ —A I 72-008 (6/79) SOILS LOG MUNICIPALITY OF ANCHORA(VWNICIPALITY OF ANCHORAGE IT ! ',V PERCOLATION DEPARTMENT OF HEALTH AND ENVIRONMENTAL PRUft&i6N` ' Tf 825 L. Street, Anchorage, Alaska 99501 264_%V01RJ,1!,,�i,.A- , �`J . --T1ON`rEST SOILS LOG — PERCOLATION TEST Ct�'-fl 2 5 1982 PERFORMED FOR: 'Dowe- H'2" A RV.FE".� Do R L LEGAL DESCRIPTION: So -v\& LaA�,e— *� 2- _5 L ko DE PTH SLOPE SITE PLAN ( FEe T) I I 1 1- 1 1 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 - 18- 19. 20 - Comm WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? 4-\." . '6 - ,, — t., 1, � � /-> " NEENREEMEN Date Gross Time ENEEMMMMME Depth to Water Net Drop MOMENEENE MWEENEENEW WINNEENMEEN MINMENOWN WINEENNEININE MINNEMME Efflow'WEN j-'.K#N I 111 NEEMENEEN 1, 35 MENNEEMEME 1136 NEENEENEEN I'Lls Reading Date Gross Time Net Time Depth to Water Net Drop 4t33 i�, �'l 1, 35 1136 I'Lls q 0 1, q 2- '06 -3 0 1,40 '2- -4 1_11_() 11; Sq — I. q115' — io rh"n j, q ')- 0 PERCOLATION RATE TEST RUN BETWEEN 51/2- FT AND r-'ec%v- 0j-' h,, 0cf MV I PERFORMEDBY: Cohnc'�) T'knsvo-- CERTIFIED BY: 72-008 (6/79) (minutes/inch) FT DATE: 16,1)1- 4 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: D2 V -e #1? 4- P e- le- / -;�' -�/ DATE PERFORMED: Ile, LEGAL DESCRIPTI I - ZO -1 � 2 jradZcal Js' -4 3 (sw Ozv 4- 6 - 7 - 8 - 9 - -ri ,e 5':? j 10 - 11 12 - P 7Are 13- 9 15- zr tvd't 16- 17- 18- 19- 20 - SLOPE SITE PLAN WAS GROUND WATER S I I I I I I I ENCOUNTERED? ".0 L# 0 P IF YES, AT WHAT E DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND - FT COMMENTS PERFORMED BY: Pat a/ CERTIFIED BY: 72-008 (6/79) DATE: X. 3, 3 o o S 9 Z -.K, /0/. 7 Y. /00. 00' W�-/- L 50 6-5 9d, 0 F;'eA M C 40 W JC4 1-,'A'4 �'To,,- ZOT IC) all -f /-/A/, (5/. z In 51. Z--\ Z or /-:Pt <50, 0 7-c - 74 /,V/C gz:� 4- 7eL 05'00 ",2f- 50. 00' O;r- ALASKA UNROWNAL COnTROL SMIUS, InC. Cn9ineering & enuironmental Studies October 4, 1984 Department of Health and Environrmntal Protection 825 L Street Anchorage, Alaska .99501 Attention: Keith Bandt Dear Keith: We would like to request a waiver of the lot line distance for installation of an on-site sewer system for Lot 10, Block 3, Sandlake Subdivision #2 (Permit 11840188). There is no sewer system an the Lot 11 as the owner of Lot 12, also owns Lot 11 and his house extends onto Lot 11. His sewer system is on Lot 12. Lot 9 is undeveloped. Lots 14, 15, and 16 located to the east of the subject lot, have on-site sewer systems. The system on Lot 15 runs at an angle of northwest to southeast on the Lot and the closest that the system comes to the lot line in question, is 12 feet. The depth of the trench is 9 feet. See attached inspection report. I would like approval to locate the septic tank, within 5 feet of Lot 9. This would allow the septic tank to be placed right at the 100 foot radius and then part of the system would go toward the east and then turn toward the south to 5 feet of the lot line of Lot 15. This would get a separation of the two system at the closest point, which is only .at the standpipe of 12 feet, which is greater than the sum of the depths of gravel of the two systems. Thank you for your consideration. M 0 tow Q itow, I No. 2251-E Sincerely, Leroy C. Reid, Jr., President PhD, P. E. (P 1200 West 33rd Auenue, Suite 13 * Anchorage, Alaska 99503 e (907) 561-5040 WATER WELL RECORD STATE OF ALASKA DEPARTMENTOF NATURAL RESOURES Division of Geological 8k Geophysical Surveys Drilling Permit No, LOCATION OF WELL (Please complete either Ia, lb or Ic.) A.D. L. No. Ia. Borough Subdivision Lot Block 1 I I b. 1/4 q I rs. E Section No. Townsh 'P N CD I Range E[:] Meridian 10 q —a (—of. S WE] Ic. DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS 3. OWNER OF WELL: Mark 'Brioton Address: Street Address and Area of Well Location 2. WELL LOG Feet Below Surface 4. WELL D.PTH: (final) '7174 E 5 DATE OF CAVCETIOA I Material Type Top float Be -A I ME ,'ShlEku & 0 7- S. 9C able tool C] Rotary [:] Driven C] Dug DAuger OJetted C3 Bored [3 Other: I -- -fA'nd\/ niliq 4 Qrayoj 7 -;1 q I �j Sq 4�g 7. USE: C3 Domestic 0 Public Supply E] Industry LdLl Qn-wel 4(p 78 0 irrigation C] Rectiorg, E3 commerical 76 1190 E] Test Well C] Other; S. CASING: 0 Th,,o9d 0 Welded C—i revv P ZC)6 I diam. (0 In. to 2"I't) ft. Depth Weight I bs./ft. diam. in. to ft. Depth StIckup it. — S'i I I A03 I ukhtk "r -a t, Q - —Z&q . nftyd 2(pq 77 9. FINISH OF WELL: If Type: _ppen uAd Diameter: Slot/Mesh Size: Length: Set between ft. and ft. Sockfilling Gravel peck MUNICIPALITY OF IANCHOPAGI: 10. STATIC WATER LEVEL: 116 ff. 4 MI DEPT. OF 1]Et�� C] Above or Below land surface Date Equipment used: 'APR 111 19E I I. PUMPING LEVEL below land surface and YIELD 1620— f t. after hfs. pumping 'ZO g.p.m. RECEF.I\/FD ft. after hrs. pumping _g.p.m. 12.GROUTING Well Grouted: [j Yes [X No Material: E3Neat Cement C]�her: 13. PUMP: (if available) HP 0 ZT-- PUMP ` (If *vo' al" H h L ng' a' Drop Pipe Length of Drop Pipe ft. capacity 9 -P.M. 00 Subm. [OD Jet E] centrifical Other 0 14. REMARKS: 4 16. WATER WELL CONTRACTOR'S CERTIFICATION: 15. Water Temperature —0 C] F C This well was drilled under my jurisdiction and this report is true to the best of my knowledge and belief; 1, WT. i6a 910,3 Registered Business Name Contract License Number Address:_ I104q(o AldolneacIr-ij lq/� 1q951 I QX6" Signed S��- d4o'ipgh , Dote:'A - 110 - 34 - Authorized Rel5resenTalive Form 02-WWR (11/81) Copy Distribution: WHITE -Stat, DGGS, PINK -Driller, CANARY -Customer 0 Z a S3.1 8 9 70 • Pi* P • �_� c. Municipality of Anchorage a If SEP 0 6 2T On-Site Water and Wastewater Program (907) 343-7904 �Q s *Y Certificate of On-Site Systems Approval > Parcel I.D. 011-134-39 Expiration Date: C—' -( 1. GENERAL INFORMATION Complete legal description Sand Lake #2 Block 3 Lot 10 Location (site address) 8133 Seacliff St. Current Property owner(s) Robin Connolly Day phone 907-529-4990 Mailing address 8133 Seacliff St. Anchorage AK, 99502 Real Estate Agent Jennifer Zimmerman Day phone 907-440-2175 2. TYPE OF DWELLING: Single Family (w/wo ADU) Li Duplex I I Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual Individual Water Storage L Holding Tank ❑ Community Class Well [J Community ❑ Public Water System [� Public Sewer WaiverNariance request for: Distance Received by: Date: q11d11 Z COSA to be released t the e neer,unless otherwise requested by the engineer. COSA Fee $ 2c Waiver Fee $ Date of Payment -_ 410-1G Date of Payment Receipt Number 0/(423C Receipt Number COSA# Q5Cf q1�' Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Forge Engineering Phone 907-522-7773 Address 1399 W. 34th Ave. Suite 203 Engineer's Printed Name Benjamin Schiller Date 09/01/17 .�nr '0::,!c.'-..r4 t- • 6. DSD SIGNATURE ; F + • eV d ?C... to System #1 Approved for bedrooms , „�.•. -P;. 0 System#2 Approved for bedrooms • 1,. r J 1 Disapproved '`• e. $�' '/2,922 �.•' Conditional approval for bedrooms, with the following s iPti . .ap.r �, ,,,, `.:-.1 t.--)F ANrti' ;. ON-SCCA CN'., 2 W PEER Pk".��k o5- N1\1 N1P %,0 �N p,S 0 QPM .N'.: F �G�J ' 6Ar7 Ste. ,---- f : `^—~ :_c -- �� B Original Certificate Date: `7 -�E+1 By: ( g 7 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet S '- c 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. Sand Lake #2 Block 3 Lot 10 Parcel ID: 011-134-39 A. WELL DATA Well type Private If A, B, or C provide PWSID # Well Log (Y/N) Y Date completed 05/30/84Sanitary seal (YIN) Y Wires properly protected (Y/N) Y Total depth 275 ft Cased to 275 ft. Casing height (above ground) 18 in. FROM WELL LOG AT INSPECTION Date of test 05/30/84 08/18/17 Static water level 75 ft. 147 ft Well production 20 g.p.m. 3.8 g.p.m. WATER SAMPLE RESULTS: Coliform ND colonies/100 mL Nitrate ND mg/L Arsenic 23.2 ug/L Date of sample: 08/08/17 Collected by: Forge Eng. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/SteelDate installed 09/13/13 Tank size 1000gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout(YIN) Y Depression over tank (YIN) N High water alarm (YIN) N/A Date of pumping q j t{ l l Pumper ISA ALS Pu;rlp,NU SC-.w'c,E C. ABSORPTION FIELD DATA Date installed 10/31/84 Soil rating (g.p.d./ft2 or ft2/bdrm) 125 SF/BORN System type 5 Wide Length 41 ft Width 5 ft. Gravel below pipe 4 ft. Total depth 1 3.5 ft. Eff. absorption area 410 ft2 Monitoring tube Y Depression over field N Date of adequacy test 08/18/17 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 19 in. Water added 600 gal. New depth 35 in. Elapsed Time: 1440 min. Final fluid depth 22 in. Absorption rate >= 450 g p d N Any rejuvenation treatment (past 12 mo.) (Y/N &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 at in. High water alarm level at in. Datum Cycles tested Meets alarm &circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot >100' On adjacent lots >100' Absorption field on lot >100' On adjacent lots >100' Public sewer main NA y T5 Public sewer manhole/cleanout NA > goo I Sewer/septic service line >25' Holding tank X75' Animal containment areas >50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: >5' 5' ' Building foundation Property line Absorption field Water main NA >1o' Water service line >10' Surface water >100' Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water main NA > 10 ' ' Water Service line 10 Surface water 100 Driveway, parking/vehicle storage >10 Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and ��.141' Or Ar ias review of Municipal records that the above systems are in i tea•,.••'`•"'••.�Q�• conformance with MOA COSA guidelines in effect on this date. iej•• 7N 4, ..• Engineer's Printed Name Benjamin Schiller r,. .:.I Date 09/01/17 r .•�...)�... ott .:. ' :Baa' ' !!c.�h,i,pp • ..":$ rlf .• 41 , ,,„. Qv _ ,K..tt,,...„ Via. •COSA brown sheet 10-10-12.doc ILot 8 I 8463M 30 N89°55'00"W 135.00 Lot 17 I O 0 Lot 9 o Lot 16 Ll.l Lo Septic vents t0 O deck W 0 11 i toca9e 0 CV 31.0 17.5 6i O �; I 0 _ N cD N89°55'00"W shed 135.00 CVO— — p t o Gravel I O Z d'ivewaN in � ° CO 0Septic vents O _ Z Ti 0 m06 .0 main coLL°° Lot 10 o Lot 15 J O —18.G G r6.Q p w LC) ,� cn 3 a, LD 6 IIN — C X24.6 • 1 L 24.0 win vent O Welt O Posi L _1'4.0 OH Wood fence 30 hi h !/ 6 ---� — 2.2 d N89°55'00"W 135.00I I Lot 14 I Lot 11 .„...• %N. Revised 8-25-17, Added septic vent r �i ;� �� OF A 1 AS-BUILT NO CORNERS SET THIS DATE Allr ��'• ' • • ' L; I hereby certify that I have performed a Mortgagee's inspection am �R,'• • '� �� of the following described property: LOTS 09&10, BLOCK 3 r G9• 49th 'c •'"9 40 SAND LAKE SUBDIVISION.ADDITION No.2 7 •. " / •.�• ) Anchorage Recording Precinct,Alaska, and that the ,,�, (+ is J`' • improvements situated thereon are within the propertylines ii" / `" •• • and do not overlapor encroach on the properly lying rr= 30' /,Fred Wal atka . a / p p y r g SCALE. , x s adjacent thereto, that no improvements on the property lying I • 3255 – S ••J� adjacent thereto encroach on the premises in question and p< . • y - that there are no roadways, transmission lines or other t O�Po• . . . • •vpa0 visible easements on said property except as indicated I ' fEssI0NA1- = hereon. t\X%%%r Dated at Anchorage,Alaska this 6th day of September ,2017. EASEMENTS OF RECORD,OTHER THAN FRED WALATKA&ASSOCIATES THOSE SHOWN ON THE RECORDED Engineers and Surveyors PLAT ARE NOT SHOWN HEREON. FB 17-6,pg 74 BE (907-248-1666) • Municipality of Anchorage Development Services Department Building Safety Division .;S4 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 # osc171412 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 3, Lot 10 of Sand Lake #2 Subdivision. This inspection revealed an arsenic concentration of 23.2 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. MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # r) I I — I '_�q — �� 1� HAA # 0 QROC) Q 1, Z 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) ,r IZ-Al 9�d _!�tFe- /0 Location (address or directions) 25rl 3.3 5,FAe 4JA4' (b) Property owner Mailing Address (c) Lending Institution Mailing Address Ilub (d) Real Estate Company and Agent Address Telephone 7_1/�r- / 7/1 Telephone : (home) —Business Telephone (e) Mail the HAA to the following address: (or check here)K if hold for pick up.) List contact person and day phone number below: plex U'P I 2. TYPE OF RESIDENCE Single-Family)K Number of bedrooms 3. WATER SUPPLY Individual Well"k Community El Public 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site'*X Public El Community 0 Holding Tank 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 Z_ 14 3 3 5�,�h LAP"S- jo 7, 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verifythat my investigation of this Health Authority Approval 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 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name -of Firm - A"r�.i Telephone 2_7�-S��;-153 Address �7fp- y Date 6. DHHS APPROVAL 4- 1.7 Approved for bedrooms by 7�;Vt Date Approved Disapproved -Conditional Terms of Conditional Approval CAUTIOW UER0 j The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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 orderto satisfycertain federal and state requirements. Employees of DHHS do not conduct inspections oranalyze data before a certificate is issued. The Municipality of Anchorage is not responsible forerrors or omissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) 'A Health Authority Approval (HAA) ch CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: A. WELL DATA Well Classification— �>,eAl4rzr– If A, B, C, D.E.C. Approved (Y/N) Well Log PresentON) —Date Completed Yield Total Depth 7�7�< 'Cased to 7�7�< " Depth of Grouting Static Water Level d17 Pump Set At Casing Height Above Ground — Electrical Wiring in Conduit ON) / I- Sanitary Seal on Casing&) — Depression Around Wellhead (Ya SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot On Adjoining Lots To Nearest Edge of Absorption Field on Lot ZO ; On Adjoining Lots /00 To Nearest Public Sewer Line AA To Nearest Public Sewer Clean out/Man hole ��(Z;A__ To Nearest Sewer Service Line on Lot Water Sample Collected by 4, k>�- J — ; Date Water Sample Test Results AJ, -1-re >'-c - A) -j',) Comments B. SEPTIC/HOLDING TANK DATA Date Installed 10-31- Size # /060 No. of Compartments StandpipesON) Depression over Tank ( y6p 7_� Air -tight Caps&N) —Foundation Cleanout&) Date Last Pumped &�) Pumping/Maintenance Contact on File (Y/N) AJ1,4 for Holding Tank High-Wa'te�A . larm (Y/N) Temporary Holding Tank Permit (Y/N) —AIX SEPARATION DISTANCESIFROM SEPTIC/HOLDING TANK: To Water-S.upply Weli To Building Foundation To Property Line To Disposal Field To Water Main/Service'O'ne /'1x-_ To Stream, Pbnd,,-Lake or MajorDrainage Course /C/V -r Comments 9. 72-026 (Rev. 7/88) Front Page 1 of 2 AY yhrjb 4Afe_G-- 40— Z_ C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed /0 -31-elT Width of Field Type of System Design Length of Field Depth of Field Gravel Bed Thickness T_ Square Feet of Absortion Area 9rlo Statndpipes PresentON) Depression over Field (Y16 Date of Last Adequacy Test Results of Last Adequacy Test AWep�--, SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well Ion,< To Property Line 5 - To Building Foundation To Existing or Abandoned System on Lot On Adjoining Lots Z__0 To Water Main/Service Line To Cutback (if present) W/X To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LI TION Date Installed Size 7iiinGallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) **Check Permitted Bedroom Rating Against HAA Request" "Pump Off" Level at — Vent(Y/N) – Pumping Cycles during Adequacy Test. I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. 6MMIMIM .01 40� OF A %%t1w Ali- 4 Signed '00000060 110 Company AV % 00 of ineer's Seal 00 rim Date 0 Soo of 0 04 MOA No. 0 0, 1 0#0 IR400000 600614 C' REID, JR. 0 a- V #41 CE - 2251 %"'- r Alp Receipt No. Receipt No. Date of Payment Waiver Fee: $ Amount: $ Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FEDERAL TAX ID # 92-0040440 ANALYc"IS REPORT BY SAMPLE lox 'Work Orday # 17377 Dota Report Printed: OCT 16 89 6, 09!.18 Client 8ample ID:LOT 10, BUY 3 MND LAU #2 Client Vluie k E C 3 P1431D :Ulk Client Acet AKEURP Collected OCT 0 89 @ 12:40 1-zs. P.O.9 NONE RECEIVED Rece-iyed OCT 12 69 � 14:00 hie. Req � Pios�rvofl with :A3 REQUIRED Ordered By Analysi's Conploted :OCT It 89 Send Reports to: Liboratory Super�iisoy ;03TEPHEN C. EDE OA E C 13 --i". - Released By : 2) 91 -'P/ /^ --- (/' -- I ......... ...... ............ ....... I ........ ....... speQial lngtxuct: Chmlab Rof t; 7949 Lab smpl ID; I Payoxceter Te3tee ------------------------ ------------ N I T R A TE - N Vatrixi WATER RmAlt/units Method --------------- I -------- ----------------- ND(0.10) !V411 EPA 353.2 S8111ple ROUTINE SAICLE . SAMPLE RECEIVED BY L� REID, Reriarks : I Tosts Pe2:fon11Gd See Spcoial Inotnictuns kboye UIL-Unavailablo ND None Detected ,ea 9implo Ranarks Above NA- Not Analyzed LT=Les. Thnn, V-G�.ontor Than Allowab, 0 Unit" 10 CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. TELEPHONE (907) 562-2343 5633 B Street Anchorage, Alaska 99518 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER -T-T-T-1 TO BE COMPLETED BY LABORATORY C PUBLIC WATER SYSTEM I.D.# Analysis shows this Water SAMPLE to . be: PRIVATE WATER SYSTEM Satisfactory ALASKA ENVIRONMENTAL Unsatisfactory Name CONTROL SERVlCE3,h1N0?- P. 0. BOX 240663 El Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send Mailing Address AN�.NORAGE, AK 99524-0668 now sample via special delivery mail. City State Zip Code EE� Date Received /19-7-0' SAMPLE DATE: Time Received 44� Mo. Day Year Analytical Method: Membrane Filter SAMPLE TYPE: X-2� Routine Check Sample (for routine sample with lab ref. no. Treated Water No. oi coloniesi-100 mi. Special Purpose Untreated Water SAMPLE Time Collected Lab Ref. Nn Result* Analyst NO. LOCATION Collected By J 4 �'-le / ' ' 7949 [13 S�� -'A , ETI 2 1 MI 3 ETI 4 1 ET! 5 --- ---- BACTERIOLOGICAL WATER ANALYSIS RECORD /0// READ INSTRUCTIONS Membrane Filter: Direct Count CD Collform/100ml BEFORE Verification: LTB BGB COLLECTING SAMPLE Final Membrane Filter Results, Collform/100ml Reported By Date Time: a.m. p.m. TNTC = Too Numberous To Count pART ONle OF TWO OB = Other Bacteria REMAINDER TO FOLLOW 1�1 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE I. General Information Application Date (a) Legal Description (include lot, block, subdivision, section, township, range) 3 /�Z —3 kJ (address or directions) 3 5�, , e- /I or— /- (b) Applicants Name 15 r-1 Telephone Home __Business,?,,,,16 -0-F-C"D Applicants Address E() 6�,Ix �-J-3 el, 9 j -D (c) Applicant is (check one) Lending Institution Buyer E:7 ; Other E:�l (explain); Owner/builder (d) Lending Institution Telephone Address (e) Real Estate Co. & Agent Address Telephone M Mail the HAA to the following address: Z. TXpe of Residence Single -Family r,77 Number of Bedrooms 3. Water SupplX I I- . �/ - I () Multi -Family r:::i 'y Other (describe) -7 Individual Well rX Community Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite Public Community Holding Tank E:I Note: If community well 'system, must have written confirmation from the State Department of Envirorunental Conservation attesting to the legality and status. [Page I of 2] 4 5. Engineering Firm Providing Inspections, Tests, File Search, Data and Information As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on7site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that, based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on7site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions In effect on the date of this inspection. Name of Firm Telephone &� o k_j 3 -3 -d ,9� S k, d Date-- 16/t/g 1(?L 4r- 7� 6��crj 6 too �'2r�NGIN��EERi SEAL) 0 04. ;Fj W . 6. DHEP Approval 00 0. lj� f....... 1.." .1 oy C. Reid, Jr. No. 2251-E I VtMo Approved for &_Lc_�bed rooms B 0 91�11 a Approved Disapproved Conditional Terms of ional Anoroval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DREP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT— ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE— MENTS. E14PLOYEES OF DHEP 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. (DHEP SEAL) RR4/ej/DI8 (Page 2 of ZI 7-19-84 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & - MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL PROTECTION HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: :510 A. WELL DATA Well Classification 79" L).? If A, B, C, D.E.C. Approved (Y/N) �V�4 Well Log Presento/N) Date Completed ��5- Z3 Yield Ze !2 0?_,tg Total Depth' o�.2 7,5-- Cased to Depth of Grouting 1� d, �ZW Static Water Level -7 ir Pump Set At Casing Height Above Ground Sanitary Seal on Casing&N) Electrical Wiring in Conduit(O/N) Depression Around Wellhead (Y0 Separation Distances from Well: To Septic/Holding Tank'on Lot /0& — ; On Adjoining Lots ;,> /00 / To Nearest Edge of Absorption Field on Lot /05- / ; On Adjoining Lots > /00/ To Nearest Public Sewer Line —A-J.IA- To Nearest Public Sewer Cleanout/Man hole A-1/4 To Nearest Sewer Service Line on Lot UZ4 Water Sample Collected by Rp_ 'i Date Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed Size Standpipes; (9N) Air -tight CapsbN) Depression over Tank (Y&� Pumping/Maintenance Contract on File--(Y/N) No. of Compartments Z — Foundation Cleanout&7YN) Date Last Pumped for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) AJ 14 Separation Distances from Septic/Holding Tank: To Water -Supply Well ��_119 To Building Foundation T� F*� .,t I i ,�- I - F y To Water Main/Service Line A-) Course Comments / Ze , Page 1 of 2 72-026(11/84) lo Disposal Held To Stream, Pond, Lake, or Major Drainage C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Type of System Design Date Installed Length of Field Width of Field Depth of Field 71 /S- / Gravel Bed Thickness 4/,v Square Feet of Absorption Area Standpipes Present(P/N) Depression over Field &N) Date of Last Adequacy Test Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well To Building Foundation 661 Lot A) To Water Main/Service Line Al To Stream/Pond/Lake/or Major Drainage Course 11JAq To Property Line 5'a 4 ��- /- /- To Existing or Abandoned System on On Adjoining Lots — Z0 �ol /S' vX, c 4 , s c4rcl's'2' To Cutbank (if present) AVA ,,V C -A e - To Driveway, Parking Area, or Vehicle Storage Area Comments 740 41-e-11 e,, Ja 74 A19W D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off" Level at High Water Alarm Level aft Vent (Y/N) Tested for P1 Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I ha_vg%0jjpck d verifi d orconformedtoallMOAandHAA Signed L"a" ""v Date A�,�J- 8P. -C ,guidelines in effect on the dateof this inspection. Company MOANo. PS--0-;t5e 20 Receipt No. . 124716 -3 Date of Payment (, -a 5 - -v5' Amount: $ 45-4� Page 2 of 2 72-026 (11184) A S7A7E OF ALASKA DEPT. OF ENVIRONMENTAL CONSERVATION / ANCHORAGE/WESTERN DISTRICT OFFICE 437 "En STREET, SUITE 303 ANCHORAGE, ALASKA 99501 June 24, 1985 Alaska Environmental Control Services 1200 West 33rd Avenue Suite 8 Anchorage, Alaska 99503 BILL SHEFFIELD, GOVERNOR Telephone.1907) Address: 274-2533 SUBJECT: Horizontal Separation Waiver Between Well and Septic Tank, Lot 8, Block 3. Lot 10,, Block 3, Sand Lake # 2,, Anchorage Alaska - 8521 -WA -190 Dear Si r: The Department has reviewed the subject waiver request and hereby waives the horizontal separation between the well and septic tank to 120 feet and well to absorption field 10 137 feet on the subject properties. Sincerely, e A4eEng, D i strict istrict Engineer SE/dd