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SAND LAKE #2 BLK 4 LT 15
Sand Lake # Block 4 Lot 15 #011-135-38 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://wv,w.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP241303 Work Type: Septic Upgrade Tax Code Number: 01113538000 Site Legal Address: SAND LAKE #2 BLK 4 LT 15 G:2224 Site Mailing Address: 5430 W 82ND AVE, Anchorage Owner: GREEFF RYAN L & KIMBERLY A Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 10/16/2024 10/16/2025 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall 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 shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received -By: L i5 u e --f-, Date: Issued By: 0,0 Date: Z11" 3 \ t r ri,tof Anchorage, Municipality S U •p:u'tmr•nt '. P.O. Box 196650 @ 4700 Elmore Road Anchorage, Alaska 99519-6650 0 (907) 343-7904 0 Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * Waiver#: OSV241049 COSA#: Permit#:OSP241303 PID#: 011-135-38 Legal Description: Sand Lake #2 Blk 4 Lt 15 Engineer: Forge engineering The requested waivers have been approved: • 3' from the proposed field to the North property line • 3' from the existing field to the North property line • 5' from the existing field to the South property line • 3.6' from the existing field to the East property line • 3.5' from the existing field to the proposed tank Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted: Date: /0z 4y Approved by: -t -- Name of ReviewV **** VARIAN C E/WAIVER REVIEW **** MUNICIPALITY OF ANCHORAGE -rR 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 1. D. 011-135-38 Property owner(s) Ryan & Kimberly Greeff Day phone Mailing address 5430 W 82nd Avenue, Anchorage, AK, 99502 Site address 5430 W 82nd Avenue, Anchorage, AK, 99502 Legal description (Sub'd., Block & Lot) Sand Lake #2, Block 4 Lot 15 Legal description (Township, Range & Section) Lot Size 6,600 _Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (ED all that apply) Single Family (SF) FX] Absorption Field FX� Initial 1-1 Single ADU) Septic Tank X Upgrade N Duplex (D) FJ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Trench to Property Line Distance: 3.0' 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: Date of Payment: Receipt Number: )2Y77 Permit No. 5q Permit App_'-'- :• :'-..:c: Waiver Fees: Date of Payment: Receipt Number: Waiver No. 0-5V Z October 11, 2024 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Sand Lake #2, Block 4 Lot 15 – 5430 W 82nd Ave Septic system design Dear On-Site Services Engineer: The owner of the above lot has an existing 3 -bedroom home on the property, so we are submitting this permit application for the construction of a new septic system. The attached site plan identifies the location of the home as well as the existing well and septic location. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. Due to the tiny lot, the new system cannot fit without asking for waivers. We have placed the tank 10’ away from the house and 5’ from the lot line, and the existing shed will need to be moved. However, the new trench extends to within 3.5’ of the north lot line. This does not undermine or threaten any adjacent properties, and only borders the ROW to W 82 nd Ave. We request a waiver to place the trench 3.0’ from the lot line. We will also be keeping the existing trench for use in the future; however, it encroaches on several separation distances. The distances that we are requesting to be waived are trench to north lot line (3.0’) and trench to east lot line (3.6’). Adjacent septic systems are shown per record drawings, and the affected systems are 1.5’ effective depth trenches, so the required minimum separation of 6’ is met. Finally, locating the new tank 10’ from the foundation means that it must be 3.9’ from the existing trench. Since that trench is deep (with 7’ of cover over it), and it is only 1.5’ effective depth, the tank will have minimal impact on that corner of the trench. It will be possible to install it without damaging the trench, and effluent from the sides will have minimal interaction with the tank. We request a waiver for 3.9’ from the tank to the existing trench. The ground surface on the lot slopes toward the road mildly near the north and west of the lot, but toward the east it is very flat. There are no slopes greater than 25% within 50 feet downslope of new site. Contours are shown on the site plan showing the grade and direction of flow. Stormwater drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241303, Deb Wockenfuss, 10/16/24 Wells on this and adjacent lots are shown. The new system will be a minimum of 50’ from all wells and surface water, and more than 5’ away from the septic tank. Please refer to the attached test hole logs, plan and profile pages for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT PV - PUMP VAULT MH - MANHOLE MT - MONITORING TUBE DV - DIVERTER VALVE TH - TEST HOLE LEGEND 1"=20' SAND LAKE #2, BLOCK 4 LOT 15 FEET 0 20 40Benjamin Schiller CE 12592REGISTEREDPROFESSIONA L E N GINEER 9/24/24 SEPTIC PLAN 3-BDRM HOME W. 82nd AVENUE SA N D L A K E R O A D 20' LONG x 5' WIDE, 6" EFFECTIVE DEPTH ABSORPTION TRENCH NEW 1500-GAL ADVANTEX TANK w/ AX20 POD EXISTING 40' LONG, 5-6' WIDE, 1.5' EFF DEPTH TRENCH EXISTING SHED TO BE REMOVED EXISTING 1000-GAL STEEL TANK TO BE DECOMMISSIONED PER CODE WELL w/ 50' RADIUS NEIGHBORING WELL w/ 50' RADIUS 180 181 182 182 179 MT MT >6.0 5.0 NEIGHBORING WELLS OUT OF VIEWPORT PV 3.2 TH#1 10.0 DV 3.9 3.6 3.0 >5.0 >5.0 EXISTING TRENCH 5' E.D. 5.0 EXISTING TRENCH 1.5' E.D. EXISTING TRENCH 1.5' E.D. 5.0 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241303, Deb Wockenfuss, 10/16/24 SAND LAKE #2, BLOCK 4 LOT 15 TYPICAL TRENCH SECTION (NO SCALE) NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER DESIGN FACTORS:SYSTEM REQUIREMENTS: 450 GPD PEAK FLOW PERK RATE: 0.2 MIN/IN (SEE SOILS LAB ANALYSIS) APPLICATION RATE: 6 GPD/SF 5' WIDE TRENCH SYSTEM 1500-GAL ADVANTEX SYSTEM BOTTOM OF TRENCH: 6' BELOW GRADE FLOW LINE ELEVATION: 5' 6" BELOW GRADE 450 GPD / 6 GPD/SF / 5' WIDE * 1.00 RED FACTOR [6" DEEP] = 15 LF TRENCH REQUIRED (20 LF SPECIFIED) 9/24/24 DRAINFIELD ROCK 6" 5' 6" GEOTEXTILE FABRIC 6" PROVIDE ADDITIONAL FILL TO ACCOUNT FOR SETTLEMENT 1.25" PVC WITH 10x 1 8" HOLES AT 2' o.c. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241303, Deb Wockenfuss, 10/16/24 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 DEPTH (feet) TEST HOLE 1 DATE READING START TIME NET TIME (minutes) DEPTH to WATER NET DROP PERCOLATION RATE: (MIN/INCH) (inches)(inches) DATE OF MONITORING WAS WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING IF YES @ WHAT DEPTH? 0.2 8/21 1 2 3 4 5 6 SP (POORLY GRADED SAND) Professional Engineers Stamp: NO SAND LAKE #2, BLOCK 2 LOT 15 8/21/2024 011-135-38 NORTHERN EXCAVATION 11:19 1 0 16 11:20 4' FILL 0:44 Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER PERC TEST LOCATION TECHNICIAN: M. JAKUBISIN 7 0 16 - NONE 8/29/24 COMMENTS: SITE PLAN 6 0 16 USCS SOIL CLASSIFICATION WAS DETERMINED BY LABORATORY ANALYSIS 8/30/24 1 0 160:56 7 0 16 6 0 16 11:22 1 0 160:55 7 0 16 6 0 16 11:23 1 0 160:52 7 0 16 6 0 16 11:25 1 0 160:55 7 0 16 6 0 16 11:26 1 0 160:56 7 0 16 6 0 16 SW (WELL GRADED SAND) Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241303, Deb Wockenfuss, 10/16/24 % GRAVEL 2.0 USCS SP % SAND 97.3 USACOE FC N/A % SILT/CLAY 0.7 % PASS. 0.02 mm N/A % MOIST. CONTENT 4.6 % PASS. 0.002 mm N/A N/A N/A N/A SIEVE SIEVE TOTAL % SPECIFICATION SIZE (mm) SIZE (U.S.) PASSING (% PASSING) 152.40 6" 76.20 3" 38.10 1.5" 100 19.00 3/4" 99 12.70 1/2" 99 9.50 3/8" 99 4.75 #4 98 2.00 #10 98 0.85 #20 97 0.43 #40 90 0.25 #60 32 0.15 #100 5 0.075 #200 0.7 ELAPSED DIAMETER TIME (MIN) (mm) 0 1 2 5 8 15 30 60 250 1440 SOUNDNESS OF AGG. (ASTM C88) DEGRADATION (ATM T-313) LA ABRASION (ASTM C131/C535) SP. GRAV. COARSE AGG. (ASTM C127) 11301 Olive Lane ∙ Anchorage, Alaska 99515 ∙ Phone: 907-344-5934 ∙ Fax: 907-344-5993 ∙ www.nge-tft.com N/A N/A The testing services reported herein have been performed to recognized industry standards, unless otherwise noted. No other warranty is made. Should engineering interpretation or opinion be required, NGE-TFT will provide upon written request. N/A HYDROMETER RESULT N/A SIEVE ANALYSIS RESULT 2024 Material Testing 6927-24 Sand Lake #2 B4 L15 24-S-13 Poorly-graded sand 8/28/2024 Aaron Kaiser Sean Totzke TOTAL % PASSING 2.0 1.0 Forge EngineeringPROJECT CLIENT: PROJECT NAME: PROJECT NO.: SAMPLE DESC.: NGE-TFT ID #: CLASSIFICATION: DATE RECEIVED: TESTED BY: REVIEWED BY: UNIFORMITY COEFFICIENT (Cu) COEFFICIENT OF GRADATION (Cc) ASTM D1557 (uncorrected) ASTM D4718 (corrected) OPTIMUM MOIST. CONTENT. (corrected) 125 130 135 140 145 150 0 2 4 6 8 10 12 14 DR Y D E N S I T Y ( p c f ) MOISTURE CONTENT (%) MOISTURE-DENSITY RELATIONSHIP ASTM D1557 SILT or CLAYCOBBLES GRAVEL Coarse Fine SAND Coarse Medium Fine 0 10 20 30 40 50 60 70 80 90 100 0.0010.01 0.11 10 100 FI N E R B Y M A S S ( % ) GRAIN SIZE (mm) PARTICLE SIZE ANALYSIS ASTM D6913 / C136 / D422 #200#40 #101.5 1/23 6 3/4 #4 #20 #60 #100 3/8 U.S. SIEVE OPENING IN INCHES U.S. SIEVE NUMBERS HYDROMETER Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241303, Deb Wockenfuss, 10/16/24 I 0 0 M O O M I w O OO O O O WELL O U') I 30.0' I I I I Lot 13 o I Lot 40 I GRAVEL ASPHALT PAVEMENT N 90'00'00"E 135.00 7.8 Lot 15 20' CANT 6,600 s.f. (MOA) 5.0' x 19.3' DECK 1.0' x 22.9' CANT 1 STORY N \RESIDENCE ri WITH,,,WALKOUT `". BASEMENT 44.0\ N 90'00'00"W�135.00' � Lot 16 82nd AVENUE-- GRAVEL VENUE WOODEN R FENCE I w o_ SEPTIC O PIPES 0 O Lot 38 0 0 O C7 0 ' 12.0' x 12.2' SHED 32.0' I Lot 37 I PLOT PLAN __— AS BUILT _X_ SCALE _ 1_ = 30' GRID _ SW 2224Project No. J24 -1491A1 ___ P.O. Box 210005 Lang & Associates inc. Anchorage, Alaska 99521-0005 (907) 522-6476 Professional Land Surveyors Jonathan®langsurvey O.F. q cam o ken®longsurvey.com I hereby certify that I have surveyed the following described property: LOT 15, BLOCK 4, SAND LAKE SUBDIVISION No. 2 (Plat No. P-176) Anchorage Recording District, Alaska, and that the improvements situated thereon are"" """' "" "" "'� within the property lines and do not encroach onto the property adjacent thereto, that G no improvements on the property lying adjacent thereto encroach on the surveyed A premises and that there are no roadways, transmission lines or other visible Q JONATHA NG o easements on said property except as indicated hereon. �% Z. �.� �. � 6� � moo° Dated this the _ � Da of __� C5 6 �� Z4 4 AFa ' .LS -9944.• ' C3 Y �__, at Anchorage, Alaska 4404OFE88�ONAO�poo It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. State of Alaska AECC963 MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this 2,�' Day of Se �L-r of 20 7.4 by and between herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65-365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as Advantex System located at (legal description) Sand Lake #2, Block 4 Lot 15 2. Maintenance, Repair-, and Alterations. (Owner is required to read, understand and initial each section) j4tr Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage back-up and costly repairs or drainfield replacement. (rev. 0511 8/20 1 8) Page I of 3 Scanned with M CamScanner Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. ,,CI-O%N,ncr acknowle'dge' s that the fine for railing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. A.11er Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. 44.4 Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. kOwner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. Z& Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transrcrrcd. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof, 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Sevcrability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 Scanned with Camscanner' OWNER: By: _(signature) -L- A- t (print name) STATE OF ALASKA THIRD JUDICIAL DISTRICT Date: 71A&1A-CdY KEN LUCERO Notary Public State of Alaska [my Commission Expires Feb 10, ]2027 The foregoing instrumeqt,%,-,as acknowledged before me this 4day of 20 4A, by 1p � ,IC FOR ALASKA expires:_ D-1-jo - 402j MUNICIPALITY: By: (signature) name) (rev. 05/18/2018) Date: Tide: Page 3 of 3 .......... . Scanned ivith McarnScanner' MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: _______________ Date of Issue: ____-____-____ Parcel Identification Number: ____-____-____ Legal Description Block Lot Property Owner Name & Address: Pump Installation Date: _____-_____-_____ Pump Intake Depth Below Top of Well Casing: __________ feet Pump Manufacturer’s Name: ___________________________ Pump Model: _____________________________________ Pump Size: ____________hp Pitless Adapter Burial Depth: _________ feet Pitless Adapter Manufacturer’s Name: _________________________ Pitless Adapter Installer: ____________________________ Well Disinfected Upon Completion?;;<HV No Method of Disinfection: _____________________________ Comments: Pump Installer Name: __________________________________ Company: ___________________________________________ Mailing Address: ______________________________________ City: ___________________ State: __________Zip: _________ Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. 011 135 38 SAND LAKE #2 4 15 GREEFF RYAN L & KIMBERLY A 5430 W 82ND AVE ANCHORAGE, AK 99502 05 12 2023 280 GOULDS 100C311-8S21 1.00 15 MARTINSON PELLETS ANCHORAGE WELL & PUMP SERVICE 7640 KING STREET ANCHORAGE AK 99518 YE MOA87/ OF A n SK Frank Murkowski, Governor 555 COVA DEPT. OF ENVIRONMENTAL CONSERVATION ANCORA iG , AK 99501 Phone: (907)269-7519 DIVISION OF WATER Fax: (907) 269-7600 httpJ/www.state.akus/dec/ WASTEWATER DISCHARGE PROGRAM May 22, 2006 Michael N. Anderson, P.E. 4640 Shoshone Avenue Anchorage, Alaska 99516 Re: I Lot 15, Block 4, Sand Lake Subdivision # 2, Anchorage, Alaska -Waiver of Separation Distance from two Class C Source Wells and an Onsite Wastewater Disposal System- ADEC Plan Tracking Number 5437 Dear Mr. Anderson: On April 21, 2006 we received an engineering report requesting that the required separation distance between two existing class C wells located on Lot 38, and Lot 12 and an existing onsite wastewater disposal system located on Lot 15, be reduced from 150 feet to 130 feet for each. The existing wastewater system consists of a 1,000 gallon two compartment septic tank and a soil absorption system which is 40 feet long and 5 to 6 feet wide with 18 inches of drain rock beneath the perforated pipe. The septic tank and drain field were approved by the Municipality of Anchorage in 1982 to serve the three bedroom single family home on Lot 15. The existing Class "C" well located on Lot 38 has been in operation since September of 1982, well's in the area are nearly 300 feet deep with confining layers identified in the well log. A recent nitrate sample results was 0.23 mg/l. The existing Class "C" well located on Lot 12 has been in operation since 1984, this well is reported to be 397 feet deep with confining layers identified in this area well logs. Therefore based upon the engineer's recommendations, existing site conditions and water sample results, the required separation distances are reduced as follows: • The source well on Lot 38's separation distance is reduced from 150 feet to 143 feet to the existing septic tank and is reduced to 130 feet to the onsite soil absorption system. • The source well on Lot 12's separation distance is reduced from 150 feet to 130 feet to the onsite soil absorption system. This approval does not imply the granting of additional authorizations nor obligate any state, federal or local regulatory body to grant required authorizations. Any person who disagrees with this decision may request an adjudicatory hearing in accordance with 18 AAC 15.195-18 AAC 15.340 or an informal review by the Division Director in accordance with 18 AAC 15.185. Informal reAew requests must be delivered to the Division Director, 555 Cordova Street, Anchorage, Alaska 99501, within 15 days of receiving the decision. Adjudicatory hearings requests must be delivered to the Commissioner of the Department of Environmental Conservation, 410 Willoughby Avenue, Suite 303, P.O. Box 111800, Juneau, Alaska 99801, within 30 days of the decision. If a hearing is not requested within 30 days, the right to appeal is waived. Thank you for your cooperation. If you have any questions please do not hesitate to contact me at 269-7519. Respectfully, William R. Rieth, P.E. Environmental Engineer cc: MOA, Onsite cc: William Smyth, WW, w/o enc. MUNICIPALITY OF ANCHORAGE / 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 � -- �'.'_'.,m�. NAME PHONE NEW A D LLAN I 'Q_7 01_ �' UPGRADE MAILING ADDRESS ® - qq 6o LEGAL DESCRIPTION L•© 7/ S 0 014, S S D LOCATION I N0. OF BEDROOMS v Y DISTANCE TO: W�e I ,� Absorption are INfMVN� Dwelling PERMIT N 2!9 7 aQ UJ f Manufacturer �� ^ (� Material f��L No. ofcompartment��O N Liq, capacity in gallons IF HOMEMADE: Inside length Width Liquid depth Y z DISTANCE TO: Well Dwelling PERMIT NO. 2 z Manufacturer Material Liquid capacity in gallons 0 w= DISTANCE TO: -1-4 WeCJ�L YM iH ✓ N Foundatio Nearest lot line PERMIT O�� H u. z W NLU o. of lines Length of each line, Total length y�lines Trencfj- i th Distance between lines x xf. Top of tile to finish gradeI f Material beneath tile / Total effective absorption area inches w Length Width Depth PERMIT NO. a a F Lu Type of crib Crib diameter Crib depth Total effective absorption area W (n DISTANCE TO: Well Building foundation Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. J W DISTANCE TO: Building foundation Sewer line Septic tank Absorption areals) OTHER PIPE MATERIALS cAs P. SOI L TEST RATING Q5 INSTALLER REMARKS OF At % 6 D • ..� . IN 2225-E :ter f,'• JUNE 25. 18ZJJ '�,• •A s APPROVED DATE LEGAL -R�, 6-/Y. t'.. -&' / , P, 'V, s __ - TYPE OF SOIL DRHINFIELD MHXIMUM NUMBER OF SOIL RATING (Al FT/BW: 85 THE REQUIRED SI OF THE SOIL HBSORPT SYSTEM IS� �EE-' ����� ������ THE LENGTH DIMENSION IS THE FEET) OF THE TRENCH QR DRHINFIELD THE DEPTH OF 8 TRENCH OR PIT IS THE DISTHNCE BETNEEN THE SURFHCNE OF THE GROUND HND THE BOTTOM OF THE EXCHVHTION (IN FEET). -1- �K K V. -AR, i-1 ���T- Of 71 Sy. 12; 0� e�; F::� K W. THE GRHYEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL. BETWEEN THE OUTFHL!- PIPE HND THE THE EXCHYHTION (IN FEET). F&AMALY X. "N KWO"F, 1 f �1'41 'S--: :'E. PERMIT APPLICANT HHS THE RESPGNSIBILITY TO INFORM THIS M U 141 1. 1:3 X 10" ^r, 170 F"', INSTHLLHTION INSPECTIONS OF ANY WELLS AN! LA, CENT TO THIS PROPERTY HND THE �EPHRTMENT/—� HEHLTH HND ENVIRONMENTHLr'�ROTECTIO THE REQUIREMENTS 1 WSPA, 825 ~' STREET/ HNCHORHGE, HC MJ01 BY THIS DEPHRTMENT WILL BE SUBJECT TO PROSE[1TIQN 264-4720 ~ ~ , IS pig V,8"S 1, 0- PEE-"..' FE, �,- 0 EE A MEE FT 1-9�� PERMIT FRI ( 820219 ) MINIMUM DISTHNCE H PRIVATE WELL TO H PRIYHTE SEWER LINE IS 25 FEET APPA, ICHNT DOUSLHS GALLANT BX 4~1 2201 LOCHTION SHND LK. OF THf LETIO�{ LEGHL LT 15 BLK 4 SH�D LK S/D LOT SIZE 7500 SQUHRE FEET TYPE OF SOIL DRHINFIELD MHXIMUM NUMBER OF SOIL RATING (Al FT/BW: 85 THE REQUIRED SI OF THE SOIL HBSORPT SYSTEM IS� �EE-' ����� ������ THE LENGTH DIMENSION IS THE FEET) OF THE TRENCH QR DRHINFIELD THE DEPTH OF 8 TRENCH OR PIT IS THE DISTHNCE BETNEEN THE SURFHCNE OF THE GROUND HND THE BOTTOM OF THE EXCHVHTION (IN FEET). -1- �K K V. -AR, i-1 ���T- Of 71 Sy. 12; 0� e�; F::� K W. THE GRHYEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL. BETWEEN THE OUTFHL!- PIPE HND THE THE EXCHYHTION (IN FEET). F&AMALY X. "N KWO"F, 1 f �1'41 'S--: :'E. PERMIT APPLICANT HHS THE RESPGNSIBILITY TO INFORM THIS DEPHRTMEMT DURING THE INSTHLLHTION INSPECTIONS OF ANY WELLS AN! LA, CENT TO THIS PROPERTY HND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. THE REQUIREMENTS 1 WSPA, U 1: Fit EVE E23 FORTH BY THE MUNICIPHLITY BHCKFILLING OF HNY SYSTEM WITHOUT FINAL. BY THIS DEPHRTMENT WILL BE SUBJECT TO PROSE[1TIQN Th I WILL MINIMUM DI5THNCE BETWEEN H WELL HND HNY ON-SITE SEWHGE DISPOSHL SYSTEM IS 100 FEET FOR H PRIYHTE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDINS ON~SITE SEWER UPON THE TYPE OF PUBLIC WELL MHY REQUIRE ENLHRGEMENT IF THE MINIMUM DISTHNCE H PRIVATE WELL TO H PRIYHTE SEWER LINE IS 25 FEET HND TO H COMMUNITY SENER LINE IS 75 FEET. HELL LOGS ARE REQUIRED HND MUST BE RETURNED TO THE DEPHRTMENT WITHIN ]0 DHY� OF THf LETIO�{ OTHER REQUIREMENTS MHY HPPLYSPECIFICHTIONS AND CONSTRU�TION DIHGRHMS HRE HVHILHBLE TO INSURE PROPER INSTFRLLHTION. FWE: Fit FS I� ��KV FEE 1WI FS EEL Fit -to A - I CERTIFY THAT' 1� I HM FHMILIHR WITH THE REQUIREMENTS FOR SITE SENERS HND WELLS HS SET FORTH BY THE MUNICIPHLITY OF HNCHQRHGE Th I WILL IN HCCORDHNCE WITH THE: CODES ]: I UNDERSTHND THAT THE ON~SITE SEWER SYSTEM MHY REQUIRE ENLHRGEMENT IF THE � SIGNED: An, .... .... ...�������� DOUGLHS �HLLHNT ISSUED B �,J � Ih SOILS LOG MUNICIPALITY OF ANCHORAG. , ` DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION I\ v TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED DATE PERFORMED:- %'/(O'®;2„ LEGAL DESCRIPTION:_ L®T / 13 {, 1Q1 SA Iti p 0,t4k,, �, "I o L SLOPE SITE PLAN SILT goat ND 1LOA Asl Z 1 H L 3- 4 � • � � 1�/ --Ca IX% 5 6 7 8 9 10 11 12 13 1 4 P-::.oT70 tA o tet; i 49 ®}u owt: mvt y p t�6d' s ••aee • •••• �1 16 �.•s• f.s .e••• P 4 0' I �, • WAS GROUND WATER J NE 25,21911E ,,�4� .G�a .. WAS''e ENCOUNTERED? \oaetA� E� r rf 6 19- IF YES, AT WHAT DEPTH? w OF A 1 4 0 \�. •• e••• q ® l 15 Depth to Water s ••aee • •••• �1 16 �.•s• f.s .e••• P 4 0' 17 -P'. J NE 25,21911E ,,�4� .G�a .. 18 \oaetA� E� 19- 20 S (� L O P E Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE TEST RUN BETWEEN FT COMMENTS PERFORMED BY: CERTIFfED BY: - �3 (minutes/inch) FT DATE: Ni N: 00 : 00 C N i N; N A N ca F z CA w A A t z� � •,zs. w w w �i H ico N O O O w w w O : m i r -I i :r -I -54 ce a w N . N cd i cd r -q' 4 ` t Q)! \: P:zs:(1)E cd o of U7 W w w w co t, o E r -I i O O O w w w cm : i 0 N:m:,\7+ 0 0 0 w w w i i ` F SNC + i N' x: t� \ E w w w w u a w w w N °o /y3 W E CD' w w w w w w co E 0: L �E ae: O C0 w w w w w w w z a x U CG a A z O O O O O O O Ni N: 00 : 00 C N i N; N A N ca F z CA w A A t z� � •,zs. w w w �i H ico N O O O w w w O : m i r -I i :r -I -54 ce a w N . N cd i cd r -q' 4 ` t Q)! \: P:zs:(1)E cd o of U7 W w w w co t, o E r -I i O O O w w w cm : i 0 N:m:,\7+ 0 0 0 w w w i i ` F SNC + i t� \ E w w w w u a w w w N °o cd cdco :\ w w w w O 00 C() r N : CY) : N C O O O w w w w O : O 00 :co 00 ; M ;,- H: rl :N :C() O O O O w w w w O F d V. z a C6 m ,. APPLI( AT FILLS -OUT UPPER HA; ONLY Property Owner cL-� - Phone Mailing Address `— –) ) , Zip Code Buyer �� � r J a v� s 1•_ I-_� N�- Date Address - _ Zip Code Lending Institution{ Phone Address Zip Code Realty Co. & Agent - Phone Address Zip Code NICIPALITY OF ANCHORAGE Legal Description �.-;r _ t <<. 1J (ec [< - - - -- J r -N --, 44 1. V Street Location CFPT Or HE`CPi a. Field Notes: . �y�, � - •_ Type of Residence - Single Family ❑ Multiple Family No. of Bedrooms c) ❑ Other Water Supply ( .�) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED Individual - ( ) CONDLIJONA��'_Aj�PP P ` ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ❑ Community - For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility - Date Sewer Installed Sewer Disposal - . Individual Year Individual Installed: Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.. - Time - Time Time Time nt AC4 CID 4 0 Date Date Date Date Inspector Inspector Inspector Inspector M NICIPALITY OF ANCHORAGE CFPT Or HE`CPi a. Field Notes: . �y�, � - •_ ENVIR.-fJhi.A i, -A - P.;O-. 1982 c) RECEIVED ( .�) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDLIJONA��'_Aj�PP P ` DATE V BY: Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received �/_ 'L" Well to Tank Septic Tank Size 72023 (3/82) C;FRTIFICATE OF HEALTH ALJ1 HORITY APPROVAL FOR A SINGLE FAMILY DWELLING i/ 3d HAA # 9)5 fl Parcel LD. D '-122-- - 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Current Propertyowner(s) Ty' �L S•141+.` 0 Expiration Date: I I � � S � ou 9G ��a Day phone 2v40 - V ? 1?q Mailing address illunicipalitp of Anchorage Development Services Department Building Safety Division On -Ste Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 vrrnv. ci. a nchorage. ak.us (907) 343.7904 C;FRTIFICATE OF HEALTH ALJ1 HORITY APPROVAL FOR A SINGLE FAMILY DWELLING i/ 3d HAA # 9)5 fl Parcel LD. D '-122-- - 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Current Propertyowner(s) Ty' �L S•141+.` 0 Expiration Date: I I � � S � ou 9G ��a Day phone 2v40 - V ? 1?q Mailing address Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSO for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Weil Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ i The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil encineer registered in the State of Alaska. Certi icates of Health Authority Approval are required for the transfer of y pt i a ys}{a prpperf e5 b6rved by as�clP family nn-.1le wgsteWater(iispnsaLaodlnr!1r[ater supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority 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. 1 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 tlI( ,Ae-/A( QN ti r4saa —Lr.,, Pko .c Address L/b tl o 4 A o4 Ay,, ' 44j& 994 /fv Engineer's Printed Name M( ekr<e_f x( At i M $eel P Date f0fi,t ot7-- 5. DSD SIGNATURE V Approved for Disapproved. 3 bedrooms. OF -4t \1 ..,,gyp:••,•. • r�P *: 49TH 1 70 • MICHAEL N. ANDERSON r q IN, � Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: Original Certificate Date: 78 0 0 (Rev 0fA7) HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: 5.anL44a 4 Z 0 /ufS ak, q Parcel ID A. WELL DATA Well type JePkvin If A, B, or C provide PWSID # t:::f� Well Log (YIN) Date completed 7 2 S.z Sanitary seal (Y/N) Wires properly protected (Y/N) Total depth tft. Cased to / ft. Casing height (above ground) 24 II in. Dale of test Static water level Well production FROM WELL LOG AT INSPECTION ✓BL 101105- 1&0 01&0 tt. 1b In tt. 4g.p.m. S f g.p.m. WATER SAMPLE RESULTS: ✓(ew Coliform J�—colonies/100 ml. Arsenic: 5.0- mg./l. B. SEPTIC/HOLDING TANK DATA / r, S•ce copy Nitrate V. * mg./I. Other bacteria V colonies1100 ml. Date of sample: L,I IF- Collected by: M N -Vz //06 Tank Type/Material c 1 �r I. _ Date instalied 'b4� Tank size 100V gal. Number of Compartments v Cleanouls (Y/N) Foundation cleanout (Y/N) _)—t Depression over tank (Y/N)/'� High water alarm (Y/N) Date of pumping /0///4, K' Pumper 4 t a Ad f [e r(v a k , PV� o,nS C. ABSORPTION FIELD DATA Date installed Vfr'46 Soil rating (g.p.dfie or 0bdrm) ,g— System type Length HD ft. Width Z. a ft. Gravel below pipe Eff. absorption area za1. ft2 Monitoring tube Y Depression over field Total depth Y YLft. Date of adequacy test /a a Results (Pass/Fail) o e For�" _ bed ...'s Fluid depth in absorption field before test -0 in. Water added 54)'031. field New depth O in. Elapsed Time: fuuOmin. Final fluid depth &I— in. Absorption rale >= 4. -ISP 'A 1g p•d- Any rejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date G �t Municipality' of Anchorabc !� Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 www.ci.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: 5.anL44a 4 Z 0 /ufS ak, q Parcel ID A. WELL DATA Well type JePkvin If A, B, or C provide PWSID # t:::f� Well Log (YIN) Date completed 7 2 S.z Sanitary seal (Y/N) Wires properly protected (Y/N) Total depth tft. Cased to / ft. Casing height (above ground) 24 II in. Dale of test Static water level Well production FROM WELL LOG AT INSPECTION ✓BL 101105- 1&0 01&0 tt. 1b In tt. 4g.p.m. S f g.p.m. WATER SAMPLE RESULTS: ✓(ew Coliform J�—colonies/100 ml. Arsenic: 5.0- mg./l. B. SEPTIC/HOLDING TANK DATA / r, S•ce copy Nitrate V. * mg./I. Other bacteria V colonies1100 ml. Date of sample: L,I IF- Collected by: M N -Vz //06 Tank Type/Material c 1 �r I. _ Date instalied 'b4� Tank size 100V gal. Number of Compartments v Cleanouls (Y/N) Foundation cleanout (Y/N) _)—t Depression over tank (Y/N)/'� High water alarm (Y/N) Date of pumping /0///4, K' Pumper 4 t a Ad f [e r(v a k , PV� o,nS C. ABSORPTION FIELD DATA Date installed Vfr'46 Soil rating (g.p.dfie or 0bdrm) ,g— System type Length HD ft. Width Z. a ft. Gravel below pipe Eff. absorption area za1. ft2 Monitoring tube Y Depression over field Total depth Y YLft. Date of adequacy test /a a Results (Pass/Fail) o e For�" _ bed ...'s Fluid depth in absorption field before test -0 in. Water added 54)'031. field New depth O in. Elapsed Time: fuuOmin. Final fluid depth &I— in. Absorption rale >= 4. -ISP 'A 1g p•d- Any rejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date G D. LIFT STATION Date installed "Pump on" level at in. Size in gallons in. High water alarm level at in. DatumCycles tested Meets alarm 8 circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO. -ASYci 9 W o'vT f- P w u r f :�- Cvr Septic tankAillimaketion on lot 9S, Absorption field on lot /0 0 t f Public sewer main At Sewer /septic service line 9 S 1.4 On adjacent lots�� mit rye On adjacent lots _ /VV r� Public sewer manhole/cleanout /Oa f e //,� Holding tank ff SEPARATION DISTANCES FROM SEPTIC/I$11VG TANK ON LOT TO: Building foundation /01, Property line -0—r Absorption field_ /p '4 Water main �� _ Water service line So r ,,L Surface water Zoo /( Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line to rf- Building foundation _ 7-0 11L Water main pCj , Water Service line 5.0 t-: Surface water /tic Driveway. parking/vehicle storage !U Curtain drain N U ' Wells on adjacent lots ler: 4 K kw.v e7 F. COMMENTS P�/ I f eoSC rtYrr� q/� wo.azr� �vr nrtj; nUwnS G105f 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 HAA guidelines in effect on this date. Engineer's Printed Name M. Car( Date /v�7''��6� HAA Fee $ 4sc) Od Date of Payment Receipt Number- "1`SQ"1'7 _SAM (Rev. 12101) �p1E u r q .JJ. ; I r ,,.•• .q *:4 • :t�/ MICHAEL N. ANDERSCN:0C 04 CE 945 Y ,� pF� � Waiver Fee S Date of Payment T r Receipt Number�i��y37 ��— wrt4 30 30 0 M W. BZn.J AVE. ,6_.46T- /3.5.00 pecK FRAME N rt:e.M. Hous A A.� a I Wist Gst 14 * FT EA/J�f i a� L of pecK FRAME N rt:e.M. Hous A A.� e Z91 U lT `� - 37 - EAST /35.00 + tiw L S CA LCsI, S 11"0. =11411 f "sn�tf;r �•� wS Se.�:.k EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED R45 -6i PLAT ARE NOT SHOWN HEREON. of •//- e2 AS -BUILT NO CORNERS SET THIS DATE 1 hereby certify that I have peAormed a Mortgagee's inspection of the following described property: Le T, / 5 , B�x/c ¢ SAn10 LAke Sueo. No, 2 I Anchorage Recording Precinct, Alaska,and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this /0{r' day of OGTOBEA Y0 OS FRED WALATKA & ASSOCIATES (907) 248.1666 Engineers and Surveyors FT EA/J�f e Z91 U lT `� - 37 - EAST /35.00 + tiw L S CA LCsI, S 11"0. =11411 f "sn�tf;r �•� wS Se.�:.k EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED R45 -6i PLAT ARE NOT SHOWN HEREON. of •//- e2 AS -BUILT NO CORNERS SET THIS DATE 1 hereby certify that I have peAormed a Mortgagee's inspection of the following described property: Le T, / 5 , B�x/c ¢ SAn10 LAke Sueo. No, 2 I Anchorage Recording Precinct, Alaska,and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this /0{r' day of OGTOBEA Y0 OS FRED WALATKA & ASSOCIATES (907) 248.1666 Engineers and Surveyors l'J Municipality of Anchorage CO. Box 15u (!X17)A1a40X) 470014 vpw Swc) • Anc•homgc, Ahtslm!M1.gl A%im rmmLorg Mayor Mark Begich Building Snfett' Division August 28, 2006 Michael N. Anderson, P.E. Anderson Construction and Engineering 4640 Shoshoni Ave Anchorage, AK 99516 Subject: Waiver Request for Sand Lake #2 Block 4 Lot 15 Waiver Request WR#: 060050 Parcel ID # 011-135-38 IIA050569 Dear Michael N. Anderson, P.E.: Your request for a waiver of the required 100 feet horizontal separation from the septic tank to the private well has been approved. The approved separation distance is a 90 foot horizontal separation waiver from well on -lot to septic tank on -lot. This waiver approval applies to the existing septic tank to private well separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there arc any further concerns or questions regarding this waiver, please call our office at 343-7904. 1 Sincerely, 4 ioodall Civil Engineer On -Site Water & Wastewater Program Community, Security, Prosperity Municipality of Anchorage Development Services Department Building Safety Division on -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchoragc.ak.us (907)343-7904 Waiver Review Worksheet WR#:060050 PID#:011-135-38 HA/Permit# IIA050569 Date Received: August 28, 2006 Legal Description: Sand Lake #2 Block 4 Lot 15 Engineer: Michael N. Anderson, P.E. Anderson Construction and Engineering 4640 Shoshoni Ave Anchorage, AK 99516 Applicant: Jeff Sandstrom Waiver Requested: 90 foot horizontal separation waiver from well on -lot to septic tank on -lot. Criteria: Geology Points: A. Water Table 8.02 B. Soil Sorption 3.13 1.46 C. Permeability D. Water Table Gradient 2.90 E. Horizontal Separation 2.6 Total: _ _ _ 18.1181 - I ........................................................................ an Waiver is Granted: X List Conditions or Reasons for above: Waiver is not Granted: Date: 10/26/05 By: Joe Goodall Name of Reviewer Rec#: 75937 Amount: $9M Date Paid: 8/2812006 of to State of Alaska: Separation Distance Waiver Guidelines for S.C.R.O. (State of Alaska Memorandum to District Office Engineers dated January 3,1985) Waiver Request for: Sand Lake #2 Block 4 Lot 15 Parcel I D#: 011-135-38 Waiver Request Number WR#: 060050 Waiver Requested: 90 foot horizontal separation waiver from well on -lot to septic tank lot. Engineer: Michael N. Anderson, P.E. IIA050569 Septic Tank Data The bottom of the tank was assumed to have a total depth of 10 feet! This septic tank was installed in 1982 and has encroached the well on -lot for more than 20 years. The slope between the well and the septic tank is relatively flat and there is a house in between. Well Data The well was installed in 1982 with a well depth of 317 feet. The well has encroached the septic tank for more than 20 years. The current'i water sample results submitted by Anderson Construction and Engineering are with -in Municipal Standards. State of Alaska: Separation Distance Waiver Guidelines for S.C.R.O. (State of Alaska Memorandum to District Office Engineers dated January 3,1985) Waiver Request for: Sand Lake #2 Block 4 Lot 15 ParcelID#: 011-135-38 Waiver Request Number WR#: 060050 Waiver Requested: 90 foot horizontal separation waiver from well on -lot to septic tank on - tot. Engineer: Michael N. Anderson, P.E. IIA050569 Water Table Points 1012 Depth of well: 317 8.02 Depth of septic system: 10 307 Distance from the bottom Point of the system to the highest Value water table In feet 0 0 8 1 17 2 24 3 30 4 40 5 85 6 100 7 290 8 1000 9 10 • Straight line Interpolation is permitted between any two values Soil Sorbtion Points 1911 3.13 Soil Type I Point Value 1 0 +(I 12 1.5 + 11 0 + 6 Clean Gravel 0 ( 307, L 307, 13071 30' Fractured Rock 1 Course Clean Sand 1.5 +113011.5 1307, + 10 ( 1.5 + (I118 6 + tc [30 Sand w/ Small Amt of Clay 2.5 307, l 307 Silt 3.5 Clay and Sand Equal 4.5 0 + 0,1 + 0 + Clay 6 0.6 + 0 + 2.3 + 0. *Use the predominant soil type but values can be averaged for a mixture Permeability Soil Type Point Valuo Clay(will channel) 0 Silt and Sandy Clay 2 Clayey Sand 3 Fine Sand 1.5 Sandy Gravel 1 Fractured Rock 0.9 Course Sand (30 grit) 0.4 Clean Gravel 0 Points 1.46 +f 12 307, .4 +[ 30711 , 1 +r , .4 +( , .4 +l 11813 307 I 307 307 j W2 0.00 + 0.02 + 0.04 + 0.02 0.17 + 0.01 + 1.15 + 0.06 *Use the predominant soil type but values can be averaged for a mixture Gradient 2.9 %Slope Points Value -60% 0 In Feet -30% 0.3 0 -20% 0.7 50 -10% 1.2 2 -5% 2 150 0% 2.93- .9}5°/, 5% 4.5 10% 6 60% 7 slopes toward well Oat slopes away from well 'If the gradient is unknown, assume the worst case Horizontal Horizontal Point Separation Vatue In Feet 0 0 25 0.7 50 1 75 2 100 3 150 5 200 6 300 7 Points �. 2.90 Points 2.6 *Linear Interpolation between two point value Is acceptable. Horizontally means straight line distance to the well not the contaminate travel distance to water table which may be greater. Conclusion: Grant Waiver Total Points: 18.118, Michael N. Anderson, P.E. Civil/Structural Engineering & Construction 4640 Shoshone Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 October 25, 2005 Municipalities of Anchorage Departments of Health and Iluman Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: Sand Lake S/D Lot 15 Block 4, Walver Request To Whom it may concern: This is a request for a waiver from the on-site well to the existing septic system.' The existing septic tank was installed 95 feet from the well. The leach field is outside of the well radius as the survey asbuilt shows. The system was constructed in 1982 and has functioned well for the past 20 years. The well log states a total depth of 317 feet for the full depth. No bedrock was found and the well is cased for the full 317 foot depth. A new water test has been done for the Health Authority and this waiver. The well is on the opposite side of the house and has 24" of stick-up from grade to prevent any runoff of breaching the well. The slope of the lot is flat for most of the lot, then flattens out to 2 to 3 percent along the southwest comer. No pounding of water has been observed near the site or in the surrounding area. If you have any question please call me at 345-3377 Sincerely is ael N.'AnArson, P.E. CUSS A W (ADEC 1 2(3849) W/ WAIVER OF 100' ' I - OeC APPROV D WAIVER ON 4-27-84. RECLASSIFIED CLS C W0. IN 1987, SEE ADEC LETTER DATE 5-23-97 FOR LOTS 1 -13 k 4042• j4T�1�FIOUSES (<25 PEOPLE) LOT 41 SE € SAND E HOIdEMERS IA N NANCY SHEFELBINE 90 243-0503 A NG-PRESI ENT. NO WELL LOG AVAILABLE. TOTAL DEPTH P97 FEET.I WELL REGISTERED FOR 3000 GALLONS DAY I SEPTIC \, SEPTIC < / sEPnc< \t OT 13 3`�`y �G T 40 % C, / ------ --- lENCF�-- \ rt W.82od ve. ` ' %`QRUATE WELL TOTAL DI'PiN 317' r � t i0. / CO RADIUS LOT 15 +r Ius SEPTIC t \ ♦ts� III Well � ` \i ' �i' '\\\ `-^L6Ti3e USS C WELL TOTAL DEPTH 294' \�, \ EPTIC TANK EC WAIVER APPROVED3-17-0�(iP9 LOT1@s° Ns J�,` \\ ;`SEpTIG�OT37 /.\ ------- SE C ------SEd\TIC Well / I ---------------- WT 17 I ■rao / i ----- -- - / SCALE: V-- 40' I ■- Septic Design Prepared For JEFF SANDSTROM �'w P� •♦.♦ LOT 15, BLOCK 4 : �,.•'' �y♦i SAND LAKE SUDIVISION NO. 2 :: 49,,, �? `::>�♦♦� Prepared By ................� • MICHAEL N. ANDERSON, P.E.................•...................... 4640 SHOSHONI DRIVE �.�';MICHAELIN. ANDERSON; (907) 345-3377 / FAX (907) 345-1391 ♦A No. i E 9x69 . SCALE: 1"=20' APRIL 18, 2006 ♦, Jul 1 2001 16:34 P.02 (-1 FrankMurlmwskl,Governor j' 555 CORDOVA DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGF, AK 99501 Phone (91171269-7519 DMSION OF NVATER r Fax: (907) 269-7600 NVASTEWATER DISCHARGE PROGRAM httpJtwww.a I �e, us ! March 17, 2006 Michael N. Anderson, P.E. 4640 Shoshone Avenue Anchorage, Alaska 99516 Rc. Lot 15, Block 4, Sand Lake Subdivision # 2 -Waiver of SeparatienDictance form a Class C Source Well and an Onsitc Wastewater Disposal System-ADEC Plan Tracking Number 5437 Dear Mr. Anderson: On February 13. 2006 we received an engineering report requesting tltat the requited separation distance between an existing class C well located on Lot 17 and an existing onsite wastewater disposal system located on Lot 15, be reduced from 150 feet to 123 feet. The existing wastewater system consists of a 1,000 gallon two compartment septic tank and a sail absorption system is 40 fee long and by 5 to 6 feet wide with a depth of IS inches of drain rock beneath the perforated pipe. The septic tank and drain field were approved by the Murielpality of Anchorage in 1982 to serve the three bccroom single family home on Lot 15. The existing Class "C" well is located on Let 17 and has been in operation since March of 1983 the well is 294 feet deep with confining layers identified in the well log. The recent nitrate sample results were 0.23 m&'1. Therefore based upon the engineer's recommendations, existing site conditions acid n-a:er sample results, the rcquLtd separation distances front the well arc reduced from 150 fat to 123 feet to the existing septic tank and 132 fat to the onsite soil absorption system. This approval does not imply the granting of additional authorizations nor obligate any state, federal or local regulatory body to grant required authorizations. Any person who disagrees with this decision may request as a4judicatory hearing in accordance with 18 AAC 15.195-18 AAC 15.340 or an informal review by the Division D i ector in accordance with ISAAC 15.185. Informal review requests must be delivered to the Division Director, 555 Cordova Street, Anchorage, Alaska 99501, within 15 days of recei drag the decision. Adjudicatory hearings requests must be delivered to the Commissioner of the Department of Environmental Conservatiaq 410 Willoughby Avenue, Suite 303, P.O. Dam 111300, Junrau, Alaska 99801, within 30 days of the decision. If a heating is not requested within 30 days, the right to appeal is waived. Jui 1 20C1 16:35 P.03 Thunk you for your cooperation If you have any questions plcase do not hesitate to contact me at 269-7529. Respectfully, William R Rietb, P.E. Emi:vnmental Engineer cc: MOA, Onsite cc: David Johnson, W W, May 22 2006 5:33 P.0' l DEPT. OF ENVIRONMENTAL CONSERVATION DIVISION OF WATER WASTEWATER DISCHARGE PROGRAn11 May 22, 2006 Dlichael N. Anderson, P.E. 4640 Shoshone Atrmte Anchorage, Alasim 99516 Frank Alurkowskl, do v"mr 1 555 CCRDOVA ANCRORAGE, AK 99501 Pbone_(907)269.7519 pax: (907) 269-7600 knpJ: i�mw.slntaak.us'dec� Re: rEt 15. Block 4 Sand Lake Suhdivi lm 4 2. Anchorage, Alaska -R' irrr of Separation Distance % two Uass C Source Wells and an Onsite Wastewa er DL poral Syatem- ADEC Plan Track=ing Number 5437 Dear Efr. Anderson. On April 21, 2006 we received an engineering report requesting that the required separation distance between two existing class C wells located on Lot 38, and Lot 12 and an existing onsite wastewater disposal "em located on Lot 15, be reduced from 150 feet to 130 fat for each. The evs = wastewater system consists of a 1,000 gallon two compartment sep4c tank and a soil absorption system which is 40 feet lotto and 5 to 6 feet wide with 18 inches of drain rock beneath the perforated pipe. The sepxc tank and drain. 6e!d war approved by the hfunicipality of Anchorage in 1982 to serve the three bedroom single family home on Lot 15. The existing Class "C' well located on Lot 38 has been in operation since September of 1982, well's in the area are nearly 300 feet deep with confining layers ideut fled in the well log. A recent nitrate sample resu'ss was 0.23 m&I. The existing Class "C" well located on Lot 12 has been in operation since 1984, this well is reported to be 397 feet deep N ith confnutg layers identified is this arca well logs. Therefore based upon the engineer's recommendations, existing site conditions and water sample results, the required separation distances are reduced as follows: The source well on. Lot 3 Ps separation distance is reduced from 150 fact to 143 feet to the existing septic tank and is reduced to 130 feet to the onsite soil absorption system. The source well on nt 12's -separation distance is reduced from 150 feet to 130 feet to the onsite soil absorpticn system. This approval does not imply the granting of additional authorizations nor obligate any state, federal or local regulatory body to grant required autherizztions. Any person who disagrees with this decision may request an adjudicatory hearing in accordance with 18 AAC 15.195-1 S AAC 15.340 or an informal review by the Division Director in accordance with 18 AAC 15.185. Informs] review requests must be delivered to the Division NY 22 2306 6:36 P.02 Director, 555 Cordova Street, Anchorage, Alaska 99501, within 15 days of receiving the decision Adjudicatory hearings requests must be delivem4 to the Commissioner of the Department of Ewuotmmental Conservation, 410 WMaughby Avenue, Suite 303, P.O. Boz I I Igoo, 7uneau, Alaska 99501, %-Rhin 30 days of the decision. If a hearing is not requested k ithin 3o days, the right to appeal is waived Thank you for your cooperation. If you have any questions please do not hesitate to contact me at 269-7519. Respectfully, �1 WilliamR. Ricth, P.E. Eavirontaental Engineer co: MOA, Onsite cc: William Smytb, %V,w/o eno. Municipality of Anchorage . Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: MICHAEL N ANDERSON Legal description: SAND LAKE #2 BLOCK 4 LOT 15 The attached paperwork has been reviewed and is being returned for the following reasons: ❑ Original signature or stamp missing on ❑ Calculation error in design. ❑ Additional soils information needed. ❑ Water monitoring results inadequate. ❑ Discrepancy in information submitted. ❑ Topographic information missing or inadequate. ❑ Incomplete; missing ❑ Incomplete; missing ❑ Additional adequacy test information needed. ❑ Water sample unacceptable. _ ❑ Measured/proposed distances/dimensions missing. _ ❑ Locations of all soils, percolation and water monitoring tests not shown. ❑ Proposed system too deep for soils information submitted. ❑ Well log required. ❑ Omission in narrative. ❑ Insufficient fill over tank or field.— E] Other. NEED TO REQUEST WAIVER FOR LOT 15 WELL TO LOT 15 SEPTIC SYSTEM. -NEED TO CHECK THERE ARE NO OTHER ADJASCENT LOT SEPTICS ENCROACHING LOT 15 WELL. IF THERE ARE OTHER SEPTIC ENCROACHING LOT 15 WELL THEN NEED TO REQUEST WAIVER FOR THOSE ENCROACHMENTS. -THERE IS A CLASS 'C' WELL THAT MAY ENCROACH LOT 15 SEPTIC SYSTEM. NEED TO DETERMINE WHAT THE ENCROACHMENT IS AND SEEK TO GET A.D.E.C. CLASS OC* WAIVER. -NEED TO SUBMIT AT LEAST 3 WELL LOGS FOR SURROUNDING WELLS. Name of reviewer: JOE GOODALL Date: 11/1/2005 Please supply the necessary information and re -submit your request.