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HomeMy WebLinkAboutSAND LAKE #2 BLK 4 LT 3Onsite File Sand Lake #2 Block 4 Lot 3 #011-135-50 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 4 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211453 PID Number: 011-135-50 Dwelling: Q Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑■ Upgrade Name DONALD LEE ABSORPTION FIELD Site Address X Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound 8023 SAND LAKE ROAD *ANCHORAGE, AK ❑ Other Phone Number of Bedrooms Soil Rating JTotal depth from original grade 907-570-8337 3 1.2 GPD/SF 11.54 MAX) Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot SEE DWG. Ft. 6.10 Ft. SAND LAKE #2; BLOCK 4, LOT 3 Fill added above original grade Gravel length Township Range Section SEE DWG. Ft. 34+ Ft. N/A Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES 2.5 Ft. - Ft. To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line 414+ FF 1 10 Ft. Well 100,+ 100'+ _ _ _ TANK 0 Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Surface Water 1100'+ 100,+ I - _ INFILTRATOR IM-1530 Gal. Material Number of compartments Lot Line 10,+ **l'+ - - NA HDPE 2 Foundation *9'+ 10'+ _ _DFTSZATION Manufacturer Capacity Remarks EXISITNGSEPTICTANK DECOMMISSIONED PER UPC PER CONTRACTOR Gal. 'SEE ATTACHED SEPTIC TANK PROFILE DRAWING "WR#OSV211084 Alarm location Electric lied by PIPE MATERIAL House to tank D3034 Tank to D3034 Installer drainfield PRECISION GENERAL CONTRACTOR Drainfield D3034 CO/MTF628i3 Inspector BENCH MARK (Assumed elevation) 99.94 ft Inspect ectioes: 1,k 11/10/21 2�d 11/19/21 Location and description 31d 11/19/21 4m 11/22/21 TOP OF MH ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp 0060 � Conditional Approval:Date oo •. j '95,4 D ... .. o _Jetfr A. Gorness- Septic System Q � .pO Q 1 CE-7 53 p APPf \ Date ���fP ��t .• 4 rN 0;< O Note: this approval does not include well permit requirements. OpaPrOfessl°oo� 4 CC884 OD�Qpp� lRcv ni/n7/i Al PERMIT NUMBER: PARCEL ID NUMBER: OSP211453 RECORD DRAWING 011-135-50 TOP OF TANK AT INLET = 95.49 INVERT OF BUNG AT INLET = 94.63 TOP OF MH = 99.94 ' MH STI 2" INSULATION PER CONTRACTOR IM -1530 2 -COMPARTMENT NFILTRATOR SEPTIC TANK FINAL GRADE = 99.44-99.64 MT CO GRADE = 98.68-99.72 r ORIGINAL GRADE AT HIGHEST POINT = 99.4 FINAL FILTER FABRIC 6.10 FEET J INVERT OF PIPE = 94.02 OF TRENCH = 87.92 v - TOP OF TANK AT OUTLET = 95.42 INVERT OF BUNG AT OUTLET = 94.49 v Air _ �...1 I. 1 �`'�.' ................. ENGINEERING, SALES - CONSULTINGr/.... ..yflt ... �. = ,; 3701 ETUDOR ROAD. SLATE 101 'ANCHORAGE. AK 99507 *PHONE (907) 337 -6179 -FAX (907)33&3246"NEHSITE:vmN.pamesurigneedn0.com %�+ , V� ����� ���• •.���.' PREPARED FOR: PHONE NUMBER: PAGE NUMBER:d 1�t1 j ,epyA _S mess :14-40 DONALD LEE 907-570-8337 4 OF 4 00 7-79)5 mLEGAL DESCRIPTION: joDRAWN BY: O®®�.,���.11 .7 SAND LAKE #2; BLOCK 4, LOT 3 D.J.G. pp��,, lil TYPE OF WORK: SEPTIC TANK PROFILE DATE: 11/24/2021 #AEcc88�4�44aaF. Sa0�'® PERMIT NUMBER: � PARCEL ID NUMBER: OSP211453 €_� 011-135-50 A B PDBLI 24.0 4.0 25.3 12.5 17.7 19.0 / 16.4 20.7 16.0 21.6 FD 1 16.5 23.i COI 45.2 MT1 CO2 51.2 35,9 O MT2 NOTE: PIPE LOCATIONS ARE , SHOWN PER GEG SHOTS TAKEN WITH LEICA DISTO S910 LASER DISTANCE METER. SWING -TIES TO HOUSE CORNERS WERE GENERATED IN AUTOCAD. [ia / / EW DRAINFIELD / a / col l '° e ' , EXISTING 3 MT1 r ' ° BEDROOM HOUSE / DBL1& FD V+- WR40SV211084 •" • e 1" O STI ° ° •�_" � H1 FCO I 4 8 o lo, T2 ( / S�zj�o C NEW IM -1530 INFILTRATOR SEPTIC TANK 1'+- WR#OSV211084 / N \ —�1 SCALE: / ® 1"=20' OF .�AV 4w �P iiw ... a 11 Tp GROU Ltd �.....::.... {4 9 �.............. ... ........ ENGINEERING SALES CONSULTING i 0 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, ALASKA • PHONE (907) 337-6179 - WEBSITE. wmvgamessengmeenng.com ++{ ... .. ................. .......... / PREPARED FOR PHONE NUMBER: PAGE NUMBER: '; e ey ess ,'kci a DONALD LEE 907-570-8337 2 OF 4 �®��J, : CE -7 53 ,' �AV PROJECTILEGAL DESCRIPTION: DRAWN BY: SAND LAKE #2; BLOCK 4, LOT 3 p•�•G, ####®'QFD ppi ill , "�:i•'e4 TYPE OF WORK: DATE: ® �Ul ESS SEPTIC SYSTEM RECORD DRAWING 11/24/2021 + �eit$likav,* 0 0 ��1 BOTTOM OF THE FOOT WAS EXPOSED DURING CONSTRUCTION - BOTTOM OF TANK ELEVATION IS CALCULATED FROM GEG TOP OF TANK INSPECTION AND INFILTRATOR LITERATURE (TANK HEIGHT) 9 FEET 55" PER INFILTRATOR kN N N IN IT , Lt " ENGINEERING -SALES, CONSULTING ---- 3701 ETUDOR ROAD. SUITE 101 'ANCHORAGE, AK 99507 ' PHONE (907) 337.6179' FAX (907) 338-3246 A.cBSITE .v v gamessengmeering.wm PREPARED FOR: PHONE NUMBER: I PAGE NUMBER: DONALD LEE 907-570-8337 3 OF 4 PROJECT/LEGAL DESCRIPTION: DRAWN BY: SAND LAKE #2; BLOCK 4, LOT 3 D.J.G. TYPE OF WORK: DATE: RECORD DRAWING FOR TANK TO FOUNDATION DRAWING 11/24/2021 'S3SOd21nd NVld-101d 2103 210'S3NIl �1a0 pooh —X—X— 33N3d A1213d021d 9NIHSIl8V1S3 )JOd'NOI17n2i1SNOD 2103 035n 38 NO3H3H V1V0 ANV O1nOH5 >Q 3A1VA 2131VM S3DNV1SWnD D ON 2130Nn T99d NOISIAI09ns 030210D321 3H1 NO HV3ddV lON 00 HJIHM S9NINV1 AVM-30-1HEAH 80 SNOI1DI211S321 'S1NVN3AOD 'SIN 30III sueyJan0 11111ta, 4 31.d IMin .W35V3 ANV 37N31SIX3 3H13NIMI 30 01 A1n10ISNOdS321 .S213NMO 3H1 SI li :31ON AdVNOISnlDX3 ala-uoD ;I -: HW Q 31OHNVW DIld3S — — — 3NIl1N3W3SV3 'NMOHS SV 210 0310N NVHl 81 H10 3dIdONVlS DI1d3S — — — 3Nn2131N3� 1SIX3 S1N3WHDVM17N3 ON (INV S3NIl A1213d021d 3H1 NIH11M 321V N0383H1031VnlIS a�vfav S1N3W3AONdWI 3H11VHl S3I311213D 0NV 9NIMV8C] SIHl NO NMOHS SV A1213d021dit SS O 2101n0 NV313 patens S3Nn 101 3H130 A3Abns 1V71SAHd V 03J.Dn0NOD SVH DNI'HD31NV1 9Dl :NOIIVDI3I1213D A3A21ns :0N3931 000 -OS -SEL -L LO 419D2Md OVON DIVl ONVS £ZOS :SS32100V ii _sv V/N :4321 L£/ZZ8 :9d/8d bZZZMS :0Ri9 9LL-d Tvld 9Z L LZ :2130210 H210M .OZ =., L :31VDS DS :A8 (I3)1D3HD dV :AS NMV2i0 LZOZ/L/ZL :31V0 NMV210 Z 'ON 3NVI GNUS '1,>1DOI8 '810l N0I1dWDS30 1V931 S311213d02id 91WVNkC] XVW/321'3DIN Vl21VJ :,18 032130N0 899 »3V S868-EVZ auoyd aulluleW ouj LiS1'll� L6ZS-Z9S auoyd luawljeda0 A@A3nS n LOS66 eNselV'a2eaOgDuV 19WIS H OSZ .0£ •S3NIl 101 SS021D Ol S2IV3ddV 39N3d 9NUSIX3 •Z 'HD31NV1 99l AO 1N3SN09 N311PJM 03SS3UX3 3H11f1OH11M NVId 101d V SV 35(1 2103 0313100W 3810N llVHS 9NIMVd(I SIHl • L :S310N 001 �°uolssa�o��0 I p�c`'���Q�1 •�' �r4o� Ln D o NVH V11V9 N3A31S �� . . . .......... .... . .. r a DQO.:.................... m Q �. H16� b j0 _S9 39Vd ' L6£ >1008 I '0330 AiNVHVM 213d 9NIHVl MOU .£ I .0E I I MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program pOBox 1em6a0 47OoElmore Road Anchorage, Alaska W8n19' Fax: Vmr>:4o'7997 Permit Number: O8P211453 Work Type: Septic Upgrade Tax Code Number: 01113550000 Site Legal Address: SAND LAKE #2 BLK 4 L 3 8:2224 Site Mailing Address: 8O23SAND LAKE RD, APT B.Anchorage Owner: LEE DONALD &TERR|LVGTRUST Design Engineer: QARNESSENGINEERING GROUP LTD This permit is for the construction of: 10Disposal Field Septic Tank []Holding Tank []Pdvy Effective Date Lot Size in Sq Ft: 1D/27/2O21 1O/27/2D22 -----' - [] Private Well [] Water Storage All construction shall beimaccordance with: 1. The attached approved 2 All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska VVaabawmber Disposal Regulations (18AAC72) andDrinking Water Regulations 3. The wa�exmatercode requires innpeuUnnaduhngthe instaUetion.The engineer shall notify 'iheDewaiopmen1 Services Department per AMC 15.65.Provide notification bycalling (8O7)343 -7Q04(24/7). n` 4. FnoOctober15tnAph|1S.omubeudacauoi|abeorpUonayetemunderconnhonUundudQfrewajngweathnr shall baeither. a. Opened and Closed onthe same day, or b. Covered, sealed, and heated toprevent freezing Special Provisions: Onsite shall be present for bottom of trench inspection to confirm soils are consistent with soils found intest holes onadjacent lots (ie.sand that perks less than 5mpi). Co_^�J #� ^ /l LSo r -Ho r\ ^ ~ / /..-~Lim,, _ \ | |+~/ '~~~`~~^v uwe^ issued By: f � V rtcnt S n llcrarhnn�t _POB 196 ox650 ®4700 Elmore Road Anchorage, Alaska 99519-6650 (907) 343-7904 0 Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Department On -Site Water and Wastewater Section Waiver#: OSV211084 COSA#: Permit#:OSP211453 PID#: 011-135-50 Legal Description: Sand Lake #2 Block 4 Lot 3 Engineer: Garness Engineering Group Applicant: Donald Lee Co A 1 eaSk 4 S°` '�— Your r uest for a waiver of the required 0 feet horizontal separation from the absorption field to the roperty line has been approved. T approved separation distance is 1.0 feet. In addition, your request for a waiver of the required -et horizontal separation between the proposed and existing absorption fields has been approved The approved separation distance is 10.0 feet. See engineer's waiver request for justifications. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. eeeeeee a neeoeeeovaeeeeeee■ease■see■mea®®se■■ee■ae■ee■eeeeeeeeeeeeeeeeeeeeeoee� Waiver is Granted: X Waiver is not Granted: Date: O'Approved by: IL"" Name of Reviewer ■oeoeee a eeeeeeoeeeeeeeeeeeee a e■eeeee ueeemeemeeeeeeeee■■eooeeeeeoeeeeeeeeeee� INIUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 011-135-50 Property owner(s) DONALD LEE Mailing address 8023 SAND LAKE ROAD *ANCHORAGE, AK Site address 8023 SAND LAKE ROAD *ANCHORAGE, AK Day phone 907-570-8337 Legal description (Sub'd., Block & Lot) SAND LAKE #2; BLOCK 4, LOT 3 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field M Initial ❑ Single Family (SF) 0 Septic Tank El Upgrade X (w/wo ADU) Duplex (D) El Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: DRAINFIELD TO DRAINFIELD; DRAINFIELD TO LOT LINE Distance: 10; 1` I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: ' 5 9 5 Waiver Fees: 9 o, a 5 Date of Payment: I a 5 0 21 Date of Payment: c n ",r�\ r Receipt Number: 0 y 6 y(o G Receipt Number: J Permit No. O S P )_11 4 5'2_3 Waiver No. O S V'-9_ 110 g L( GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Coag 1 Eli ff011.191 miliv November 11th, 2021 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic System Upgrade for Sand Lake #2; Block 4, Lot 3 To whom it may concern: A permit was approved for the subject property on 10/27/2021. On the design drawings, it was stated that a C/O and MT be installed at the end of the southwest portion of the existing trench. During the installation of the new septic tank, a new cleanout and monitoring tube were installed on the trench (as required by the permit). As can be seen on the attached drawing, the trench runs southwest and encroaches upon the previously proposed trench. Based upon this fact, a change order is required. On the attached drawing, the location of the new IM -1530 infiltrator septic tank is shown in addition to the existing trench and the proposed deep trench. We are requesting that your department allow for previously granted waivers (1' to lot line and 10" to existing trench), be "transferred" to the newly proposed drainfield. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any , uestions, please contact us at 337-6179. Thank you for your assistance. Sineer-0Y, n t f i , P. E., M.S. 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211453, Rebecca Carroll, 10/27/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211453, Rebecca Carroll, 10/27/21 DESIGN CRITERIA: NUMBER OF BEDROOMS: 3 GALLONS PER DAY (GPD): 450 - PERCOLATION RATE/S:' PROPOSED APPLICATION RATE: 1.2 MINIMUM DRAINFIELD SQ.FT.: 375 FT' 'SEE DESIGN LETTER FOR JUSTIFICATION DRAINFIELD DESIGN: MAXIMUM DEPTH OF EXCAVATION: 14 FEET- I IS NOT RECOMMENDED THE TRENCH BE INSTALLED AT THIS DEPTH. IT SHOULD BE INSTALLED AT A DEPTH THAT ALLOWS FOR ADEQUATE FALL FROM SEPTIC TANK (LIKELY NOT 14 FEET) WIDTH: 2.5 FEET LENGTH: 32 FEET EFFECTIVE: 6 FEET ACTUAL SQ.FT.: 384 FT' CONTRACTOR TO HAVE 100' WELL RADII, NORTH AND SOUTH LOT LINES FLAGGED BY A PLS KEYBOX (PER PRIOR TO CONSTRUCTION. AS -BI ILT SURVI C -0-t 1 GEG, Ltd. HAS AN 8 PAGE SPECIFICATION LETTER THAT PERTAINS TO THIS DESIGN. BY PROCEEDING ` FORWARD WITH THIS INSTALLATION, THE -1— ENGINEER, WELL DRILLER, CONTRACTOR AND - PROPERTY OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND CONDITIONS OUTLINED. WEST V I �/ E WEST 80TH AVENUE APPROXIMAT-E-10�0'�WELL ��,, I SAND LAKE #2; "`=:MUS BLOCK 4, LOT 2 APPROXIMATE LOCATION OF EXISTING TRENCH: NEW CLEANOUT AND MT WERE INSTALLED AT SOUTHWEST END RECENTLY INSTALLEDIM1530 INFILTRATOR SEPTIC TANK; INSTALL DOUBLE CLEANOUT AFTER TANK- / / EXISTING 3 ST c BEDROOM HOUSE .., O o�n SAND LAKE #2; BLOCK 4, LOT 51 SERVED BY WELL ON LOT 50 6v 10'+WgVIER REQUEST FROM EXISTING DRAINFIELD / PROPOSED DRAINFIELD M SAND LAKE #2; O BLOCK 4, LOT 50 SERVED BY SEPTIC TO THE NORTH T ` 1+ , o} I SAND LAKE #2; BLOCK 4,LOT 4 SAND LAKE #2; BLOCK 4, LOT 49 1 SAND LAKE #2; BLOCK 4, LOT 5, 6.47 & 48 / a ®®��w oe Aw a fir® sr � ................... ........:... 0 ENGINEERING SALES - CONSULTING s u _ 3701E TUDOR ROAD, SUITE 101 • ANCHORAGE, ALASKA • PHONE 907 337-6179 - WEBSITE. VAV.V.gamesRn cneerin�� / PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ♦ � •, y Garn SS W DONALD LEE 907-570-8337 1 OF 1 ,� J, 7-7953 PROJECT/LEGAL DESCRIPTION: DRAWN BY: ® �` , SAND LAKE #2; BLOCK 4, LOT 3 D.J.G. ®0� Fp�'•p'''��`U......... f,•�'�P�, TYPE OF WORK: DATE: LICENSE®rAR ESS\ O �� SEPTIC SYSTEM DESIGN UPGRADE 11/11/2021 # LICENSE 4 ®ra`p'e N F b J 4 Ln IDJ .00'09 Hinos 0 U 0 .00.09 Hinos a_Lu LU �❑a � m ❑ yQy m ❑VO2i DVI gNb5 C7 m F ❑ J O ��� • r C3 x va u m 0 cs � o G Q N ❑ _j Ln 0 =tea � NOz Ol1nSt� : 'sze9� o x 4 S a 6 0 LU wa�w u o f x G'LZ 8'9 E o [u$❑� OLU � Cc c O N r r m � d 0 O z LU 0 xlll a i2 -W F2 b C) Z0 Ts XN O J M !n 0 10 LO x Ln P wco I co ❑ x P co f!] 2 a a N C3 7 d ❑ W Y W w 2 m p w ° .6.6 pZO cn=x p�rjp 7 ❑ n. =�omcc x N x Ln zbwo p2Qp t��w _� ❑w X 2 Z�~~� INaWaSd� DIHL�31� ,� 00 swau'cz x ❑Lij .00.09 Hinos a_Lu LU �❑a � m ❑ yQy m ❑VO2i DVI gNb5 C7 m F ❑ J O ��� • r .1a�a��4Q x va �w cs � o G Q N ❑ _j Ln =tea � NOz Ol1nSt� : 'sze9� o Z O x va �w � o Wp _j Ln =tea � NOz Q 4 S a 6 2— LU wa�w [u$❑� OLU V 1Q0 pii2C�7 DW Q a H a d 0 O z ❑ LU C)x a i2 -W F2 = m ff M¢7 O J $ ❑ Z V 2zw b a 2 �❑2a 0LU ❑ 0 w nl� 4 2 a a a � p C3 7 d ❑ W Y W w 2 m p w pZO cn=x p�rjp 7 ❑ n. =�omcc Ln W -j❑ N x Ln zbwo p2Qp t��w _� ❑w O0 2 Z�~~� _ 00 swau'cz ❑Lij - W Q rwpa � W �� u�oz rl �Qa = F 00 Z ❑07 ?ad�0W y =� F Q v7ia�0 OO�5 H c 0 s J � m Q O �� Q4 �a x a p a z u r � � ~ 2 Q Z LL LU a Ln N N w 5C o 0 Ile a 0 � uz�oa o� ❑ CL aLDL mrn� N r oz a Z J �o n d Q u w ti a Of c d m 0 ❑ ❑ Z Z Y LV 0 LU Ca ❑ V Ln MUNICIPALITY OF ANCHORAGE e 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 M�!` rt N PHONE EW ❑UPGRADE MAILING ADDRESS LEGAL DESCRIPTION I—of 3 _/ 10 a 4, 6 -601)dka}`e- *z LOCATION E06T -5IUO Qr8041\opf kakejzJ NO. OF BEDROOMS U1 DISTANCE TO: Well eLrnei Absorption area Dwelling N PE NOC n F- Z W� Manufacturer �f�eC Material ems I No. of compartments Liq. capacit in gallons IF HOMEMADE: Inside length _ Width l ,_® Liquid depth —� 0 Y JUZ DISTANCE TO: Well Dwelling PERMIT NO. = z Manufacturer Material Liquid capacity in gallons O w= DISTANCE TO: Well �ril�n Foundatir�n b0;i Nearest lot line I P J LL z F Z w No. of lines Length of a in Total leng Ines Trench width/�/ �-C-inches Distance between lines < F D Top of the to finish grade 15/L— Material beneath the 4'/7 inches Total effective sor tion area Lu Length Width Depth PERMIT NO. a F CL wa Type of crib Crib diameter Crib depth Total effective absorption area wWell rn DISTANCE TO: Building foundation Nearest lot line J J Class Depth Driller Distance to lot line PERMIT NO. W DISTANCE TO: Building foundation Sewer line Septic tank Absorption area (s) OTHER PIPE MATERIALS k>TM 0,3 SOIL TEST RATING 07' INSTALLER REMARKS iI V115 v Yif} k— C�1F� ( J!/L� R nspedej bc4 Loqar- -%2 APPRO ED DATE LEGAL O 'C c;26 &e ,l - k 3 1 Cd ICA qL©3 g 72-013 (Rev. 3/78) MUNICIPALITY OF ANCHORAGE The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE _ / D Q d GALLONS # # Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. # # # TWO(2) INSPECTIONS ARE REQUIRED # # # Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper.installation. # # # PERMIT EXPIRES DECEMBER 31, 1 9 u 3 # # # I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3 bedrooms. /� Signed: `9"�ATIssued by: Applicant / Date: SWP 024 (1/81) /ec o Cl / 5_0 'o 10ef1"A-1 9-C &/ / 7� Department, 'F Health and EnvironmentaY_`rotection „ 825'_ Street, Anchorage, AK. _?501 264-4720 # # HANDWRITTEN PERMIT � 3v �WELL Permit # AND/OR ON-SITE SEWER PERMIT Applicant: M,4Qk 1"� Mailing Address: ACQ3 .SFAs. J lj ct75D 2 Location: Phone Number: Q 48 -lox( Legal Description: kat 3 81ccX. 4 zoZ Lot Size: Type of Soil Absorption System Is: Trench: Drainfield: Seepage Bed; Holding Tank: Maximum Number of Bedrooms: Soil Rating(sq.ft/br) -v/34 The Required Size of the Soil Absorption System Is: DEPTH CI LENGTH _v GRAVEL DEPTH s5 WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE _ / D Q d GALLONS # # Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. # # # TWO(2) INSPECTIONS ARE REQUIRED # # # Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper.installation. # # # PERMIT EXPIRES DECEMBER 31, 1 9 u 3 # # # I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3 bedrooms. /� Signed: `9"�ATIssued by: Applicant / Date: SWP 024 (1/81) /ec o Cl / 5_0 'o 10ef1"A-1 9-C &/ / 7� MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST {, SOILS LOG I� PERCOLATION TEST PERFORMED FOR: l X Il�i.�- `( �t��` 'l DATE PERFORMED: LEGAL DESCRIPTION: ��i-r' 1 l 1� �l`--A—�� Xol-3 SLOPE SITE PLAN 1 DEPTH �`•-_i �,n TMI 2 t r� 3 s ' Q r r 5 7 tl , �r 8 �rf21 bC� 6° 1Yi 9 c t Net Time Depth to Water Net Drop i 10 t i i . t 11 t t s ' a 7 12 r r 13 14 15 16 17 18 19 20 Ki7i�itPi WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? A olJ S .��- L O P E Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE TEST RUN BETWEEN PERFORMED BY: CERTIFIED BY: 72-008 (6/79) (minutes/inch) FT AND FT I DATE:6 - ja'_ LOCATION OF WELL (Please complete either la, Ib or Ic.) la. Borough bdj vista nl Lot Blofck Ib. I/4 gire. Ic. DISTANCE AND DIRE�{CTIO,-N�1. FROM ROAD INTERSECTIONS Street Address and Area of Well Location 2. WELL LOG Material Type --,,WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological a Geophysical Surveys Drilling Permit No. A.D.L. No. Section No. Township N❑ Range E❑ Meridian S❑ W❑ 5, OWNER OF WELL: Address) Feet Below Surface 4. WELL DE JH: (final) L ft. 5. DATE OF COMPLETION % — f Ci — r—_.:) Tap Bottom CCJ ;) 6. fl Cable tool ❑ Rotary ❑ Dri von ❑ Dug ❑ Auger ❑-Jetted ❑ Bored ❑ Other: t, '� +f 12.GROUTING Wall Grouted: ❑ Yea P No 7. USE: ❑ Domestic ❑ Public Supply ❑ Industry ❑ Irrigation ❑ Recharge ❑ Commerical ❑ Test Well ❑ Other: _-> c;"— /� ""' �^("'7 `• L�- ' Is. PUMP: if available) HP .nre,.a�d e/d� Welded / 8. CASING ❑ Threaded diam. /� in. to';iso]- ft. Depth Weight ✓ lbs./ ft. diam. in. to ft. Depth Stickup_.-- It. c w c� N Length o1 Drop Pipe capacity 9. FINISH OF WELL: Type; i's'» _f.«*. Diameter: Slot/Mesh Slze: Length: Sot between ft. and 11 Sockfillinq Gravel pack ^ •'^l % � • 1�7 '�4� 14. REMARKS: z 10. STATIC WATER LEVEL:140 ft. Dote ❑ Above or '}� Below land surface Equipment used:, 11 PUMPING LEVEL below land surface and YIELD . ry l r Ara. pumping A0 a. D. m. ft. after hrs. pumping 9-p M. 12.GROUTING Wall Grouted: ❑ Yea P No Material: ❑ Neat Cement ❑ Other: ' Is. PUMP: if available) HP fY ft. g -p -m- c w c� N Length o1 Drop Pipe capacity ® Subm. ❑ Jet ❑ Centrifical ❑Other r o 14. REMARKS: z 16. WATER WELL CONTRACTOR'S CERTIFICATION: r 15. Water Temperature —° ❑ F ❑ C This well was drille In under .My j jRegistereb Business N Address: r.) ))0 -r Signed: %_ Aut Form 02-WWR (II/81) urisdiction and this report is true to the bbee�5l of my knowledge and belief; aloe Contract License Number Date: Representative Copy Distribution: WHITE - State DGGS, PINK - Driller, CANARY- Customer CONSTRUCTION AND OPERATION CERTIFICATE ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION . PUBLIC WATER SYSTEM APPROVAL TO CONSTRUCT Plans for the construction L J4 'L PA- .Ltd) i� _ public water system located in A 4't k.1 a4 o A Alaska, submitted in accordance with 18 AAC 80.100 by_ C n nA A . � ;�_t, l cZ( have been reviewed and are approved. ❑ conditionally approved (see attached conditions). BY TITLE DATE 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. APPROVED CHANGE ORDERS Change (contract order no. Approved by Date or descriptive reference) .�.nw t,, The "APPROVAL TO OPERATE" section must be completed before any water is made available to the public. APPROVAL TO OPERATE _ a (, A The construction of fhc �a r t b4 3 g ( t� public water system was completed on /—/,q xq (date). The system is hereby granted interim approval to operate for 90 days following the cpmpletion date. 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 ope ate. 4 TITLE ATE SUUT1iu-L- lTi L RLGIu AL OFFICE 437 "E" STREtI, SUITE 2CO AiMC.Iu=::vE, ALASKA 99501 274-2533 MUNICIPALITY OF ANCHORAGE June 25, 1954 DEPT. OF HEALTH & ENVIRONMENTAL PROTECTIOM i•ir. Carol Brinton JUN 2 71984 P.U. Box 4-2853 RECEIVED Anchorage, Alaska 995U9 Dear Sir: Subject: Lot 3, Block 43 Sand Lake #2, Section 10, T12N, R4W Anchorage, Alaska ife have revievied the as -built Elan and for„Is for the grater and sewage sys-eris on the above property and they are approved. Sincerely, %Janes C. Allen Anchorage/Western District Supervisor sm cc: Robbie Robinson (F10A) • Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 FET Y Certificate of On -Site Systems Approval Parcel I. D.011-135-50 1. GENERAL INFORMATION: Expiration Date: '3 ' J 'Z Oz-22— Complete ZZ Complete legal description SAND LAKE #2; BLOCK 4, LOT 3 Location (site address) 8023 SAND LAKE ROAD *ANCHORAGE AK Current Property owner(s) DONALD LEE Day phone 907-570-8337 Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Shared Well ® Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for:, Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ yq ?- Waiver Fee $ Date of Payment 6bo� 1 Date of Payment Receipt Number Qq 2 q&G Receipt Number COSA # 0 S C 2 1 10 g Waiver # i��4 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: Garness Engineering Group Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: f 2(Z 2 - In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE 2 Y_ System #1 Approved for J bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following.' 14 4 u �i ...../. ........ ..... .� /.. ..... •.. I r r y Ger- es 9. �`"sr '••.IZJ� �:•��• •'• - •' -• ��O vvl�profAs�io�o� o' #AECC884 S\ �E N1 PEER,, SER o Ji�0A �����,�� Original Certificdt'd�T 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_ Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other 01-1 Legal Description: SAND LAKE #2; BLOCK 4, LOT 3 If more than 1 septic system on lot: COSA Checklist # of Parcel ID: 011-135-50 Structure served by this system A. WELL DATA L SHARED WELL LOCATED ON BLOCK 4, LOT 2 ❑ Well log is filed with Onsite (or attached) Well production at time of test �,.,_.....nr Date drilled ]Alater5it54'age tank volume gallons Total depth ft Well disinfected for coliform test? ❑ Yes ❑ Nc Cased to ft ❑ Coliform bacteria is Negative ❑ Sanitary seal is functionin rrectly Nitrate mg/L ❑ Nitrate less than MRL (ND) ❑ Wires are properly p cted Arsenic 22.0 u /L g ❑Arsenic less than MRL (ND) Casing height (ab ground) in.Collected by GEG Date of flow t for COSA Date of Sample 10/4/2021 Static er level at beginning of test ft. B. TANK DATA Age of tank(s) NEW years Tank type/material SEPTGH" Measured operating fluid level in septic tank N/A Al Standpipes/foundation cleanout per record drawing Date of pumping N/A D. ABSORPTION FIELD DATA Which system tested (date installed) "/2212' ❑ ALL standpipes present per record drawing Total measured depth from grade 11.8 ft (max) Measured depth to pipe invert from grade 4.6 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 N/A gallons Comments/Deficiencies: COSA Checklist yellow sheet C. LIFT STATION ❑ Required maintenance corn Age of lift station y Lift station :aterial Comments Adequacy test date NEW Results Rl Pass For 3 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 - E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) I SHARED WELL Septic Tank/Lift Station on Lot > 100' Yes if No Community Sewer Manhole/Cleanout > 10 ' If absorption field is under driveway comment below ❑ Yes if No ft _( if No ft Neighboring Tank > 100' ❑ Yes if No ft Private Sew is Line >/25' 0 Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No ft olding Tank > 100' ❑ Yes if No ft Neighboring Absorption Fields > 10 ' Animal Containment > 50' ❑ Yes if No ft Yes if No ft Manure/Animal Excreta Storage > 100' Co ewer Main > 75' r-1 Yes if No ft ❑ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No *91 ft Surface Water > 100' Q✓ Yes if No ft Property Line > 5' Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Yes if No ft Private Wells > 100'[]✓ Yes if No ft Water Main > 10' Q✓ Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Water Service Line > 10' P11 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 If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No **1'+ ft Wells on Adjacent Lots: Water Main > 10' Yes if No ft Private Wells > 100' E] Yes if No ft Water Service Line > 10' Q Yes if No ft Community Wells > 200' R Yes if No It Surface Water> 100' 0 Yes if No ft F. ENGINEER'S COMMENTS *SEE ATTACHED PROFILE DRAWING **WR#0Sv21 1 0A4 G. ENGINEER'S CERTIFICATION o� of (certify that 1 have determined through field inspections and review 000P'� •' s o0 of Municipal records that the above systems are in conformance with Ay MOA COSA guidelines in effect on this date. _ �Q . .......... ......... ,U . frey Go ness: Q49j'•. CE -79P3 � COSA Checklist yellow sheet �Q p 0 ea rofessio�o \ =7 #AECC884 40000Od�� 111 www.muni.org/onsite Arsenic Advisory Certificate of On -Site Systems Approval # OSC211398 Subdivision: Sand Lake #2, Block 4, Lot 3 A water sample revealed an arsenic concentration of 22 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.